A Trip to St. Elsewhere: Part II
If one were to ask a friend what they were doing on July 1st twenty years ago I would bet in most cases the reply would include the words “foggiest”, “idea” and “haven’t”. Now ask a friend what they recall from a distant vacation and suddenly one is inundated with tales of waltzing on the beach by the light of the ocean moon. So it is with events in life that are so intense that they weave themselves into a tapestry that hangs on the walls of Memory forever.
So it is with doctors and their hospitals. Doctors can remember every ward, emergency room and stairwell they ever spent more than a day navigating (by the way, interns use stairwells when going off-duty in order to escape before being confronted with a new problem while waiting for the !@#!&! elevator to appear). Hospitals are memorable places, where death and birth pass each other in the halls on the way to their next assignment. The impression left on patients, families and health care workers by hospitals is indelible - I can still clearly see the room in the emergency ward at Iowa Methodist Medical Center where a teenage girl was brought in by helicopter in July 1978 after being crushed in an ATV accident. I had a summer job there as an orderly. She died in that room, surrounded by a crowd of shouting and sweating people. I remember… I remember…I will never forget that sweet girl, Julie Stone. It was the first time I had ever seen desperation displayed on a physician’s face.
Since this is the second part of our tour of St. Elsewhere, however, let us walk away from the scary places and visit one of the more amusing chambers of the hospital. Come with me down these echoing stairs into the lovely suite known as Radiology, where the internal secrets of even the most electrifying celebrities are exposed with all their flaws. If the owners of these various organs have avoided the evils of drink and smoke, however, there is no reason why their lungs and liver should not look as pristine on x-rays as those of Mr. Universe himself.
My own safaris to Radiology have not been all that jolly. During medical school I spent my rotation trapped in a reading room so small I half expected the intercom to deliver a message from Mission Control about our lunar landing. Not only was it cramped in there, but the attending liked to chain-smoke unfiltered Camels as he taught us how to read CT scans. This was but a minor distraction, although we all sped home after the first day and drew up our wills. The radiology department did not exactly earn the title “Beloved by All” during the residency, either, for it was during this stretch that I learned how to find and read my own damn x-rays, owing to a lack of coherent personnel in the department. This shortcut produced at least two undeniable results: 1. I was never late for lunch, and 2. the odds of a patient slumbering through the night with an undiagnosed pneumothorax increased nine-fold. Surprisingly, it was after becoming an attending that radiology entered the Dark Ages of customer service. For example, the following dialogue was recorded I believe during the first Clinton administration:
Cheerful Oncologist (rummaging through files of manilla x-ray folders), sotto voce: How poor are they that have not patience!
Radiology Librarian (threateningly): What are you looking for?
Cheerful Onc. (brows furrowing): I’m looking for Mrs. So-and-So’s x-rays.
Radio. Librar.: Don’t go through the files! I’ll get them for you! (leaves, without eating roots or shoots, I might add, in a huff)
C. O.: Lasciate ogni speranza, voi ch’intrate!
R. L.: Don’t talk back to me, buddy!
So it went, year after year, as I tried to hunt down x-rays for review while avoiding the headhunters in the film library. It was a lesson in survival for me. I searched for a friend in Radiology like a Casablanca spy seeking letters of transit. I began to send members of my staff in my place, which led to bitter denunciations of my lack of courage, but better them than me to face Godzilla, Mothra and the other movie stars in the department. After all, I was aging rapidly and needed to watch my blood pressure. Just when I had resigned myself to a destiny chained to the the beast called Aggravation, the radiology department blessed its patrons with the most precious gift of all:
It disappeared.
Now by the miracle of the internet, all imaging studies are digitally transferred to the hospital website where they may be viewed on any computer, anywhere, anytime, by any interested party with the proper security clearance. There is no reason to pass through the heavily guarded doors of the department any more, unless one wants to stand around with one’s hands in one’s pockets like an eager fan holding the 1,758th position in line to see a game on opening day. I worry that future generations of doctors will not get to enjoy the kindling of the same relationships we ancient mariners have developed over years of sparring with the radiology department. Is nothing sacred? Next thing we know, we’ll press a button and our lunch will appear on our desk, complete with a tasty space beverage. Wouldn’t that make a trip to the cafeteria nothing more than a wistful memory? Oh, perish the thought, if not the food!
Next: A Trip to St. Elsewhere: Part III - the Cafeteria and the Parking Lot
