* * Anonymous Doc: Oh, of course, it's... you!

Friday, February 17, 2012

Oh, of course, it's... you!

"Hello, Ms. Patient. It's good to meet you."

"Meet me? I know you. You're my doctor."

"No, I don't think so."

"Sure you are. I've been trying to make another appointment with you for months. I call the clinic and request you specifically, every time. I've referred two friends here to you also. I've been telling everyone how terrific you are."


"Yeah, you don't remember? I had untreated syphilis..."

"Um... that doesn't necessarily narrow it down. But, uh, sure. I'm glad you had such a positive feeling about our one appointment."


"Oh. Wow. Let me take a quick look at your chart. Hmmm. Those do indeed seem to be my notes. I'm sure it'll all come back to me as soon as I read through... no... no, nothing's seeming too familiar...."

"So you really don't remember me?"

"I think I should probably say I do."

"It's okay, I understand."

"And you haven't changed anything about your appearance since I last saw you?"

"Uh, no... I don't think so... oh, except now I'm dressing as a woman."

"You've had a sex change...???"

"No, I was just kidding. You just don't remember me, do you?"

"I'm sorry. I don't."

"I may stop referring my friends to you, if that's okay."

"No, I understand."


  1. I came across this blog recently after a colleague brought it to my attention. For context purposes, I'm an orthopedic surgeon at a university hospital located in a major city.

    While I appreciate your candor and effort to detail the nature of your profession along with system and atmosphere of the hospital where you work, I find your accounts to be a form of bashing everyone in your field---patients, colleagues, even staff.

    Look, I get it, residency is tough. The hours suck, pay isn't great, sometimes you are forced to work with people who may not seem as competent as you yourself would like, and yes, there is a great deal of drudgery and administrative bullshit you have to put up with from time to time.

    I've had a chance to browse through your postings, from the year you started, and it seems that the vast majority of your writings contain contempt and frustration with not only your patients but your fellow colleagues as well.

    I understand that you are a stranger, you might be using this as a kind of way to blow off steam in the form of dark humor, and perhaps there was a valid reason why you were upset at a fellow resident that day, annoyed by a medical student on this day, etc.

    It appears that no one is spared your vitriol, not even the hospital interpreter or the janitor.

    I understand every hospital is different and receives a certain kind of demographic depending on its region. I take it that a majority of your case load is probably "unremarkable" in that there are no serious health issues and treatment can be administered easily.

    But for those cases that you mention to be blog-worthy, you characterize your patients and their families as idiotic, insane, selfish, unreasonable, uncooperative, or demanding. Sometimes, they are all combined.

    Do I doubt you? No, because I've had my share of a few difficult patients too and yes, I got frustrated with them as well. But I did not go around the internet under the guise of total anonymity to complain on a daily basis about how simple-minded, insipid, or maddening these individuals are in your encounters. It's unprofessional. This does nothing but lessen our credibility as physicians and indirectly encourage others to reinforce any previous misgivings they may have about healthcare providers.

    The public is already disturbed by the current political situation regarding healthcare and hold less-than-favorable opinions of providers such as ourselves.

    Our goal is to help improve the quality of life and the patient's health is our primary interest but how can others believe this to be true when we have doctors like you constantly expressing how your patients lack the wits to follow your recommendation or that they are constantly demanding your attention.

    Even if this particular patient of yours was disappointed at your failure to recognize her, do you think any patient, who did know you and about this blog, would be receptive to coming to you for treatment after reading what you wrote?

    If you think that your hospital could be run more efficiently or your department could use some changes that you think would beneficial, make your observations known to someone who can do something about it.

    If you find such dissatisfaction with your current patient demographic then open a practice and market your way through, if that's what you want.

    A crowd of internet strangers isn't going to help you achieve these changes for you so it's up to you. We can only give our musings, opinion, pity, and commiseration.

    In this particular, I have one request and if you don't want to take it, that's fine. For the sake of your team and your patients, don't lash you bitterness out on them. Act with courtesy and empathy.

    Save up your entries for a private journal and delete this internet blog, because trust me, sooner or later, someone is going to recognize this as you.

    1. For context purposes, I am am internist.

      Many of us enjoy this blog. Whatever the reason Anonymous doc has for publishing, it gives him utility. Is this worse for the profession than House of God? The author is recounting events of his life without violating HIPPA or compromising the privacy of his patients in any way. If he tells the truth and it people lose faith in medicine than it was misplaced faith in the first place. No one can fault an individual for observing and writing about facts.

