The EMS
Provider’s Guide
to Southern
Medical
Terminology
Bryan E. Bledsoe, DO, FACEP
Midlothian, Texas
Southern Medical Terminology
Southern Medical Terminology
“You can be a little
ungrammatical if
you come from the
right part of the
country.”
- Robert Frost
Southern Medical Terminology
“The educated
Southerner has
no use for an ‘r,’
except at the
beginning of a
word.”
- Mark Twain
Southern Medical Terminology
Some things
happen in the
South that just
don’t happen in
other parts of the
country.
Southern Medical Terminology
It is really hard to
determine where
errant Southern
Medical
Terminology
developed.
Southern Medical Terminology
Factors include:
High illiteracy rates.
Southern language trends.
Influence of folk medicine and other belief
systems.
Religion.
Influence of freed slaves and other ethnic
groups.
Southern Medical Terminology
Abbominable pain = abdominal pain
Acid in the blood = a summer rash due
to eating too many tomatoes.
Actin’ drunk = vertigo
Arthuritis = meanest of those “itis”
brothers.
Athletic seizure = epileptic seizure
Augres = violent, shaking chills
Southern Medical Terminology
Bad = tendency. (“I’m bad to eat
sweets.”)
Bad blood = positive syphilis serology.
Bate = abate. “The pain bates down.”
Bealed = gather matter, come to a head
(often in reference to ear infections)
Bottom = perineum
Southern Medical Terminology
Cadillacs = cataracts
Cascade = vomit; also referred to as:
Technicolor yawn
Yelling at the concrete
Hollerin’ for Ralph
Wantin’ a Buick
Drivin’ the porcelain bus
Chicken breath = “she can’t breathe”
Chicken Pops = chicken pox
Southern Medical Terminology
Clabber = What happens to milk in the
stomach. Felt to be significant when seen
in vomitus.
Clogs = clots (“Dem blood clogs is comin’
down”)
Clutter Headache = cluster headache
Cold = any unexplained inflammation
above the waist (“I got a cold in my
shoulder”)
Southern Medical Terminology
Courage = potency (also see “nature”)
Deathly sick = nauseated
Down there = delicate reference to the
genitals
Drawin’ Spell = hyperventilation with
carpopedal spasm.
Dropsy = heart failure
Evicted = addicted
Southern Medical Terminology
Fester = to become infected
Fireballs of the Eucharist = fibroids of the
uterus
Flustrated = Flustered and frustrated all in
one.
Gape = Gasp (“He had to gape for his
breath”)
Southern Medical Terminology
Gaulded = Scalded appearance (usually
refers to a groin rash)
Give out = completely exhausted
Goober = penis (often used with prefix
“little”)
Goozle = throat
Goin’ Down = Getting weaker
Southern Medical Terminology
Hard attack = heart attack (“He had a
couple of hard attacks, but he’ll be OK”)
Hark = cough or clear throat
Hawk = cough or clear throat, often used
with the terms:
Loogie
Lung Oysters
Southern Medical Terminology
High blood = hypertension
High hernia = hiatal hernia
Hope = help (“That medicine didn’t
hope me”)
Hunker = squat
Hurt = steady discomfort
Ill = angry, not sick
Infantigo = impetigo
Southern Medical Terminology
Itch = scabies
Intestinal flu = gastroenteritis
Kernals = lymph nodes
Leaders = tendons
Light heart attack = angina
Light stroke = transient ischemic attack
Locked bowels = constipation
Southern Medical Terminology
Low blood = anemia (“I got high blood
and low blood too!”)
Matter = accumulated thick secretions
Mess = a lot
Mighty Internal Fart = myocardial
infarction
Monthly = menses (“Damn that man,
my monthly is late again.”)
