Commonest Erythematous Palpation, Status Post

When I was a postbac student shadowing doctors in the hospital, I learned that medical centers have a status hierarchy all their own. It resembles a cult, actually. I wrote about this in “Medicine Dress Code:” medical students wear short white coats, residents have slightly longer coats, and attendings – highest on the seniority ladder – have near-wizard length, Merlin-style white robes. I have no idea where this custom originated or why it persists, but it is helpful in quickly indicating who you don’t want to irritate.

What I didn’t realize is that the medical world goes further into cult-dom than I originally thought. In fact, medicine has its own language entirely.

Of course, you probably knew this already. Doctors talk to each other using totally unintelligible words – words like “pedunculated,” “demyelinated,” salpingo-oophorectomy,” and “pheochromocytoma.” These words, though, actually serve a purpose. They communicate a complicated or detailed concept in just a single word. For instance, “pedunculated” means “growing on or attached by a stalk,” like some kinds of tumors. This is particularly relevant, of course, in anatomy – no one wants to describe the phrenic nerve as “that white string that comes down from the neck place and loops around that big tube.”

But in the quest to sound important, medicine has adopted nomenclature that sounds impressive while conferring precisely zero advantage over the normal English word. For example, “status post” sounds awesome, right? “STATUS POST!,” one might yell at someone while a patient is going into shock. Or you can yell it in surgery when you’ve clamped the bleeder, like Nicholas Cage defusing the nerve gas bomb hiding in the doll in the beginning of The Rock. STATUS POST. CLEAR!!

Unfortunately, “status post” just means “after.” That’s it. No dramatic flourish, no urgency. Just, after.

Why?! Why does this phrase exist? On patient notes, people will abbreviate status post to S/P. So you’ll see, “S/P Hysterectomy 2003.” I can discern no possible use for S/P in this context. Or in any context. If you write “Hysterectomy 2003,” and the year is 2013… doesn’t that imply “status post?” There is no reason whatsoever to use this, except to sound intentionally confusing.

Another of my favorites is “dilatation.” I bet you can guess what that means.

….

….

Did you guess, “dilation?” If so, congratulations! By adding two letters to a normal word that everyone understands, you get a similar-sounding word that means the exact same thing. There is zero difference between them. I similarly have zero idea why anyone uses “dilatation.”

There’s a whole host of these words. I polled my classmates, and these are some of their favorites.

  • Erythematous. This word is pronounced “air-uh-THIM-a-tuss.” For those five syllables, the precise translation is “red.”
    • SERIOUSLY?! Why!? Why do you need to make the word “red” complicated?!
  • Commonest. For some reason this keeps coming up in lectures. A note to all you aspiring doctors: “commonest” is nonstandard English. This is a word that hasn’t been used in a grammatically correct way since the British Empire was still, you know, a thing. Most common is how normal humans say this word.

Some of the senses are represented with unneeded fancy words.

  • Palpation: touch
  • Visualization: see
  • Auscultate: listen.
    • This one makes especially little sense. You listen to someone’s heart. You listen to the noises someone is making. The word “auscultation” confers no advantage at all! It’s a totally useless word!

There’s quite a long list. Here are some of the others – and remember these words are exact synonyms for their English translation. They confer zero advantage in denotation or connotation, meaning there’s no compelling reason to use them at all:

  • Percussion: tapping
  • Mastication: chewing
  • Micturation: peeing (yep)
  • Stool: poop (also yep)
  • Edentulate: toothless
  • Verruca: wart
  • Exudate: fluid
  • Anastomose: join
  • Pruritic: itchy. Seriously, itchy has its own word.

There’s one other “medical”  word that deserves special treatment. All of our classes – and this holds true for most medical schools – have lectures based off of learning objectives. You remember those, right? “Understand the function of blah blah thingy with regards to blah blah important and probably gross bodily process.” Lecturers have recently burned out from the word “understand,” apparently, and have sought a new word.

That word is “appreciate.”

I. Hate. Appreciate. It has no meaning. How do I appreciate a medical idea? I don’t look at a cartoon of the heart arteries and think, “wow, that’s a gorgeous circumflex artery.” No one reads up on sodium absorption in the kidney and, er, appreciates the artistic beauty of a transporter protein.

In small group session a few weeks ago, our facilitator got on the Appreciate Bandwagon when describing heart failure. After describing the physiology of the process, he saw blank looks on our faces and got fired up. “Can you appreciate that? Do you appreciate that? You need to appreciate this, this is important. Make sure you appreciate this before the end of the week because it will be on the test.” I GET IT LEAVE ME ALONE JESUS I APPRECIATE IT.

Of course, what he really means is “understand.” Why our educators don’t just stick to the normal words… I will never, uh, appreciate.

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6 thoughts on “Commonest Erythematous Palpation, Status Post

  1. ah the joy of words! will describe the student body at osher 55-103 yrs-they have alopecia(baldness) and much presbycusis_hearing aides abound on all those grey heads.anyway,love your blog . remember shakespeare wrote”a rose by any other name smells just as sweet.
    add to your list another annoying speech marker-NO PROBLEM
    hope your potluck was fun. can’t wait to see you . love,grandma

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