“I want it done, now.” These were words I said so many times during my residency. 

A test needed to be done, or a lab needed to be drawn, and some technician or radiologist would hem and haw about how it would have to wait until the morning. 

It was such an often-repeated scenario that my previously calm and quiet demeanor was soon replaced with a more pushy, lion-like persona. 

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At some point, I knew that the sense of urgency was sometimes false. Struggling on behalf of patients for scarce resources required a certain need for exaggeration.  After all, these were life and death circumstances — maybe not at the moment, but eventually. 

We are often forced to leverage the facts for our own benefit, if we want to get our work done, tuck our patients in, and leave the hospital at a reasonable hour.

I was naïve during those early years to believe it was only the doctors-in-training that were using such tactics. I now realize the attending physicians, nurses, technicians, and radiologists each had their own bag of tricks. Even our patients had caught on.

The strategy is to present the facts in such a way as to feign maximal urgency in a given situation. Each data point drawn out with an unspoken sentence dangling ephemerally in the air. The implications being Or he will die, Or she will become septic.

Years later, I am finally paying the price for my younger hubris. Each time I get an urgent fax from the pharmacy or a midnight call for some banality or another, I wince at my previous behavior. 

When it comes to health care, we truly have become an alarm nation. With emergency room overuse, and our voicemails pushing patients to dial 911, it’s a wonder that health care is being delivered in any location other than the hospital. 

The problem, of course, is alarm fatigue. The more alarms that are ringing at any given time, the less any one can be heard.
Have you ever sat at the nursing station of a busy hospital floor or emergency room?

The only thing more bewildering than the constant ringing and buzzing, is the fact that no one looks remotely concerned about what all the racket even means. Are we so busy sounding the alarm that nobody remembers how to respond?