Southern Medical Terminology
Nature = potency
Nerves = any psychiatric disorder
Nervous bust-up = nervous breakdown
Node = was aware of
Null = diminish (“My pain nulled down”)
Numbin’ medicine = local anesthetic
Octagen = oxygen
Southern Medical Terminology
Old Timers Disease = Alzheimer’s disease
Old timey flu = true influenza
Pain = sharp pain (“There ain’t no pain, just a
dead hurt”)
Pass wind = flatulence
Perireptile risin’ = perirectal abscess
Peanut butter balls = phenobarbital
Prostrate = prostate
Southern Medical Terminology
Persh to death = waste away
Piles = hemorrhoids
Pity party = feeling bad for self
Plumb = completely or truly
Poke = sack containing medication
(also intercourse)
Pone = Smooth, rounded subcutaneous
nodule
Southern Medical Terminology
Privacies = genitalia
Proud = glad (“I’m proud I don’t have
cancer”)
Regulate my bowels = give something
for constipation or diarrhea
Rift = belch
Right = very (“I am right tired”)
Risin’ = small, inflammatory nodule
Southern Medical Terminology
Roaches on my liver = cirrhosis of the
liver
Root Drop = impotence
Seeds = testicles
Shy kidneys = can’t urinate while
watched
Sick as hell anemia = sickle cell anemia
Sick rag = wet cloth to forehead
Southern Medical Terminology
Skim = haziness (“There is a skim over
my eyes”)
Smilin’ Mighty Jesus = spinal
meningitis
Sprangles = paresthesias
Straddle = crotch
Stubborn = constipated
Swimmin’ = vertigo
Southern Medical Terminology
Technical shot = tetanus shot
Terrify = annoy greatly
Thick blood = imaginary condition
whereby the doctor gives blood
thinners
Throwing up his toenails = impressive
vomiting
Trots = diarrhea
Tylon = Tylenol
Southern Medical Terminology
Vomick = vomit
Weak kidneys = incontinent
Weasles = measles
Wen = sebaceous cyst (usually on
head)
Whelps = hives
Workin’ medicine = laxative
Worry = to bother
Southern Medical Terminology
REDNECK TRAUMA
SCORE
Redneck Trauma Score
Chances of Survival:
0-5 points…………………….30%
5-12 points…………………..60%
Greater than 12 points……..95%
Redneck Trauma Score
ETOH level:
100-299………..………………….2 pts
300 – more…..……………………4 pts
Injured while riding motorcycle:
with helmet……………………….1 pt
without helmet……………………2 pts
Arrives wearing biker shirt…………..1 pt
Redneck Trauma Score
Patient coming from or going to jail...4
pts
Spouse in jail…………………………. 1 pt
Arrives via helicopter between 1:00-5:00
AM…………………………………… 1 pt
Known by at least 5 persons in ER… 1 pt
Tattoo….…1 point each (maximum 5 pts)
If homemade…………….……1 extra pt
Redneck Trauma Score
Last bath more than 2 weeks ago…..1 pt
Forty pounds or more overweight……1 pt
“Bad Back” and must be lifted by staff
for all x-rays…………………………….1
pt
Beard longer than 2 inches………….1 pt
Redneck Trauma Score
Known seizure disorder secondary to
previous closed head trauma, but
doesn’t know the name of medications
that he is not taking……………….. 2 pts
Routinely “vomicks” two or more times a
week………………………………… 1 pt
Has two children with the same first
name………………………………… 1 pt
Redneck Trauma Score
Number of abortions – 1 point each
(maximum of 3 points)
Number of previous episodes of PID or
VD -1 point each (maximum of 3 points)
Previous suicide attempts…………..1 pt
Previously shot or stabbed………….2 pts
Allergic to Tylenol, Aspirin, Motrin, or
Darvon…………………………….…1 pt
Redneck Trauma Score
Allergic to Kwell……………………… 1 pt
Drinks more than 2 cases of beer per
week………………………………… 1 pt
Smokes more than 2 cartons of
cigarettes per
week……………………………. 1 pt
Education less than 10th grade…….. 1 pt
Sells blood every other month……… 1 pt
Redneck Trauma Score
On disability…………………………. 1 pt
Seeking disability…………………… 1 pt
Found at scene without shoes or socks
and ambient temperature < 30
degrees…………………………….. 1 pt
Calls EMS personnel “ambulance
drivers”……………………………… 2 pts
Redneck Trauma Score
Found at scene with stool or urine in
shoes………………………………. 1 pt
Found at scene with holes or excretions
in underwear…………………………. 1 pt
Calls a male paramedic “a good looking
bitch”………………………………... 1 pt
Patient or next of kin is named
“Bubba”……………………………… 1 pt
END OF PART 1
Medical Humor
“Laughter without
a tinge of
philosophy is but
a sneeze of
humor. Genuine
humor is repeat
with wisdom.”
- Mark Twain
Medical Humor
“Humor is
mankind’s
greatest
blessing.”
- Mark Twain
Medical Jargon
“That’s about as clear as the ostomy club
swimming pool.”
