>A Fine Line II

>I’ve been on the road 5 hours in the past 24 going to and from an interview, so I’ve had some idle time to think things over as I drove home and these were some of the ideas swimming around my head


I realized that as I walked into the ED today for my interview, there was a large sign on the door, in big block 1 foot high letters, “SAFE HAVEN”. Is that not what we strive to provide for all our patients? Not just new mothers and their unwanted newborns, not just well behaved, well mannered, the sober, well dressed and clean smelling patients?


I don’t plan to make responding to comments in a post a regular habit, but I think this whole thing is a discussion worth continuing, and I’m glad its generated a few comments, even if they don’t agree with what I have to say.
(comments from the previous post)

“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.”





I may be a medical student but I’m not wet behind the ears by any stretch. I took several years off  between college and med school, many of them serving in law enforcement, so to say I have no idea what the public is like would be an inaccurate statement. I know first hand how frustrating the type of patients described above can be. My 31 years of life experience let me know most people are not cruel and mean by nature. Perhaps they were harmed in their past, abused or neglected, or maybe they drink because they can’t  face their problems, perhaps they take drugs because they never had the chance to develop the ability to cope, maybe they yell because they are frustrated, or they smell bad because they don’t have the capacity to care for themselves.


But as you point out, I don’t have the experience working in the E.D. that some of the other writers do, but in a way, maybe that makes me more like a patient than like a provider, so maybe if I am finding some of the things being said a breach of trust, maybe our patients are too. All I am asking is that people think about the impact the things we are writing about may have on others.


“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 not that simple. We’re not just blogging about cookie recipes here, We have a responsibility to those we serve. We’ve taken an oath to protect them, to put their needs before ours. Further, we as physicians are a community, together we work to serve the greater good, so what others say and do is important to me. In fact, I think we should all at least occasionally read and listen to things we don’t like to hear, both in medicine and in life as it’s important to challenge ourselves, hear what the other side has to say, and to be made to think critically. 




“Its really not cool to quote another bloggers post and criticize them.” 


While you think it may not be cool to quote another bloggers post and criticize them, I think it would be less cool to stand by mute when you feel something should be said. I’m not critizing ERstoryteller, he’s a great writer, and clearly cares about his patients, his job and his family. This is not about him, its about all of us. Even great, stand up people occasionally make mistakes, they occasionally say something perhaps they should not have.  I think this was one of those occasions. But maybe I am wrong. The rest of the blogosphere is welcome to disagree. I hope its clear that I not trying to call the author out individually, but unfortunately I am using his post as an example of what I am frequently seeing in the blogosphere, and I don’t think its right, and I think something needs to be said.


Basically, after much mulling and marinating,  I think it all boils down to this. I know when talking about patients we all do our best to make it anonymous. But what if it wasn’t anonymous. What if the patient was sent a copy of what we wrote and it had their name stamped on it. Would they be upset by what we wrote? Would the patient lose faith in us? Would they feel violated if they knew what we had said about them? If the answer is yes, then I think we need to think twice about saying it somewhere that is 100% open like the internet, regardless of how anonymous it is. Patients and the public will see and know that we are talking about them in a disparaging manner. Saying something or telling a story to your colleagues in the break room, or over a beer after a hard shift is one thing, I totally understand and support us all blowing off some steam. I bitch and moan about the things that drive me crazy just like everyone does. We just need to watch where and when we do it. There are ears and eyes listening, even if they don’t belong to the patient you are talking about. If you wouldn’t say it in a crowded elevator, don’t say it here on the worlds largest public elevator either.


I welcome any additional feedback and perspectives on this.

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 17, 2011, in Blogs, Emergency Medicine. Bookmark the permalink. 3 Comments.

  1. >I have 30 years experience working in an ED setting and I find your comments thoughtful and refreshing .The fact that a younger person starting out in this field is motivated to consider issues beyond self interest and to reflect on patient related issues beyond their concrete physical needs is very impressive .

  2. >Thanks for your kind words!

  3. >I agree with your thoughts on his post. His statement to the nurse who reminded him that it could have been his sister, "um…no" just shows ignorance to the fact that at some point in life EACH one of us has made a bad choice. Some of us have been lucky enough to receive grace and compassion in those times, and others of us have been punished or ridiculed in those times. Or ended up as blog fodder, I suppose. I have spent more of the past 10 years inside an ED than outside and I use my levels of compassion as a gauge to know when it is time to take a break, do a contract somewhere else, or work a little less. Maybe he's just burnt. I (like many of my colleagues) use humor and/or venting on my blog to get through, so I am not faulting his post for that. But in-line with what was said earlier–if I thought that details about my underwear would show up on a public forum, I'd have much less trust toward the medical system as a whole. It is something to always consider when we post stories about our interactions with patients. Good food for thought, Albinoblackbear

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