The Routledge Encyclopedia of Narrative Theory, published under the editorship David Herman, Manfred Jahn, and Marie-Laure Ryan, is more than a new dictionary of narratology. (1) It is an unprecedented work that defines and examines thousands of terms and concepts, distributed in four hundred fifty articles and related to narrative in all its forms and in all the variety of its media, formats, periods, genres, and subgenres. This innovative encyclopedia concerns students, teachers, and researchers, all those who recognize “the very predominance of narrative as a focus of interest across multiple disciplines” (x), whether in history, philosophy, psychology, anthropology, discourse analysis, or literary studies. However, we might consider whether the notion of “theory” here is likely to be a simple metaphor. The list of articles in this very rich volume can be easily divided in historical accounts (on schools or trends, such as the “Tel Aviv School of Narrative Poetics”), methodological accounts (on the different approaches to narrative, from “Computational Approaches to Narrative” to approaches more inspired by the humanities), or lexical accounts (on concepts or notions, more or less linked to the original terminology of such and such author), all accounts of varying length. The volume also contains the presentation of problems, old and new, from plot structure to the literary representation of thought and consciousness, that feed theoretical reflection on narrative. (2) The editors chose not to devote articles to individual theoreticians (but the bio-bibliographic information concerning them can be accessed through the index).

The ambition of the Encyclopedia is not only to present the history, the conceptual and methodological tools, and the terminology of narrative theory or “narrative studies” but first and foremost to underline its importance and topical interest. Apprehending two new phenomena was the main focus for the editors in their work. The first one is well known in the Anglo-Saxon world as the “narrative turn.” In the last twenty years this transformation has put the problematics of narrative at the center of not only historical, ethnographical, and psychoanalytical thought, but also juridical, political, and even medical, thus endowing narrative theory the status of a new paradigm for knowledge theory. In the article “Narrative Turn in the Humanities,” Martin Kreiswirth gives an extensive, rigorous, and well-informed presentation of this phenomenon. His article also contains a number of cross-references to the index or to other entries in the volume (see in particular “Ethnographic Approaches to Narrative,” “Historiography,” “Law and Narrative,” “Medicine and Narrative,” “Psychoanalysis and Narrative”). The “narrative turn” and the new uses it defines for the word “story” also form the subject of the first part of Ryan’s article “Narrative,” which I will come back to. The second phenomenon is the renaissance of narratology in a plural, diversified form: Narratologies, significantly, is the title of a collective work published in 1999 under the direction of David Herman. In the introduction to this work, David Herman proposes the term “postclassical narratology,” taken up in Luc Herman and Bart Vervaeck’s article, “in order to group the various efforts to transcend ‘classical’ structuralist narratology, which has been reproached for its scientificity, anthropomorphism, disregard for context, and gender-blindness” (450; also see the entries “Implied Reader,” “Narrative,” “Natural Narratolology,” “Cultural Studies Approaches to Narrative,” “Gender Studies,” and “Feminist Narratology”). However, one can wonder, when reading some of the articles in the Encyclopedia (”Education and Narrative,” “Medicine and Narrative,” “Narrative Psychology,” “Narrative Therapy,” “Theology and Narrative,” all of great interest on their own), if the encounter of certain disciplines of the “narrative turn” with the new narratology, with its postclassical and poststructuralist features, is just due to circumstances and if it does not derive from an editorial strategy rather than a true synergy.

Seeds of Central America and Southern Mexico: The Economic Species. By David L. Lentz and Ruth Dickau. xi + 296 pp. Memoirs of the New York Botanical Garden, Volume 91. The New York Botanical Garden Press, Bronx, NY, USA. 2005. US $65. ISBN 0-89327-467-4 Cloth.

This addition to the limited number of seed identification manuals is welcome, but comes with several caveats (see below). seeds of Central America and Southern Mexico: The Economic Species includes photographs and species information for over 500 economic and weedy species. Economic plants are those used for food, medicine, timber, or ornamental purposes. Each description provides: scientific name, family, both English and local common names, geographical range, habitats, growth habits, and economic uses summarized from a variety of published sources, as well as a description of the seed. The last gives shape, dimensions, color, surface characteristics, and whether appendages (e.g., wings, hairs) are present. There is a glossary, which appeared to be thorough, containing all the terms I looked up.

