Tuesday, March 22, 2011

writ large, small talk

Many of you have noted that I talk about medicine much less than I used to on this blog, and you're all absolutely right. I still talk about medicine generally, of course--ideas and themes and problems in medicine, but except for the book, I would wager that it's probably been a couple of years since I wrote anything appreciable and specific about any particular case or patient experience.

Part of it is because, with the kids and everything else, medicine constitutes a much smaller percentage of my waking thoughts than it did during medical school and early residency. But the other part of it--maybe the main part of it--is now that I'm The Attending Of Record, I am much, much, much more conscious about patient privacy and HIPAA. The last thing I ever want, now that the buck stops with me, is for a patient to Google my name (I always joke that if I'm doing my job right, my patients unfortunately never remember meeting me--but of course some of them do remember, I get nice thank-you cards from some, and there's that unusual and memorable last name that I have) and turn up a story of my blog that, disguised though it may be, is clearly recognizable as them. So I just sort of avoid it altogether. Not that there aren't times I wish I could tell those stories, of course--stories about individual patient interactions are the most moving of all. But in my field and in my scope of interaction it's just not the kind of relationship where I feel like I can ask patients about sharing stories, nor do I feel that those stories are always appropriate to share. I know that it's hard to understand, but there's something extremely intimate about the practice of anesthesia, and bearing witness to a patient's medical care and diagnoses while they're unaware. I just tend to keep more work stuff to myself nowadays is all, and I think that's probably the right way to go.

However, it's not that I don't have things to say about medicine. I think a lot of thinks, you know. Most of them are largely frivolous (see my Twitter feed for the truest evidence--I guess that's true of society in general, where everyone's internal monologue becomes externalized) but some thoughts, if not intelligent, at least bear some insight that comes with time and perspective. And maybe some people are interested in hearing about them.

Anyway, I've been asked to give an additional talk at the Iowa Writer's Conference--thank you to the medical students that suggested this to the conference administrators, I am flattered and I am pleased as punch to fly in a day early to hang out with you all. The title of the talk is, "Humanism: The Radical Notion that Doctors are People, Too" and it touches on some of the more general topics in medicine that I've talked about recently. Anyway, it's going to be a fun talk and I'm going to show some of my comics and we're all going to chat and commiserate and hopefully feel a little better about this crazy life that we somehow signed up for. And if you happen to be in Iowa City Friday April 22nd, I'd sure love it if you'd join us. Conference information is here. And if anyone is still interested in an informal meet-up, I'm thinking that Friday night--check back here for more information and I'll figure out a nice spot that I can walk to and that serves food and perhaps some kind of non-obnoxious booze.


  1. Anonymous9:52 PM

    MS1 med student here in CA. I would LOVE to attend both your talks if it was possible. Is there anyway someone could video record your talks and have them posted on youtube? That would be SO AWESOME!

  2. Maybe you could have them audio-recorded and then we could download them as a podcast?

    I'm sure your talks will be insightful and wonderful. Your blog is still interesting without the patient specifics. It's just different now.

  3. Wow, sounds awesome. I'd definitely love to listen in! And I agree with OMDG - still a great blog, just moving in a different direction.
    Cheers to you,

  4. I'd say transcripts or podcast would be awesome!

  5. Agree with above suggestions... or come make an appearance in Canada!

  6. Both talks will be video recorded, so I'll see if we can get them online. Thanks for the interest!

  7. I am in Boston so definitely can't make it out to Iowa, but I'd love to watch/listen if possible! I...fifth? these suggestions!

  8. I'm really heartened to hear your stance on patient stories. I don't think this has anything to do with HIPPAA or even CYA, but it stems from a basic respect for faith and trust that all of our patients put in our hands (doctors, nurses, techs, etc) when they come to us for care (yes, care, not just "treatment" or "appointments").

    I understand that sometimes they can be sufficiently de-identified so that even the patient themselves would not recognize their own story (in that case I have no problem with it). However, there is a distinct subgroup of medblog stories that I call "S#@! my patients say." Why is it ever ethically permitted to post these stories?

    As a patient (who hasn't been one?) and a medical student, I wish more medbloggers adopted your stance. Thank you.

  9. Anonymous4:41 PM

    I think Michelle does a fine job of making her medical posts about herself and her experiences, not, as DD put so well, "S#@! my patients say". The patients are not the subject. The doctor is. That's the strength of her writing.

  10. Anonymous9:30 PM

    Hi Michelle,
    I'd like to have some version of "the radical notion that doctors are people too" printed on a t-shirt. I'd _love_ to come to your talk - but given that I'm in Australia, it might be a bit challenging. I really hope it's possible for the talk to go online - I'd love to hear it.

    One of my favourite medical writers is Gabriel Weston, an ENT surgeon from the UK. I wonder whether you've come across her book, "Direct Red"? She does a very good job at humanising the junior doctor experience, and so many of her stories struck a chord with me.

    A Doc in Oz