Dictation System Bloopers
When I started writing what since has turned into this
essay, I had a private psychiatric practice that was both small and part-time.
Eventually, it seemed that it was wisest to go with a dictation/voice
recognition system rather than a live secretary. Actually, the preceding sentence was to read
‘dictation system’ but came out ‘patient system’. However, my wife, who functioned as my
part-time secretary then, would argue that my patients sometimes did seem to
run my practice.
I have been using a dictation system for years now,
with mixed results. With a slower than recommended processor, and smaller than
desirable random, (random was what the dictation system recorded, which is not that
far off - I meant RAM) it was a slow process initially.
On the one hand, I have been impressed with its
ability to come up the first time with words such as "obsessive-compulsive," and even "neurovegetative." How it came up on
the first try with correct spelling of the Italian-origin name for our
psychologist at the time, Narducci, is beyond me. On the other hand, as a Child
and Adolescent Psychiatrist whose bread-and-butter is Attention Deficit
Hyperactivity Disorder, which it eventually got right even with all the initial
capitals, it didn't like "Ritalin" anymore then many of my patients
or their parents do. It took a long time to learn to spell the name of that
drug right.
It dawned on me that some of the words and phrases it
came up with, as opposed to what I thought I was saying, could be
entertaining. It was then that I thought
of sharing these tidbits with my fellow readers at a freebie magazine we docs
used to get for our entertainment called Stitches. Most of these excerpts are from reports that
I was writing back to referring positions (ah - that was supposed to be ‘physicians;’
no offense meant…but what position might these colleagues be in when they are
pleading with me to see some behaviourally disturbed child or adolescent!!!) or
school professionals.
So, here are the morsels, beginning on the left with
what was supposed to be said, Pavarotti the (Gee, I knew I was a great singer
but how did that get in here – it’s supposed to read…) ‘followed on the’ right
after the hyphen by what was said, plus some editorial comments by the author.
Debby Danyluk, the school counselor came out ‘deadbeat
data luck’, the school counselor. With all due respect to my esteemed
colleagues, I suspect some students would think of their school counselors in
this way. Another time the Guidance Counselor, whose name was Bianca Li, came
out ‘Beyond
the Lead,’ which also lends itself to interesting interpretation as to where
she might be in relation to where her students really are.
Restless Leg Syndrome
- restless lake syndrome—certainly changes the perspective on the
nocturnal tossing and turning that might be occurring. Some poor partners of
restless sleepers might think they
were on a boat in a storm. The sleeper might be dreaming something similar.
Low ferritin levels - low American levels –. Is this
referring to one of those rare disorders that only North Americans bother with?
On a more serious note, we know even many in more-or-less affluent North
America do lack nutritionally. On a related note, ferritin level came out – ‘ferrets
in level.’ When I was in medical school it was ‘serum rhubarb.’ Maybe the nerds
who make these programs know that abnormal conditions have gotten a lot
worse/lively since. And who is it that has those ferret pets anyway? Is it true
there are more of them in psychiatrically disturbed households? They do bite.
Being in terror = being in care. Unfortunately, that
is too often the situation for unfortunate children. We too often hear stories
about children in care being abused and even dying at the hands of their foster
parents.
Flu walks a team - I didn't know fluoxetine was
indicated for influenza and able to get them up and walking again, even with
others, but who knows?
Little known -
does no one—that about says it, doesn’t it – in other words, does no one
know of this little known disorder or drug use, where that phrase is used?
View this - presents—another pretty good synonymous
choice.
Amitriptyline - enemy clean—and the trip leans – Emmy
the lien – well, when you are using Elavil ® for all the not-indicated uses we
do in Child and Adolescent psychiatry, it might just be an enemy, or a trip
down who knows where, not to mention ‘Emmy the lien’ – there could be a lien in
there somewhere if a big lawsuit came my way because of some off-label
prescription that cause problems because of things like side effects.
St. Boniface Hospital (a Winnipeg hospital I often
spent time in, or made referrals to from my rural practice at the time) - same
ponderous hospital. Most such institutions do tend to be rather similar…and
ponderous.
Menarche – manner key – getting your menses (here my
program typed ‘midseason’, which could be another new euphemism) is certainly a
key that you are coming of age and should be growing up and exhibiting manners.
Another time menses came out – amenities. I am sure a number of our
female counterparts sometimes wish that they didn’t have these ‘amenities!’ Still
on this topic, pre-menarchal came out pre-monarchal. I guess if you're not old
enough to have your periods, you're not old enough to be a queen. Or did women
not have menses before they got the right to be queens? Then, if you get pain with your periods or Dysmenorrhea
my dictation system wanted to say ‘basement area.’ That may well be where the
ladies feel like they are with this problem.
