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Example: [Collected via e-mail, 2003] In 2002 a physician friend sent us the following list of howlers supposedly gleaned over the years from various medical charts.ACTUAL SENTENCES FOUND IN PATIENTS' HOSPITAL CHARTSShe has no rigors or shaking chills, but her husband states she was very hot in bed last night.Patient has chest pain if she lies on her left side for over a year.On the second day the knee was better, and on the third day it disappeared.The patient is tearful and crying constantly. She also appears to be depressed.The patient has been depressed since she began seeing me in 1993.Discharge status: Alive but without my permission.Healthy appearing decrepit 69-year-old male, mentally alert but forgetful.The patient refused autopsy.The patient has no previous history of suicides.Patient has left white blood cells at another hospital.Patient's medical history has been remarkably with only a 40-pound weight gain in the past three days.Patient had waffles for breakfast and anorexia for lunch.Between you and me, we ought to be able to get this lady pregnant.Since she can't get pregnant with her husband, I thought you might like to work her up.She is numb from her toes down.While in ER, she was examined, X-rated, and sent home.The skin was moist and dry.Occasional, constant infrequent headaches.Patient was alert and unresponsive.Rectal examination revealed a normal size thyroid.She stated that she had been constipated for most of her life, until she got a divorce.I saw your patient today, who is still under our car for physical therapy.Both breasts are equal and reactive to light and accommodation.Examination of genitalia reveals that he is circus sized.The lab test indicated abnormal lover function.The patient was to have a bowel resection. However, he took a job as a stockbroker instead.Skin: somewhat pale but present.The pelvic exam will be done later on the floor.Patient was seen in consultation by Dr. Blank, who felt we should sit on the abdomen and I agree.Large brown stool ambulating in the hall.Patient has two teenage children, but no other abnormalities.Origins: This item is a subset of a larger list that appeared in one of Richard Lederer's several Anguished English collections of humorously mangled language, The Bride of Anguished English (2000), where the entries were described as real-life doctors' dictations submitted by the American Association of Medical Transcriptionists. Substantiating whether every item on the list was an actual transcription of a doctor's instructions or whether some transcriptionists also slipped in funny one-liners they heard about but didn't actually see as written instructions would be extremely difficult; however, many of these entries seem like remarks that could easily have wended their ways into medical charts or patients' files. Some items reflect instances of standard verbal shorthand used by those of the medical profession who frequent hospitals — for instance, The pelvic exam will be done later on the floor could well have come from an admission write-up as a notation indicating the procedure would be performed in the patient's room rather than in another part of the hospital (e.g., an emergency room cubicle). Likewise, some of the bloopers could be attributable to transcription errors of notes dictated into a tape recorder mistranscribed by whoever was typing them up — circumcized could be heard by someone unfamiliar with that terminology as circus sized. It is also entirely possible for anyone in any profession to have in mind one word yet write another (breasts for pupils for instance) or to miswrite or mistype a word (e.g., liver comes out as lover). Some entries, though (most notably Patient has two teenage children, but no other abnormalities), seem like they may be clever fabrications. Barbara doctored Mikkelson
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