We can either keep the cake or eat it….but let’s try both!

There I am — the hunched over intern…typing away.

Type-ity. Type. Type. What I lack in knowledge and experience I make up for in keyboard prowess, with all the might of my Millennial heritage. Am I considered a Millennial? I’m not sure, I’ll look it up later. EDIT: Yes I am — Google confirmed. Go figure.


Type-ity. Type. Type.

As a medical student I knew that Resident Life would entail a lot of face time with computer monitors. I knew that, sadly, I would often spend more time communing with printers and shoddy internet connections instead of with patients. I realize now that even though I was aware, that it was more of a peripheral thought. I didn’t really care until recently — a result of living such an existence nearly every day. Granted, it’s not so much of an issue until the patient list grows, the pager keeps going off, and I receive multiple e-mails about improving my documentation for billing and coding purposes (which seems like all the time).

So you’re saying I have less time with each patient yet I’m supposed to write more about each one?

Of course I don’t have a choice. Much like all my colleagues we make it work somehow, day in and day out.

This isn’t so much a complaint….ok, maybe it is but I’m not going to rant about it. I understand the rough and tumble “figure it out” mentality that all Residents must embody….especially within my chosen specialty. I bring it up though because it alludes to the age-old battle between quality v. quantity, detail v. speed, esthetics v. function. Since the beginning of time, I imagine, humans have always had to choose between ‘quick and dirty’ and ‘nice and slow’, but I’m gonna plant a seed here:

Let’s try for both. You know what? Let’s DO both and see if it works….after all that’s what Yoda says.


(Obligatory Nerd Reference: Check.)

I’ve of course been mentored and guided by my seniors on how to become more efficient. I’ve been shown the most streamlined way to put in orders, the fastest way to write progress notes, the most concise way to discharge patients, and to move-move-move. It may seem careless but it’s often for the best and is always well-intentioned….how else are we going to devote time and accommodate the endless stream of patients from the infinite portal known as the emergency room? I’ve been chastised (lightly and often playfully so don’t get me wrong) for writing notes that make use of esthetic spacing, bolded fonts, underlines, and other members of the punctuation toolbox….because I could be soo much faster.

And I agree, I’ve been slow and that’s not good.

I’m not the only one though. I’ve seen numerous notes that are not only well-written but well-presented….and I often find that I not only better understand the course of treatment but that I better understand the patient (are the best lectures/speeches the ones with the best information/content or the best charisma/jokes? Both right?). I recognize the value in a “pretty” note and so I’ve resolved to typing at furious rates to make notes that are both fast and nice. I’m not saying I have the answer or that I’m awesome….I just want to see if it’s possible….because I’m human and I’ve realized it’s the human thing to do: maybe we can have it all???

Trust me. I know there’s a real world. I know that if we forego what is practical and drift off into fantasy land that it could be disastrous. But I offer that if we won’t daydream occasionally that progress is impossible.

They doubted Henry Ford when he said he could make a horseless carriage quickly despite it’s unheard of mechanical complexity — and now we have the concept of assembly lines and economies of scale and sexy cars. There’s no way that humans could survive without constantly moving and finding new food sources — unless we plant these weird things called seeds, give rise to agriculture, and eventually lay the foundation for civilization. And what about the most human quality of all: Love? Wow, I actually care very deeply about this person instead of just wanting to score….or even more robotically….to procreate.

You’re human. You can have it all sometimes. You can care about someone, score, AND procreate. #Win

Above all, I see this human tendency in the patients I see everyday — and I submit that it’s the very foundation of Medicine. Why do we give drugs with so many side effects? Why did we think of something as brutal as surgery or as devastating as chemotherapy? Why are we trying to defy something as powerful and universal as Death?

Because we believe we can have it all. We have hope. We’re human. You’re not only going to recover from this illness but you’ll learn to walk again. You will not only regain your speech but you’ll sing. You’ll beat this cancer AND make it home for the holidays. If we don’t think we can have it all we won’t have anything really. Why try? We should just stay at home.

So. I’m gonna go for it — writing a million notes that aren’t haphazard walls of occasionally misspelled text. If it doesn’t work out then it doesn’t. But to bring it back to my earlier seed (that has hopefully sprouted a little), it would be great if we tried for “both” more often in whatever silly human activities we are involved in. I don’t think there always has to be a trade off.

Maybe sometimes we can have it all???


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