7/24/2023 0 Comments Hard to escape synonymAligned with the students, I gently voice my medical language pet peeves.Ī patient with cellulitis cannot fail a course of dicloxacillin, although his cellulitis could worsen in the setting of a drug-resistant organism. The group readily agrees on the terms accurate, concise, and efficient, but also proposes patient-centered and nonjudgmental as other markers of competent communication. Listening to the presentation of Ms Smith's case, and sensing an opportunity, I ask the students, “What are the most important elements of medical language?” One student jokes, “Combining as many abbreviations as possible,” and we all laugh, each one of us guilty of progress notes filled with more abbreviations than words. Published in 1900, Dr Carroll 11 reports: “In spite of the above, together with bandaging all the limbs, and giving hypodermics of ether, whisky, nitroglycerin, strychnine, etc, my patient failed to react, and died at 4 pm, just in time to escape the transfusion which I was preparing to give.” Escape, indeed! Where Dr Carroll seems surprised at his patient's demise, I remain rather astounded at the profound resilience of his patient in the face of those hypodermics. 6 – 10 In addition, a case report that is more than 100 years old inadvertently and somewhat humorously supports our notion that we should not attribute a poor outcome to the failure of the patient. 5 Early uses of the term deny almost uniformly refer to cases in which the patient did not admit to alcoholism or venereal disease. ![]() The phrase patient complaint appears in the inaugural issues of major medical journals, 1 – 4 although the phrase can be found as much as 200 years earlier. The use of the words complain, deny, and fail in the context of a medical case (their medical etymology) dates back more than 300 years. Medical language is deeply rooted in tradition, and sharing the patient's history with colleagues is as old as the profession. I find myself cringing as the student's presentation unfolds and wondering how such harsh words as complaining, denies, and failed have found their way into the history of Ms Smith's illness. She has a history significant for metastatic colon cancer, and recently failed chemotherapy.” As the group assembles to meet Ms Smith, we are introduced to a lady who is appropriately concerned about her sore chest, who feels that she is breathing normally, and for whom chemotherapy had been unfortunately ineffective. ![]() “Ms Smith is a 74-year-old hypertensive diabetic complaining of chest pain. Each student has clearly memorized the formulaic structure that primes the listener with the patient's chief complaint and ends with, hopefully, a concise assessment and plan. “T ell me about your patient.” Seated in a conference room with 11 medical students, I am facilitating a seminar on the finer points of “The Oral Presentation.” Having just started their first inpatient rotation, their excitement is palpable.
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