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Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

In 1950, Elizabeth Lee Hazen and Rachel Fuller Brown isolated a novel anti-fungal compound from Streptomyces noursei bacteria. They ultimately patented and named this molecule "nystatin," a homage to their employer, the New York State Public Health Department. Notably, Hazen and Brown gave back their entire share of $13 million in nystatin royalties to philanthropically support scientific research endeavors.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Research universities add tremendous value to society, including the development of economy-stimulating technology and enterprise. Whereas some feel that such ends (eg, the creation of jobs and subsequent collection of corporate/individual taxes) represent sufficient return on investment, others insist that society deserves a more pronounced dividend from the companies it helped create. How such private-public payback or profit-share schemes would actually function, however, is not altogether clear; unlike the altruistic discoverers of nystatin, many patent holders (and their research universities) funnel their profits in opaque brokerage accounts or endowments. This issue exemplifies the difficulty of marrying capitalism with equitable access to publicly funded research, technology, and education.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

The etymology of "omphalocele" is epic (truly). In Ancient Greek mythology, Omphale, the Queen of Lydia, bought Heracles after he was sentenced to a year of slavery (a punishment for a murder committed by Heracles, constituting a "serious" breach of hospitality). Omphale and Heracles became attracted to each other; their tryst resulted in four children. It was said that Heracles took a particular liking to Omphale's navel. This story helped justify the Greek term for navel, omphalos (eventually superseded by its equivalent Latin term umbilicus, roughly meaning "small knob"). Omphalocele's latter portion, "-cele," also hails from Greek and signifies a cavitated pouch/hernia.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

The question forms the basis of a long-debated philosophical conundrum known as "the problem of evil," the defense of which has its own dedicated term, "theodicy." Despite centuries of dedicated argument and scholarship, it nonetheless remains difficult to justify (without sounding somewhat callous) the existence of an omnipotent, omniscient, omnipresent, and benevolent force underlying the universe with what appears to be futile suffering — a newborn baby ailing from an omphalocele at birth, for example.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

It is unclear how the term "pimping" came into the medical lexicon. However, an often-cited paper entitled "The Art of Pimping" fictitiously postulated that the word stemmed from 19th century German physician Robert Koch (think "Koch's postulates"), who wrote a series of questions that he intended to ask on rounds. He entitled these pümpfrage (with -frage meaning "question" and pümp- meaning "pump," said to refer to the rapid pace of the inquisition). Although this etymologic supposition was written in jest, it has nonetheless propagated throughout the literature!

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Quite a lot! Words carry intention, emotion, and associations that can heal or hurt. Moreover, words have cultural and linguistic legacies that, much like DNA, mutate over time (this is partly why etymology is fascinating). Like organisms, they can also go extinct (either naturally or purposefully); new words fill their voided niche. With this said, it's hard to see why the humorous and whimsical-sounding pümpfrage could not supplant modern medicine's use of the word "pimp." The word itself probably has no bearing on patient care or physician training, and its current association with sexual exploitation is arguably the exact opposite of medicine's primary goals.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

In 1377, plague raged through Europe. The rulers of Ragusa (now Dubrovnik, Croatia) came up with a plan: They enacted a law requiring 30 days of strict isolation for any person wanting to enter the city; the law also pertained to its own citizens who ventured outside its walls and sought return. This policy became known as trentino, stemming from the Italian word trenta, meaning "thirty." For unclear reasons, however, the isolation mandate was lengthened to 40 days (theorized as possibly an early instance of the now famous and ubiquitous "abundance of caution" justification). In Italian, "forty" is quaranta, and thus the policy of trentino was changed to quarantino, eventually becoming the quarantine widely implemented today.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

When effective, policies enforcing "social" distancing, isolation, and quarantine have the capacity to save countless lives and prevent needless suffering. On the other hand, they can also deprive many citizens of their livelihoods, induce crippling mental illness, and cause potentially irreparable damage to economies and institutions. Unfortunately, it is probably impossible to calculate and weigh these direct and indirect costs a priori, especially for contagious outbreaks without precedent. In an ideal world, democratic societies might allow citizens to have a say regarding which quarantine policies should be implemented, as well as when their removal is indicated.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

