What the Heck! Comedian Decodes ER Terms

Medical words can sound like spells, and that confusion has a cost. When you don’t understand what a clinician just said, it’s harder to advocate for yourself, follow instructions, or spot a real emergency. So we built a game: we put everyday emergency medicine and toxicology terms in front of a stand-up comedian and let her take her best shot at pronunciation and meaning, then we translate everything into plain English without losing the nuance.

We dig into computed tomography (yes, the CT scan), what it actually does, and why contrast matters. We decode choledocholithiasis into a clear picture of gallstones in the bile duct and why that location changes the urgency. We also tackle the legendary sphygmomanometer, the blood pressure cuff you’ve met a hundred times, and use it to talk about how clinicians think with simple vital signs.

Then the stakes rise with toxicology and overdose care. We explain N-acetylcysteine as the antidote for acetaminophen (Tylenol) overdose and why timing matters for liver protection. We cover naloxone (Narcan), how the nasal spray works, when a Good Samaritan might consider it, and what it can do to someone who’s dependent on opioids. 

We even zoom out into public health with DDT, malaria control, environmental harm, and the very real mosquito problem, before closing on “NPO,” nothing by mouth, and why anesthesia teams care so much about an empty stomach and even your nail polish.

If you like smart medicine with real laughs, hit subscribe, share this with a friend who hates medical jargon, and leave a quick review so more listeners can find the show.

THANKS TO OUR GUESTS:

Dr Mike: emergency room physician, medical toxicologist, addiction medicine specialist YT/IG/TT: @toxdocx

Paula Kosienski: comedian, IG/TT/YT @paulacomedy FB: Paula Kosienski https://nateland.com/pages/paula-kosienski

Subscribe wherever you listen, share this with a friend and leave a review so more people can find honest conversations about healthcare and a little comedy along the way.

This episode was produced by Angie Debelak with post-production editing by Ben Hill Sound.

Thanks for listening to Dr Ben and Friends.  Laughter is the best medicine...unless you're treating bowel or bladder incontinence.  See you next time!

Team Dr Ben

The Needles Group
Experience elevated coastal living in Marco Island & Naples. Connect with The Needles Group today!

Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.

Transcript

Welcome To Medical Comedy

Dr Ben 0:09

Knock knock howdy folks, Dr. Ben here. We are putting the MED in comedy. Today we have very hilarious stand-up professional comedian, Miss Paula Kosienski. And we have board-certified emergency medicine physician and medical toxicologist, Dr. Mike. All right, are you folks ready to play What the Heck? In What the Heck, Dr. Mike here is gonna show Miss Paula here some medical terms that doctors use every day, but Paula may or may not have heard. And so Paula's gonna pronounce them and tell us what she thinks they mean. What they may be used for, might be a medicine, a drug, a disease, a condition, a tool, an instrument. All right. Anything's fair game here. Are we ready to start? Oh, I'm ready.

Paula Kosienski 0:57

I'm so ready.

Dr Ben 0:59

All right, what the

CT Scans Explained Without Fear

Dr Ben 1:00

heck? Dr. Mike, let's give Miss Paula her first word. Let's test her knowledge.

Dr Mike 1:06

Here's your first word.

Speaker 1:08

All right.

Paula Kosienski 1:08

All right. Computed tomography. Oh, wow.

Dr Mike and Dr Ben 1:12

That rolled off the tongue. What does that mean? We got a ringer here. That's right.

Paula Kosienski 1:16

All right.

Dr Ben 1:17

What is compute? I can't even say it.

Paula Kosienski 1:18

Computed tomography. Yeah, what is that? Well, I think a tomography is a test done. Um it's a reading of some sort. I'm guessing it's something similar to maybe like an ultrasound or something.

Dr Mike and Dr Ben 1:33

What are the first two letters of each word?

Paula Kosienski 1:36

C T.

Paula Kosienski, Dr Ben and Dr Mike 1:37

Oh my god. That was a good clue. That's a good clue. C T. Do you think that's a clue?

Paula Kosienski 1:43

C T I I feel that's a that's a good clue.

Dr Ben 1:46

Have you heard of that? CT.

