'Secret Language of Doctors' Reveals Slang Hospital Staff Use for Patients

By Ubelacker, Sheryl | The Canadian Press, April 28, 2014 | Go to article overview

'Secret Language of Doctors' Reveals Slang Hospital Staff Use for Patients


Ubelacker, Sheryl, The Canadian Press


Book reveals how doctors really talk

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TORONTO - For anyone who's been a patient or a family member attending a loved one in hospital, the expectation -- or at least the hope -- is that doctors, nurses and other care providers are empathetic to what ails them and respectful of their needs.

But away from the bedside, perhaps in hallways or at nursing stations, there may be quick and quiet conferences among hospital staff that suggest they are anything but.

In his new book, "The Secret Language of Doctors," Dr. Brian Goldman reveals a veritable dictionary of verbal shorthand used by many physicians, nurses and other health professionals to discuss -- and often diss -- various types of patients and even their own colleagues.

Patient-directed slang includes such terms as: "Yellow Submarine," referring to an obese patient with cirrhosis of the liver; "frequent flyer" or "cockroach," for a patient who repeatedly comes to the emergency department with one health complaint after another; and "status dramaticus," used to describe patients who noisily magnify their symptoms to get quicker medical attention.

Despite its title and contents, Goldman maintains the book isn't meant to be just about the jargon that medical personnel trade amongst themselves.

"It's a book about what the language reveals about the culture of modern medicine and what's inside the heads and hearts of physicians and allied health professionals, but also the problems that they face, the challenges," he says.

Goldman, a longtime emergency medicine specialist at Mount Sinai Hospital in Toronto, says disparaging slang used by some doctors and nurses often reflects the frustration they feel when faced with certain types of patients.

For instance, bariatric patients, who could weigh anywhere from 400 to 800 pounds, can pose difficulties for health providers who don't have size-appropriate stretchers or mechanized lifts to transfer obese patients from the bed to a surgical gurney.

"And I didn't know until I spoke to surgeons how challenging it is to operate on a patient who is morbidly obese," he says, explaining that it takes more time to get through layers of fat to reach an organ or other operating site, there are higher complication rates, and patients often need to recover in hospital longer.

Goldman, host of the CBC Radio program "White Coat, Black Art," interviewed doctors and nurses across Canada and the United States for "Secret Language." He found slang was often used about certain groups of patients -- the economically disadvantaged, those with a psychiatric illness or addiction, the chronically ill, the frail elderly, and people with dementia.

"I have never heard in the hospital where I work a phrase like 'cockroach' used to describe somebody who comes back again. If I did, I would stop that person immediately," says the 30-year ER veteran.

"And pejorative slang about seniors? I come from a hospital where we treat seniors with respect and dignity," he says of Mount Sinai, which includes trained geriatric management nurses among staff.

"So I was really surprised to hear that in some institutions that kind of slang still exists."

Still, Goldman admits he has favourites when it comes to medical argot.

"I like witty slang -- and I'm getting into dangerous territory here -- because I love puns," says the bearded physician-author. He thinks he may even have invented one term -- dyscopia -- referring to a patient or family member who has difficulty coping.

"Code brown" is another. A word play on the drop-everything, come-running emergency "code blue," code brown is hospital-speak for feces that needs cleaning up on the ward. …

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