The Gomers have Mneumonia

I figure something a little light for today… A little humour if you will considering Taslima is about and can also come have some fun here with medicine. Since the rest of my posts (for when they go up) are a torrent of invective, swearing and bile aimed at the idiots of the world.

Medicine has it’s own unofficial language. It’s a language of complete disrespect (for good reasons) that masks the pain and suffering you face as a doctor. It is alleged that the career with the highest incidence of PTSD is not the armed forces, but medicine.  I can see why it’s that way atleast during times of peace. And one of the coping mechanisms used to be the medical jokes. The jokes you tell at your patient’s expense that are hidden away. Medical Slang is a dying or dead art. It used to be a coping mechanism because frankly? After you have seen your 40th patient of the day you just need a laugh. And sometimes patients come in with conditions that simply are beyond the pale.

For instance, what would you say to a young man who comes in for vomitting (Emesis for the medics)? You can be nice to him. What if you give him a potent drug that stops vomitting (often used to treat cancer patients) and he still throws up? You eventually realise he is triggering the mechanical reflex of vomitting by sticking his fingers down his throat. You cannot laugh at him, you cannot call him stupid. So you call your other doctor friends and have a laugh. Otherwise you will go CRAZY. The number of tales like this of the top of my head? The Darwin Award, The Harpoon Man, The Homeopathic Emo, The Broken Arm, The Best Form of Contraception… Plenty of cases where you need to laugh. On the one hand these euphemisms and acronyms are hurtful if you read them on the other hand you are removing a coping mechanism for a high stress job, a job so stressful and often thankless that you will probably die younger than your patients (I have no illusions. My mother will eventually lose a leg or two to her job. My dad too. Both are doctors. I know what awaits me with age. My life expectancy is a full 5 years shorter than my patients.).

The history of this is old. Latin used to be the language of medicine and had it’s use in this. You could write things on patient’s charts which wouldn’t alarm them. Even if a patient was dying you could mark the chart but tell the patient that things will be fine so as to keep them happy till the end and stop them panicking. It stopped nosey relatives from dividing up estate by poking though charts or abandoning those who were destined for death. The medical acronym came about to dodge the change from Latin to English.

Some of them are harmless. TTR in the UK stands for Tea Time Review, or “check on Mr. Smith after he has had his tea”. Some of them are funny but hurtful CNS-QNS is Central Nervous System – Quantity Not Sufficient. Pumpkin Positive is another amusing term that indicates that if you shine a pen torch into their mouth their eyes and ears would light up like a pumpkin. There are terms that indicate what happened to a person such as PFO and PGT (Patient Fell Over/Got Thumped). There are terms for treatment and prognosis CTD (Circling the Drain) and TEETH (Tried Everything Else, Try Homeopathy). There are even terms for each other. In fact most of our “short” terms are for each other.

The most well known of these is the ENT, Ear, Nose and Throat specialists aren’t a “thing”. That’s a medical joke to shorten otorhinolaryngology. But others include Rheumaholiday (Rheumatology is considered a “lite” subject) and the Freud Squad (Psych. If you didn’t already guess).

Then we have the medical students. We have mneumonics (for those who are unaware) which is a phrase or an acronym that allows you to recall information. And medicine is full of them for the aspiring medical student… These are some of the most raunchy ones unimaginable, because the dirtier they are the better you remember them…

Oh! Oh! Oh! TTouch And Feel A Girls Vagina, Ah! Heaven! (Olfactory, Optic, Occulomotor, Trochlear, Trigeminal, Abducen, Facial, Auditory, Glossopharyngeal, Vagus, Accessory and Hypoglossal nerves) are the cranial nerves.

Scared Lads Try Positions That They Cannot Handle (Scaphoid, Lunate, Triquetrum, Pisciform, Trapezius, Trapezoid, Capitate, Hamate) are the bones of your wrist (The Carpals)

There is Obs/Gynae and the ever populare


Pain, Ectopia, Neisseria, Infertility, Chlamidya, Actinomycetes, Gravidae (Causes and Effects of Pelvic Inflammatory Disease)

Not all are raunchy some are based on modern phenomenon.

