The leaf blower/CT scan quandary

December 14, 2014

To critics who admonish emergency physicians like myself for our excessive use of CT scans, I’ll ask them to consider the leaf blower. I’m sipping my morning coffee on our front porch, a bright, idyllic autumn day in New England, the tranquility ripped apart by the landscapers across the street. For many jobs, a powerful leaf blower might prove superior to a rake or broom. But in my neighborhood known for smaller yards, the humble rake and broom would work as well, if not better.

I’m not a leaf blower person. Raking my yard takes hours. It leaves my muscles knotted and hands calloused. Not so the speedy landscapers, nonchalant with technology strapped to their backs. Laughing and screaming over noise that assaults my eardrums, they bully grass clippings and leaves into a dancing cloud that swirls onto the street, often finding refuge on my lawn.

Why should the status of lawn detritus, or my serene coffee moment, concern them? They’re responsible for my neighbor’s lawn, not the yards nearby. And if leaf blowers improve the speed and perhaps the quality of their work, why wouldn’t they take advantage of the opportunity? Imagine the following argument from a landscaper-philosopher: “What is a leaf blower anyway but a push of air, like a strong wind? You have a problem with the wind?”

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Duly Noted

December 8, 2014

If Kurt Vonnegut had been a physician, would his phrase “and so it goes” have ended each section of his clinic notes? Would a patient history written by Charles Dickens wax poetic and verbose over the orphan’s plight, no matter what the patient’s chief complaint? Perhaps Ernest Hemingway’s charting would be spare with impeccable narrative development.

No, they would have wanted nothing to do with medical documentation—bastard child of the biography and the legal brief. Like the physicians who author them, medical notes are hobbled by too many conflicting functions, both banal and profound. Yet they also reflect a physician’s voice, and, under the technical jargon, a story always hides. Read the rest of this entry »