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Is it broken? Nah, it’s just fractured.

April 02, 2011 By: Dr. K Category: For Vets, General, Opinion

A colleague’s recent appointment went hysterically awry when the owner misunderstood the explanation of the dog’s illness.  Upon presenting to our clinic with a “swollen nipple”, my colleague diagnosed the dog with mastitis, a painful infection of mammary tissue.  Her owners recounted the treatment plan, consented to labwork, and waited while the diagnostics were performed. When the veterinarian and dog arrived back in the exam room, one owner said, “What’d you call that problem again? Mass tits?”

Mispronunciations and misunderstandings are a staple of veterinary medicine and I rarely fault my clients for them. Refills of subscriptions, ascriptions, and scriptions fill the prescription inbox. Eyedrops treat cadillacs. Elbows are knees, wrists are ankles, their left is my right. This list goes on and on. I usually chuckle and note I should keep a list (yes, I should definitely keep a list) but a few pet peeves still get to me.

Spaded

Every veterinarian has been there.  A client requests to have her puppy “spaded” and you fight the cringe. I’ve tried gentle coaxing with, “We can certainly set up an appointment to have your dog spayed; The receptionist can set that spay up for you.” This rarely works though I find myself trudging forward on a fruitless journey. It seems as though this term is firmly rooted in the client vernacular.

If gentle guidance doesn’t fix the misnomer, this is one better left alone. The correct term for removing the ovaries and uterus is an ovariohysterectomy. The general term for the procedure is a spay. It turns out spay is an English term derived from the French term espee, the early derivative of the sharp blade used in fencing called the épée.  A spade is a tool used to dig, cut, or remove. Maybe spayed and spaded aren’t so far apart afterall?

It’s Just Fractured, Not Broke

Somewhere in the history of medicine someone decided broken and fractured were both recognized medical terms for varying degrees of bone injuries. The idea spawned faster than mosquitoes in an abandoned tire. The misconception that fractures are minor injuries with minimal bone separation and “broken” applies to bone fragments in different counties is simply…false. Fracture is the only professional term describing the traumatic separation of contiguous bone. If it’s broken, it’s fractured. Separated bone ends are called displaced fractures. Bone fragments jutting through the skin are called compound fractures. Comminuted fractures refer to bones in multiple pieces.

This one is easy to remedy. Most clients are eager to learn about things relatable to humans. They describe the fracture in detail to friends and family and some even want copies of the radiographs to wave in people’s faces. (Much like me, many people can’t refuse the opportunity to show bruises, wounds, and other injuries in a attempt to either shock or one-up people. Some time I’ll tell you about the worst blood draw I’ve ever received. We’re talking full arm bruising. I digress.) Use this opportunity to correct wayward clients.

Lyme’s Disease

I tolerate client misinformation fairly well, but the term “Lyme’s Disease” is one I am seeing crop up on paperwork from other veterinary practices.  My skin crawls and my ears buzz when I hear a veterinary professional say “Lyme’s Disease”  further propagating misinformation and general ignorance to a highly endemic disease. If a professional can’t bother to use the correct name, how confident are you these veterinarians know the most up-to-date treatment and monitoring protocols for it?

Lyme disease is named after Lyme, Connecticut, ground zero for Lyme Disease. Perhaps I am particularly sensitive to this issue because I practice on the east coast where 9 out of 10 dogs will test positive for exposure to Lyme. Perhaps it’s because every time I turn around there is another consensus report on proper diagnostics, treatment, and follow-up on cases of Lyme disease popping up from researchers at my Alma Mater.  Or perhaps I expect the same level of attention to detail as I would give. Either way, straighten up. It’s Lyme, not Lyme’s. Read your JAVMA.

7 Comments to “Is it broken? Nah, it’s just fractured.”


  1. Hahameow…we had a client bring a cat in for ‘growths’ on it’s underside, turns out they were nipples and the owner said ‘But it’s a boy cat’….

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  2. I’ve had clients bring in their pet for tick removal. They were tugging on nipples the whole time. Yikes!

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  3. Don’t forget “distemperment”!!! My dog will be very crabby if he doesn’t get his “distemperment” shot. :)

    I’m glad I’m not the only one with confused clients. It really IS hard to keep a straight face when clients say “spaded” especially if they say it multiple times in a row. “Lyme’s” drives me nuts too and I agree that it’s worse when other veterinarians say it.

    Oh, and I’ve certainly had to explain to people why their male cat or dog has nipples. “Just like people,” I tell them.

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  4. The most frustrating one for me is that Word that’s never spoken because the client can’t remember it. That Word – you know, it stands for something the other vet recommended for an animal you’ve never seen personally, but are now calling to report lab results. You know, that test the other vet told them about? The cat can take that test and it would make it unnecessary to test T4 so often in the future. Hmm… Radioactive iodine? Does that ring a bell? No, that’s not it. That’s not what the other vet said.

    Three years out of school, and I still don’t know the name of that test. For shame.

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  5. Dr. H –

    Look on the bright side. At least it’s not “dismemberment.”

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  6. “Doc, she’s been licking her hmm-hmm/pee-pee/down there/etc.” Nobody wants to say “vulva.” I did have one client call it “her uvula”. That, and the tangent it spawned, was a topic of conversation for weeks with my staff.

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  7. Ryan,

    Ah, yes. Genital euphemisms. Pubix, thingy, v-jay, stuff, expletives, stones, pills, marbles, nuts, balls, gems, rocks, buttons, boy/girl parts….

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