Ever wondered what your doctor really thinks about you?

MEDICAL MATTERS:Many doctors use eponyms that patients don't recognise

JUST INTO my second month of using an iPhone, and it still amazes. The apps (applications) are so numerous, how could one person ever view them all? And the medical apps are great, allowing, among other uses, quick updates of treatments. One of the first I downloaded was “medical eponyms”, which has proven tantalising during those rare moments of idleness on trains and buses.

Medicine is a highly eponymous discipline, with many diseases named after people, but also places. Sometimes they describe appearances, such as bat wing oedema, a description of a particular X-ray appearance seen in patients with excess fluid in their lungs. Murphy’s sign refers to a sharp increase in tenderness when a person with an acutely inflamed gall bladder stops breathing in.

Queen Anne’s sign refers to the sparse eyebrows seen in some people with low thyroid function; it refers to the practice of shaving the outer one-third of one’s eyebrow, which apparently was fashionable during the reign of Queen Anne from 1707 to 1714.

Eponyms are especially popular when describing medical syndromes – a collection of signs that seem to relate to a particular disease process. Benedikt’s syndrome, which has nothing to do with the current Pontiff, describes a series of clinical findings that result from the blockage of certain branches of the basilar artery in the brain. Charles Bonnet, an 18th century Swiss philosopher, described a type of visual hallucination occurring in blind people; he is since remembered in medicine for the Charles Bonnet syndrome. And a male patient with the Aussie-inspired John Thomas syndrome has more than a hip fracture to worry about.

If eponyms are a nod to medical history, then the practice of medical acronyms is very much a modern phenomenon. There is a theory that acronyms are designed by progressive and politically correct hospital administrators, perhaps as a way of keeping other healthcare staff in their place. However, I don’t think medics can escape blame entirely; in my experience acronyms – derived from the Greek “acro”, meaning top or summit – are especially beloved of junior hospital doctors. In any event, administrators have moved on to abusing the English language with references to service users, roll-outs and best practice toolkits.

Medicine is full of acronyms. Their use seems to have multiplied with the development of high-tech medicine. So while a patient refers to his heart-bypass operation, a doctor writes CABG, the acronym for coronary-

artery bypass grafting, pronounced cabbage. A TURP is a man who is about to have a trans-urethral resection of the prostate performed; in layman’s terms his prostate gland will surgically be made smaller to deal with difficulty passing water. Then there is the un-PC chart entry “LOL presented to ED with SOB and LOC”, which translates as “little old lady who came to the emergency department with shortness of breath and an episode of loss of consciousness”.

Some are crude. That medical classic, “The House of God”, contains the acronym GOMER, referring to an unwanted patient as “get out of my emergency room”. PAFO may be politely explained as “inebriated and fell over”. An overly theatrical patient may have case notes that include the term RADA, for Royal Academy of Dramatic Art. This is unprofessional and not for the faint-hearted but what do you think RATTFO might stand for?**

American 16 year olds take a general education test. The following answers to medically themed questions are apparently genuine. Give the meaning of the term “Caesarean section”: “The Caesarean section is a district in Rome.” What is the fibula? “A small lie.” What are steroids? “Things for keeping carpets still on the stairs.”

And my favourite: what does the word benign mean? “Benign is what you will be after you be eight.”

I can’t wait until these kids graduate from medical school and start contributing acronyms. On second thoughts, maybe they will start a new trend for medical malapropisms . . .

** Reassured and told to f… off.

mhouston@irishtimes.com