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Medical Slang for Your Weird Diagnosis

What the hell is a "fascinoma"?

Jenny Zych

The Word: Fascinoma

Example: “Where are all the medical students? I have to show them my fascinoma!”

Who Uses It: internists/brown-nosing residents/doctors over 60

No one wants to be a “fascinoma.” The word, which is constructed from the adjective “fascinating” plus the Greek suffix “-oma,” for a tumor or growth, suggests you have something your doctor has never seen before. A neuromuscular condition he has only read about in books, or an exotic infection from your vacation in the tropics. The first thing the doctor will do, after declaring you a fascinoma, is parade every white coat in the building by your bed—ostensibly so they’ll know what to look for next time, but actually to preen over his diagnostic coup.

Like any slang, the word distances the person who knows it (the doctor) from the person who doesn’t (the fascinoma himself). “It’s an in-crowd way of saying something is interesting,” says Dr. Rita Charon, who edits the journal Literature and Medicine. The instinct to translate conversations into medicalese has created other coinages, such as “incidentaloma,” which refers to something you weren’t looking for but stumbled on in an exam.

Solving a fascinoma is a good way to impress the higher-ups and advance your career. In the novel The House of God, a send-up of medical culture from 1978, the dour chief of medicine displays “a rare burst of excitement” over “a real ‘fascinoma’ ” named Olive, shouting, “Great Case! Come on, boys, let’s go see her!” But the desire to stand out can lead eager young doctors astray. That’s why greenhorns learn the popular maxim, “When you hear hoofbeats, think horses, not zebras,” meaning that the answer is probably the most common pathology that fits the symptoms, not the most bizarre. No one wants to be a fascinoma, but every rising medical star wants to be the first to see one.

Nora Caplan-Bricker is a staff writer at The New Republic.