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The Altoona List
 of Medical Analogies

Communication of complex medical concepts can be challenging and frustrating.  The medical analogy is a valuable tool to bridge the gap between clinician and patient.  The goal of the Altoona List of Medical Analogies is to raise consciousness of this tool and to begin sharing the rich variety of analogies available.  

Browse, enjoy, send us your favorites; really communicate with your patients.

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"An good analogy is better than gold, yea than much fine gold"                 Paraphrase of Proverbs

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An analogy is like a car.  If you take it too far, it breaks down.

As with any medical intervention, an analogy can cause harm.  Analogies, especially if misused, can mislead the patient.  Use clinical judgment.  None of the analogies here come with a warrantee, but they are returnable.  Some are great, some are a little lame, but they should spur your creativity.

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More about medical analogies
How to use medical analogies
Special analogies
How to submit a medical analogy (or make comments)

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Altoona List of Medical Analogies

Adherence Taking medicines Watering a garden
Taking medicines on a regular basis is like watering a garden.  If you wait until the plants are a little wilted, it's too late.  Water every day.
Adherence Accepting help Helicopter story
Sometimes patients resist medical help because "God will heal them".  Without contradicting them you can tell this story.  The floods were rising and the police car came to evacuate a man.  "No, God will help me."  Later his house was surrounded by water and a boat came to rescue him.  Same response.  Later he is on his roof and a helicopter comes.  "God will save me".  He drowns.  In heaven he says, "God, I had such faith, why didn't you save me?"  God says, "I sent a police car, a boat and a helicopter.  What more did you want?"
Cancer Radiation Attacking fortress
Convergence in radiation treatment is like a general attacking a fortress.  He is limited by the defenses to sending only a few troops each route, the general uses all roads from all sides to bring his troops in to successfully attack the fortress.
Comment:  Explains why we can deliver radiation to tumor while sparing the normal tissue.
Duncker K. On problem solving.  Psychological Monographs, p. 58
Cardiovascular Aneurysm Garden hose
An aneurysm is like the bulge you can get in a garden hose.  The bigger the bulge, the weaker the wall and the more likely it will burst.
Cardiovascular Angina Cramp
Angina is like the cramp in your side you get when you are running.
   Dr. John Pfenninger
Cardiovascular Angioplasty Roto rooter
Angioplasty is like using a rotorooter on a pipe, to clean it out.
Comment: May not be real accurate.
Cardiovascular Arrhythmia Milking a cow
A normal heart rhythm squeezes blood from one part of the heart to another in a coordinated fashion like milking a cow pushes milk out.  An arrhythmia is like an inexperienced milker who isn't coordinated.
Comment: How many people these days have hand milked a cow?
Cardiovascular Blood flow Pipes
Blood flow is like water flowing through pipes
Comment:  Loses concept of flexibility of vessel walls
Cardiovascular Arteriosclerosis Kitchen pipes
Over time cholesterol builds up in the arteries of your heart or head like rust and debris build up in the pipes under your sink.
Comment: Of course, now everyone has plastic pipes!
    Dr. John Pfenninger
Cardiovascular Cardiomegaly Body builder
Having cardiomegaly is like being a body builder who is muscle bound.  He has lost his flexibility and can't work well, even though his muscles are big.
Cardiovascular Cholesterol Various
Click here for many analogies in the area of cholesterol.
Cardiovascular Hypertension Pressure on pipes
High blood pressure is like having high pressure in a pipe.  It damages the pipe, but you often don't see a problem until it bursts.
Cardiovascular Murmur radiation Cardboard tube
The radiation of a heart murmur is like whispering in one end of a long cardboard tube and hearing it clearly out the other.
   Dr. John Pfenninger
Cardiovascular Myocardial infarction Rubber band
When you have a heart attack, it is similar to placing a tight rubber band around your little finger.  First it hurts, then after a while, you don't feel anything.  Your finger turns blue and can be permanently damaged.
Decision-making Making decisions Choosing stocks
Making medical decisions is like picking stocks.  You carefully investigate a certain stock.  You buy it and it goes down.  Did you make the wrong decision?  No.  You made the right decision with the wrong results.  You shouldn't feel guilty about a decision because of the wrong results, only if you didn't choose carefully.
