Which brings me to television political pundits and this recent posting to "Blogborygmi," a humorous and informative blog by Nicholas Genes, M.D., Ph.D., about life in what used to be called the "emergency room" but has been since promoted to the "emergency department."
If Political Pundits Covered an Emergency Department Shift
This long, rambling dialog took shape while I walked home from the ED just now, to yet another night of surprising election results. To follow the analogy, just substitute "doctors" with "voters," "patients" with "primaries" ... and the causes of abdominal pain... as major US presidential candidates:
Jeff Greenfield: If you’re joining us from home, this is a very special night in the ER. After hearing about diseases for so long, a group of doctors is finally going to step up and decide what's ailing a waiting room full of patients.
Wolf Blitzer: It’s a big night, no doubt, and let’s see how doctors are evaluating their first patient.
Dan Rather: She’s a young woman with several hours of periumbilical pain. Now it seems to hurt a little more on the right. She’s vomited. That's all we've been able to uncover.
Chris Matthews: I was talking with some of the doctors tonight. While they've obviously given this a lot of thought, many seemed ready to back appendicitis.
Anderson Cooper: Appendicitis has received major endorsements from several surgeons, and it clearly has the name-recognition among the general public. It’s a heavy hitter.
Jeff Greenfield: The ER docs are conferring. I wonder what they’re discussing?
Keith Olbermann: Maybe they want to know if the patient is pregnant? Afebrile? I think they’re ordering labs of some kind.
Doris Kearns Goodwin: Well, it hardly seems to matter at this time, Keith. Appendicitis has a well-honed message of fear. These doctors, facing uncertain times, can’t afford to back a dark horse diagnosis now.
Larry King: I think I heard one doc mention torsion. What do you think of that?
Jeff Greenfield: Torsion is very popular among this demographic.
George Stephanopoulos: You know, torsion has surprised me a lot recently. Women *and* men seem pretty impressed by the pain and damage from gonads twisting on a stalk. This is one diagnosis they don’t want to overlook.
Larry King: Well, here we go. The patient’s getting a CT scan. And there’s the wet read! We are calling it appendicitis!
Wolf Blitzer: Amazing. You know, grassroots organization really carried appendicitis in this first key patient of the night. Everybody knows somebody who's lost their appendix -- and that kind of familiarity with the disease really figured into the doctor’s decision-making.
George Will: And, you know, as I look across the waiting room at all the patients clutching their bellies, I really think appendicitis is going to run the table tonight.
Jeff Greenfield: You think everyone with abdominal pain has appendicitis?
Anderson Cooper: Appendicitis has the momentum, Jeff. Its brand is strong.
Chris Matthews: Appendicitis has reached the top of the differential by borrowing from so many other diseases. It's like a chameleon. And these doctors are just blown away by its broad appeal across so many key demographic groups. They're true believers.
Jeff Greenfield: Here’s another patient. The doctors are evaluating him. How do you think this one’s going to turn out?
Ted Koppel: A wise man once said, if you want to know what’s ailing the patient, you ought to ask the patient. And measure vitals, do a physical exam, and consider some imaging and labs – and also, spend some time building an appreciation of pathology.
Chris Matthews: I don’t know, I’m ready to just call this one for appendicitis.
Sean Hannity: Appendicitis is a *juggernaut*. The other diagnoses should just *give up*.
Dan Rather: You know, the other day I was talking with an agent of Yersinia... From a certain point of view, Yersinia and appendicitis have a lot in common.
Chris Matthews: Yersinia’s time has passed. It’s embarrassing that Yersinia is still on the differential diagnosis.
Larry King: The doctors are looking up something... prior visits, it would seem. And now, orders are going in.
Dan Rather: I don’t see any calls to surgery, nor is there a CT scan ordered. We may be looking at a major upset.
Larry King: They’ve given their fluids, pepcid... and some reglan! And they’re moving on!
Tim Russert: Gastroenteritis! The doctors have spoken.
Jeff Greenfield: Unbelievable. This is a huge setback for appendicitis.
Wolf Blitzer: But what an amazing comeback for an old standby. Lately gastroenteritis didn’t really seem to have the vision, or the ability to reach doctors on a visceral level anymore. Tonight it seemed almost like an afterthought, especially with that first patient.
Dan Rather: Acute gastroenteritis has pulled itself back from the diagnostic abyss.
Tim Russert: I have to wonder what the doctors are basing their decision-making on. It’s almost as though there are factors besides momentum that play into their thought process.
George Stephanopoulos: I think doctors were trying to send appendicitis a message – appy’s got to earn its spot at the top. The doctor's aren't so enamored with it anymore, that's for sure.
Anderson Cooper: Well, it just goes to show, doctors are a fickle bunch. There’s still a long way to go in this shift, and now the ER is a battleground for disease.
Dan Rather: This is where the fun starts.
Forgive the length. And I don't mean to imply that the presidential candidates cause upset stomachs. Just that voter's decisions, like medical decisions, are a good deal more sophisticated than the talking heads give them credit for. If pundits spend time on fundamentals, like policies and platforms, instead of candidates' momentum and maneuvering, they might improve their accuracy -- and at the very least, render more of a service to their viewers.
Disclosure: The author of this here blog, The Nitty Gritty, is related to a television political pundit and finds the best way to digest such conventional wisdom is with the sound off. Really. No one remembers what you said, anyway. Just how you looked. This does not work well, however, on National Public Radio's "All Things Considered," where my personal pundit will have a weekly spot at 4:45 p.m. Eastern time on Thursdays starting Jan. 31.
Pet Peeve: Television anchors, and occasionally some pundits themselves, who pronounce it "pundit." As in the answer to the question, "What's the best option on 4th and 15 on your own 30?"
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