Thursday, 25 March 2010


Do you like speaking to an answering machine, to leave a message? It seems that most people don't. And yet talking down the 'phone to leave dialogue on a machine that reproduces what you say, perfectly, should be seen as a good and reliable way to communicate. Better than the alternative of leaving a message through just a few words of text, surely? But no, most of us choose to text a few words (despite how fiddly it might be) rather than leave a voice message, just talking, which should be a more natural and effortless and familiar way to be.

Machines, even those which are perfect at what they do, don't always deliver sweeping changes and aren't always warmly embraced.

How desirable is perfection?

Common sense says it's got to be a good thing, right?

Clinically, in mental health we often strive for "good enough" or "as good as can be" rather than perfection.

Our machines have loftier aspirations.

It seems that every ECG machine now wants a perfect reading. Anything less than perfect is flagged as abnormal. Indeed, it's printed out, "Abnormal ECG," along with conjecture as to why. Almost always it is normal. Or normal enough. Not something that a doctor would document as "abnormal" anyway. But unless it's perfect, the ECG machine chews out paper documenting "abnormality" which causes no end of stress and nuisance.

I really do want to do something quite gratuitous to it's rusty innards.

Sometimes I don't want perfection, I want normal.

1 comment:

Eileen said...

Two points here, I suppose:
What happened to the "within normal limits" comment, and
I am only too aware of a lack of evidence of clinical skills which leads to many (not all)younger doctors not being able to make a diagnosis (even if it's only that there is something not right that needs more adventurous investigation) when a patient complains of something over a longer period and the blood values are always not indicative of anything in particular.
There is a sad lack of comprehension of the statistics of the matter: by definition, 50% of patients will be a bit different from your average patient and 10% (5% at each end of the range) will be very different.
That's just the way it is. And if those who are able to think can't do it, the chances are the computer won't!! And as you obviously DO think - I do wish I had come across you a few years ago as my consultant.