"...you're welcome"
By Timothy A. Robieson

Delivered to The Chicago Literary Club
April 5, 1993

The clinical use of the computer, in the dental setting, came as a pleasant surprise to me about two years ago.

I had gotten out of dental college just in time to not have to learn how to their computer system and I have sort of been running away from computers ever since. It has been twenty four years since my first really "close encounter" with automated data processing, but like the proverbial fish, I got caught this time only because I opened my mouth at the wrong time.

When I was growing up, the familiar I.B.M. card was used for keeping track of virtually everything. Even tax refunds and government paychecks came printed on those crisp and official I.B.M. cards. Very neat looking things with a beveled corner on the upper left and rows of seemingly random but perfectly punched rectangular holes. Strength, efficiency and the U.S. Government seemed to affirm the sacredness of those three letters, I.B.M. Most cards were printed with the admonishment, do not fold, spindle or mutilate this card.

In the pre60's environment no one I knew would have considered violating that sort of pristine and authoritative data processing document. J. Edger Hover, I.B.M. and the U.S. Government held great weight with all us patriotic citizens of the post war Eisenhower era.

Then came the irreverent era of the 60's. The lid came off and I don't think ever be put back on. I remember laughing myself silly when a comedian joked that whenever he came across a data processing punch card, he always mutilated it in some subtle way. A little punch, a bend or staple hole. Whatever was necessary so that the card would be rejected by the automatic processor. That way he and his accounts would always get the personalized individual attention that he deserved. I never had the guts to try that out. Compliance through fear, an I.R.S. and government tool that works. Computers have a way of blind siding you. They come out of no where, just all of the sudden and you're at their mercy! I got sucked into my first, rather formidable, encounter with an industrial sized data processing monster aboard the U.S.S. ENTERPRISE in 1969. My training in the Navy at that time made me an Operating Room Technician. My usual haunt was the surgical suite adjacent to Sick Bay.I liked the job and the few perks that went with it. But when our aircraft carrier pulled in to the dry dock at Portsmouth, Virginia, the operating room schedule went to zylch. This was due mainly because our ship's surgeon was transferred to a shore based hospital and I became what is known as "an extra body." With no one for me to serve in my O.R. Tech capacity the Medical Service Corps. administrators looked around to find something for me to do.

I got sent down the passageway to work with the nuclear power technicians in what is called The Radiation Health Protection Office. This position was totally void of perks! The job involved the radiation monitoring of all crew members who had any exposure to radiation. My new job was to develop x-ray films that came out of each crew members film badge. Every person has to wear a photo I.D. film badge if they do any work in the nuclear power and/or nuclear weapons spaces. From this Radiation Health Protection office, my new home, once a year a report of the doses of every individual who wore a film badge on the ship had to be made to Admiral H.Rickover. He is known affectionately as the "father of the nuclear navy". Since I was just an extra lukewarm warm body only recently transplanted from my spacious air-conditioned operating room and lounge, I did not have a clue about this report to Admiral Rickover. Aboard a ship the size of the Enterprise a full compliment of sailors and marines numbers over 5,000 souls. The probability of my having a face to face dialogue of any kind with the ships captain is remote. However with my formerly scrubbed and antiseptic hands now sloshing x-ray films in their final rinse water bath, I did come face to face with Captain Peterson. His regal countenance cast a disarmingly casual pose at the "dutch door" of our small office. I registered nothing but dull surprise when his request to see this report was verbally passed to me by the nuclear power technicians with whom I worked. I knew nothing of what he requested. My vacant expression was not making him very happy and he was quickly gone with his Marine Corps entourage in tow. My education in the matter was swift and I found myself in the ships data processing center. Loaded down with 20 pounds of punch cards on which needed to be re-punched the appropriate radiation dosages for several hundred sailors, I surveyed my dilemma. Buzz, buzz, clickity, clickity, click, bang, bang, buzz, click, buzz, click. I delicately approached a keypunch machine and began my "on the job training" doing "Data Entry". Each persons film badge had an associated punch card with that individuals name on it. I had no idea what other information was already punched on those cards. It set me back several hard weeks worth of work when I eventually did find out what useless information was already punched in. Entering the data should not have been too intense or difficult. An individuals card would slide through the keypunch machine and I would type the dosages they received on the correct lines. My first day went well and the job seemed pretty straight forward. Next day however, things got a lot busier in the data processing room. The only keypunch machines available for me to use was ones that did not print while they punched. That meant that every letter and number I punch had to be perfect. The smell of machine oil and clatter of the massive computer printer and the umpteen keypunching machines graced my new "Operating room" environment.

