Are you smarter than a fifth grader?

fifthgrade by JohnnyCashsAshes

I watched this new game show, and I experienced a mix of horror / shock / mortification at the stupidity of these people. I mean, how can you CHEAT off of a fifth grader? But really, Americans are pretty stupid. Whenever we talk to patients, the rule of thumb is that we need to speak at a fifth grade level, to ensure that we are understood.

That doesn't sound too bad, but you probably haven't spent any time with fifth graders recently. Keep in mind, these kids are the target audience of shows like Power Rangers. It takes active effort to keep to that kind of vocabulary.

My personal rules are that you shouldn't use any word longer than 3 syllables, and you should use language to talk to families than is similar to talking to children. Now, you shouldn't treat them like children. It's just that your language has to be comprehensible.

I had a patient in the ICU, and the cardiologist spent time with the patient's DPOA and afterwards, I talked to the DPOA as well.

Cardiologist: Your brother had two lethal arrhythmic events, likely from acute MI. We've coded him twice now, and we did stenting on the LAD. Right now, he's on two pressors and he's hypotensive. I think that you should think about making him DNR.

me (after the cardiologist left): So, did you get any of that? [DPOA shakes head no]
Alright, your brother had a heart attack, [pause while she soaks it in] and his heart rhythm became so messed up from the heart attack that his heart stopped pumping blood two different times. We gave him CPR and shocked him, and the heart doctors opened up one of his arteries.
His heart is beating now, but at this point, we have to give him two emergency drugs to keep his blood flowing. Does all this make sense? [DPOA nods yes]
If his heart stops again, I'm not sure that we'd be doing him any favors by doing CPR or shocking him. We're already doing a lot of last resort types of things. You should think about what he would have wanted.

Seems like I said almost twice as much as the cardiologist, but to his credit, he did take it a step in the right direction. After all, this is how I signed this patient out to the on call resident: 58 male s/p v.fib x2, now s/p LAD stent. Maxed on dopamine and levo. Full code for now.