Labour, Abruption of placenta, Rupture (eg. ectopic/ uterus), Abortion, Cholestasis, Rectus sheath haematoma, Ovarian tumour, Fibroids, Torsion of uterus (Abdominal Pain during Pregnancy)

Some are just weird

Skin colour, Heart Rate, Irritability, Tone, Respiration and together you need to remember to note the time of meconium. (APGAR score for infants during childbirth)

It’s a weird world full of silly medicine humour. Give it a try the next time you need to remember something.

Remember though, raunchier the better. For some obscure reason we fail to remember the nice PG ones and remember the ones about Penis Cages…


  1. says

    I heard the Oh Oh Oh one from a classmate who got it from an anatomy tutor. Although their version was much creepier and involved the words “Virgin” and “Hymen”. So I’m pretty sure anatomy tutors don’t have to pass Working With Children background checks.

  2. brucegee1962 says

    The (cleaner) version of the cranial nerves one that I came across while doing research on a story was “On old Olympus’ tiny tops, a Finn and German share some hops.” But that one has two different letters for the last two, so I don’t know.

  3. Tsu Dho Nimh says

    Bah! You whippersnappers are so vulgar!

    On Old Olympus’ Torrid Top, a French and German vinted average hops.

  4. Hunt says

    All fine and good, but if you ever paint a face on my penis while I’m under, I’m going to sue the shit out of you.

  5. hamstur says

    My mother was a nurses assistant way back in the 70’s in Alabama. She told me the doctors used an acronym when they didn’t know what was wrong with a patient – ADR – for “Ain’t Doin’ Right.”

  6. rowanvt says

    While I work as a ‘nurse’ in a veterinary hospital rather than a human one, we have these same sorts of jokes. We have the ADRs, the ROBO dogs (Run Over By Owner) and general phrases used at specific hospitals. Where I work “Has a badness” lets everyone know a particular animal has a really nasty cancer.

    My favorites though came about thanks to my brother, who helped me study while I was going to school for my registered veterinary technician license. I have gained the perpetual nickname of Emesister from him. He would also distort the questions on my flash cards. The one I remember the best was when he looked up from the card and asked “What is a sex-change?” I had to figure out the actual question, and then answer it. Biotransformation, I will never forget you.

  7. Zinjanthropus says

    >Scared Lads Try Positions That They Cannot Handle…are the bones of your wrist

    Or, if you’re at University of Edinburgh: “Scottish Lads Take Prostitutes to the Caledonian Hotel”

  8. MaryL says

    I’ve always liked FLK (Funny Looking Kid) and LOL/M in NAD (Little Old Lady/Man in No Apparent Distress). Of course I’ve read The House of God! And worked in nursing home administration (talk about gomers…) and later, in doctors’ offices.

  9. Curcuminoid says

    Do you have a source for this? PTSD is not an issue I’ve considered before as it pertains to medicine, and I’m curious about several things.

    The career with the highest incidence of PTSD is not combat, but medicine

  10. astrofiend says

    Enjoyed that a lot – I’m going to keep an eye on my charts for stuff like CTD though if I ever end up in hospital.

    I mat even start grabbing doctors and demanding to know what each acronym stands for!

  11. says

    Many medical professionals start off in General Wards and A&E. It’s a thankless job and it’s a good place to learn skills so it’s dumped on us. And remember other fields have a tonne of tragedy too. Psychiatric wards have higher rates of attacks on doctors. Medicine and Surgery have mortality rates. Even something like obstetrics which we associate with birth has it’s bad days.

    A significant percentage of us will die due to mechanical trauma. Every doctor will be exposed to a fair few deaths unless they are ridiculously lucky.

  12. Curcuminoid says

    And on top of that there’s the risk of being around the sick constantly. Fairly recently, my father, an EM physician, nearly got Hep when he got stuck with a needle used on an infected patient. Very fortunately, the patient was non-communicable (IIRC, negative for antibodies).

    Still, as dangerous and traumatic as medicine can be, I’m be very surprised if its rates of PTSD exceeded that of combat personnel. Can you furnish me with a source for that statistic?

