In an #ADC_JC from the dawn of time we discussed a paper concerned with the outcome of retrievals of children with bilious vomiting. We spent a disproportionate amount of time discussing the meaning of the word bile.
Medicine is, amongst other things, a language. I remember once hearing that medical students were asked to memorise an additional 100,000 words, over and above normal, day to day vocabulary – which, depending on who you are and what you talk about, would range from 8000 to 20,000 words. That vocabulary is increasingly available to the non-medical lay world, and I’m frequently struck that sometimes we, in medicine, revert to the lay meaning, perhaps because we don’t understand the need for precision in medical terminology, or perhaps because we don’t actually understand the medical term. It doesn’t mean that the lay meaning is wrong – it is just that it is a different meaning, so we accept the lay use at a risk. For example, in the list below, if all the children we see with (lay) projectile vomiting are treated as if they have (medical) pyloric stenosis, we’ve made a big error.
Here’s a very brief lexicon, that Bob Phillips and I came up with – what do you think? Can you come up with any others?
|Term||Lay meaning(s)||Medical meaning|
|Bile||Anything that you vomit that isn’t food; what you vomit once your stomach is empty of food||Containing bilous – green – pigmentation.|
|Projectile||Lots of vomiting, bringing up everything||Extremely forceful vomiting; for example,will hit the wall or medical student opposite.|
|Chronic||Bad||There for a long time|
|Acute||Really bad||There for a short time|
|Squint||Screw up your eye lids||Strabismus; mal-alignment of eyes|
|Smoking||Smoking in the presence of the child||Smoking at all|
|Sick||vomit or nausea||Call the intensive care team|
|Having a fit||Temper tantrum||Seizure|
|Wheeze||Upper airways whistle I can hear||Lower airways polyphony|
|Tourette’s||Swearing and badly behaved||Specific neurological condition|
|Tumour||Malignant and possibly untreatable cancer||Lump|
|Cyst||Malignant and possibly untreatable cancer||Fluid-filled lump|
|Shadow||Malignant and possibly untreatable cancer||Greyish area on a radiograph, or an actual shadow|
Can you come up with more? Why not tag them in the comments below, and share via your favourite social media platform using the tag #MedicalMeanings