   Dr. John Pfenninger
Decision-making Making decisions Hunting deer
Making medical decisions is like hunting deer.  You scout the hunting site for days and put your blind where you see all the deer.  If on opening day you don't see any and they all go somewhere else, did you make the wrong decision?  No.  You made the right decision with the wrong results.  You shouldn't feel guilty about a decision because of the wrong results, only if you didn't choose carefully.
   Dr. John Pfenninger
Dermatology Acne Balloon
Acne comedones are like balloons.  They take a long time to blow up (two months for a comedone), but not very long for it to pop if it is overfilled or it is stomped on (appearance of inflammatory acne lesions are overnight). 
Comment Illustrates need to treat all involved skin, time needed to see results and need to be gentle to the skin
   Dr. Thompsen
Dermatology Cyst Balloon
A cyst is like a balloon with water or pudding in it.
   Dr. John Pfenninger
Dermatology KOH Pile of leaves
Finding hyphae in a KOH of a skin scraping is like finding tree branches in the pile of fall leaves.  Look for clumps of cells which will be partially ghosted by the KOH, then look for lines that cross over or go beyond the cell walls. 
   Dr. Daniel Stulberg
Dermatology Tx of onchomycosis Pouring oil on hood of car
Topical treatment of onchomycosis is like pouring oil over the hood of your car.  It may make you feel better, but it won't help the engine.
   Dr. Bailey
Dermatology Seborrheic keratosis Barnacle
A seborrheic keratosis looks like a barnacle, stuck on the skin.
   Dr. Rowe
Dermatology Skin Rubber band
Skin is like a rubber band.  It becomes less elastic with age.  When exposed to the sun, it deteriorates.
Dermatology Tinea versicolor Moss
Tinea versicolor is like moss growing on trees.
Dermatology Warts Spies
The wart virus is able to live on the body because it acts like a spy and puts on "friendly clothes" even though it is the enemy.  The body's immune system doesn't recognize the disguise and doesn't fight it off.  It is only after the "clothes are taken off" that they are revealed to the body's immune system and the body gets rid of them.
   Dr. John Pfenninger
Dermatology Wound healing Plants
Caring for a wound that is healing is like caring for a plant.  If you let the plant dry out or let the weeds flourish, it will not grow well.  You need to keep the wound moist with antibiotic ointment and prevent the scab from growing.
   Dr. Thompsen
Ear/Nose/Throat Croup Straw
Take a drinking straw and blow through it - no noise.  Flatten one and and crease it with your fingernails to the shape of a marquis.  Show the parents how the edges are closer together.  Blow through it hard.  It reproduces the sound of the honking cough.
Comment:   Practice this ahead of time.
   Dr. W. Sullivan
Ear/Nose/Throat External ear canal Conveyor belt
The external ear canal is like conveyor belt, it grows from the inside out.  It will push the wax out if you leave it alone.  If you use a Q-tip, it will push the wax up the belt and get it stuck.
Ear/Nose/Throat External ear canal Self cleaning oven
The external ear canal is like a self-cleaning oven.  If you try to clean it (Q-tips) you can damage it (like chemicals can damage the oven).
Ear/Nose/Throat Serous otitis media Ketchup bottle
The fluid in otitis media with effusion is thick like ketchup in a bottle.  If you can get a little air in there by "popping" the ears, then the fluid will run out, like the ketchup comes out after some air gets inside.
  Dr. John Pfenninger
Endocrine HgA1C Sugar on donut
The RBC is like a donut and the HgA1C measures the amount of sugar stuck to the donut.
Endocrine Hypothyroidism Factory
Having hypothyroidism is like running a factory without an adequate power supply.
Endocrine Insulin Key
Insulin is the key that lets the sugar into the cell where it can be used.  Sometimes the door gets stuck and other medicines help unstick the door.
Comment:  Or the key gets rusty and drugs or exercise lubricates the key.
   Deborah Sturpe
Endocrine Osteoporosis Various
Click here for many analogies about osteoporosis.
Endocrine Pituitary Accountant
The pituitary is like an accountant.
Endocrine Thyroid Thermostat
The thyroid is like the thermostat for the body.
Endocrine Thyroid Conductor
The thyroid is like the conductor and the body is the symphony.
