Infamous Scribblers

SCRIBBLER, n. A professional writer whose views are antagonistic to one's own.

Ambrose Bierce

Andrew Sullivan has some astute reflections on the nature and impact of blogging. Overall the blog, in its personal and omnivorous aspects, seems to have most in common with the essay, but it is so much more visceral and immediate than its print predecessor. A blog post is essentially a micro-essay, and can be either tasteless or witty, graceless or ponderous.

It has always been the case that a physician or therapist has the right to openly share his or her views, not only about the profession, but about politics, literature, or whatever so long as the clinical commitment is not detrimentally affected. Before the Internet this could take the form of letters to the editor, academic or general articles, case reports, etc. No screen of anonymity should prevent a physician or therapist from publishing a memoir or book of poetry, again, so long as the rights and prerogatives of patients are not harmed. As I wrote the other day, it is not for me to question the anonymous blogging of others (the more voices the better), but it makes sense for me to drop the pseudonym.

Any argument that could be made against "open" medical blogging can be equally made against print publication in general. The same potential threats to patient privacy exist in both, and this privacy must be safeguarded above all. To be sure, no patient wants to feel that in seeing a doctor or therapist, he or she may be "merely" grist for the blogging mill, but the same concern could exist for a doctor in the habit of publishing books or articles. So long as privacy is not infringed upon, one can hope that the greater openness and dialogue generated by blogging, as by publication, will more than compensate for any awkwardness that could result from a doctor having a public voice. To be sure, such a public voice encroaches upon the blank screen or white coat of the therapist or doctor, respectively, but this pretended facelessness has been on the wane for a long time now.

So I will write openly, although to reiterate, despite the vaunted ease and casualness of blogging, I will convey only those matters that I would feel comfortable seeing above my name in a newspaper, journal, or book. That is, the matters can still be personal, and all kinds of subjects beyond psychiatry are fair game (with the understanding that in many cases it is personal and not expert opinion that is at issue), but I will not write in any identifiable detail about family, friends, or colleagues; their privacy matters as much as that of patients. In general I think that combining respectfulness with a critical and creative approach is more crucial than the exact medium, whether print or Internet.

I have listed my email in case anyone wishes to comment directly and not openly; as always anonymous comments are welcome, and I would not of course publicize the contents of any emails received. All I ask is that the basic respectfulness I mentioned be mutual.