A Thousand Words

pdnews@elsevier.com

I've been a bit grumpy the last couple of weeks. We had to put down our 10-year-old electronic medical record system, and I am still working through the grieving process.

She was getting long in the tooth. Homemade by one of our doctors, she had served us well. Everybody loved her from Day 1. But keeping her healthy had become expensive and frustrating. She didn't interface with our off-the-shelf billing and prescribing platforms. She had to go.

What we pediatricians had liked about her was that she allowed us to handwrite our notes and scan them in quickly. Our new system is point and click or type in free text boxes. Dictation just doesn't fit our practice styles. For me, typing isn't much of an issue. In one of her wiser moments, my mom decided that I wasn't going to waste the entire summer of my 11th year at the town swimming pool. She taped over the keys of one of my Dad's old typewriters; gave me a water-stained copy of a learn-to-type book and set me to transcribing Reader's Digest articles. The result is that I am a fast but inaccurate typist whose brain is littered with deep pockets of useless knowledge and anecdotes.

I am trying to learn to keep my eyes off the keyboard and the screen. It's a struggle but I know I can make the adjustment. The reason for my persistent grumpiness is that while the keyboard can replace my handwriting (and probably should have years ago) it can't replace the scores of drawings that decorate my charts.

I have always been a drawer. Ask me for directions and I'll draw you a map. Ask me any question and the odds are 2:1 that I will pull out my pen and illustrate my answer on an old envelope or a paper napkin. It must be genetic. My mom was trained to be an art teacher. My dad always designed and made our Christmas cards. My sister is a whiz with fine-tipped colored markers. My college major was art history. I'm just a visual guy.

It's always been easier for me to draw the distribution of a rash than to describe it. “It hurts here” is more efficiently sketched than written about. The size, shape, and location of laceration are unmistakable when I can draw the wound. A quick outline of the tympanic membrane allows me to remember how much and where the fluid was collecting.

While I am a prolific medical illustrator, the quality of my work is spotty. I have certain favorites and strengths. I am particularly proud of my renderings of legs, fingers, trunks, and genitalia. My sketches of faces and noses are good, my tongues and tonsils are fair. Profiles, ankles, and teeth are pretty shaky but always unmistakable. Even my worst work offers our medical record staff multiple opportunities for a good laugh at the end of a long day.

I have never warmed up to the concept of adding my own lines and dots to the preprinted anatomically correct drawings available on off-the-shelf forms. Somehow it makes me feel that I am prostituting my artistic talents.

There is technology out there that might allow me to draw on the computer, but I've been told it won't be finding its way to our little corner of Maine for quite awhile. So I will be struggling to describe what I have been drawing for years. My vocabulary of anatomical names, which has atrophied from disuse, will have to be rebuilt. For decades I have relied on my sketches and shoddy penmanship to disguise my spelling deficiencies.

But in my darkest hours of grumpiness I am reassured that I will still need my pen and paper to illustrate my mini lectures for patients and parents. They need to “see” what a middle ear looks like and how an inguinal hernia forms. Or why a swollen prepatellar bursa is not as serious as an intra-articular effusion.

Every picture is worth a thousand words … at least.

pdnews@elsevier.com

I've been a bit grumpy the last couple of weeks. We had to put down our 10-year-old electronic medical record system, and I am still working through the grieving process.

She was getting long in the tooth. Homemade by one of our doctors, she had served us well. Everybody loved her from Day 1. But keeping her healthy had become expensive and frustrating. She didn't interface with our off-the-shelf billing and prescribing platforms. She had to go.

What we pediatricians had liked about her was that she allowed us to handwrite our notes and scan them in quickly. Our new system is point and click or type in free text boxes. Dictation just doesn't fit our practice styles. For me, typing isn't much of an issue. In one of her wiser moments, my mom decided that I wasn't going to waste the entire summer of my 11th year at the town swimming pool. She taped over the keys of one of my Dad's old typewriters; gave me a water-stained copy of a learn-to-type book and set me to transcribing Reader's Digest articles. The result is that I am a fast but inaccurate typist whose brain is littered with deep pockets of useless knowledge and anecdotes.

I am trying to learn to keep my eyes off the keyboard and the screen. It's a struggle but I know I can make the adjustment. The reason for my persistent grumpiness is that while the keyboard can replace my handwriting (and probably should have years ago) it can't replace the scores of drawings that decorate my charts.

I have always been a drawer. Ask me for directions and I'll draw you a map. Ask me any question and the odds are 2:1 that I will pull out my pen and illustrate my answer on an old envelope or a paper napkin. It must be genetic. My mom was trained to be an art teacher. My dad always designed and made our Christmas cards. My sister is a whiz with fine-tipped colored markers. My college major was art history. I'm just a visual guy.