Over the course of my days at the keypunch machines I was at the non-printing keypunchers about 25 percent of the time.

When I finally finished this huge deck of punch cards, they were put into the reader/ printer to make my report. This machine was like an industrial sized loom. It stretched some 10 feet across. Extra wide Z-folded white and green stripped computer paper was loaded into this machine from behind. The huge sheets were printed on with typewriter like keys that were arranged the full length of this wide paper and they all struck at once. Each key must have had the full alphanumeric compliment of characters because they would strike the line all at one time. I quickly got over my marveling at the mechanics of this monster when I saw what kind of report was being generated by my several hundred punch cards.

The pre-imprinted data that was already on the cards before I came got the job was total chaos. Add to that the mumbo jumbo that I punched on them while using the non-printing keypunch machines and the scope of my task went through the roof (overhead that is).

Weeks later, when the job at length was completed, I was one happy operating room technician. To be finished with computers and also with the Navy a few short weeks later.

My next personal brush with this technology had a far happier ending. Out in civilian land I went back to college and then after two years of undergraduate work was admitted to the College of Dentistry of the University of Illinois. In our sophomore year there were some rumblings about every dental students clinical requirements each being kept track of by computer. Those rumblings got louder and louder but the deed was not done until I was a senior in Dental College. The underclassmen and instructors had to attend seminars and sessions in order to become familiar with the punch cards and data input documents. I cringed as I watched students and teachers alike #2 penciling their way through the new system. Mountains of that great green stripped report paper loomed out of my past with near crippling anxiety. I graduated just in time to escape those machines. I felt like Steve McQueen must have in his dramatic jump over the prison camps barbed wire on his motorcycle in the movie "The Great Escape". Graduating from dental college was all the sweeter for me because of that timing. Times have changed and computers are doing things in the 1990's that relegate all of my data processing experience and understanding to the archives. Those really the dark ages.

So vastly different is the current technology that a reasonable case can be made for the probability of its really being of extraterrestrial origin.

An appreciation for what a computer might do for me in my line of work was slow in coming. I am still new at the computer business and I am finding out what a mixed blessing it is. Voice operated computers are here. I have been using one in my dental office for two years now. It is not what you probably think, I actually use it in my treatment room with a patient in the chair. It doesn't drill any teeth for me but it does a fabulous job of entering clinical data by voice with a hands off head mounted microphone. Data entry is confirmed automatically since the machine parrots back what ever I say. And like any good parrot it repeats back some things that I don't say. But in so doing I can verbally correct it's error since I heard it out loud.

It has been over two years since my first fateful encounter with something called,"Victor Voice Chart". I was innocently walking through the Chicago Dental Society's exhibition area at the yearly Mid-winter convention. Miniature television cameras and computers were being pushed by several manufacturers. They looked nice, were high priced and I wasn't even considering buying anything. I casually told my wife that I probably wouldn't buy a computer until they made one with which you could just talk. That was the sound of a fish opening his mouth for the hook. I was sure that that comment would insulate me from making a computer purchase for another decade.

I was just two aisles away from Avanti Systems,International. Their "Victor Voice Chart" was being demonstrated and I had named my poison.

A skillful dentist, with a microphone clamped to his temples, was reading clinical data through that microphone into a personal computer. This data was the usual type of dental conditions that are common to all dentists examinations. That being missing teeth, fillings, bridges, crowns and periodontal defects. The computer was repeating the words he spoke as it registered the information on a beautiful multicolored television display. As I listened to him answer someone else's questions, I wondered if the costs of this marvel would ever be within my reach. Then if that wasn't enough there was a color printer that traced out an accurate duplication of the computers screen image on paper in full color. With this system, clinical data can be conveniently stored and meaningful color copies of a persons dental conditions can be made.

As one might expect at a dental convention where there is a lot of expensive equipment for sale, special financing was available and I became almost instantly automated with a my own "Victor Voice Chart" voice recognition computer system.

To thus be able to convert volumes of boring, meaningless dentalese into beautiful and understandable pictures for patients to see was more than I could have hoped to do. Visualize if you will these 8+" x 11" full color, detailed dental charts, listing patients gum disease, broken fillings and missing teeth. These to be given to the patient to take home and display to their spouse and probably hang on the front of their refrigerators with my complimentary oversized tooth magnets.

What a motivator it is for people to see such a tangible, colorful representation of their deteriorating dental conditions. With MY name address and phone number in the margin, these charts as good as an 8+" x 11" business card!

The system itself looks no different than any personal computer in any other office that one might see. It has a keyboard, monitor and central computer processing unit where you insert the floppy disks. In fact most computers can be used as a voice operated system with the addition of a voice circuit board, microphone hook up and the proper programming instructions.

