the underwear drawer

nonymous

Hey everyone, thanks for all the feedback on the last entry! Lots of good questions and issues, please keep contributing in the comments section if you're inclined. I might as well explain the background a little bit first, because I see no reason not to--at worst, nothing will come from it but it'll provide some interesting topics for future blog posts at least.

A few weeks ago, I got an e-mail from John at Glass Hospital (and an internist at the University of Chicago) who was interested in submitting a proposal for a panel discussion about the role of blogging in medicine at the Iowa Writer's Workshop's annual conference on "Writing and the Art of Medicine." I thought that sounded fun. So we (along with a third medical blogger--I'll not put his name here yet because I'm not sure that he's officially signed on though I hope he will) are working on putting together an abstract to submit. All credit to John who has done most of the research and who has written the first draft of the abstract. I just wanted to see what people would want to hear us talk about if we were to be lucky enough to be invited to present. (Also, I love corn. Corn is Iowa, right? Potatoes? No, wait, that's Idaho, Iowa is corn, definitely corn--I remember that from watching "The West Wing." You know, ethanol, government subsidies, Josh Lyman and whatnot. Sorry, I know a lot about certain things, but social studies is not one of them.)

I'll save some of the topics for later, especially in the event that we actually get to do this panel, but I want to address one thing, and that is the fact that I blog under my real name.

I started blogging way, way before the internet was the pervasive a social media force as it is now. And I started blogging under my real name because it never occurred to me not to. I think I really thought that the majority of people who would be reading my blog would be people I knew in real life, along with a random sprinkling of perverts or weirdos, because who the hell would read the blog of an unknown medical student except for people who somehow felt coerced into it? Obviously this was naive, but this was ten years ago, remember. We didn't know any better.

It's hard for me to say if I would have started blogging un-anonymously (nonymously?) if I started my blog now, in the age of the so-called "blogosphere" and Facebook and YouTube--but the truth is that by the time I realized that people were actually reading this thing, it was kind of too late. Short of shutting down this blog and starting a new pseudonymous one, there was no way to make people un-know who I was. And let's be clear here, that sounds way overly dramatic--I'm not a big-name blogger by any means, nor have I ever really tried to be. (I figured the more people that read this blog the more likely I would be to get in trouble, so I never really did all the blog-promote-y things like networking with other bloggers or linking to this that or the other guy or being super-active in other online venues. I just wanted to share my experiences as a medical student and, later, as a resident. If people wanted to read, fine. If people didn't read--also fine.) But anyway, I started my blog under my own name, and that's how I stayed.

That said, even if I could go back in time and could make the choice again, I don't think that I would blog anonymously. Obviously now it's more convenient for book promotion, but even that aside, I prefer to be out in the open about my life and my blog. I think it keeps you honest. And I think it holds you accountable for what you write. I've seen way too much "anonymous" action out on the internet, and though it is occasionally for good reason (for blogging in medicine I particularly understand the concerns), I've seen way too much craven sniping bullshit to want to be a faceless figure myself. What I put on my blog I want to be able to say to anyone to their face. I don't want anonymity to be an excuse or an alibi for any bad behavior that in which I'd be inclined to indulge--and believe me, I have inclinations towards plenty.

But obviously, blogging "out in the open" produces more restrictions on what I feel comfortable writing about. All of these restrictions are self-imposed. I don't talk about the fact that I have a blog unless people ask me directly (it's not a secret, I just don't want to be the dork blaring to people to OMG READ MY BLOG YOU GUYS!!!!) but I am totally open about the fact that I have one. If patients Google my name, my blog is the first (and second, and third, and fourth) link that pops up. As such, I feel the need to be accountable to my content as well. Long-term readers might notice that for the past, oh, at least five years, I haven't really talked about very much specific in terms of clinical content. Not much about specific patients or specific cases, and certainly any individual stories have been either significantly veiled or at least temporally displaced enough that it would be very difficult to identify anyone in specific. That's just my responsibility, and that's not negotiable.

I have been recognized, but believe me, it's not as glamourous as it sounds, nor is it a common thing. I've been recognized at the hospital, recognized at the supermarket, recognized heaving Cal in his stroller up the subway steps. But it's not a big thing. Usually it boils down to someone asking me, "Don't you write a blog?" or "Didn't you do those comics?" and me acknowledging. And then we move on. Sometimes people e-mail me that they recognized me on the street (this was more common in New York, where people actually walked on the street) but were too embarrassed to come up to me and say hi. You should not be embarrassed. I should be embarrassed, because I have scrub hat-head and am yelling at Mack to stop eating rocks. But you should say hi. (Hi!)

The people in my residency and the people at my current job are well aware that I write online. This has never been a problem for anyone, but I like to think that I have made sure that I write in such a way that no one should be able to have a problem with what I present online. I am well aware that I am representing not just myself, but the practice of medicine, my institution, and my colleagues. As such I hold myself to the same standards that I do at work. Discretion, honesty, and restraint where called for. I hope I've succeeded. I guess you guys will tell me if I fail.

When it comes to blogging about my family, this is well-tread territory for in the "mommy blogger" realm, so I'm not going to rehash too much, but I do talk about my kids and I do post pictures of them, despite what some (in my opinion, the more hysterical amongst us) warn me that this means people are going to kidnap and sodomize my children. Partially this is because my blog is part public, and part personal documentation--I like looking back on old entries, especially about my own kids, look at the pictures, and see how much all of us have changed. And partially, it's all coming back to the honesty piece again. I know that a good portion of people who read this blog are in medicine, and I feel a responsibility to represent my perspective on what it's like to balance a career in medicine and a family. Sometimes it's cute and fun, and sometimes it's tiring and difficult, and I want people to know that, or at least know one perspective.

So anyway, blogging in medicine. It's a big topic, and I'm sure it's only going to get bigger. I would love to hear your thoughts.