Gastrointestinal Bowel movements Bananas
Like a banana, bowel movements can have many consistencies and still be normal.  They can be firm like a green banana or soft like an over-ripe banana, and still be normal for the circumstances.
Comment: May not always be true, but can reassure the anal-conscious.
Gastrointestinal Bowel movements Rocks/water
Bowel movements can have many consistencies and still be normal.  As long as they are not runny like water or hard like a rock, they are OK
Comment: May not always be true, but can reassure the anal-conscious.
Gastrointestinal Fiber Sponge
Fiber in your diet is like a sponge.  If you take fiber with enough water, your bowel movements will be soft, without water they will be hard.
Annie Giffin
Gastrointestinal Gallbladder BP cuff bulb
The gallbladder is like the bulb on a blood pressure cuff.  If it is full of stones, it would hurt when you squeeze it.
Comment: Hold up the BP cuff
Gastrointestinal Hemorrhoids Varicose veins
Hemorrhoids are like the varicose veins you see in your leg.
   Dr. John Pfenninger
Gastrointestinal Hernia Tire
A hernia is like an inner tube inside a tire.  If the tire is cut, the inner tube bulges through.
Dr. Jack Pfenninger
Gastrointestinal Peristalsis Ketchup packet
Peristalsis is like squeezing ketchup out of a single serving ketchup packet.  You squeeze the packet near one corner and run your fingers along the length of the packet toward an opening at the other corner.
Comment: Motility disorders
Newby TJ and Ertmer PA, Instructional analogies and the learning of concepts.  Paper presented at the Annual Meeting of the American Educational Research Association (New Orleans, LA, April 4-8, 1994) p 4
Gastrointestinal Irritable bowel syndrome Headaches
Irritable bowel syndrome is like a headache.  If you examine every cell a person with headaches, they would probably all look normal.  Yet, we believe that they have pain even though we don't "find something wrong".
Comment: Answer to "why can't you see something wrong?"
   Dr. John Pfenninger
Gynecology Bacterial vaginosis Animals in the woods
The bacteria that live in the normal vagina are like the little creatures that live in the woods in balance, like foxes and squirrels.  If there are too many foxes (BV), you need to kill some off to restore the normal order and allow the squirrels (good bacteria) to flourish.
Comment:  Not an STD, just an imbalance of normal bacteria.
   Dr. A. Bonin
Gynecology Breast exam Various
Benign findings on a breast exam are like feeling blueberries, grapes, gummy bears, oatmeal
Cancer is like feeling rocks, pebbles, sand, raisins, peanuts
Like a towel on a sandy beach.  You feel through the towel for the pebbles.
Gynecology Cervical dysplasia Road
The progression of cervical disease is like taking a trip on a long road.  The first step seems to be catching the wart virus.  Then comes atypia (the cells on the cervix just don't look "right").  Then comes dysplasia (the cells definitely are NOT right, but NOT CANCER).  This starts out mild, then becomes moderate, then severe.  Then it can become little nests of cancer (carcinoma in situ) then spread.  It is when it spreads that it actually becomes cancer.  Just as it takes a long time to take the trip, it takes a long time (usually 10-20 years) to get from a normal cervix to cancer.  At any step, you can turn back.  The closer you get to the end, the harder to turn back.  Earlier, people can turn back on their own or stop.  Treatment turns people back.
Comment: This analogy communicates the difficult idea of a "precancerous" condition.  Many patients with dysplasia think they have cancer.  It gets across the time element.
Terry Ruhl
Gynecology Colposcopy Black light
Putting vinegar on the cervix is like using a black light in a dark room.  The abnormal areas light up white.
   Dr. John Pfenninger
Gynecology Cryotherapy Mulch
We treat dysplasia to keep it under control, not to cure it.  When we spread mulch on the garden, we don't expect to kill all the weeds, just keep them from growing and causing problems.
Comment: Many people don't understand why we don't just destroy all the warts.
   Dr. John Pfenninger
Gynecology Fibroids Potatoes
Fibroids are like potatoes, buried in the good dirt of the uterus.  Some stick a little out of the ground.
   Dr. John Pfenninger
Gynecology Latent viruses Cold sores
Cold sores tend to come back again and again in the same spot.  That shows that the virus is there all the time, even when you can't see it.  Other viruses can lay latent (dormant) until it comes out.
