The physician’s relationship with the beeper


If you’re thinking about a career in medicine, there’s a piece of technology you’ll come to know intimately. It’s small and sleek, with excellent battery life and remarkable durability. It’s not an iPhone; it’s not a Pixel. It’s a beeper. You will come to know, and to respect, this tiny black rectangular prism. It will govern your life. You will be at its mercy, yes, but it also offers you a chance at salvation. Come with me on a journey of exploration as we deconstruct the pager, and find out what makes it beep.

Physical appearance

You’ve seen it before, and don’t tell me you’re not impressed. Maybe on a TV show, maybe you’ve actually had the misfortune of being in a hospital yourself. Some young gun, blond hair flowing, sprints down a medical corridor. His scrubs hug the curves of his body, outlining a strong set of pectoral muscles. His stethoscope dangles from his neck. Affixed to his waist, you see not one, and not even two, but three beepers. Three god damn beepers. “Who is this guy?” you wonder. “And why is he so powerful?” Three beepers. The presence of such a multitude of beepers indicates gravitas, importance. This man is needed. People depend on him. Maybe he has them with him at all times, answering them at any time of day, during a date even, or a party. Maybe he has a fourth that is temporarily in the shop. You just don’t know! But you do know that this guy isn’t fucking around. He’s a guy with expertise. He’s a guy with answers.

Technological aspects

The graphical interface of a beeper is deeply unintuitive. There are usually two to three buttons along with a basic LCD display. The functionality of the buttons is not fixed but arbitrary, changing with the display screen. You’ll have to master these three buttons. They must be pressed in precise sequence, or you’ll end up in an endless loop of button pressing leading nowhere. Even the most simple ‘read my page’ operation takes a precise combination of presses so arcane it would challenge the most ambitious Dance Dance Revolution expert. Additionally, there is a row of symbols on the bottom of the LCD screen that comprises the “menu” section of the phone. These symbols – a wavy set of lines, a microphone, a small child, a house, a large X, a sheet of paper – are so unknown, so wildly obtuse of meaning, that there are teams of NIH scientists and language experts who have the sole task of decoding these strange characters. You should never interact with these symbols, but be aware that the device you carry contains knowledge you could never possibly understand.


There are sounds in this world that bring people joy. The jingle of sleigh bells. The crackle of a roaring fire. The pitter-patter of rain. Then there are the sounds that beepers make. It is an unholy aural torment, emanating from an infernal maw. The sound begins without warning. There is no gradual crescendo or buildup. It just appears in consciousness at a full 10/10. It is droning, incessant, deathly. It is the sound secret prison camps might play to break people. The sound of a robot screaming in anguish. It is a sound scientifically designed to cut to the core of your being, eradicating all pleasure and happiness. Your current train of thought is decimated by the 8-bit screech. It replaces whatever you were thinking of with a single, unending thought: make it stop. The sound is shrill, dense, and unyielding. The AI uprising prophesized Elon Musk could begin with these devices, if properly integrated with one another. A continuous, unending chorus of shrill beeps would probably be enough to annihilate most organic life on earth. But it may even be too powerful for AI. If every beeper in the world went off simultaneously, our sun would explode.

Audio-limbic neural response

The chain of feelings, thoughts, and physical actions brought on by the tone of a pager is complex, and requires deep analysis. Here is my best attempt to map this response in a coherent flowchart.

  1. Beeper goes off.
  2. Instant panic. What is producing that sound?
  3. Sadness. The beeper is producing that sound.
  4. Despair. Why am I getting paged? Whatever they want, this means more work for me.
  5. Desperation. Where the hell is the beeper? You rifle through your white coat, check your three beepers individually, stand up suddenly, check under your seat, grab your neighbor’s beeper, hand it back to them because why are you grabbing their beeper??, double check your beepers, check your pockets again. Finally, silence as your neighbor turns their beeper off.
  6. Ecstasy. It was your neighbor’s beeper! Your instincts were right!
  7. Relief. Thank the sweet, merciful lord it’s not my beeper.
  8. Freedom. My time is my own. I can do absolutely whatever I want – I don’t have to return a page! I’m the master of my destiny!
  9. Equanimity. OK, OK. I still do have a beeper. Let’s just hope it doesn’t go off again. Even if it does, I’ll be ready. It’s fine. I’m getting paid to do this job, and this is one aspect. Returning pages. No problem. I can –
  10. Beeper goes off. Return to step 2.

Philosophical implications

The underlying philosophy of a beeper is deeply logically flawed. Someone wants to get in touch with you. So what do they do? They send you their number, and then you have to call them. This makes absolutely no sense. The onus of communication should be on the person who wants to communicate. When your house is on fire, you don’t text the firefighter your number and hope they call you back. If you have to get in touch with someone, there should be a way in 2017 to have a one-time initiation of conversation without the bizarre back and forth. Paging is the equivalent of calling someone, then as soon as they pick up, shouting “call me back!” and hanging up. It’s the equivalent of tapping someone on the shoulder, then turning around as if you didn’t do it, and then acting all surprised when they look at you like you need your head examined.

Spiritual significance

The medical beeper is a sort of modern oracle. On admitting days, the beeper is the central hub of activity in the team room. If a few hours pass without a page, this usually prompts a team member to make some seemingly benign statement like “been a few hours since we’ve been paged — things are looking good!” This is uniformly met with widespread condemnation from the more senior members of the team. You don’t tempt the fates like that. You just don’t. The will of the pager is inscrutable, mysterious, unknowable. You don’t make comments about how few pages you’ve gotten until after a shift is over, your destiny for that day decided. It’s not superstition; there is an underlying ethic regarding your relationship with the pager. The pager goes off because, on some deep level, you wanted to be paged. Only by deeply accepting this fact can you understand why senior members of the team never make such proclamations. Falsely declaring that they can know or understand the patterns of when the pager goes off is heretical and mocking of a larger, unknowable force. The pager is the conduit, the messenger. The pager will go off when it desires, and we will bend and sway our lives to the tune of these ancient devices until we transcend these mortal bodies. Or, at the very least, until our shift has ended.

Ben Gold is a physician who blogs at his self-titled site, Ben Gold, M.D.

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