Phantom vibration syndrome among medical staff: a cross sectional surveyBMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c6914 (Published 15 December 2010) Cite this as: BMJ 2010;341:c6914
All rapid responses
Phantom vibrations, as discussed by Rothberg et al, may indeed be a
psychological occurrence - a subconscious desire or expectation to hear
from someone. However, it would be worth exploring whether the muscles are
responding to electromagnetic emissions that occur when the phone is
making contact with the base station, as implied by Williams in the BMJ
rapid responses. This would be easy to do using a cheap radio set to AM
and carried close to the phone. Analysis of times when 'phantom'
vibrations occur and when radio interference occurs would reveal whether
there is any correlation.
I hypothesise that the muscles are generally able to detect the
emissions from cellphones, but by using the phone on vibrate regularly the
muscles become entrained to respond to that exposure. It may depend upon
the frequency and modulation parameters of the phone in question, which
would account for those who find changing models stops the symptom.
Records of 'sufferers' phone brand and model may reveal this. Changing
storage location would require new muscles to become entrained.
If the symptom stops merely by taking the phone off vibrate, then
perhaps there was a call but the caller hung up.
A remaining question is why do the muscles only respond occasionally?
Competing interests: MR has received travel grants to attend a bioelectromagnetic conference and a scholarship for doctoral study about cellphones
Rothberg et al present results of a survey of the incidence of
phantom pager vibration, but omit data regarding subjects' most recent
meal. I typically wear my pager on my belt near my lower abdomen, and
commonly experience phantom vibrations when I am hungry, a phenomenon I
attribute largely increased gut motility, or "stomach growling." As shown
in this issue, physicians are likely to be poorly hydrated (1), and I
suspect they are likely to be poorly nourished as well, especially the
harder-working medical students and house staff. Finally, the authors
point out that junior clinicians are more likely to experience increased
stress, also associated with increased gastrointestinal motility (2).
(1)Solomon AW et al., Urine output on an intensive care unit: a case-
control study. BMJ2010;341:c6761
(2) Gue M. Effect of Stress on Gastrointestinal Motility. Physiology of
the Gastrointestinal Tract, Fourth Ed. ed. LR Johnson. Academic Press
Competing interests: I almost never set my pager to vibrate.
Is that PVS in your pocket or are you just pleased to see me? PVS has
been known for many years. Some say that it is just a learned response
muscle twitch. It sometimes happens just prior to receiving a call or
message. Or sometimes not.
This suggests that it is linked to a housekeeping "handshaking"
signal that phones make with a cell transmitter. The same signal that
makes an annoying noise on any radio that happens to be switched on
nearby. Older 2G phones seem to cause this more often than a 3G phone.
So can we get a prescription for an upgrade? And how are we receiving the
Competing interests: No competing interests
The simple but instructive survey by Rothberg et al showed that 68%
of medical staff have sensory hallucinations (1). I have experienced
similar sensations when carrying a mobile phone with a vibrate function,
but these disappeared after acquiring a new phone without a vibrate
function. A hallucination is defined as a perception in the absence of a
stimulus and the authors are right to describe these sensations as
hallucinations in the abstract.
The authors suggest mechanisms contributing to these hallucinations
and these can be synthesised through a cognitive formulation. An
emotionally salient stimulus (a vibrating bleep indicating a potential
medical emergency) experienced repeatedly in an aroused state (being on
call) leads to a hypervigilant state where a similar perception is
experienced in the absence of the stimulus. The authors suggest that this
is more likely in junior medical staff, their inexperience possibly
heightening their anxiety that a mistake made in responding to a medical
emergency will have catastrophic consequences. The role of sleep
deprivation, long known to lower the threshold for hallucinatory
experience, is not reported but may contribute.
This formulation can also explain other common hallucinatory
experiences. The lifelong companionship of couples experienced in sensory
terms as repeated stimuli in all modalities leads to significant numbers
of bereaved people feeling, seeing or hearing their loved ones soon after
bereavement (2). This formulation can also help us to understand the
relationship between repeated abusive experiences in childhood and
subsequent derogatory and intrusive voices in adults given a diagnosis of
schizophrenia (3). Acknowledging that 68% of doctors hallucinate and that
"normal brain mechanisms" may be involved in the generation of
hallucinatory experiences can only reduce stigmatising attitudes towards
severe mental illness and improve our attempts to help patients make sense
of distressing and overwhelming experiences.
1 Rothberg MB, Arora A, Hermann J, Kieppel R, St Marie P &
Visintainer P. Phantom vibration syndrome among medical staff. BMJ 2010;
341: 1292-93 (18 December)
2 Rees WD. The Hallucinations of Widowhood. BMJ 1971; 4: 37-41 (2
3 Larkin W, Read J. Childhood Trauma and Psychosis: Evidence,
pathways, and implications. J Postgrad Med 2008; 54: 287-93
Competing interests: No competing interests