A thorough story of US residency usually mentions Dr William Halsted (famously addicted to cocaine and morphine), who helped found the first equivalent of a residency program at Johns Hopkins in the late 1800s. It is said that the term "residency" reflected trainees' willingness (and possible necessity) to take up residency in the hospital where they trained. As time went on, specialty boards (starting with ophthalmology in 1917) began certifying and requiring residency training in order to practice.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Although very few endorse a return to the working life of the late 1800s, the debate continues on how many duty-hours a resident can safely work. Some argue that a fatigued resident at the end of a 28-hour shift is a danger to patients, whereas others claim that the "handoff" period between shifts is more dangerous to patients, and thus, longer working hours reduces handoffs and makes patients safer. Of note, compounding this issue is the common requirement for residents to self-report their duty-hours, which, if exceeded, risks disciplinary action taken on the resident or residency program.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Despite the impressive range that the word "scrub" has within the English language (including "to wash" and "a poorly skilled basketball player"), its exact origin is incompletely understood. More is known, however, about how it was adopted into its hallowed place within the healthcare community. It is said that as operating surgical theater lights became more advanced (and brighter), many noted that white surgical gowns (popular at that time) caused eye strain. To combat this, in the 1940s, hospitals began experimenting with colored uniforms that were soon referred to as "surgical greens" and "theater blues." It is theorized that these soon adopted the name "scrubs" because of their association with the similarly "scrubbed" environment of the operating room.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Many have sought to answer this patient-centered question by surveying patient preference. Most studies compare different combinations of white coat (or not) atop a more formal costume (eg, blouse and skirt, shirt and tie) vs "surgical" wear (ie, scrubs). Perhaps it's not surprising that the conclusions from these studies vary inasmuch as each specialty has a unique patient population (eg, pediatrics vs geriatrics) and modus operandi (eg, inpatient, outpatient, at-home visits).

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

The word "tablet" probably stems from tabuleta (the diminutive of the Latin tabula), meaning "little table." Tablet-based medicines (as opposed to powders or liquids) were relatively rare until the 19th century, when pill-pressing technology blossomed. This new advance was capitalized in 1884 by Henry Wellcome who, alongside his business partner, began selling medicines with the trademark Tabloid (a portmanteau of "tablet" and "alkaloid"). Of note, the word "tabloid" began to take on the meaning "compressed" or "condensed," eventually giving rise to the term "tabloid journalism." Upon his death in 1936, Wellcome's fortune was used to create the Wellcome Trust which, as of 2020, had become one of the largest charitable foundations worldwide.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Trackable pill technology is relatively new; it was first approved by the US Food and Drug Administration in 2017 for "aripiprazole tablets with sensor." These "smart pills" essentially function by sending a signal to an internet-enabled device after being processed by the stomach. The long-term consequences of this technology are unclear. On one hand, electronically tracking medication adherence may improve patient care as well as provide relief to patients, their families, and clinicians (and possibly the police). Moreover, combining this technology with other biometric monitoring may also facilitate new research avenues and discovery. On the other hand, the technology may cause a "big brother"–like atmosphere, stoking fears that ultimately harm mental health.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

The word umami is Japanese, a contraction of umai ("delicious") and mi ("taste sense"). Although umami-rich foods have been enjoyed for millennia, the molecular nature of their sensing is a relatively new discovery. In 1908, a Japanese professor, Kikunae Ikeda, isolated glutamate as the causative savory flavor of kombu (seaweed) broth; nowadays, chefs take advantage of this by adding monosodium glutamate (MSG) to foods. Notably, however, not everyone tastes umami similarly; analyzing the genomes of "non-tasters" has evidenced the idea that taste bud receptor genes TAS1R1 and TAS1R3are important for the "normal tasting of glutamate-induced savory flavors."

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Genes that lower one's perception of umami may have no link to lifespan. This is not the case for all genes, though. And as technology advances, it is unclear how genomic analysis will inform predictive models on human health, lifespan, and behavior. Rather preemptively, the US Congress passed the 2008 Genetic Information Nondiscrimination Act (GINA), which forbids genetic information from being used to affect access to employment or health insurance; however, life insurance restrictions were not included.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