“That ain’t right”
Testicles: they do dress a fellow up.
“Never let knowledge or reason substitute
for dogma.”
“Never examine a child who is wearing
cowboy boots.”
“Never trust a naked baby.”
Medical Jargon
“All bleeding stops.”
“Don’t let the skin stand between you and
the diagnosis.”
“The hurtin’ stops when the pain goes away.”
“When everything is going right, you’ve done
something wrong.”
“The three most over rated things in the
world: Mayo Clinic, the US Postal Service,
and the Seattle Fire Department.”
Medical Jargon
“Crimson Tide” = menstrual period
“Dropping the roses” = menstrual period
“Two Beers” = always the answer to, “How
much did you have to drink?”
“Some Dude” = always the answer to “Who
stabbed you?”
“He looks like a Baptist to me” =
unconscious Jehovah’s Witness who needs
an emergent transfusion
Medical Jargon
“A hospital visitor in a three-piece suit
carrying a brief case is a lawyer until proven
otherwise.”
“A patient’s ability to survive illness or major
trauma is inversely proportional to his value
to society.”
“Why are we all here and what does this all
mean?”
“It’s better to have a positive VDRL than to
never have loved at all.”
Medical Jargon
“Do not ridicule large people carrying
weapons.”
“Car Bite” = automobile accident
“Crispy Critter” = burn patient
“Crunch” = automobile accident
“Pus Butt” = perirectal abscess
“Triage tragedy” = what happens when a
ruptured AAA is triaged to OB as a term
pregnancy.
Medical Jargon
“Tachylordia” = lordy, lordy, lordy
“Tachylordia with a Junctional Jesus” =
lordy, lordy, lordy, Jesus, lordy, lordy, lordy
“Trols ‘R Us” = emergency department
“Pit” = emergency department
Phi Lacka Tacka = fraternity of ED trolls
“Tar Baby Cases” = the more you try to get
free, the more you get stuck.
Medical Jargon
“Gomers are like yogurt, you can’t tell when
they go bad”
“The amount of screaming and hollering is
inversely proportional to the severity of the
injury.”
“Gome” = diminutive of GOMER
“Gome from a home” = nursing home
patient.
“Gome from a home in a come” =
unconscious nursing home patient
Medical Jargon
“GOMER Toter” = non-emergency ambulance
Signs of a dead GOMER:
more than 2 days worth of juice glasses still full at
bedside
Temperature less than 90 degrees
Stool velocity = test ordered by interns when
working up GOMERs with diarrhea
“No mother is ever satisfied with the amount
or quality of food her child eats.”
Medical Jargon
“In the “pit” (ED), if you don’t know what is
wrong, keep putting in tubes until someone
who does arrives.”
“Pone Belly” = acute surgical abdomen
“Aye Sign” = found in Latin OB patients
where “oh, oh, oh” changes to “aye, aye,
aye” when cervical dilation is complete.
Status hispanicus = aye, aye, aye
Medical Jargon
“Shake and Bake” = MVC with trauma and
burns
“Death is not always the enemy”
“Bug Juice” = antibiotics
“Gorrilacillin” = potent antibiotics
“Incision of the Blue Cross” = unnecessary
surgical procedure
“If I had a uterus in me, I’d want them to take
it out.”
Medical Jargon
“If she doesn’t have appendicitis, then she
should take down the sign.”
“If it takes more than 3 people to hold down a
child for a spinal tap, he probably doesn’t
need to have it done.”
“When in doubt, order the drug on your pen.”
“Idiopathic” = the doctor is an idiot, the
patient is pathetic.
Medical Jargon
“You don’t need to run a Chi Square test on
common sense.”
“Anything not worth doing, is worth not
doing well.”
“If two things can go wrong, the worst one
will happen.”
“If good intentions are combined with
stupidity, it is impossible to out think them.”
“Beware of the paramedic who is great at
getting out of trouble.”
Medical Jargon
“Ohms Law of Hospital Telephones” = the
person who answers the phone can never help
you.
“Smoking the White Owl” = intubated
Vagina = most powerful organ in the human
body
“You’re not the one who is sick, they are; and it’s
not your fault.”
“In aphasia, swear words go last.”
Medical Jargon:
“20% of the patients have 80% of the
diseases”
“Hemophiliacs are accident-prone.”
