Big happenings in the world of medical blogs.

First Barbados Butterfly disappears.  Then Fat doctor is "exposed" by a coworker (or cow-orker, as Dogbert would say).  Finally my dear friend Flea goes AWOL.  You all know the story (if you at all read medblogs).

I understand the situation with Flea (I think).  He is in the middle of a lawsuit, and has actually blogged about details of the suit.  I suspect his lawyer (or Mrs. Flea) saw the fact that this is risky.  Should the contents of his blog become part of the court proceedings, his statements could become a liability.  I hope that once his suit is done (and he has won, hopefully), he will once again be part of the medblog community.  He is sorely missed.

The other two instances are harder for me to grasp.

Yes, these are medical professionals telling about their lives.  Yes, their lives touch on the lives of other people.  Yes, they have a professional responsibility to respect patient confidentiality.  We live with that every day.  I come home to my wife and she asks me "how was your day?"  I learn to live as a normal person, needing to vent, complain, or rant at times about things that I have encountered; yet I also know that my patients have the right to expect that I don't tell others about what they tell me.

That does not mean I don't tell about my day.  It simply means I don't give specifics.  Can I say: "I saw a guy today with appendicitis?"  I think I can.  Can I present the case on my blog?  Again, as long as I don't give specific identifying information, I think it is simply me expressing my freedom of speech.  I do write knowing that my patient could possibly read my blog and read about themselves.  It might just happen one day.  But I won't let my life be run by fear of the opinions of others.

As a medical student and resident, I was warned to not engage in "elevator talk."  It is common for students and residents to discuss their work while walking through the hospital.  If you do so while in the elevator with others standing by you, you don't know who these people are.  They may be related to "that kid on the fourth floor with the rash."  So we avoided this.  I think it is good practice.

Yet one time I think it went too far.  I was called into the office of one of our attendings because the parent of a child was angry at me.  I had made an off-hand comment on the elevator about a certain medication being worthless.  We were just talking shop and doing our usual resident strutting.  Apparently, this parent had felt that the drug that fell under my derision had done wonders for their child.  They were so upset about this that they took down my name and told the attending of my waywardness.  I thought this was ridiculous.  If I had said that I don't like Ford Escorts, would I have been pulled aside and chided because the child was brought to the hospital in a Ford Escort?  I was voicing an opinion.  It is certainly the parent's right to disagree and even get angry, but I have equal right to hold and express my opinion.

I think some people feel it is their job to get offended.  They look for ways to feel pain from innocent statements and then blame the person who made the statement for callousness.  There is nothing wrong with talking about our lives, and even our frustrations with other people.  We need to be sensitive in how we do it, but so does everyone.  I would not talk about my neighbor any more harshly or openly than I do a patient.  It is just plain courtesy.

That is why I am not anonymous.

Revealing my identity makes it harder for me to fall into the "chat room" mentality that uses anonymity as a springboard for behavior that would never happen if my name was known.  What I say, I stand behind.  If I say something offensive, they have the right to challenge me.  If I am wrong, I will say so and make the correction and/or apologize.

My partners know I blog.  My staff knows I blog.  My wife and my Mom know I blog.  If my patients ask, I give them the URL of my blog.  I am me on my blog - faults and all.  Some people out there seem to think that medical professionals aren't just normal people.  Thanks to the "professionally offended," we are losing voices of real people doing hard jobs.

This is ironic, given the popularity of the new book: How Doctors Think.  People want an author to tell them how doctors think, but God forbid that the doctors themselves should say how they think!

Val, you still want to go for that beer?

Clark, I think it is the secularists.

Flea, I am sending my psychic energy in your direction.

Fat Doctor and Barbados Butterfly, your loss is our loss.

It's a crazy world.