Paula Kosienski 1:49

Sometimes it really is just that simple.

Dr Ben 1:51

So what so what is uh computed tomography, Dr. Mike?

Dr Mike 1:54

Thinking about it, it's a lot of x-rays that are re that are put together by the computer in order to give you a three-dimensional image.

Paula Kosienski 2:01

Gotcha. And sometimes contrast is used.

Dr Mike 2:05

Yeah, sometimes contrast is used to give our radiology colleagues who are part-time gardeners because they hedge a lot.

Dr Ben 2:10

Oh and I think veterinarians, when they use it, they call them cat scans.

Dr Mike 2:15

Yeah, absolutely. We got a new one over at one of the hospitals. It's a biologic cat scanner. Basically, they take a cat and when it meows, it means it found something.

Paula Kosienski 2:24

Wow, you guys are very sophisticated. You missed you're calling us vets.

Dr Ben 2:28

Yes. Dogs cannot perform MRIs, but cats can.

Dr Mike 2:32

Yeah, exactly. And when you're looking for cancer, it's a PET scan.

Paula Kosienski, Dr Ben and Dr Mike 2:36

So, listener, um, you can sound smart by instead of saying CT, you could say computed tomography. All right, good one. All right. Are you ready for the next one? You were on you, it was a test. Yeah, you got it right. All right, I just overcomplicated that one. Dr. Mike. What the heck? What is this word, Dr. Paula?

Gallstones Stuck In The Duct

Paula Kosienski and Dr Mike 2:54

Coleodocalitiais. That's pretty good.

Dr Mike and Dr Ben 2:58

Wow. That's pretty good. Great pronunciation. Thanks. And what does that what is that?

Paula Kosienski 3:03

Okay, the only thing I know is coleodocal, which is in your bile ducts. Oh. Um, and I know that because I had a cyst recently taken out, and it was called the coleodocal cyst. So thiac, I don't know if that means like you, it doesn't, I don't think you take it out. Maybe you like you do take it out.

Dr Mike 3:21

You need to take it out, yeah.

Paula Kosienski 3:22

Oh, yeah, okay.

Paula Kosienski, Dr Ben and Dr Mike 3:23

So, so choline, like you said, gallbladder doco in the duct and lithiasis, lith is a stone. A stone. Gallstone. That's gall gallstone that's stuck in the duct. That's actually that's an emergency. That's a real emergency.

Paula Kosienski 3:37

Gotcha.

Paula Kosienski, Dr Ben and Dr Mike 3:37

And if you hear of nephrolithiasis, kidney kidney stone, right? Okay, gallstone, kidney stone. Makes sense. Yeah. Good job on pronouncing it.

Paula Kosienski 3:45

Thank you. Well done. I literally had a colioed resection less than two years ago. Two or three years ago.

Dr Mike and Dr Ben 3:52

Wow. So you knew what that word was. That's impressive. We have to sound smart, so we can't just say gallstones. We have to.

Dr Mike 3:58

Well, yeah, it's it describes where it is. So when I'm I I need you to take a de coli dokole. I'm associated with a certain GI doctor who has, you know, oh, I can't say the next maybe it's on here. I don't know. I don't I don't want to say that word. Okay. Let's save

The Blood Pressure Cuff Name

Dr Mike 4:10

it here.

Dr Ben 4:10

Let's Oh, what is this word? Dr. Paula, what is this word? Um sound it out.

Paula Kosienski 4:18

I'm gonna go with Phymometer.

Dr Ben 4:23

Okay. Like the S is silent?

Paula Kosienski 4:26

Yeah.

Dr Ben 4:26

Okay, the S is silent.

Paula Kosienski 4:28

I thought I thought the S was silent. I thought maybe the G was silent.

Dr Mike 4:31

Okay. The S is not silent.

Paula Kosienski 4:34

Oh, okay, so then Spomanometer. Spymenometer.

Paula Kosienski and Dr Mike 4:40

Sphignomenometer. Sphignometer.

Paula Kosienski 4:42

Oh wow, so none of those are silent.

Dr Mike and Dr Ben 4:45

Any idea what it is? What would you guess?

Paula Kosienski 4:47

Spig reminds me of like your sphinx or something.

