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At the heart of general practice since 1960

Haslam's view: Finding phrases that stick in your brain

It really is time that I stopped buying books. It's not that I don't want them, can't afford them, don't covet them or won't enjoy them. It's just that I've now started the third bookshelf at home purely saved for books I've purchased but haven't got round to reading. If I just worked my way through the ones I already own that are demanding my attention, I could spare myself the expense of any more books for at least six months. But where would the fun be in that?

I used to think that I was alone in my book buying addiction and felt a vague sense of shame that I was happily paying out for books that would quite possibly never get opened. Indeed, I had a bizarre belief that the simple ownership of a book was an important step, even if one never read a word. I honestly felt that the information in a book could find its way into my mind via some form of literary osmosis.

Then I read Nick Hornby's wonderful book The Complete Polysyllabic Spree and realised that I wasn't alone, that this sort of compulsion was very normal and that I didn't really need a self-help group or counselling at all.

It's even worse in this post-Christmas spell, when the gift books clamour for attention too – at least the ones that didn't immediately get relegated to the library in the smallest room.

This year saw my library expand with I Before E (Except After C): Old-School Ways to Remember Stuff by Judy Parkinson – an anthology of the mnemonics, rhymes, and other tricks that you learned in your schooldays. Phrases like ‘Richard Of York Gave Battle in Vain' for the colours of the rainbow stick in your brain for the rest of your life.

But for me it was medical school that cluttered my head with the most memorable mnemonics. Maybe it was because I didn't really understand great swathes of what we were taught, and had to learn the facts by rote, but mnemonics got me through many an exam.

A typical example was ‘MOST DAMP' for the management of heart failure – and please remember that this was in the late 1960s and is now purely of extraordinary historical interest. MOST DAMP stood for Mercurials (diuretics), Oxygen, Sit up, Tourniquets (rotating, to slow venous return), Digoxin, Aminophylline, Morphine and Phlebotomy (to lessen the overload in blood volume). Not an ACE inhibitor in sight. Not an ACE inhibitor had been invented.

How I wish I could clear my mind of such useless information – an equivalent of a hard drive format would be good – but I suspect I'm stuck with it. I'm also stuck with the mnemonic for clubbing, ABCDEF, as in Abscess (lung), Bronchiectasis, Cancer, Decreased oxygen, Empyaema and Fibrosing alveolitis. Stuck in my brain. Never used.

Everyone recalls ICE for exploring the patient's Ideas, Concerns and Expectations, or even RICE for injuries (Rest, Ice, Compression and Elevation).

But there is a real lack of useful mnemonics for the things we need to know now, such as Read codes, or which computer file the guideline you need is stored in, or what we are allowed to refer this week, and where.

And maybe one day they will be as bizarrely useless as mnemonics like MOST DAMP. We can but hope.

Author

Professor David Haslam CBE
FRCGP
GP, Ramsey, Cambridgeshire; President, Royal College of General Practitioners; national clinical adviser to the Healthcare Commission; and Visiting Professor at de Montfort University, Leicester

Haslam's view There is a real lack of useful mnemonics for the things we need to know

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