Louisville Medicine Volume 66, Issue 12 | Page 39

OPINION DOCTORS' Lounge UNCOMMUNICADO David Seligson, MD T he 10 th of March 1876, Alexan- der Graham Bell, a Scottish born teacher at the Boston School for Deaf Mutes and inventor/innova- tor, spoke into his experimental electronic voice transmitter, “Mr. Watson, come here, I want you!” and immediately his assistant came to the door of Bell’s lab- oratory: this was the first telephone voice communication. This first phone call pro- vided a clear, immediate, direct message. During residency, I often passed the plaque on Cambridge Street that reads: “Birthplace of the Telephone. Here, on June 2, 1875, Alexander Graham Bell and Thomas A. Watson first transmitted sound over wires. This successful experiment was completed in a fifth-floor garret at what was then 109 Court Street and marked the beginning of world-wide telephone service.” Today, the phone can use up time, often causes confusion and may create more prob- lems than it solves. Just how did we arrive at this situation? It is a process where the re- ceiver of a call becomes “uncommunicado.” For example, try calling Donald Duck. “Ring, ring… You have reached the tele- phone of Donald Duck. I am either on the phone or away from my desk. Please leave a message after the beep, and I will call you back.” This is the most basic form of Uncommunicado. Predictably, the return call will come at an inopportune moment – you are talking to the boss, in scrubs, using the bathroom. (The bathroom is not such a bad place. Do those noises transmit over the line?) Note that this sequence changes the workflow from the caller to the recipient of the call. Bell asked Watson to appear. Watson appeared. In this example, the per- son one wanted to talk to is in charge of the transaction. Commonly, one can hear, “You have reached the mobile phone of (502) 123-4567, this phone has a voice mail box which is full. Goodbye.” Soon, the person you have called rings you back. What could have been a short phone call turns into min- utes more of an ordeal. The extreme form of this process is, “You have reached the offices of Associates in Obscure Diseases. If this is an emergency, hang up and dial 911.” The equipment owned by the medical practice is telling the caller what to do. Phones used to be available in color as long as the color was black. The phone had a rotary dial – put your finger in and turn the dial clockwise from the number to the stop at the end. If the phone at the other end was ringing, there would be a purr in the receiver. If the phone at the other end were in use, there was a ‘busy signal,’ and if the number dialed did not reach a func- tional receiver, there was an annoying bark. Today however, the receiving phone is in charge. For example, “You have reached the telephone of Mickey Mouse. Your call is important to me. Please stay on the line. Your call will be answered in the order it was received. You are the third caller in line.” One of the delights of summer in New Hampshire was the crank phone on the par- ty line. Turn the handle on the box, talk to the operator and tell her with whom to connect you. This machine is a delight for small children; the faster the cranking, the brisker the ring. A magneto generates Elec- tric current to power the bell. Today, the remnants of old crank phones can stun fish. My dad used to take me to his office near the Old State House where I could sit at the switchboard, put on the headphones, receive the incoming calls, pull the appropriate line and plug it into the board to make the con- nection. Electronic switching, introduced in 1965 and now ubiquitous, was one of the many patents from Bell Laboratories lead- ing to today’s nearly universal connectivity. Today, the phone rings and brings in- terruptions from any number of unwanted callers - advertisers, politicians and solici- tors. One bright spot in recent weeks has been the ability of the phone system to identify a call as a ‘scam.’ The number is duly identified but not put through. More systems to restore balance at both ends of the phone line will hopefully appear in the future. For the time being, I have defenses. When someone says, “Can I put you on hold?” I answer “no.” If mindless music lasts for more than 30 seconds by my watch, I dis- connect. Unless, of course, I am on call and being paid. I no longer attempt to phone and talk with known message system abusers, the Incommunicadi; instead, I send them a message to call me. Indeed one wonders if all the folks who are away from their desks are off together having coffee somewhere. The phone, which began with such promise, now uses a great deal of time in our lives. Restoration of a more reasonable balance will reduce the dread interruption of the ringing, unanswered telephone. Dr. Seligson is Professor in the Department of Orthopedics at UofL and practices with Uni- versity of Louisville Physicians.  He specializes in Orthopedic Trauma.  MAY 2019 37