LOS ANGELES, CA – Cliff Kershaw of UCLA Medical Center etched his way into the record books early this morning as he wrote the fiscal year’s first perfect note. The southpaw orthopedic surgeon not only defeated his patient’s left femoral neck fracture with a successful operation free of complications, but also completed his medical progress note without the use of words, including the total omission of nouns and verbs.
“It’s truly surreal,” Kershaw shouted, celebrating with his teammates. “I just wanted to write a quick note, move on with my workday. To go out there, in front of all my fans, and write a note like that, it’s a dream come true.”
Several other surgeons in medical history have written no-worders, but Kershaw’s perfect SOAP note is the first one this year. It is also Kershaw’s first career perfect note. He has consistently displayed the potential for writing a wordless note, in fact completing three short one-worders earlier this year: “Stable” in May, “OK” in June, and “Worse” in July.
The last perfect no-word note was written by Jacob Zimmermann at Georgetown’s University Hospital last season, when he simply wrote “D/C” on a patient’s chart. Zimmermann’s masterpiece remains the most concise and efficient note in medical and surgical documentation history, totaling two letters, a slash, and zero words.
Zimmermann scrubbed out of the OR to call Kershaw and congratulate him on the feat.
“It’s an exclusive club you’re in,” Zimmermann told Kershaw. “Congratulations and definitely enjoy it while you can!”
Kershaw simply dominated the progress note from the get-go despite suboptimal conditions of poor lighting and a splotchy pen. He left pronouns, nouns, verbs, and prepositions in the dust, and displayed his complete mastery of abbreviations, acronyms, the no symbol (Ø), shorthand, commas, slashes, and numbers, all the while walking the fine line between legibility and illegibility. It was a true masterpiece and one that can be appreciated whether or not you’re a fan of Kershaw.
“When I retire, I’ll look back, reread my note, and relive this day,” Kershaw commented, signing autographs, white coats, and babies. “It’s pretty unbelievable.”
“Wow, I’m amazed and really jealous,” said Tom Lincecum with infectious diseases at UCLA Medical Center. “My average ID progress note contains 5,620 words. Sometimes I have to divide my note into chapters.”
Kershaw’s flawless note reads as follows:
AF/VSS
AAOX3, NAD
RRR, CTAB, NWOB
S/NT/ND/NABS
LLE dsg C/D/I, DP 2+
34 yo M s/p L THA POD1
WBAT LLE
DVT ppx
PT/OT
D/W HMS
D/C SAR vs. HHPT
“The crazy part is that I think I can do better, way better,” joked Kershaw, soaked in champagne. “I can probably shave the note by another ninety percent. Gives me something to shoot for going forward, you know?”
The wordless SOAP note has been retrieved for safekeeping and will likely be enshrined in the Surgery Hall of Fame (SHOF).