Dr Mike 4:50

Your sphincter?

Paula Kosienski 4:51

Yeah.

Dr Mike 4:51

No. It's a good try, though. So maybe go with when we go with the second words. That might give you a hint.

Paula Kosienski 4:59

Mammoth. Mammogram?

Dr Mike 5:03

Manometer is a pressure. So it's a pressure meter.

Paula Kosienski 5:07

And it's not like the pressure in your butthole.

Dr Ben 5:10

No, not the sphincter. Sphincter pressure.

Paula Kosienski 5:12

I'm really. Not the sphincter pressure. I think that would be worth knowing what the pressure of the butthole is.

Dr Mike 5:19

This is your this is your standard blood pressure cuff. Whenever you go to the doctor or the paramedic shows up, we call it a BP cuff. Okay. That's a hard word to say a lot.

Paula Kosienski and Dr Ben 5:28

Yeah. I was thinking at least one of those letters. Takes your blood pressure.

Dr Ben 5:32

The blood pressure cuff. Yeah. It's the sphigmomanometer.

Paula Kosienski 5:35

Sphigmomenometer.

Dr Mike 5:37

Exactly. It just rolls off the tone.

Paula Kosienski 5:39

Yeah.

Dr Mike and Dr Ben 5:39

I'd like

ABCs Of Emergencies Plus Anesthesia Jokes

Speaker 1 5:40

again we makes us sound very good. What the heck? All right.

Paula Kosienski 5:43

ABC, airway, breathing, circulate. And it's the three things that you're supposed to check in an emergency situation, correct?

Dr Mike 5:51

That's part. Yeah, that's part. That's excellent. Yeah, this is what I specialize in, the ABCs.

Paula Kosienski 5:56

Because it's like if someone's like unconscious, you're like, you're checking their airway, you're checking if you're breathing, and you're checking if they're have a pulse.

Dr Mike 6:02

Exactly. Dr. Paula. There you go. So first things that we, you know, we teach baby trauma surgeon or the ABCs. So airway, breathing, circulation, deformity, exposure, right? Okay. So do you know what the second thing we teach a song for baby trauma surgeons? Do you any idea? It's the head, shoulders, knees, and toes, right? So head, shoulders, knees and toes, eyes or mouth and nose. That's how you do a trauma assessment. Ah! Did you know that there is another verse to that song? Tell us. It's a Dr. Hayoun original. So it goes chest, belly, back and thighs, back and thighs. Don't forget to check the groin as well as the axilla.

Dr Ben 6:32

Ah, okay.

Dr Mike 6:33

This is this is a Hayoun original.

Dr Mike and Dr Ben 6:34

I like it. Dr. Mike Original. Now the ABCs of anesthesia, that's a little different. Yeah. They have to make sure airway is a and then they need to make sure they have a book and a chair. Airway, book, chair are the ABCs of anesthesia.

Dr Mike 6:49

Did you know that they uh we we, you know, last month was Valentine's Day? Did you know that they write their own Valentine's Day cards?

Dr Ben 6:54

Anesthesiologists do?

Dr Mike 6:55

Yes.

Dr Ben 6:56

No. Tell us.

Dr Mike 6:56

Yeah, the one. The first one is will you be ketamine?

Dr Ben 6:59

Will you be ketamine? Ketamine listener is a uh drug that anesthesiologists use.

Dr Mike 7:03

Yeah, I propofol for you.

Paula Kosienski 7:05

And some people, some people use it recreationally.

Dr Mike and Dr Ben 7:09

They do. Don't do that. But yeah, the second one is I propofol for you.

Paula Kosienski 7:12

I propofol for you.

Dr Ben 7:14

All right.

Paula Kosienski 7:15

I love it.

Dr Ben 7:15

Ready for what the heck? What's our next word, Dr. Mike?

Dr Mike 7:21

What is this word? We mean we mentioned this one already.

Tylenol Overdose Antidote Basics

Dr Mike 7:25

This is a me, this is a toxicology word.

Paula Kosienski and Dr Mike 7:28

Okay. So I think it I think it's N Asirosistenine. Systenine. That was so good.

