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Reflections in a Head Mirror

Reflections - Archive

6/21/2012

Typing Class

In teaching you cannot see the fruit of a day's work. It is invisible and remains so, maybe for years.
- Jacques Barzun    

As a sixth grader, I trembled in fear. Seventh grade was, to me, a looming, terrifying, child-eating giant.     

Seventh grade would mean a new school. Junior High kids were so cool! It was the late-1960’s. Would I be allowed to wear bell-bottoms and denim shirts? Would Mom let me grow my hair? I wanted to be like the “big kids” in the worst way.  

Anticipating Junior High classes, though, was also frightening. I had heard from the older kids about History class. I would have to memorize “The Gettysburg Address” and the Preamble to the Constitution. Math would have impossible tests and pop quizzes. Science would involve a fill-in-the-blank Periodic Table and dissecting a giant worm. The English teacher would make me write my first “term paper.” I was scared.  

Nothing, though, loomed as frighteningly as Typing class. Mrs. Locker was the classic “stickler.” “Posture, boys and girls!” She demanded perfectly aligned margins, accuracy, precision, no eraser marks, and clean technique. Type too quickly and the keys would jam. Type too slowly, and Mrs. Locker would be over your shoulder, keeping you rattled. There was no slacking off. EVERYONE was held to the highest standards. “The quick brown fox jumps over the lazy dog! Again! Again!!!”  

Once I was in Junior High, all of my worst fears were confirmed.  

In Typing class, Mrs. Locker made us work hard. She waxed poetic about the speed and accuracy of great students from the past. I knew that I would never live up to her expectations and worked to stay beneath her radar. Some of the students, of course, had perfect scores on every quiz and won every typing contest.  

As I despaired at my Typing test results, I remember thinking, “Why does it matter, anyway?” I did not know any adults other than secretaries who needed typing skills. I knew typing would come in handy writing papers in high school and college, but I could not imagine I would ever need to type anything after that. My dad owned a Ben Franklin Store; he had an old manual typewriter which he rarely used. Even if I had known that I would someday become a doctor, it would not have mattered. Doctors were known for their handwriting, not their typing.  

Oh, my, how things have changed.  

I started typing again when I first worked with Radio Shack computers during residency in 1983. My first work computer, in 1989, was an IBM 286. At the time, faculty computers were used to prepare academic papers and write letters; it was just a fancy typewriter with some memory. Medical charts were still paper. Clinic notes were two handwritten sentences and a line drawing. Mail came in stacks with rubber bands and paper clips. Email came much later, as did the internet.  

During my professional lifetime, American medicine has become completely dependent on computers and the information that is indiscriminately poured into them. Medical billing – and the Electronic Medical Record upon which it depends – prizes lots of detail and, hence, lots of words.

These days, the cynic in me sees a room full of doctors pounding away on keyboards as a room full of people providing great patient care.  

Everything depends, in the final analysis, on typing.  

In seventh grade, I was not the best typist nor was I the worst. When typing hyphens or numbers, I still have to look at the keyboard and then hunt-and-peck.  

Pearl Buck once said, “One faces the future with one's past.” My socially-inept, seventh-grade experiences are all a part of who I am as a person and as a physician many, many years down the road. As a physician, my Science class helped me explore nature and biology. My English class helped me listen to and record patients’ stories.

But, Mrs. Locker’s Typing class turned out to be one of the most important experiences from that period of my life. Fortunately, I paid enough attention to make me functional as a physician.  

And, somehow, that is kind of sad.

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The following is feedback received for this blog:

My only B in all of high school was typing class in 1974. I should have taken it more seriously, since it became an essential skill in my journalism career. Now, as an accountant, I have (somehow, finally) become comfortable with the number keypad. But I would surely fail a "texting" class.
- John

Posted 10:37 AM
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Could a greater miracle take place than for us to look through each other’s eyes for an instant?
-Henry David Thoreau    

It is almost 7:00 a.m. and I carry my briefcase and lunch bag from the car to my office. I nod to some of the night shift employees heading home. Another day has begun.  

I type my password and check the computer, reminding myself of the twenty patients I am scheduled to see today in the cancer clinic. A few new consults with untreated or recurrent cancers occupy the longer appointment slots. Follow-up and post-operative patients will be seen more quickly. It will be a full day but, hopefully, I will grab a few minutes around noon to eat my sandwich.  

I print out some office notes and carry them with me to our weekly 7:15 a.m. Tumor Conference. Several physicians present cases for discussion. We review the scans and the pathology, making recommendations for treatment. We determine who is eligible for a clinical trial. We look at recent research results. Usually, a brief discussion will mean better news for the patient; we have something to offer. A longer discussion can reflect the lack of good options.  

Clinic gets going. First is a 64-year-old man with a tongue cancer. Symptoms have been present for about six months. The scans are helpful. The cancer has not caused much damage. Only one lymph node is involved. Everything else looks fine. I run through the surgical risks, benefits, and alternatives. I prepare the consent form and look at the schedule. Any questions?  

He drops his head, hands gripping his knees. “My wife would have known what to ask,” he tells me. “She died six weeks ago. That’s why I waited to come in. I was caring for her.”  

I pause. There is a story pressing in on us from all sides. It floods the room.  

“I am so sorry,” I reply. “I am glad you are here. Your cancer is still very curable. Tell me about her.”  

We spend some time. I am soon behind on my schedule. There will be more stories that need to be shared before the day is through.  

A recent You-Tube video from the Cleveland Clinic is a spot-on rendering of what happens every day in a hospital. See what you think. No matter where we are, stories surround us, but they are closest to the surface when we are most vulnerable. Recognizing this reality should be part of the repertoire of every physician. We teach this to our students and residents. Even still, how easily we all forget.  

The day in clinic draws to an end and everyone has gone home. At 6:00 p.m., my charts are half-complete. I pick up my briefcase and lunch bag. I find my car and head home.

Tomorrow will be here soon enough.

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The following is feedback received for this blog:


   Dr Campbell, Your Reflections are always so moving including this one. The You-Tube Video from the Cleveland Clinic was excellent.

- Mary Ann, an RN
 
 
 
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Bruce Campbell, MD, grew up in the Chicago area, graduating from Purdue University and Rush Medical College. He completed an otolaryngology residency at the Medical College of Wisconsin and a head and neck surgery fellowship at M.D. Anderson Cancer Center. He has been on the faculty at Froedtert & the Medical College of Wisconsin since 1987.

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