I had made a malapropism, which comes from the character Mrs. Malaprop in an 18th-century play. (The name came from mal a propros, or French for “inappropriate”).
There is no specific term for medical malapropisms, or mondegreens. However, I call them roaches, after the famous “roaches in the liver” (cirrhosis). We have all seen these lists of roaches, whether generated by patients or bad dictation skills. Some examples are:
- The patient was treated for Paris Fevers (paresthesias
- It was a non-respectable (unresectable) tumor;
- A debunking (debulking) procedure was performed;
- Nerve testing was done using a pink prick (pinprick) test;
- I had smiling mighty Jesus (spinal meningitis
- She used an IOU (IUD) and still got pregnant;
- He has very close veins (varicose
- She had postmortem (post partum) depression;
- Heart populations and high pretension (palpitations and hypertension
- A case of headlights (head lice
- Sick as hell anemia (sickle cell anemia
- The blood vessels were ecstatic (ectatic).
These roaches are generally amusing. They are certainly not anything a hospitalist would ever say or hear, though. Our patients are well informed, and our communications skills are flawless. We all know the medical malpractice risk of poor communication, and all of our patients are medically savvy and sesquepedalinistically erudite (whatever that means).
The next time you tell a patient they have a PE, remember they may be wondering what their medical condition has to do with monkey (an APE) and why you need to spell it out, or how their dyspnea is related to a high-school gym class (PE). You will have to excuse me now, I’ve got another hyponatremic patient and have to go hypertonic sailing. TH
Jamie Newman, MD, FACP, is the physician editor of The Hospitalist, consultant, Hospital Internal Medicine, and assistant professor of internal medicine and medical history, Mayo Clinic College of Medicine at the Mayo Clinic College of Medicine, Rochester, Minn.