Friday, February 4, 2011

Kid stuff.

Everybody has been sick this week. Me. The kids. All the kids in my kids' classes.  And all the parents of the kids in my kids' classes, too. It's that predictable germ circus that parades into every neighborhood every year-- right along with the cool weather.

This is the busiest time of year for pediatricians. The schedule usually looks something like this:

Fever, fever, fever, wheezing, fever, wheezing, flu?, fever, fever, fever, lice/scabies, fever.  

Never in my life was I ever so happy to see scabies or lice as I was during the yucky-crud season. It's because fever can mean everything or nothing. It can mean over-exaggerating parent ("My baby has a fever of 108!") or a clueless parent ("My baby had a fever of 108 but I gave him a popsicle!") leading to a 911 emergency. When fever is the chief complaint, you really can never call it. But lice? Scabies? Ooooohh. . .and YES! I almost forgot--a nice big, round ringworm? This time of year those are all welcomed with resounding hallelujahs.

Here's the thing about the sick season in pediatrics--as predictable as it is unpredictable, the part that makes it hardest is the parents. The tired, worried, frustrated-because-they-keep-having-to-miss-work, sick-of-hearing-their-children-whine-and-even-sicker-of-cleaning-up-vomit parents. Yeah.

Now that I no longer see kids in my practice, I must admit that I don't really miss that part. But one of the parts I do miss is just the whole pediatrics culture. That alone probably explains why I've even bothered to maintain board certification in pediatrics in the first place. Kid medicine always takes me on a throwback to that whole pediatric culture.

You know. . . .

The Snoopy neckties, the stickers, the brightly colored walls, and the bulletin boards filled with all sorts of baby and school pictures. All so uniquely peds (pronounced "peeds" for you non-medical folks)--you just had to love it.  But of it all, do you know what I miss the most? The lingo. That strange pediatric lingo! These days, that's the part of the everybody-is-sick season that I do like. All these sneezing, coughing, febrile people and their kids have given me plenty of opportunities to talk "peds"--just like old times. The whole thing has me warm with nostalgia.

Wait, huh? What is "talking peds", you ask?  Let me explain.

Pediatricians use medical language, yes--but they also have a jargon that is uniquely their own.  I found myself using my old peds lexicon while describing my children and their evolving illnesses. And you know what's funny? I never used these terms to describe my own illness or that of any adult under my care.  Why? I really don't know.

It's not like these words are official medical terms or anything. Most, in fact, are utter nonsense. Somehow, some way, no matter where you trained or where you see kids as your patients. . . .these same words find their way into your vocabulary. I've heard them come from old professor mouths, young intern mouths, heavily accented non-native English speaking mouths, and any pediatric professional mouth in between. These words aren't in any American Academy of Pediatrics publications, nor are they in the big green pediatric bible (a.k.a. Nelson's Textbook of Pediatrics.)


The truth is that I have no idea how this bizarre pediatric language managed to go viral. My best guess is that at some point, Hippocrates sat down at a table with a couple of toga-clad pediatricians. Together they decided that there would be a few universal medical words reserved exclusively for those caring for little ones. They busted out a granite tablet and worked the whole thing out until everyone was in agreement. 


Somebody at the table came up with one stipulation that for reasons that escape me, Hippocrates didn't veto:

That every one of the words must end in "unky." 

Yes. You read that right. I said "unky." Completely confused, are you?  Bwaaah ha haaaa! Just keep reading. . . .

Understanding the "Unky" Pediatric Lingo
by Dr. Manning, board-certified and recertified pediatrician

"PUNKY"  (adj.):   

Descriptor for a child, usually under the age of six, who is less active and ill-appearing. Usually secondary to a viral illness, but can also be seen with bacterial ear infections, before the onset of a serious illnesses, and prior to the resolution of any acute process. synonym: puny.

Note: Not to be used interchangeably with "lethargic"--a word that uniformly scares the crap out of pediatricians. Another note: Don't call your pediatrician using the word "lethargic" unless your kid is like a rag doll. Otherwise, say "punky." They'll know exactly what you mean. . . .


"Hey babe. Do you think Zachary can go to school tomorrow?"

"I don't know. He's still a little punky but let's see how he looks in the morning."

my "punky" Zachary

 "GUNKY" (adj.):

Used to describe any form of discharge coming from the eye or ear of any child under the age of six.


"I need to make an appointment for my child to be seen."

"What's going on with your son, ma'am?"

"His eye is gunky."

"Oh, you must be a pediatrician."

"How'd you guess?"


"JUNKY" (adj.)

Universal descriptor for any sound other than clear air exchange when auscultating the chest of a child under the age of four. Can also be used occasionally to describe moist coughs and rattly breathing.

Note: Not to be confused with "junk" found in teenage and adult "trunks", or the junk drawer in my house.


"I'm sending him for an x-ray."

"You think it's pneumonia?"

"I don't think so, but he is breathing fast and his chest sounds totally junky."

"Yeah--good idea. He looked pretty punky in the waiting room."

"hmm, sounds junky. .  ."

and my all time favorite . . . . used more times in one day by pediatricians than can be counted. . . .

"FUNKY" (adj.):

Universal term used to describe anything in any child that in any way is not right (read: you don't know what the heck it is.)  Including, but not limited to, physical exam findings (especially in the newborn period), complete blood counts, rashes, genitals, smells, behavior, lab results and anything else that has you totally perplexed. Usually not a life threatening condition. (See "lethargic.")


"Hey. . .can you come give a second opinion on this kid?"

"Sure, what's up?"

"He has some kind of funky rash all over his body. It's blue with yellow asterisks. I have no idea what it is."

"Is he punky?"

"No, but his eyes are kind of gunky."

"What about his lungs? Are they junky?"

"No, but check out this chest x-ray . . .  What do you think?"

"Hmmm. Looks kinda funky."


Now. All you non-pediatricians. . . .

Go forth and pose as kid doctors. Armed with the language, you'll be welcomed as a trusted colleague and  no one will ever suspect that you're an impostor!


*Disclaimer:  Med student applicants to pediatric residencies should not use the aforementioned language until they have officially matched into an ACGME-accredited pediatric residency training program.


  1. Loved this post, a few more reasons why Peds is great. Thanks for letting us in on the Pediatric vernacular!

  2. Love your blog! I, too, am a Med/Peds trained, now only IM physician, former chief, and mother of two, who also misses peds but not crazy parents. I found your blog through BooMama and feel like you're an old friend. Congrats on your award nomination - I'll cast my vote for you.


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