Who was Eddie and why would anyone want a piece of him? That was the question that troubled me for decades. “Bum bum baba bum bum bum bum … I want a piece of Eddie.” Every time I heard that song by The Ramones, it drove me to distraction. I couldn’t stand the band. It wasn’t their Proto-Punk cacophonic guitar jams or their dysfunctional family antics—it was Eddie. Why did they want a piece of him? It was a mystery I couldn’t solve.
Then last year I was listening to a radio piece on The Ramones when they mentioned that song. It turns out that the lyrics are actually, “I want to be sedated.” I want to be sedated? Not a piece of Eddie? How odd, and then how hilarious. Suddenly I was singing the song in my head. What a relief: There was no Eddie. It would be the prefect theme song for an anesthesiologist. I wanted to be sedated!
Terms that sound alike are called homonyms; whole phrases are called oronyms. Some examples are stuffy nose and stuff he knows; pullet surprise and Pulitzer Prize; and delicate and delegate. There is an oronym poem that has circulated the Internet that goes, “Eye halve a spelling chequer, it came with my pea sea … ”
What Eddie and I had experienced was a mondegreen. This term was coined by Sylvia Wright in an article published in 1954 in Harper’s Magazine. It comes from a 17th-century ballad. Its line sounds like “And Lady Mondegreen,” but in fact it is “and laid him on the green.” The term refers specifically to song lyrics that are misunderstood. Here are some of my favorite examples; the mondegreen is followed by the actual lyric;
- “There’s a bathroom on the right”/”There’s a bad moon on the rise” by Credence Clearwater Revival
- “ ’Scuse me while I kiss this guy”/“ ’Scuse my while I kiss the sky” by Jimi Hendrix
- “The girl with colitis goes by”/“The girl with kaleidoscope eyes” by The Beatles
- “I’ll never leave your pizza burnin’ ”/“I’ll never be your beast of burden” by The Rolling Stones
- “Oh, Louisa Brown”/“All the leaves are brown” by The Mamas and the Papas
- “No ducks of Haslem in the classroom”/“No dark sarcasm in the classroom” by Pink Floyd
- “Bring me an iron lung”/“Bring me a higher love” by Steve Winwood
- “Midnight after you’re wasted”/“Midnight at the oasis” by Maria Muldaur
You get the idea.
It is not always songs that get “misunderheard.” The complex lingo of medicine is also difficult for the neophyte or—worse—the patient to comprehend. When I started medical school, the most practical advice given to me was from my friend Jon’s father, who worked in the related profession of alcohol distribution. He told me to learn the buzzwords. I took his advice to cardia.
So there I was on rounds, a third-year medical student. A patient had an Na of 116. I wisely stroked my beard, and said that we should watch out for central pontoon myelinolysis. I guess they weren’t listening too carefully to what I had exactly said. For the next 14 years, I uttered dire warnings about central pontoon myelinolysis, until a first-year medical student corrected me. Oh, pontine, the pons—now that makes more sense!
I had made a malapropism, which comes from the character Mrs. Malaprop in an 18th-century play. (The name came from mal a propros, or French for “inappropriate”).
There is no specific term for medical malapropisms, or mondegreens. However, I call them roaches, after the famous “roaches in the liver” (cirrhosis). We have all seen these lists of roaches, whether generated by patients or bad dictation skills. Some examples are:
- The patient was treated for Paris Fevers (paresthesias);
- It was a non-respectable (unresectable) tumor;
- A debunking (debulking) procedure was performed;
- Nerve testing was done using a pink prick (pinprick) test;
- I had smiling mighty Jesus (spinal meningitis);
- She used an IOU (IUD) and still got pregnant;
- He has very close veins (varicose);
- She had postmortem (post partum) depression;
- Heart populations and high pretension (palpitations and hypertension);
- A case of headlights (head lice);
- Sick as hell anemia (sickle cell anemia); and
- The blood vessels were ecstatic (ectatic).
These roaches are generally amusing. They are certainly not anything a hospitalist would ever say or hear, though. Our patients are well informed, and our communications skills are flawless. We all know the medical malpractice risk of poor communication, and all of our patients are medically savvy and sesquepedalinistically erudite (whatever that means).
The next time you tell a patient they have a PE, remember they may be wondering what their medical condition has to do with monkey (an APE) and why you need to spell it out, or how their dyspnea is related to a high-school gym class (PE). You will have to excuse me now, I’ve got another hyponatremic patient and have to go hypertonic sailing. TH
Jamie Newman, MD, FACP, is the physician editor of The Hospitalist, consultant, Hospital Internal Medicine, and assistant professor of internal medicine and medical history, Mayo Clinic College of Medicine at the Mayo Clinic College of Medicine, Rochester, Minn.