Friday, December 4, 2009



· A (whole new) can of worms: A complicated problem, the extent of which is not obvious until you start to look into it. (Her situation at home was a can of worms that the doctor did not want to open.)

· A dark horse: A person who is not expected to be successful or a person who proves unexpectedly to be successful. (Carlos Moya was the dark horse of this year’s Australian Open.)

· A dime a dozen: Nearly worthless or common. (Promises of a cure for the common cold are a dime a dozen.)

· A drop in the bucket/the Ocean: A minute amount, not worth considering. (The amount of money spent on cancer research is a drop in the bucket compared to the amount needed.)

· A fall guy: A person who is duped or has bad luck and has to take the blame. (The patient is delusional and claims to be the fall guy for the Vietnam War.)

· A good rule of thumb: Something broadly accurate but subject to variation. (Eating several servings of green vegetables every day is a good rule of thumb for a healthy diet.)

· A gray area: An issue, which is difficult to understand or to make rules about because it cannot easily be classified. (The idea of multiple personalities is a gray area for many lay people, as well as for many in the field of psychology.)

· A loose cannon: Someone whose actions are unpredictable, illogical, and, often, harmful. (The doctor said, “I hate to release this patient, because he is a loose cannon, and I’m afraid he will harm himself.”)

· A new lease on life: The chance to live longer or with a higher quality of life. (Since recovering from surgery, he has a new lease on life.)

· A piece of cake: Something easily obtained, finished, accomplished, etc. (The patient thought that lifting the cinder block would be a piece of cake and, therefore, didn’t ask for help.)

· A shot in the dark: To guess blindly without all the facts, details, etc. (She was not sure how many would be in attendance, so she took a shot in the dark and set up 20 tables.)

· A sign of the times: A thing that shows the nature and quality of a particular period. (The rising level of drug abuse among teenagers is a sign of the times.)

· Ace in the hole/ace up your sleeve: To keep a useful plan, piece of information, etc., secret until the last minute. (The patient’s home remedy was an ace in the hole for his sick daughter.)

· An ounce of prevention is worth a pound of cure: It is better to be careful and prevent a mishap than it is to correct matters after one has occurred. (In the case of AIDS, an ounce of prevention is worth a pound of cure.)

· ASAP: As soon as possible. (If the symptoms worsen, return to the emergency room ASAP.)

· At the cutting edge: In the forefront of new developments. (Sloan-Kettering is at the cutting edge of cancer research.)

· AWOL: Absent without leave (permission). (The patient has gone AWOL from the rehab program at Cherry Dale.)

· Back to the drawing board: To return to the initial stages of a project. (If this cycle of drugs does not produce the desired effect, the doctors will have to go back to the drawing board.)

· Back to the salt mines: To go back to work, to one’s place of employment. (I believe this patient to be exaggerating his symptoms as a way to collect worker’s compensation. He states that he dreads going “back to the salt mines.”)

· Be on the safe side: Taking no risks. (It is wise to be on the safe side and use a high-factor SPF sun block even on overcast days.)

· Being led down the garden path: Being deceived. (Investors are being led down the garden path by financial institutions.)

· Bend someone’s ear: To talk to someone about a problem one has. (Are you available? I need to bend your ear for a moment.)

· Bite the bullet: To prepare to suffer hardship bravely. (Even though chemotherapy is painful, a patient must bite the bullet and undergo it.)

· Blown away: To be completely astounded or amazed. (The teenager reports that his parents were blown away when he revealed the whole extent of his drug usage to them.)

· Buckle down: To do something, however unpleasant, without fuss. (The patient’s weight is a major obstacle to a successful recovery. He needs to buckle down and lose weight immediately.)

· Bummer: Interjection used for any unpleasant experience, occasion, situation, etc. (When told of his diagnosis of diabetes, the patient looked despondent and remarked “what a bummer!”)

· Bury your head in the sand: To pretend that an obvious danger or problem does not exist. (You can’t bury your head in the sand about your son’s drug problem.)

· By the book: According to the rules, in the usual manner. (That doctor practices medicine by the book.)

· Catch-22: Frustrating situation in which one is trapped by contradictory regulations or conditions, which defy any solution. (The conflicting regulations of medical and private insurance companies create a real catch-22 for some elderly patients.)

· Chip on your shoulder: A grudge or grievance; and unprovoked display of defiance. (The patient has a real chip on his shoulder and refuses to cooperate with any of the medical staff.)

· Come clean: To confess or reveal all, especially after lying or hiding the truth previously. (Nixon never came clean about Watergate.)

· Dear John letter: A letter from a person informing their spouse/girlfriend/boyfriend that the relationship is over. (He received a Dear John letter from his girlfriend the day before his suicide attempt.)

· Don’t burn your bridges: Don’t do anything that prevents you from turning back during a course of action. (It is never a good idea to burn your bridges when switching doctors.)