Dr Mike and Dr Ben 7:36

So good, so close. She was close, wasn't it so close? If she said it on the phone to me, I would accept it. I know what she's talking about. On Jeopardy, we would accept. Yeah, I think that's close.

Paula Kosienski 7:44

That's the chemical, right? That um you use for uh to hang on. That's the one that for benzos. It's like one of the two, isn't it like one of the two things that you use?

Dr Mike 7:56

For in toxicology. So it's benzos and this.

Paula Kosienski 7:58

Benzos and that.

Dr Mike 7:59

Yeah, so this is the treat. Yeah, this is the Tylenol antidote.

Paula Kosienski 8:02

Tylenol, okay. Yeah.

Dr Ben 8:04

So it's what Dr. Mike would use if you took too much Tylenol.

Paula Kosienski and Dr Mike 8:06

Exactly. This is a this is an antidote. Wait, can you put it back up for a second? So it's N acetylcysteine.

Paula Kosienski 8:11

Okay, so acetomenophen, like does is it similar? Is it the ACT same thing?

Dr Mike 8:16

No.

Paula Kosienski 8:17

Oh, I wasn't sure if it was ACET, like acetonophen or the colour.

Paula Kosienski and Dr Mike 8:20

Yeah, no, but no, it's acetyl. It just it's just where the where the groups are. Okay. So yeah, it's because it just it helps what the structure looks like of the molecule.

Paula Kosienski 8:29

Okay.

Dr Mike and Dr Ben 8:29

And what does that do to Tylenol? So this is a detox. So what it does is it adds a sulfur group to it.

Paula Kosienski and Dr Mike 8:35

Is it a base so it doesn't make it acidic? Is that what you said? Not in this case, not in this case. I got too excited.

Dr Mike 8:40

No, you I know I love I love acid bases, exactly. The acid subbases, acid bases. No. In this particular case, it's a sulfur donor and it helps the body detoxify the the toxic compound. Um so yeah, I was reading the Tylenol chapter the other day and I got tired. So I took a nap key, which is the toxic compound. Nap key. That's my tox joke.

Dr Ben 8:59

Now, how is that administered? N acetylcysteine.

Dr Mike 9:02

So it's administered either ivy or orally. Okay. So um, but if you drink it, we usually keep it covered because it smells awful, because it has a sulfur group. It smells like rotten eggs. Oh it doesn't taste bad. But I don't let people smell it because they're not gonna drink it because it smells terrible. Well, okay. It smells like rotten eggs, but usually we give it through the IV. Okay, yeah. Oh, my favorite. One of my favorite medicines. All

Narcan And When To Use It

Dr Ben 9:25

right, what the heck? Ready for your next word, Dr. Pullan?

Paula Kosienski, Dr Ben and Dr Mike 9:27

Oh, naloxone or narcane. Oh, boss over here. Our favorite. The boss. That's the one that everybody should know about. That's right. We all want to have it.

Dr Mike 9:36

Yeah, tell us what it's for.

Paula Kosienski 9:37

It is to reverse uh a drug overdose related to like narcotics.

Dr Mike 9:43

Correct. Wow, Dr. Paula. Well done. Well done. That is correct. So it's a shorter acting opioid antagonist. So it blocks the or it reverses the opioid agonism. That agonism means stimulation, right? Okay. It hits the receptor, so it reverses that. So this is this this is available and you can save lives with this in the field. It comes in an IV form and it also comes in an intranasal form. So you can give it in, you know, anybody can give it as a nasal spray. So yeah, very good. It's such an important medication.

Paula Kosienski 10:14

And you can give it to them in the nasal spray, even if they're not breathing.

Dr Mike 10:17

Right, conscious. Yeah. Yeah. Exactly. Because yes, correct.

Paula Kosienski 10:21

If you see a random person passed out on the street and you have access to narcan, is it better to just give it no questions asked?

Dr Mike 10:29

I th I think it would be safe under Good Samaritan law.

Paula Kosienski 10:32

Okay.

Paula Kosienski and Dr Mike 10:32

I think that would be if they're not breathing. If they're not breathing, I would give it. If they're breathing, probably don't give it. They're probably just sleeping. They assaulted me with this basis for this random woman. In the park.