   Dr. John Pfenninger
Gynecology Latent viruses Redwood seeds
Latent viruses can be like redwood seeds.  They can fall to the ground (infect) and stay dormant for 50-100 years.  They only sprout when the conditions are just right (after a forest fire).  With the right conditions (smoking, poor diet, immune suppression, other viruses) the warts will become apparent, even though they have been there for a long time.
Comment: Many people don't understand latent period.
   Dr. John Pfenninger
Gynecology LEEP Ice cream scoop
Removing cervical tissue during a LEEP is like taking a scoop of ice cream.
   Dr. John Pfenninger
Gynecology Menopause Various
Click here for many analogies having to do with aspects of menopause.
Gynecology Squamocolumnar junction Vermillion border
The cervical os is like the mouth and the squamocolumnar junction is like the vermillion border.
   Dr. John Pfenninger
Gynecology  Wart viruses Dogs
Various types of wart viruses are like types of dogs.  Some are really dangerous (like pit bulls) and some are quite indolent (poodles).  Even though they are all dogs, they do different things and like to live different places.  Some are long hair (condyloma) and some are short hair (flat warts).
   Dr. John Pfenninger
Hematology Lymph nodes Oil filter
Lymph nodes are like oil filters, filtering out bacteria and other things that don't belong in the body.
Hematology Platelets Cornstarch
Platelets are like cornstarch, thickening the blood and clogging up any holes in the walls.
Comment:  Not everyone knows cornstarch. 
Hematology Platelets Leaves in a beaver dam
Platelets are like the leaves that catch in the sticks of the beaver dam.  They plug the holes and stop the water.  If this happens in a leaky vessel, it is good.  If it happens inside a blood vessel it can block it and cause a stroke.  Using aspirin is like putting silicone on the leaves.  They then slip right through the dam.
   Dr. John Pfenninger
Hematology Platelets Patches
Platelets are like little patches floating around in the blood, ready to patch any holes.
Hematology Red blood cell Truck
A red blood cell is like a truck.  They both transport essential supplies from one place to another through a system of passageways.  The RBC can only carry so much oxygen.  Need the truck (RBC), truck driver (hemoglobin) and load (oxygen) to work.  Increasing oxygen without enough trucks doesn't work.
Comment:  This analogy can go lots of directions to explain anemia, need for blood transfusions etc.  A variation is comparing them to barges floating in a river.
Newby TJ and Ertmer PA, Instructional analogies and the learning of concepts.  Paper presented at the Annual Meeting of the American Educational Research Association (New Orleans, LA, April 4-8, 1994) p 1, Tina G. Ban
Infectious disease Antibiotics, taking Termites
Taking antibiotics only until the symptoms are gone is like treating your house for termites without treating the termites in the ground underneath.  You need to treat long enough to kill them all.
Infectious disease Antibiotics Lysol
Antibiotics are like Lysol, killing germs.
Infectious disease Antibiotics for viruses   Various
Click here for many analogies that explain why we don't use antibiotics for colds, acute bronchitis and other viral illnesses.
Infectious disease Croup Straw
Take a drinking straw and blow through it - no noise.  Flatten one and and crease it with your fingernails.  Show the parents how the edges are closer together.  Blow through it hard.  It reproduces the sound of the honking cough.
Comment:   Practice this ahead of time.
   Dr. W. Sullivan
Infectious disease Fever Siren
Fever is not a part of the disease any more than red lights and sirens are a bank robbery.  The fever is the RESPONSE to the disease, like the police are a response to the robbery.
   Dr. W. Bailey
Infectious disease Sedimentation rate English setter
A sedimentation rate is like an English setter that goes on point for anything moving in the bushes, not only for pheasants.  The sed rate increase means something is there (could be a pheasant, a rooster or a cat) but doesn't say what it is.
Comment:  How do you explain "nonspecific"?
   Dr. John Pfenninger
Infectious disease Sedimentation rate Stain on clothes
An elevated sed rate is like finding a red stain on an article of laundry being taken out of the washer. Could be Koolaid, cranberry juice, cherries, beets, magic marker, even paint.  If you ask more questions, you may find out what caused it.  You may never know.
Comment:  How do you explain "nonspecific"?
   Dr. LM
Medical economics Primary care physician Gatekeeper
A primary care physician is like a gatekeeper, deciding who gets care and who does not.
