Are you now or have you ever been a GOMER?
Has a doctor ever received a Prince of Whales award for treating you?
Perhaps worst of all, are you suffering from FTD?
If the latter, you may need flowers delivered. But right now, in the unsparing language of doctors and other medical people who are supposed to be your caregivers, you are old and terminally ill and, inconveniently, you are Failing To Die.
The Secret Language of Doctors, Dr. Brian Goldman's second book, is disturbing and hilarious, sometimes concurrently. In easy-to-understand language, it unveils scores of clandestine acronyms and caustic phrases -- a private medical language designed to describe and frequently disparage patients and their conditions.
This language is as tightly focused as surgery, and can be just as painful. How hilarious you find it, of course, depends on whether you are one of its many targets.
Goldman, an emergency physician at Mount Sinai Hospital in Toronto and host of White Coat, Black Art on CBC Radio One, demonstrates the widespread use of this vivid language in North America through many interviews, citations from medical journals and quotations from news media.
Not all medical argot is malevolent or even secret. Television dramas such as ER have made Code Blue a widely recognized warning for a cardiac arrest.
Other phrases are easy to decipher: Code Brown, for example. Hints: it flows downhill, and doctors delegate its cleanup as far down the nursing hierarchy as possible.
But much of this language and many of these jokes, some of which Goldman charitably asserts "come from frustration mixed with despair," go unheard or at least unnoticed by patients.
This book could change that. Hospitals are not likely to hand out The Secret Language of Doctors to help pass the time waiting to see a doctor -- but perhaps they should.
The 15 chapters focus on categories of medical language and attitudes. Sample titles: Status Dramaticus (patients who are "irritatingly overanxious in deportment and underwhelming in illness and injury"), Incarceritis (patients in custody will try the craziest stunts to get out of jail) and Cowboys and Fleas (many doctors apparently despise other specialists; surgeons are cowboys, internists are fleas).
Creating some welcome balance, Goldman reports on many compassionate medical practitioners and displays his own enthusiasm for curing patients and keeping them healthy.
"With more than 30 years of practising medicine in my rear-view mirror, I'm still convinced that doctors and other health professionals are among the most ethically grounded people on the planet."
Interestingly, Goldman reveals that his benevolence toward patients has limits. He explains one of the most satisfying elements of his work in Emerg: "My involvement with patients is transitory. When I have a patient who is pushing one of my buttons, I almost always have an out: I can refer that patient to someone else."
He expresses repentance for his own occasional use of doctors' secret language. "Every time I think of the patients I secretly mocked and ridiculed, I feel ashamed."
Could this book be the good doctor's penance?
Though Goldman's news is not all bad, his conclusion to the book is disheartening.
"That the slang I uncovered exists in such volume and is spoken by so many doctors and other health professionals can mean only one thing. If you're old, demented, frail, mentally ill, overly anxious about your health, morbidly obese, addicted, in police custody or if you just call on us too often, we're not keen on having you as a patient."
That would include GOMERs -- patients who should Get Out of My Emergency ward because doctors can't treat what really ails them. They may be frequent flyers who gravitate to the ward for something as basic as companionship.
The Prince of Whales Award? At an unnamed medical school, that annual prize recognized the anesthesiologist who administered an epidural sedative to the fattest woman in labour, according to an anonymous medical resident quoted in the book.
The sexist attitude that underpins much of the nastiness of the secret medical language persists despite the growing percentage of female doctors, Goldman reports.
Perhaps, though, the traditional connection of testosterone and medical hauteur lies behind the only patient-generated acronym mentioned in The Secret Language of Doctors: NMD.
That's the request of a woman giving birth for No Male Doctor.
Duncan McMonagle is a Winnipeg writer and editor with great appreciation for nurses. He is married to one.