Sunday, 13 February 2011

Confidentiality Revisited

It's tough, you know. However hard I try, whatever I do to maintain confidentiality, events continue to conspire against me. People know people. My community is small, and my patients have family. Family have friends. And the friends read my blog. No matter what I do to try and change the facts, the facts are still there, in some form or other. And that means I am taking a risk, every time I write. For every one of you who lives so far away that the stories are just stories, there is another of you for whom these stories are ever so real.

And what does it matter? Well, I try so hard to include only enough reality to make the stories real to you, Constant Reader. I ensure that any medical information is couched in such terms as to negate the breach of confidentiality that these tales perform.

But, what if it were your kith or kin that were written about? What if you knew that what was written was at best inaccurate, and at worst a fabrication, would that matter to you? I am, on occasions, a little irreverent. How might it feel to you, reading that, at least I had gained a pair of scissors while attending to your loved one, injured so badly in a car accident that he lies between life and death on a hospital bed?

I don't know the answers to these questions. Maybe soon I will. Maybe the family of the lady I wrote about in "Scissors" will tell me. And, maybe, their words will bring this blog to an end.

You see, I write how I feel. And I cannot change the way I feel. Without the humour, the irreverence, I would not be able to cope with the endless sea of nameless faces.

To all of you out there, to all the families of those I have saved and those I haven't; please forgive my breaches, my fabrications and my irreverence. The patient is always first and uppermost in my mind, both at the roadside and at the keyboard. If you cannot forgive, then please try to understand.


  1. I think that you're unfortunate in that you stand out from the crowd, and it's still relatively rare to have a basics doc turn up, so the chances of someone recognising a case or patient is higher.
    If you change the details too much, it becomes a complete work of fiction, rather than being a series of facts, wrapped amongst your own inner-monologue, and emotions. I've always had the sensation from all of the service bloggers that their blog is a way of releasing some tension, and emotions, almost laying to rest some of the memories.

    As for having a dark sense of humour, it's almost certainly necessary to have one. If you don't then keeping your own mind intact will become a struggle. It's not being heartless, or emotionless, far from it. Without it or an equivalent, you'd be reduced to a blubbering wreck and be of no use to anybody.

    Whether I would be happy for one of my family to appear as a blog post? It's difficult to say, I'd like to say "yes, of course" instantly, but nobody can know how they would react until they're in that situation. I think it would depend at least in part on the outcome of the situation.
    Recognising a story about someone may not necessarily be a bad thing, and it may well form part of the closure process to them, as well as offering a personal connection to someone who was there at the time.

  2. As for me and mine, if our story can be of use in educating or moving others, I would encourage you and other bloggers to keep it up!

  3. If ever I were in an accident, or similar, I would want everyone and their dog to know about the people who saved (or tried to save) me. In fact, I shall make a point to tell my nearest and dearest this wish.

    Bad things happen, and people deal with it in different ways. I'm one that uses humour, so I can definitely relate to the scissors!

  4. I have been asked by film crews before if I am willing to be filmed, I have refused due to people reconising me in the street and how I appear to the people watching. However I have been a subject of a blog post of a Doctor who has treatment me and only I and my dearest people worked out it was me. However I didnt have a problem with this as I feel blogs provide the real stories not the edited soft versions you get on tv and can be used as a learning tool for people. Yes some people would object however I beleive most people wouldnt if most of the information contecting them to the post is romoved which I believe you do. Only the family seem to work it out not the general public, they know what happened anyway so they arent learning much new.

  5. I like to think that it should be out there. If one sentence stops somebody doing something stupid, or prompts someone to get CPR training, then every detail would be worth it. I don't know how I would react if it was about people I loved. I am blessed to be an anonymous reader from the other side of the world.

    I check your blog every few days, and it is the dark humour, the shift in veiwpoint that keeps me coming back. Details are the same the world over, but sometimes to get me through I focus on the scissors too. Thankyou, Ashley