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One woman complained of "fireballs in the Eucharist." Another was concerned about a "deviant" septum. Physicians Stephen Davis '80 M.D. and Tina Kenyon, who collect such slips of the tongue from their own practice and those of colleagues, understood that the patients were really trying to tell them about fibroids in the uterus and a deviated septum. In a Commencement Forum titled "Medical Malapropisms as Diagnostic Clues," Davis, a clinical associate professor of medicine at Brown, and Kenyon, formerly with the department of family medicine, explained that while such mistakes are often amusing, they can signify a communication gulf between health-care professionals and their patients.

Davis and Kenyon have been collecting medical malapropisms for several years, grouping them into categories organized around what each malapropism reveals about the speaker. In one case, for example, a patient referred to a "constipated" (rather than congested) nose. In Spanish, constipado means "congested," and the mix-up between the two words alerted the physician that English may not be the best language for the conversation.

According to Davis and Kenyon, misused medical jargon can also signal that the patient is anxious about his or her condition. Into the Freudian-slip category falls the malapropism of a patient who said she hadn't had a "Pap scare" in a long time. When one man referred to "drinking himself to Bolivia" instead of "into oblivion," he was also telling the doctor that his education might be limited. "If we know this about someone," Davis said, "then we can tailor explanations to harmonize with the person's educational level."

In the majority of instances, however, the explanation behind medical malapropisms is simple: those who lack medical training are often confused by medical terminology and are simply trying to navigate through the unfamiliar terrain of medicalese. The result is both uproarious and revealing: patients speak of "an atomic pregnancy," "frolic acid," and "cerebral hemorrhoids."

Although Davis and Kenyon kept the audience rollicking with their presentation, they were quick to caution their listeners, many of whom were physicians, against smugness. Malapropisms can happen to anyone, Davis stressed, "no matter how educated the speaker is." In fact, during a visit to Rhode Island, President Clinton voiced his support for allowing mothers to remain in the hospital after childbirth until they are fully recovered. According to Davis, Clinton got a bit tongue-tied - speaking earnestly of reducing "drive-by pregnancies" instead of drive-by deliveries.





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