For my job, I listen to hundreds of recorded medical visits. I dutifully click my mouse to assign a functional code to each utterance spoken by patients, providers and their families. It’s a lot of clicking.
Many recordings are de-identified, meaning names and certain information may be removed from the audio, and all are labeled with an eight digit number. Thus each heap of human interaction I encounter is both an integer and an anonymous memory, untethered by time and earthly context.
I frequently anticipate this work with an amount of dread —and coffee— that I cannot exaggerate. On bad days, I pause repeatedly just to calculate the minimum time I’ll need to finish coding. It’s a compulsion I now find very hard to resist.
When I signed up for this job, which was offered to me by a sweet and unfailingly supportive family friend I barely knew at the time, I really had no idea what to expect. Now, years of mechanical clicks later, it still seems odd that this is someone’s job—mine.
Because I so often fail to describe my job in a coherent way and because it obligates me to extraordinary amounts of time alone, I have given much thought to the existential considerations of what it is that I do, and I have come to the conclusion that sixteen words are the minimum required to convey the magnificent and terrible limbo my occupation inhabits: “Hi, honey. I’m at the doctor’s. They just told me I have three weeks to live.”
“Hi, honey. I’m at the doctor’s. They just told me I have three weeks to live,” says the patient’s voice through my headphones. Seconds before, the familiar tones of the iPhone keyboard had warned me of the present phone call. She hangs up quickly. She doesn’t sob. She mentions errands to be run later that afternoon. Minutes later, the woman’s physician returns.
The time patients spend alone in the exam room is excised from the coding record per standard procedure. It’s been nearly three years since I heard those sixteen words of which no record exists.
I once heard a Spanish speaking family cry together in horror when the father realized he had lost his wallet. As the children began to moan, I heard a mutter: “Oh, hell.” It was the doctor. “They’ll help him find it, let’s finish up here,” she said flatly.
Just the other day, I heard one patient celebrate the finding that the gnarly, painful tumors in his gut were “benign.” Another learned he had a 50% chance of surviving his upcoming surgery. “Okay,” he responded. He sounded tired.
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