Tuesday, March 24, 2015

Should Physicians Write about their Patients?

To survive, you must tell stories.- Umberto Eco

There was a discussion happening on Twitter recently after an article in The Atlantic Monthly by Dr Anna Reisman. As is usual on Twitter, there were many varied opinions. In a Medical Humanities book club that I participate in, the general view amongst the Philosophers was that Physicians ought not to co-opt the patient experience of illness, they felt that in their reading of pieces written by doctors that the tone was sometimes condescending and detracted from an balanced view of the illness experience.

As a doctor, who wants to write, I thought that it is important that one is able to express one's viewpoint as a clinician. Writing is a way of thinking and often, putting things on paper, clarifies situations and cements understanding. Writing is a way of reflecting about our relationship to the larger world around us.

As a means to aiding in a more reflective, self aware practice, I participate in a local medical humanities research group. It is a book club of sorts, where a diverse group of doctors, educators, pscyhologists, philosophers, students meet monthly, during the academic year to read and discuss books, essays, short stories, scholarly articles after dinner. When we have discussed works by physicians, some of the non-medical folks have remarked that the physician- writers can be facetious in talking about their patients and have objected to their viewpoint as being paternalistic, at times. They have felt as if the doctor in his narrative writing has co-opted the patient's illness experience.

I have to admit that I have never felt that my writing has impinged upon the patient's experience of their illness. I have frequently asked my patients if I may write about them and they have always generously agreed. Occasionally, they will look at me quizically, as if to ask, what is so interesting about me? I tell them what I find interesting about them and they seem to accept my explanation. I am conscious of HIPAA and make sure that no one I talk about is identifiable publically. Also, my writing is private, except for erratic blog posts. There is little chance that my patients will read about themselves.

Even so, my writing has therapeutic value for myself and indirectly for my patients, too. When I write about my patients, I am able to deal with my reactions to my work as a hospitalist. My patients are sick, scared and often in the process of dying. By writing about them, I hope to honor their experience and process the thoughts that arise when I am interacting with them. This is my best bulwark against burnout.

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