Wheres the auto-pilot?

Where's the auto-pilot?

Recently, a commercial airplane overshot it’s destination by about 150 miles.  The pilot and co-pilot were both using lap-tops.  They were engaging in what we might call ‘distracted flying.’  Of course, the phenomenon is not new.  Drivers are frequently accused of distracted driving.  Talking on cell-phones was the major issue; now it’s texting while driving.  I can’t imagine trying to write a text while driving my car.  But then, I’m getting older and I have a cataract.  I’m happy to keep it between the lines.

I always wondered how people could drive their cars with enormous speakers blasting from the back seat.  Remember them?  The folks I knew in high school would sometimes fill the entire back seat with speakers.  Of course, rock was still worth listening to then; it would make a lot less sense now.  Besides, no one needs to fill the back seat!  With iPod ear-phones, the speakers can be as loud as you like, but blare directly into your ear.  No need to share hearing loss with people down the block; it’s all nice and personal now.

Medicine has its own risks of distracted practice.  I remember the sweet old lady in the hospital bed, not terribly ill, but complaining of cough or something like that.  As I tried to focus my stethoscope on her frail form, I heard the television in her room, on the wall behind me.  ‘This summer’s hottest swimsuits, featuring Eva Longoria!’  I love my patients, but it took a real act of will not to dislocate my head from my neck and turn around.

Pneumonia or Eva?  See what I mean?

Pneumonia or Eva? See what I mean?

Computers are now integral to medicine, and as such are ubiquitous in hospitals.  But each one typically has Internet access.  It’s a constant temptation to check e-mail, look up a website or do other such things during down-time, or between patient-care activities.  And even when sites are blocked, many staff now have iPhones or Blackberries, or even bring lap-tops to work, in order to engage in social media.

Distraction is possible.  But then, it’s nothing new.  Distraction was always possible.  Before cell-phones it was personal calls on the hospital line.  Or magazines instead of computers.  Human minds are always searching for stimuli, and believe it or not, medicine can easily become mundane.  Or at least, it can seem mundane.  Even the most thrilling job can become commonplace if we do it long enough.  So, we communicate, we look, we learn.  We are social beings by nature, who increasingly use new technologies to learn and explore the world around us.  However, these are not excuses for dereliction of duty.  Anyone in a critical career, where safety is paramount, has to be aware of the dangers of distraction.

Now, as folks are shaking their heads in agreement, let me also expand this definition. Distraction comes from other directions.  Too many forms to fill out, too many memos to read, both serve as distractions.  Too many rules and too much charting can distract physicians and nurses from their primary missions of patient care.  The fear of lawsuits, the fear of firing or censure, the fear of being constantly watched, condemned, evaluated or criticized by supervisors or patients, these are distractions from the proper practice of our professions.

And we are all distracted inside, aren’t we?  We are distracted by the way our bodies feel, by the way our hearts break or soar.  The joys and pains of everyday life often leave us confused, battered and scarcely able to breathe, much less function in our workplaces.  Anxiety, guilt, uncertainty, anticipation, passion, addiction, relationship struggles, even fatigue can distract us and adversely impede us.

Distraction is everywhere!  Before we beat the drum too loudly about devices or communication, we ought to look carefully at the way our very systems distract and demean us, and the way our very humanity leaves our  frail minds wandering.

Focus is an act of will, and we can learn it.  But distraction, I fear, may be our natural state as humans.

Edwin

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