A ‘rash from chocolate’ - harassed from chocolate. You
get the idea; but that would be bothersome.
Gets tonsillitis - gets consolations. I hope so;
tonsillitis is no fun.
Doesn't need a WISC. - doesn't need a ‘full of
whiskey.’ A WISC (Wechsler Intelligence Scale for Children) is often referred
to as an IQ test. Being full of whiskey
might accomplish the same ends in some cases.
Toys in – poison. I knew the toys in my office are
getting old and broken, but that bad? Or is that a reference to the germs that
may be on them. Yikes, maybe I should
sanitize them.
Co-morbid – cool orbit. Venn diagrams of many
co-morbid psychiatric illnesses (illnesses that can or do occur at the same
time) do look cool with all those circles and orbits interlocking and
overlapping.
Addition of new information - edition of new
innovation. New information may need to be edited, and can certainly be
innovative.
An anxiolytic - a tendency only take. Unfortunately,
too many anxious people take too many anxiolytics like this, and they are then
too reinforcing as a prn. Rather than taking them when they have the
"tendency", they should take them on a regular basis.
Hard drugs – hard drives. Yeah, well, they can drive a
hard bargain on one's life in the end.
Forceps were needed – forces were needed – true
enough. You don't use forceps in the delivery if you don't need a little extra
help.
Religious views – vintages views – well, to some they
are.
Blaine Waldie – our Intake Worker at the time – he’d
be tickled if he thought he was of “butane quality”. High-powered guy!
Fixing her computer - pitching her computer. Not too
far off there often I’m sure.
Does go out – doesn’t cope. We’ve all had friends like
that.
Predisposing events - previous closing. Such
antecedents do close doors and reduce opportunities.
Agoraphobia – tiger phobia. It is a strong phobia. It
means afraid of going out, which one would wisely be if there was a tiger
nearby.
Buspirone (another medication for anxiety) – peace by
her own. Who needs drugs if you can do it alone?
Etrafon - Extra Bond – yes, it is a combination
product.
Parents use timeouts – pans Chinese timeouts – I’ve
heard of Chinese water torture, what sort of discipline were these parents
effecting that was getting a bad rap?
Autistic disorder
– artistic disorder – Indeed, some of these individuals are gifted,
especially musically.
Some akathisia – some activities you. There was no
explanation given about the activities, which sort of parallels the experience
of akathisia, which is simply an urge to keep moving aimlessly.
Olanzapine – a land subpoenaed – starting these new
antipsychotics can be a big proposition, and there may also be legal undertones.
Actually, that last word came out (undertows) which might not be too far off to
describe what could happen.
Disturbance of Mood and Conduct - Disturbance of Food
and Conduct - this diagnosis could be accounted for by the side effects of
medication, namely olanzapine. Then again, depressed people often eat too much.
Child and Family Services - Child and Talent and
Services - the agency would be pleased to be recognized as having talent.
Sometimes I seriously wish some members of these teams had a bit more of that.
Co-operation - a wide-ranging thing – it would be
wonderful if co-operation were always wide ranging, sometimes it’s quite narrow
and limited in scope.
Parents - inheritance – that’s pretty close, at least
in meaning.
Comma – thing-a-thing-a – could be. What use are
commas anyway? While we’re on punctuation, period - thing. Indeed, a period is
a thing.
Irritable and - beautiful man - I’m not sure to whom you're beautiful when
you're beautiful…
Misinterpreting – one time it was ‘life-threatening’,
which could be the situation if you made a bad error in judgment. Another time
it was ‘visiting everything’, which could also relate to the paranoid tendency
to read too much into everything.
Karen Kroeger - caring to reviewing of the other thing
– this was a co-worker’s name, and as a Community Health Worker, that could
describe her task.
Murdered – deferred. If you were murdered you would
have to defer. Your life would certainly be 'deferred.'
Academically – indefinitely. If one doesn’t get help
for those learning disabilities, the struggles may be indefinite.
Baby-sitters – Vietnamese hitters – No offense here,
nor does one want to be politically incorrect, but ouch – watch those Viet
nannies.
Cognitive restructuring - cognitive refinancing –
Indeed, if one changes one’s thinking, it can mean ‘money in the bank’,
sometimes more than just metaphorically.
Psychotherapy – thing within the paying. Aye, there’s
the rub. Psychotherapy costs, and some would say that if it doesn’t, it isn’t
as effective.
Taken medication – paid in medication. Yes, well, one
does have to pay generally when one takes medication. Sometimes there is a cost
other than financial, such as when side effects surface. Then you are ‘paying’
in a different way for taking the medication. Also, on the topic of medication:
Medication is indicated – medication invaded. Yes, our drugs are powerful and
when they March into those farthest recesses of your body, who knows what
happens.