· Down and out: To feel despondent or depressed about losing something: a job, money, a place to live, etc. (After being laid off from the factory, Ralph was feeling down and out.)

· Draw the line: To indicate the point at which you will no longer do something yourself or tolerate a behavior from others. (After tolerating a lot of nonsense from his son, the father drew the line at buying him a motorcycle.)

· Dyed-in-the-wool: Through and through. This phrase is used to describe people with fixed and often bigoted views. (He is a dyed-in-the-wool racist and refuses to allow a foreign doctor to examine him.)

· Everything but the kitchen sink: Absolutely everything, even useless, unnecessary items. (The patient is very demanding. He has asked for absolutely everything but the kitchen sink.)

· Face the music: To accept the consequences of your actions. (If this diabetic continues to drink alcohol irresponsibly, he will eventually have to face the music.)

· Fall through the cracks: To go unnoticed. (This child fell through the cracks of the system, because the welfare agency is overworked and could not give him individual attention.)

· Fly-by-night: Describes an unreliable person/business who settles briefly to some (usually dishonest) activity, then departs without a trace, thereby creating problems for the people left behind. (Many fly-by-night companies have sprung up during the AIDS crisis promising expensive miracle cures.)

· Flying by the seat of your pants: Situation without formal guidelines where improvisation, instinct, creativity are needed. (The parents did not have these types of behavioral problems with their first child so they are flying by the seat of their pants with the second child.)

· Fool’s paradise: Happiness based on the delusion that all is well when it is not. People who live in a fool’s paradise are deceiving themselves: their happiness is based either on a misunderstanding of the true situation or on false information. (To dream of a new world order in the near future is to live in a fool’s paradise.)

· Get on a soapbox: To lecture others, to give (usually unwanted) advice, or to be a know-it-all. (“I know that I should pay more attention to my diet, but I really wish you would get off your soap box about it.”)

· Give someone a shoulder to cry on: To be a person who gives sympathy and comfort to another (She offered a shoulder to cry on when her friend’s father died.)

· Go for broke: To risk everything in one determined attempt to succeed at something. (Since none of the other treatments succeeded, I am going for broke and will try this experimental course of treatment. This could be my last chance.)

· Go psycho: To behave in a very abnormal, especially violent, way. (Every time the patient drinks, he goes completely psycho.)

· In the loop: To be included in the shared information about a plan, situation, etc. Conversely, “out of the loop” refers to being excluded or excluding yourself from information shared by others. (The doctor asked the family to keep him in the loop about the patient’s symptoms over the next week.) (I’m tired of this recurrent problem with no apparent solution, so I’m out of the loop. Figure it out yourself!)

· Labor of love: A very tedious and difficult task done with much care and concern involving whatever it takes to complete the job. (Rewriting the entire school curriculum was an arduous process but a real labor of love.)

· Lay down the law: To make dogmatic statements and demand that they be followed. (Having had quite enough, this irate father laid down the law to his unruly children.)

· Life in the fast lane: To live recklessly and carelessly or care free. (Many top models and movie stars live life in the fast lane to the detriment of their careers.)

· Lift your game: To improve at something. (If you plan on becoming a successful doctor, you really need to lift your game. You are not spending nearly enough time studying.)

· Like riding a bike: Used to describe something that is not easily forgotten. (Once you learn how to type, it’s just like riding a bike. You’ll never forget how.)

· Made in the shade: Used to describe an easy and favorable outcome. (If he gets this promotion, he and his family will be made in the shade.)

· Nail in the coffin or coffin nail: A derogatory term for cigarette. (Each cigarette you smoke is another nail in your coffin. When are you going to stop those coffin nails?)

· No frills: Without any extras; having only the necessities. (The patient is allergic to many additives and has been put on a no-frills diet.)

· No pain--no gain: You cannot obtain something worthwhile without suffering through the process of getting it. (She does not necessarily enjoy going to her aerobics class, but understands no pain--no gain.)

· No way, Jose: Absolutely not. This is a popular saying due to “way” and “Jose” rhyming; can be used with anyone. (Can I borrow ten dollars?” “No way, Jose. You never repay the money you borrow.”)

· On a roll: To be on a winning streak. (The patient is really on a roll with his physical therapy.)

· On the ball: Very efficient, alert. The phrase is often used as “Get on the ball!” (An emergency room nurse must always be on the ball because situations change so rapidly.)

· On the wagon: Abstaining from alcohol. Conversely; “off the wagon,” or “fell off the wagon” means resuming drinking after a period of abstinence. (The patient told his doctor that he has been on the wagon for 15 years.) (Unfortunately, he fell off the wagon so his family put him in detox.)

· One for the road: A term signifying one last drink or alcohol before leaving. (With the strict laws against DWI in America, it is never a good idea to have one for the road.)

· Out in left field: To be completely wrong. (The doctor was completely out in left field when he prescribed that medication.)