In order to include as many genera as possible, not all species are illustrated. Also, according to the Introduction, species illustrated in four North American works are not included (but see below). Almost all species are of New World origin. Occasionally, some species that have limited economic use or weedy status are included (e.g., Gunnera insignis Oerst.; large leaves are used as protection from rain), but their presence provides a look at seeds not found in other seed identification manuals.

All photographs have a scale bar and are black and white. Those for seeds smaller than 2 mm are scanning electronic microscope images. For seeds larger than 2 mm, a stereomicroscope was used and those larger than 10 mm were photographed using a macro lens. There is certain pleasure in looking at photographs, for example, of Begonia sericoneura seem., Manilkara zapota (L,) P. Royen, and Saurauia kegeliana Schltdl., with their elegant seed coats. Most photographs show more than one seed, providing a range of sizes, variety of shapes, or both lateral and hilum views. In some, the fruit is also shown and then fruit type (e.g., capsule, drupe stone, samara) is usually noted. Although images are generally of good quality and some excellent, others are not sharp or blend too much with the background. Soft edges, in some cases, are due to the difficulties inherent in accommodating for the seed thickness of many species.

This volume, as noted by the authors, makes available, in a readily accessible form, the Percy Wilson seed Collection, seed and fruit material from the William and Lynda Steere Herbarium, and the personal collection of Dr. Lenz built over more than 20 years of fieldwork. The first two collections are at the New York Botanical Garden, the third is at the Chicago Botanic Garden.

The accounts also provide insights into the varied uses made by local people of the plants available to them. Among them are species that also occur in North America, with ranges extending south along the mountains: Liquidambar styraciflua L. is planted as an ornamental shade tree; resin is used as incense and for flavoring, as well as to treat sores and gonorrhea; hardened gum is chewed to clean teeth; and wood is used in construction. The sap of Lobelia cardinalis L. is used to cure infection caused by imbedded thorns or wounds and fruits are edible(l). The fruit of Lycopersicon esculentum Mill, (tomato) is used for food and fresh fruit is rubbed on the neck to treat mumps. Phragmites australis (Cav.) Trin. ex Steud., a reviled invasive in North America, is used in basketry, construction (e.g., roof poles and wattle (poles interwoven with branches or reeds)), and for food, forage, and as a source of gum and medicine. The crushed rhizomes of Typha latifolia L. are used as a ‘restorative’ shampoo. (Could this be tried for greying hair?)

Species new to me: Utricularia hispida Lam., a terrestrial species, is sometimes planted as an ornamental. The latex of Castilla elastica Sessé, now used for waterproofing clothing, was used by Precolumbians to make rubber balls. Dried seeds of Pouteria sapota (Jacq.) H.E. Moore and Stearn, which is also the source of latex, medicine, and poison, are used to flavor chocolate. Finally, although many more could be cited, Rauwolfia tetraphylla L. is used to treat malaria and snake bites. (Reserpine, derived from other Rauwolfia species in other parts of the world, is used for the treatment of high blood pressure and mental illness (Mabberley 1997; The Plant Book: A Portable Dictionary of the Vascular Plants. Cambridge University Press, Cambridge, UK). It is significant that people have found medical uses for such widely separated species).

This volume brought to mind tropic forests, mountainsides, and gardens cut in the jungle or behind someone’s house that I have seen; memories of my first wild Begonia growing on a thatched roof, huge Gunnera leaves in a cold mountain reserve, and the same weedy Galinsoga that I have seen in my New Jersey garden. However despite the addition of many new images and information provided in the accounts, there are a number of additions that I believe would have made this volume more useful to those for whom it was designed, namely field biologists, wildlife managers, ecologists, agronomists, paleoethnobotanists, archaeologists, and amateurs interested in seeds. Hopefully, these can be addressed in a second addition. First, while I can appreciate the difficulties of putting together a comprehensive seed catalog for tropical southern Mexico and Central America, providing the number of species in each genus would be helpful in ascertaining whether an unknown seed can only be assigned a genus name (a caution made in the Introduction).

Illness representations have been shown to differ across cultures. The aim of the study was to study disease terminology and lay prototypes among a Northern Sotho community in South Africa. The sample for a free listing of disease terms included 41 (55%) women and 34 (45%) men, with a mean age of 36 years (SD=5.6, range 18 to 75 years). The sample for pile sorting of disease terms included 80 Northern Sotho-speaking third-year students from the University of Limpopo; 44 women, 36 men, mean age, 23.4 years (SD=3.4). From free listing of disease terms 50 were selected for pile sorting. Using hierarchical cluster analysis the following clusters could be identified: (1) respiratory problems, (2) internal body problems and sexually transmitted diseases, (3) chronic diseases and head diseases, (4) child diseases and mental problems, (5) child diseases and cancer, (6) feet problems, (7) gastrointestinal diseases. There was homogeneity of features within cluster and difference between clusters.

