Stupid Tuesday questions, sweetness and light edition

I read a lot of medical reports.  Any time a patient goes to see a specialist for any reason, sooner or later I’ll get a report back detailing the visit and the recommendations.  On an average day I read half a dozen or so.  (Given how familiar I am with them, it is no great shakes for me to write a fake one convincingly.)

There is a tendency, which I suspect is unique to pediatrics, for the consultants to toss in some kind of complimentary remark about the patient and/or the family.  “Patient is a lovely 9-month old girl…” “Thank you for referring this charming family…”  In almost every single report I get, there’s something of this nature.  “Adorable.”  “Delightful.”  “Sweet.”  Etc.  It is, frankly, hilarious, especially when I know full well that the patient is not particularly charming, lovely or delightful.  I don’t know when or how it started, but it seems de rigueur for the report to contain some kind of paean to the patient’s graces.

Only once have I read a report that said, flatly, “patient is filthy and ill-kept.”  I presume the consultant included this remark because: 1) the patient was indeed so filthy and ill-kept that to maintain otherwise would have been borderline fraudulent, and 2) because it was relevant to the reason for the referral, which was skin infections in numerous areas related to poor hygiene.  Even then, it was so out of keeping with the norm to be a little bit startling.

Anyhow, that brings us to this week’s question — is there some silly professional custom that you’ve observed or participated in like this in your field?  Some nicety that probably started as a pleasant notion, that has now become so routine and removed from reality as to be somewhat ridiculous?  I’m genuinely curious.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. The restaurant hand shake.

    In my industry if you and the people you work with see someone else from your industry in the same restaurant, you have to walk over, shake hands, smile and make 5 or 10 minutes of small talk. Even if they are your competitors, and you don’t like one another.

    Everyone knows that the gesture is insincere, and no one really pays attention to what people are saying about their lives, their families, their hobbies. But everyone does it anyway, every single time. And then when you part, each party snarks about having to have just gone through the whole charade. And still, every single time…

  2. Software progress reporting is usually a collection of polite lies. If the truth were being told on all sides, software construction would work exactly like house construction. We’d have an architect first sit down with the client, work out what’s really wanted. The architect would take it up with a construction foreman who would then help price out what was specified. The client would get sticker shock, compromises would be made, eventually all the parties would get the permits and off they’d all go. There might be a few problems along the way but most of it would be known quantities.

    Instead, consultants are obliged to fill in status reports for completely bogus requirements, as if the project had been mapped out to a series of tasks. If a prospective home owner’s first question of the architect was “When can I move in?” the construction foreman might have a good laugh, asking the client “Uh, what do you want to move into?”

    There’s a whole specialty to this bullshittery. It’s called PMP. It has absolutely no bearing on how software projects are actually managed but it’s a tested methodology for keeping idiotic clients satisfied.

    • A former employer of mine was notorious for rewarding account managers for making obscene promises. They’d promise the sun and stars, programmers and testers and deployment specialists would work around the clock to get it done, and the account manager would get named employee of the month for “making it happen” when all they made was the dang promise.

      From the QA side of things, my least favorite part about the absolute lack of progress monitoring was that, when things were going poorly – but not too poorly – the deadline would pass while it was in our hands. We budgeted seven working days to get through it, we were given it two days before the deadline, but it was consistently our fault that it was late. Or, if we got it done just in time, it was Deployment’s fault (though if it was that close to the deadline, that was considered a success story).

  3. One of mr favorite lines from a pediatric subspecialist report about my then 6 month old was “Patient presents as a pleasant boy.” Because most 6 month olds are rotten bastards.

    In philosophy, there is a tendency among Americans to use Briticisms and unnecessary Latin: “I shall demonstrate,” “inter alia,” “ceteris paribus.”

    During the main philosophical convention where many initial job interviews occur, there is an evening alcohol event where candidates stand around trying to look attractive and hoping a department with a job opening will throw a look their way. This event is still called “the smoker.”

  4. The one that leaps to my mind is not from my own field but from politics. When members of Congress oppose one another in floor speeches or committee hearings, they refer to the author of the unacceptable policy positions as “My friend from [State].” You’ll hear or read things like “My friend from Indiana has made a proposal to modify the appropriations criteria that I simply cannot agree is in the national interest,” so we’re supposed to think that these guys really hang out and stuff and this is an honest, principled policy disagreement rather than “I hate that guy’s guts so I’m going to oppose his policy on that basis alone.”

    The more strenuous the disagreement, the stronger the avowed but obviously insincere friendship becomes, as in “My good friend from California,” or “My very good friend from South Dakota,” or “My very good friend, poker buddy, drinking companion and sometime lover from Florida.”

    In my profession, I often see letters sent about matters from one lawyer to another, or from a lawyer to a party, concluding that the lawyer sincerely and strenuously hopes that the problem can get worked out without restort to litigation. That’s bullshit and everyone knows it. Having just spent two pages of text and a considerable amount of time explaining why he’s going to win if he files the lawsuit, it’s pretty clear that either the lawyer believes what he just wrote in which case he wants to file the lawsuit and get paid more than if the dispute settles without litigation, or the lawyer does not believe what he just wrote, in which case the hope of money without litigation is sincere but the threat of credible litigation is not.

    • Also, does any non-politician use the word “folks”?

      • I do. I also picked up howdy somewhere along the line… It sounds about as strange coming from me as it did coming from my Indian-American friend…

Comments are closed.