Spearfish Lake Tales
Contemporary Mainstream Books and Serials Online
Molly showed up at Dr. York’s office within half an hour of Heather’s call. She proved to be a woman about Tricia’s and Heather’s age or a little older, nice looking, with shoulder-length black hair in bangs, and maybe a little more solid than Heather. Tricia liked her almost instantly.
In a rather hurried interview between patients, Tricia soon learned that Molly had several years’ experience as a dentist’s receptionist, and before that had been a nurse’s aide. She was very bright and personable, and seemed like she’d be a good addition to the practice. “Might as well get you to work,” Tricia said after only a few minutes. “You’ll have to figure out the system here on your own. Don’t get too attached to it, since we’ll be upgrading it as soon as possible.”
“Shouldn’t be much problem” she said. “If something comes up, ask, right?”
“For right now, if something comes up, do your best to fake it. There’s nobody left who understands Betty’s system, not that she understood it very well herself.”
“One of those deals, huh?” Molly grinned. “I’ll do my best.”
“I’m sure you will,” Tricia replied. “One thing,” she added, picking up a stack of forms, “I want to get a fresh medical history on everyone who comes in the door, except maybe the mailman. I don’t know how much to trust the ones on file and they’re pretty slim anyway. I ran these off on my printer at home yesterday, but we need to get a regular supply.”
“Not a problem,” Molly said. “I’ll have the print shop run some off from these.”
“Good, you’ve got a handle on it already. One other thing. People who come to us are looking for medical care, and they, or their insurance companies as the case may be, pay a lot for it. It’s my intention to see they get their money’s worth, not just a lick and a promise.”
“Dr. York,” Molly smiled, “I think I’m going to like working for you.”
It took a few days for Tricia, Heather, and Molly to learn to work together, but soon they settled into a well-oiled team, which was fine as the patient count increased almost daily. They soon evolved ways they could support each other, with Heather able to do a lot of preparatory work. If she got stacked up, Molly proved to know how to do some of the simple things that would help take the load off her, such as taking temperatures and blood pressures. That meant Tricia could actually spend more quality time with each patient, looking for and dealing with real problems rather than the routine things Heather and Molly could handle.
One of the things that slowed them down a lot was patient records. There were actually two different problems there, and each had to be dealt with separately.
The big problem, as Tricia had known from the first, was the old records, all kept in Dr. Luce’s crabbed and nearly illegible handwriting. Some of them went back for decades, and she noted that his handwriting had been much better thirty years before than it had been as he was approaching the end. Even then, the records were thin, and there were things missing that Tricia would have expected to see.
In the short run, there was nothing much that could be done about the problem but live with it. That didn’t mean that trying to decipher the records didn’t take minutes and sometimes hours out of the day; sometimes Tricia even took records back to her new house in the evening and tried to puzzle out something that had proved to be a problem with one patient or another. The only solace lay in the fact that Dr. Luce’s patients had tended to be older than average, so in the long run the problem would diminish, not that it was exactly a happy thought.
The second problem lay in the fact that new records had to be kept. While Tricia’s handwriting was pretty good for a physician, it still took time to do. Tricia tried typing them up herself, but she was not a very good typist, and sometimes it was just quicker and more convenient to make a quick note in handwriting. However, she could see quite clearly every time she looked at Dr. Luce’s records that down that road lay the path to ruin, and the problem would just get worse as the patient load increased.
For a short period they experimented with Tricia taking medical notes on a pocket recorder, and having Molly type them up from the dictation. That didn’t last long; while Molly proved to be a jewel in several ways, making sense out of Betty’s appointment system where no discernible sense had previously been evident, and being helpful in other ways, she just wasn’t familiar with much of the terminology. Although that would improve in time, Tricia had to go over all of Molly’s transcriptions and make corrections, and the only thing good about it was that it could be done in the evenings at home. Clearly it was a system that was going to break down before long; besides, Molly had other things she needed to be doing too.
Since Tricia was still learning how to manage a medical practice, she met with Gene Metarie once or twice a week for hints and tips, often at his home. One quiet weekend afternoon she laid the whole problem out in front of him. “The only thing I can think of is to come up with a voice-to-text computer program,” she said. “I’d still have to go back over and correct it, but at least it would take some of the load off Molly.”
“I can’t help you with that one,” he said. “I do have a good medical transcriptionist who can work off voice recordings, but I spent a long time getting her trained and she’s about as busy as she wants to be. I still type up some notes myself, especially on more complicated things.”
“Well, darn,” Tricia shook her head. “I wouldn’t want to have to add to your problem. I’ve stolen enough of your people already.”
“It’s been for the good,” Gene said, “in a number of different ways. But to get back to the problem, I have to think that a voice-to-text arrangement might work. I don’t know much about them, but I do know someone who’s forgotten more about them than you and I will ever know. She might be able tell both of us what we want to find out. If you like, I could take you over and introduce you.”
