“Don’t park in the back; park in the Maxi’s lot,” I text my daughter from the restaurant table. “There you are. I can see you through the window. Look a bit to the left!” How many texts like this have I sent? How often have I sent clarifications, instructions, amendments to plans on the fly? I wonder how we ever found each other when meeting in public places or when emergencies changed our plans. This is true not only in our private lives. Nothing has changed so much in the many years of my practice than the ease of communicating with people.
When I started in medicine, back before the Flood, there was the overhead paging system. Hospitals were cacophonous, with the names of people being called overhead. There were the codes: 99 was the code for cardiac arrest and 55 for an emergency call at the Montreal General Hospital and the Royal Victoria back in the late ’70s. The Jewish General, always a little different, would page for Dr. Swift when there was an arrest. This was all well and good until Arthur Swift started his internship there. “From now on, you are Dr. Arthur!” the head of the telecommunications team informed him. As students and residents, this led to a bit of a secret language. “What happened to that patient?” someone would ask. “Oh, he swifted,” was the reply.
As a rotating intern at the late lamented Queen Elizabeth Hospital in Montreal, we had the innovative new beepers. I remember that first beeper well. It was green and black and about the size of today’s cell phone. All it could do was beep, and that would instruct you to call “Locating,” where the operator would let you know which local in the hospital required your response. The range was so limited that even going out to sit on the lawn of the building was a risky business. The locating operators were the neural net of the hospital. There was one who always seemed to be there nights and evenings. Her name was Claire, and she must have had a sophisticated mental map of the whole hospital. “You want Dr. Unikowsky, Chere,” She would say, “I just spoke to him on Five West. Why don’t you just go up there and see if you can find him?”
As I became more and more heavily pregnant, she used to wake me up very gently. “Hello Perle,” she cooed, “I know you need your sleep, Chere, but Denise needs you stat on the sixth floor.”
When I gave birth that summer of 1981, at the Royal Vic, I was lying in my bed on postpartum, listening to the names of all my friends and classmates as they were called out on the overhead paging system. I finally drifted off to sleep, exhausted. Then, suddenly on the overhead, the loudspeaker barked urgently, “99 Dr. Feldman, 5 Cardiac, 99 Dr. Feldman.” From my deep sleep, on instinct and training, I leapt to my feet. I was at the door, my johnny shirt flapping open when the pain woke me. I abruptly realized it was not me they were calling!
By the mid-’90s, beepers got more sophisticated, now displaying phone numbers. They could reach all over town. They also became more common. They were now carried not just by doctors but by drug dealers, undercover cops and hip young men who wanted to be cool. There was also a new piece of technology, cell phones. The original Motorola was the size and shape of a brick. They were expensive, and I resisted getting one.
One night I did a delivery at two am. I was starving. I knew that we had no bread, eggs or milk at home. I thought I would go to the all-night diner across the street from the Jewish, but it was shockingly closed. There were no 24-hour markets in those days, and the only place I could think of that was open was a diner under a strip club on St. Jacques St., not the most savoury area in Montreal. That is where I drove, through a sleety night, past the sleazy hotels, focused on the vision of toast, eggs and coffee. As I turned the corner, my beeper went off, locating’s number on the small screen. Then, not ten seconds later, it went off again. Locating would sometimes do this when there was something very urgent. Envisioning a postpartum hemorrhage or even a PE, I pulled into the gas station, where there was a payphone. In the pool of light cast by the streetlamp, I jumped out of my van, fished a quarter out of my pocket as I saw some cars slow down, the drivers eyeing me curiously. I stood in a freezing slushy puddle, dropped my quarter into the icy pool, fished it out and called locating. “Oh no, Dr. Feldman,” said the puzzled operator, “there must be some mistake. I was not calling you!” Wholly demoralized, I drove directly home, abandoning my breakfast fantasy. The following day I ordered a cell phone.
Now when I am on-call, I text my resident before I leave the house. In addition, I can access all kinds of data, podcasts and other teaching materials from the little box clipped to the waist of my scrubs.