Acronym Madness – Part 2

Medical acronym use has become almost a necessary part of discussions of advances in cardiovascular medicine. All acronyms are simply abbreviations – usually in upper case (as in NATO) but sometimes not (as in radar). Medical acronyms tend to be formed from single words found in the name of a programme (CHEP for Canadian Hypertension Education Program, MAUDE for a cardiovascular database of the FDA, SEARCH for a collaborative group [1], CHAMP for the Cardiovascular Health Awareness and Management Program) or formed from letters in words used in the title of a clinical study or trial (as in the DREAM study) (2). In the broad area of cardiovascular medicine research studies, one can find hundreds of acronyms, some very easy to pronounce (CHEP, HOPE, etc). For the most part, no strict rules apply to their derivation because the acronyms from some studies may have little meaning taken alone and may not constitute a word (as in the IPPSH study) (3). Acronyms may contain a word and number (TIMI-II study) (4), or designate an ST segment MI (STEMI). There are new cardiovascular study acronyms created almost every week and one can have fun with them. In 2004, a two-act play called “Acronym Madness”, containing 221 English acronyms from a broad range of cardiovascular studies, was published in The Canadian Journal of Cardiology (CJC) (5). Since then, many new cardiovascular study acronyms have appeared. Two hundred thirty-one new acronyms, previously unused as well as some from the original play, were chosen for use in the sequel. The basis for the creation of such plays is humour. Laughter may still be the best medicine.

A synopsis of the original play, using the previous acronyms, will be helpful.

Dr CARLOS D HANE of MIAMI, FLORIDA, with a PhD from SIAM University and an MD from the University of EPHESUS, applied for a position as house physician at the ACUTE COMA Hospital in London, England, in 2004. His interview with a Prof ADAM PARK had gone poorly. PARK judged his curriculum vitae (CV) to be seriously flawed. HANE admitted to being a keen ACRONYM collector but his research claims were suspect and his rapport was less than ideal. He failed the interview and did not get the position.

Undeterred, CARLOS D HANE has now applied for a hospital position in Nova Scotia. A transcript of his latest interview follows.

ACT 1

Scene: Office of Prof VICTOR ASCOT, St BENEDICT Hospital for Diabetes, 5845 TRITON ROAD, SALTIRE CAPE, Nova Scotia (Prof ASCOT is immersed in paper work).

Time: The present.

(Enter Dr CARLOS D HANE, with great VELOCITY and MOMENTUM, wearing a CASHMERE sweater and looking clearly RED, SOB and flustered. He slams the door noisily and quickly sits in a nearby chair.)

HANE: (loudly) “Have you received my CV?”

ASCOT: (scrutinizes his visitor critically, sips his cold CAFE, looks at his WATCH and pauses) “You MUST be Doctor CARLOS D HANE! Please REDUCE your voice! Did my LOYAL secretary, RITA, allow you to barge in like this – like a SEISMIC explosion?”

HANE: “RITA isn’t there – no TRACE of her – gone home in her Honda ACCORD to UMPIRE a high school game, according to ATHENA.”

ASCOT: “Strange! I thought RITA drove a SATURN….and who is ATHENA?”

HANE: (clearing his throat) “One of two doctors playing CARDS outside – waiting to see you. She did, to her CREDIT, PERSUADE me to take her turn. She has a kind HEART.”

ASCOT: (obviously impatient) “I ADMIT you do not lack COURAGE, coming in with such GUSTO.…like a METEOR! But we prefer POISE and GRACE – and to not EXCEED professional etiquette. It will ENHANCE your application.”

(He RIFLES through a SHEAF of papers and finds what he needs) “Yes, I did EXAMINE your revised CV for ACCURACY and SYNTAX. I see you still write and speak in ACRONYMS.”

HANES: “Yes, I see you do too. I have some MORE new ACRONYMS and I am now an AVID palindrome SCOUT.”

ASCOT: “That’s fine, but I need MORE references from VALIDD names of scientific LEADERS.”

