Let's not exaggerate the force of the hurricane that cut a swathe across central Scotland on Thursday 8 December 2011. It wasn't Katrina. A few roofs came off, a few trees came down, and a few cars were squashed. I went into work on Friday to find we had no electricity in Aberfoyle (we have two dispensing practices in villages 7 miles apart), and, while we had heating and lighting in Buchlyvie, the computers had crashed. I spent most of the day seeing patients in Buchlyvie.
It was a tremendously exhilarating experience. No EMIS, no Docman. The screens were blank. I started out thinking that the loss of access to the patient record would be, though far from insurmountable, an impediment. In fact, the collective memory of patient and doctor easily compensated, and I quickly came to appreciate the advantages of being liberated from the Third Eye in the room. It was all a question of Focus: I and the patient were able to turn our backs, literally, on all the paraphernalia of IT, and concentrate on one another. That I was able to give the patient my undivided attention became self-evident. The sharper focus of the patients was more subtle; they were aware that we were operating under constraints, and that therefore it behoved them to be candid, succinct, and to the point. From an ethical point of view it was as if the patients had suddenly become aware of the concept of ‘justice’ and of the moral imperative that they see their own problems in the context of the individual and collective problems of the community, to retain a sense of proportion about the extent and limit of their own personal needs. It was as if we were operating in a war-time footing.
There was a blitzy atmosphere of camaraderie among all the staff. Suddenly we were all talking to one another. If we encountered a difficulty we improvised, in good faith and to the best of our ability. We had a great day.
Would I want to dump all the computers in a landfill? Of course not. We have crossed a Rubicon there. But it is all a question of proportion. On that Friday morning when we realised the system had crashed, some management scientist in an obscure recess of the Health Board allegedly suggested, without any trace of irony, that we pack up and go home. Nothing could be more redolent of the insanity of our devotion to cyber technology than this suggestion that, on a day when, for example, our most elderly patients might be at their most vulnerable, we doctors might consider ourselves effete just because we couldn't turn the computer on. It's just a tool. EMIS or GPASS or Vision are just fancy versions of a Lloyd George envelope. That's all. If we really think the essence of what we do is somehow enshrined in a PC then not only have we lost our way; we have lost the plot. We have lost our humanity.
- © British Journal of General Practice 2012