Understanding the layperson’s terminology of diseases is an important part of communication studies and health psychology (Lalljee, Lamb & Carnibella, 1993). Language plays a vital role in health terminology because it gives a broader definition of diseases, their causality and the possible ways of curing them. Health beliefs have been shown to be related to a wide range of processes. They include the identification of bodily signs as symptoms of particular illness, seeking professional help, compliance with medical advice, and interactions with people who suffer from that illness (see for example Bishop & Converse, 1986). Research on disease prototypes has revealed that lay illness diagnosis is influenced by symptom typicality, suggesting that it represents a “prototypematching process” (Von Lengerke, 2005). In addition to general concepts of illness, people also hold organized conceptions - termed disease prototypes - for particular diseases (Bishop 1991). For example, a person may have a disease prototype of heart disease. Similar to general illness conceptions, prototypes of specific diseases help people organize and evaluate information about bodily sensations that might otherwise not be interpretable. Thus, a person who holds the belief that he or she is vulnerable to heart disease is more likely to interpret chest pain in accord with his or her prototype of heart disease than is a person who does not hold this belief (Bishop & Converse).

Leventhal, Nerenz, and Steele (1984) suggested that illness representations have several components including the label placed upon the illness, its typical cause, and its expected consequences. Labeling a set of bodily signs as symptoms of a particular illness implies a particular set of causes, the likely duration, consequences and the method of cure (Lalljee et al., 1993). The features of representation of any particular illness are likely to be correlated rather than independent. For instance, Lau and Hartman (1983) have shown that there is a close relationship between a person’s view of the cause of an illness and his/her conception about how to cure it. Generally, the representations of different illnesses differ and little attempt has been made to investigate the relationship between beliefs about different illnesses. The analysis of disease terminology will add greater coherence and systematization to the field of linguistics and psychology. Baumann (2003) showed that illness representations differ across cultures (e.g., egocentric versus sociocentric cultures). Therefore the aim of the study was to examine disease terminology and lay prototypes in an African (sociocentric) culture with possibly linguistic specificities of a Northern Sotho community in South Africa.

METHOD

STUDY ONE: FREE LISTING OF DISEASE TERMS

Sample and procedure The sample consisted of 41 (55%) women and 34 (45%) men, with a mean age of 36 years (SD=5.6) and a range from 18 to 75 years. Purposeful sampling was used aiming at a heterogeneous sample in terms of Northern Sotho dialect, age, places of origin (rural versus urban), gender and educational level. Participants came from Mankweng, Botlokwa and Tzaneen (Medingen and Mamphakathi) villages of the Limpopo Province, South Africa. Among the Northern Sotho sample, 25 used Tlokwa dialect, 25 Lobedu dialect and 25 used Sepedi sa ga Mamabolo. With regard to the participants’ places of origin, 50 (67%) originated from a village and 25 (33%) were from an urban area. With regard to their level of education, 9 (12 %) participants had no education, 9 (12%) had primary education, 31 (41%) had secondary education and 26 (35%) had tertiary education. With regard to their marital status, 34 (45%) participants were single, 35 (47%) married, 1 (1.3%) participant was divorced and 5 (7%) widowed. With regard to their occupational status, 13 (17%) were unemployed, 5 (7%) were businessmen/women, 9 (12%) were pensioners, 10 (13%) were housewives, 22 (29%) were students and 10 (13%) had other occupations. Permission to interview the participants was obtained from the chiefs at the villages and an informed consent to participate in the study was obtained from all participants.

RANDY COLLICA IS a modern-day treasure hunter. As a senior business analyst in Palo Alto-based Hewlett-Packard Co.’s customer data and knowledge services department, his job is to mine data in search of insight that can help marketers better understand various customer segments. He stumbled upon a veritable gold mine a few years ago as he riffled through notes taken by HP’s call-center representatives. “I just knew there had to be nuggets of valuable information in there, given the volume of data we had,” says Collica. “But I also knew that finding them would be impossible if we didn’t have a tool to automate the analysis.”