Dr Ben 10:46

But it's fairly safe, right?

Dr Mike 10:48

As far as it's so so yeah, it's safe. Um, if you have narcotics on board, if you're chronically taking pain medications and you have not had an overdose, and you give that, they're gonna have a very bad day. You're gonna reverse their therapy. They're gonna start hurting. They're gonna start hurting and vomiting. It's it's not a good day. Okay, all right. But you're probably not gonna kill anybody.

Paula Kosienski 11:05

All right, all right.

Dr Ben 11:06

What the heck?

Paula Kosienski, Dr Ben and Dr Mike 11:07

Dr. Paula's doing great. Nobody dies now. What else do we

DDT Pesticides And Mosquito Risks

Dr Ben 11:10

have here? Doctor Paula Okay, what is this word?

Paula Kosienski 11:15

Okay, I'm gonna say it slowly. Dye chloret die fentanyl trick low row.

Dr Mike 11:28

You're so close. So it's dichloral, diphenyl, trichlorine.

Paula Kosienski 11:35

Okay, so dye, chloral, two, chloral something, two, phenyl something, three, like, is that the measurements or whatever?

Dr Mike 11:47

Are you making a cake here? Two measures of chloride from a recipe.

Paula Kosienski 11:53

Like two of two of those, two of the other chemicals and three of the last chemicals.

Dr Ben 11:58

What is it like a instrument or medicine or disease, or what is this?

Paula Kosienski 12:03

You don't know?

Dr Ben 12:04

I was asking Dr Paula!

Paula Kosienski and Dr Mike 12:07

I don't know. I gotta look this one up.

Paula Kosienski 12:09

If if you're asking me, it seems like a chemical.

Dr Mike 12:11

It is a chemical, absolutely chemical. I just not sure what the uh what the what the more generic name is for it.

Dr Ben 12:17

Okay. This one's uh stumper.

Dr Mike 12:19

Yeah, I gotta look, I gotta look this one up.

Dr Ben 12:21

This one is related somewhat to toxicology. It's uh uh abbreviated DDT.

Dr Mike 12:26

Oh, this is just DDT.

Dr Ben 12:27

So it's uh pesticide. Yeah.

Dr Mike 12:29

Do you ever see any pesticide toxicities? Oh, yeah, I love pesticide toxicities. Okay. Yeah, DDT. It's um that's why I was looking. I'm like, what are the letters that this is probably doing? Tell us about DDT or pesticides. Yeah, DDT is an anti uh anti-malarial. It's it's very important. So it kills off a lot of the mosquitoes and help knock down malaria all around the world. They're um very effective, very cheap. The reason we don't see it anymore is it's been dangerous to wildlife specifically, uh, makes eggshells of certain birds very brittle. Okay. So it it's very persistent, but it has been credited with saving literally millions of lives all over the world. Um preventing malaria.

Paula Kosienski 13:07

Is that the same as what people say? DEET?

Dr Mike 13:09

No, no, no, DEET is different. That's just for local mosquitoes. This is DDT. This is used for in a country level. Oh, okay. So it's a great question.

Dr Ben 13:16

Dr. Paula, what animal do you think kills more people worldwide every year? What animal?

Paula Kosienski 13:21

I would say probably either ticks, mosquitoes, or dogs.

Dr Mike 13:27

Ah I'd say humans.

Paula Kosienski 13:30

There's always gonna be one.

Dr Mike and Dr Ben 13:32

I think it is the mosquito, though. Mosquito, yeah, it kills a lot of people, a lot of arboreal viruses.

Paula Kosienski 13:36

Okay. Mosquitoes are really bad in northern Minnesota.

Dr Ben 13:41

The mosquitoes? Yeah. Hopefully don't have malaria.

Paula Kosienski 13:44

No, I'm being so serious. Like, northern Minnesota has some of the worst, like they the mosquitoes are so bad, the ticks are so bad. There's nothing like poisonous in that sense, but you just can get all those tick-borne and mosquito diseases. Probably not malaria, but like, like I had a friend who got West Nile.

Dr Mike 14:01

Oh wow.

Dr Ben 14:02

Wow.