It's always been easier for me to draw the distribution of a rash than to describe it. “It hurts here” is more efficiently sketched than written about. The size, shape, and location of laceration are unmistakable when I can draw the wound. A quick outline of the tympanic membrane allows me to remember how much and where the fluid was collecting.

While I am a prolific medical illustrator, the quality of my work is spotty. I have certain favorites and strengths. I am particularly proud of my renderings of legs, fingers, trunks, and genitalia. My sketches of faces and noses are good, my tongues and tonsils are fair. Profiles, ankles, and teeth are pretty shaky but always unmistakable. Even my worst work offers our medical record staff multiple opportunities for a good laugh at the end of a long day.

I have never warmed up to the concept of adding my own lines and dots to the preprinted anatomically correct drawings available on off-the-shelf forms. Somehow it makes me feel that I am prostituting my artistic talents.

There is technology out there that might allow me to draw on the computer, but I've been told it won't be finding its way to our little corner of Maine for quite awhile. So I will be struggling to describe what I have been drawing for years. My vocabulary of anatomical names, which has atrophied from disuse, will have to be rebuilt. For decades I have relied on my sketches and shoddy penmanship to disguise my spelling deficiencies.

But in my darkest hours of grumpiness I am reassured that I will still need my pen and paper to illustrate my mini lectures for patients and parents. They need to “see” what a middle ear looks like and how an inguinal hernia forms. Or why a swollen prepatellar bursa is not as serious as an intra-articular effusion.

Every picture is worth a thousand words … at least.

pdnews@elsevier.com

I've been a bit grumpy the last couple of weeks. We had to put down our 10-year-old electronic medical record system, and I am still working through the grieving process.

She was getting long in the tooth. Homemade by one of our doctors, she had served us well. Everybody loved her from Day 1. But keeping her healthy had become expensive and frustrating. She didn't interface with our off-the-shelf billing and prescribing platforms. She had to go.

What we pediatricians had liked about her was that she allowed us to handwrite our notes and scan them in quickly. Our new system is point and click or type in free text boxes. Dictation just doesn't fit our practice styles. For me, typing isn't much of an issue. In one of her wiser moments, my mom decided that I wasn't going to waste the entire summer of my 11th year at the town swimming pool. She taped over the keys of one of my Dad's old typewriters; gave me a water-stained copy of a learn-to-type book and set me to transcribing Reader's Digest articles. The result is that I am a fast but inaccurate typist whose brain is littered with deep pockets of useless knowledge and anecdotes.

I am trying to learn to keep my eyes off the keyboard and the screen. It's a struggle but I know I can make the adjustment. The reason for my persistent grumpiness is that while the keyboard can replace my handwriting (and probably should have years ago) it can't replace the scores of drawings that decorate my charts.

I have always been a drawer. Ask me for directions and I'll draw you a map. Ask me any question and the odds are 2:1 that I will pull out my pen and illustrate my answer on an old envelope or a paper napkin. It must be genetic. My mom was trained to be an art teacher. My dad always designed and made our Christmas cards. My sister is a whiz with fine-tipped colored markers. My college major was art history. I'm just a visual guy.

It's always been easier for me to draw the distribution of a rash than to describe it. “It hurts here” is more efficiently sketched than written about. The size, shape, and location of laceration are unmistakable when I can draw the wound. A quick outline of the tympanic membrane allows me to remember how much and where the fluid was collecting.

While I am a prolific medical illustrator, the quality of my work is spotty. I have certain favorites and strengths. I am particularly proud of my renderings of legs, fingers, trunks, and genitalia. My sketches of faces and noses are good, my tongues and tonsils are fair. Profiles, ankles, and teeth are pretty shaky but always unmistakable. Even my worst work offers our medical record staff multiple opportunities for a good laugh at the end of a long day.

I have never warmed up to the concept of adding my own lines and dots to the preprinted anatomically correct drawings available on off-the-shelf forms. Somehow it makes me feel that I am prostituting my artistic talents.

There is technology out there that might allow me to draw on the computer, but I've been told it won't be finding its way to our little corner of Maine for quite awhile. So I will be struggling to describe what I have been drawing for years. My vocabulary of anatomical names, which has atrophied from disuse, will have to be rebuilt. For decades I have relied on my sketches and shoddy penmanship to disguise my spelling deficiencies.

But in my darkest hours of grumpiness I am reassured that I will still need my pen and paper to illustrate my mini lectures for patients and parents. They need to “see” what a middle ear looks like and how an inguinal hernia forms. Or why a swollen prepatellar bursa is not as serious as an intra-articular effusion.

Every picture is worth a thousand words … at least.