27 January 2008

Identity Leak

I blog anonymously. By which I mean that nowhere on this site do my name or my likeness appear. But I'm not really anonymous. In the early days of the blog, my name appeared on it, and Google's memory is forever. I have been quoted in the media under my real name, with my blog referenced. Once, an enterprising, and fortunately benign, commenter used the limited info I provide, some very good inductive reasoning and Google to figure out my real identity.

All of which is to say that anonymity is a thin veil, too easily pierced. As was learned, with serious consequences, by superb (and much missed) med bloggers such as Barbados Butterfly, Flea, and Trenchdoc. The list of medblogs to abruptly vanish for this or similar reasons is a very long one - too long to properly credit them all. I only highlight the above ones because they were among my favorites and went down more or less simultaneously.

I post this to remind myself and all the other medbloggers out there that you need to be conscious that what you post is no different from what you write in a medical record -- unlikely to come back to haunt you, but as dangerous as a loaded gun should you write the wrong thing and get unlucky. Anonymous or not, there's no escaping responsibility for what you write.

I have had a couple of aspiring medbloggers ask me about this topic, and my advice is this:
Do not count on your pseudonym to shield your real identity. Know that getting outed is a likely probability, increasingly so the longer you keep up the hobby. Never post anything under cover of anonymity that you would not be comfortable putting your name to, or that you wouldn't want your boss or a malpractice attorney reading back to you as you sit on the witness stand. Have a plan for how you will handle it should the question ever arise, and consider immunizing yourself against that contingency by informing your employer in advance of any negative press.

On the plus side, I recently interviewed a resident for a position in our group, and while we were chatting idly, talking shop and telling stories as doctors do, he referred to a post I had written. He didn't know I was the author, and he didn't reference my blog by name. But, damn! He reads my blog!

Ah, fame, you are a harsh taskmistress that we take such risks for you...

12 comments:

Anonymous said...

Thanks for the advice.

Would you happen to have any experience and how to increase one's anonymity(if thats possible)while writing about ones daily life?
By the way, what happened to those that were "caught" with their blogs?

a said...

Thanks for the advice.

Would you happen to have any experience and how to increase one's anonymity(if thats possible)while writing about ones daily life?
By the way, what happened to those that were "caught" with their blogs?

Elizabeth said...

If you didn't see it yet, there was an interview with Flea on New York Personal Injury Blog. I'm sad that he's gone, but he ignored some very specific warnings (both privately and as comments on his blog), from me, Eric, and others.

shadowfax said...

Those whose blogs run afoul of their work most typically are simply ordered to cease. That appears to be what happened to Trenchy and Barb (though I hold out hope for her return). Flea famously wound up settling a malpractice case after being surprised on the stand with his blog. Some, like Fat Doctor and Nurse K go temporarily off-line but later feel safe in resuming the blogs. I recollect some nurses and EMTs who got fired, though details are never clear.

The short answer is that you CANNOT protect your anonymity reliably when blogging. If you don't disclose your name/location/field/work site, of course you're safer, and avoiding any personal references that might be recognizable helps, and you can fictionalize. But the deeper into that you get, the more it constrains your authorial voice and the less compelling your writing will be, the less satisfying it is as a creative endeavor, and the harder it gets to maintain the charade.

So my advice is to accept that blogging is by its nature a public endeavor, keep your name off the blog, be circumspect with the details, and ALWAYS pause a moment before hitting the "PUBLISH" button to reflect, "Do I really want this out there?"

Oh, and never, ever blog drunk.

Nurse K said...

As someone who's been around the medi-blogosphere, I've known your real name for a long time...

I'm not a total asshole, however. Back when I thought other medical bloggers weren't assholes, I used to respond to emails from other bloggers using my real name because I didn't have a blog-specific email, oopsie daisies. Baaaad idea.

shadowfax said...

Well, geez, K, I can't imagine who you might be referring to. I wonder whatever happened to good ol' N-0.01?

Nurse K said...

The Speaker went here for a bit...She's needs a psych consult. Badly. Very, very, very badly.

johnny urologist said...

It's interesting that you should write this post now. I have been wondering since your St. Baldrick's entry ("I shave my head and post the pictures here for all the world to see.") whether you were preparing to "out" yourself officially, or whether photoshop would still keep us from gazing into your innocent, doe-like eyes while admiring your shiny pate...
--j

JimII said...

Also, you might have some clueless friend from college who does not notice that 1) you never use your name and 2) everytime he uses your name on a post it gets deleted.

Hypothetically.

Febrifuge said...

Indeed... and you might find that until you feel like you see a volume of patients that's sufficient to obscure the who, what, and when, you wind up talking about medicine less and less, and movies and TV more.

And then you run out of time for movies and TV, so your poor blog winds up sitting there sadly.

litbrit said...

I've read this blog for a while now, having discovered it, oddly enough, while searching for violin solos as opposed to medical information, which I also research and read like mad. So for me, finding Movin' Meat was a double bonus (thank you, Google, O God of Us Agnostics Whose Existence is About Light, Who Is All-powerful and All-knowing, and Who Brings So Many Like-minded and Interesting People Together).

Anyway, you do strike a good balance here, Dr. SF, as I've never read any stories about which I would have been upset were I the patient in question.

Well, maybe the one about the woman who was embarrassed for not having shaved. It did inspire me to remember to pick up razor blades, though. (And I don't mean that in the bad way.)

scalpel said...

Don't blog from work. Don't comment on other people's blogs from work. Don't read your blog at work. Don't tell your co-workers you blog. Don't blog about famous events. Alter significant details about your clinical cases, and don't post about cases in real-time. Give cases some time to marinate before posting about them.