  13. says

    Looking as we speak. I may have mentioned something told to me the head of Psychiatric Medicine. If that’s the case “IGNORE ME”

    Apparently this is one of the unofficial things in medicine rather than something official. I redact my statement…

    Although? I would expect it to be higher than non-combat era soldiers since they aren’t seeing trauma while the doctors are exposed to it.

    Oh and my needle stick was from a HIV positive patient. I had to take zidovudine prophylaxis and blood tests for a year before i was considered all clear. Clumsy medical student who didn’t know how to hold a syringe did it.

  14. katansi says

    Do you know many American doctors? If so, do you know how any of them feel about having to let patients basically suffer and die because of our healthcare situation? Assuming you go into a profession like medicine to help people I would imagine that this would be traumatizing to go through especially repeatedly as would be the case here.

  15. says

    I do know a few. They don’t like the way the system runs. There is no oversight for doctors and indeed there are a lot of quacks in your system (The example I bring up is Mayer Eisenstein.) who get away with it.

    Your system’s issue is not one of availability of healthcare but availability of primary healthcare. Prevention is better than a cure, but the USA takes the idea that cures are better than prevention. Yearly check ups save money on the long run. Socialised practices such as “walking buses” and compulsary sport reduce costs in the long run.

    The issue is you have privatised medicine where it is in their best interest to be as bloated as possible. There is something called a “basic” medical list. You can treat a tonne of issues with that list. You literally have just a handful of issues outside that list such as cancer… But for the most part you can fight real disease quite effectively with a bag of medicines that can easily be carried by a single human being.

    I work in India. There are people you cannot help. In the UK out of 1000 children born only 4 will die (In the USA it’s roughly 6 but that’s due to dumbasses and categorisations. The USA is only slightly worse than the UK at keeping infants alive)

    In India the norm is 60 deaths per 1000. We have premature babies who have higher survival rates than that. With medical intervention that number halves. I have to accept that despite all my efforts I will lose 6 times the number of patients I would in the UK. I cannot do anything about it. If I am traumatised I cannot be a doctor. I have to go in despite that.

    Things that are harmless in the west kill here. 30% of children die to diarrhoea. Roughly 30% die to measles. 30% to pneumonia. All preventable. If we do our job correctly we would reach 10 per 1000 births like the state of Kerala, but the rest of us have a long long way to go. We are overstretched and embattled.

    It’s the same in the USA for doctors. They cannot help, the decisions are made by managers and politicians and employers. Doctors have little to no say. So the lack of insurance for A or B is just you having a condition that cannot be treated.

    I prefer a socialised medical system with a small payment (for placeboe effect purposes) for prescriptions. It’s simple, cheaper and you can prevent and control diseases before they get out of hand. It will cost the USA a tonne of money to set up but it will save money every single year if done correctly.

  16. katansi says

    Oh I definitely understand why our system sucks. I’m a big fan of NHS systems as I know them through friends and family. I know the value of preventative medicine because I don’t have access to it. I’m looking forward to a future of not being able to walk because of joint problems and continuous damage that I will likely never get to in time, if at all. My mom will work until she dies because if she relies on our current medicare situation she won’t be able to get adequate treatment for her lupus though it’s well controlled now. My dad is currently piling on the treatment after spending two years jobless, and eventually homeless, which led to serious health problems being left to fester. In my experience I’ve mostly had doctors get mad at me for not taking care of problems while completely ignoring the part where patients like me will never have out of pocket money available for either co-pays, insurance or direct payment to them. I mean they sure weren’t going to waive payment altogether even though that’s what kind of happens when you get to the point of debt collection.

  17. Hunt says

    Not entirely true that there is nothing American doctors can, or are, doing. There are organizations like Physicians for a National Health Program that have a certain amount of clout simply by virtue of the fact that doctors have a certain respected social status and are listened to. They aren’t a massively influential at this point and certainly most politics and policy are swayed at a much higher level, but it’s not true that American doctors are just powerless pawns on a corporate chessboard. Even nursing (or especially nursing) organizations have a fair amount of lobby power here. The reason probably being that nurses are in very high demand here and there is incentive to keep them happy.

