Tuesday, October 18, 2011

Plug and prey

I'm a bit late with this week's column and that's because I'm still recovering from the painful experience of passing a kidney stone.

However, the ordeal was not without some useful insight into our technology and the way we use it.

When the ambulance arrived in response to my 111 call (yes, it was *that* painful and I was getting really concerned that I might pass out and vomit at the same time), they rolled up and threw a blood-pressure/pulse monitor cuff on my arm.

This unit is attached to a fancy box with big LCD display, touch screen, knobs, buttons and a price-tag that would probably make your second car look cheap.

When they pushed the "go" button, a firm but polite voice said "please connect".

The ambo lady frowned and pushed the button again....

"please connect"

She wiggled the wires, removed and reinserted the plugs -- then frowned again when it continued to say "please connect".

Eventually it started working and the cuff inflated, my BP and heart-rate displayed and there was a barely perceptible sigh of relief from its operator.

For a moment I was wondering (amidst the pain) if I'd have to start diagnosing a fault in the medical gear before we'd even get into the back of the ambulance.

When I got to the emergency room I was wheeled behind a curtain and, after the usual questions (are you alergic to anything? What is the capital of Peru? etc, etc) an ultrasound machine was wheeled out.

The probe was greased up and applied to my abdomen which, fortunately, was now not as painful as it had been just 15 minutes earlier.

This ultrasound machine was pretty new apparently. It too had a big LCD display with touch screen and lots of blinky lights.

Unfortunately I saw the doctor frown as he began stabbing at the screen.

Was I going to die? Had he seen something awful inside me?

No... as it turns out, he was having trouble making the machine work.

Or, to be precise, he was having trouble figuring out *how* to make the machine work.

After much poking (of the screen, not me) it finally started behaving and he had a good old virtual rummage around inside me.

Nothing wrong there -- everything about the right size and in the right place -- although he couldn't find my left kidney but attributed that to a little gas in my intestines.

It was becoming increasingly clear however, that our medical people are often quite naive when it comes to the use of their hi-tech gear. Obviously, in making these things fool-proof we remove any need to understand the basics of how they work.

Unfortunately, that means that when/if they don't work -- all you get from those trying to use them is a nasty frown.

This drawback to uber-friendly technology has been a trend apparent ever since the middle of the 20th century, when automotive technology changed from something you could easily understand and fix with a screwdriver or hammer -- to a big box of "magic" that requires shelves of diagnostic computers and a PhD in nuclear physics to properly comprehend.

Now, so long as all this new-fangled stuff works as it should, we all benefit.

Unfortunately, when it doesn't do what it's supposed to, I can easily see that (at least in the area of medicine), doctors and nurses could become to focused on "fixing the machine" rather than fixing the patient.

Me thinks there's room for improvement here.

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