Cell-Phone Ring Tones: A Cautionary Tale

Just this past week I was doing some home visits for my local visiting nurse agency. Three out of four visits were for psychiatric patients who live on their own and need daily visits to monitor their medication compliance. I've been doing this sort of thing for years, so I always know what to expect, more or less.

While I was visiting my second patient, we sat at his kitchen table as I prefilled his medication box for the upcoming four days. We chatted about the weather, his apartment, his general health, and his family. It was a normal visit with a paranoid schizophrenic, and our rapport was comfortable despite the fact that we had never met before.

Halfway through filling his medication box, my cell phone rang. Unfortunately, I had not set my phone on silent and the sound of the phone's ringing filled the air. Now, I am not one to download a new ring tone from the Internet every week like some people seem to do. In fact, when I received this phone earlier this year, the pre-programmed ring tones were so annoying, I searched for something in earnest that I could embrace as my own. Eschewing all mechanical sounds, I opted at the time for the sound of a galloping horse (paying $1.99 for the privilege of its use) and have had that ring tone ever since.

Enter the psychiatric home visit. Perhaps you see what's coming.....

As my phone rang a third time, my patient----who suffers from paranoid schizophrenia with auditory and visual hallucinations---began looking around the room in order to identify the origin of the sounds of the galloping horse. Seeing that he was not answering my most recent question due to this new distraction, I realized that he was likely experiencing my phone ringing as a psychological phenomenon, his eyes darting around the room nervously as the ringing continued. Struggling to extract the phone from my pocket, I hurriedly opened it, turned it to silent, and apologized profusely for the rude interruption. He looked at me perplexed.

"That sound of the horses you just heard----I heard it too," I said. "It's actually my phone. I downloaded that ring-tone. I'm so sorry if it frightened or confused you."

He looked at me blankly for a moment and then a look of realization came across his face. "It was your phone? I was hearing your phone?"

"Yeah, it was just my phone. Sorry, again." I smiled weakly.

"OK, OK, no problem." He looked dazed.

"Well, let's finish this med box and I can get out of your hair this morning." I returned to the task at hand with a silent sigh of relief.

He seemed to come around back to his originally clear-eyed self after several minutes, and as I left, I apologized again and closed the door behind me, all the while chastising myself for my negligence in not silencing my phone when my home visits began an hour earlier.

So, nurses and other concerned citizens, movies and cafes are not the only places where the ubiquity of ringing cell phones can alter the trajectory of one's day (and annoy others in the process). I learned an interesting lesson that day, one that can potentially be translated to other professions and life situations. Cell phones may be useful for staying connected with one's friends and family, but they are often intrusive, ill-timed, and in this case, downright disturbing. A cautionary tale, indeed.