Intended for healthcare professionals

Mixed Messages

Pimp my slang

BMJ 2007; 335 doi: (Published 20 December 2007) Cite this as: BMJ 2007;335:1295
  1. Paul W Keeley, consultant
  1. 1Department of Palliative Medicine, Glasgow Royal Infirmary, Glasgow G4 0SF
  1. paul.keeley{at}

    Struggling to understand what your colleagues are saying? Paul Keeley provides a guide to some medical neologisms

    One of the principal virtues of English is its malleability and easy incorporation of new words, and new meanings for old ones. The language has been constantly changing, enriched by each wave of immigration and by exposure to other languages, most notably during the days of the British Empire.1

    The rate of change has accelerated recently with the advent of electronic media. Coupled with this has been the development of urban slang, tracked by online publications such as the Urban Dictionary2 New terms can be derived from existing words or from popular culture (especially film, television, and the internet). Just as doctors need to familiarise themselves with new words arising from new concepts and technologies they need to keep up with changing usages and slang.

    But it can be hard,3 particularly for those who don’t recognise the references. Here is a small selection of new terms in current use. I would be delighted to hear of more. (No personal inventions, please.)

    404 moment

    The point in a ward round when-despite all efforts to look through the notes or access electronic systems-a particular result cannot be located. (From the world wide web error message “404 document not found.”)


    The pleasantly decorated and furnished palatial offices of trust management or the dean.


    The flurry of pointless emails and paperwork that emanate from the adminosphere.


    The (usually vain) attempt to answer the question, “How long have I got, doc?”


    A session of mutual recrimination during which a multidisciplinary team attempts to apportion blame for some particularly egregious error.

    Disco biscuits

    E, ecstasy, or methylenedioxymethamphetamine (MDMA) - a class A drug under the Misuse of Drugs Act 1971. Commonly used as a recreational drug by clubbers. An emergency doctor might say: “The man in cubicle 3 looks like he’s taken one too many disco biscuits.”

    Father Jack

    The confused, usually elderly patient whose constant high pitched verbal ejaculation and attempts to get out of bed are responsible for insomnia on wards. (From a character in the television series Father Ted, who would sit in the corner of a room shouting “Drink,” “Feck,” “Arse,” etc.)


    A middle grade doctor seemingly unflappable in any medical emergency. Based on the character Arthur “Fonzie” Fonzarelli from the American sitcom Happy Days. The allusion is to a conversation in the final scene of the Quentin Tarantino film Pulp Fiction:

    Yolanda: You don’t hurt him!

    Jules: Nobody’s gonna hurt anybody. We’re gonna be like three little Fonzies here. And what’s Fonzie like? Come on, Yolanda! What’s Fonzie like?

    Yolanda: Cool?

    Jules: What?

    Yolanda: He’s cool.

    Jules: Correctamundo! And that’s what we’re gonna be. We’re gonna be cool.


    A combination of broad spectrum antibiotics, thiazide diuretics, and nebulised bronchodilators (with or without corticosteroids) prescribed to elderly patients admitted to UK hospitals between October and March.


    A patient presenting to accident and emergency with an injury with a bizarre explanation. (After the former Baywatch actor David Hasselhoff, who suffered a freak injury when he hit his head on a chandelier while shaving. The broken glass severed four tendons as well as an artery in his right arm, which required immediate surgery.4)

    It’s like . . .

    The opening words of every medical or nursing student sentence. Just ignore.

    Jack Bauer

    A doctor still up and working after 24 hours on the job—now something of a rarity but will be recognised by older clinicians. Usually a bit tetchy:

    Colleague: Going for lunch, Jack?

    JB: (shouts) “THERE ISN’T TIME!”

    (From the lead character in the television series 24.)]


    The lateral movement of the head to an angle of 45° to the vertical by a palliative care nurse specialist. It is intended to convey sympathy and understanding. (Mac from Macmillan nurse—a specialist palliative care nurse—and tilt.)

    Mini me

    A trainee or medical student who emulates their senior colleague a little too much but doesn’t say a lot. Can be very annoying. (From the character in the Austin Powers films.)


    Expendable member of a team. (After Ringo Starr, drummer with the Beatles. John, Paul, and George went on to successful solo careers. Ringo did the voiceover for Thomas the Tank Engine.)

    Search and rescue

    The medical middle grader allocated to look after the patients dotted in non-medical wards.


    The holding forth with expressive hand gestures by a consultant on a subject on which he or she has little knowledge. (Concatenation of testicle and gesticulate.)

    Ward 101

    The source of referrals that fills the recipient with dread. (From room 101, which contained all the deepest fears of the protagonist in George Orwell’s novel 1984.)


    • Competing interests: None declared.

    • Provenance and peer review: Not commissioned, not externally peer reviewed.


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