Monday, June 7, 2010
To blog or not to be
I've been struggling lately with the raison d'etre of this blog. I tend to write about a variety of topics, usually medically related, but it seems the best posts have been the ones based on actual patient encounters in my practice. And I've been wrestling with the significance of that fact to such an extent that I had to just shut things down for a while.
Blogging is by nature an extraordinarily solipsistic expression of individuality. It isn't enough for the blogger to privately fill notebooks with his ramblings---no, he must publish them to a world wide audience. It takes a certain degree of pompous audacity, let's be honest, to embark on such a task. One has to believe that what one is writing is unique, interesting, important enough to be read by strangers. I've always hated this implication of blogging. To blog is to cry out for attention.
The stakes are much higher for medical bloggers who go beyond writing about healthcare policy and reform. To write about a meaningful patient encounter is to cheapen it somehow. And I have become increasingly uncomfortable with the exploitative, self-aggrandizing solipsism inherent in writing about patients. I grown tired of Myself and the Voice I provide on Buckeye Surgeon. I'm always constructing these narratives where I'm some super-compassionate doctor of mercy, unique in ability to identify those anecdotal moments of human connection. I'm tired of the narrative, the underlying message of I'm a nice guy and a superb clinician that runs through the thread of posts. The blog dangerously veers toward being more about me and my supposed superior compassion and diagnostic acumen rather than about the patients or functioning as some sort of edifying source of inside medical information. It's irritating as hell. I'm a real person, with real shortcomings and faults. I ought to be writing more posts about how I was rude on the telephone late night with some nurse or how I was impatient with a patient's relative because she kept asking the same damn question over and over or the time I made a delayed diagnosis. It wouldn't be such a glowing portrait of me, but at least it would be an honest one. (But then you ask yourself, why do I even need to be painting accurate self portraits for strangers to peruse on the internet? Wouldn't that hurt my career? Isn't it better to concoct some alternative personality that people can read about on line?)
I feel this blog has unintentionally created a Doppelganger Dr Parks who is always kind and wise and decent, who never makes errors, who always sees the little streaks of humanity glimmering under the veil of illness in his patients. I mean I have tried to write honestly about things over the past three years. I wasn't intentionally trying to manipulate facts. But you cant help writing in such a way that makes you look maybe better than what you really were, in retrospect. In the act of writing, I'm able to capture my life and my experiences in such a fashion that I see myself as an agent of good. That isn't a bad thing I suppose. We all have our private little forms of solace as we navigate through unwieldy, unpredictable life. But a blog isn't private. It ends up being a slanted representation of a real person. I can do the same thing and derive the same benefit in a private journal, just perhaps more honestly and with more perspective.
The one good thing about the blog is that its mere existence has forced me to contemplate my life as a surgeon on a more consistent basis. A blog is always starved for material and the experiences I've had have been a fruitful fodder to fill the hungry beast. My reflections on specific encounters have changed me more than the encounters themselves. But I don't want to keep repeating myself. I don't want Buckeye Surgeon to devolve into a bunch of sappy, regurgitated tales from the front lines of the hospital. That's not what this was supposed to be about. It was supposed to transcend its author, a medium through which author and reader alike could possibly make some sense of illness and death and human fallibility.
One thing I've discovered on these travels is this idea that the patients don't so much need me as I need them. The authenticity of a meaningful patient encounter fills some indescribable void in my life (pathetic as that sounds). I need them. I need the 88 year old guy recovering from a perforated bowel surgery who tells me he prayed last night for the first time in 50 years. I need to see the lonesome mother holding the hand of her prodigal son, suffering in the ICU with severe alcohol-induced necrotizing pancreatitis, whispering for him to open his eyes. I need the brash 77 year old Senior Olympian (diskus and hammer throw) recovering from a bowel obstruction who gives me shit every morning about how I played soccer in high school instead of wrestled. But I don't want to exploit them or splash their vulnerability all over some public blog anymore. Conversely, if I dont write about them, I lose them; they slip from the tenuous realm of my active memory. They strike me like those big beautiful snowflakes in early November that quickly melt and dissipate on your sleeve. I want to keep as many of them frozen and crystalline and perfect for as long as I can. I want to be like that kid in the book Snowy Day who hides a snowball in his pocket, hoping it will be there when he wakes in the morning.
I'm not entirely certain what will happen with Buckeye Surgeon. I'm still grappling.