Steve Ruffenach: Tech, my new medical assistant

steve_ruffenachI have a new medical assistant (MA) and I’m trying to learn how to get along with him.

My new MA is named Tech and I bet you have one too. I see him with nearly everyone in clinics and it seems no one can do their rounds without him in the hospital. Everybody, every day, always brings along their new constant companion and quiet confidant.

And why not? I tell Tech things and he in turn tells me things back. He is always with me ensuring I am right on schedule. He sends and collects memos for me. I can ask him medical questions and he quickly delivers answers. He entertains me too with stories and songs, and he knows directions to anywhere I want to go.

To demonstrate my insight into picking this new associate, I show him off to colleagues to demonstrate all that he can do. Everyone oohs and ahhs.

I actually miss him when he’s not with me and I find myself going out of my way to make sure he is by my side. He’s more than an associate; he’s my new friend.

But with our frequent exchanges, I can’t help but begin to feel that the bloom may be coming off the rose with Tech. He has long fingers and a deep memory and is given to making frequent annoying sounds.

And he never shuts off.

I first thought his constant readiness and endless work ethic was a good thing. He never takes a day off, he never wants to rest. But I am now realizing that it is this very constancy that I am beginning to find wearing. Previous MAs with whom I have worked had book covers I could close and calendars that would hang unread. I could miss a memo or two and life would go on. I even had times when I had nothing but my own thoughts to ponder.

But now Tech will have none of that. In his new shiny digital form he is always working, waiting, watching. While I sleep, he buzzes in the wires in my neighborhood and reaches into every gadget I own. He waits with endless power to do something—anything. He doesn’t seem to understand that often the mail can wait, the calendar can be set aside, and sometimes he should just keep quiet.

I have come to realize that sleep is something I need and enjoy but Tech does neither. And that is indeed the problem.

Because when Tech was just starting out, all he could do was wait for me to do something to him; open him, read him, write in him, etc. But now he does stuff to me and he won’t stop. He won’t stop reminding me, telling me, alerting me, even entertaining me. Tech won’t stop because he can’t stop and he can’t stop because, no matter how much we complain about it, we won’t let him. And truth be told, we don’t want him to.

We have come to need Tech as much as he needs us. He is deeply a fact of our life. He is our new best friend with an emphasis on forever.

Thoreau went to the woods to “live deliberately, to front only the essential facts of life.” He aimed to understand what life was and what it was not. He “wanted to live deep and suck out all the marrow of life”

I worry that our friend Tech is doing that to us. In his constancy, in his power, in his fundamental ease of companionship, he is sucking out of us the marrow of being a doctor and leaving us as hollow vacuous shells that have lost their abilities to do what Tech cannot do; love, laugh, cry, and yes—sleep.

So I have to accept that Tech will not sleep. That‘s what he cannot do. But we can and we will. And in knowing that difference, we can defend our ground, use Tech when we need him and search and embrace those places where we can’t.

Steve Ruffenach is an internist and medical informaticist living and practicing in Tucson, Arizona, USA. He holds a teaching position as a clinical assistant professor of medicine at the University of Arizona and has a keen interest in medicine and machines.

Competing interests: None declared.