Doctor slang is a dying art

The inventive language created by doctors the world over to insult their patients - or each other - is in danger of becoming extinct.

So says a doctor who has spent four years charting more than 200 colourful examples.

Medicine is a profession already overflowing with acronyms and technical terms, and doctors over the years have invented plenty of their own.

However, Dr Adam Fox, who works at St Mary's Hospital in London as a specialist registrar in its child allergy unit, says that far fewer doctors now annotate notes with acronyms designed to spell out the unsayable truth about their patients.

Top medical acronyms CTD - Circling the Drain (A patient expected to die soon) GLM - Good looking Mum GPO - Good for Parts Only TEETH - Tried Everything Else, Try Homeopathy UBI - Unexplained Beer Injury

The increasing rate of litigation means that there is a far higher chance that doctors will be asked in court to explain the exact meaning of NFN (Normal for Norfolk), FLK (Funny looking kid) or GROLIES (Guardian Reader Of Low Intelligence in Ethnic Skirt).

Dr Fox recounts the tale of one doctor who had scribbled TTFO - an expletive expression roughly translated as "Told To Go Away" - on a patient's notes.

He told BBC News Online: "This guy was asked by the judge what the acronym meant, and luckily for him he had the presence of mind to say: 'To take fluids orally'."

Quaint up North

Regional dialects abound, even in the world of the medical acronym.

In the north of England, the TTR (Tea Time Review) of a patient is commonplace, but not in the south.

And the number of terms for patients believed to be somewhat intellectually challenged is enormous.

From LOBNH (Lights On But Nobody Home), CNS-QNS (Central Nervous System - Quantity Not Sufficient), to the delightful term "pumpkin positive", which refers to the implication that a penlight shone into the patient's mouth would encounter a brain so small that the whole head would light up.

Regular visitors to A&E on a Friday or Saturday night are also classified.

DBI refers to "Dirt Bag Index", and multiplies the number of tattoos with the number of missing teeth to give an estimate of the number of days since the patient last bathed.

A PFO refers to a drunken patient who sustained injury falling over, while a PGT "Got Thumped" instead.

Medical terms - A glossary Digging for Worms - varicose vein surgery Departure lounge - geriatric ward Handbag positive - confused patient (usually elderly lady) lying on hospital bed clutching handbag Woolworth's Test - Anaesthetic term (if you can imagine patient shopping in Woolies, it's safe to give a general anaesthetic)

This is an international language - Dr Fox's research reveals that a PIMBA in Brazil can be translated as a "swollen-footed, drunk, run-over beggar".

Doctor insult

And much of the slang is directed at colleagues rather than patients.

Thus rheumatology, considered by hard-pressed juniors one of the less busy specialties, becomes "rheumaholiday", the "Freud Squad" are psychiatrists, and "Gassers" and "Slashers" are anaesthetists and general surgeons respectively.

Dr Fox is keen to point out that neither he, nor the other authors of the paper, published in the journal Ethics and Behavior, actually advocate using any of the terms.

He said: "It's a form of communication, and it needs to be recorded.

"It may not be around forever."

He said: "I do think that doctors are genuinely more respectful of their patients these days."

If that is the case, perhaps the delights of a "Whopper with Cheese", "Handbag positive" or "Coffin dodger" could be lost forever.

Yasmin Alibhai-Brown: Muslims have much to thank Britain for

We have never acknowledged the fact that 'infidels' campaign ceaselessly to guard our rights

Published: 10 December 2007 (The Independent)

Around this time of the year, my mum, Jena, a devout Shia Muslim, who died last year, would ask to be taken to see the Christmas lights in town, and when dropped off back home would entreat in Kutchi, our home language: "Say something nice in your newspaper article, time for that. It's their Christmas. Don't make people upset. This is a good country for us, you know."

I can hear her mellow voice today, and do as she bid. For in many ways, she is right. This is a good country for us and we Muslims don't say that often enough. Mea culpa.

Even now, in the riven world, our lives here are more secure, treated as more precious, than they are in most Muslim and European countries, the US, Australia and the Far East. British Muslims, or at least the most vocal of them, have never acknowledged the fact that "infidels" – Christians, atheists, Jews, secularists, Hindus and Sikhs – campaign ceaselessly to guard our fundamental rights as citizens of this nation.

These allies may recoil from Muslim militancy and the perpetually dissatisfied British Muslims who demand accommodation of their cultural practices, some of which are abhorrent in a free society. Yet they go all out to defend us when the state threatens to take away our freedoms or invoke undemocratic measures to protect democracy.

When the Home Secretary, Jacqui Smith, plans to increase from 28 days to 42, the time suspects can be held without charge, the right-wing Tory David Davis comes out fighting as if for his life. Why should a powerful white man care to oppose something brought in to intimidate and quell Muslims? But he does.

Henry Porter, the journalist, white and powerful, has been even more committed and uncompromising. Liberty, under Shami Chakrabarti (most definitely not a Muslim), has given unprecedented time and resources to interrogate skilfully and disable the tyrannical anti-terrorism measures dreamt up by New Labour since 9/11.

A 23-year-old British Muslim saleswoman, Samina Malik, was convicted last month under some of these draconian laws after downloading some jihadi material and for writing miserable and murderous poems fantasising about beheadings. I find what she did repellent, but hers were thought crimes, which should not lead to prosecutions in any democracy worth the name.

English PEN rose to condemn Malik's conviction, and among the most eloquent of the writers to come out for her was Hari Kunzru (again, not a Muslim) who wrote: " ... rationality seems to be ebbing away. We seem to have accepted the principle that it should be illegal to think, read and write certain things ... We are being taught to be circumspect. How long before it's suggested we should shut up altogether?" Malik might just escape her inner demons if she allows herself to read humanist writers like Kunzru.

Martin Amis's xenophobic "adumbrations" and imaginings were met with fierce moral and intellectual ripostes from white men, such as the novelist Ronan Bennet, Peter Wilby, the former editor of The New Statesman, and Professor Terry Eagleton. And also the Indian writer and critic, Pankaj Mishra (no, not a Muslim). When there are attacks on Muslims on the streets they are supported by grassroots organisations set up to defend all victims of racially aggravated crimes.

The same empathy is evident when looking at foreign affairs. Lindsey German of the Stop the War Coalition has never stopped reminding the nation of the mayhem in Iraq; Robert Fisk, the most highly regarded journalist in, and on, the Middle East, is not, I don't think, a closet Musselman. A few weeks back, at a conference, we heard the lawyer Phil Shiner reminding us of the alleged torture of Iraqi prisoners by British soldiers. For years now, he has tried to get justice for them, as has Rabinder Singh QC.

I am not suggesting Muslims have not been as effective and involved in these struggles. They have, and some have proved themselves impressive battlers, in particular, lawyers and politicians. However, there is too little public recognition of the non-Muslim individuals and lobbyists who have taken up our cause and stood with us. Decency demands we give them thanks.

That wouldn't suit or please separatists like Hizb-ut-Tahrir et al, for whom there is only them and us, the West and Islam, forever clashing on the road to hell. Sadly, the most integrated Muslims at times seem to have persuaded themselves that they are hated by the rest of humanity and their faith is under siege.

Such a view is only possible if you close down, shut the doors, turn off the sounds and blank out the sights that tell you a different story – that even these worst of times bring out the best in the best of us. For such big mercies, I am truly grateful. Mum always was, and she was right.

mailto:y.alibhai-brown@independent.co.uk