Thursday, December 30, 2004


I got an email a few weeks ago from our office manager. I'd seen a patient with pinkeye in her left eye, and on the charge sheet, under "diagnosis," I'd written "Conjunctivitis, O.S."

The email reminded me that O.S. -- short for Oculus Sinister, meaning left eye -- was on the official list of forbidden abbreviations. And word's out that next time the JCAHO inspection team shows up to determine whether the hospital remains up to accredidation standards, sniffing out usage of the forbidden abbreviations will be high on their agenda. So I'd better watch it. And that goes for Oculus Dexter,

and Auriculus Sinister and Auriculus Dexter, as well. No Latin. No abbreviations. It's Left Eye and Right Eye from now on. Got it ?

And why ? The abbreviations are "confusing." Confusing ? CONFUSING ?

A beautiful and evocative bit of historical medical terminology is being jettisoned because of, oh, the RAMPANT ILLITERACY OF MEDICAL PROVIDERS ?????

Oh, dear. Had I become some Mel-Gibson-like, ultra-orthodox, Latin-spouting traditionalist freak ?

Qui tollis peccata mundi, anyhow ?

I calmed down.

Medicine has already ruined the whole left/right thing for me, anyhow. I look at people face to face all day. That's Mr Jones' right eye over there, on the same side as his liver and his right atrium, and that's his left eye over there, along with his spleen and his sigmoid colon. So when I think of my own right hand it feels like it's on on the same side as Mr Jones' left hand, so is it my right or left hand ? And when I'm hugging DK and he says "oh, scratch my back" and then "more to the right !" what the HELL does he mean by that ? My right ? His right ? Which is really my left, isn't it ? But it's his BACK, so doesn't that reverse it ?

Where am I ?

Don't even get me started about the brain's diabolically crisscrossed wiring and confrontational visual field testing.

A med school professor claimed that we habitually chose to sit on either the right or the left side of the amphitheater for neurological reasons. I was a right sider. As I am today, at the movies. My right, that is. Facing forward. Toward the professor. Who was looking back at me sitting on the left side of the hall. Or was he ? Would you turn around for a sec, professor ? And raise your right, no, your left hand ?

It's all a sinister plot.

As a corollary, I realized that, whenever I've shared a bed, I've always slept on the left side. Which, as you face the bed from its foot and point at it, is the right side. But when I lie on my back, my left hand dangles over what must be the left side of the bed. QED ? (Can I still write that ?)

And how does bed side relate to auditorium seating ?

So let's see if I've got this straight: I'm left-of-bed, right-of-hall. Assuming the foot of the bed is where the professor is standing. Assuming he is facing us...

I give up.

So the boys from the JCAHO can scour my charts for OS and OD. I'll show them. I can reform, modernize, get with the program. Bring them on, I say.But if the inspector, deeply impressed by my dextrous avoidance of the forbidden abbreviations, were to give me a congratulatory hug and ask me to scratch his back, a little more to the left please, I, and my hospital would be sunk.

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