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Honest to Pete, this woman has no clue about pronunciation. A couple of reports ago she's reading a radiology report and says very clearly "primitive destruction" and then goes on to spell it "permeative." Those are two very different words and to me have very different pronunciations.
Now she's on a patient who has had chemoradiation therapy, "altima" and zometa. Umm, you mean Alimta?
It's going to be a long afternoon.