>A Fine Line

>Since writing it, I’ve been thinking more about my New Year’s resolution and what it means to me and what I am going to write about here. But since it’s been on my mind, I’ve also been noticing a lot of what other people are writing out there the medical blogosphere. One post in particular really struck a chord with me in regards to the type of posts I wanted to be careful about. In general, the author of the below blog is an excellent, thoughtful and compassionate writer and physician. But I think a line was crossed in this post. (Full Post)

On their cot, obviously intoxicated, sat a peroxide-blond female, in her mid-twenties, with her head slumped to her right side and her breasts barely contained by her skimpy halter. Her hair was messed, the hairspray she spritzed earlier in the evening unintentionally spiking clumps in all directions. Her face was streaked with tears, darkened trails of waterproof-less mascara collecting at her chin. Drool gathered at her mouth’s angles.

As the nurse removed this patient’s clothing to put her in a gown, we discovered that the patient had on three layers of compression garments around her middle–a spanx, a girdle, followed by another spanx. For those of you not familiar with spanx (and I wasn’t, so the nursing staff kindly informed me), it is a stretchy, spandex-type piece that, after you hold your breath and squeeze yourself into it, acts like a casing to your sausage body. Miraculously, you look thinner and more fit. Without going to the gym or watching your diet. Your difficulty breathing, profuse sweating, and pinched-up, cyanotic face, though, might just be dead-giveaways that you are wearing one.

“Why in God’s name,” Barb continued, not learning her lesson about asking questions from before, “are you wearing three of these? I’ve never seen anything like this.”

“Well, duh,” the patient answered again, “maybe so I can get laid by a guy who likes skinny girls.” I get it–three layers tripled her chances.

I’m assuming that she was assuming that she looked more attractive all squished into her itty-bitty jeans and shirt with the help of her garments, but really? Did she think this situation through? What guy, one who was probably out drinking at the same bar as her, would be able to remove three of these things? Would the effort be worth it? Would his spanx-removal talent have a big payoff? Sober, I doubt any guy would be able to succeed in getting this patient out of her spanx, but throw some drinks into the equation and what do you have? Besides the fumbling, frustrated fingers of her date? Failure, through and through. 

Finally, though, my biggest shock of the evening came from what the nurse shared with me. It seems that as the tech and nurse finished undressing the patient for observation, they were unpleasantly surprised to find this patient and all her southern female parts barely covered by her thong underwear.

Her American flag thong underwear!!! Three square inches of red, white, and blue fabric.

I was never less proud to be an American…

Is this inappropriate to write about? I feel like it is and I’ll try to explain why. While these types of posts are entertaining to tell and read, and details are changed to protect identity, I sometimes wonder what happens when members outside our community read such postings? For example, I showed the above post to V and her response was along the lines of “If I have to worry in the slightest that something I saw or share with my doctor, or god forbid what kind of underwear I have on, might end up as fodder for an internet post, you can bet that I’ll never share anything with them again” And I think she’s right. Even if the women above was completely shitfaced, acting like a total ass, I think its unprofessional to talk about it in such a forum as the internet. I know black humor is part of the job, and I’m not saying we need to get rid of that. I’m guilty of it myself and we all need a way to blow off steam, but a 100% open to the world forum such as a blog, is not the place for us in the medical community to do it. 

As a reminder, from the oath we all took (or are going to shortly in my case)…

“Whatever, in connection with my profession service, or not in connection with it, I see or hear, in the life of men, which out not to be spoken abroad, I will divulge, as reckoning that all such should be kept secret. Those things which are sacred, are to be imparted only to sacred person; and it is not lawful to impart them to the profane until they have been initiated into the mysteries of the science”

I’m sure your hospital has those same signs in the elevator that mine does. “Please do not discuss patient details in the elevelator.” If someone overheard two doctors having a conversation similar to the one above in the elevator, what do you think their reaction would be? Would anyone find it egregious? Would anyone actually argue that it was acceptable and profession behavior. I don’t care if patient details were changed or not, I personally find it disconcerning to discuss a patient in a derogatory way such as above, in the world’s largest elevator, the internet. Blowing off steam to colleagues in a private environment is one thing, posting your vent for anyone with an internet connection to see is another.  

What do you think? Is this even a discussion worth having? What should I do about it? 

About ER Jedi

I’m a resident doctor in Emergency Medicine and I’ve learned during the past few years that 1) I’ve had some pretty amazing experiences 2) I have a very bad short-term memory. So this blog is just a place for me to write about some of these experiences, from the ER, medical school, the wards and life in general. At least that way I’ll have some idea as to where I’ve been all this time. A scrap-book of sorts, a place to vent, organize some clinical tools and post a few good songs I’ve heard along the way.

Posted on January 16, 2011, in Blogs, Emergency Medicine. Bookmark the permalink. 6 Comments.

  1. >i read that post and commented how sad it was that the girl got that drunk. Something(s) must be really wrong in her life. So many commenters thought it was funny. i didn't.

  2. >i think it was okay to post it, obviously no names were given out…on the other hand…were this girl to read the blog and recognize herself…what would the reprocussions be? Highly improbably she would read, however, you never know….

  3. >Your objection is perfectly valid .In a somewhat related matter there is now a new standard that applies to case publications in the psychiatric literature .In the past these reports had to disguise patient's identity.Now in addition to this the patient also has to give formal agreement to the publication.It's all part of a general process of heightening awareness of the need to address patients' rights in a different manner than the patronizing one that prevailed in the past .Keep up the good work .

  4. >@Tracy Thanks for commenting!My concern is more than whether or not she will recognize herself. Rather, its our job, especially as ER workers, to take people at their worst and not pass judgement (at least no openly). People have to trust that we will accept them and treat them with respect regardless of what ever embarrassing trait may be afflicting them, thong under wear or otherwise. In my opinion, posts like that one, even though patient identity is protected, violate that unspoken trust, or at the very least, plant a seed of doubt. And my little rant is not against the author. I'm just trying to make people aware of the things we might sometimes say. Somebody had to point this out to me after I said some things I probably shouldn't have in a situation I probably shouldn't have. I'm glad they did because I'm a better person and (future) physician for it.

  5. >I think that you should decide what you write about and others should decide what they write about. If you don't like what others write don't read them. You are being judgemental. Its their blog not yours. Its really not cool to quote another bloggers post and criticize them. As a medical student who has never really practiced medicine and you have no idea what health care and the public are like. Perhaps you should withhold judgement until you actually get out there.

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