We hear a lot of catastrophic predictions these days.  From global warming to nuclear weapons, hurricanes to electro-magnetic pulse weapons, threats abound.  So imagine my anxiety when, without benefit of a think-tank or foundation, government grant or government agency, I fell upon one of the worst of all possible threats.

What if, suddenly, all of our hospital computers stopped highlighting abnormal labs!  What if there were no *H, or *L, no letters in red, no ‘abnl’ beside the tests we order!  Let’s face it, the culture of medicine is different from what it was 50 or even 15 years ago.  We do too much, and are compelled to do it too fast.  So the truth is, we all scan those lab sheets for ‘abnormals,’ provided to us by the laboratory department via nicely configured computer programs.

What if the glucose of 23 were the same color as a normal glucose?  What if the cardiac biomarkers were all black, with no H or L next to that elevated Troponin?  What if, dare I say it, the pregnancy test that was positive wasn’t written in bold letters?  Or the Mono-spot?  Or, (gasp) the positive strep or gonorrhea swabs?

The very fabric of reality might begin to unfold.  Confused old ladies with sodium levels of 110 might be sent home with a ‘huh, I don’t know!’  Women would continue to wonder why their protruding bellies kicked them in the night.  Men in college would have no explanation for the intense burning with urination, and would struggle to find different soaps and shampoos.  Children with foul breath and large lymph nodes would continue to say ‘mommy, it hurts when I drink,’ because we doctors might roll right over that abnormal lab!

OK, it might not be that bad.  But we have to be careful.  I’ve glossed over labs that were abnormal AND highlighted!  The pace at which modern emergency departments, clinics, even private offices move can seem staggering.  And frankly, enhancing computer technology to prevent errors will only go so far.  Sometimes, overwhelmed is just that.

We do need to take a minute here and there and look things over! We need intellectual pauses, without a constant barrage of questions, forms and phone calls.  We must take time  to look at that EKG.  Review those labs.  we have to step away and try to put it all together.

However, the labs, the computers, the programs, the tests of every sort are all simply representations of our attempts to fix a given problem.  They are the way we use our intelligence to look inside our fellow humans to fixthe problem.  Computers, after all, are not intelligence; tests are not compassion; x-rays are not skill.

The ultimate tool is human knowledge, skill and compassion.  We use tests, and all of those H, L and Abnormal marks at the end, to apply our brains to the people who come to us.

Imagine the chaos, not of labs unmarked, but of minds uninterested, skills unused and compassion undeveloped.

Now that’s scary!

Edwin

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