After almost 11 years as an MT it is not words like mesencephalohypophyseal or lactoylglutathione that make me stop and do the Macarena! Without even thinking about it I know exactly which hip to swivel on and which hand to throw up behind my head in order to grab the book needed to verify a medical spelling, my eyes never have to leave the computer screen and my ears never miss a single word of dictation as it plays in my ears.��. mesencephalohypophyseal�. Dorland's page 1089! Hey! Macarena! 

It is those other words that trip me up. Good old English language words, obscure perhaps, indigenous to a specific country, state, town, not really slang, but certainly colloquialisms that are fully understood by the dictator, the nurses, the patient...and, 9 times out of 10, whose meaning is a puzzlement to the MT, who might be a country away or just one mile down the road, trying to make sense of the voice coming through the headphone! These words slyly hide in the middle of a sentence, tippy-toeing around to smack me right between the eyes and bring my production to a screeching halt while I attempt to locate a proper spelling; make the all important decision...edit or not edit; flag it or not to flag! These are words that make QA supervisors gnash their teeth in frustration while they watch MTs using up precious minutes trying to document them; words they don't teach you about in MT school; words that the dictator took the time to speak and darn well wants in the medical record..."that is what I said and that is what I meant, put it back in there right now!" ...says the dictator...Hey! Macarena!

Some days I feel like one of those people in Russia who make a practice of jumping into a hole chopped out of river ice in the middle of winter, my body in total shock as I root around on an old bookshelf trying to locate a Spanish-to-English dictionary used years ago in high school because the ESL (English as second language) dictator forgot what country he was seeing this patient in..."patient states he has dolor de echo con nausea, vomito o sudor and he just does not feel well..." Macarena! Macarena! Macarena! 

Medical words are by and large self-explanatory. If you can break the word down into its syllables you can pretty much figure out what it means and whether or not it is appropriate given the context of the dictation. Laryngectomy means just what is says, larynx-larynx, ectomy-excision, laryngectomy, excision or resection of the larynx. English words get a lot trickier!  When the dictator says the "patient was scorched" the MT is expected to know from the context of the report whether the patient has a bad burn; had too much alcohol to drink; took an overdose of drugs; is having a very bad temper tantrum or whether that portion of the dictation needs to be flagged because the word makes no sense at all...Hey! Macarena!  

"EMS report from the scene says patient was the belted driver in a T-bone." Certainly no one smacked (belted) the patient in the face, in this instance the word is a shortened form of seatbelt, a mandatory safety requirement for drivers in many states. Not wearing the belt at the time of an accident often results in the car insurance company refusing to pay medical costs. Webster's shows that a T-bone is a cut of meat and I don't think that dictator was taking a stroll through the butcher's section of the grocery store while doing medical records! T-bone is the shape made when one car hits another smack in the middle and forms the shape of the letter T when the two vehicles come to rest, a common accident that happens frequently at intersections when one driver is not paying attention. Even though it will not be found in a dictionary it is a commonly accepted term used by ER physicians, patients, the insurance company and should be used in the medical record exactly as dictated. A couple of weeks doing emergency room reports is enough to douse any MT with a lot of very cold ice water and make clear that physicians have a language all their own; a language that has nothing to do with dictionaries, medical or English.... Ohhhh Marcarena!  

Sometimes it is perfectly valid words that cause the hips to swivel and rotate in the chair while the MT does the "double-reference grab" (subconsciously ticking off the mental minutes used to search