Technology without Compassion - A Bad Combination

A couple of years ago, I made an unplanned visit to an emergency room in a major urban hospital. The staff was top-notch in the triage phase of my treatment. They ruled out imminent danger and then put me into a bed and hooked me up to a very sophisticated monitoring system. I had wires connected to nearly every part of my body, which transmitted signals about my vitals signs to a centralized hub of computers so that my nurse could oversee the care of a cadre of patients (myself included) from his cubicle.

After several hours, I required a nurse's assistance. I looked in vain for a call button. There was none. I thought at first that I was just confused about where it might be located. But it soon became apparent that the one-way communication system was intentional; there was no way for us patients to contact our assigned nurse. The man next to me, who was a diabetic, began to call out for someone to bring him some orange juice as a precaution against insulin shock. No one heard. No one was listening. Even when he said that he'd never ever come back to this hospital again.

Another patient cried out periodically, warning that she was going to lose her dinner. No one responded. I heard her call out at least 5 times over 30 -45 minutes. She wasn't kidding. We all heard the retching and then the inevitable disgorging -- all over the tile floor. The resulting mess was a half-inch thick and covered an area 6 feet in diameter, I observed later (it was over 15 minutes before the staff mobilized to clean it all up).

Technology is a wonderful thing. I personally and professionally endorse the development and use of technology on nearly a daily basis. I owe my career to the advent of the computer age; my first 7 years of professional life were spent in a software application company where I thrived in the atmosphere of creativity and innovation.

But technology is no substitute for human interaction. There are things you cannot learn about your patients sitting at a centralized hub of computer monitors. Technology without compassion is more than bad medicine and bad business; it drains the human community of its life force. The essence of good medicine is the comforting touch of a nurse's hand on a troubled brow.

I had an advantage in that environment; I was mobile. When I needed something, I pulled all the plugs out of the machines, gathered up the wires so that I could carry them without tripping, walked up to the hub and demanded attention. When I returned to my bed, I plugged everything back in. Once or twice, when I was bored, I pulled everything out and went for a walk. I watched to see whether the nurse would notice the flat lines on the monitor and come check on me. But he never even looked up from his screen.

After a miserable 36 hours in that ER, I finally checked myself out against medical advice and went to another hospital where I knew a doctor. The first thing I noticed when they showed me to a bed was an old fashioned call button attached to the pillow. I felt strangely comforted by the sight of it.