Pennsylvania 6-5000 and 867-5309 (Jenny!)

There’s a Massachusetts nurse practitioner I sometimes encounter in the course of my work who always closes her reports with, “If you have any questions about this dictation, dial . . .” and she gives a number. “Dial?” To judge from her voice, which is really all I have to go on, at most she is very early middle age, probably in her thirties--does she even REMEMBER rotary phones? I’m pretty slow to adopt new technology, but even I had a touch-tone phone back in the days when there was still an extra charge for it on the phone bill--1980s. Has she ever “dialed” a telephone number?

Then again, I’ll still have people ask that a “carbon copy” be sent somewhere. “Carbon copy?” I think I last used carbon paper in typing class in the mid-1970s. Photocopiers pretty much ended “carbon copies.” The “cc” at the bottom of a document or piece of correspondence now pretty much means “courtesy copy.” Granted, some of the doctors, etc., doing the dictating are long enough in the tooth to remember “carbon copies,” although I’m sure none of them have seen such a thing in more years than they can remember, aside from maybe some forms (but even those are mostly “NCR”--no carbon required--these days). That doesn’t really explain why, say, a medical resident born in the mid to late 1980s would ask for a “carbon copy.”

What I suspect is that at some point they learned that “cc” was an abbreviation for carbon copy; having no reference point, really, to them, “carbon copy” means simply, “copy.”

I get the same feeling sometimes about all the acronyms we use, or that medical professionals use--it is as if the acronym has become the de facto “name” of a given disease entity. COPD--chronic obstructive pulmonary disease--is perhaps my favorite example because I’ll often hear people talk about “chronic COPD,” apparently forgetting what the C in the acronym stands for. As transcriptionists, of course, in certain sections of reports--diagnosis, etc.--we have to expand all abbreviations, and we are also supposed to transcribe “verbatim.” Somehow I’ve never managed to convince myself that it would be okay, even preferable, to type “chronic chronic obstructive pulmonary disease.”

I cannot remember ever hearing a psych professional refer to post-traumatic stress disorder as anything but PTSD, or attention deficit hyperactivity disorder as anything but ADHD, although I’m sure it happens.

I suppose that it really doesn’t matter, in any real sense, whether something is called “CLL” or by the polysyllabic mouthful, “chronic lymphocytic leukemia” (although there are other expansions of that particular acronym, which could conceivably lead to confusion): The physician presumably knows what he’s talking about, and calling it one thing versus the other won’t alter his treatment plan.

Still, sometimes the increasing use--and, to my mind--overuse and over-reliance on acronyms threatens to reduce “medicalese” to a kind of pidgin English, in the same way that a similar process has reduced much “on-line” communication to the same.

I first went on-line in 1996, about a month before AOL (anybody remember AOL?) went “unlimited”--that is, started charging a monthly flat rate rather than a per-minute charge for on-line usage. All the acronyms so widely used now, all the “wtf” and “lol” and “roflmao” and “fml” and so on, were born in the days of per-minute charges. People held on to that language even after the advent of “unlimited use,” when you no longer had to worry about every character you typed into an “instant message” or a chat room costing you money. It evolved somehow from “necessity” to “cool.”

Medicalese seems to have followed a similar progression. What makes me think that is that I hear so many “lay” people--people who are not medical professionals--slinging the acronymic lingo, as if it makes them part of the medical crowd, or something. The “medical crowd” reinforces it by talking to lay people--you know, “patients”--in the same lingo, the same pidgin. Interestingly, nurses seem to be some of the worst offenders. While the nursing profession has gone to great lengths, or so nurses have told me, to develop a language “separate” from that of physicians--a “laceration” becomes an “disruption of skin integrity,” or something like that, a nurse practitioner once told me--once they become advanced practice nurses, they embrace the medical pidgin with gusto, and speak in nothing BUT acronyms unless it cannot be avoided.

This is sometimes problematic from a transcriptionist point of view, of course, especially when so many spoken sounds can be so difficult to distinguish from each other (“f” and “s,” for instance, “m” and “n” to a slightly lesser extent; c and e and d, falling in the middle of a hastily blurted acronym, can be virtually indistinguishable from each other--sometimes all you can really hear is a sort of an “eee” sound).

Acronyms, in online communication or in the medical field, were originally designed as “shortcuts” that would enable us to communicate more information, faster and more efficiently, and they’ve succeeded.

Still, I cannot help but wonder sometimes if, after passage of a generation or two, we are not shortcutting ourselves out of any ability to communicate meaningfully with each other at all.

Random side-note regarding rotary phones: It occurred to me while pondering this stuff today that songs like Glenn Miller’s “Pennsylvania 6-5000” and Tommy Tutone’s “867-5309” could not be written now. Somehow, “613-814-5000” or “913-867-5309” just wouldn’t have the same, um, ring to them.

Gotta love progress!

Occupational Hazards

Motivating oneself to work on a cloudy, cold Sunday can be challenge enough without seven highly unmotivating factors within easy eyeshot: Two cats asleep on the bed, another asleep on the chair I’ll have to occupy in an hour or so, yet another one asleep on the recliner in the living room, and the last stretched out atop the television case, sleeping quite comfortably. Then there’s the large dog asleep at the foot of my chair, and another one, the puppy, curled up on the couch, happily and increasingly sleepily gnawing away at a rawhide “bone.” The third dog, Nina, is the self-designated protector of the household and all within it, so she prefers to stay outside--but I’m pretty sure that if I were to look out the kitchen window, I would see her curled up in the corner of the yard between the house and the garage, asleep. This is not an environment conducive to maintaining the degree of alertness one needs when tackling medical reports.

When you first start working at home, you will be offered all kinds of advice and warnings from people who have tried it and succeeded (or failed). Prominent, of course, is that you must keep potential distractions--kids, spouses, phone calls, or, in my case, sunshine streaming through a window--to a minimum. You’ll be advised to keep your work space separate from your living space (and my work computer is indeed separated by 4-5 feet from my bed, 6-8 feet from my “play” computer, the one I use to write and go online for news and photo-edit, etc.). One self-described “crazy cat lady” who had a couple dozen cats told me that she put up a screen door between her office and the living room so that the cats could see her, and she could see them, but they couldn’t take up residence on her chair or stretched across her monitor (these were the days before flat screens; cats LOVED stretching out on those old-timey monitors).

Nobody ever warned me about the dangers of the cozily sleeping cat(s) on the kind of day people call “made for sleeping.”

Xena, the large sleeping dog, has now awakened--she apparently senses that it is almost time for me to begin my shift, and wants to make a trip outside. Dogs DO learn your schedule when you work at home, by the way. I used to have a Pomeranian, Pixie, who would get antsy and try to lead me back to my office when it was just about time for me to go to work. Cats are aware, as well, although they handle the situation differently: One or another of my matriarch cats, Sabrina or Evi, will curl up on my work chair about 10 minutes before I need to settle into it, practically daring me to move her.

Guess I’ll follow Xena’s example and step outside for some fresh (frigid) air.