One of the features that attracted me to this voice technology was that it worked so well side by side with the more usual word processing, spreadsheet and office type of programs.

Again I confess that I am new at this computer process, and I know I am not alone in being new, this after all is a revolution. And it is also another case in which misery loves company. There have been more than one session of the blind leading the blind in my office as I have encountered programing and equipment problems. And speaking of companies, when it comes to finally getting a computer, the number of computers and companies that sell them is legion.

I happened to move my office a few years ago and I was pleased with the new location being near a major highway intersection. This is what I expected to be a good landmark for my patients to orient themselves when coming to my new office for their next visit. I wasn't long at the new office before I discovered that the real landmark in my area, that so many people were familiar with, was ELECTEK. The major computer store across the street. Cross streets work O.K., but nearly everyone knows ELECTEK's location.

A few weeks after the convention my computer system arrived at the office. And as they say at the Olympic meets, let the games begin! The instructions and installation took about three hours. The main difficulty with the introduction was that afterward I had no idea how much I didn't know yet. I knew there would be a lot to learn, but I know now that the learning process continues infinitely. New computers and something called components as well updated programs to run on them fill countless catalogues and computer magazines. And they are all constantly being updated, duplicated or outmoded.

In fact one of the major discomforts in getting computerized is the complete assurance that no matter how much money you spend and how careful you are at selection your system, in six months it will not be as good or as fast as the new models. In sixteen months your system will be yesterday's technology. In sixty months you will be embarrassed to even admit that you ever owned one so inefficient so and slow.

Any way, once the personal computer had found its way in to my life, I found it was another thing with which it is easy to become frustrated. I like predictability and most times my computer system is predictable. When something doesn't flow like I expected it to, then I have reason to get up tight.

One important principle that I follow that helps to keep me from immense frustration is to not ask the question "why". I don't ask why the computer does this or that. I should assume that if something wrong happened it is my fault. I just relax and do the operation over again and try to be more careful. If it fails again, I stop and read my manual. In computing circles manual is pronounced "documentation".

The keyboard is the main entry point for most data to go into the computer. Each of the keys send specific electrical signals to the system. These keys serve double purpose sometimes when used in conjunction with and "Alt" key.

My system is "fitted" with a voice board that takes electric signals from a microphone and converts certain word patterns to keystroke signals. When the "Voice Chart" recognizes a word pattern, it registers it and with a synthesized voice, repeats it back for confirmation.

When my system is not in use I keep the microphone on a hook behind me. Extraneous vibrations are often picked up by the microphone as I bump the counter or cabinets. Every now and then if the microphone is turned on it will register and say something. It likes to say eight. A bump on the counter will sometimes get me an eight response. To keep from this annoyance and possible confusion I can turn the microphone off.

Very humorously sometimes when the microphone is on and the voice board is "listening" it will respond out of the blue with a "...you're welcome! I have had patients happily chide me with comments to the effect that "It sounds like your computer has an attitude". In addition to the unexpected verbal out put, my programming has both male and female voices. This has led to one patient to observe that my computer is sexist because the female voice seemed to do more work than the male voice.

To make these dramatically appealing color dental charts, my system employes a Paint jet printer. Alas, that poor thing is an orphan. In the race to build equipment that is faster, better, and cheaper, some models do not find a wide enough acceptance quickly enough to be come one of the standards. My printer is just non standard enough to not work with some of the more generic software programs. For example: when installing a software program that needs to utilize a printer, the program will list a number of the widely used printers for which it has the proper interfacing instructions. I have used at lest three different programs that do not list my Paint Jet printer. It still makes good dental charts and that is what I bought it for and someday I will get a second printer that all other programs will recognize.

Computer literacy is a concept which strikes fear into the hearts of many people, even well educated people. I have felt this "angst" many times when in the presence of those technosnobs whose entire conversations at length revolve around their cascading torrents of technobabble. Now I am ashamed to admit it, but to paraphrase one of our frequently quoted presidents, Ich bin ein technosnob. I too am now guilty of subverting many opportunities for meaningful fellowship into microchip chatter and disk talk. The first assumption very quickly is that everyone listening understands what you are talking about. The second assumption is that if some of those present don't understand then that is their problem.

Much of the technobabble is kind of amusing. I think my favorite is the acronym W.Y.S.I.W.Y.G. Sometimes you have W.Y.S.I.W.Y.G. and some times not W.Y.S.I.W.Y.G.. This is an acronym for What You See Is What You Get. I believe it relates to what ever is displayed on the monitors screen is what you will get printed out on paper. I imagine I like the sound of it because it reminds me of my childhood and Uncle Wiggley.