The word "vaccine" is ultimately derived from the Latin word for cow, vacca, via vaccinus, "from cow." In the late 1700s, British physician Edward Jenner experimented with the use of "cowpox" viral preparations and self-published their remarkable ability to provide cross-immunity against smallpox (a long-used technique known as variolation, with "variola" meaning smallpox). Of note, however, is that in 2017, researchers genome-sequenced a commercially available smallpox vaccine from the early 1900s. Their data strongly suggest that these vaccines were actually from horsepox, not cowpox (a possibility that Jenner himself suspected). It is intriguing to think that had this fact been widely known at the time, the word "vaccine" might have been replaced by an equine equivalent.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Cited concerns surrounding vaccines often include issues of informed consent, equitable access, human testing, risk vs benefit, and vaccine mandates. Indeed, how the COVID-19 pandemic will alter society's view of this latter issue remains to be seen, especially to what extent certified proof of COVID-19 vaccination status (the "vaccine passport") will be required to go to work, school, or certain countries.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Unexpectedly, the modern usage of the word "wellness" is relatively new. In 1979, on the widely viewed TV show 60 Minutes, Dan Rather described it as "...a word you don't hear every day." Many trace its modern meaning to Halbert Dunn who, in the 1950s, began espousing its benefits. As legend has it, in 1972, preventive-medicine resident John Travis picked up Dunn's book High-Level Wellness from a $2 clearance table at the Johns Hopkins Medical School bookstore. Travis was apparently "...enamored with the way Dunn presented his ideas..." and eventually opened the "Wellness Resource Center" in Mill Valley, California, in 1975. The term caught on, but not everyone was a fan. In fact, it wasn't until circa 2000 that the cautionary "usage note" on "wellness" was finally removed from The American Heritage Dictionary.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

For unclear reasons, US physicians suffer "burnout" and depression and commit suicide at a higher rate than their age-matched counterparts in other countries. Notably, these maladies have been shown to negatively affect patient care. Providing physicians more time for wellness would be a good first step to address this travesty; a simple approach would be to reduce work hours or increase paid time off. However, with patient contact hours (and possibly profit) the priority, these interventions are not easily achieved.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

The etymology of "x-ray" is particularly beautiful. It is said that on November 8, 1895, the German scientist Wilhelm Conrad Röntgen discovered a previously unknown type of radiation (in German, strahl, meaning "beam" or "ray"). This new type of ray was subsequently described with the prefix "x," taking after the algebraic symbol for an unknown quantity. The custom of using x for the unknown was itself introduced to the scientific community via the mathematical treatise La Géométrie (1637) by René Descartes.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Every time a patient is exposed (or not exposed) to an x-ray–based study, one faces a challenge: balancing the potential risk from the x-ray radiation (increased cancer, etc.) vs the risk of missing a treatable diagnosis, like an early malignancy or pulmonary embolism. Compounding this is many physicians' worry of subjecting patients to x-ray contrast agents, which may be necessary for diagnostic accuracy but also carry a situational (and highly debatable) risk to the kidneys. As a result, imaging screening guidelines for diseases such as breast and lung cancer are constantly scrutinized and altered with the emergence of new data.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Yttrium was isolated from a mine near the Swedish village of Ytterby in 1787. As legend has it, part-time chemist Carl Axel Arrhenius found a conspicuous, heavy black rock that he subsequently named ytterbite, from which yttrium was later isolated.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Yttrium-90 is generated via the radioactive decay of strontium-90, itself a byproduct of the nuclear fission of uranium. This makes yttrium-90 a useful, reused byproduct of nuclear waste. It is nonetheless a radioactive substance, whose production and disposal are fraught with complicated environmental and water-use concerns. More generally, the use and disposal of yttrium-90 connects to the greater problem of medical waste, of which an incredible amount is generated each year. This includes not only radioactive waste, but also biohazardous material, biologically active pharmaceutical metabolites, and troublesome non-biodegradable plastics. Certainly, reducing the amount of unnecessary waste should be a priority of healthcare; innovations that promote the reuse of materials (such as N95 masks) will most likely be welcomed by Mother Earth and her tenants.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

The word "zoster" hails from a type of Ancient Greek belt or girdle (ζωστηρ) primarily worn by male warriors. It is theorized that original Ancient Greek zosters were asymmetric, having metal studs on one lateral side of the belt.

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

When I was a child, pretty much everyone caught varicella zoster virus (VZV, aka "chickenpox"). Most recovered without any complications. Every year, however, a small number of children died or suffered permanent neural injury from VZV. The development of the VZV vaccine (first released in the United States in the 1990s, with comparatively little controversy) essentially eliminated these devastating occurrences; it has also lessened adult suffering from shingles. Indeed, stories like these suggest that safe and effective vaccines represent one of humanity's biggest victories. Sharing these stories may further precipitate advances and innovation (and possibly their acceptance). Toward the goal of increasing public interest in the science of medicine, perhaps what we call "the arts can play a powerful and unique role."

Ever Been Pumpfraged? A Colorful Look at Medical Words: N Through Z

Nicholas R. Love, MD, PhD | June 24, 2022 | Contributor Information

Meet Nick Love, the Artist and Author

You can find Nick Love's artwork and musings on medical words that begin with the letters A through M here.

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21 Clinical Mnemonics

Physician-artist Nick Love's latest creations are whimsical and memorable. Who could forget four Mr Ts?Medscape Features Slideshow, Jun 2020
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