Putting the Ack! in Medical Acronyms

Have you ever taken an upside-down peek at your medical chart, only to bristle at seeing “SOB” written on it? Don’t take offense! “SOB,” in this context, is likely to stand for “shortness of breath”--not anything rude--and it’s but one of the head-swimming number of acronyms doctors use in their trade.

Acronyms to help students remember the names of veins and bones and drugs. Acronyms like “NIDDM” to avoid wasting ink by writing “non-insulin-dependent diabetes mellitus” over and over again. (These days, how much time with a doc would even be left after he or she had written down “non-insulin-dependent diabetes mellitus”?)

Acronyms don’t end with the doctor’s office or med student cram sessions, says Dr. Michael Berkwits, assistant professor of medicine at the University of Pennsylvania. He’s concerned about a whole other class of groovy names: the ones that get used, more and more, to name large clinical trials.

Time was, he says, such trials weren’t given names. The first one he knows of dates from around 1970: the University Group Diabetes Program, which came to be known affectionately as UGDP. UGDP. A name only a mother could love.

But names have come a long way, baby. These days, trials have soaring names such as CAPTURE, SHOCK and EXCITE. Then there’s SYMPHONY (Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events post-acute corONary sYndromes) and MIRACL (Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering). No one could accuse the UGDP folks of forcing their acronym, but the same could not be said of SYMPHONY (What’s with that “corONary sYndrome?”).

Part of this naming game is fun, pure and simple, says Berkwits. Medical researchers aren’t like geneticists, who have had oodles of fun down the years naming their mutant flies and fish things such as “rutabaga,” “sonic hedgehog” and “tiggywinkle hedgehog.” Giving a zappy name to a trial “can be fun, taking a break from the serious business of clinical research,” Berkwits says.

Also, if lots of scientists at different universities are involved in a trial, having a cool name can help unify the far-flung team. But Berkwits and some of his colleagues also worry that this kind of naming can subtly influence the way doctors and patients view the trial and the drugs a trial is designed to test. Will a good trial acronym make a patient more likely to enroll? Make a scientist’s study higher-profile? A doctor more likely to eventually prescribe if the trial goes well? Aren’t these names marketing of a kind?

Words, Berkwits further points out, do elicit emotional responses in people. In psychological tests--no big surprise--words such as “friend” and “holiday” were very pleasing to people; words such as “death” and “hatred” were strongly disliked. Even nonsense words such as “juvalamu,” “bargulum” and “chakaka” evoked different feelings in readers. (“Juvalamu” was best-liked, then “bargulum;” “chakaka” (yeuchh) was positively disliked.)

The Mighty Mouse

Talking of names, this week we took another dip into a fun book called “Medical Meanings,” by Dr. William S. Haubrich, which (as you might guess) lists all kinds of medical and anatomical terms along with their origins.

Here are a few:

* “Uvula,” that little bit of flesh at the back of the soft palate, comes from the Latin word for “grape.” The fleshy appendage actually looks more like a worm than a grape, but a surgeon in the Middle Ages just happened to see one when it was swollen. He gave it the “grape” name, which stuck--long after the patient’s swollen tissue had turned to dust.

* “Muscle” comes from the Latin word musculus, which means “little mouse.” Why on earth? Perhaps, muses the author, the rippling of muscles looked like the scurrying of rodents to the Romans. “Or perhaps it was fancied that the shape of dissected muscles resembled that of small rodents.” Hmmmm.

* The term “internal medicine” may have originated in 19th century Germany to distinguish doctors who studied the internal organs from the droves of physicians who specialized in how diseases--especially venereal diseases--affected the outside appearance of the body.

*

If you have an idea for a Booster Shots topic, write or e-mail Rosie Mestel at the Los Angeles Times, 202 W. 1st. St., Los Angeles, CA 90012; rosie.mestel@latimes.com.