11 hours ago
What your doctors are writing about you behind your back
Have you ever wondered what your doctor is really thinking about you when you're sitting in their office?
The truth is, the world of medicine has long been home to its own secret language – shorthand acronyms and slang that doctors use to communicate about patients to other healthcare staff, often behind their backs.
However, this is somewhat of a dying art, as today's medical slang now largely exists in whispered conversations or informal notes.
These colloquialisms rarely make their way into a patient's official records, because they're often considered unethical and potentially offensive.
Also, using them could result in legal trouble for doctors or hospitals if patients discovered them and decided to pursue legal action.
Adam Fox, a collector of medical slang, once shared an example from one of his annual reports to the BBC.
A practitioner had written 'TTFO', meaning 'told to f**k off', on a patient's chart.
When asked about the entry in court, the practitioner had to pretend the initials stood for 'to take fluids orally'.
Another reason for the decline in this sort of slang is that they may be confused with genuine medical terms, potentially leading to misunderstandings.
Leading GP, Dr. Zac, tells that he remembers an incident where this happened.
'A patient ended up suing – and winning – after she overheard a clinician referring to 'the cow in the room',' he says.
'She assumed she was being insulted. But the reality was that the clinician had been venting about a COW: a 'Computer on Wheels' that was malfunctioning again (as they often do).
'The context was lost, and what followed was a legal headache no one needed, but it served as a wake-up call. Ever since then, there's been a push to remove any language that could be easily misconstrued, especially when emotions are already heightened in a hospital setting.'
According to ex-TedxSydney founder, Remo Giuffre, who explored this phenomenon in his book series Remorandum, some of the codes include:
ART: Ain't Right There (patient has an unusual demeanour or behaviour)
BWCO: Baby Won't Come Out (needs Caesarian)
CFL: Chronic Frustrated Lawyer (frustrated patient who threatens legal action frequently)
CSTO/DSTO: Cat/Dog Smarter Than Owner (used by vets)
CTD: Circling the Drain (a critically ill patient who is deteriorating)
DBI: Dirt Bag Index (this multiplies the number of tattoos by the number of missing teeth to give an estimate of the number of days since the patient last bathed)
DUB: Damn Ugly Baby
EGO: Excessive Gas Output (patients with frequent flatulence complaints)
FF: Frequent Flyer (patient who frequently visits the ER for non-emergency issues)
FLK w/ GLM: Funny-Looking Kid with a Good Looking Mum
FUBAR: F**ked Up Beyond All Recognition (extremely complex or difficult situation)
FURB: Funny, Unusual, Rectal Blockage (people who use unusual objects in their anus)
GOK: God Only Knows (patient with symptoms that are baffling or defy a clear diagnosis)
GOMER: Get Out of My Emergency Room
GPO: Good for Parts Only (patients whose injuries may mean they are unlikely to survive)
GRAFOB: Grim Reaper At Foot Of Bed
LOBNH: Lights On But Nobody Home (patients who are alert but mentally absent)
LOFA: Lack of F**king Ability (patients who struggle with simple tasks or who seem helpless)
LOLINAD: Little Old Lady In No Apparent Distress
NQR: Not Quite Right (patient who doesn't have a clear diagnosis but isn't healthy either)
PITA: Pain In The A**
TEETH: Tried Everything Else, Try Homeopathy (chronic cases that resist standard treatment)
TMB: Too Many Birthdays (elderly patients, often with multiple chronic issues due to age)
TOBP: Tired of Being Pregnant (especially patient demanding Caesarian)
TSTL: Too Stupid To Live (patients engaging in extremely risky or unhealthy behaviour)
UBI: Unexplained Beer Injury (injuries of unknown origin associated with alcohol consumption)
VIP Syndrome: A high-status patient who expects special treatment that disrupts standard care
WADA: Weak And Dizzy All-over (patients with vague, non-specific symptoms)
Dr Zac says that while most of these terms are on the way out, some acronyms still hold a strong clinical place and are routinely used in day-to-day care.
These are the ones that serve a real purpose in communication and patient safety, not 'cheap laughs', he says.
Here are a few that remain in standard use:
FAST – Face, Arms, Speech, Time (stroke recognition tool)
ABCDE – Airway, Breathing, Circulation, Disability, Exposure (standard trauma and emergency assessment structure)
SOAP – Subjective, Objective, Assessment, Plan (common structure for medical notes)
PEARL – Pupils Equal And Reactive to Light (used in neurological exams)
AVPU – Alert, Voice, Pain, Unresponsive (used to measure level of consciousness)
'So while the cheeky acronyms of old might still make the rounds on Reddit or late-night handover jokes, in practice, they've mostly been replaced with clearer, standardised terminology,' Dr Zac says.
'And maybe that's a good thing.'
