Friday, June 18, 2010

a brief tour of a hospital's network

Yesterday I was at my old fieldsite hospital for a meeting. Wanting to linger in the place I had grown so familiar with, I thought I'd visit the bowels of the building and find someone who might know something about the hospital's pneumatic tube system. The corridors down below were deserted. It wasn't long before someone saw that I looked lost though, and I was soon directed to Engineering Services. Again the place was deserted, empty desks showing signs of everyone at lunch. After more wandering I came across the Operations Coordinator of the department (pseudonym Frank). He sat me down and listened intently to my interest in the pneumatic system. Without hesitation he then sprung off his chair and whisked me into the corridors for his tour of the network.

Waiting for the elevators, I found out that the tube system dealt with 2,400 'transits' a week, servicing over 30 units within the hospital. All computer controlled - Frank could even manage the system from his home computer. It was fast, he said. Fast communication; "a highway hidden from the cosmetic face of the hospital". The system meant that the doctors and nurses didn't have to run around with samples. The workload is increasing he told me. Increasing because of the number of tests they are doing, and because diseases are becoming more complicated.

Soon we were heading down the corridor to the pathology department where we were admitted into a humming hive of pathological activity. Majestically, at the end of the room, stood one of the largest pneumatic tube processing units in the building; the endpoint of three separate railways throughout the hospital. Frank showed me how the pathologists used to put too many canisters in the system, and how his technicians had adjusted the infrastructure so that the pathologists could only fit one canister. There were towels lying in the troughs, hospital towels, ready to catch the falling tubes. I loved these signs of adaptation of the system.

On our way out of the pathology department Frank told me that the whole system depended on its users. When things went wrong he knew who to blame - the doctors. "The illogical things that humans do ... humans don't realise the logic of machines". He told me that the doctors would put samples in the canisters incorrectly, leading to spillage. His team would have to clean the canisters carefully, with antiseptic. Even worse however, the fluids would leak into the vacuum, causing trouble. Frank very carefully explained to me the difference between pneumatic and vacuum, which I still don't understand. I was puzzling over these simple engineering facts as we walked back along the corridor. He pointed out the window to the top of the other side of the hospital building, to the plant room, where the pumps for the system were housed.

It was time then for our tour to finish. Frank had to get back to work. His pager had remained silent but there was always something to do. He was a tradesman, he said. A tradesman who loved hospitals. He had worked in the hospital for the last 21 years. Almost everyone we passed in the corridors had said hello. I could tell there was much more to learn from Frank. He gave me his business card (after rifling through his stack, most with little notes to himself on the back), and I will call him again one day.

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