Gorked

Yesterday, Mrs. SC came home quite irritated over a new development at the hospital she presently works at. She's spending the month doing inpatient pediatrics, which tends to mean three things: 1) kids with severe/chronic illnesses, 2) kids who have been in accidents, and 3) victims of child abuse.

It's that last category that we're going to take a second to focus on. Mrs. SC is at one of the larger hospitals in our area right now, and states that there are 4 teams attending to patients in the pediatrics ward. Each team gets an abuse victim who needs to be checked in every week, so at 4 per week, that's over 200 kids a year. And the cases they see are just the ones where the parents know that the children might die if not attended to.

For example, a 2 month old baby that was brought in yesterday, with the parents claiming that it had fallen out of a carseat proved to have not only a dislocated leg, but a broken thigh and three fractured ribs. While the leg dislocation is plausibly explained by the story, and perhaps even the thigh, SC is informed that the rib injuries are far more consistent with shaking the baby than with the other explanation. Further indicating this was the presence of bruises spaced as would be expected if grabbed by human hands about the sides.

Another baby seen yesterday has a half-paralyzed face, and has limbs contorted into various highly unnatural positions, which tend to change only when the baby has seizures. This occurred as the result of being strangled by the umbilical cord, causing grossly inadeuate flow of oxygen to the brain, and resulting in the death of crucial neurons. In the best case, the child will grow up like any other victim of cerebral palsy, able to function normally, but treated poorly by people who mistake the physical symptoms for retardation. In the worst case, the child will fail to resume normal development, and will end up permanently institutionalized.

It's hard not to cry when confronted with the viciousness of supposedly human beings towards someone so helpless and innocent. Or with the sort of cruel accidents that leave a child scarred for life from the very beginning. Unfortunately, perhaps as a defense mechanism, some of the medical personnel have taken quite a different tack. What brought Mrs. SC home upset was that for the first time, she was introduced to the word "gorked". Originally, it was apparently slang for someone who was anesthetized, but it now is used to refer to someone with brain damage, or who has been significantly mangled; one personal account of hearing it applied to loved ones can be found here. The problem with it is not so much that there is a slang term for these conditions, but that, as attested by Mrs. SC, it's used in a derisive fashion to joke about the patients.

Slang is something which inevitably arises in just about any field of endeavor. The computing field is particularly rich in that regard. However, there is hardly any reason that slang should be wholly incompatible with etiquette, or at least some very basic human compassion. SC is sure there's some sociolinguistic work out there -- not that he's familiar with it -- examining the correlation between slang terms and social distance, respect, or other ways of defining attitude. It's not hard to understand how "gorked" might have come up as shorthand, if only because "anesthetized" and "brain-damaged" both are formal and not conducive to casual speech (if there's any sound symbolism, it's lost on your host, but he's not expert in this area) -- but that's not at all a reason to stop trying to empathize with patients, or to treat them with something less than human dignity.

Comments

[steve]

I can attest that this term was current in the '60s when I was doing my medical training. I was told then, on no particular authority, that it arose as an acronym for "God only really knows," the typical response by house staff when asked what was causing a (typically elderly) patient's profound unresponsiveness.

Similarly, "gomer," referring to patients who are gorked out for no discernable reason, was said to arise acronymically from the response (thankfully, rarely vocalized) of the frazzled ER house staff when such patients were wheeled in: "Get out of my ER."

[Joe]

My wife's a pediatric resident and I can attest to the use of "gorked" or "gorked-out" to describe patients with serious brain injury. I've never heard her or any of her colleagues use it to solicit laughs. I can't imagine any of them using the term in front of a patient's family intentionally or unintentionally. I think it's a kind of short hand they use in private to contain the horrors they see every day for months on end. It no doubt de-personalizes the injuries enough that they can continue caring for these patients without losing their own grip on reality. A job where you tell your replacement who is likely to die in the next 12 hours is likely to create a need for such terms.

[PJ]

Part of the problem with the term "gorked" is that there seem to be two common usages that I have heard (working in psych and neuropsych units, not medical units)- one descriptive and one derisive. The descriptive usage of gorked is a as a short hand for a person with unrecoverable brain damage. In this case 'gorked' is used as an adjective as if to say that their neurons have been disconnected or destroyed, and it is a very useful way of conveying a type of impairment that is not adequately described through any diagnosis. The other, more derisive usage typically refers to
a person who suffered a brain injury through reasons of their own making. For example, the term gorked when used to describe a brain-damaged child is not likely to be meant as a joke, but rather to convey the severity of the child's impairment and the unlikeliness of the brain being able to recover from the trauma. The term may be used as a joke, however, to describe someone who suffered a brain injury from a drug deal gone wrong or a stupid risky act (i.e. driving 110 on a motorcycle with no helmet).