“Fine with me. This is starting to be really irritating and I’d love to talk to someone who knows something about the software.”
Fifteen minutes later they got out of Gene’s Chrysler in front of a nondescript home a few blocks from Tricia’s place. “Let me warn you,” Gene said. “This gal might be the brightest person in Spearfish Lake, and easily the most imaginative. But she has some problems she’s had to learn to live with the hard way, so her perspective on the world is a little unusual.”
“You’ll see,” he smiled as he pushed the doorbell.
Almost instantly a deep male voice came over a hidden loudspeaker. “Please identify yourself and state the purpose of your visit.” To Tricia, it sounded like Jennifer Walworth’s husband Blake speaking in an English accent from a script written by Dr. Hartwell-Harris.
“Shovelhead and Dr. York here to see Wendy, Jeeves,” Gene replied.
“Hey, great,” a feminine voice came over the loudspeaker. “I’ve been wanting to meet Dr. York. Door’s open, you two. Come on in.”
Gene opened the door and held it for Tricia, who stepped through it. In the middle of an otherwise normal-looking living room was something that sort of reminded her of a dentist’s chair, with an array of indescribable devices surrounding it; the only thing she could identify was a large flat-screen monitor. In the reclining dentist’s chair, or whatever it was, a rather wizened blonde woman lay, wearing what looked like a hospital gown. It didn’t take Tricia more than an instant to realize that she was a quadriplegic, and probably a low-functioning one at that.
“So, Wendy,” Gene said, “what’s happening with you today?”
“A little frustrating,” she replied. “I’ve done this damn scene four times and I still can’t get it the way I want it.”
“Lex gets frustrated like that at times, too,” he smiled. “Anyway, Wendy, this is Dr. Tricia York, our new physician in town. She took over Dr. Luce’s practice.”
“I know,” the woman in the recliner smiled. “I’ve been hearing good things about you, Dr. York. Everyone I’ve talked to who’s met you says you’re a real breath of fresh air. I hope you’re settling into Spearfish Lake all right.”
“It’s getting a little easier,” Tricia said. “I can usually drive home from the office without missing any turns.”
“Dr. York,” Gene said formally, “I might as well shortcut a lot of explanation about Wendy. She was injured in a jetski accident shortly after I arrived here, and has been a quadriplegic ever since. She has respiratory difficulties if she’s sitting up, and usually has to be on oxygen when she does, which is why she’s reclining most of the time. For a quadriplegic, she’s amazingly independent, partly because she has a little control of two fingers on her left hand, but partly because a group of volunteers built an amazing array of inventions to support her, and they continue to upgrade it.”
“Say hello, Jeeves,” Wendy grinned.
“Hello, Dr. Metarie,” the Blake-like voice said. “And good day to you, Dr. York. I’m pleased to make your acquaintance.”
“The first iteration of Jeeves had a spoken vocabulary of perhaps thirty words, and probably understood about that many commands.” Gene grinned. “He’s come a long way since then, but computers have come a long way, too. He can do a great many things for her, all by voice command.”
“Dad and Mark and the others keep tweaking him faster than I can keep up with them sometimes,” Wendy smiled. “To be honest, there’s nothing really new or groundbreaking about him. It’s just a mixture of existing technologies, but a lot of it is keyed specifically to me. Some of it is just tricks done for fun, like what he just did introducing himself, just to show off to people.”
By now, Tricia had her jaw hanging open. She’d seen quadriplegics with computer support before – but none this good! The ones she’d seen had something like that thirty-word vocabulary Gene had mentioned.
Gene apparently had seen the reaction before. “Wendy can show you tricks all afternoon that mostly make Jeeves look smarter than he really is. Most of the real part of Jeeves is not all that complicated, just innovative, created by guys who have made a hobby out of building him. The bottom line is that he largely replaces a human caregiver, just doing simple functions Wendy can’t do for herself.”
“The person who’s really been liberated by Jeeves isn’t me,” Wendy explained, “but instead my mother. For a long time somebody had to stay with me all the time. But even the early versions of Jeeves made it possible for me to stay alone for long periods of time, so long as someone is in a position to come quickly when Jeeves or I call for help. Quickly meaning minutes, not seconds. We’ve all had to work together to make it work.”
“Still, wow!” Tricia shook her head.
“This gets us away from the point,” Gene said. “Tricia, you probably don’t realize that Wendy is the second most famous person in Spearfish Lake, next to Jennifer Walworth. Not because of what Jeeves can do for her, but what off-the-shelf voice command software allows her to do, particularly voice-to-text software.”
