Patient’s don’t ‘Say Ahhhh’; TV to blame

I have found, over the past several years, that patients (in general) don’t know how to say “aaaah” during the ENT exam.

It goes like this:

me: Open your mouth widely and say ‘aahhhhh’
pt: opens mouth widely, makes no noise whatever
me: say ‘aahhhh’
pt: nothing
me: (bumping stretcher) say ‘aahhhhh’
pt: ‘aahhhh’

I don’t know when we stopped teaching how to say aahh. I learned in the doctors’ office from about 2jillion cases of tonsillitis, but I have an idea who’s to blame: TV.

Old doctor show: Marcus Welby, MD; you got a friendly exam by a nice grey-haired doc, and at some point ‘aaah’ came in.

Today’s doctor show: Intubation, central lines, chest tubes, cracked chests or crack babies. No aaah.

OK, that’s a little simplistic, but I’m a simplistic guy.


  1. That’s hilarious. I was just jumping through hoops trying to get a kid to say “ahh” 20 minutes ago. I mean, is this rocket science, say freaking “ahh”. . . silence, no visible tonsils . . . LOL.

  2. Sometimes it helps if you tell them to say “aaa” as in “apple” not “aahhhh” as in “Augmentin.” The “aaa” seems to drop the back of the tongue more; plus since it’s a different sound from what they’re expecting they are more likely to actually emit a noise.

  3. Funny thing, I have more patients say AHHHH! during a rectal exam than I can make say Ahhh during an ENT exam. Go figure!