I arrive at work, and quickly check my emails on my phone before I enter the signal black hole that is the hospital where I spend my working life. The SHO is not in yet, so I persuade the ward clerk to briefly give up one of only 3 functional computers on the ward and update the patient list with the details of the 2 new patients, whose names are scrawled onto the whiteboard. I skim through their notes, and cast my eyes over them to make sure nothing urgent is required. I leave a note for the SHO requesting her to arrange some tests, before I go to the secretaries’ office to hunt for a working dictaphone and a spare tape.
I arrive in outpatient clinic 15minutes before the first patient’s appointment and turn on the PC. I find the printed lists of the expected patients and pick up the first set of notes, searching through the years of mis-filing to find the referral letter. I finally find it in between a yellowing letter from Ophthalmology in 1994 and one from General Surgery in 1990 that I’m sure was typed on a typewriter.
By the time I have read the referral letter the computer has loaded up as far as the login screen. I enter my details, listen to it whir, and watch the egg timer turn over and over. I call in the patient and start the consultation as I wait for the screenprompts to enter separate passwords for the Radiology and Pathology applications. I take a history and perform a physical examination. I finally get access to laboratory tests, but have to filter the results in several different ways to get all the results I need. I can then finally look at some recent imaging, although I can’t compare this to old xrays as they have been archived and I don’t have time to ask the computer system to retrieve them from the data store as this has all taken quite a while and there are many patients waiting in the corridor.