January 27, 2007

Lost in Translation

I like to quote movies. The title of this entry popped into my head as I thought about the content of this entry and I think it is especially pertinent.

A lot of people laugh about movie quotes... for me, it is about finding someone else who can recognize what I'm saying and we identify with each other. We make a connection.

This sort of "reference recognition" is the basis for a lot of jokes, even in medical school. I've made very subtle jokes about people being uptight by talking about their colonic tone... a classier version of Wayne's World's "Sphincter says what?" sort of a thing. My classmates get it right away and they thought it was hilarious.

Unfortunately, this sort of joke is hinges on its exclusivity. Only people who understand the reference get the joke. People who need the joke explained to them rarely laugh about it because in the process of explanation, the humor is lost. :) Inside jokes are brutal this way. :-\

Yesterday, my Anatomy professor was talking about raising our hands. She said "From now on, you guys will be thinking in your heads 'Infraspinatus (first 15 degrees), Deltoids!'" The class laughed. I didn't really, because I realized that this was a broader joke than I first realized. Last week, my friends made the exact same joke in reference to suprascapular nerve damage!
"How would you lift your arm if you couldn't move your infraspinatus?!?"
They took turns inventing various methods (all of which looked retarded.) Batting up the arm with a flick of the hip up into the air won first prize. I said 'man, I hope you guys don't crack up when you meet a patient who does the exact same thing!' I meant it in a nice way. Sort of.

The purpose of this joke, of course, was for reference. Now that we laughed about it, we would never forget which muscles ABduct the arm and when they worked.

However... these jokes don't work on the laypeople! A lot of things I find completely hilarious right now wouldn't make any bit of sense to non-medical types.

Even worse, I'm afraid that I'll forget this more and more as I become a doctor. Sarah talked about this earlier today, mentioning how third-years at the homeless clinic were asking their patients if they had "hematochezia," which is basically blood in their stool. "Stool?!?" she added... "they don't even know what stool is!!! Say poop."

A lot of things get lost in translation. For the sake of my future patients though... I'll have to remind myself to become well-versed in cute and poetic analogies to explain things. I've got a few already that I'm awful fond of and I know that they will be more valuable than most of my medical knowledge when I communicate with patients.

It isn't about dumbing down the vocabulary. It isn't about talking down to the patient. It is about effectively communicating with them so everyone is on the same page! They won't tune out the big intimidating words. I'll work hard on giving them just one a session and try to include one analogy or story. I think that this will take me far in translating medicalese into something that is actually INFORMATIONAL.

How cute. I think I started already with this entry. :)

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