As medical professionals, we know the foreign language of medicine, with its short hand and jargon. No one envisions a vegetable when discussing a patient who had a CABG. We know what “to tube” and “to scope” means.
But do our patients understand us? Health literacy is one of today’s hot topics.
Much is studied and written about patients understanding us and how we communicate. In a time when so many patients consult Dr. Google or assume they will have every side effect listed on the pharmacy handouts provided when they pick up medications, developing communication skills is paramount. A patient with adequate health literacy can understand, use, and communicate health information.1
But maybe, just maybe, we are looking at it from the wrong angle. Instead of how we communicate with our patients, what about how they communicate with us? A history is the backbone of every good medical record. Yet, do we understand what the patients are saying? Do we have patient literacy?
To that end, we have collected a variety of terms used by patients across the country. Remember, communication is the key and many of us are transplants and do not know the colloquialism of the region where we practice.
Thus, we offer this primer on “patient speak.”
Body parts and body functions are always important. This can tell us how the patient feels and the chief complaint. Appetite and digestion head the list.
When a patient says, “I feel poor” it is not an economic statement. Generally, feeling poor refers to being run down and losing weight. A person who is cachectic is “poor.” Sometimes this can be in the eye of the beholder. Many patients who are morbidly obese and have lost some weight (but still morbidly obese) will describe themselves (or family will describe them) as “poor.”
…and body function
Our patients don’t always urinate. They “make water.” Or they “urine”’ (can it become a verb?) “Urine stones” are kidney stones. We may call foamy urine a sign of albuminuria but to some patients, it is” beer urine.”
Elimination is a top concern. Patients may nod yes to queries about bowel movements but then will tell you they are “stove up” which is a pretty close description of constipation. While the opposite term is diarrhea to us, many patients’ “run off” or “have the trots.”
Your patient may look at you blankly if you ask about incontinence but will agree when they get “into a tight” they don’t always “make it.”
If they want something for “piles,” think hemorrhoids. When they are “stove up,” suggest a physic (laxative).
Sexual in nature…
Following ingestion and elimination are terms involving sexuality and genitalia.
Men might say their “sack is swollen” (scrotal edema). As many of our patients have diabetes, hypertension and are on several medications, a top concern for men is often their “nature.” Whereas if asked if they experienced erectile dysfunction, they may say “no.”
Some men may have a “Prince Albert,” thought to enhance sexual pleasure. Think piercing of male organs.
Women, on the other hand, often have concerns about their “pocketbook,” a term which includes all things female below the waist. Women also suffer from “fireballs” (fibroids) which make menstruation painful.
Diabetes and other diagnoses
Common among diabetic patients are “risens.” This covers a variety of dermatology diagnoses including abscesses, folliculitis, or furuncles.
One patient referred to scalp nodules as “donomores.” Upon closer questioning he revealed he once got into an altercation and has residual glass fragments in his scalp. As a result, he resolved to “do no more” fighting.
Patient-ese also covers diagnoses.
“Arthur” (arthritis) visits many of our patients, making movement painful. The patient with volume overload is “swoll”’ or “swolt.” Serious volume overload is ‘dropsy’ (congestive heart failure).
Many patients suffer from “the gouch.” In fact, gout is very painful and gouch is very descriptive; it combines gout and ouch.
A patient with “low blood” has low hemoglobin. Having “sugar” or “sweet blood” refers to diabetes (or as one patient said, the “diabetus” with an emphasis on the us).
Tell a patient he or she is hypertensive and you may get a blank look. However, the patient may relate that “high blood” runs in the family.
On hot days, patients may become dehydrated and “fall out,” or in other words, become “faintified” or have an “acute gravity attack.”
A patient might relate during an acute illness that they are having “banana skin” which is interpreted as acute jaundice.
Ever present are head and body lice, also known as “bugs in the rug.” Rug can also refer to a man’s toupee while “wig hat” is what women wear.
These are just a few gems contributed by advanced practitioners across the country. One of the most striking facts of “patient speak” is the incredibly appropriate descriptive quality of many of the terms. Often, many of us find using “patient speak” a bit more functional than medical language.
Health literacy is a two-way street. Patients need to understand us but equally important is that we understand them. Understanding “patient speak” can add a richness and dimension to our practice that Taber’s Medical Dictionary totally lacks. Plus, patient speak allows us to relate to our patients and they to us.
The authors welcome any additions to our lexicon of “Patient Speak.” Contact them via firstname.lastname@example.org.