    When and if it comes, single payer (socialized finance, like American Medicare) will probably first come at the state level, since federal politics are way too influenced by the big money of corporate insurance company. As you may are may not know, part of “Obamacare” was going to include a single payer option, but even that tentative measure was defeated by the insurance lobby.

    It all boils down to the fact that American health insurance companies are massively powerful since the amount of money involved is staggering and our political system is entirely subject to the influence of money. In order for true socialized or at least single payer financed health care to gain purchase here, something is going to have to break the back of corporate influence.

  18. Aliasalpha says

    IT has similar unofficial and generally cruel acronyms & mnemonics. To remember the 7 layer OSI model (Application, Presentation, Session, Transport, Network, Data link, Physical), one of my teachers taught me to remember “Australia Post Sucks, They Never Deliver Parcels”.

    Related to the OSI layer, something that is clearly user error is referred to as a Layer 8 problem. The other version of this is the PEBKAC error, Problem Exists Between Keyboard And Chair.

  19. says

    When I worked in the R&D lab of an electronics factory, I once described a problem with an end-of-line test set as “Wetware failure. Suggest replace operator with a functioning unit.”

    Somebody who didn’t understand the significance of that phrase actually wrote it up like that in the official record …..

  20. brenda says

    “Although? I would expect it to be higher than non-combat era soldiers since they aren’t seeing trauma while the doctors are exposed to it.”

    Medical professionals are not the direct targets of trauma, they witnesses to it. Even in non combat situations soldiers not in the direct line of fire are still targets. IEDs are not known to discriminate between combatants and non combatants. Grenades, incoming missiles, chemical weapons, IEDs, suicide bombers, all are capable of taking you out.

    It is the threat of imminent violent death without warning or predictability that is responsible for PTSD. EMTs and ER med students are not under that threat. They are merely exposed to others’ suffering and the stress of long hours and high expectations.

    Children, particularly young girls, acquire PTSD because they are in a living environment, one they cannot escape, where their life and bodily integrity is under constant imminent threat. Abusers are unpredicatable. ER med students have a home to go to. They can get away. Soldiers and children who are abused have no escape.

    You know nothing about PTSD.

  21. Some Old Programmer says

    The field of electronics has its own mnemonics; the one for the order of color codes for resistor values being, in its original form, breathtakingly racist, misogynistic and a rape joke to boot. The cleaner version is “Bad Boys Rob Our Young Girls But Violet Gives Willingly”.

  22. Corvus illustris says

    “Bad Boys Rob Our Young Girls But Violet Gives Willingly”

    Followed by Get Some Soon to add a mnemonic for the tolerances.

  23. katansi says

    Hey there, person diagnosed with PTSD here.

    Seeing people in pieces is traumatic. Seeing someone whose face smashed in is traumatic. Seeing the victim of abuse, murder, rape, and any other type of visible damage is traumatic. Seeing parts of people on the outside that are supposed to be inside in an uncontrolled environment is traumatic. Seeing children dead from preventable disease is traumatic. He did not say this is not traumatic to the victims of the violence. Post *Traumatic* Stress Disorder.

    “It is the threat of imminent violent death without warning or predictability that is responsible for PTSD. ” – that is so untrue it’s not even funny that you’d minimize other trauma by comparing it to the threat of death. Because personally the biggest cause of my PTSD is based on the threat of imminent violence without death on a completely predictable basis because it was literally every day.

    One super duper thing about PTSD being so freaking terrible is that you bring it with you where ever you go. So those cops, ER docs, abuse counselors, who help the people who get raped and get their faces smashed in and get their limbs blown off but were not there when it happened, bring back knowledge that the world is a vast pile of shit in many places and there is very little they can do to stop it. Seeing that over and over again is traumatic. Do you think rape counselors aren’t traumatized by hearing horrible stories over and over again? Do you think the docs in Germany at the US bases responsible for most of the critical care for soldiers aren’t traumatized by seeing their fellow soldiers in pieces?

    How much do you know about PTSD if you do that thing where you minimize someone’s experience just because someone else may have it worse. Having a less traumatic experience is not in the same ballpark as having a healthy experience. Are you that person that quotes the “I cried because I had no shoes until I met a man who had no feet”? Because that’s belittling someone else’s experience and pain and is fucked up to do. YOUR PTSD might be different. That doesn’t make it The Only PTSD out there.