Although standard data-mining systems can detect patterns hidden within structured tables of information, such as the transactional data of an ERP system, they are essentially useless with unstructured data–and notes taken during a phone call are about as unstructured as data gets. So Collica turned to text mining, a type of data-mining technology that combs through text and gives it structure so it can be analyzed.

Collica’s hunch turned out to be right: text mining revealed, as one example, that customers in lower-value segments ask a lot more questions about business processes, such as HP’s contract-negotiation procedures, than do the company’s best customers. “That insight has been invaluable in helping marketers come up with solutions and campaigns targeted at different customer groups,” says Collica.

The latest generation of technology, developed by vendors flush with post-9/11 government investment (see sidebar, page 81), is still far from perfect. But it is allowing corporations with large data sets to perform important feats they couldn’t before. “It really is the next frontier of understanding in business intelligence,” says Martin Schneider, an analyst at The 451 Group in New York.

Key to the improvements have been advances in natural language processing, a method of extracting meaning from printed words that now allows the software to “understand” complex phrases about 80 percent of the time. Text-mining systems can also be programmed to assign value to expressions. Suppose a telesales representative has entered the following note: “Nov. 15 - Cstmr not happy w/cell phone. Wants to switch to Yellow Inc.” The software can recognize that November 15 is a date; that “cstmr” is a customer; that he has a cell phone and is unhappy, which is bad; and that he wants to switch to a competitor, which is worse.

Once that kind of information is extracted, it can be structured in a format similar to a database and further analyzed, often more quickly than a human analyst can locate his reading glasses.

And the possibilities aren’t limited to customer service. San Francisco-based LoanPerformance, a provider of credit-risk-decision support tools for residential mortgage operators, uses text mining to offer its clients improved predictive analytics. Traditional risk-scoring solutions for loss mitigation and delinquency management incorporate only structured data such as a borrower’s interest rate, outstanding balance, and monthly payments. That ignores rich information that could help a mortgage servicer better determine how likely a delinquent borrower is to miss more payments or, ultimately, default. “If someone says they missed a payment because they lost their job, that’s different from ‘I forgot to send my check,” explains Damien Weldon, director of mixed-data analytics at LoanPerformance. When the company included data mined from call-center conversations in its scoring calculations, accuracy rose by 15 to 20 percent.

Text mining is finding fertile ground in the life-sciences and pharmaceutical industries, too. The brain-tumor research department at Children’s Memorial Hospital in Chicago uses text mining to comb through reams of medical journals and unearth gene-pairing information that can accelerate critical scientific breakthroughs.

Pharmaceutical companies like Pfizer Inc. mine patent documentation for insight on new directions in research. “This serves as an early-warning system to identify trends,” explains Mark Burfoot, head of information management at Pfizer in St. Louis. “We can see what competitors are doing and, by linking that information with our own R&D data, make a decision about whether it’s an area we should be looking into.”

Text mining often starts as a way to automate manual processes and then spreads as companies see its potential. At Bank of America N.A., the E-commerce team used to manually read, sort, and categorize the comments it received on surveys and feedback forums. Now text mining does the job instantly, producing graphs and charts about prevailing attitudes that help the team prioritize proposed service enhancements. Johnson Controls Inc., the Milwaukee-based autoparts supplier, first started using text mining in its call center several years ago, then began mining notes from the company’s 7,000 field-maintenance and installation engineers, searching for ways to improve products and reduce maintenance costs. More recently it has set up a program to scour Web logs and chat rooms to assess consumer opinions on car batteries. Next, the company plans to mine warranty claims for early warnings on product defects.

Clinical trial reports typically provide univariate data on adverse events in the form of rates. Little or no consideration is given to providing data on syndromes or constellations of adverse events in clinical trials. We describe three methods for analyzing adverse events; these methods focus on constellations of events within the same patient. A computer algorithm enumerates the constellations of adverse events in the data and counts the number of patients in each constellation. The proposed algorithm also preserves the identifiers of patients in the constellation and other covariates for further analysis. A log-linear model is used to estimate the magnitude of association of two or more adverse events by analyzing the count of patients in each of the possible subsets of the constellation. These methods make a unique contribution to the determination of safety in the development of new therapeutic agents.

Clinical trials provide evidence of the safety of new therapeutic agents by collecting data from a fundamental safety triad: (1) safety end points, (2) clinical laboratory values, and (3) reports of adverse events. The clinical protocol mandates the ascertainment of safety end points for every patient randomly assigned to the study. Furthermore, the protocol provides a prospective definition of safety end points and dictates the method by which these end points are determined. The clinical interpretation of clinical laboratory values is well defined (1).

