I’ve read a lot of medblogs and non-med blogs that have really made me scratch my head and wonder “did this person *really* want to put this on the intertubes?”
For me, the purpose of blogging is several-fold. Mostly, I think I have a pretty interesting story to tell and I want to tell it. Maybe someone else will want to read it, maybe not, but first and foremost I’m writing for myself. I want to tell the story because in the telling, I’ll create a record of my thoughts, actions and feelings during a pretty tumultuous and thrilling time in my life.
The blog is a place for me to post open, creative and un-inhibited thoughts, memories and recollections that reflect how I feel at any particular moment. It’s a journal. It’s my journal.
However, I’m writing in a medium that will eventually be read by people who know me. I realize that this will inevitably affect aspects of how I write, and that’s not necessarily a bad thing. It motivates me to write more – yes, that’s right. Having readers makes me want to write and makes me feel more accountable to produce somewhat-reasonable thoughts and coherent posts, instead of a rambling internal monologue.
A good quote from Rafael Yglesias (c/o this article) sums it up:
Write what horrifies you, write what charms you, write what repels you, write what you love, write, to be aphoristic, what you cannot stop yourself from writing.
Yes, you will have to find “your voice,” and yes, you will have to learn the craft of writing, which is endlessly demanding and so varied that you will probably never feel you are more than a clumsy student. And don’t limit yourself to study only the craft necessary to produce your particular kind of writing. Also learn how the writers you have contempt for do what they do; you may discover something useful for your work.
But all of those necessary skills are servants to your Lord and Master: write what you cannot stop yourself from thinking about, even if it disgusts everyone you know. Readers read to subsume their consciousness, for a profound but limited time, into another’s. Some want reassurance, some want challenge. Some want pleasant lies, some painful realities. You may be unlucky and be fated to have a small audience. That’s too bad. (By the way, it is the fate of almost every writer.)
Over time, if you work hard and write what obsesses you, there will be readers who will want to live in your peculiar universe, and precisely because what you have provided is rare they will be all the more grateful for your creation.
My compromise is: the blog is not a place for anything that would prevent me from getting a job, scare my mom, or embarrass my dogs.
That means several things, some of which are obvious. Firstly, patients have the legal right not to have their protected health information disclosed. Morally, I am bound to protect their privacy and anonymity. That means that names and details are ALWAYS changed.
Accordingly, I will not post stories about my patients. There are blogs who rely significantly on “shit my patients say.” I think that doing that is breaking the trust and faith that our patients place in us every day. To the extent that interactions with patients affect me, I will write (in a heavily anonymized style) about *my* end of the interaction. Rarely, I might like to write about patients and my experience with them more directly. In that situation, I’ll obtain their consent and indicate that I’ve done so before blogging.
Honestly, this isn’t ethical rocket-science and I am kind of appalled that this stance isn’t more common. Simply changing someone’s name and physical description, then reposting their quote verbatim for the entire interweb to read and mock hardly seems like what we should be doing in this line of work. If you want to quit medicine and go into comedy writing, Hollywood awaits (aside: I know a guy from college who is a comedy writer. It is bitterly hard work. He is both really funny and from an extremely politically-connected family and it still has been a battle for him to break into the industry. He’ll do well, though.).
Secondly, this blog is filtered. That’s a good thing – you don’t want to know what color my scrubs were today or which suit jacket I wore with which shoes. There are other (“med”) blogs that tell that story, and I’m sure they think it’s interesting. Also, I don’t want you to know the deepest inner workings of my mind. Believe it or not, I am a private person. I’m writing because I think its a better way for me to catalog and reflect on my experiences than off-line journalling. That doesn’t mean I will publish everything, or make every post public. When this blog started off, it was private with zero readers. Eventually, I’ll let the training wheels come off, but not before I’m capable of writing the way that I want to.
These are the rules of my blog. I’ll check in on myself from time to time to make sure I’m upholding them, and (if I ever open the blog to other readers) I invite you to remind me of them at your leisure.