Don’t misunderstand: I support text capabilities in pagers. I like knowing what people want when they page me. With numeric pages, I’m never entirely sure of the urgency of the message or the impatience of the caller. Text pages facilitate efficiency:

• We’re meeting in the cafeteria at 10. See you there.
• I have no new recommendations for your patient, but please page 555-5555 if you have any questions.
• There’s another consult for you in the ER.

Furthermore, text pages permit fun (which helps decrease the anxiety associated with receiving pages):

• Got out of clinic early. Call me when you’re ready for dinner.
• Do you want Ethiopian or Thai food tonight?

Text pages, however, also permit spam pages:

• Buy a new leather couch 2day! Leather is the best! C U @ leather isgrate. co m

Spam pages during the day are tolerable. Spam pages at night—like at 1:15am, when most people are sleeping—are annoying as all get out. Spam e-mail at least allows the reader to receive the messages at his or her leisure. Pages, whether they be spam or not, demand attention immediately, whether one is asleep or awake.

And in the middle of the night, pages—like telephone calls—never bring good news.

Gabriel was the first left-handed person I knew. We were in the same second-grade class. Though a quiet kid, he was smart and had a fantastic sense of dry humor (though neither he nor I appreciated this until later grades). In addition to his handedness, his talent of flipping his eyelids “out” (so that the undersides of his eyelids were on display) distinguished him in our class. (The eyelid trick was pretty gross.)

I asked him a lot of questions about his handedness. Did he always know that he was left-handed? Was it difficult to write? Did he find doorknobs and ink pens annoying?

Certain medical conditions are disproportionately associated with left-handedness:

• mental retardation
• epilepsy
• schizophrenia
• autism

However, left-handedness is also disproportionately associated with talents in

• music (including the ability to discern perfect pitch)
• art
• mathematics
• athletics

Though theories abound, no one really knows why these traits are associated with left-handedness.

Additionally, many of our recent Presidents were/are left-handed:

• Gerald Ford
• George H. Bush
• Bill Clinton
• Ronald Reagan (who apparently could also write with his right hand)

Fascinating.

According to Mental Health America (an agency I had never heard of until today), many people are depressed in the US. They produced a report (which I have admittedly only skimmed) about depression in each state in America. They used data, which included

(1) the percentage of the adult population experiencing at least one major depressive episode in the past year, (2) the percentage of the adolescent population (ages 12 to 17) experiencing at least one major depressive episode in the past year, (3) the percentage of the adult population experiencing serious psychological distress, and (4) the average number of days in the past 30 days in which the population reported that their mental health was not good

to rank each state in its “depression status”. (They used DSM criteria to define “major depression”. They also used a scale (”K6″) that has six questions to assess “psychological distress” and a scale that the CDC apparently uses to measure “poor mental health days”.)

According to this report, South Dakota is apparently the least depressed state and Utah is the most depressed state.

They also assessed suicide rates within each state, extrapolating (fairly) that depression can result in completed suicides. They included an “age-adjusted” suicide rate (adjusted for the most recent suicide data they had, which was from 2004).

According to this report, New York has the lowest suicide rate and Alaska has the highest.

The paper goes on to argue that five factors—mental health resources, barriers to treatment, mental health treatment utilization, socioeconomic characteristics, and mental health parity laws—were associated with better depression status and lower suicide rates.

These factors makes sense, of course.

Of note, South Dakota, which is the “least depressed state”, is ranked #40 for suicides (where the higher the number, the higher the suicide rate). Utah, which is the “most depressed state”, is ranked #45.

If we cannot attribute the suicides in South Dakota to depression, then what are other underlying causes?

Alaska, which had the highest suicide rate in this report, ranked #21 for depression. Can alcohol abuse alone explain this disparity? (Washington sees a fair number of Alaskans, whether they be travelling to or from the state, and we often hear about the large volumes of alcohol Alaskans can consume.)

New York rated #19 for depression. That’s only two positions away from Alaska’s #21. Can we attribute New York’s low suicide rate to the availability of services, etc. alone?

Many, many confounders. Plus that whole thing about lies and statistics.

Hospital staff can easily tell when the medical center has hired new telephone/paging operators: They sound absolutely terrified when they announce codes.

To their credit, they try to speak calmly and clearly, but their voices invariably betray their fears:

“Code one-nine-nine, second floor, south wing, room twenty… code one-nine-nine, SECOND floor, SOUTH wing, room TWENTY… CODE ONE-NINE-NINE SECOND FLOOR SOUTH WING ROOM TWENTY—”

oh my GOD someone just told me that someone is dying will you PLEASE hurry up and DO SOMETHING

Within a few months, after announcing several codes, they sound like all the other seasoned operators. They announce codes like cynical junior high teachers who are performing roll call to a class of out of control kids. (Not that I was ever a part of that or anything.)

For all of us, it becomes business as usual.