Beeper be damned

It's been almost 30 years, but I can still picture that bulky, brushed-silver device on my old man's belt.

Back then, most beepers let out a series of shrill notes, followed by a burst of static and the voice of a clerk or someone instructing the physician where to call. Dad wore his all the time-when he went to his office, when he worked on the farm we owned, and when he flew his small plane. He also wore it beneath his blue blazer at church. As he twisted in the pew to reach the hymnal, his jacket would slide back, revealing the silvery beeper against his blue button-down oxford shirt. I remember this image most vividly of all.

Ever present, that implacable little box offered him little escape. He could hear its beeping sound over the roar of the tractor engine as he mowed the fields. He could hear it over the fully revved motor of our boat as we bounced across the lake on a summer afternoon. He never hurled his beeper in anger at being disturbed, but he often expressed his desire to do so, in language not quite fit for print.

How could I measure up to that standard? I asked myself as I began college. Instead of trying, I veered away from fields that had anything to do with medicine. That plan worked for a few years, but nothing I did could make me forget the awe I'd felt as a child for those who carried the beepers and stethoscopes, who were called upon to serve at all hours, and who did what they did for the benefit and respect of their community.

On my graduation from the University of Florida College of Medicine, I wore my dad's academic hood, a priceless gift from him and a symbol of the tradition he represented. I treasure that garment to this day, but I now know something that I didn't know at the time: The great generation of physicians that had done so much to elevate the practice of medicine in this country had also, unwittingly, sewn the seeds of its destruction.

A symbol of a broken covenant

A month after graduation, I began my first day as a resident, accepting my own beeper with fear and, yes, pride. It went off not long after I'd begun my first rounds.

A nurse called for a Tylenol order for a patient assigned to me, someone I'd not as yet seen. After four years of high-priced graduate school, clinical rotations, and two board exams, I was absolutely terrified. What was the patient's history? Would there be an adverse reaction with another drug he was taking? Did he have underlying liver disease that the medication would worsen, or make fatal? I set my jaw, stiffened my spine, and did what every resident ever born had to do at some point-I faked it. "Yes," I said confidently. "Give the Tylenol."

Within the next 10 minutes, the beeper went off at least five more times. By the end of the week, I was ready to prop it against the backyard fence and fire a round into it.

But I didn't. In fact, as the weeks and months of residency passed, I learned to accept the little black box clipped to my belt. It alerted me to patients in respiratory distress, to women starting labor, and to other situations where people were counting on me, including a family who needed my counsel before deciding whether to pull the plug on their brain-dead father. I'd also begun moonlighting at the local ED during my second year of residency, and this added to my hectic schedule.