Loosing the Beeper


A momentous event passed in my life recently...Aside from my midlife crisis.

I am now beeper-less for the first time since I was a third year medical student - 20 years ago.  We were having physicians coming to visit our office to look at our workflow and use of our EMR, and one of them commented that they had not worn beepers in a long time.  He told me that their community used text-messaging instead of alpha-numeric paging.  This seemed like a good thing to investigate, as it is one less thing to carry and a good excuse to get a new fancy phone.  The price was right, and so we made the change.

My first pager was a blue monster that all third-year students at Jefferson (my medical school) wore when in-house.  I felt like I had become more significant when I got the pager, although nobody paged me much - who really needs to ask a third-year medical student a significant question?  The only reason I was paged was to call me to rounds with my resident or to do some menial task to make their life easier.  Pager use was intermittent over the next two years, as was the frequency of the pages.  The more it went off, the more significant I felt.

Then came residency.

I remember being handed my pager during orientation and thinking that this gadget would be a much more significant factor in my life.  I was right.  Interns are often the first to be paged for any problems.  If an IV fell out of a toddler and the nurse could not put it back in, the intern was paged so they could fruitlessly try to get it back in (except with extreme luck).  If a patient needed a tylenol order, the 2AM page would inevitably come.  Abnormal labs of no significance would always come during the deepest stages of sleep.  Was I more significant?  Yes, but I also felt like a whipping-boy.  Call was in-house and was frequently with little or no sleep.  An angry nurse could team up with your beeper and make your life miserable.

Beyond internship, the pages kept coming, but not with the annoying frequency.  I could push many of the dumb calls to my interns.  A much higher percent of pages were important/worthwhile.  I did get paged to pronounce a patient dead once, but found that they were still alive - so the dumb calls still came in, but I was definitley happy to be past internship.  Many calls were from anxious interns who couldn't get IV's in, but I now had the latitude to do a central line or just say it could wait.

In private practice, my calls were all from home.  The pagers were now alpha-numeric, giving me a thumbnail of what the call was regarding.  I shared call with a group of internists and pediatricians.  The internal med pages were more often from the ER about admissions and were much more often a call to a few hours of work.  My heart would sink with any pages after 11 PM, as they would often mean I wouldn't sleep much.

The very worst of the pager torture, however, was pediatric call.  We did not have a nurse triage system, so all calls came to us - be they significant problems or parents needing the dose for Dimetapp.  It was here that I realized the true meaning of the term: Status Beepelepticus: a beeper going off uncontrollably for hours.  Weekends on pediatric call were spent on the phone.  I would get 6-8 pages per hour during the busy times - most of which were more regarding parental anxiety than real problems.  I remember feeling like crying during these calls.

Things finally improved when we did two things: we began to use hospitalists for adult patients, and we got a pediatric nurse-triage system.  The first change meant that we were now only occasionally called to the hospital (for pediatric emergencies, mainly).  Rarely did a night-time page mean a significant loss of sleep.  The real significant change, however, was the nurse-triage.  To say the change was dramatic would be as much of an understatement as saying that Hitler was naughty.  I would have bowed and groveled at the feet of these saviors if I had a chance.  I had my life back.

These two changes allowed us to start taking call for more than one night at a time.  For the past few years, we have been "on call" for a week at a time, with days passing sometimes between pages.  When any new doctor complained about being on call, I would sigh and think: "they have absolutely no idea."  My pager was still important - as there were still emergencies I had to attend to, but they were rare. 

These changes, along with the emergence of cellular technology finally brought an end to my 20-year affair with the beeper.  My emotions toward the appendage rose and fell, depending on the situation.  It was a necessary evil.

Now it is history.

Do I mourn its loss?  No way.  But I did write a poem to my pager to honor its passing.  Technology moves on.