Tuesday, October 01, 2013

Ten Crackers

Graham crackers.

For years they have been an on-call snack staple for young doctors in training throughout the United States.  These little morsels have probably saved more lives than defibrillators after hours, especially if they are topped with a hefty dollop of peanut butter.

Admittedly, these flat brown crispy tastees don't contain much nutritional value.  They are probably a dentist's nightmare.  But after many late hours on call well after the dining hall closes, you'd be surprised how good these little devils taste, especially when they can be enjoyed in a quiet reflective moment alone or with a colleague in the nutrition room.  Graham crackers have a way of bringing you back to earth after you've dealt with a code, had to pronounce someone dead, or worked through a difficult family interaction in the wee hours of the morning.

But times are tough for hospitals now: censuses are down (as are revenues) as the uncertain effects of health care reform descend. Consequently, it makes sense for hospitals to trim budgets where they can.  After all, if its between graham crackers or nurses, I'm sure we'd all agree that graham crackers should be trimmed before nursing staff.

But I wonder if supplying an entire ward of fifty patients with only 10 of these little packets a day makes sense for physician and nursing morale.  Doctors and nurses, already dealing with reduced incomes and threatened with even more to come, are finding it harder and harder to find the tiny perks that make the late nights and long weekends tolerable.  Finding none of these hidden snack treasures on a ward after working 15 hours straight certainly isn't the end of the world, but when people are tired and hungry, it's noticed more than any highly-paid administrative decision-maker who's tucked neatly in bed could ever imagine.

Good leaders listen.

Good leaders know the value of small gestures.

But it's only the best of leaders that appreciate the importance of an ample supply of graham crackers.



  1. i think it is important to note that what this sentence ["But times are tough for hospitals now: censuses are down (as are revenues) as the uncertain effects of health care reform descend."] says is that there are less patients within a hospital because of the uncertain effects of healthcare reform.

    if healthcare reform, as you state, is already keeping people healthier then i would think you would applaud that.

    you know what- i think it is ok for doctors and nurses to have to purchase their own snacks and leave the graham crackers for the patients they are intended for.

    there is a surgeon at a hospital in chicago that makes $2.5m a year. have him buy you graham crackers.

    1. It is about humanizing a human.doctors n nurses are human too. U're totally not understand, the condition tht someone is working almost 48 hours in a row, without sleep and food, facing death and misery of others ppl.you're totally don't understand

  2. Gotta say that when I've been on my feet for 8+ hours, without a stop to eat, pee or catch my thoughts and feel like I'm about to pass out, the graham crackers are a lifesaver.

    You, anonymous, have obviously never done a residency.

    I always have an ample supply of crackers, but the patients want the turkey sandwiches. At least in my ED.

  3. Doc, I'm gonna assume you wrote this after a very long day. Please re-read. Then maybe visit a Head Start classroom. Ooops. Sorry. They're closed. Well better yet, a food pantry. You need to get out in the real world.

    I make 50K a year. Every Friday I bring in a box of cookies to share. I'm going to guess you make more than 50K. Bring in your grahams next Friday.

  4. So, it's time to play The Biggest Sacrifice: "I'll take your ED and raise you one Head Start classroom?" How sad.

    I give our nurses and doctors get Dove chocolate. Of course, we have graham crackers, too. I see how hard things can be in their eyes. I hurt for them. I worry, about them. Too many times telling a family that their loved one died wears on you. It does something to the soul. This is the real world.

  5. Your comment about 'unhealthy snacks' may be true in regard to 'fats'. However peanuts are a rich source of protein. An occassional 'blast' of fat yields enormous calories for peak mental or physical energy and the protein, well, you know. I found this link: http://nutritiondata.self.com/facts/legumes-and-legume-products/4357/2 After all you know that peanuts are a legume .


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