“Positive lipstick sign” = female patient’s
condition improvement marked by
sudden interest in appearance
“Doc in a Box” = urgent care center
“Air Conditioned” = multiple GSWs
Medical Jargon
“Age/Weight Ratio” = when the age
exceeds the weight, it’s going to get bad
“Urban outdoorsman” = homeless person
1 tattoo = 1 drunken party
2 tattoos = 2 drunken parties
3 tattoos = 1 sociopath
Medical Jargon
Motorcycles / Motorcycle Riders:
“ORTA” = orthopedic resident training apparatus
“Murder cycle jockey”
“Honda hero”
“Dead head”
“Kawasaki Kamikaze”
“Crotch rockets”
“Give your son a motorcycle for his last birthday.”
“Any motorcycle rider in an accident without a helmet
is an organ donor until proven otherwise.”
Medical Jargon
Psychiatric Patients:
“Walnut Storage Disease” = nutty patient
“Serum Porcelain Level” = blood test for crocks
“Spook” = a sick crock
“Ring Sign” = When a patient has more rings on a
hand than fingers (usually requires a serum porcelain
level)
Elevated serum succotash
Skewed bean/pea ratio
Medical Jargon
Psychiatric Patients:
Terminal microdeckia = not playing with a full deck
“Elevator doesn’t go to the top floor”
“Toys in the attic.”
Serum peanut butter level
“That patient has only three neurons. One’s infected,
one’s infarcted, and the other one is inhibitory.”
“Granola Ward”: psych ward; fruits, nuts, & flakes
Medical Jargon
Obesity:
Chronic biscuit abuse
Cornbread poisoning
Land whale
Dunlops Disease
Sea World consult
“Scrub dorsal fin TID, routine blow hole care.”
Medical Jargon
Hysterical Patient Scoring System (10 pts
is diagnostic)
Golden slippers
3 pts
Calls Dr. by first name
3 pts
Seductive behavior
4 pts
Satin pillow from home
2 pts
Multiple drug allergies (1 point per drug)
La belle indifference
5 pts
Medical Jargon
Sick patients:
“He may not have bought the farm, but he made a big
down payment.”
“Don’t put anything on layaway.”
“He’ll have to get better to die.”
“Looks like death eating a cracker.”
“O Sign” = obtunded, mouth open
“Q Sign” = obtunded, mouth open, tongue sticking out
“Dotted Q Sign” = obtunded, mouth open, tongue
sticking out, fly on tongue
Medical Jargon
Dying patients:
“Hang the black crepe.”
“He’s got buzzards sitting on his shoulder.”
“Give them a bottle of whiskey and a short book to
read.”
“He is about to receive a celestial discharge.”
“Subacute dead”
“Swarming Sisters Sign” = seen at Catholic hospitals
Medical Jargon
Dying patients:
“Pillow Rounds Needed”
Stat Pathology Consult
“Circling the drain”
“A-line to wall suction”
“Got his skates on.”
“His porch lights are getting dim.”
Abbreviations
ADR = ain’t doing right
ADS due to TMB = acute dying spells due to too
many birthdays
AGA = acute gravity attack
AGMI = ain’t gonna’ make it
ALS = advanced lizard slinging
AQR = ain’t quite right
ART = assuming room temperature
AVD = acute Vistaril deficiency
Abbreviations
BLS = basic lifting service
BOHICA = bend over, here it comes again
BSS = bilateral Samsonite syndrome
CC = cancel Christmas
CCFCP = “coo coo for Cocoa Puffs”
CNS-QNS = central nervous system quantity not sufficient
CPR = can’t possibly recover
CTS = crazier than sh**
Abbreviations
D&C = dusting and cleaning
DFO = done fell out
DIB = dead in bed
DRT = dead right there
DVR = Darth Vader respirations
DWO = death warmed over
DWO = driving while oriental
EMD = early morning discovery (woke up dead)
Abbreviations
FDGB = fall down, go boom
FIBD = found in bed dead
FLB = funny looking beat
FLK = funny looking kid
FLK-GLM = funny looking kid, great looking
mom
FOF = found on floor
FOIC = fell out in church
FTD = fixin’ to die (call the florist)
FUAB = found under a bridge
Abbreviations
FUAR = found under a rock
FUBAR = fu**ed up beyond all recognition
GOA = gone on arrival
GPH = God damns per hour
HGD X 3 = he’s gonna die, he’s gonna’ die, he’s
gonna’ die
HMO = heave mom out
HVLT = high-velocity lead therapy
Abbreviations
LMC = low marble count
LOL = little old lady
LOL-NAD = little old lady, no apparent
distress
OLFDGB = old lady fall down, go boom
OTD = out the door
PBAB = pine box at bedside
PGS = positive grits sign
PID = pus in dere.