  24. brenda says

    Hello Katansi
    “that is so untrue it’s not even funny that you’d minimize other trauma by comparing it to the threat of death.”

    One of the things of this medium is that you need to edit out every possible alternative because you just can’t list them all or if you use conditionals and non-gendered words and everything you can imagine it just destroys English.

    Of course I am aware that not all who suffer from PTSD were necessarily in life threatening situations. But quite honestly I think that health care personnel do not have the same kind of stresses that those they treat do. I have held a young man’s arm that got caught in a corn picker. Amazingly efficient machines those. I have taken a man to the whirlpool who slipped and fell into a machine that processed cattle. Two children to have a plastic mask fitted to mold their scars into something resembling a face. And on and on…

    I am not traumatized by the patients I have done my best to help. I do not suffer from ptsd because they suffered. I am glad I was there to render the little assistance I could. I went home at night and slept well. That makes all the difference in the world.

    To me it would be grossly inappropriate to claim that simply being there at those times with those patients somehow traumatized me. I read “House of God”. I never laughed so hard, ok… maybe a couple of times, but it’s very funny. But I don’t think that kind of humor indicates ptsd. It’s just the way that people blow off excess stress.

    “Do you think rape counselors aren’t traumatized by hearing horrible stories over and over again?”

    No I don’t. I think that unless you are threatened with life or limb for extended periods of time the stress that you experience, as intense and even harmful as it might be is not in the same league as the kind of trauma one experiences when your life or bodily integrity is under constant threat. I think that’s different.

    Soldiers for example, are *trained* to sleep lightly because they may need to leap into action at a moment’s notice. They know, even in their sleep, that their life is under constant threat. The same is true for children subjected to systematic abuse. Their abusers could come for them at any time, even, and especially, when they’re asleep. How can I compare any stress I might have had to theirs? I can’t do it.

    “Are you that person that quotes the “I cried because I had no shoes until I met a man who had no feet”? Because that’s belittling someone else’s experience and pain and is fucked up to do.”

    Yes, that is a good technique to employ. It isn’t belittling because you only use it to return to baseline and in fact visualizing that others may have had it worse than you is part of standard dialectic-behavioral therapy in treatment and is backed up by clinical studies that shows it helps in recovery. As long as you don’t use it to put yourself above others but simply to put distance between you and your triggers it is just fine and indeed, recommended.

    That’s how I feel.

  25. katansi says

    “How can I compare any stress I might have had to theirs? I can’t do it.”

    You just tried that by telling someone that they couldn’t be traumatized by something that is clearly having that sort of effect on them. You are using your personal experience to negate others’. It’s the suffering olympics. “Don’t complain because someone has it worse” means only one person in the entire world gets to complain. That is belittling. You are quite literally trying to make out someone else’s feeling to be unimportant just because they’re not important or appropriate to you. More than one horrible thing can go on at the same time and one being worse doesn’t make the other thing not horrible.

    It is traumatizing to be a victim of violence and it can be traumatizing to witness violence. It is luck if you are not traumatized by this for whatever reason. Maybe you had a nice family, maybe you had a crappy family but had resources and genetics on your side. Your feelings are not the arbiter of reality. You telling someone that they know nothing about PTSD because that’s how you feel doesn’t actually mean they know nothing about PTSD and trivializes their experience because it doesn’t match whatever personal definition you have for suffering.

    It is also a really poor approach to any mental health issue to be told you’re not suffering enough to be allowed to talk about how it feels to you. This is not putting yourself above others it’s admitting some terrible thing/s happened or keep/s happening and that the thing doesn’t happen in a void in which only the immediate victim is present.

  26. katansi says

    “Not entirely true that there is nothing American doctors can, or are, doing.”

