A Million Little Pieces Of My Mind

My next contract was also a hospital, the main one in Arlington, Virginia. This was an easy commute from Reston. They were putting in a new hospital care computer system, and I was to be the liaison between the hospital and PHAMIS, the company creating the new system, the idea being that I, being a good communicator and a programmer with both hospital and Tandem computer experience, would be able to work with the PHAMIS people, who seemed to be very technical but not actually good with people.

PHAMIS, as I encountered them in early 1985, was still very much the scrappy, brainy outfit from the Pacific Northwest—Public Health Automated Medical Information System, or something close to that, depending on which engineer you asked and how much sleep they'd had. Their roots were in a statewide public-health project for Washington State, a system built to track patients and services across a sprawling network of clinics. It had the earnest, slightly homemade feel of software written by people who cared more about solving a problem than about polishing a brochure. But underneath that was a seriousness of purpose: they believed hospitals could run on a unified, patient-centered electronic record long before that idea became fashionable.

By the time they arrived at Arlington Hospital, they were in the middle of reinventing themselves. The public-health system they'd built out west had served its purpose, but it wasn't built for the round-the-clock, everything-must-work environment of an East Coast hospital. So they were rewriting it—sometimes redesigning it on the fly—while we tried to prepare the ground for them. My job was to stand in that narrow space between the hospital's expectations and PHAMIS's evolving reality, translating one world into the other. They were bright, idealistic, and frequently arrogant; but they were also building something no one else had quite dared to attempt yet, and you could feel that energy in every meeting.

The boss was a young man named Chris. One of the data entry guys was also named Chris, as was a fellow who came in with pages to be keyed by the data entry folks. Two of the PHAMIS people were also Chris, so if I yelled, "Chris!" I could be answered by as five men at once.

A job Chris the Boss gave me after a week or so came about because I had somehow become the man to be called in the middle of the night if the night computer operator had any problems.

The night operator, James, had risen to his level of incompetence. He had previously been the janitor, and his job had been simply to clean and vacuum the computer room. But somehow that had evolved into his being assigned to start the running of the reports that were supposed to be printed and distributed to the various departments. But he didn't actually know how to do that, and for some reason no one had thought to give him a written cheat sheet. So, when the phone rang at 1 AM, I was surprised to find out he had no idea how to start the report he ran every night.

The command he needed was

I knew the command by heart, so I recited: "RUN dollar sign VOL dot SUBSYS—"

"Wait," he interrupted. "How do you spell 'VOL'?"

So I backed up. "V-O-L…dot S-U-B-S-Y-S slash R-E—"

"Wait!" he interrupted again. "How do you spell 'slash'?"

It was at that point that I realized I would need to automate this procedure, because I sure as heck didn't want to have to spell 'slash' every night at 1 AM. Besides, Automation is my middle name!

So, before my contract was done, I presented Arlington Hospital with the Tandem Unattended Report Distributor. Yes, the acronym was TURD but since it was only used internally, neither I nor any of the Chrises saw that as a problem.

As it happened, Chris the Boss and I bonded and became pretty good friends. But I had no idea I would ever see him again when my three-month contract expired. But first, we were about to make a serious change in location, because my next job was in Fort Myers, Florida…not an easy commute from Reston!