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Blogging about patients

Here's another reason I haven't been posting much recently: I haven't quite gotten comfortable with blogging about patients.

It's not a HIPAA thing. I'm not tempted to post anything on my blog that would identify a specific patient, and that shouldn't be surprising. Plenty of great medical bloggers put up interesting posts all the time about the patients they see, and HIPAA's never an issue. See, for example, Dr. Bard-Parker's post about this stabbing victim. I'm hesitating not because of patient confidentiality, but because of my knowledge that the patient himself or herself might sometimes be able to identify themselves if they read my blog. And even though I'm fairly certain that they aren't reading my blog (famous last words, those), I'm still a bit wary of the whole thing. I ask myself: if I were a patient and I read about myself some evening on a doc's blog, what would I think? Well, I personally wouldn't feel upset if I wasn't being mocked in the post, and provided that no one else could tell it was me. But I can imagine that other patients might feel differently.

And that's why I'm not rushing to blog about my shifts in the pediatric ER, or my days and nights in the PICU (yes, my schedule has been peds-heavy so far this year).

Eventually, I'll find the approach that works for me -- the right level of detail, the right amount of historical separation between when I've seen a patient and when I've blogged about what I've seen. But for the time being, I'm not posting a lot about what I've spent most of my time doing. Draining abscesses, stiching up lacs, getting LPs (my first successful one two weeks ago!). I suppose I could blog about the single most time-consuming activity of my residency so far: filling out paperwork. But that'd be boring.

In the meantime, I'll post a part of a poem relevant to hospitals and sickness by one of my favorite authors:

Let him escape hospital and doctor,
the manners and odors of strange places,
the dispassionate skills of experts.

Let him go free of tubes and needles,
public corridors, the surgical white
of life dwindled to poor pain.

Foreseeing the possibility of life without
possibility of joy, let him give it up.

Let him die in one of the old rooms
of his living, no stranger near him.

Let him go in peace out of the bodies
of his life--
flesh and marriage and household.

From the wide vision of his own windows
let him go out of sight; and the final

time and light of his life's place be
last seen before his eyes' slow
opening in the earth.

Let him go like one familiar with the way
into the wooded and tracked and
furrowed hill, his body.
. . . .

--Wendell Berry

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