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Beeper blues

June 2008

It was April of my last year of residency. All of my colleagues were counting down the days to June 30th. All of them were either ready to start life, if they were going on to private practice, or to continue the torture, if they were going on to fellowships.

Me, I was looking forward to nothing.

I knew I didn’t want to do general outpatient pediatrics. And I was so sick of academia that the thought of three more years as a fellow threatened to give me an ulcer that I avoided only thanks to Big Pharm and the Generic Brothers.

I had just finished looking over an application from one of those locum tenens positions–enthralled by the glossy photos of happy doctors surrounded by pristine beaches and snow-capped mountains–when I received an e-mail from my program director. A neonatologist in Northern Virginia was looking for a hospitalist.

At the time, the term “hospitalist” was beginning to resonate throughout medical practice. Adult hospitalists were already pretty well established, but this was the first time I had heard of a job for a pediatric hospitalist.

The job description intrigued me: caring for hospitalized pediatric patients, going to deliveries to stabilize newborns, rounding on the newborn nursery, doing ER consults.

I translated this in my mind: shift work, interesting patients, opportunities to do procedures, no well-child checks, good salary.

And no beeper.

Let me digress for a second about THE BEEPER (you may know it as THE PAGER or, if it is on silent mode, THE VIBRATOR).

For the longest time, the beeper was a status symbol. Before cell phones became ubiquitous, the beeper was the preferred means of communication for doctors (legal drug pushers) and drug dealers (illegal drug pushers). A beeper hanging snuggly on a belt (or directly from your pant waistband, depending on your fashion preference) signified to the world that you were an important member of the medical community, someone whose talents and skills were so important that a beeper was necessary to summon you at a moment’s notice. The beeper, not the staff of Aesculapius, should have been the symbol of medicine. Unfortunately, the Greeks were too worried about beating back invaders and wondering about how the universe began to have time to invent it.

The day you receive your first beeper in medical school is a day of joy and celebration. You have a place in the health care team, even if you’re being beeped to get a super-duper-enormous-extra-sugar-extra-expresso-extra-foam-no-whip-medium-temp-pinch-of-cinammon latte for the senior resident. The first time your beeper goes off, harps play in heaven. I saved my first page for months on the beeper’s memory.

But pretty soon, you realize the beeper is evil. It is an instrument of torture, a modern-day rack, an electronic handcuff more insidious than electroshock therapy. When you’re on, it goes off all the time; when you’re off, it beeps for no apparent reason. Apparently, if it’s not beeping on a regular basis, the pager feels lonely, left out, unimportant. It then proceeds to discreetly drain its battery so it will have a reason to complain loudly.

Even when it is turned off, it tortures you, its blank screen an incessant remainder that maybe you’re slaking off, missing out on good educational opportunities, avoiding someone important who is trying to get hold of you. So you go and turn it back on, and hope for the best.

You can imagine how fed up I with my beeper toward the end of residency, so a job that offered NO BEEPER was like manna from heaven.

Caveat emptor: Always read the fine print. When I went to my interview, I realized that the description said “no beeper FROM HOME” and that I would have to carry a beeper around the hospital for deliveries, for consults, for everything. The beeper would still be there, attached to my sagging scrub pants, its faint light illuminating long nights of ED consults; vibrating while I was struggling to place umbilical lines; beeping because, inevitably, at 4 a.m., when you have just laid down to sleep for a couple of hours, someone needs the anesthesiologist, and mistakenly dials your number. “Hello, is this Dr. Sleep?” “NO, BUT I WISH I WAS!!!!”

Another lesson for another day: Never yell at the nurses, and always treat them with loving-kindness. The beeper is their ally.

I took the job anyway because, no matter how bad the beeper is, it is better to have a beeper while you’re in the hospital as opposed to having it beep/vibrate/yell/whine when you’re out.

That was when I was a community hospital pediatric hospitalist. Now that I’m back in academia (it took me a few years to forget and heal), I carry my beeper everywhere, but only when I’m on service. At least now I can change the beeping to different, soothing electronic versions of my favorite Michael Bolton songs!

“Tell me how am I supposed to live without you…!”