Once upon a time, when I was a medical student, I was doing morning pre-rounds at a military hospital. I was on the general medical service, but we were following a patient on the orthopedics service who had some significant medical issues. (As a general rule, just as you don’t want your internist pinning your fractured femur, you don’t want an orthopedic surgeon managing your diabetes.)
The role of the student when “pre-rounding” is to gather all the relevant data on the patient that has accrued since rounding the previous day: blood tests, imaging studies, vital signs, nursing reports, consultations, procedures. Those data then get presented in a concise form to the rest of the team during rounds to catch everyone up before visiting with the patient.
Since this was an ortho patient who was being followed after an orthopedic surgical procedure, the ortho service’s notes were of particular relevance. The ortho resident’s note, however, just said “LGFD.” That was an initialism I’d never seen before and, worse, it wasn’t in my handy-dandy pocket book of medical abbreviations. The World Wide Web wouldn’t be public for a year or two yet. I asked a few folks on the floor, but nobody had heard the abbreviation.
I was sure it was something that I should know (the life of a medical student is filled with anxiety about not knowing something that’s common knowledge amongst healthcare providers) so when it came time to present the patient, I rather sheepishly said “The ortho note just said LGFD; I couldn’t figure out what that means.” The older, high-ranking attending physician’s face went blank. He stared straight ahead and started to turn red. I was sure I had committed a major gaffe. Finally, when it looked as though steam might soon be issuing from his ears, he muttered through clenched teeth…
“Looks good from door.”
He asked the team to wait and he left, presumably to find the ortho resident. I seriously did not want to be anywhere near the ensuing encounter.
I was reminded of that incident during yesterday’s Xfinity debacle. The customer service agents at the Xfinity store just glanced at a computer and said that everything was okay, and blamed the customer equipment. I didn’t tell the whole story yesterday: it actually turned out that the slow speeds were due to a defective stretch of Comcast-installed cable, not modem problems (though the new modem does support faster speeds than the old one could deliver). The cabling problem absolutely can be seen from the head end, though I’m not sure Xfinity gives their customer service representatives access to that data. It was a problem I’d encountered in the past when I had Comcast service at my business. There was an intermittent faulty in-line connector. For weeks, our service was all but unusable. Comcast kept insisting “everything is fine.” When I finally reached an actual technician (a Herculean feat!) he was able to tell me within seconds exactly where the defective connector was. A repair person was dispatched and it was fixed within hours but, of course, only after weeks of fighting customer service. (What finally worked was posting my experience to Reddit).
If it’s your job to identify and correct problems, it’s good to be proactive (why doesn’t Comcast regularly scan customer circuits to identify faults?). If you can’t be proactive, at least put a little effort into checking things when called upon to do so. Otherwise, everything just “looks good from door.”
—2p