I am an emergency physician.  As such, I spend a great deal of time communicating with other physicians.  ‘Will you see this patient?’  ‘Will you admit that patient?’  ‘What do you think about these symptoms?’

I have turned into a pretty effective communicator.  After years as a physician, I can get to the point in short order.  No more long histories, suspenseful build-up, dramatic conclusions.  Those were the devices of my youth, when I was not confident.  Now, my sentences are more neolithic.  ‘Heart attack.  Stable.  Thrombolytics.  You admit.  Ugh.’  (For a while I tried to be eloquent.  I once told our surgeon, in the spirit of the British authors I love, that my partner needed him for a trauma victim, who was ‘really quite sick.’  I might as well have spoken Bushman:  ‘Click, click, click.’)

Still, the one impediment to communication that remains is the OR circulating nurse.  I understand the need for circulators.  But I wish they were used more for errands at our hospital than for talking between physicians.  And mind you, by way of disclaimer, this may be a phenomenon only at my facility.  But it still bears telling.
My call to the surgeon, who happens to be in the OR, usually go like this:

‘Hi, this is Dr. Leap.  Is Dr. Adkins there?’

‘This is Julie, the circulator.  He’s scrubbed in.  What can I tell him for you?’

‘Tell him (I say this in my simplest prose) that I have an 18-year-old male patient with appendicitis, confirmed by CT.’

‘OK.  Dr. Adkins?  This is Dr. Leap.  He says he has a patient with appendolokolism.  I don’t really know what he means.’

‘What?  Ask him again.’

‘Dr. Leap, he doesn’t get it.  What did you say?’

(I heard the entire exchange.  My blood pressure is rising slowly, but surely, and causing serum to leak out my eyes.)

‘Julie, tell him I have a patient with appendicitis.  An appendix that’s sick.  You know?’

‘Dr. Adkins, he says the patient has had aploxilitis for 18 years.’

‘He’s crazy.  He’s full of %&*#.  Tell him to explain what he means.’

(I’m seizing, on the floor.  Foam out my mouth.  I don’t know how to communicate this any better than I have.)

‘Julie.  This patient is 18 years old.  He has appendicitis.  Dr. Adkins needs to see him when he’s done with that case.  Can you tell him that?’

‘Dr. Adkins.  Dr. Leap is kind of testy and he says for you to come to the ER as quick as possible.’

‘Tell Dr. Leap to go….’  (You know the rest.)

Ultimately, Dr. Adkins calls me.

I say, ‘Jim, the patient has appendicitis.  The CT is positive.  That’s all.’

‘Well why didn’t you just say that?’

‘Because, old chap, I’m really just an emergency physician, quite!  Crumpet?’

What I want to know is this.  Aren’t there speaker phones? Aren’t there Blue Tooth attachments?  Isn’t there semaphore?  Morse code?  Smoke signals?  Why, oh why, am I still trying to talk through the circulating nurse?

As we say in the South, ‘Bless her heart!’

Have a clearly communicated day.  And for heaven’s sake, don’t get appekidolikilitis!’

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