HANE: “OK. You MUST have heard of COPERNICUS – a very NICE Polish ASTRONOMER – very PROactive he was, a real TOPCAT – the BEST in his FIELD. His motto was ‘A STITCH in TIME saves nine’. He made the first DIAGNOSIS of COMET dermatitis, a STELLAR case too. My other HERO is MOSES (pauses) but I also like PLATO, Thomas MORE and, of course, AMADEUS Mozart (a great ARTIST). Since 2004, I have been taking MARIMBA lessons. I have also inherited a 1668 STRADIVARIUS called “The EMERALD” from my deceased violinist uncle, OSCAR CAPARAS (who could play every ARPEGGIO). He was featured on BBC ONE many times.”

ASCOT: (shaking his head) “Never heard of him! We don’t get BBC ONE – only CBC. I need ALIVE referees, HANE – not your HEROs! I ADMIRE Professor PARK, so I’ll call him for your RECORD. Return in two HRS! As you seem interested in SPACE and STARS, we have a BEAUTIFUL planetarium in SALTIRE CAPE, on GEMINI ROAD, one of great FAME – an ELITE place – perhaps the finest on EARTH. DROP-IN! Have lunch in the CAFE – they serve TAPAS and COOL-AID. Ask for my friend TRIANA. You might see SIRIUS, perhaps a CORONA or the ANDROMEDA galaxy but unlikely an EcLIPSE today. You need good VISION and sharp ACUITY to see an ASTEROID or JUPITER because of the ALTITUDE, somewhat poor CLARITY and today’s MIST. You MUST take a TAXi – it’s a long way.”

HANE: “No, no. I have TIME. I’ll run – I’m MRFIT! I use a NORDIC track daily.” (He PATS his chest). Is COMET Champion visible yet?”

ASCOT: (shakes his head) “No but it’s ONTARGET for later this year. Will you need a COMPASS?”

HANE: (shakes his head and exits with a WAVE and a SMILE).

ACT 2

Scene: The same.

Time: Approximately 2 h later.

(HANE enters and sits. He remains QUIET.)

ASCOT: (looking up) “Did you find the planetarium?”

HANE: “Yes and I saw APOLLO pass DIRECT overhead. (pauses and grins) Did you replace RITA with MARISA? I hear she has better HIPS than RITA.”

ASCOT: (frowns and shakes his head) “I have spoken to Prof PARK across the SEAS. He remembers your RECORD – your PROFILE. He has faxed me a copy of your previous CV. I see you did remove the fallacious RESEARCH RECORDS and REVERSE the MEGA claims of musical talent! Prof PARK says you lacked FINESSE! You are no MARVEL or boy SCOUT either! (pauses) Are you MORE WISE? Have you acquired new INSIGHT in five years?” (he pauses with a smile).

HANE: “Why do you SMILE? Please STOP! Prof PARK did not TREAT me fairly. His wife, MADAM PARK, has a short FUSE. In addition, although BEAUTIFUL, she did not CAPTIVATE me. I don’t ADMIRE either of them. She enCOURAGEd me to jump in the THAMES! ADAM PARK was ill, so I saw her instead. He is probably a secret VINO drinker! I BET they would FIRE him ASAP if they knew. He is a NUT CASE. Well, since 2004, the SANDS of TIME have moved at a FAST SPEED for me. My PARTNER and COMPANION, one of the best LEADERS in RESEARCH, Doctor BART ICTUS and I, by VALIANT effort – without MRC or NIH RESEARCH funds, I should add – decided to AIM-HIGH in PURSUIT of a CURE to TREAT the AWESOME condition, COMET dermatitis, first seen in SWISS restaurant dishwashers – but now seen everywhere. We were able to CREATE an extract containing a TRACE of CACTUS juice, lots of NAPA wine and a DASH of TNT – a real ADVANCE. BART is the PARAGON of excellence – very SMART – lots of ESPRIT too. He’s like a PERISCOPE – he can see things normally out of sight. (he pauses) I hear COMET dermatitis is common in SALTIRE CAPE. (He pulls colour photos from his pocket) For the RECORD, I will ILLUSTRATE in DETAIL some IMAGES of ADVANCE results, which will IMPRESS you and ALLAY your doubts. Look! CAST your eyes here. PREPARE for a surprise of EPIC proportions. You will B-CONVINCED. MOST dermatologists would say, ‘Holy MOSES! – a great ADVANCE – a real VICTORY!’

