Many years ago I was asked to speak on something “funny” at an EMS conference in Biloxi, Miss. Now, I am not like Steve Berry. I don’t go to sleep and wake up thinking funny things. In fact, most humans are not like Steve Berry but that is another story. So, I developed a talk entitled, “An EMS Provider’s Guide to Southern Medical Terminology.”

The talk was well-received, and when I left the convention center, I had numerous pieces of paper contributed by audience members that contained other similar terms and phrases unique to the South. I never intended to give the talk elsewhere. But, begrudgingly, I agreed to give it in New Hampshire. To my surprise, those Yankees in New Hampshire laughed harder than the people in Biloxi, and I again left with several pieces of paper with new phrases for my lexicon.

I eventually gave the talk throughout the United States and once in Canada. It always goes over fairly well, except I occasionally upset one of the church ladies in the crowd. I have to be careful because some terms alright, most terms are not politically correct.

This month I thought I would lighten things up and detail some Southern medical terms and useful abbreviations. I am curious to see what gets through the editing process.

Southern Medical Terminology

Athletic Seizure An athletic seizure results when one “falls out,” falls to the floor and begins shaking. It’s best to chart it as an epileptic seizure, though.

Blood Clogs Blood clogs result from the coagulation process whereby liquid blood becomes solid blood. The more clogs that are present, the more clinically significant the case is.

Cadillacs On several occasions, patients have reported problems with their Cadillacs. They did not have problems with their car; they just couldn’t see. Fortunately, they went to the eye doctor who skillfully removed their Cadillacs more commonly referred to as “cataracts”.

Cascade The term “cascade” is the proper term for a Southern belle to use in describing her drunken boyfriend’s vomiting spell at the local Dairy Queen. There are similar terms, all with the same meaning, but equally colorful. Vomiting can also described as: “A Technicolor yawn,” “Yelling at the concrete,” “Hollerin’ for Ralph,” “Wantin’ a Buick,” or “Drivin’ the porcelain bus.” The term “pukin’ up his toenails” is reserved for use only in describing impressive vomiting.

Clabber Clabber is an abnormal chemical state of milk. Evidently, when somebody drinks a glass of milk, the acids and enzymes in the stomach cause the milk to “clabber.” Many patients deem it clinically significant to report that their children vomited and it contained the dreaded “clabbered milk.”

Cold In the South, a cold is more than an upper respiratory infection. It is really any sort of inflammation. Thus, it is not uncommon for a patient to tell you they have a “cold in their shoulder” or a “cold in their back.” Interestingly, the “Southern cold” is just like the typical upper respiratory infection “cold” you can take medicine and it will be better in a week. Take no medicine and it will be better in seven days.

Dude The dude is the meanest hombre in the South. Anytime you ask a gunshot victim about who shot them, they will always say, “Some dude.” If a guy gets beat up in a bar fight and you inquire about the assailants, rest assured he will tell you it was “two dudes.” It is bad enough that we have the “dude” now we got “two dudes” to deal with. Oh, the humanity!

Fell Out The first time I ever heard the term “fell out” I was a rookie EMT and a young male was sprawled across a sidewalk in a front yard. With my handy Dyna-Med penlight in hand, I began gathering a history just like the book said I should. When I asked what had happened, I learned the patient “fell out.” I looked around and said, “Fell out of what?” The family member, not amused at my lack of experience, said, “No man .the dude fell out. You know, fell out.” I said, “Oh, OK.” Later my partner taught me that “fell out” and “passed out” were synonyms.

Fireballs of the Eucharist Once when I was taking the medical history from a very pleasant elderly woman, she stated that she had a hysterectomy several years prior. When I asked the reason for the surgery she stated, “The doctor said I had Fireballs of the Eucharist.'” With a little thought, it became clear that she had suffered from “fibroids of the uterus.”

Mighty Internal Fart One day, a very nice woman, while relaying her husband’s medical history, told me that he once had a “mighty internal fart.” Now, this was a new one. But, unfazed, I continued and it became clear that his “mighty internal fart” was indeed a “myocardial infarction.”

Old-Timer’s Disease Many people think that dementia is a normal part of aging. That, of course, is only true for politicians and editors. Many well-meaning people seriously call Alzheimer’s Disease “Old-Timer’s Disease.” I think that is the case, but I can’t remember for sure.

Peanut Butter Balls Any time you are taking a history and the patient, or a caring family member, states that the patient takes “peanut butter balls,” you can assume with confidence that the patient probably has a seizure disorder and takes phenobarbital.

Prostrate In the South, the term “prostrate” means both lying flat on the ground and is the name of that small gland men have that produces semen. In the rest of the world, it’s referred to as the “prostate.”

Ptomaine Poisoning Ptomaine poisoning is the great fear of mothers. It is an archaic term that existed before the days of refrigeration and resulted from eating chemicals that resulted from the breakdown of animal tissues by bacteria. The ptomaine chemicals have lovely names such as putrescine and cadaverine. So, I can say with confidence, “No, Mrs. Wilson. Unless your son is a buzzard, I doubt he has ptomaine poisoning.”

Sick Rag A sick rag is very important to Southerners, and very therapeutic. A sick rag is a washcloth (that is a small towel for those on the Left Coast) that is moistened and placed on the patient’s forehead. It is very effective and should never be touched by EMS providers.

Smiling Mighty Jesus Many think use of the term “Smiling Mighty Jesus” is an urban legend. But I have heard it many times from people in the South. The first time I was questioning a young mom who brought her sick child to the ED, she said that he had “Smiling Mighty Jesus” when he was a baby. Perplexed, I asked for details. She said, “You know, they put a spinal tap in him.” Then I realized that she was talking about “spinal meningitis.”

Abbreviations For Southern EMS

Here are some helpful abbreviations if you ever happen to find yourself a Good Samaritan in the South:

ADS due to TMB Acute Dying Spells due to Too Many Birthdays
CPR Can’t Possibly Recover
CCFCP Coo-Coo For Cocoa Puffs
DRT Dead Right There
DVR Darth Vader Respirations
FLK-GLM Funny Looking Kid Great Looking Mom.
ORTA Orthopedic Resident Training Apparatus (i.e., motorcycle)
PID Pus in Dere
TSS Toxic Socks Syndrome
WNL We Never Looked
WWI Walking While Intoxicated

I have many more but these are enough for now. When you get to thinking about these, remember that humor is a good way of dealing with stress. Mark Twain once said, “Laughter without a tinge of philosophy is but a sneeze of humor. Genuine humor is replete with wisdom.” He also said, “Humor is mankind’s greatest blessing.” I think on that we can all agree.