Oncologist Baffled by Cryptic Writing on Chart: DNR/DNI

NEAR SHORE MEDICAL CENTER, MANHASSET, NY – Dr. Kim Okemo was perplexed to find six cryptic letters on the chart of a 92-year-old patient.  “DNR/DNI?” uttered Dr. Okemo, who acquired over three-thousand acronyms in the forty-eight years it takes to become an oncologist.  “What could it possibly mean?  Diagnosis Nebulous Re-consult? Dose Needs Intensification?”

Mmm this DNR/DNI is so odd, what could it mean!?

Review of the chart of the patient whose ejection fraction is less then Dick Cheney’s, only deepened the mystery, with new and strange terms such as “Comfort Care” and “Hospice.”

Dr. Amy Loyd of Nephrology offered a plausible but unsatisfactory theory: “DNI?  Dialysis Now, Immediately!”  Radiation oncologist Dr. Al Farads was also not much help.  “DNR… Hmmm, doesn’t ring a bell.  Perhaps… Destructive New Radiation…?”

Worried she may have missed something during one of her three fellowships, Dr. Okemo checked the Oxford Textbook of Oncology: no luck.  Next she looked through the latest issue of Oncology Today.  Perhaps DNR/DNI was a brand new therapy or a diagnostic? Again, nothing.

In a last ditch effort, Dr. Okemo called the one man who always has the answer, local Stryker rep Pat Ella.  Quick on the fly as always, he pitched his idea: “DNR/DNI?  Of course!  Duly in Need of Reconstruction/Definitely Necessitates Implants.  I’ll be there in a jiffy with a full ortho tray… So what, if you are an oncologist.”

Not satisfied with ortho shenanigans, Dr Okemo took action.  She reported the unsafe acronym to the administration, requesting that DNR/DNI be added it to the list of banned abbreviations such as QID, QOD, OMG and WTF.