Phil Agre, writing on the The Red Rock Eater News Service mailing list in 1996:

Computer people are fine human beings, but they do a lot of harm in the ways they “help” other people with their computer problems. Now that we’re trying to get everyone online, I thought it might be helpful to write down everything I’ve been taught about helping people use computers.

Agre goes on to list fourteen hard thuths about people with computer problems. I agree with them all and I couldn’t help notice how they echoed my day-to-day work in the hospital. I’m a doctor and a computer nerd, so I have helped people both by resetting their heart and by resetting their NVRAM (though not at the same time).

These are Agre’s fourteen hard truths about tech support, adapted for the modern doctor:

1. Nobody is born knowing this stuff.
2. You’ve forgotten what it’s like to be a beginner.
3. If it’s not obvious to them, it’s not obvious.
4. A computer hospital admission is a means to an end. The person you’re helping probably cares mostly about the end. This is reasonable.
5. Their knowledge of the computer their body is grounded in what they can do and see — “when I do this, it does that”. They need to develop a deeper understanding, but this can only happen slowly — and not through abstract theory but through the real, concrete situations they encounter in their work life.
6. Beginners face a language problem: they can’t ask questions because they don’t know what the words mean, they can’t know what the words mean until they can successfully use the system understand their illness, and they can’t successfully use the system understand their illness because they can’t ask questions.
7. You are the voice of authority. Your words can wound.
8. Computers Hospitals often present their users patients with textual messages, but the users patients often don’t read them.
9. By the time they ask you for help, they’ve probably tried several things. As a result, their computer body might be in a strange state. This is natural.
10. They might be afraid that you’re going to blame them for the problem.
11. The best way to learn is through apprenticeship — that is, by doing some real task together with someone who has a different set of skills.
12. Your primary goal is not to solve their problem. Your primary goal is to help them become one notch more capable of solving their problem on their own. So it’s okay if they take notes.
13. Most user interfaces systems in the hospital are terrible. When people make mistakes it’s usually the fault of the interface system. You’ve forgotten how many ways you’ve learned to adapt to bad interfaces systems.
14. Knowledge lives in communities, not individuals. A computer user person who’s part of a community of computer users people will have an easier time than one who isn’t.

I think it’s humbling to see that half of them required no changes at all.