Doctors and paramedics are among those who still use pagers

Laurie Kellman and Sarah Parvini
| Associated Press Press Agency

The little plastic box that beeped and flashed numbers was a lifeline for Laurie Dove in 1993. Pregnant with her first child and home outside any town in rural Kansas, Dove used the small black device to keep in touch with her husband as he delivered medical supplies. He wore it, too. They had the code.

“When I really needed something, I would text ‘9-1-1.’ It meant anything from, ‘I’m about to go into labor’ to, ‘I really need to get in touch with you,’” she recalls. “That was our version of texting. I was as nervous as a long-tailed cat in a room full of rockers. That was important.”

Pagers and all they symbolized — a connection to each other or, in the 1980s, to drugs — went the way of answering machines decades ago when smartphones erased them from popular culture. They resurfaced in tragic form Tuesday when thousands of pagers exploded simultaneously in Lebanon, killing at least a dozen people and wounding thousands in a mysterious, multiday attack as Israel declared a new phase in its war with Hezbollah.

Many of the photos show traces of blood where pagers are typically clipped — on a belt, in a pocket, near the hand — a graphic reminder of how intimately people still hold these devices and how connected they are — or vulnerable to the attacks they involve.

Then, as now—though in much smaller numbers—pagers are used precisely because they’re old-fashioned. They run on batteries and radio waves, making them immune to Wi-Fi dead zones, cell phone-free basements, hacking, and catastrophic network outages like those during the Sept. 11, 2001, attacks.

Some health care workers and first responders prefer pagers to cell phones, or use them in combination. They are useful for workers in remote locations, such as oil rigs and mines. Busy restaurants also use them, handing customers flashing, hockey-puck-like devices that vibrate when a table is ready.

For those wary of data collection, pagers are attractive because they offer no way to track users.

“A mobile phone at the end of the day is like a computer you carry around with you, and a pager is a fraction of that complexity,” said Bharat Mistry, CTO of U.K.-based cybersecurity software company Trend Micro. “People who use it now want to maintain their privacy… You don’t want to be tracked, but you want to be connected.”

Pagers were the first version of the “always on” device

From the very beginning, people have viewed pagers with mixed feelings and an irritating feeling of having to call them when someone else is convenient.

Inventor Al Gross, considered by some to be the “founding father” of wireless communication, patented the pager in 1949, intending to make it available to doctors. But they, he said, balked at the prospect of being on call 24/7.

“The doctors didn’t want anything to do with it because it might interfere with their golf game or it might interfere with the patient’s work,” Gross said in a video recording he received when he received the Lemelson-MIT Lifetime Achievement Award in 2000. “So it didn’t have the success I expected when it was first introduced. But that changed later.”

By the 1980s, millions of Americans reportedly used pagers. The devices were status symbols—signals clipped to belts that the wearer was important enough to be on call at all times. By the 1990s, they were being worn by doctors, lawyers, movie stars, and journalists. In 1989, Sir Mix-a-Lot wrote a song about them, rapping, “Beep diddy beep, I’ll call you maybe.”

By then, pagers were also becoming associated with drug dealers, and schools were cracking down on them. More than 50 school districts, from San Diego to Syracuse, N.Y., banned them from schools, saying they hindered teen drug use, The New York Times reported in 1988. Michigan banned the devices from schools statewide.

“How can we expect students to just say no to drugs when we allow them to wear the most dominant symbol of the drug trade on their belts,” James Fleming, assistant superintendent of public schools in Dade County, Florida, was quoted as saying.

According to telecommunications company Spok, more than 60 million pagers were in use in the mid-1990s.

Dove, who became the mayor of Valley Center, Kansas, and an author, says she and her family now use cell phones. But that means accepting the risk of identity theft. In some ways, she fondly remembers the simplicity of pagers.

“I worry about that,” he says. “But that risk seems like a part of life now.”

The pager market today is small but solid

It’s hard to pinpoint the number of pagers in the world. But more than 80% of Spok’s pager business is in healthcare, with about 750,000 subscribers in large hospital systems, according to Vincent Kelly, the company’s CEO.

“When there’s an emergency, their phones don’t always work,” Kelly said, adding that pager signals are often stronger than cellphone signals in hospitals with thick walls or concrete basements. Cellular networks “are not designed to handle every subscriber trying to call at the same time or send a message at the same time.”

Members of Iranian-backed Hezbollah on Israel’s northern border have been communicating by pager for years. In February, the group’s leader, Hassan Nasrallah, ordered Hezbollah members to get rid of their cellphones to avoid what he sees as sophisticated Israeli surveillance of Lebanese cellphone networks.

Tuesday’s attack appeared to be an elaborate Israeli operation against Hezbollah. But the widespread use of pagers in Lebanon meant the detonations claimed a huge civilian toll, detonating in the blink of an eye across the landscape of everyday life — including homes, cars, grocery stores and cafes.

Kelly says first responders and large manufacturers also use pagers. Manufacturers have employees use the devices on factory floors to prevent them from taking pictures.

Most medical staff use pagers, chat rooms, instant messaging services, and other services to communicate with patients without revealing their home numbers—an attempt to truly disconnect from their responsibilities when they’re not working.

Dr. Christopher Peabody, an emergency room physician at San Francisco General Hospital, uses pagers every day—albeit reluctantly. “We’ve been on a crusade to get rid of pagers, and we’ve failed miserably,” said Peabody, who is also director of the UCSF Acute Care Innovation Center.

Peabody said he and other hospital workers tested the new system and “the pager won”: Doctors stopped responding to two-way text messages and only answered pagers.

In a way, Peabody understands the resistance. Pagers provide a certain autonomy. Two-way communication, on the other hand, carries with it the expectation of an immediate response and can provide an avenue for follow-up questions.

Peabody said the problem is that paging is a one-way communication, and providers can’t communicate back and forth through the paging system. The technology, he said, is inefficient. And paging systems aren’t necessarily secure, a critical issue in an industry that must keep patient information private.

“This has been the culture of medicine for many, many years,” he said, “and the pager is likely to be with us for a long time.”

Parvini reported from Los Angeles.