Sunday, August 28, 2011



The above is G. K. Chesterton, one of whose books I am finishing up. I recommend his writing.

As I've invited readers of Michael Kirsch's blog to wonder over here, I probably should post something every now and then to make the trip worthwhile. I've forbidden myself from posting until I've written a Primer for Patients: Colonoscopy Coding, and perhaps I'll do it today or tomorrow. Michael, you shouldn't have challenged me to do this own my own. I really can't be responsible for what might show up here.

Wednesday, August 17, 2011

Proceding with great peril

In simpler times man would have his need to "hold forth" at a bar or cafe or perhaps even sitting by the campfire. My opinion may not matter much, but by golly I need to express it to whoever might listen. It matters not that anyone actually listens, only that holding forth serves a primal need. Blogs are good for that sort of thing.

A physician blogs with great peril as everything he writes is potentially discoverable. One might know better than to declare that "Wow, there was a colossal blunder at the office, and I sure hope I don't get sued over it". One might, in an unguarded moment, state that, for instance, "Using a hot biopsy forceps is substandard", only to use a hot biopsy forceps and have it generate some complication. Under those circumstances the plaintiff's lawyer need not hire an expert witness; you yourself, along with your blog, will serve quite nicely in that capacity.

Any small business owner, which a solo doctor is, needs to exercise some discretion in his public statements lest he offend some advocacy group and they show up at his office with "boycott" and "protest" signs.

Using a blog as a personal journal is also fraught with danger, unless you're a recluse or independently wealthy and have no concerns over what anyone might think about your state of mind. A patient of mine might not be reassured if I were going through a cataclysmic existential crisis and declared that all thoughts and actions are inconsequential and that no life is fulfilled or can be judged complete until we die. I don't believe that, but if I did it would not be wise to air such angst in a blog which could be read by millions.

The winds of change are blowing through the medical field like an F5 tornado. I might rail against the "corporate takeover of medicine", only to sign on with a corporation next week. It would look bad.

I've worn out my welcome on three forums, two of which were music-oriented and one of which was sports-related. Public forums are not welcoming to conservatives (unless it's a conservative forum), and a writer who is capable of typing out venom will not last long, unless he's a progressive.

No matter. For all the good that most public discussion accomplishes, one might as well air them on a blog and leave it at that. That's what I intend to do.

I will comment on politics, but by intention only in broad and philosophic terms. I'll comment on medicine, but of all the things I could talk about, I am the most uncomfortable discussing medical topics. The more I learn about medicine the less confident I am in expressing an opinion because I truly grasp the depths of my ignorance, unlike religion, music and cycling.

Before I was banned from the Internet Cello Society, I issued a challenge that the politically-oriented members there read Alasdair MacIntyre's "After Virtue". It had been about five years since I had read it, and I suggested that the most relevant chapters were the first three and the final one.

I took up my own challenge and I'm working on my third reading of the book. My recollection was correct. All of the book is an excellent read, but the first three chapters state our dismal state of affairs better than anything else I've come across. If I might offer an extended quote from the end of the third chapter:

[Political] debates are often staged in terms of a supposed opposition between individualism and collectivism, each appearing in a variety of doctrinal forms. On the one side there appear the self-defined protagonists of individual liberty, on the other the self-defined protagonists of planning and regulation, of the goods which are available through bureaucratic organization. But in fact what is crucial is that on which the contending parties agree, namely that there are only two alternative modes of social life open to us, one in which the free and arbitrary choices of individuals are sovereign and one in which the bureaucracy is sovereign, precisely so that it may limit the free and arbitrary choices of individuals. Given this deep cultural agreement, it is unsurprising that the politics of modern societies oscillate between a freedom which is nothing but a lack of regulation of individual behavior and forms of collectivist control designed only to limit the anarchy of self-interest.