    2. Really? I don't see Anonymous Doc's posts as bashing at all. In fact when reading his/her posts, I've often thought that this is a doctor who is reflective, compassionate, humble, and values thoroughness and good communication. This is a resident who advocates for patients, trainees, and patients' families. This is why I keep reading this blog - it often reminds me of important things is medicine like not to make assumptions. Sometimes Anonymous Doc recounts funny conversations with patients or trainees. I don't see how that is offensive. If these stories mean that Anonymous Doc is teaching trainees not to miss gangrenous toes on diabetic patients, then what's wrong with that? I wonder why Anonymous Doc's writing offended the orthopedic surgeon commenter above... did the writing hit too close to home?
      - A Canadian family doctor

    3. Seriously man, it's just a blog. Lighten up, it's not like this Anondoc guy is doing any harm right?

    4. For context purposes, I have a sense of humor.

      If you don't like his writing, piss off and go somewhere else.

    5. I bet you'd prefer a crappy doctor that doesn't complain, to a good doctor that does, which would make YOU representative of everything that is wrong with this field, or perhaps the world.
      Just sayin'

  2. If you don't enjoy the blog, you don't have to keep reading it.

  3. Don't listen to the hater. Love your blog; don't change a thing!

  4. Anonymous Orthopod:

    Just a tad ironic that you'd call out Anon Doc for "go[ing] around the internet under the guise of total anonymity." I am also an anonymous writer, but I am not calling the kettle black.

    For context, I am a third year medical student with a big, bleeding, liberal heart and a strong commitment to professionalism and compassion. I think you're failing to read between the lines of Anon Doc's posts. This post, for example, is not making fun of his patient. If anything, it's a way to share an embarrassing encounter. I know I would be embarrassed if I didn't recognize a patient like this, and there was absolutely no commentary that this patient was being unreasonable. I've been reading Anon Doc from the beginning and I can tell he cares a whole crap load for his patients and for teaching and for providing quality care and gets frustrated at all the barriers that exist in our society to doing so.


  5. Sorry anonymous orthopod, I agree with Anon Doc's supporters here. Yes, there is a lot of irony/sarcasm ... but I think he also handles these outlandish situations with sensitivity, all things considered. ... Perhaps there is some generational thing going on here as far as how his tone is interpreted . .. I read this as a newly minted med student and find it interesting and in some ways instructional. It helps me brace myself for the coming inanity of the medical training/medical care system. Not even you think he's making any of that up! ... If there is a societal problem with medical care, maybe it is warranted, and going back to the Old Boy's Club protect-your-own model does not seem to me a step in the right direction. ... I think you are entirely well-meaning, and I suspect if you two met you would get along. ... There's always that issue of reading the wrong tone in emails that we've all experienced - and it applies to blogs as well. ... I encourage you to be a daily reader for a while and see if you continue to have the same impression - reading daily is a bit of a different experience. If you do, chime back in when you hear Anon Doc being contemptuous, or whatever. I suspect he will be open to the constructive criticism and I, for one, will be interested in reading your perspective.

  6. Funny that an Orthopod chooses this post to complain. I go to an ortho group and have two docs there. Neither recognize me without looking through my chart (even after several visits and a surgery). Nor do they remember most of what I say.

  7. For context, I am a junior doctor working in the UK. I too blog anonymously about my days in the hospital. Every day the job throws up something entertaining, unusual, frustrating or mundane, and I, as I'm sure all the medical bloggers out there do, find it cathartic to write about them. It also provides an opportunity for others to learn from our experiences.

    None of us is in this profession to get a rise out of our patients or colleagues. Anon Doc's tone has never been condescending or derogatory in all the posts I have read, and most of his/her posts utilise a form of self deprecating humour that makes for an enjoyable read. This is merely publicised reflective practice!

  8. For context purposes (:D), I'm a wee, non-trad premed stilling churning on the path... and I love the blog! Kind of like Dr. Grumpy who articulates his daily humor/sarcasm/wit. This blog lets me know that:

    1) I will someday feel similarly at times
    2) it is normal to feel angry/tired/happy with patients
    3) I am not alone when feeling angry/tired/happy
    4) I will survive and thrive through med school, residency, fellowship, and medical professional life

    What more could you ask from a blog?!

    Keep the stories coming!

  9. I feel like that anon might be the same anon person that left me a comment a few weeks ago that was upsetting. Something about needing to be weeded out, and the comment had not much to do with my actual post. I think someone might be projecting their own feelings and reading way too much into what we are actually writing. I love your blog so I'm going to tell you what others told me, just keep on writing what you want and don't listen too much to one person who isn't seeming to actually read what you wrote.

  10. Just found your blog and love your voice and stories. You can't make this stuff up. Don't change a thing.