Mental health writing pet peeve -- what's wrong with "I"?

[MacDonaldTriad]

Oh my gosh, I do this too! (From my post in 1/31/2014 with a small artistic edit)

“After serving the patient an involuntary hold, the patient suggested that this author had an overly ambitious and unique resolution to his Oedipus complex.”

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[Ceke2002]

It's British.

Any American using it sounds affected and is probably using it incorrectly. And I laugh at them.


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Thanks, I wasn't sure if there were perhaps a few areas in the US where the speech patterns had retained a bit more Englishness to them. And yes I can imagine most people don't use the word correctly. I use it myself a fair bit, but for example I'd say something like - "Whilst I do agree with some of what you said, I don't necessarily agree when you say *insert whatever specifics*" -- what I wouldn't say is something like "Would you mine waiting here whilst I head up to the shop" in that example I'd use 'while' not 'whilst'.

 

[AcronymAllergy]

It's British.

Any American using it sounds affected and is probably using it incorrectly. And I laugh at them.


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While in grad school, another student and I had an informal ongoing wager to see how often we could slip words like, "heretofore," "whereupon," "thereafter," "henceforth," and "aforementioned" into our reports without our advisor trying to strangle us.

 

[smalltownpsych]

While in grad school, another student and I had an informal ongoing wager to see how often we could slip words like, "heretofore," "whereupon," "thereafter," "henceforth," and "aforementioned" into our reports without our advisor trying to strangle us.

In my undergrad I found that in humanities courses that if I wrote complex and incomprehensible sentences using some of the aforementioned words to connect complex sentences, I would get better grades on papers. I actually began to take pride in how meaningless my writing could become and still get a high A. It all started because I would get Bs when the writing was clear and concise.

 

[Trismegistus4]

While in grad school, another student and I had an informal ongoing wager to see how often we could slip words like, "heretofore," "whereupon," "thereafter," "henceforth," and "aforementioned" into our reports without our advisor trying to strangle us.

Don't forget my favorites: whence, whither, thence, and thither! I really need to start using them more often.

"The patient, who had heretofore voiced suicidal ideations, was asked about his intentions after discharge, whereupon he was able to describe a coherent plan to keep himself safe. He is agreeable to returning to the shelter, whence he had come to the ER, and shall return thither, thence to seek more permanent housing, and henceforth to abstain from drugs and alcohol."

 

[smalltownpsych]

Don't forget my favorites: whence, whither, thence, and thither! I really need to start using them more often.

"The patient, who had heretofore voiced suicidal ideations, was asked about his intentions after discharge, whereupon he was able to describe a coherent plan to keep himself safe. He is agreeable to returning to the shelter, whence he had come to the ER, and shall return thither, thence to seek more permanent housing, and henceforth to abstain from drugs and alcohol."

 

[splik]

you forgot whence - one of my favorite.

e.g. "Dispo plan" She returned from whence she came"

 

[Trismegistus4]

you forgot whence - one of my favorite.

e.g. "Dispo plan" She returned from whence she came"

Not only did I use "whence," but you made a common error. "Whence" means "from where." The "from" is redundant! Back to grammar school for you!

 

[splik]

you did use whence! I'm sorry! and although you are correct about the meaning of whence, it is perfectly good english to use "from whence". if it was good enough for Shakespeare it's good enough for me.

 

[splik]

quality of documentation has definitely gone down. I always enjoy reading notes from many years ago. This is probably why I still read psychiatric textbooks from 70-150 years ago and they are as relevant today

Back in 1969 psychiatry residents wrote notes like this:
There is no question that the psychosis continues…Yet, within the overall personality there is… an ego-adaptive, coping, observing, trying to judge—albeit from a weak, uncertain and tenuous position…[often] overwhelmed in the face of inner chaos and psychosis. But there are islands of strength within the psychotic seas, and when the seas diminish, seemingly of their own accord, one can see these islands more clearly than ever before…One can only wonder if all these islands are not somehow connected beneath the sea, and if so, how does one continue to raise the land mass, that is, capacity to cope and adapt above the level of the waters of the raging impulses of her psychosis.

 

[Shikima]

I wish I were as poetic. At least the billers and coders wouldn't be bored.

They might even start a book club on such documentation.

 

[Ceke2002]

I wish I were as poetic. At least the billers and coders wouldn't be bored.

They might even start a book club on such documentation.

You could always start writing notes in rhyming slang, if you felt like they required an extra challenge.

