I’m not sure if it is completely correct in calling these neologisms (after consulting the msn encarta dictionary) - but they are entrants in the Washington Post’s ‘Style Invitational’, and are words made from other words by adding, subtracting or changing one letter. Then you have to come up with a clever definition of the new word.

Ignoranus: A person who’s both stupid and an asshole.

Bozone: The substance surrounding stupid people that stops bright ideas from penetrating.

Inoculatte: To take coffee intravenously when you are running late.

Osteopornosis: A degenerate disease.

Decafalon: The grueling event of getting through the day consuming only things that are good for you.

Arachnoleptic Fit: The frantic dance performed just after you’ve walked through a spider web

Adiposure: Someone who exaggerates their weight at the beginning of a diet so his “loss” will be more impressive.

Contestosterone: The hormone that accounts for why 14 of 15 all time top ‘Style Invitational’ losers are male. Females instead have the hormone havealifeogen.

Or some true neologisms from the past:

Coffee: The person on whom one coughs

Flabbergasted: Appalled at discovering how much weight one has gained.

Abdicate: to give up all hope of ever having a flat stomach.

Lymph: To walk with a lisp.

Flatulence” An emergency vehicle that picks up someone who has been run over by a steamroller.

Testicle: A humorous question in an exam.

Rectitude: The formal dignified bearing adopted by a proctologist

Pokemon: A Rastafarian proctologist.

Circumvent: An opening in the front of boxer shorts worn by Jewish men.

 The recent patient who thought she was dying of cancer inspires me to comment on how information, and its accurate communication between doctor and patient are so crucial.

OK, a high sounding platitude. But I am always crying to my patients about how hard it is to get information. And how information is absolutely essential to know how to treat you.

If I don’t know you had a heart attack, I don’t know to get serious about trying to modify your risk factors (blood pressure cholesterol etc). If I don’t know you had breast cancer, I might not be thinking that pain in your back could be metastases. If I don’t know you have already gone through an extensive work up for hematuria (blood in your urine), I’m going to be ordering IVP’s and all sorts of other expensive/invasive tests (like having someone stick a scope up your willie.)

In the practice I am in, we have electronic medical records (EMR). Some others in town do also, including the local hospital - but because of lack of “connectivity” (the ability of systems to talk to each other) we have to go to their site and down load ER records, Discharge summaries, labs etc in hard copy.

I shall spare you the rant about trying to read these, because the system has been designed by geeks, lawyers and coders - so it’s a glorified billing template with a mass of CYA information you don’t want to know, like how the patient was transported to the x-ray, and a bunch of other stuff the IT guys think you have to have, all of which does a good job of burying the information you really do need. But I digress.

Some other docs in town have EMR, but when they do, we can’t access their records. So when I send a patient to a specialist, I’m usually in the dark, except if I occasional get lucky and one of these guys sends me a perfunctory letter - a few weeks later.

Most amazing of all, I find myself in agreement with Sen. Chuck Grassley because he is trying to reform electronic medical records. Mainly he seems to be beating on the companies about systems that; misread intracranial pressures; calculate wrong drug dosages; appear to have gag orders that stop anyone disclosing their faults, and a bunch of other shady sounding business practices (but hey, we’re in the land private enterprise). But, bless his cotton socks; he is also reputedly on the industries case about “connectivity” also.

Apart from getting information from other providers who get to broddle with your patients, getting information to the patient, in an accurate from, is another challenge. I am prompted to write about this now because of a woman from whom I recently removed what I thought was a sebaceous cyst. Well, it turned out to be a lipoma (a very common and very benign growth in the fatty layer just under the skin).

Although she was coming in soon to get her stitches out, I diligently reported on the pathology, that it was a lipoma, and sent this info’ to the message nurse to call the patient.

By the time I got to her, at her follow up visit, she had calmed down a bit, because my wonderful nurse had put her strait. But she had been in panic mode since getting the phone call from the message nurse, because she had heard, not “lipoma”, but “lymphoma”.

It’s like the joke about the old fart in hospital with the oxygen mask that keeps asking the shy and discombobulated student nurse “are my testicles black?” Only after she finally, with great embarrassment and desperations, lifts his gown and checks out his stuff, does she remove his oxygen mask to hear him better and find he is asking, “are my test results back?”

Mr. Harrigan is a bit uptight and a little sensitive - and at a recent office visit to follow up on his paroxysmal atrial fibrillation he made me aware of a new etiology  - “Tele-tension” .

Reluctant to take the beta-blocker, Labetalol, his cardiologist had prescribed him, he was asking about ways to prevent further episodes. He had stopped alcohol and caffeine already. I was asking him the standard stuff about any other sources of stimulation, like over the counter decongestants, thyroid disease, or “too much adrenalin in the system” from anxiety. This prompted him to a profound thought.

The context

To fully appreciate the influences on Mr. Harrigan, you have to follow the American media. True to form, they are raucous and inflammatory - currently filled with gloom and doom about Haiti, suicide bombers and insurgents.

Or if you happen to be a supporter of health care reform and Obama you are also liable to be distressed by:

The loss of a filibuster proof majority with the election of Scott Brown in Massachusetts (also famous for another win, as “Americas sexiest Man” when he posed naked in Cosmo’s centerfold).

The Supreme  Courts reversal of a restriction on corporate contribution - in place since 1907 - which is liable to bode badly for the Democrats.

And, most vexatious of all, interviews with the ‘Teabagger’s (a term that has two meanings. One, according to The Urban Dictionary, is as in this case, a group of ” conservative activists. . . .  so ignorant that they protest against tax cuts that benefit them”. The other, that the ‘baggers’ are not so happy with, is related to its rather obscene sexual connotation).

At a recent rally in Washington they accused Obama of “aborting babies all over the world”, taking away freedom of speech. That he is the antichrist mentioned in the bible. That we “need a Christian in White House, not a Muslim”, that we should “bury Obama care with Kennedy “. That we shouldn’t go on paying for slavery by providing welfare to the poor who are predominantly black. And should have conservative talk show host “Glenn Beck for President”.

I did not enquire into Mr. Harrigans politics. But whatever his beliefs, obviously all this stuff has the same sort of effect on his cardiovascular system as it does on my blood pressure.

I am hopeful however that he will be free of further attacks of his atrial fibrillation and what we have dubbed “Tele-tension” - as, when coming out of his reverie, he announced, “maybe I should stop watching the evening news”.