Tuesday, December 10, 2013

Code: Face Pain

I work for a large, unnamed hospital. I would name it but then I'd have to kill the internet. I don't want to do that, so I'll just tell you about me, James and Brian.

James and Brian are my coworkers, and we survive our positions as Data Stewards for the unnameable hospital, which I've decided to call Blinky, by acting like 3rd graders. This involves a lot of these kinds of conversations, that always center around the same insult:

Me (approaching them): What's up?

James: Your face.

Brian: Oh! Burn!

So to back up here for a second, or actually, to back up a number of years, the three of us are college graduates. None of us majored in the thing that would have prepared us for the job that we do. In fact, none of us are sure what we do. When people ask me what I do for a living the following conversation ensues:

Stranger at a party (he is standing across from me wearing a suit and holding a martini. I don't go to parties where classy people stand around holding martinis, I'm just making up that scenario because I go to swankier parties in my mind): So what do you do?

Me: I'm a Data Steward One.

Stranger at a Party: What's that?

Me: I think it's something to do with medical information.

And I think I'm right. I am also right in that there are levels for whatever it is that I do. Me, Brian and James are "Data Steward One." One of our other coworkers is a Data Steward Two. We don't know how she got to the next level. And we also don't have a clear understanding about what she does so we don't know how she's stewarding the data at a higher level than we are.

So not only are we unable to describe what it is that we do, we don't know what anyone else around us does either.

"James," I said the other day. "How do I find a patient's last x-ray in the new system?"

"I dunno, I don't work in that system. Ask Latasha, I think she does."

"Right! Latasha, she knows everything!...What does she do?"

"Um...she knows shit."

Latasha is the person in the office who is a treasure trove of information. She's familiar with all of the database systems, she knows key people in other departments, and she can switch out toner in the printer. But none of us know what she really does except that she knows everything. So we have decided that that is her job. Omnipotent Coworker One.  Every office has one. Find out who this person is and bake her cookies.

Just as an aside, I can tell that I am pretty much useless at my job because when I typed out the term "database systems" in that last paragraph, I became confused. I'm not really sure what a database system is. It's one of those terms that alludes me like "patient encounter" and "EMR." You know what an EMR is? It's an "electronic medical record." I just gave you information that I learned a year after I started working with EMR's. Do you know what a patient encounter is? I don't know either, but I can tell you that it doesn't involve aliens as (I feel) the word "encounter" clearly implies.

Anyway, it wasn't Latahsa who taught us the code for face pain, which has been the single most useful piece of information that me and my boys have learned at Blinky. Our coworker Pete does something with medical codes. We don't know what that thing is, but he's at a Level Two with it so we're impressed but we don't know why.

One day I was stewarding the data and I came across a patient encounter where the chief complaint was "Pain in the Face." As sympathetic as I usually am whenever I have to read a diagnosis, I could not stop laughing at Pain in The Face. For one thing, it's just funny to imagine saying.

"What brings you in today?"

"My face hurts."

No reason. A brick didn't land on it. This pain is mysterious.

Secondly, there's an accusatory nature to the diagnosis as if this patient is a pain in everyone else's face.

"What brings you in today?"

"I'm a pain in the face."

Now I swear, I really do care about other people's pain. I also care about their privacy so I didn't tell anyone who this patient was. But I did run up excitedly to Brian and James and said, "Guys! Guys! Face pain is a real thing. It's a real diagnosis!"

"No!" said James.

"Yes!" I said.

"It's a medical condition?" asked Brian.

"Apparently so!"

Pete did some quick typing in whatever program it is that he uses. "There's a code for it," he told us.

"NOOOO!" we said.

"Yep. Medical code 784.0. Pains, face."

We were delighted. Pete then emailed us the different medical listings for face pain.They are:

Pains, face 784.0
Pain in the face 784.0
Chronic pain in face 784.0
Atypical face pain 350.2

Our minds boggled. How different is "Pains, face" from "Pain in the face?" Why is Chronic pain in the face the same code as (what we assume is) occasional pain in the face? And! And! What is atypical face pain? Is "atypical" describing the pain or the face?

The fact is, people, that we just don't know enough about face pain.

We have, however, taken our 3rd grade sense of humor to a whole new level of geekiness.

"What's up James?"


"Oh! Burn!"

We are at Geek Level 16. Though it's not reflected on our employee badges, you can tell when you talk to us just how advanced we are. We are not 784.0. We are definitely 350.2, and we're not looking for a cure.

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