Air Force Language (1962); Medical Slang (1994)

[Douglas G. Wilson]

>... As to the def. being 'sanitised', I don't know. Not consciously so.

I do not suggest that Jonathon Green has 'sanitized' the definition. I've
seen the 'sanitized' version elsewhere, and I ran it by a couple of ER MD's
of my acquaintance a while back, to ensure that I was not alone in my
perception. The definition reads "old, dirty, difficult or chronically ill"
-- which tends to weaken the 'injustice' of what I think is the real usual
application of this somewhat dismissive term -- i.e. to an ordinary OLD
(blameless) patient with (usually) multiple chronic illnesses and (usually)
some degree of dementia or confusion. A 35-year-old alcoholic derelict who
is filthy and abusive and who has failure of multiple organ systems and
diminished mental function would not usually qualify as a 'gomer'; OTOH
most of us will so qualify ... if we live long enough.

>  For the
>record the longer, two-part def. in my jargon dict. runs as follows:
>
>GOMER acro. (medicine/US): Get Out Of My Emergency Room: 1. a notation on
>the file of a patient (very often an elderly one) whose less than
>immediately vital problems are witholding the possibility of offering real
>medical aid to someone near death.
>2. patients who are apparently too sick to stay at home but not so sick as
>to die, requiring long-term care and keen to take every advantage of the
>hospital and its staff.  (The female GOMER is a GOMERE).

This is better; I'll have to get a copy of this book. However, 'gomer' is a
word for speaking, NOT for writing on a medical chart!

The acronym-etymology is spurious, I think; another bogus candidate is
"Grand Old Man of the Emergency Room". I think the origin is related to the
other "gomer" -- like in "Gomer Pyle" ... maybe the original form was "old
gome" or so, and maybe "gome" = "man" (from OE "guma" or so; cf. "gome"
[and "gomerel"] in OED): BTW "gome" is used as an alternative = "gomer"
(but maybe just an abbreviation?). Probably reinforced (I speculate) by
"gummer" = "one who gums (i.e., chews without having any teeth)" and maybe
by "gnome" also. [I consider acronym-etymologies to be FUPO (= false until
proven otherwise). (^_^)]

>The DoJ also notes inter much alia that a 'grume' (no ety.) is a 'notably
>filthy gomer'

"Grume" also = simply "filth"/"debris"/"grunge". I feel sure of the
etymology: a generalization of the SE "grume"/"grumous" shown (e.g.) in OED
("grumous" = "bloody"/"messy"/etc. is used in [at least semi-]serious
medical discourse). The grume need not be a gomer; he/she may be young, I
think.

>'LOL in NAD' is Little Old Lady in No Apparent Distress: any
>patients of either sex who enjoy the care and comforts found in a hospital,
>but have no immediate or critical physical problems

Right, although I haven't myself heard this applied to a man. "NAD" is a
'double-entendre', also used seriously for "no acute disease".

>a SHPOS is a 'sub-human piece of shit'; the most derogatory dismissal of a
>patient'

Right. It was "SPOS" where I came from, pronounced like "spozz". Probably
reinforced by "spaz[z]" = "spastic"/"clumsy person", I speculate.

>and a 'toad' is a 'trashy old derelict', a ref. often, but by no means
>only used of a hospitalised vagrant.

Again I suspect the acronym-etymology is retrospective. "Toad" has a
general sense like "unattractive little person". I encountered one surgeon
who routinely referred to medical students -- and (I think) junior
residents [MD's in postgraduate training] -- as "toads" (I don't know
exactly why).

-- Doug Wilson