Fun with mnemonics
A recent Geriatric Gem in Canadian Family Physician (https://www.cfp.ca/content/65/10/723) discussed weight loss in older patients. Family doctors know this can be a vexing problem given the wide range of possibilities causing or contributing to this common presentation. The article introduced me to a new mnemonic, STOP WEIGHT LOSS. The number of letters found in this memory aid supports the principle that there are a lot of potential causes of weight loss. I usually have used what I consider one of the “worst” mnemonic’s out there: MEALS ON WHEELS. The reason I describe it as such is that almost no normal human could remember what the letters actually stand for, but it is a great resource to refer back to for guidance in the evaluation of weight loss. Thinking of this got me thinking about how fond we are of mnemonics, and their pros and cons.
Not surprisingly, the word mnemonic is classical in origin and comes from the Greek (mnēmonikos), meaning "of memory, or relating to memory" (reference Wikepedia). The ancients considered these strategies to be part of “artificial memory” or ways that you could improve upon our innate memory. One approach to memory that is still used by people who perform prodigious feats of memorization is often termed “mansions of memory” (suggested reading- Moonwalking with Einstein- The Art and Science of Remembering Everything). Familiar physical spaces (your house for example) are linked with the objects/words/numbers to be remembered and the person essentially walks in their mind through the location and connects different parts of the space with specific items to remember. This works well for memory competitors, but is a bit unwieldy for docs.
Types we do use include spelling mnemonics (e.g. hyoscine butylbromide is Buscopan , while hyoscine hydrobromide is scopolamine), The most common form of mnemonics used by physicians are often called word mnemonics; physicians my age learned some that would not likely be taught in medical school in 2018 (the vulgar one for cranial nerves for example). Rhymes can be used as mnemonicics (“Nerves 2,3, and 4 keep the urine off the floor”), but music mnemonics are less common in medicine. Most physicians are not comfortable singing in front of patients or their clinical clerk. Name mnemonics (acronym) combine the first letter of each word to be remembered into a new word (SOCRATES for the symptom and pain analysis). A useful one for remembering how to spell mnemonic is, "Memory Needs Every Method of Nurturing Its Capacity” although I have written the word enough writing this blog that I can now spell it without an aid.
Compared to when I was a medical student, there are many ways to get lists of medical mnemonics to guide studying or to help in professional development as a practicing physician. Not surprisingly, Wikipedia has a long list and, not surprisingly, there is a $1.99 app for that too. Although I rarely use these resources in daily practice, I do use my longstanding favorites and enjoy coming up with associations or acronyms that can help my aging brain to remember relevant knowledge. And I am very comfortable remembering the mnemonic, but not what it means, because it is so easy to find the key to the code online. For example, I just read the CFP article on weight loss again to remind myself what STOP WEIGHT LOSS stands for, and I helped write it!
I’d love to add your favorite memory aids to my repertoire so please let me know any gems you use (e.g. GEMS- geriatric patient, environmental assessment, medical assessment, social assessment). An important recent mnemonic for geriatricians and family physicians is the Geriatric 5 M’s- please see the article in Canadian Family Physician to remind yourself who might benefit from geriatric assessment https://www.cfp.ca/content/65/1/39 .
