On the televisionMost of the time the television in a patient’s room is more of an annoyance than an item of interest. On continuously, it is usually cranked up to some absurd volume where communication with the patient becomes difficult and auscultation for cardiac murmurs and other subtle sounds becomes nearly impossible. (Say what? Your nurse just gave you a spanking? Oh, pardon me, you said your nurse is bringing you a blanket!) I usually try to turn the thing off when I can get away with it, but for some reason many nurses and family members seem to view the television as comforting to their non-awake patients or kin, leaving it on 24/7. Awake patients do need the television to ward off boredom, that I understand, but it so ends up that nine out of ten occupied rooms in your average hospital will at any time have their T.V.’s brightly lit up, hour after hour drowning ear drums and burning retinas.
Where the television can really become a problem, though, is when there is an item of intense interest to the medical team on the T.V. Instead of paying attention to the patient, team members will steal glances up at the screen, straining their peripheral vision in an effort to discreetly absorb as much information as possible. I can recall several times over the past few years seeing patients while being more interested in their televisions than in the patients themselves. I can’t say I felt great about it, but let’s be honest – it has to be a pretty good story of chest pain to match the excitement of catching a glimpse of the World Cup final. I was only a first year medical student on 9/11, but I imagine that hospital rounds on that day must have been excruciatingly painful. The medical staff, starved for images and information, would have wanted nothing more than to sit down together with their patients and to fix their eyes upon the flashing television screens.
The lesson for patients, I suppose, is that if they want to command as much of their physicians’ attentions as possible, they should turn the T.V. off and keep distractions in their room to a minimum. We do care, we’re just a distractible bunch. Besides, it goes both ways – it’s not an uncommon patient who’s more interested in what’s on the television than in what his docs have to say. (“Sir, I’ve been asked to see you because your kidneys aren’t working.” “That’s nice, but I don’t care.”) A few minutes sans T.V. for some sound medical advice – that’s not such a bad bargain. What’s more, we’ll actually be able to hear your heart sounds.