I think W.Y.S.I.W.Y.G. may also relate well to buying computer systems. It can be difficult for the uninitiated like myself to know precisely what I am getting just by looking. There are more options and varieties of hardware available for computing than you can believe.

The average beginner like myself will buy an "off the shelf" or "turn key" system. What you get looks like a ivory colored box with a keyboard and a television set.It turns out to be considerably more. By that I mean there are poor quality keyboards out there. There are technically superior keyboards for sale too.

The data storage disk, or hard disk, is a separate component that can be triple A quality or grade Z. It can store data fast and give it back out at a snails pace.

The circuit board that makes a color monitor work can be of any degree of quality from good to ho hum.

The pitch of the T.V. screen can be clear or fuzzy.

Clearly W.Y.S.I.W.Y.G. may not be what you think you are getting.

Now that I know somewhat about what is available I have the dilemma which boat owners call two foot-itis. That is always looking to upgrade to the next size larger boat.

For me it will be the next faster processing chip. The greater disk storage space. Faster speed of computing and ultimately, yes, more prestige among other technosnobs.

When I finally do manage to purchase my next "upgrade", there will be an absolute blossoming of my self image. I will reload the half a dozen software packages which I had to remove from my smaller hard disk to make room for my literary club papers and other vital video games.

I think will have to be somewhat complacent about my current system a few more months perhaps a year or so. That is until dear Hillery sorts out what she wants to do to healthcare providers.

I truly do enjoy being able to do word processing for all sorts of writing on my computer.

Among them: Inventory control. Purchasing dental supplies is a breeze with my telephone hook up.

I utilize a computer facsimile system which sends data and receives messages over the phone lines.

When my children visit the office they run programs to tutor themselves in Spanish, Algebra, Frogger and PacMan.

I wonder what kind of systems and programs will my children be sharing with their kids?

Part of the trauma of getting into computers is creating change.

I remember a story my father told me about an accountant that kept books for a manufacturing company where he worked. This accountant had reluctantly agreed to computerize his books but he never could bring himself to really trust the computer. In the end he was found to be secretly keeping a regular set of books on paper and doing double the work because he just couldn't let the old way go.

I think a little wariness about what a computer can and can't do is a good thing. Computers are mechanical devices that have moving parts and are subject to breaking down. As I get more and more accustomed to relying upon my computer, I know what a mess I will be in when it eventually does break. Who hasn't been inconvenienced by a computer glych, malfunction or interruption? Even if you don't own or operate a system, the government on all levels and their agencies have each of us in their data banks. We're at the mercy of an errant keystroke or botched programs from any of them.

Of course this talk of computer breakdowns brings up the subject of computer viruses.

Biologically viruses live and multiply within the framework of a living host.

Electronically speaking, viruses do not live. They are cleverly written program instructions which can be maliciously placed in totally unrelated good and valuable programs. These cleverly hidden virus programs can create everything from mild humor to absolute chaos.

A small virus program can instruct your personal computer to Format your main data storage disk. This Format instruction erases all data that you have placed on it. On Michaelangelo birthday last year a fairly widespread virus which they named the "Michaelangelo Virus" caused unsuspecting computer operators to sit powerlessly as they watched their computers format all the data on their storage disks into oblivion.

Another, more complicated, virus puts on a little show for you while it destroys your data. Imagine typing a letter to someone and as you read over what you have written, individual letters begin to randomly fall off the screen. The "D" in Dear comes unglued and tumbles to the bottom of the screen only to be then followed by the comma after the name. Then an e and an m and then several s's cascade snowflake like down on top of an quickly growing pile of useless alphabet soup.

There are now virus detecting programs to help protect the storage disk and its data. Doing what is call a "data back up" is also helpful to keep from completely loosing valuable information. Preventing your system from becoming infected is not 100% possible but there are things that make virus contamination less likely.

One of the things that personal computers do best is to copy data. Copying complex and expensive computer programs costs virtually nothing and can be done in minutes. So much good software is on the market and in the business environment that it is common place for people to "share" their copy of this or that with someone who doesn't have that particular program. Never mind that that is a violation both of copyright laws and of good moral judgement.

The temptation is strong and a lot of "shared" software is loaded onto peoples personal computers.

Consider now the virus factor. When the desire for a certain software package is so strong, there will be people who will help meet the need by making "bootlegged" copies of it to sell to whomever they will. Only in some instances, lurking somewhere in the boiler plate and programing instructions, somewhere that only the computer experts can find, is a virus program. The damage and havoc certain to be caused by this virus will make one wish that they had spent more money. Only by using authorized and legal copies of programs on ones computer system can they do what is best to prevent virus contamination of their valuable data base.