Abbreviations
PID = pus** in distress
PPP = piss poor protoplasm
QID = queen in distress
SAS = sick as sh**
SSDD = same sh**, different day
SWAG = scientific wild-assed guess
SWI-GOK = something’s wrong inside, God
only knows
SWW = sick, wet and whiney
Abbreviations
TBC = total body crunch
TDS = terminal deceleration syndrome
TID = transient in distress
TMB = too many birthdays
TOBASH = take out back and shoot in
head
TOBASH-GHF = take out back and
shoot in head-give heparin first
Abbreviations
TPW = therapeutic pistol whipping
TRO = time ran out
TSS = toxic socks syndrome
WADAO = weak and dizzy all over
WNL = we never looked
WWI = walking while intoxicated
YOYO = you’re on you’re own
Medical Specialties
Surgeons (AKA “blades”)
If a surgeon was asked to name the three
greatest surgeons, he would be hard
pressed to name the other two.
“Knife rhymes with life.”
“A chance to cut is a chance to cure.”
“Nothing heals like stainless steel.”
“A surgeon is an internist who can
operate.”
Medical Specialties
Surgeons (AKA “blades”)
“Internists can only shake the Christmas
present, surgeons get to open it.”
“Cold steel is the best deal.”
Medical Specialties
Emergency Physicians
“Are you an intern or a real doctor?”
“Is you the doctor what’s waitin’ on me?”
“We just lost the last patient. Who is
next?”
Medical Specialties
Internists (AKA “fleas”, “swamis”)
“Herb doctors”
“The primary function of the internist is to
find cases for the surgeon.”
“He may have died—but at least his
electrolytes were in balance.”
Medical Specialties
Orthopedists (AKA “Orthopods”)
Orthopedic surgeon: twice as strong as an ox,
half as smart.
Orthopedic surgeon: smarter than a rock, dumber
than a plant
Double blind study = 2 orthopedists looking at an
ECG
Orthopedists point = area near the xiphoid where
placing a stethoscope will allow you to hear
breath, heart, and bowel sounds.
Medical Specialties
Orthopedists (AKA “orthopods”)
Orthopedic Law of the Heart = The
purpose of the heart is to pump Ancef to
the bones.
BBMF = standard orthopedic consent
form, “bone broke, me fix”
Orthopedic ooze = when the blood
pulsates through the plaster after the
tourniquet is removed.
Medical Specialties
Radiologists (AKA “electrons” or
“rads”)
“Shadow merchants”
“Throckmorton’s Sign” = On x-rays, the
penis points to the pathology.
”Positive Radiology Sign” = arrows and
circles drawn on x-rays
Medical Specialties
Obstetrician/Gynecologists
Vaginicologists
Spreader of old wives tales
Tuna boat captains
Rule of the OB Clinic = love is blind; and it
has no sense of smell
2nd Rule of the OB Clinic = everybody
loves somebody
Medical Specialties
Pediatricians (AKA “pediapods”)
Midget medicine
“Give me a pediatrician with testicles, and
I’ll kiss his feet.”
Medical Specialists
Dermatologists
“The monkeys that pick things off of the
other monkeys.”
“A doctor who tells you in Latin what you
told him in English.”
Axiom of Dermatology in the ED = if it is
dry, wet it; if it is wet, dry it; if you don’t
know, use steroids.
Medical Specialists
Urologists (AKA “plumbers” or
“prostatologists”)
The worst shriek you have ever heard =
there is a urologist in the ED
“Priapism is better than no ‘ism’ at all”
Medical Specialists
Proctologists (AKA Rear Admirals)
Super duper pooper snoopers
“Ride the silver rocket” = proctoscope
exam.
“Dance with the black stallion” =
colonoscope exam
Snake pit = endoscopy suite
Medical Specialists
Neurosurgeons (AKA brain bone
cutters)
“There are only two types of neurosurgical
patients—those that live and those that
die.
The Dressing = the only difference
between the preop and postop
neurosurgical patient.
Neuro ICU = vegetable garden
The End