As is traditional after a bank-holiday weekend, this week’s column will try not to tax your brain cells too much. So let’s have a look at medical slang.
Medical jargon is something some readers will perhaps be overly familiar with. If you are a patient, or a patient’s relative, you will have been exposed to the many acronyms doctors appear to revel in.
Asking if you’ve had a “cabbage” is not a question about your dietary habits but rather a reference to CABG, the acronym for coronary artery bypass graft, aka open heart surgery to bypass a blockage in the vessels that supply blood to your heart. Hopefully your exposure to jargon has been accompanied by clear and simple explanations of these terms by the doctor.
But there is another doctor “language” you are unlikely to hear much of. That’s medical slang, a surprisingly large lexicon that still survives in these politically correct times. In fact, there are subgenres of slang specific to paramedics, emergency physicians and other specialists.
Brian Goldman, host of the Canadian Broadcasting Corporation's radio programme White Coat, Black Art has written a book, The Secret Language of Doctors, in which he cracks the code of hospital slang that takes readers behind the medical curtain.
In writing the book, Goldman says his thesis was “If you want to understand the culture of medicine, you should pay attention to how doctors and other health professionals talk.” Basically, he says, if you listen to their slang you will learn a lot about doctors’ attitudes towards patients, situations they find frustrating and problems they have with each other.
He rightly credits Samuel Shem, author of the seminal House of God, as the person who brought medical slang into the open. Terms from the book, such as "Gomers" (get out of my emergency room) and "turfing" (transfer responsibility to another clinical team), have stood the test of time. They have been joined by "beemer" and "code brown", neither of which would win a prize for sensitivity.
Secret vocabulary
Goldman notes a more accurate term for medical slang is argot. A French word, argot is defined as “a more or less secret vocabulary and idiom peculiar to a particular group”. The purpose of argot is twofold: to prevent outsiders understanding what you’re talking about, and to create a bond between team-mates or colleagues. As an informal nomenclature, argot is used in sport, hobbies and particular occupations.
In his 1862 novel Les Miserables, Victor Hugo described argot as "the language of misery". Both Goldman and Shem feel this is significant in a medical context, as junior doctors work some extraordinarily long hours in challenging conditions. In other words, while some of the terms are derogatory, they must be understood in the context of a black humour seen as necessary to survive the quotidian human tragedies laid bare in hospital practice.
Derogatory terms
But there is no denying that many of these terms, used about you or your loved ones, are derogatory. How would you feel about being referred to as a “horrendoma” because of some horrible illness? Or if your loved one was a relatively young and morbidly obese person admitted to hospital with a pressure ulcer on her buttocks and a doctor referred to her as a “beemer”? It’s medical slang for someone with a high body mass index (BMI), and is meant to convey an image of someone who is so overweight they are unable to move position in bed.
So if code blue is slang for a cardiac arrest (a reference to the skin colour of a patient with no blood flow) and a code red would fit with an emergency involving severe bleeding, you probably have a fair idea of what “code brown [in the bed]” means.
An easy term for doctors to use when they are not the ones who have to clean it up.
The Secret Language of Doctors by Dr Brian Goldman is published by Harper Collins
mhouston@irishtimes.com muirishouston.com