I use the word "abort" in my dictations: "Her migraines are aborted by Imitrex" or "He was seen in ER, where the seizure was aborted by Ativan" or "The MRI was aborted due to his claustrophobia".
At least twice a year, most recently yesterday, I get an angry letter or phone call from some patient who is reading my notes on them and becomes incensed over this. They see the word and automatically assume it means they HAD an abortion (No, sir, that is biologically impossible") or that my use of the word is expressing a political viewpoint ("I'm devoutly pro-life! How dare you use that word in a note about me!").
Usually I just explain to them what it means, and send them to a dictionary. It's amazing how many people are stunned to find out it has some other meaning then THAT ONE, and are fine once they realize this.
In spite of this, in the last 10 years I've had 3 patients change neurologists over this issue. Whatever.
Part of being a doctor is respecting your cultural, religious, and political beliefs. That's why I never discuss mine. Words in my notes are just that. Words.
31 comments:
Education. That thing where you go to school and read and learn words, but they call it "vocabulary." Also they teach how to put words together in a good way, like sentences. Sometimes ppl evn lrn how 2 spell.
Were these 3 people simply offended by the word "abort". Or are they just too stupid to know that it can be used in different ways? These people need to get a life (no pun intended).
Though it's upsetting when someone decides not to like you over a misunderstanding (or stupidity) on their part, I suppose you can be happy to let those patients go.
Good riddance. Go torment someone else.
Another part is a grasp of the English language. Amazing how many people have never heard of a thesaurus.
Also, I think people are just looking for a fight. Perhaps they just aren't feeling too strongly about what they thing and therefore need to validate their beliefs in any miniscule way possible.
Interesting topic.
-Flavius
Kinda crazy. People need to get acquainted with this book that has the word dictionary written on it. I am not a native speaker (of English) but I still know that '(to) abort' is not just used for embryos and fetuses. Some people really get upset for no reason.
Suggest you substitute "terminate" for "abort". It's a "nicer" word that means the same.
"The seizure was flaccidly aborted with Ativan, leaving the patient limp and spent."
"Patient was evaluated for stroke; when asked to lift left arm he could not get it up."
You could have so much fun with this. ;)
in therapy notes, we frequently write that the informant "denied a history of ______." this indicates that we asked and they said no. as a result, i have had more than one person infuriated with me because they think my reports are filled with implications that they are lying.
The change in the word abort to the more common meaning is part of the "euphamism treadmil." Here's a quote from an article I just read:
"Abortion originally meant premature birth, and came to mean birth before viability. The term "abort" was extended to mean any kind of premature ending, such as aborting the launch of a rocket. Euphemisms have developed around the original meaning. Abortion, by itself, came to mean induced abortion or elective abortion exclusively. Hence the parallel term spontaneous abortion, an "act of nature", was dropped in favor of the more neutral-sounding miscarriage."
A lovely article about all euphamisms can be found on Wikipedia!
I've had a similar problem when I've used the word prophylaxis.
Amazing what people choose to get all worked up over. Explaining probably doesn't help much. Not like you're dealing with mental giants to begin with.
Try to do ER and have to give out the "spontaneous abortion" pre-printed discharge instructions after a patient miscarries.
At my pharmacy, the prescription labels have all the pharmacists initials that dealt with the script printed on it. At least once a month, someone accuses us of putting "codes" on their bottle that we use to label them as problem patients. I guess they haven't figured out we really put microchips in the capsules so we can track them with GPS.
So you've had to abort your doctor-patient relationship with three people over this so far? Can I have their Imitrex?
Bored Mum- Yes. I used to use the phrase "migraine prophylaxis" to mean meds to prevent migraines.
But due to insane patient complaints, and even a few insane doctors, I've had to change it to "preventative medication".
these people should get onto NASA as well with all their aborted missions! in fact their new alternative escape system is called Max Launch Abort System (MLAS).
I have to say, despite being an English professor who knows the varied meanings and contexts for the word, it didn't feel good when I had my second miscarriage and saw "habitual aborter" written on my chart. My mother-in-law still remembers having a miscarriage and a nurse walking in her hospital room saying, "Are you the one who had the abortion?" . . . and she didn't know there was any other meaning. I would never complain, though; I know it's only terminology When it comes to migraines, I really don't see why anyone would respond in that way.
X2 on Nurse K's comment.
Credit Mark Twain with this astute observation that seems to apply here: The trouble ain't that there is too many fools, but that the lightnin' ain't distributed right.
Giant speculums, abortions... what kind of Neuro are you, Doc? ;)
What's the deal with prophylaxis? I've never come across that one (misunderstanding, I mean)?
So when your 3 patients watch movies with military personnel who scream "Abort! Abort!", they think there's someone there about to terminate a pregnancy on TV?
I had a similar experience during A & P II class last year. The Professor was explaining a disease that could cause spontaneous abortion and used that exact term to describe it. One of the nursing students, raised her hand and when called upon, asked him if he would use the term miscarriage instead. He then proceeded to explain, not so kindly, that the term abortion IS the appropriate term and miscarriage is not. He also told her to grow a thicker skin if she wanted to be a successful nurse because she actually wanted to argue the point with him that, "no, abortion is not a medical term." I just chuckled and enjoyed the show.
It's unbelievable. One of the causes of my dearly loved father in law was "exacerbation of prostate cancer". The ruddy registar's office (when births deaths and marriages are reported in the UK)did not know the meaning of the word "exacerbate" and refused to believe me when I said it meant "worsening". Nor did they have a dictionary in the office!. We waited three hours in a blazing hot office with two toddlers before they found a senior registrar who said that my definition was correct. Arrrghhhh!!!!
I think there are people around who think solely in emotions, and use words that to them convey specific emotions. The trouble comes when speaking with other people who understand critical thinking, and that words are just words.
Also, imagine doing optho, and having to deal with 'oculus dexter' versus 'oculus sinister' all day.
Yes I've had several people who come in for an ultrasound with an order from their doctor with the diagnosis "spontaneous abortion" and have the patient clarify that they aren't having an abortion, but a miscarriage. That's when I like the doctors that will just write "SAB".
Next time, use the word niggardly in a dictation. That'll go over real well.
You should try explaining an "abortion storm" to a farmer some time.
In the early 80s I had a co-worker - devoutly religious - who was offended by the word "abortion" - didn't matter that we were using it in an IT environment - ie - the program aborted. We explained. She was still offended. We ignored her. She got over it.
I was in a pediatric patient's room today with my attending and told her that my patient's knee looked inflamed. Or inflammation. Whichever word.
Patient's lovely father screamed that there is no chance that his son is gay and my towel head was never to come back into his room.
I should be offended, but really, I'm more amused by the situation.
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