Dr Mike 14:02

Dengue West Nile.

Dr Ben 14:04

I think the Duluth Chamber of Commerce just unsubscribed for my podcast. Oh wow.

Paula Kosienski 14:09

Fix your problems.

Dr Mike and Dr Ben 14:11

Wow. That one that one was a little blood sucking right there, wasn't it? All right. What the heck?

Dr Mike 14:16

Ready for number last one. Last one.

NPO Rules Before Surgery

Dr Ben 14:20

What does this mean?

Paula Kosienski 14:21

Oh, I know what this means. N PO means as needed. Or by mouth. I can't remember.

Dr Mike 14:28

Nil. Nil? What? It says nil.

Paula Kosienski 14:31

Oh, I thought you were saying nil as in no. Okay. No paros nil paros.

Paula Kosienski and Dr Mike 14:37

Peros. Okay. No paros. So so try it again. What do you think that means?

Paula Kosienski 14:41

Nil paros.

Dr Mike 14:43

What do you think it means?

Paula Kosienski 14:45

Oh. I've heard this before.

Dr Mike 14:47

Yeah.

Paula Kosienski 14:50

I think it either means by mouth or as needed.

Dr Mike 14:52

It is by mouth. But what by mouth?

Paula Kosienski 14:55

The medication is by mouth.

Dr Mike 14:57

Nothing per mouth by mouth. Nil. Nothing by mouth. Nothing by mouth.

Paula Kosienski 15:02

Well, it like actually kind of pisses me off because I knew that. I so knew that.

Dr Mike 15:05

Well, you knew it by mouth. You did great there.

Paula Kosienski 15:07

Yeah, but that's not, I didn't get it right.

Paula Kosienski, Dr Ben and Dr Mike 15:08

Before surgery, you have to be nothing by mouth. That would not be accepted on a test question. I would have gotte3n that wrong. Yeah, you would have gotten that one wrong. But this is like the main reason, you know, this is gonna prevent you from getting your surgery.

Paula Kosienski 15:18

Yeah.

Paula Kosienski, Dr Ben and Dr Mike 15:19

Like the first nothing to eat or drink. The first question. Nothing by mouth.

Paula Kosienski 15:21

The thing is, I know what it I like when you when they write on your stupid board, NPO, you can't have anything, and you like gonna beg them for ice chips and they give you this little sponge with water on it.

Dr Mike 15:32

Did they salt the ice chips?

Dr Ben 15:34

We're not trying to be mean, it just saves your life.

Dr Mike 15:37

Exactly, exactly.

Dr Ben 15:38

If contents from your stomach go into your lungs, that could be potentially fatal.

Dr Mike 15:42

So our anesthesiology colleagues appreciate not having to deal with a bad airway.

Dr Ben 15:46

So NPO, nothing by mouth.

Dr Mike 15:49

I don't get that benefit in the emergency room. I'm like, patient needs an airway. It's like, well, have you fasted for the last six hours? I'm not gonna put that airway.

Dr Ben 15:57

I don't get that. Uh patients, they say, well, you said I couldn't eat or drink anything, and they have like a big uh dip in their mouth or something. So don't eat or drink anything when they tell you.

Paula Kosienski 16:06

Why don't they let you paint your nails?

Dr Mike 16:08

They don't let you paint your nails.

Paula Kosienski 16:10

If you get surgery, you can't have your nails painting.

Dr Mike and Dr Ben 16:12

Because they need to do the pulse sock. So they the the uh the machine that's used is is they put a sensor on there.

Paula Kosienski and Dr Ben 16:18

So can I just paint not one nail? Like, can you just tell me that's which nail you because this is like truly when you go in for surgery, Don' t paint your nails. they it's so like you it's so you just don't get anything. It can be like really dehumanizing. So to be able to do something silly like paint your nails or something, you feel a little more like buzzkills.

Dr Ben 16:36

Buzzkills can't eat or drink, can't paint your nails.

Dr Mike 16:38

She's kidding, anesthesia, plenty of a buzz.

Dr Ben 16:42

I love it. All right, listener, what the heck?

Final Laughs And Wrap-Up

Speaker 2 16:51

Dr. Ben and Friends.