“Not quite ‘off-the-shelf,’” Wendy said. “Among other things, I’m a beta tester for the software company for the voice-to-text program, so I’m usually two or three versions ahead of everyone else. That’s still not as far as you might think. What I’m using today is so far ahead of what I had when I did the book about Carole and Brenda it isn’t funny.”
“You’re a writer, then?” Tricia smiled.
“I play around with it.”
“She’s being modest,” Gene grinned. “Epic fantasy is not my taste in reading, but I’ve read a couple of her books. Wendy is one of the stars of that genre, right up there with people like Dave Patterson and Meghan Solerai. Five books so far, all of them real doorstoppers, and she has the sixth under way.”
“And a couple non-fiction books, too,” Wendy smiled.
“I hate to say it,” Tricia shook her head. “But I’m not much of a reader unless it’s something like the Journal of the American Medical Association, so it’s not surprising I haven’t heard of you.”
“My first fantasy book was titled Ferry to Kolombanara,” Wendy explained. “I’ve done five books in the series and like Shovelhead just said, the sixth is under way. I’m also playing around with another series, just for the sake of doing something different.”
“I have to say Wendy’s writing is pretty imaginative,” Gene explained. “But like I said, I’m no expert in the field. Anyway, Wendy, we came over today because Dr. York has some questions about voice-to-text software as a tool in keeping patient records. I explained that you know a lot more about the software than anyone else in town.”
“Well, no doubt about that, but it’s probably better to demonstrate it than it is to just talk about it.” Wendy smiled., then spoke in a slightly different voice, “Jeeves, write. Mode Charlie. New file, ‘Doctor York One.’”
“Yes, ma’am,” the ethereal voice said. “Program operational.”
“Voice-to-text software is like most computer software,” Wendy said a little slower, being a little more clear with her voice. “It’s computer based, and like most computer applications it does what you tell it to do. It can’t tell what you’re thinking. However, to a great degree it can learn if you take the time to teach it what to do. Dr. York, you’re probably thinking about saving patient records vocally and having them saved in a print format, am I correct?”
“Essentially,” Tricia said. “I know simple voice-to-text software is available, but I’m thinking it could take more time to have to go back through each file to correct spellings, and that sort of thing.”
“You’re correct in that,” Wendy replied. “However, as I mentioned, the software can be made to learn if you are willing to teach it. You probably noticed I’m being a little more precise in my speech than I was earlier. That’s because I’m having the software save this conversation for printout, so you don’t have to take notes on this. It will also be doing that for your speaking, and Dr. Metarie’s, so please speak clearly, and perhaps a little more slowly than you just did. I can see on my screen that it took your words down correctly, but you used nothing but simple words the software understood. Jeeves, pause.”
“Dr. York, I can’t twist the screen so you can see it,” Wendy said in a more normal tone, “But if you’d like to come over here you can see just how well it worked.”
Tricia got up from her chair and went over to stand next to Wendy. “Wow, worked pretty well,” she said after a moment. “I don’t see any errors there, although there were a couple places I might not have punctuated it that way. It even got Dr. Metarie’s name right. That’s not a common name.”
“No it’s not, but let me take this off pause before I explain it,” Wendy told her. “Jeeves, unpause.”
“The reason it spelled Dr. Metarie’s name right,” Wendy explained as the words appeared on the screen before her, “is that the software has heard it before and has added it to its dictionary file. Dr. York, could you say some complicated and uncommon medical term that people are not likely to spell right if they heard it?”
Tricia looked at the screen as the word “Acetaminofen” came up instantly, highlighted by a blue background. “Not bad,” she said. “Close, but not quite right.”
“The program heard the word and tried its best to get it right phonetically,” Wendy said. “In human terms, it knows it was guessing on that one since it’s not in its dictionary. That’s what the highlighting is for. I’m going to give a command, then you say the word the way you said it before, and spell it out slowly. Jeeves, dictionary add.”
“Acetaminophen,” Tricia said, “a-c-e-t-a-m-i-n-o-p-h-e-n.” The word appeared on the screen correctly now, and the highlighting went away.
“Jeeves, continue. If someone uses that word to the program again, that’s how it will get spelled,” Wendy explained. “One of the problems with any voice-to-text software is that it does not handle homonyms well. It can sometimes get them correct, sometimes through luck, sometimes through context. A little earlier it got your name correct, not because it had heard it before, but because ‘York’ is a common word already in the dictionary, from ‘New York.’ If your name was spelled, ‘Yorick’, like in Shakespeare, you see what happens.” The word ‘York’ appeared on the screen with no blue highlighting.
“That’s just a plain, old fashioned error,” Wendy explained. “It’s no trick to go back and fix it but it would be time consuming and could be overlooked. If it were a word I thought it was going to commonly hear, I’d change my pronunciation slightly and add it to the dictionary. Now, in your situation you’d probably have to add several hundred words to the dictionary, but you’d only have to do it once. However, it would be important to say the word the same way every time you use it. There are a few other tricks to using the software, but most of them are in the documentation, and I’ll be glad to work with you on the nuances.”