· Out of the woods: To be heading toward a resolve, but to not be quite there yet. (The patient is feeling much better but is not out of the woods.)

· Paint a gloomy picture: To suggest that a situation, event, etc., is not going well. (The doctor didn’t want to paint a gloomy picture but told the family that it appeared the patient would need surgery.)

· Playing hardball: To act aggressively. (We are going to have to play hardball if we want to get funding for the new research center.)

· Run-of-the-mill: Ordinary, average. (The baby has a run-of-the-mill cold but nothing for the parents to worry about.)

· Sink or swim: To be in a position to fail totally or to survive by one’s efforts. (I have given this patient all the help I can, and it is now up to him to sink or swim.)

· Six of one, half dozen of the other: Two identical things described differently. (Both courses of treatment have advantages and disadvantages. It is six of one, half dozen of the other.)

· Spinning one’s wheels: Not making any progress, static. (The doctor felt like he was spinning his wheels with his patient’s course of treatment.)

· The ball is in your court: It is up to you to do something. (I have given the patient the names of 3 local detox centers, and now the ball is in his court.)

· The blind leading the blind: Describes a situation in which the person helping or advising someone knows as little about the subject as the person who is being advised. (We were both assigned this project that neither of us is familiar with, so making progress is like the blind leading the blind.)

· The old ball and chain: Derogatory term for husband or wife. (The patient was extremely intoxicated and kept repeating, “The old ball and chain keeps nagging me.”)

· The whole enchilada: The entire collection of facts or things. (When she finished giving her medical history, she stated, “That’s the whole enchilada.”)

· The whole kit and caboodle: See the whole enchilada. ‘Caboodle’ is a nonsensical word; this is the only place you will ever see it.

· Three sheets to the wind: To be intoxicated. (At 2 a.m., he staggered through the door three sheets to the wind.)

· To cover old ground: To review something that has already been discussed. I don’t want to cover old ground, but I will continue to do so until you listen to my advice.)

· To cut corners: To do something in the easiest, quickest, or cheapest way, often by ignoring rules or omitting something. (If the hospital continues to cut corners to save money, I cannot guarantee that patients will receive quality treatment.)

· To cut the mustard: To reach or surpass the desired standard of performance. (It remains to be seen whether or not he can cut the mustard.) Often used in the negative as: (He couldn’t cut the mustard so he had to drop out of the training program.)

· To explore every avenue: To investigate every possibility. (Understandably, the patient wishes to explore every avenue before deciding on which treatment to pursue.)

· To get plastered: To get very intoxicated. (By the end of happy hour, Jack and his friends were all plastered.)

· To go off on a tangent: To change quickly from one course of action or thought to another. (The patient is not a good historian and keeps going off on tangents.)

· To have someone over a barrel: To have someone in your power; to have someone stumped. (According to the patient, her husband really has her over a barrel. She is unemployed and he controls the purse strings.)

· To hit pay dirt: To find success. (I think we have hit pay dirt with this regime of drugs.)

· To play with fire: To dabble in something potentially very dangerous or to enter into something very risky. (He is playing with fire when he drinks and drives.)

· To sound like a broken record: To be repetitive, especially with unsolicited or unwanted advice. (I hate to sound like a broken record, but you really have to stop smoking.)

· To tie one on: To become intoxicated. (The women at the bachelorette party decided to go a club and tie one on.)

· To toe the line: To not stray from a rigidly defined boundary. (The patient will have to toe the line at the detox center. They are very strict.)

· To turn the corner: To pass the critical point in an illness or a period of difficulty and begin to improve. (The patient’s fever has broken. I feel she has turned the corner and is well on her way to recovery.)

· Tunnel vision: Derogatory expression used to express the inability to see or understand the wider aspects of a situation, an argument, etc. (His tunnel vision is preventing him from considering an alternative course of treatment.)

· Turn a deaf ear: To pretend not to hear or to refuse to listen to a complaint, request, warning, etc. (The judge turned a deaf ear to the prisoner’s petition for leniency.)

· Turn over a new leaf: To change one’s way of life in order to become a better person. (After hearing about my friend’s experience with drugs, I decided to turn over a new leaf and I quit smoking marijuana.)

· Under the gun: To be under pressure to finish a project, find a solution, etc. (As the patient is rapidly deteriorating, the doctor is really under the gun to come up with the proper diagnosis.)

· Until blue in the face: To work, etc., as hard and as long as one possibly can, usually without success. (I have talked to you until I am blue in the face, and you still never listen.)

· Water under the bridge/water over the dam: Describes a situation, event, mistake, etc., which has already happened and cannot be changed so is not worth worrying about. (Her past drug use is water under the bridge; we must concentrate on her present situation.) (That issue is water over the dam, so let’s move on.)

· Work hand in hand/hand in glove with someone: Work closely together, on very familiar terms. (The entire team of doctors must work hand in hand/glove if the patient is to receive the best possible treatment.)

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