I came to work in the emergency department yesterday morning and found taped above our communal desk.  It concerned a chart I had dictated the day before. 

The note, from the transcriptionist, said:

‘If it were possible to rate with a minus, this dictation would warrant it; this dictator clips words, chops off sentences and changes thought direction in mid-sentence, leaving intent to the imagination of the hearer.’

It is, I must admit, an eloquent description of the difficulties the transcriptionist experienced.  If I it were possible to rate the transcriptionist’s comment with a plus, this comment would warrant it!

So hey, color me embarrassed!  I think I may have been speaking to a couple of consultants on the phone during my dictation.  It was a busy day of admissions. 

However, I’m not known for my skill at dictation.  It has been my consistent observation that virtually every chart I dictate has a blank that I later have to fill in by hand.  Maybe I mumble, maybe I hold the phone too far from my mouth.  I know that I have a habit of speaking too fast.  Combined with my native West Virginia inflections and my adopted South Carolina ones, it’s a prescription for unintelligable communications.  My heart goes out to the ladies and gentlemen who have to decode my rambling.

Still, I feel I have to respond to some of the comments.  First, I’d like to say thanks for the term ‘dictator.’  While I understand it was being used in the context of a medical chart, it does give me a feeling of power, a sense of total dominion, that I actually don’t feel in my day to day life.  If I were a dictator, practicing modern medicine, rest assured heads would roll.  But that’s another discussion altogether.

Now, regarding the allegation that I leave intent to the imagination of the hearer: I am a writer.  Imagination is very important to me!  If the hearer or reader finds himself or herself transported to a realm in which they can try to picture the scene in the ER, or where they have the singular delight of trying to construct mental scenarios of why patients did some of the tragically silly things I report, then so much the better.  Imagination is useful and powerful.  And frankly, imagination is what I frequently employ when the history and physical are so lacking in reality or actual findings.

But most important, before closing, I want to say this:

I ap..gize for any…I may have….  Sometimes, banana (?) I get comfuzzled in the ring/rang fluffy.  Of course, if I cood have brean any cleaner, it wouldn’t have hurried along, but the bunnies were running in the field (!) before Mr. Johnson fell down yesterday at 3 PM resulting in an intrauterine pregnancy which, when Pompeii was covered in lava made the transcriptionist appear to feel, or be, angry, whose vital signs were stable, or unremarkable, and not psychotic or delusional.

I remain, yours, confusedly and with obfuscation,

Egwart Leeapt, ND

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