I signed up on Twitter because of the hullabaloo but quickly lost focus. I did not understand why I should give a flying you know what about the barrage of 150 words that endlessly occupied my phone. And due to my litigated-against profession, Facebook was never an option.
When the hospital and the physician group began to push email down my throat, I politely agreed and neglected to look at it. I still remember a medical student looking in horror over my shoulder at the number of emails never opened. He was tasked with erasing them.
Did I miss something important, maybe? My goal was to provide the best care I could, and I think on a one to one basis I did that. It is not an easy thing to do. Every patient encounter is bespoke. I like that word. It, in a Queen’s English kind of way, provokes a gravitas that “custom” fails to do.
The digital revolution forced me to do an audit of my mental capacity: to inventory the memory and the processing power available to my aging mind. I determined the limits, and then decided what was necessary and left the other behind.
I envisioned practicing to a ripe old age. Experience in many ways supplants vigor. The longer I practiced the more efficient I became. In training, we would be confronted by wizen old doctors who could tell a patient’s entire history by watching them walk into the room. I was becoming one of these soothsayers.
This is part of the craft and not a saintly power bestowed on only a few. It requires decades of attention to detail, careful history taking and examination, and then the ability to formulate a proper note.
The act of writing allows the mind to catch up with the data stream. It allows for the split seconds needed to devise a plan. And it stores much of the information gained in long term memory, so it can be drawn upon later.
Of course, the reader can probably see where I am going with this. See why I abandoned my calling younger than I had anticipated, and went off to invest the energy left to me onto other areas of interest. A digital world I could not ignore finally caught up with me in the form of the electronic medical record.
I knew I was in trouble during the first of two two-hour lessons delivered by the provider of the software. Four hours of disjointed instruction by trainers, who truly could not understand that they were replacing a system developed over hundreds of years with a wholly insufficient and cumbersome digital equivalent.
But strike that last word. There is not a thing equivalent to several blank pieces of paper and a trained mind. Simple things turned complex and complex things were ignored. The patient encounter designed to be helpful, compassionate, and believe-it-or-not fun, turned ugly.
I spent six years in strident effort trying to perfect a thing that I knew after the first several weeks of use was hopeless. The digital world had bested me. I gave up. It took years to not feel guilty about the decision. And I suppose by writing this I am admitting to myself that I am not yet over it.
What prompted this thought process was the Iowa caucus debacle. In a purely selfish way, I take solace in the apps failure to count a few votes in a state with less population than Chicago. It looks like the collective consciousness of the country has many of the same issues with digital that I have.
But I am not good at wallowing, so I will continue to download the next best weather app and to post my bread baking victories on Instagram. That is, at least until my neuronal network ceases to connect!
February 2020