“I do not PROFESS to be a MERLIN or a WIZARD but CONTRAST the RADIANCE the cases ADOPT after the CURE. Look at this. It’s like MAGIC. I PREDICT a winner here (pauses). This is a TRIUMPH, my great PASSION.”

(He continues) “The IDEA is to SMOOTH and CARESS the skin with CARE before you ADVANCE the CURE – it’s BEST to use a large MATCH – but not a SHARP one, then a sun LAMP for a few hours. It’s a SNAP!”

ASCOT: (showing fascination) “Why not use a PATCH?”

HANE: “It’s in our plans.” (puffing up) “We COMMIT every DETAIL to a written Guide and also RELY on useful TIPS from our PATIENTS. A word of caution: the skin will always ABSORB the CURE but you must AVOID a TRAIL or TRACE anywhere else. Professor ASCOT, this CURE will TRANSCEND all treatments for COMET dermatitis.”

(He is suddenly QUIET, stares at the photos, shakes his head). “I must ADMIT something. (pauses) There is a CAVIAT – the CURE doesn’t work in SENIORS with diabetes.”

ASCOT: (laughs loudly) “Very interesting, HANE – a great IDEA but this is a diabetes hospital. How do you HOPE to ACCOMPLISH a CURE for our many SENIORS? I’m afraid you do not INSPIRE ME – you fail to meet our IDEAL Hospital PROFILE.”

HANE: (rising slowly, moves toward the rubbish BASKET, turns and replies with a TRACE of sadness): “It was my DREAM to CONVINCE you – to ALLAY your concerns. I try to be an OPTIMIST and I know I’m IDEAL for this job but…I see my CHARM and my CRUSADE for this CURE are not enough. (drops photos in BASKET) Our CURE – some day we will IMPROVE-IT!”

ASCOT: (trying to look sympathetic) “I PREDICT you will SURVIVE and perhaps PROSPER and BLOOM elsewhere, HANE. Look AHEAD, try to aDAPT and use MORE POISE. Try not to HARP. CAST your NET wide. You could try PRINCE Edward Hospital on the ISLAND of PEI. We seek ACCORD and SYNERGY here. You may not know that our staff eat FISH almost every day and take OMEGA-3 capsules too. Our doctors sing in a CHOIR, always with CLARITY and ACCURACY when we SERENADE our patients. Last year, our CHOIR won the PRINCESS TROPHY. Some of us can sing three OCTAVES! St BENEDICT hospital has been blessed by the Pope! Your new CV is TRENDY but you now prefer CALYPSO music – a big GAP in your musical taste. What happened to RAVEL, VIVALDI and VERDI?”

HANE: (ponders the question and shrugs) “I can’t INVEST in all SCORES. They are not CHEAP!”

ASCOT: “Too bad – but before you go – do you have any NICE new palindromes?”

HANE: “Of course. In English or LATIN?”

ASCOT: “Try LATIN.”

HANE: “I have many but the IDEAL one for you Professor ASCOT GOES like this: ‘subi dura a rudibus’”.

ASCOT: (looking puzzled) “My LATIN is very rusty…”

HANE: “It means, ‘endure rough TREATment from uncultured brutes.”’

ASCOT: “Very funny! Go jump in the LIDO on HORIZON ROAD!”

HANE: (turns, attempts a SMILE) “I am leaving with a SADHART but I still have my PRIDE.” (He WAVES as he leaves and shouts). “PEACE on you AMIGO!”

Curtain falls