Published On January 15, 2014
Raymond Chandler once wrote: “The truth of art keeps science from becoming inhuman, and the truth of science keeps art from becoming ridiculous.” In that spirit, this short story humanizes an aspect of clinical care that very few people see—an IT guy’s role in rolling out new health care technology.
The mermaids are braiding each other’s hair behind the nurse’s station. Irena works like a pro, not a pause in whispered gossip as her fingers make impossible topologies from Jen’s blonde haystack. When it’s done, she looks like a Ukrainian virgin on her wedding day. Irena sneaks off-unit for a smoke.
They called each other mermaids, Raquelina explained, because of the scale-gray scrub tops and sea-green pants that make up the uniform for oncology floors.
“Before the buyout, we could wear what we wanted,” she sighed, “but this is all right. Easier.”
“Uniforms help,” I agreed, tugging at my blood-red polo. I didn’t say I thought they made them more beautiful, the industrial standard contrasting with their strong arms and kind eyes. That was the third night of the rollout. They knew I was there with them, not just for them like the voices on the helpline.
On day 10, the new system still worries them. Click by click, they regain their ease and routine. Done right, it works. More and more of them have seen it catch a med error, or a downward trend. But like their mermaid scrubs, it comes from the boardroom, and it’s new and uniform and kind of ugly. All the new numbers they have to punch into the chart are a language we’ve made up to describe sickness. And sickness is a body’s kind of failure to be uniform—perhaps on this ward more than others. When they spin down the blood in the lab, it doesn’t turn into numbers.
Still, no tears tonight. They know they can complain to me, and they do. In the dry span from 0300 to morning draw, I play bartender: sympathy, short-term fixes, control over something dangerous I can sell but never touch. This and that are still too slow; I promise to take it upstairs again. When it’s most quiet, we talk about our hometowns. I’m the only one who misses mine right now.
“Hey Red,” says a familiar resident shuffling out of the dictation room, “can I ask you something?” I’ve been reduced to the color of my shirt by people with no time for names. I go with him to the monitor and perch at his shoulder. “Can you help me document on this expired patient? Another floor,” he quickly adds, as if he doesn’t want me to blame myself.
I show him where the cause and time and disposition all go, and explain that the rest is on the state-issued paper. “I know,” I say, resigned, “not really a paperless system like we promised.”
Now comes the schoolboy in him. “Um—do you have a pen?”
“Of course.” I always have a pen. I stock up with handfuls from the local bank, habits learned from my mother and her 23 years teaching ninth grade. “Keep it.”
When I return, the mermaids have left the station to make hourly rounds. I hear everything else: A printer spitting out labels. A giveaway pen scratching out a death certificate. A ventilator beeping Morse code for IS, IS, IS.
Stay on the frontiers of medicine