During the analysis of the study, clinical laboratory values are summarized at each patient visit and are analyzed for differences between study treatments. The laboratory values are analyzed in two ways: (1) by defining extreme laboratory values as clinically significant and calculating rates of occurrence for each clinically significant value by treatment group, and (2) analysis of covariance (ANCOVA) using treatment as a factor and the baseline value as a covariate.

Both of these measurements, safety end points and clinical laboratory values, provide focused, objective measures of the safety of study medication. Adverse events, however, are broadly defined to include a wide range of medical events. The following definition of adverse events is from the International Conference on Harmonisation (ICH) Guideline for Good Clinical Practice (2):

Any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An adverse event can therefore be any unfavourable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.

Adverse events are either self-reported by the patient or provided by the investigator. The reporting of adverse events may vary from investigator to investigator because of differences among investigative sites in patterns of care and patient mix. Adverse events are reported verbatim with information on the start and stop dates of the adverse event, outcome, countermeasures, severity, and the investigator’s opinion of the relationship of the adverse event to the study medication.

The verbatim description is classified as a preferred term using an accepted dictionary of preferred terms for adverse events. Two such dictionaries are COSTART and MedDRA (3). During analysis of the study, the resulting preferred terms are summarized as rates for each treatment group in the study and are analyzed by statistical assessments of the difference in rates between treatment groups, usually in the form of P values from significance tests such as the Fisher exact test. This article outlines novel methods of analyzing adverse events and diseusses the concepts derived from the disciplines of computer science and statistics to implement them.

BACKGROUND AND RATIONALE

In the routine analysis of adverse events from clinical trials, clinical researchers typically focus on the rate of a single adverse event and seldom attempt to determine the rate of concurrence of various adverse events in patients. In examining and diagnosing patients, however, it is standard practice for physicians to think of clinical signs and symptoms as a constellation within the same patient, as an aid to diagnosing the underlying disease, or, rarely, as the hallmark of a newly emerging disease. We maintain that a conceptual gap exists between the univariate reporting of adverse events in clinical trials and the physician’s conception of medical signs and symptoms as a constellation of events to be studied. Standard univariate reports of adverse events do not draw on this physician perspective in their interpretation, isolating the consideration of one adverse event from another in the process of safety monitoring and review. We propose a new method of analyzing adverse events by enumerating, and determining the importance of, clinical syndromes and adverse event constellations.

Stedman’s Medical Dictionary

American Heritage Dictionaries

Houghton Mifflin

222 Berkeley St., Boston, MA 02116

0818428992 $27.00 1-800-225-3362

Medical library reference collections seeking an updated medical dictionary packed with the latest research should look no further than this newly revised second edition of Stedman’s Medical Dictionary: it’s been completely revamped to include the latest tests, diseases, treatments and medical technology and provides a jargon-free reference which assumes no prior medical background to prove useful. From biographical entries for leading scientists and physicians to charts, illustrations, and usage guidance, Stedman’s Medical Dictionary is clearly a ‘must’ acquisition.

Webster’s New Explorer Medical Dictionary

Merriam-Webster

Federal Street Press

25-13 Old Kings Highway North #277, Darien, CT 06820

159695020X $10.98 www.federalstreetpress.com

The price tag of this hardcover reference is so low as to represent an unbelievable bargain–especially for over 800 pages of the latest medical definitions which includes a section on signs and symbols and provides general-interest consumers with over 37,000 entries and 2,000 new terms. From brand-name medicines and generics to bacteria genus and anatomical definitions, WEBSTER’S NEW EXPLORER MEDICAL DICTIONARY is packed with reference details perfect for either home or public lending libraries.

MedicineNet.com, a privately held Internet provider of proprietary 100 percent doctor-produced healthcare information on the World Wide Web at www.medicinenet.com and IDG Books Worldwide (Nasdaq: IDGB), of Foster City, Calif., the award-winning technology, how-to and professional content provider, Wednesday announced the publication of Webster’s New World(TM) Medical Dictionary, written by the doctors and experts at MedicineNet.com.

Presented as “Your Guide to Symptoms, Diseases, Treatments, Pharmaceuticals, and More,” the dictionary is packaged with a CD-ROM that contains a fully-searchable electronic version. Webster’s New World Medical Dictionary is now available at Barnes & Noble, Amazon.com, Borders, Books-A-Million, Crown Books and a number of independent bookstores across the country.