    “Can’t” might be more along the lines of “may destroy your life if you try to help this one person.” On the scale of greater good a good doctor that keeps practicing may be better than a good doctor that screws up once outside the system and can no longer practice. It’s reasonable to fear for your own personal future. I think if single payer option comes at the state level first it will fail and that failure be used to bolster more unsupported arguments against socialized medicine. Many of the people in poorest states now, which rely heavily on the public options, don’t even seem to realize that’s what they’re doing and it still gets voted down.

  27. says

    A word on PTSD…

    You can get PTSD despite not being subjected to trauma. Medicine is a physically demanding (I have started developing dilated leg veins. I will eventually get varicose veins) and trauma associated (A lot of body fluids are involved. AND a lot of willing trauma is inflicted.

    There are soldiers who feel guilty because they got PTSD despite never having been injured. There are cops and fire fighters and doctors and nurses who are the same.

    The issue with doctors (at least) is that you have no other option but to go back to work. You have no skills that apply in other careers and none of them pay as well as medicine. You literally grit your teeth and get on with it. You cope, you find camaraderie. Or you turn to substance abuse… Medicine has a lot of substance abuse within it. THere is a lot of suicide and depression. Mainly because doctors are so bad at getting help and there is no system for us. No one wants to appear weak.

    In addition, we are subject to violence. I have been threatened by two angry mobs of people angry about something out of my control. I know doctors here who have been beaten or killed by them for not achieving the impossible. I know medics in the UK attacked by patients.

    As I said, I had a needle stick injury with a HIV patient. Can you imagine spending 2 months waiting and hoping that the zidovudine you take stops the virus? Because HIV is a death sentence too. It may not kill you like a bullet but it will kill you. In fact if it hits it will kill you more times than a bullet would…

    PTSD and trauma are very real things for medical staff. Just because they directly aren’t threatened doesn’t mean they don’t contract it.

  28. Christoph Burschka says

    Medicine has it’s own unofficial language. It’s a language of complete disrespect (for good reasons) that masks the pain and suffering you face as a doctor. It is alleged that the career with the highest incidence of PTSD is not the armed forces, but medicine.

    From this I hazard a guess that House MD sometimes steers closer to non-fiction than most would like to believe…

    The most well known of these is the ENT, Ear, Nose and Throat specialists aren’t a “thing”. That’s a medical joke to shorten otorhinolaryngology.

    Huh, I didn’t know that one. Here in Germany, the literal translation of ENT (HNO) seems to be a pretty official acronym and is also used in the name of their trade union.

  29. Corvus illustris says

    “There are soldiers who feel guilty because they got PTSD despite never having been injured … “

    There’s also the “executive rat syndrome” of experimental psychology: shouldering the responsibility is the stress that does the damage. A relative who is a lower-ranking Nat’l Guard officer has gone to one of the US’s recent battlefields. He didn’t lose a soldier under his command, because his previous experience in the regular army had taught him survival skills that non-professionals don’t learn and he passed these on to his people. But the stress of getting things done while keeping risk bearable gave him (well-diagnosed) PTSD, the consequences of which have been hideous.

  30. Hunt says

    I can imagine that was pretty terrifying. The closest I can come to relating to that was that once I drove my suddenly sick cat to the veterinarian and it died in the car. For one reason or the other I became paranoid that it actually had died of rabies. Rabies in humans is of extraordinarily low incidence here in the USA, but one prior indication is caring for a pet that dies without known cause, which didn’t exactly make me sleep any better.

    As I’m sure you know, HIV is no longer a death sentence, at least in the West, with access to proper anti-viral drugs, though I can’t speak to its status in India. Magic Johnson became HIV positive twenty years ago and is still going strong, though it’s possible that he is naturally resistant to the virus.

    I’m convince that you’re basically right in that there are many opportunities in medicine to acquire PTSD. The people who focus only on the calm, deliberative clinical settings, the settings we all hope that we will be in when we go to a hospital, are ignoring the fact that someone has to occupy front lines, and some pretty horrible stuff can be witnessed there.

  31. Nepenthe says

    The common cause of PTSD is fear. It doesn’t particularly matter what causes the fear, just that it’s intense and traumatic for the person who experienced it.

    You appear to be one of those people who is not susceptible to PTSD. Congratulations. This does not make you more moral or rational than people who do have PTSD and it does not negate their experiences.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>