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Surgical Reminiscence
October 1998


Arch Surg. 1998;133(10):1138. doi:10-1001/pubs.Arch Surg.-ISSN-0004-0010-133-10-srm8003

IT MAY BE HARD to imagine, but at one time there were 1000-bed hospitals spanning city blocks with only an overhead system or a lighted numbers system for summoning personnel from one place to another, often stat. No pagers. No cellular phones.

During the daytime, the overhead squawk box coupled with the larger number of health care workers provided enough communication to ensure that any given surgical resident could be found. But once the on-call night shift was running the show (usually after 7 PM), it took real ingenuity to track down someone making his or her appointed rounds, or in some eating or sleeping area. It might be easier to understand the complexity of the search if it is explained that a surgical intern or resident was expected to draw blood, pass tubes, transport patients, or do anything else necessary to care for all the patients on the service (which may have been spread over 2 city blocks) who did not have private nurses (30-50 patients per service). Further, bedrooms were not assigned to the staff, so it was catch-as-catch-can in securing a bed each night—upper or lower bunk—in a bullpen of 6 to 10 beds and 3 to 5 telephones. Finally, one might note that even a very experienced physician could spend a good part of the night passing a Miller-Abbott tube in preparation for a gastrointestinal operation the next morning, or locating the results of tests vital to the smooth and efficient rendering of patient care.