Diane H. Schetky, M.D.

Cell phones are an invention most of us cannot live without yet one that is a frequent source of irritation. I recently attended a performance at the Metropolitan Opera in New York. From my perch, I had a good view of the $200 orchestra seats where I could see cell phones lighting up like fireflies. The most amazing part of this light show was that their owners were checking messages between scenes, unable to wait until intermission. A few of the opera patrons may have had justification such as being on-call or had concern about a sick child or relative. I suspect that many operagoers are no different than teenagers, however, who have a need to stay connected and cannot stand to miss a call.

The cell phone has become the great umbilical cord of the sky that protects us from loneliness, solitude, and learning to be at one with one’s self. Endless inane chatter minimizes the opportunity for self-reflection and may dull our other senses and awareness of the world around us. Cell phones are symbolic of an increasingly impatient society that wants instant gratification and equates time with money.

The obnoxiously loud rings and tunes of newer cell phones cry out, “See how important my owner is.” At a recent professional meeting, offensive, distinctive rings would go off during sessions, and physicians, who had forgotten to turn off their phones, also seemed to have forgotten where they had stashed them or how to silence them.

Today’s cell phone users tend not to value privacy. Conversations range from the banal to the intimate and business transactions that should be private. Their owners may strut about in public places as if on stage, wildly gesticulating while loudly giving orders to a secretary or associate on the other end. My idea of torture is being stuck in airports where there is no refuge from cell phone users. I would sooner be watching peacocks and listening to caterwauling crows. En route to Toronto during a layover, I changed seats in the waiting area four times to escape cell phone users only to have yet another one sit down and light up beside me. I finally gave up

Once, during an eight-hour weather delay in Newark, I took refuge in the airport chapel. Silence is becoming a rare commodity as technologies continually bombard us with stimulation. Fewer people seem to read anymore while waiting and prefer talking. A blogger proposed an antidote to the ubiquitous jabbering of cell phone users and described how he started reading aloud to the bewilderment of the person on the cell phone beside him.

Physicians are not exempt from indiscreet and inconsiderate use of cell phones. I overheard a doctor using his phone in a hotel lounge broadcasting his patient’s X-rays and lab findings in a tone that could not be ignored. I have also heard physicians discussing professional matters on cell phones in stalls of restrooms with apparently no concern for who might be listening. Not only do such conversations violate patient confidentiality but they also give the message to the public that physicians cannot be trusted. I am reminded of a sign I saw in the restroom of the airport in the Falkland Islands, which also serves the military base. It read, “Hush up and wash up. You never know who might be listening.” Good advice.

The advent of the cell phone has led to the expectation of instant access to physicians regardless of the day of the week or the hour. Physicians may feel the need to return calls immediately in this era of rapid communication without heed to where they are. They may also become overly confident about the reliability of the cell phone as a dependable means of communication. While it allows us more freedom while on call, it can also lead to frustration when geography conspires against us. During much of my private practice in Maine, there were no other child and adolescent psychiatrists around with whom I might share call, so I was on call 24/7. Once, while camping on an island to which I had kayaked, my pager went off. I tried to return the call but the signal on my phone was too weak. Back ashore the next day, I called the number only to find out it had come from a hungry tourist trying to order lobster who had dialed the wrong number.

Another time, I was moored for the night in a tranquil harbor when my pager went off. I attempted to return the call on one of the early cell bag phones only to discover that I was in a dead zone. I recognized the number as being that of the mother of a patient with bipolar disorder. Concerned about my patient, I rowed ashore in the dark of night and was fortunate to find a phone booth. The latter are, by now, scarce as hens’ teeth. Cell phone towers are fortunately expanding their province, but black holes persist. And then there was the time I lost a new cell phone while reaching into my backpack for something else on a paddling trip. It now lies at the bottom of ETHICS The Tyranny of the Cell Phone “Hush up and wash up. You never know who might be listening.” Penobscot Bay. Freud might say that I was weary of being on call.

I would remind readers of basic rules of cell phone etiquette:

1. Do not use cell phones to discuss patients or converse with them unless you are in a place where others cannot overhear your conversations.

2. Be aware that sound carries in airplanes, over water, and in waiting areas.

3. Cell phone lines are not secure. Inform patients that you are conversing by cell phone.

4. If cell phone reception is questionable in the area to which you are traveling, provide a backup coverage number on your answering machine or call in for messages from land phones.

5. Turn cell phones off in lectures, concerts, religious services, restaurants, court, and so on. This is a basic courtesy to colleagues, patrons, and performers who have come to experience these events, not hear your conversations.

6. Use the vibrate mode if you must be reached in public places. It can also serve as a good cover-up if you wish to exit a bad lecture or performance.

7. Be respectful of those around you if using a cell phone in a public place for non-professional calls, and be mindful of the fact that you are intruding on someone else’s space.

In closing, I challenge you to try cell phone-free weekends and vacations. We are not as indispensable as we may like to think we are. If going into the wilderness, try using the phone only for outgoing calls in case of emergency. If you are able to survive this challenge, try going without a watch or clock for a week. It can be liberating, trust me, I have tried it.