Wednesday, August 23, 2017


“Train wreck,” for the uninitiated, is medical slang for a patient with EVERYTHING wrong.

Example: “Mr. Smith in the ICU, room 17, is a train wreck. He has metastatic cancer and advanced renal disease. He was getting dialysis yesterday when he suffered a heart attack and then went into respiratory failure. He’s on a ventilator now, and has developed sepsis.”


One day back in residency we were doing our usual morning rounds, presenting cases to the attending. My friend Zack was telling him about a guy he'd admitted the previous night.

Zack: “Okay, the next one, in ICU room 7, is a train wreck. He…”

Dr. Proper: “NEVER SAY THINGS LIKE THAT! Patients are people, and I don’t want to hear slang! Present the case to me in medical terms."

Zack: “I'm sorry, but I mean…"

Dr. Proper: “STOP! Let’s try this again. Why is the man in room 7 in the hospital?”

Zack: “Um, he was driving his car and was hit by a train."


bobbie said...


Anonymous said...

He could had said the patient experienced a sudden de-acceleration involving a motor vehicle and a train,resulting in blunt force truma.

Jono said...

I actually DID laugh out loud that time. I do feel bad for the patient, though.

Ms. Donna said...

Like bobbie, I am sniggering, but have to agree with Dr. Proper.

was1 said...

sometimes a cigar is just a cigar.

Anonymous said...

"And his name actually is Gomer."

Tarquin "R.J." Toffeebridge V said...

"It was a prophylactic-related injury to the anus sustained during sexual activity, which is why I said the patient was a fucking scumbag asshole."

John Woolman said...

Back in the day, more than1600 days agon now, one the post take ward round, the attending says to the distinctly non-coping gentleman, admitted for the umpteenth time with a minor overdose -"you really have to learn to stand on your own two feet". Resident - "Um, sir, that's his artificial leg under the bed"... Happy days.

Tom Bridgeland said...

We use the phrase 'hot mess' for folks with everything going wrong.

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