Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

“I’m with it. I’m hip . . .”

"Austin Powers," photo by by Dennis Jarvis, WikiCommons, public domain,


Sometimes, swimming along with your younger learners can help you learn and grow.

“I’m with it. I’m hip . . . ”
-Austin Powers


I was on the wards with the residents listening to the overnight report on one of our patients.


“He was looking surzee so I threw some VC onboard,” the resident said.


He went on but I was stuck trying to figure out what “surzee” was. I feared asking openly, just in case this turned out to be rather well known medical stuff. I continued mulling it over until it finally struck me while rounding at the bedside. The resident meant that the patient developed SIRS (Systemic Inflammatory Response Syndrome).


Clues that I was no longer “hip”

At that moment, I realized that I had transitioned to the uncool “belong-to-some-historic” generation who should not hang around the cool residents. In fact, there were clues everywhere . . . my clothes, shoes, and a tie so broad that the fishes on it seemed tired swimming across it. They were all completely out of place. Nothing was the right brand name or had just the right amount of embellishment to make a statement without making one. My notes—oh my—they needed a lot of work. I hardly used abbreviations! So uncool and waste of bandwidth. I never used words like  “iso”  (in setting of) and “usoh”(usual state of health). Not to mention brbpr, N/V/D, and sob (in my generation that meant something else entirely). The list is endless.


I knew I was out of fashion when I expressed my interest in talking instead of texting. Now residents can text an entire H&P (see what I did there) in a minute to each other.  And I’m not sure where I am with respect to emojis. They may be useful but I hope they don’t replace my not-so-favorites brbpr or n/v/d.


While change is inevitable, some of us make this transition easily and some like me struggle or try to resist and get stuck in the uncool crowd.


It wasn’t that long ago that the New England Journal had a description of a new “palmomental reflex.” It was “elicited” by asking a question on rounds and involved trainees quickly pulling out their digital assistants (PalmPilots) or similar device and repeated stabbing at them with their styluses to get to the answer. The attending docs of those days seemed to complain that the PalmPilots appeared to have replaced the trainees’ brains and thinking abilities. Well, looks like things turned out just fine. And today, trainees have no idea what a PalmPilot is.


The other day, as I walked through a warehouse store, a voice just stopped me and said, “is that a pager?! Can I take a look at it?!”


I handed my “advanced” texting pager over and looked at his face full of wonder and amazement at actually holding a pager in his hand.


The next day I turned in my pager to be replaced by yet another “app” on my phone. One of last resistant pager users had surrendered.


After much thought, I’ve decided to swim with the current as much as possible. As long as it helps improve patient care, I suppose I should stop whining. I am sure I will complain occasionally but more often than not, I hope I can still hang out with the cool crowd.


Here are some tips for those docs stuck in the transition zone:


1. Don’t reject new technology just because it’s new. Try it. You might even like some of it and find you can be more efficient. Give it a fair trial.


2. Texting and typing is here to stay and will likely replace most talking at work. Get used to it and use dictation if you have problems. Emojis should still be used sparingly. Frequent use comes with high risk of ridicule from both the cool and uncool crowd.


3. Get clarification on anything you don’t understand. Just “Google” it and you’ll find the answer to your question. Ignorance or the wrong use of new lingo or an abbreviation is awful. Practice them a couple of times before you start throwing them around like a pro.


4. For the men—broad ties with fishes swimming across are not cool. Get rid of those.


As I think about this more, I plan to create a smart phrase (see I am learning more) to text and welcome my new residents next time I am on the wards.  “Dear residents, I am Kit, your new Chads2vasc 0, NYHA I, AM-PAC 24 attending.” Welcome J!”

I can already feel the cool vibe. What do you think?