Comment: Derogatory term that reduces the physician to a pawn of the payment system instead of an advocate for the patient.  Please send suggestions for replacement analogies.
   Dr. Terry Ruhl
Neurology Seizure Rock concert
The brain cells during a seizure are like people at a rock concert.  One person starts screaming and dancing, then those near and soon it all spreads around and they are all screaming together.  Dilantin tones down the troublemakers.  An EEG is a microphone in the background.
   Dr. Ross Bridge
Nutrition Diabetes education Going to church
Diabetes education is like going to church.  You don't get it all the first time.  You have to go back again and again.  You're always forgetting things and always learning something.
Nutrition Fiber Sponge
Fiber in your diet is like a sponge.  If you take fiber with enough water, your bowel movements will be soft, without water they will be hard.
Annie Giffin
Nutrition Insulin Freeway
Glucose is like cars on the freeway.  The insulin opens up the offramps so it can get out of the blood stream and into the cells where the sugar is needed.
Mary Paeth
Nutrition Overeating Downpour
Your body when you overeating is like the sewer system in a downpour.  Usually it can handle the rain well if spread out, but when it comes all at once it can not handle it.
Mary Paeth
Orthopedics Nonvisualizing fx Paper cut
A nonvisualizing fracture is like a paper cut.  When you first do it, it is razor thin and you might not see it until it starts healing and forms a "scab".
   Dr. John Pfenninger
Orthopedics Sprain or fracture Paper
Take piece of paper and have them hold one corner firmly.  Take the other corner and pull.  No problem with eh "normal ligament".  Then put little sprain (tear at the midpoint) and pull again.  The paper tears.  We don't want this to happen to your ankle.
Comment:   Practice this ahead of time.
   Dr. W. Sullivan
Orthopedics Sprain or fracture Toothpicks
A healing fracture or sprain is like gluing together two toothpicks or tongue blades.  If you keep taking them apart to check them (try walking on a sprained ankle) they will dry and not be stuck together.
Comment: Heal it right the first time.  Also works for lacerations.
   Dr. John Pfenninger
Obstetrics Cervix Turtleneck
The cervix is like a turtleneck.  The baby's head must push hard against it to open it up.
Obstetrics Cervix Flower
The opening of a cervix is like the blooming of a flower.
Obstetrics Forceps Shoe horn
Obstetrical forceps are like a shoe horn.
   Dr. John Pfenninger
Obstetrics Labor Balloon
The uterus is like a balloon and the cervix is the neck and opening of the balloon.  The neck has to get big (to 10 cms) before the baby's head can come out.
Obstetrics Rhogam Sunblock
Using Rhogam is like using sunblock to block the sun.  It blocks the baby's blood from reaching the mom and causing a bad reaction.
Obstetrics Stripping membranes Balloon on cup
Stripping membranes to encourage labor is like running your finger between a balloon resting on a cup.  You don't break the balloon.
Oncology Cancer spread Various
Click here for many analogies for how cancer spreads in the body.
Oncology Living with cancer Various
Bike race (Lance Armstrong), climbing Mount Everest, chess match, marathon, a drama, ad dance, a collaborative exploration, journey
Ophthalmology Eye Camera
The eye is like a camera, the retina is the film, the cornea the glass and the lens is like the lens.
Comment: Cataract: steamed up lens, detached retina: wrinkled film
Philosophy Life Car
Life is like a car.  Do you want to be the driver or the passenger?
Preventive care Cancer screening Animals/fences
The purpose of cancer screening is to detect certain diseases, like fences are made to keep certain animals in.  A fence would be important to keep in a rabbit, that would otherwise get out and cause trouble like a cancer screening test is designed to find diseases that can then be stopped or slowed down.  It is not so important to build a fence for turtles that move so slow that they won't get far.  Likewise it is not important to detect a slow growing cancer that is unlikely to become a problem.  A fence isn't much good to keep in woodchucks, since they always find a way to dig out.  Likewise, we don't screen for some cancers because we can't cure or slow them down even if we do find them.
Dr. Jennifer Good
Preventive care Counseling Hammer/nail
We tend to treat counseling about risk behaviors like hammering in a nail by giving patients more and more information.  We need to think of the risk behavior like a nut rusted to a bolt (the patient).  Hammering can make it worse.  The nut must be teased off, using patience.