There is a reasonable possibility that these sophisticated and damaging virus programs have actually been created and disseminated in order to discourage the use of stolen or unauthorized copies of programs. It works for me. I have had offers from people to copy this or that program for my own use. It is a moral issue, and if the program is good and I can use it, then the author and its creators deserve their royalties. And they should be inspired to continue development of quality software.

I think those who write creative viruses should be acknowledged too. It seems like their product should fit into some form of socially acceptable form.

How about a computer virus that would redirect junk mail and return it to its sender? Or do the same thing for nuisance telephone calls.

How about a "full disclosure" virus that would not allow government accountants to lump multitudes of questionable expenditures under vague headings.

Let's have a legislative consistency virus that won't allow non related amendments to be attached one to another.

Think about that a moment. We may have just discovered the genesis for the computer virus. I can describe a computer virus as a noxious little amendment, which no one in their right mind would swallow, which is tacked onto a very good and desirable program that everyone wants. Bingo! Legislative virus. That is officially sanctioned contamination of legislation by "riders".

From Mike Edelhart/PC Computing/August 1992 issue magazine here is a humorous sampling of some pretend viruses: The Boris Yeltsin Virus - It reformats your drive and alters your PC's basic operating principles every ten minutes, making it completely inoperative. Meanwhile, an onscreen message begs you to be patient and wait 90 days for results. The Warren Commission Virus - It won't allow you to open any of your files for 75 years. The Michael Jorden Virus - It slam dunks your PC 40 times every 60 minutes, never the same way twice. The National Enquirer Virus - It incessantly scans your files for evidence that you are cross-dressing, have been abducted by aliens, or are secretly dating Princess Di. The Teenage Virus- You can get your PC to do what you want, but only after an interminable argument that leaves you feeling horribly guilty. The Pat Buchanan Virus- It shifts all screen output to the extreme right. The Bill Clinton Virus - This virus mutates from region to region; we're not sure exactly what it does. Appears to mate with other viruses at random. The Jerry Brown Virus - It blanks your screen, then incessantly flashes an 800 number. The David Duke Virus - It makes your screen go totally white. The Spike Lee Virus - It makes your screen go totally black. The Jesse Jackson Virus- Your screen becomes a beautiful rainbow, but your PC can't accomplish anything. The Paul Tsongas Virus- Suddenly, your PC becomes incredibly drab and boring. The Mario Cuomo Virus- Should it attack your system or should it leave your system alone? This virus can't seem to decide what to do, but and onscreen message says it withholds the right to destroy all your files at a later date.

Enough about viruses.

I have around one thousand patients names, addresses, home & work phone numbers. Clinical data for hundreds of examinations, newspaper articles, club papers, personal letters, business correspondence, inventory lists, various assorted programs and games loaded onto my personal computer.

The time it has taken to load all that stuff in and the time that it would take to key it in again would be very great. This brings me to the first cosmic law of computers. Data that is destroyed can not be recreated easily. Data can be copied very easily and that is call backing up. As once was said by a contributing Graduate student to another PC magazine article:

Woe befalls those who operate PCs on insufficient sleep or while taking prescription cough medicine. PCs should be considered heavy machinery. -Graduate student

It is rarely the cause of a computer virus which blasts vast quantities of valuable data to the nether world. Most usually it is an inadvertent flick of a finger that sweeps away the wrong files. As in "Haste Makes Waste" nothing can waste faster than some errant and unadvised key strokes. If you're not sure what you are doing it is like tip toeing through a mine field. A Secretary- admonishes from experience:

When the computer prompts you, "Are you sure?" ponder the question for a moment.

Most good programs have a highly technical menu selection called "UNDO". Undo covers a multitude of goofs but it usually only covers the very last keystroke or command.

As we get familiar with our computer systems we get faster and quickly out run the ability of the Undo command to save us because we have moved more than a single keystroke past our goof before we noticed. To quote an other:A Network supervisor-

Sooner or later most users of PCs learn just enough to become dangerous.

Of course it is overcoming the danger that we find life's greatest rewards.

I wanted to write this paper as an encouragement to people like me who stood on the sidelines. Go ahead jump in and get your feet wet. If you even learned to type with just two fingers, this new technology just brought almost all typists back to that same level. There are twice as many goofy keys as any typewriter so that everyone has to hunt and peck.

To be sure, as we venture into the technologies of the future, we are at the mercy of technical support personnel. But there is great news here. There are tons of people who will assist you in person or over the telephone and get you past those mine fields into absolute verdant fields of clover.

This is a risk worth taking!

Return to PAPERS
Return to Main Menu