The late Art Linkletter had a 25- year run on radio and then television with a segment called “Kids Say the Darndest Things” in which he interviewed grade-schoolers with simple questions leading to surprising answers. Kids don’t have a corner on surprising responses. One of the things I like most about medical practice is the unpredictable things patients say to me during our encounters. “What brings you to the office today?” “I came in a cab.” “Look at the eye chart and tell me which is better, one or two?” (Silence) “Which is better, one or two?” (Silence) “Sir, which is better?” “I’m sorry, I thought your question was rhetorical.”
The other day, one of my technicians was abstracting some charts for quality control, and she came across a patient’s laudatory letter that I had read two years ago and then filed in the chart. As a glaucoma specialist, I like to save all such letters, since unlike cataract and refractive surgeons, I don’t often improve a patient’s vision, just prevent it from getting worse. The letter, written by a PhD English professor, whose gender is not relevant, praised the “collective skill of you and your callipygian staff.” I hasten to add that the patient had been cared for by both male and female technicians in our office.
This incident came to mind as I was musing about how what is happening in our profession mirrors what is happening in society. Newspapers are experiencing declining circulation as people seem to prefer 30- to 60-second sound bites of television news. That doesn’t count the 10 to 20 seconds wasted on “teasers” about the content to be covered later in the program. Politicians run on image and “quotable quotes,” ignoring the details that would allow a rational person to evaluate a position. Instant messages on the cell phone are limited in length, so a phonetic shorthand has taken over universally. (Thankfully not yet in epitaphs.) Everywhere we turn, our communication gets packaged in smaller, more easily digested pieces. For us ophthalmologists, how easy it is to depend solely on the summaries of medical research that we read in EyeNet and Academy Express, and the myriad of other publications that digest and abstract what experts say at medical meetings and conferences.
Here at EyeNet, we prominently feature synopses in Journal Highlights of peer-reviewed literature that usually occupy more pages than any of our other sections. Academy Express offers even more condensed précis, but always with a link to allow the interested reader to access more information or even the full-text article. At the Academy we feel better about grounding our content in the peer-reviewed literature. Reporting what is said at meetings, even by world-famous experts, has not endured the scrutiny of peer review. When we do report opinion by experts, we always try to find at least one other expert to provide a different viewpoint. Not as good as peer review, but at least balanced.
But I digress. I do worry that I’m getting lazier, more accepting of summaries, and less likely to find the time to consult the original report. The trend of life is to a shorter attention span, and I feel myself succumbing to the trend. As I resolve to discipline myself to dig deeper, I remember that whenever I do click through on a link for more information on a topic that interests me, or read an article referenced in an article, I always find something to satisfy my intellectual curiosity. For example, I could have enjoyed a good laugh a couple of years earlier had I been motivated to look up that adjective in my patient’s letter.