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West Virginia's middle finger 

A narrow strip of land that pokes up between Ohio and Pennsylvania
The city of Wheeling is located on West Virginia's middle finger.

M.A.N.S (Middle Aged Nazi Syndrome) 

When someone worked in a job for ages and is in a powerful postion ish and is a moron
My Boss Mr Reid has got M.A.N.S badly the fuck wit

The doctor's middle finger 

A slang term for opioids, where they are viewed as a doctor's way of giving someone the middle finger. If the doctor can't diagnose a patient's condition, and the patient continues to insist on treatment options in spite of the doctor's reluctance, the doctor may prescribe the patient opioids as a way of simply shutting them up rather than helping them figure out what's wrong. Given the naturally addictive nature of opioid medications, this is often seen as a doctor's way of hurting someone back, often being viewed as the worst-kept secret of American healthcare.
"I recently found out my grandma's death was attributed to an opioid overdose. She'd received the doctor's middle finger over her chronic kidney troubles in 2006, and things were never really the same for her since then."

Exilelu Eliza Coupe's Middle Finger Knuckle 

Exilelu Eliza Coupe's Middle Finger Knuckle
Exilelu Eliza Coupe's Middle Finger Knuckle

St. Paul’s Middle School

This assy school. I hate this bum ass ratchet ass school. It’s full of hood rats and slow people. People be fucking In the bathroom when they be ah school dance . I remember in 6th grade two girls were literally fucking in the bathroom. Bo I hate this dirty ass school
St. Paul’s middle school is a cock suckin school, filled with hoes

Mcgee's crossroads middle 

a school that claims to "prepare you for high school" when in all actuallity, treats you like 3-year-olds. often attended by "scenesters" or "rednecks" but often has a high population of absolute freaks. avoid this school at all costs
Guy:"Dude, i go to Mcgee's crossroads middle"

Other Guy:"oh man, im so sorry"