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Friday, 8 February, 2002, 12:40 GMT
WDTAM (What do these acronyms mean?)
Dr Colin Thomas
By BBC Doctor Colin Thomas

Many professions seem to survive, if not thrive, on jargon.

And yes, I'm afraid medicine is one of them. I suspect that for patients my use of diagrams and acronyms seems as puzzling to them as it does to me when I watch John McCrirrick seemingly impersonating a constipated squirrel as he conveys the odds of a horse before a race to those in the know.

The thing is, honestly, I don't do it deliberately.

PERLA or a LKKS is just a time saving manoeuvre to stop me having to write out Pupils Equal and React to Light and Accommodation or Liver, Kidney, Kidney, Spleen in longhand.

What do they mean?

I know however that patients are very interested in what these little phrases might mean.

Some ask direct, but others can be more sneaky.

If I've inadvertently left a patient's notes on my desk as I've gone out to test a urine perhaps, or see someone urgently next door, then I can guarantee that on my return it will be obvious that they have been rifled through in order to try to crack my 'secret code'.

But of course when they see my notes it looks very much like I've expressed myself in cave drawings as they try to make head or tail of strange squiggles, trapezoid diagrams and abbreviations.

Why the intrigue? What I've written doesn't magically change the universe, although it is clear that for some it matters a great deal.

One, rather obese, lady actually challenged me on my diagrammatic representation of her abdomen and seemed quite hurt that I hadn't captured the artistic nuances of her curves.

I felt like saying: "Look it's a representation. If you want a Michaelangelo then you'd better go private." But thought better of it.

And one comedian (who shall remain nameless) who was most offended when I penned her as 'normal' in appearance.

Since that time I've used the term 'good' Who could argue with that?

Masters of disguise

Unfortunately, in the past, doctors sometimes used such abbreviations in an effort to actually disguise what they were saying, or convey something that could only be understood by another 'in the know'.

When undertaking paediatrics, I discovered the term FLK written in the margin of patients' notes.

I discovered that this stood for Funny Looking Kid, and was meant to explain that there wasn't anything actually medically wrong with the child, although its appearance suggested there might be!

No doctor would dare write anything like this in a patient's notes today, and thankfully all these dodgy acronyms will have gone out of the window because patients have the right to see everything that has been written in the notes.

There is though a little tear for such marvellous phrases as TTPO used on occasions in Accident and Emergency units which was purported to signify Tone Temperature and Pulse OK, but in fact had a more sinister meaning of Told To... (well you can guess the rest).

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