wordelf said:

Like death eating a cracker:

Two other phrases come to mind, similar in that they involve food and death, but different in that in these expressions, death is not the eater but the eaten:

1. "You look like death warmed over."
2. "How do you feel?" "Like death on toast."

I agree with Elysia that these phrases connote queasiness, or that strange, hollow feeling your stomach may get when you have been deprived of sleep. #2 was a pretty common expression at Valparaiso U. in Indiana when I was there (6 years ago) between people commiserating about staying up way too late writing papers. "Death warmed over" just sounds nauseous– at least, it makes me think of someone using the iffy leftovers that have been languishing in the fridge; by analogy, the person you say this to looks like he or she is but tenuously alive, or like a walking stiff.

I disagree. It was mentioned on the show that the expression first appears in 1962.
I believe it has to do with the Cuban missile crisis in 1962. People were instructed to stock up on survival items in case of a possible nuclear attack. One of the popular items many people stocked up on was biscuits (or crackers) because of their long shelf life.
That is how NABISCO (National Biscuit Company) got national exposure.

Therefore the expression implies that you are looking so bad as if "death" itself is barely surviving (since death has resorted to eating the survival rations).

Just my thoughts.. Thanks.

mullenfam said:

In the same episode, there was a discussion of "turf" as in "turfing a patient to another physician." I'm not sure I buy the "turf out" explanation given by the hosts given the context. In the same medical context, there is often a discussion of "turf" with the sense of "territory." Radiologists, for example, claim medical imaging as their "turf." And there are often long battles over who owns the domain as new specialties take on the tools of their trade. Who owns a the patient's cholesterol level, is that the Primary Care Doc's or the Cardiologist's turf?

Given that common usage, I wonder if the idea of "turfing a patient" is more about moving a patient to another doctor's territory, more than it is a link to the ancient ideas of landing or kicking out.

In my experience, you're right. When I was in my residency training, residents talked about "turfing" a patient when they/we wanted to move them to another specialist's service. There was sometimes a bit of the "let's get rid of this guy" attitude in there, but usually it was an appropriate move. For example, if I was on the surgery service and the surgery was complete, but the patient still needed management of their medical (non-surgical) problems, we might "turf" them to the internal medicine service. I also heard the phrase "buff and turf" for getting the patient as healthy as possible on one service and then transferring them to another. I figured that meant like buffing silverware or a copper pot, shining it up so that it at least looks nice. I don't use either expression anymore, because I do find them a bit offensive.