Ah, the stethoscope. It_s the iconic symbol of power for those working in the health-care industry. It not only transmits the internal sounds of any species with a pulse, but it communicates merit and reverence to its possessor. When slung around the neck in a resting position, it brings instant respect to the bearer of its weight.
For this reason, you_ll find just about anybody and everybody in a health-care facility wearing one, even the custodial, secretarial and kitchen staff. I often wonder if that irritates the originators of this now-deemed-essential auditory attire. Surgeons were the first to curl these lanyards around their collarbones. It_s rumored that God and other lesser members of the health-care profession who were jealous of the surgeon_s power soon followed this ritualistic adornment. Eventually, this included even, gasp, EMS providers. Oh, the pain those surgeons must have felt! Trying to regain their hierarchy of visual supremacy, surgeons began wearing scrubs outside the OR. Now even dental assistants wear scrubs while flossing your incisors. Sure, surgeons still have pagers to signify elitism, but Twitter will soon neutralize that pictogram.”ž
I have to admit, the first time I adorned my tubule amplifier as an EMT student, I felt overwhelmingly empowered. Similar to the character Gollum in theLord of the Rings,my “precious” stethoscope instilled me with instant confidenceÆ’despite the fact that I couldn_t distinguish rales from a hyperactive nose whistle.
I soon learned that one must also have a particular brand of stethoscope if you wanted to be a truly ostentatious medic. In other words, the stethoscope had to be expensive. Prices for ear trumpets range from $5 (Toys-R-Us) to $400 (Broke-Am-I), but any stethoscope cardiologists use is always revered.
Again, most medics can_t distinguish awhoosh, lub-dub, galloporru from gas, but that isn_t the point, not when image means everything. Besides, you_re eventually going to suffer mild to moderate hearing loss from those lovely sirens, so you might as well give in and buy an expensive stethoscope from the onset.”ž
The only problem with having an expensive one is that you can never take if off your neck for fear someone may “accidentally” walk off with it. That_s why I keep mine at home and borrow my partner_s.
What irritates me about providers who constantly wear their stethoscope is that theyconstantlywear their stethoscope. I_ve had partners who even wear them while eating. Unless the hamburger is undercooked and you_re listening for a pulse, there_s no need to look cool for the Burger King mascot. And besides, a study inAustralia Health Newsfound that lanyards carry a median bacterial load 10 times greater per unit of surface area than your name tag. Why would I want an acoustic tool that harbors pathogenic bacteria so close to my face while I_m chowing down?
And, what_s with the wild, neon-colored decorative stethoscopes? They call these “patient-friendly stethoscopes.”“ž On top of that, some EMTs and medics put on ornamental covers or clip-on koala bears or monkeys to their rubber hoses. Some stethoscopes are even made with interactive light emissions. OK, I can see this for pediatric patients. But if I were a patient hanging upside down while entrapped in a rollover vehicle, the last thing that I want to see is a stethoscope that screams, “Hi! I_m Barney, the purple dinosaur, and I_ll be performing CPR on you today.” We have to balance individuality with being taken seriously.
Maybe this isn_t fair, but I find a kind of paradoxical humor when I see a health-care provider lighting up in a designated smoking area with a stethoscope around their neck. I always want to approach them and ask, “What is the primary function of a stethoscope?” With the follow-up question of, “And what are the primary organs affected by long-term smoking?” I don_t follow through with this because the secondary function of a stethoscope is a strangle-enhancing device.
A doctor told me my rookie year that the most important part of the stethoscope is what_s between the two earpieces. Ever since, I_ve taught my trainees that the only way they_re going to know what bad hearts and lungs sound like is to have listened to a thousand good hearts and lungs. So yes, a stethoscope should be a mandatory part of every patient assessment, thereby requiring it to be readily available. But please don_t wear it as a prop or hang it on your rearview mirror.
Oh, and take good care of it. Not only does it signify coolness, it also makes for a good substitute when playing air guitar. But, does it also give us a sense of respect? Ironically, maybe we in EMS hope the stethoscope, which enhances listening, also enhances our chance of being listened to.
Until next time, keep those tubes Armor All_ed and the diaphragm germ-free.JEMS
Steve Berryhas been a paramedic for the past 25 years in the southern Colorado region. He_s the author of the cartoon book series I_m Not An Ambulance Driver and invites you to join him and others of the EMS community to ride in the 2009 National EMS Memorial Bike Ride (www.muddyangels.org). Visit his Web site atwww.iamnotanambulancedriver.com to purchase his books or CDs.