Travelling this summer – travel with suffering – Ah,
many a traveller would agree that being on the road can be a pain.
On depression: Depressiveness – prison mission. What
more can one say about what depression sends one into? Her level of depression
is not as bad - Malevolent impression is managing – that says it fairly well too. A couple of thing ears –
uncommon years. Yes, they were – the whole sentence included ‘struggling with
depression…” And the computer knew that, so thought it would throw a modifier
of its own into the mix. Why not? Another time ‘depressiveness’ came out depressive mess, but I guess that would describe it well
enough.
She is pregnant – she is non-native. I know pregnancy
brings about some changes, but I didn’t think they were that extensive so as to
change your identity!
Discharge – detergent – I think we do a fair job of
helping our patients clear up some of their problems when they are admitted,
but I won’t go so far as to say that we wash them clean away by the time they
are discharged.
The child within the family – the shouting within the
family. There was a teen-age pregnancy here, and shouting may have been part of
the story too.
Institution and it’s staff – institution and
admitting. Hey, wait a minute, I never said anything about an admission to an
institution…yet. There’s the computer thinking ahead again.
Voc rehab – hope we have. Perfect. If they get the
training there is more hope for their future.
Treatment Centre – incentive. Again, we hope being
there would be an incentive to patients getting on with their lives as a result
of treatment.
“Nag you” was meant to be the name of the meeting
facilitator, Nadja, who was going to call someone to attend the next meeting
again. That could be nagging.
Elective student – electric student: it could be when they are as attractive as
this one was. Ooh, did I say that?
Rich City Community Service - Every Geek Community
Service: yeah, well, that is mostly who
gets referred there.
Ruled out - root out:
I guess that's pretty much the same thing
Rule out vasculitis - Bastard like This - Yeah, a
vasculitis (blood vessel inflammation) can be that if it causes a lot of
damage.
Subtle - thoughtful. No problem with that one, but it
wasn't the word I was looking for.
Wanting to say “the star,” came out as follows, but
that may have been somewhat accurate too, knowing the difficulties this boy can
present: He had
been ‘the scar’ in a Social Skills Group.
Dragon dictation also changed ‘blue bruise’ into
bloopers. Will, finely it recognized what it was doing. It went straight to the
point. If it can't get the word right it may as well name it for what it is.
ICBC - icy BC. Well, the Insurance Corporation of BC
does deal with accidents that could be a result of ice in BC. And again, some
clients might feel that is the kind of reception they get when they go to these
officers.
I had a patient named Sakura whose name came out as ‘sexual
wreck’. How did the computer know she had gender identity issues? Another time it came out as ‘rectum’; now that's a low blow. Somehow I
don't think my computer likes this patient.
Gym - jail - for some kids, yes
Public Trustee - Custody. Interesting, that dictation
program is so smart it's getting right to the point again. It's when custody
issues arise that we often turn to the Public Trustee.
Clearly – query. Somehow, I think questioning
something would not suggest it was clear.
Off-topic - off coffee. This might apply to some
coffeeholics who have not had their beverage for the date.
Overly swayed - overly sweet. Isn't that just the way
people who try too hard come across sometimes?
“Letter sent to new department head” said this: PS I
dictated this and almost sent the email out without noticing that the subject
line interpreted my "congratulations and welcome" as
"congratulations unwelcome!" That would have puzzled him, given what
was in the body of the letter.
Richmond School Division - Richmond Screw Division.
Yes well a lot of adolescents might think so.
3 students - 3 stooges. Enough said.
Lives on her bed - lies on her bed. If you lie on your
bed a lot, some might think that's where you live.
The liver is improving - grooving. You might just feel
that happy if a bad liver improves because that is not something that happens
very often.
In discussing a student's course load, “one core
course, two electives and a spare” became “… despair. Indeed, that could
be the case for an unhappy student.
Lithium and Abilify became: We will continue the
lithium and vilified. Indeed, antipsychotics are vilified by some.
Minoru Place Residence, the top Personal Care Home in
our city came out as follows: minimal place residence. It could indeed be that
kind of a place to some of its residents and their families. We hear a lot of
complaints about the level of care in institutions like this nowadays.
Talking
about a community psychologist's interest in my understanding of attachment
came out as “it had been his experience that
most attackers did not understand it,” where attackers should have been
psychiatrists. Indeed, some psychologists and others may feel that
psychiatrists do attack them.
Demoniac - give money act, day
money back. Not sure anyone in that category would give you your money back.
Militants - stimulants. Maybe? To someone or
something.
