The purist element in most of us dislikes the use of abbreviations. We tend to view them as unsightly, a blot on the language, a sign of laziness or ignorance. We are irritated that only a select few (but others than ourselves) understand what they mean. Take AB, a 59yo BM (a non-scatological term) S/P TURP/DES, BBPR, with elevated JVD from CHF, Dx GOK or NYD. Or William Bean's patient (Tower of Babel, 1963), a “45 yo SCF hsewfe G10 P6A4 c C.C SOB, 4mo PTA. Sn's & Sx's CHF c PND, DOE, & PE. LMD found m's of MS, MI, AS, AI & ?IVSD (R/O IASD & PDA). EKG showed LVH, RVH, LAH, RBB, PVC's, AF, old MI....” Despite further w/o and Rx, “on the second day the patient jumped out of the window.” Nowadays, computer literate residents prefer to write case insensitive histories, such as “49 hisp, fem, hd, sz, htn, sob, cp, ccu, dx esrd, dm, ams, cp, chf, gi obstr.” Some medical journals allow so many abbreviations that their articles cannot be read without constant reference to a glossary. Yet long words take a long time to write down, and people have always felt the need to use abbreviations. In the 19th century, in her letters, Jane Austen referred to her novels as P&P, S&S, and MP. A popular system used lower caps superscripts, such as informn, communn, or realisan. A recent computer search disclosed 14,994 matches for “medical abbreviations”—lists, glossaries, dictionaries, and even books. Hospital committees periodically publish lists of “approved” abbreviations—largely ignored. How much more practical are the stock exchanges, where symbols for MCD (what we eat), BUD (what we drink), MO (what we smoke), or MRK and GLX (drug makers) are official, fixed, and universally recognizable? It is a pity that medicine does not have such a universally agreed system, at least for some commonly used terms. It would eliminate a great deal of confusion and errors, as well as much hd, aggr, and wc (writer's cramp).