Believed to be the first time that a medical Internet company has published its proprietary content in book form, Webster’s New World Medical Dictionary is written for consumers, as opposed to other reference books written solely for medical professionals. The dictionary was designed to be of use to everyone concerned with health — their health and the health of those that matter to them.

The fact that the content of the dictionary is 100 percent doctor-produced by MedicineNet.com ensures an unusual degree of professional expertise, reliability and perspective that is sensitive to the needs of those confronting health issues.

Since it was founded in 1996 by a group of dedicated, forward-thinking physicians and high-tech executives, MedicineNet.com has become the premier resource for quick, easy-to-access, reliable health terms. Webster’s New World Medical Dictionary contains more than 7,500 entries, fully cross-referenced.

Diane Steele, publisher for Webster’s New World, said: “We’re very proud of the results of our alliance with MedicineNet.com. This new dictionary features a large number of both classical and contemporary medical terms. Some of the entries are longer than standard dictionary entries, and are actually miniature medical essays.”

Computational linguistics is demonstrating its relevance to commercial concerns. During the past few years, not only have companies funded and carried out research projects in computational linguistics, but also several products based on linguistic technology have emerged on the market. Franklin Products has created a line of handheld calculator-like dictionaries which range from a spelling dictionary to a pronouncing dictionary with a speech generator attached to a full thesaurus. Franklin Products, Texas Instruments, Casio, and Seiko all produce multilingual handheld translating dictionaries. Many text editors and word processors provide spelling checkers and thesauruses, such as those used by WordPerfect. Grammatik IV and Grammatik Mac are widely available style and grammar checkers. Merriam-Webster and the Oxford University Press have recently released their dictionaries on CD-ROM.

Both the commercial success of these linguistics products and the promising nature of their underlying theoretical basis encourage more ambitious work in industrial research. Outside of the United States, particularly in Europe and Japan, there is great interest in machine translation, although products remain on the research level. The Toshiba Corporation has developed a JapaneseEnglish typed-input translating system for conversational language. Within the United States, Unisys, SRI, and Hewlett-Packard(t) have developed natural language understanding systems with prospective applications of database inquiry and equipment control, among other areas. In the area of electronic dictionary development, both the Centre for Lexical Information (CELEX) in the Netherlands and Oxford University Press publishers of the Oxford English Dictionary) in England are developing dictionary products that are sophisticated both in the linguistic data they contain and in the way the data is accessed.

Ambrose Bierce was an American writer and satirist who was known for his incisive wit. In 1911, Bierce published The Devil’s Dictionary, (1) a compendium of clever, sometimes scathing definitions that commented on his times. Although his dictionary primarily consists of nonmedical words, Bierce tossed a few barbs at the medical profession:

Diaphragm n. A muscular partition separating disorders of the chest from disorders of the bowels.

Disease n. Nature’s endowment to medical schools.

After spending a weekend going through Bierce’s dictionary, I thought I would coin some alternative definitions of my own.

acute adj. Sudden, without warning. As in the pain one gets when approached by a drug rep at the end of a busy day.

aphorism n. An adage or wise saying, as in, “Half a nurse is better than none,” or “A gallbladder in the hand is worth 2 on the floor.”

atrophy v. To become smaller with disuse. As in the state of mind brought on by successfully matching in the residency of one’s choice.

circumcision n. Elective surgical procedure that has continued into modern times so adolescent males can shower at school in peace.

clinical practice guidelines n. Cliff’s Notes for doctors.

deferred v. Refers to part of the physical exam that was not done on admission. It is not likely to be done after admission either.

drug n. A substance that when given to a patient produces the side effect you forgot to mention.

fetal monitor n. Electronic device that allows obstetricians to avoid bodily fluids for as long as possible.

fever n. A change in body temperature that decreases a doctor’s sleep but increases his income.

foreign body n. Any object smaller than a toaster that is left in the vicinity of a young child for less than 2 minutes.

heart n. (orthopedic definition) A muscular organ that has the sole purpose of pumping antibiotics to the bones.

hemorrhoids n. The body’s revenge for a high-fat diet.

informed consent n. The only thing that stands between a surgeon and his 9-iron.

nonpaying patients n. Relatives.

not really n phr. Expression used to dodge questions on rounds (usually when a resident forgot to do something). Attending: Was the patient anemic? Resident: Not really.

oriented x three adj phr. Less confused than your physician.