Can't Afford Med - indeed, I had just filled out the
forms to provide coverage of this patient's medications, and the name of the
doctor is Kentford Nedd.
So, I was dictating my nephew-in-law's name, Javi, and
it came out happy. I'll have to check on that.
" a number of us went to ‘importance’ for
beverages and ‘suites’.” Tim Hortons might be important for a lot of Canadians,
but even they don't rent rooms. They just provide sweets.
Facetiously came out as sheepishly. Well, perhaps one
would end up looking that way if a facetious comment was misunderstood.
I was writing my brother on a point with which we have
some disagreement so I said I was not looking for his full-fledged approval.
Coming out of this way “fault-fledged approval” was
probably appropriate under the circumstances.
Tow truck - total truck: your vehicle might be the
latter (totalled) when you need a tow truck.
Mental night brethren > I won't tell my MB friends
that this was how my attempt at dictating Mennonite Brethren came out.
Ace Car Rental - Nice Car Rental. I hope so, but the
misleading address meant going elsewhere to actually get the car.
None of it - Nunavut. Well, some people might think
this region has little to offer.
I don't know
more: first try for Idle No More. 2nd try: I do
know more. Which is right? Some critics might say those 2 responses sum up the
movement.
Optimal - off the wall – huh? Well, maybe sometimes it
is untried.
Dealing with addicts and studying the biblical parable
of The Sewer and the Seed: my dictation for stony ground came out as phony
ground, which may reflect the attitude that some clients come to the program
with, avoiding things and not really want to change, so putting on a false
front.
Upon starting pills, it came out stuffing. Indeed,
under the situation where we are undergoing multiple trials, and the patient is
still very depressed, one might want to stuff her with something that would
make her better sooner.
Plenty spam – clonazepam. Indeed, clonazepam is the
most powerful benzodiazepine. Some people think it causes a lot of problems
too, like spam, which it can do with you become dependent on it.
Principal Maria Made It was supposed to be Maria
Medic, but I guess if you have reached the level of principal, you have made
it.
Life Skills turned out light skills. Indeed,
with respect to the general public they would be.
A point in your back < Iraq – Well, there are parts
of the country where it might be dangerous enough that this could happen to
you, although from what we hear in the news, personal injury is more likely to
come from a bomb.
Only retards go here - weak tired school here. Some
might say that schoolwork only "retards" end up going would be a
school that would be weak or not offer much.
Lisa Toffalo, Horizons Alternative School teacher =
Lisa possible. That's what she is there for, to help make things possible.
Not doing homework if he thought the teacher would
reject it. This was meant to be ‘inspect it,’ but the fear is probably the
same. If the patient had said this instead of me saying this about him, one
could have said it was a Freudian slip.
Ferris Elementary [school] - Fairest Elementary. I am
sure the staff would like their school to be known that way.
Sulfa medication - cell phone medication. Well, maybe
sulfas are somewhat outdated antibiotics nowadays, and teenagers might like
cell phone medication better, whatever that is.
Pat the Wilding, I don't know her personally, she
might fit that bill, but this Guidance Counselor's real name is Patsy Wilding.
Disappointment came out instead of this appointment.
Maybe it was a disappointment of an Appointment.
AK disturbing at a Christmas banquet. I really
meant serving, but if you knew his history you might think AK would have
been capable of the former as well.
The brat gathering - We, our family, might be that,
but I really did mean the Brandt gathering. Honest I did.
So, this dictation program is called Dragon. The dragon has been a prominent feature of mythology. It is a strong, powerful, possibly even intelligent creature. This makes me wonder about Dragon Dictation. Is it that intuitive? It can hear what I'm saying and put it out there in words. Sometimes it even seems to be putting out in words what might be thought but not deemed worthy of verbal expression. Sometimes it seems to uncannily downright put out in words what my subconscious might be thinking.
Dragons in mythology were also quite scary creatures. Sometimes what the Dragon puts on paper is funny, but sometimes the way it reads things it is also is a little eerily scary.
And there you have a sampling of what I've been
struggling with as I try to do up my own reports. Sometimes the Dragon also
stutters, and I get a rash of words starting with two or three of the same
consonants. At other times my attempts
to be articulate result in additional articles or prepositions tagged on to the
ends of my words. Of course, a spell checker is generally useless in these
situations, and one has to read the document over carefully. I know the odd
blooper has slipped through that I am sure must have made the recipient of the
report in question wonder. I hope it
didn't - I mean did - make them laugh.
If you enjoy these, I might be able to come up with a second installment. However, if my system is working the way it
really should, it shouldn’t be making many bloopers anymore, it should be
ashamed - I mean, which would be a shame. Rats, Dragon again.