  Dr. Richard Botelho, FPReport February 2000
Preventive care Health maintenance Car maintenance
Taking care of your health is like doing maintenance on your car.  You don't wait until you blow your engine before you change the oil.
Preventive care Seatbelts Roller Coaster
You can't hold yourself in a car if you have an accident.  If you have been on a big roller coaster, imagine what it would be like without being strapped in.  The forces in an accident are much worse.
  Dr.   Devan
Psychiatry Schizophrenia Kaleidoscope
Having schizophrenia is like viewing life through a kaleidoscope.  It is hard to put the pieces together and they keep changing.
Pulmonary Bronchospasm Rubber band
Bronchospasm is like a tightening rubber band.  Albuterol relaxes the band.
Pulmonary Inhalers Birth control
Inhalers are like the birth control.  Anti-inflamatory inhalers are like the Pill that you take every day whether you think you are going to need it or not.  The B agonist inhaler is like a condom that you only use when you need it.
    Dr. Mary Fry
Pulmonary Inhalers Car parts
Inhalers are like the safety devises of your car.  Asthmacort is like the seatbelt, albuterol is the airbag.
Pulmonary Lung function/asthma Car engine
The peak flow meter is a speedometer. People with inadequately controlled asthma function like an 8 cylinder engine firing on only 4-5 cylinders. These cylinders are not firing because they are clogged with goo. Someone may not notice that his speed has decreased to 45 mph until he checks the speedometer.  The frequency of checking the speedometer or the peak flow meter depends on how stable things have been, on how much historical fluctuation there has been, and on whether there are known hazards present. 
If one drives on the interstate at 35 mph will he get to where he wants to go, but it may take longer and he may also get rear-ended by a truck. The ideal time to fix this problem is long before he sees the truck 20 feet behind him. Albuterol is for the lungs as stepping on the gas is for going too slow: 1) it is quick acting, 2) it does not last a long time, 3) if the engine is clogged up, it will not respond well to stepping on the gas, and 4) if one finds that he is doing it a lot he better look at some maintenance. If the cylinders are clogged, a fuel additive can be used to dissolve the deposits. This is analogous to inhaled steroids or other maintenance therapy: 1) not everyone needs it (those who only step on the gas less than 2-3 times per week), 2) it does not work quickly, 3) if it took this step to fix the poorly functioning engine, they it is probably beneficial to use it to some extent even when the engine is seemingly running well, and 4) maintenance use of this item will require smaller amounts than reparative use.
Pulmonary Spontaneous pneumothorax Blisters
A lung with emphysema is like having blebs or blisters on the lung.  When a blister breaks, it lets the air out of the lung, causing a collapsed lung.
Renal Kidney Filter
The kidney is like a filter, taking bad things out of the blood.
Annie Giffin
Rheumatology Gout Sugar in coffee
Having too much uric acid in gout is like adding too much sugar to your coffee.  If you add too much, it will crystallize on the bottom of your cup.
Comment: Not for people who drink their coffee black.
   Dr. John Pfenninger
Substance abuse Smoking Various.
Click here for many analogies about how smoking damages the body.
Surgery Adhesions Two cut fingers
If you had shaved off the sides of two fingers and you taped them them together for six weeks, they would grow together like a skin graft.  This is like an adhesion that happens after a surgery. 
   Dr. John Pfenninger
Urological BPH Donut
The prostate is shaped like a donut.  The urethra is like a rubber hose going through the donut.  Over the years, the donut grows, the hole gets smaller and the hose is squeezed.
Urological Hematoma after vas Balloon
The hematoma we sometimes see after after a vasectomy is like a water balloon on a water faucet.  Nothing keeps it from getting real big.
Comment: None
   Dr. John Pfenninger
Urology Sperm Polliwogs
Sperm look like little polliwogs.
   Dr. John Pfenninger
Urological Testicular exam Peach
Examining the testicle is like squeezing a peach.  It should be soft.  If you feel something hard, like the pit, call your doctor.
Urological TURP Roto rooter
A transurethral resection of the prostate is like taking a roto rooter to clean out a pipe.

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More about medical analogies
How to use medical analogies
How to submit a medical analogy (or make comments)