"Patient presented to the ED with a chief complaint of pain in his Ginger Meggs. He further stated that said pain had occurred immediately after donning his new whistle (a present from his cheese n kisses ) whereupon he had had been viciously bitten by several Joe Blakes. After taking a captains for myself I informed the patient that I could see no evidence that he had been bitten by any Joe Blake. Also noting that the patient smelt like he may have been on the Aristotle at some point that day, I discretely enquired as to whether or not the patient may, or may not have been a bit molly the munk. To the patient's credit he did admit that he had headed to the local near and far and blown the froth of a couple, before heading home after work, but he assured me he was as sober as a rock and lurch when the Noah's had attacked him. Noting that the patient had now changed his grim and gory, I informed him that a Noah's Ark on land was nails to me, and asked what had happened to the Joe Blakes -- at which point, confirming my suspicion that he was telling porkies, the patient began loudly insisting that I fetch him a dog and bone so he could ring the local Johnny Hoppers and lodge a complaint. At this point, satisfied the patient was in no immediate medical danger, and charting a diagnosis of "All quite on the western", I decided to leave the patient sitting on his pat for a while as I headed off to complete his discharge papers. Upon my return I noted that the patient was still carrying on like a two bob watch, so I chucked him the aforementioned discharge papers, and informed him of my intent to have him escorted off the premises if he continued acting like a Gregory Peck. The patient, now having relaxed considerably, then made enquiries as to how he was supposed to get home, to which I replied that considering he only lived a few metres up the frog and toad perhaps he might consider riding shanksters pony."

 

[smalltownpsych]

You could always start writing notes in rhyming slang, if you felt like they required an extra challenge.

"Patient presented to the ED with a chief complaint of pain in his Ginger Meggs. He further stated that said pain had occurred immediately after donning his new whistle (a present from his cheese n kisses ) whereupon he had had been viciously bitten by several Joe Blakes. After taking a captains for myself I informed the patient that I could see no evidence that he had been bitten by any Joe Blake. Also noting that the patient smelt like he may have been on the Aristotle at some point that day, I discretely enquired as to whether or not the patient may, or may not have been a bit molly the munk. To the patient's credit he did admit that he had headed to the local near and far and blown the froth of a couple, before heading home after work, but he assured me he was as sober as a rock and lurch when the Noah's had attacked him. Noting that the patient had now changed his grim and gory, I informed him that a Noah's Ark on land was nails to me, and asked what had happened to the Joe Blakes -- at which point, confirming my suspicion that he was telling porkies, the patient began loudly insisting that I fetch him a dog and bone so he could ring the local Johnny Hoppers and lodge a complaint. At this point, satisfied the patient was in no immediate medical danger, and charting a diagnosis of "All quite on the western", I decided to leave the patient sitting on his pat for a while as I headed off to complete his discharge papers. Upon my return I noted that the patient was still carrying on like a two bob watch, so I chucked him the aforementioned discharge papers, and informed him of my intent to have him escorted off the premises if he continued acting like a Gregory Peck. The patient, now having relaxed considerably, then made enquiries as to how he was supposed to get home, to which I replied that considering he only lived a few metres up the frog and toad perhaps he might consider riding shanksters pony."

Is that all real Aussie slang? Never heard much of it as the crocodile hunter was my main source for that and since he died things haven't really been the same.

 

[Ceke2002]

Is that all real Aussie slang? Never heard much of it as the crocodile hunter was my main source for that and since he died things haven't really been the same.

Yes that is real Australian rhyming slang, it's very rarely actually spoken anymore though (slang in general, yes, but not rhyming slang). I still use a few phrases myself here and there, but it really depends on the company I'm around at the time.

And a translation for that passage...

"Patient presented to the ED with a chief complaint of pain in his legs. He further stated that said pain had occurred immediately after donning his new suit (a present from his Mrs ) whereupon he had had been viciously bitten by several snakes. After taking a look for myself I informed the patient that I could see no evidence that he had been bitten by any snake. Also noting that the patient smelt like he may have been on the bottle at some point that day, I discretely enquired as to whether or not the patient may, or may not have been a bit drunk. To the patient's credit he did admit that he had headed to the local bar and had had a couple of drinks, before heading home after work, but he assured me he was as sober as a church when the sharks had attacked him. Noting that the patient had now changed his story, I informed him that a shark on land was news to me, and asked what had happened to the snakes -- at which point, confirming my suspicion that he was telling lies, the patient began loudly insisting that I fetch him a phone so he could ring the local police and lodge a complaint. At this point, satisfied the patient was in no immediate medical danger, and charting a diagnosis of "All quite on the western (front...work it out )", I decided to leave the patient sitting on his own for a while as I headed off to complete his discharge papers. Upon my return I noted that the patient was still acting up, so I threw him the aforementioned discharge papers, and informed him of my intent to have him escorted off the premises if he continued acting like a pain in the neck. The patient, now having relaxed considerably, then made enquiries as to how he was supposed to get home, to which I replied that considering he only lived a few metres up the road perhaps he might consider walking."

 

[HarryMTieboutMD]

Trolling in notes is fun, and definitely an art, but the whole point of writing a note (especially now with EMR where handwriting is not an issue) is so that another MD can read an understand my note/line of thinking (I really don't care if nurses/SWs/midlevels/whoever can't understand...). I used to do some above the above (still write in the Queen's from time to time), but after realizing that I had neither the time nor the patience to read a long, boring H&P with meaningless detail, I pared down my notes substantially