If you're a hospital patient and a doctor refers to you as a "rock" it's probably not a compliment, but try not to take offense if a nurse mutters "S.O.B." in describing your condition.

Those are just two examples of the common slang and shorthand that reveal one of medicine's little secrets: Doctors and nurses gossip just like anyone else, and they're not above gossiping about the patients they serve.

Some of the jargon is harmless or even useful; for instance, "S.O.B." usually is an acronym for shortness of breath.

But medical educators are trying to curtail the use of more callous language that can lead doctors to think of their patients as obstacles to overcome, rather than human beings deserving of empathy.

Medical residents tend to pick up such terms quickly during training, and many said the lingo ranges from humorous to downright nasty. A patient not in obvious need of surgery may get the tag "lgfd" — short for "looks good from the door."

But a "rock" describes someone whose condition never seems to get better or worse, creating a hassle for doctors who often see their job as moving patients smoothly through the system.

"It's implying that these human lives, these suffering people, are no more than mere insults to you," said Dr. John Schumann, a professor of internal medicine at the University of Chicago Medical Center who tries to prevent medical students from adopting crude habits of speech.

Medical slang is always changing, but doctors say many of the terms in current use appeared a generation ago, when residents routinely endured seemingly endless shifts and a crushing workload that was supposed to prepare them for the rigors of medical practice.

Some residents said they still pick up slang terms from the influential 1978 novel The House of God, one doctor's fictionalized account of the absurdity and emotional churn of medical training. One of the most infamous words that book introduced was "gomer," short for "Get Out of My Emergency Room" — usually for elderly patients with difficult, chronic illnesses.

"Oh, we never use that word anymore," said Dr. Alexis Dunne, a third-year internal medicine resident at Northwestern University School of Medicine. "That's old school."

But other trainees said the dread word still makes an appearance now and then. Dr. Mark Obermeyer of Loyola University Medical Center said his colleagues strive not to use offensive language around patients, but some amount of venting is only natural.

"A lot of this work is pretty morbid," said Obermeyer, a resident in internal medicine and pediatrics. "If you're working in an ICU with people who may die any day, you use different ways to keep your mood up."

Indoctrination into the finer points of slang is part of what many professors call the hidden curriculum of medical school and residency training. The official coursework requires reading textbooks and paying attention during medical rounds, but the rest comes from watching how older doctors and nurses actually deal with the sometimes overwhelming experience of caring for patients.

A common slip happens when doctors refer to a patient as his or her disease — as in, "the gall bladder in Room 602" or "the P.E. (short for pulmonary embolism) who was admitted last night."

Gregory Makoul, director of Northwestern's center for communication and medicine, said such references can make doctors forget the human dimension of their decisions.

"When you start labeling someone as a disease you can't help but see them as a problem and not as a person," Makoul said. "We try to get people to recognize that, the power and detriment of that sort of label."

Some residents note that medical privacy regulations have made doctors and nurses careful about using a patient's name, which can encourage shorthand such as referring to patients by their diseases

Many medical slang terms revolve around the struggle to get patients in and out of the hospital in as short a time as possible. Schumann said such concerns reached new heights in the 1980s, when Medicare and many insurance plans began paying hospitals fixed rates according to a patient's illness, putting a premium on wrapping up care quickly