Get it together

Bill Simmons sometimes pokes fun at the journalism cliche of collocated words that rarely appear apart from each other -- you don't often see the word 'ruffled', and when you do, you  know the word 'feathers' is likely to be close by.

There's a similar phenomenon in medicine, though I stubbornly have refused to acknowledge it.

Consider the followed dialog that transpired during a recent overnight ED shift:

Resident: "I have a 32 year old woman with hyperemesis. I'd like to start antiemetics and IV fluids."
Me: "Is she pregnant?"
Resident, befuddled: "Um, yeah? I said she has hyperemesis."

Of course, the resident was using hyperemesis to denote hyperemesis gravidarum. But really, hyperemesis just means lots of vomiting. Just because it's rarely used outside the context of pregnancy, it doesn't mean it's not a useful term (indeed, cannabinoid hyperemesis is another entity we sometimes see in the ED.)

What other terms get truncated like this? Anorexia nervosa comes to mind -- saying "the patient has anorexia" literally just means there's a lack of appetite, not a lethal eating disorder.

I'm sure there are countless others, but I'm wondering: could any of these medical terminology shortcuts lead to particularly dangerous misunderstandings?

I don't think anyone would mistake a triad for a joint if a colleague said, "they've got Charcot..." On the other hand, abbreviating the confusing term "superficial venous thrombosis" could lead to a mixup in therapies...

Program Note

Bora's back hosting Grand Rounds this coming Tuesday at his site, Blog Around the Clock -- but I'm going to help him collect submissions over the weekend. Please email me a link to your best recent material at nick /at/ (a little blurb is helpful, too)! Deadline is Monday night.

How'd you get to be happiness

Somebody at Apple likes Goldfrapp.

They've used her latest album for this tutorial (scroll down) and the sublime Seventh Tree was pictured on the first Apple descriptions of the Remote app.

It's nice when a monolithic institution shows a little personality.

Of course, my interest in Goldfrapp is mostly professional -- who else has sung as well about ending up in an emergency department?

Independent point of view

Here's a confession: Despite my steadfast advocacy of medical blogging as a means to promote understanding and education, I continue worry a lot about professional liability. Not just whether the things I write could hurt my career, but, in terms of academic output, is blogging a waste of time? What view does my department's leadership take on blogging?

Still, I've continued to support medical blogging as a useful academic endeavor, hoping that someday this support would be borne out. When sites like Sermo and Facebook came along, I despaired that more physician opinions were going to be hidden behind walled gardens, available only to select colleagues or friends.

Then, last week, some revelations -- I discovered a member of my department's leadership was blogging, or at least, had commented on a  blog. How about that!

The other revelation? Facebook may be the last great hope for academic discussions to flourish on blogs.