A reflection on how humor and bedside manner can help defuse high-stress service calls in the operating room.
By: J. Scot Mackeil, CBET, senior biomedical equipment technician, MGH Clinical Engineering Dept
Technological downtime in the operating room is frequently attributed to catastrophic hardware failure or complex software corruption. However, field observations from 45 years in the health technology management (HTM) industry suggest a significant percentage of “dead” units are actually in a state of “advanced user-induced hibernation.”
Here, I outline the “Magic Finger” strategy—a sophisticated intervention that relies on theatrical presence, verbal signaling, and the precise application of a single digit to the correct location.
The Ritual of Entry
The surgeon’s workstation is a critical node in clinical PC and biomedical device connectivity. When a workstation fails to respond, the biological response from the surgical team is typically a high-decibel “biomed call.” For the responding technician, particularly those supporting operating room locations, the repair does not begin at the computer; it begins at the door.
To successfully deploy the “Magic Finger” protocol, the BMET must first establish environmental dominance. This is achieved through the Verbal Beacon: entering the room and announcing, “Biomed is here.” This immediately shifts the room’s atmosphere from “crisis mode” to “It’s OK. Biomed is here.”
Case Study: The ‘Dead’ Surgeon PC
Scenario: A frantic call was received from the operating room. A surgeon reported a complete system failure. The unit would not respond to mouse movement or keyboard input.
Root Cause Analysis: Investigation revealed the previous user had deviated from the standard “log off” SOP, choosing instead to execute “shutdown.” The surgeon, expecting a “wake-on-mouse” response, perceived the dormant state as a hardware fatality.
The Methodology:
- The Diagnostic Gaze: Upon reaching the unit, the BMET must lean in, give a knowing look, and utter the mantra: “Let’s see what we have here…” Even if the fix is obvious, this five-second “visual scan” builds the necessary tension.
- Tactile Deployment: With the registered nurse (RN) and surgeon watching, the BMET extends the index finger and applies exactly 0.5 Newtons of force to the power button.
- The Restoration: As the Windows splash screen appears, the technician must maintain a stoic expression, drawing on decades of foundational technical knowledge.
The Dialogue:
- RN: “What did you do? I tried everything!”
- BMET: “I used my Magic Finger.”
Technical Specifications for the “Magic Finger” (Model MF-V1)
| Specification | Operational Parameter |
| Vocal Announcement | Minimum 65 dB (“Biomed is Here”) |
| Pre-Touch Latency | 3–5 seconds of “thoughtful silence” |
| Tactile Pressure | Sufficient to engage microswitch; below bezel-cracking threshold |
| Post-Fix Narrative | 100% attribution to “magic”; 0% explanation of Windows power states |
| Required Fueling | 200mg Caffeine / 1x hospital cafeteria pizza slice |
The Psychology of Sorcery
The “Magic Finger” is more than a physical act; it is a psychological tool. By labeling a simple power-cycle as “magic,” the BMET—often a mentor to new generations of professionals —accomplishes two critical goals:
- De-escalation: It uses humor to break the tension of high-stress surgical and anesthesia environments.
- The Mystique: By knowing the difference between shutdown and logoff and how to find the physical PC in the video integration systems rack, the BMET mitigates a serious disruption of clinical workflow. This reinforces clinicians’ understanding that the BMET team is a mission-critical group within the surgical services division and assures them that the BMET team is there when needed for problems both large and small.
Maintenance of the Illusion
While we spend our careers mastering Dräger anesthesia systems, surgical video integration, and clinical PC connectivity, we must never forget the human component of the interface. The “Magic Finger” protocol proves that, in the world of biomedical engineering, 90% of the job is fixing the perception of the clinician, and 10% is repairing the technology, all while maintaining the professional illusion of sorcery.
The ultimate metric of success for a service call isn’t just the “on” light—it is the atmosphere of the room. When you can exit the OR saying, “Happy Friday, everyone,” and leave a clinical staff smiling and amused, you have done more than fix a PC. You have reinforced the BMET as a trusted, calming presence in the chaos of modern medicine.
In the end, the “Magic Finger” isn’t about the fix itself. It’s about how the fix is delivered—using humor, confidence, and bedside manner to restore not just functionality, but trust.
Disclaimer: The “Magic Finger” ability is non-transferable. Attempting this miracle without a CBET certification and a faded pair of scrubs may result in “user error” loops and increased downtime.
About the Author: J. Scot Mackeil, CBET, is a senior biomedical equipment technician at Mass General Hospital in Boston with over 45 years of experience. He is a 2018 GE/AAMI BMET of the Year recipient and a frequent contributor to HTM publications and symposiums. When deploying his “Magic Finger” in the OR, he specializes in anesthesia, neuromonitoring, and advancing Right to Repair legislation.
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