“Interesting,” Tricia smiled. “This looks like it might be worth looking into. It might solve a lot of problems.”
“It’s a matter of getting used to it,” Wendy said. “I have no alternative, so I had to do it. But the software is improving all the time. One of the new tricks in this beta package is a voice filtering system. You’ll notice that it’s noting everything both of us say.”
“Jeeves, write, mode bravo.”
“You’ll notice it’s still taking down what I say. You say something, anything.”
“This is absolutely amazing. I never dreamed of anything like this.”
“Jeeves, write, mode Charlie.”
“You’ll notice it didn’t write down what you said. It only listened to my voice. That’s true voice recognition filtering. You could talk till you were blue in the face, and it would just ignore you, like your husband would if he was wrapped up in a baseball game on TV.”
“That is really cool,” Tricia said, and her words appeared on the screen again.
“Unfortunately, it’s not quite perfect yet, but they’re working on it,” Wendy grinned. “It works just fine if the two of us are talking politely to each other like we are now. If there are four or five people around all talking at the same time, it doesn’t work as well. As far as that goes, it wouldn’t work well if we were interrupting each other or talking over the top of each other. It still picks up my voice but misses things in the confusion.”
“All right, I have a question. Can I record something on a digital recorder, then have it play back to the program?”
“As far as I know, yes, if I read the documentation correctly. I haven’t tried to use it that way. I’ll be honest, this software works for me. Many writers I have talked to would be unable to use it. Their thoughts are used to working on a keyboard. I can’t do that, so I’ve had to learn to use this. It would probably work just fine for you if you’re taking concise notes. If you were trying to write, oh, a fight scene, you’d get so frustrated with it you’d just turn it off and do things the old fashioned way. I don’t have that option, so I have to do it this way. Sometimes it means I have to go through a scene several times to get it like I want it. It’s a little easier to do that than it is to edit a major scene with this equipment. But that’s getting better too. In your case, editing would be much simpler since you can use a keyboard and a mouse.”
Gene shook his head. “I didn’t realize this was that advanced,” he said. “Marilyn would turn blue to see how this works.”
“Marilyn?” Wendy asked.
“My medical transcriptionist. She’d be out of a job.”
“Unfortunately, it’s not perfect,” Wendy said. “There are limitations and you have to be careful how you present things to the program. That’s why I’m speaking rather concisely and slowly, and being careful with my pronunciation. A human is smart enough to fill in the gaps. Gene, you remember Brenda Hodunk, don’t you?”
“She’d be hard to forget.”
“Back when she was a reporter for the Record-Herald, she said once, about a very early version of this program, ‘I have seen the future. I’m not sure I like it, but I’ve seen it.’ Voice to text has advantages, but I don’t think it’s going to replace keyboards anytime soon.”
“Interesting woman,” Gene grinned. “I haven’t heard anything about her in a while.”
“She’s still with WNN,” Wendy smiled. “She’s in Iraq right now, but we get to talk on the phone once a week or so. Still no boyfriend, and I’m beginning to doubt she’s ever going to find one.”
“Like I said, interesting woman,” Gene shook his head. “Tricia, has anyone ever told you the story about her?”
“No, but I suppose it’s one of those ‘I’ll hear about it sometime’ things.”
“Oh, yeah,” he laughed. “And it’s not simple. Fascinating, but not simple. Wendy wrote a book about it.”
“Well,” Wendy said, “if we’re going to get into that story, and we’re done talking about voice to text, I’ll stop the file and save it. Dr. York, if you’d like a copy of what we’ve just talked about, I can e-mail it to you in just a few words.”
“Might not be a bad idea. Do you want my e-mail address?”
“Give me a few seconds to get it set up and you can tell Jeeves directly.”
It was a couple hours later when Doctors Metarie and York left Wendy, after sitting around letting Wendy tell one of the more unusual stories Tricia had ever heard. But Gene assured her it was true and that Wendy had been right in the middle of it so she knew what she was talking about. Spearfish Lake had its unusual people, all right!
It had been a fun afternoon, one of the best casual times Tricia had spent in town. She’d not only learned a lot about voice-to-text software, but she had become extremely impressed with Wendy. That young lady was not what she expected a quadriplegic to be, not in the slightest! If anyone had taken a lemon and turned it into lemonade, she had. It was pretty awesome, no matter how you looked at it.
In her hand, Tricia had a brand new print copy of Ferry to Kolombanara, fresh from a box in a nearby closet. She wasn’t sure when she was going to have time to read it, but it promised to be interesting, too.