Saturday, October 22, 2011

Ode To The Computer Guy

The computer guy (our trainer) is starting to look stressed. The sweat roles down his forehead as he hunches over the lab top. A cell phone is perched between his shoulder and ear. A line of people are standing behind him. He tries to inconspicuously look at his watch while he waits for a response on the telephone line. Only a few more minutes till quitting time.

Our "go live" has ended horribly. It's the close of day two, and there are still major glitches in the system. The eprescribe functionality is missing in action. Scanning of external documents is restricted and the auto fax is nonoperational.

My partner, who hadn't bothered to peruse the online learning modules, runs after the trainer between each patient. He struggles to input precious information that swirls randomly in and out of his consciousness.

My office manager is perturbed. Half the staff aren't up to speed. The other half are threatening to quit.

It's a miracle that any medical care has actually taken place in the last few days.


I feel strangely above the fray as I observe the seen unfolding in front of me. I can't help but harboring a touch of scorn for the computer technician.

He thinks he's stressed!

At the moment I have a patient in the nursing home dying of lung cancer. He's in severe respiratory distress. His family crowds around as he struggles to suck short wisps of air through fibrotic lungs. He is like a fish out of water. I order intravenous morphine and ativan around the clock.

A nurse just called to report that my psychotic patient who ripped open his scrotum spiked a fever. A moment ago, the lab informed me that my demented patient with "non cardiac" chest pain has positive markers.

I'm thirty minutes behind in the schedule and my last patient managed to vomit on the medical assistant

Yet, I haven't broken a sweat. I manage these, as well as all other crises, with an air of confidence. This is a typical Friday afternoon. I feel completely at home in the midst of chaos.


But maybe I'm not giving the technician enough credit. Maybe he is wiser then I. His job is methodical and orderly. He finishes with one problem, and then moves to the next. At the end of the day he's done.

Physicians, on the other hand, have let their profession get out of hand. We have lost control of our most important commodity-time.

It probably happened decades ago when the pressure of paying for overhead spurred us to become more efficient. Take on more cases. See more patients.

Now we manage thousands of lives. We takes histories, answer overhead pages, and tend to our cell phones simultaneously.

As our heads spin, our hearts palpitate, and our blood pressures rise, we find our internal rhythms changing. We become over-caffeinated. We concentrate intensely in small spurts.

We live in a facebook/twitter society. One blink and everything changes.

But wouldn't it be nice, for once, to be like the computer guy. To greet each patient as if there aren't four other crises or five other people trying to get our attention.

As if the patient sitting in front of us is the only one.

The only one who exists in the world.

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