Portal de Periódicos da CAPES

EM Blogs Carving Out a Corner in Cyberspace

2005; Lippincott Williams & Wilkins; Volume: 27; Issue: 11 Linguagem: Inglês

10.1097/00132981-200511000-00006

1552-3624

Anne Scheck,

Web and Library Services

As the mainstream media chronicled the devastation of Hurricane Katrina, behind the scenes were other stories. Firsthand accounts. Tales of patient care under trying circumstances. Angry diatribes. One told of patients with diabetes and kidney disease being transported out of the eye of the storm to a Fort Worth, TX, hospital, and a narrative about it appeared almost immediately. The readers of this report didn't venture out their front doors to retrieve their local newspapers or flip from CNN to MSNBC to compare the facts. Instead, they flicked on their computers, and clicked their way to their favorite blog. The story about the diabetes and kidney disease patients appeared on GruntDoc.com, an emergency medicine blog that chronicled Katrina's aftermath from the personal view of its author, creator, and monitor, Allen Roberts, MD. “The patients I cared for showed what you'd expect in a debilitated, chronically ill person with no adequate sanitation for three days,” he told visitors to the blog. But aside from the deprivation, there were other differences, too, which probably wouldn't have been news to a camera crew or newspaper reporters. Along with photo albums and other family keepsakes whisked away from the encroaching flood waters, these patients toted their medical records.Table: Emergency Medicine Blogs“All but one showed up with his inpatient hospital chart [in a binder], and one had not just that but prior charts dating back several years,” Dr. Roberts said. One evacuee, who arrived in a standard hospital gown, also was clutching a bottle of what turned out to be Tabasco sauce. The patient had carried it all the way to where Dr. Roberts practices in Fort Worth, TX, “just to make sure it was available for meals,” he explained. If emergency medicine has, as many have observed, a Shakespearean soul, the heart of it can be viewed not only in the ED, but in the way such events are recorded almost daily on blogs. The tragedies of Katrina, for example, didn't just inspire reports of patient care, but expressions of outrage, empathy, and even a new burst of criticism for what could be called the perpetual lawyer lambast, a swipe at the legal profession that is posted daily somewhere. My concern is this,” wrote one blogger on the popular emergency medicine blog called Symtym. “Once the rubble is cleared and the power restored, the plaintiffs' lawyers will ooze back into the scene.”Figure: Dr. Allen Roberts“It is theater for people with short attention spans.” Dr. Allen Roberts Modern Town Square Why so many blogs? Dr. Roberts hypothesized that some emergency physicians have something to say and need a place to say it, but instead of a town square, they carve out a corner in cyberspace. “There are new ones coming out every week,” he said. As the creator of one of the first emergency medicine blogs, Dr. Roberts said he suspects that his colleagues who start blogs do it for the same reason he did: “It gave me a release. It was fun.” Blogs actually began about a decade ago, but they were largely the domain of computer enthusiasts who set them up to communicate with like-minded individuals. For a few years, they remained a largely unnoticed, relatively unvisited phenomenon on the Internet. The Iraq war changed all that, according to Wikipedia, the online encyclopedia that chronicled their growth. The reaction to the war created what is known as “blogstorms,” which occur when a crowd of Internet users issue public comments via blog. In fact, the blogosphere after the invasion of Iraq became news itself, first because it occurred so quickly and secondly because the material on such sites sometimes revealed events the embedded media had missed. In emergency medicine, blogs also burgeoned and flourished, spewing forth information and opinion. Dr. Roberts noted that some physicians in his field just seem to have “blogger personalities,” which he said arises from a compelling need for expression. “I am the guy who is a little noisy in the room,” he said, adding that he also is a bit of a “computer geek.”Figure: Dr. Richard WintersBlogging is a way of “letting go of some of the things I tend to bottle up inside.” Dr. Richard Winters For anyone with a similar bent, Dr. Roberts has some advice: Blog writing takes time, it can become a chore, and most worrisome of all, “blogs are a good way to lose your job.” He knows fellow bloggers who got burned by relating blow-by-blow descriptions of less-than-stellar administrative decisions at their facilities. “If you write something edgy, put it away a little while before you [post] it,” he advised. For anyone who wonders why blogs spark so much interest, it likely comes as no surprise that there are scientists studying how words and pictures in computer-based environments lasso people in. One theory goes that a conversational style promotes an interactive relationship. “Some people have suggested we are attuned to a social partner, even when it is a machine” like a computer, said Richard Mayer, PhD, a professor of psychology at the University of California, Santa Barbara. Voice and graphics may enhance that perception of computer as partner, he said. Dr. Roberts has a simpler explanation. “It is theater for people with short attention spans,” he said, noting that some emergency physicians seem to fall into that category. Emotional Outlet This kind of public diary can be “a healthy outlet for emotions and concerns,” noted Richard Winters, MD, an emergency physician at Saint Agnes Medical Center in Fresno, CA. Dr. Winters said blogging, for him, is a way of “letting go of some of the things I tend to bottle up inside.” A fairly typical post from Dr. Winters' blog, which is called richard[WINTERS]md, is written in a Haiku-like way, a kind of storytelling that appears to flow like a bit of free verse: Guy has his 21st birthday. At midnight he enters a bar and drinks large volumes of alcohol in a small amount of time. Gets dropped off in a cab at our emergency department at 2 a.m. Vomits on our EMT. Placed on a gurney in a monitored room to sleep it off. At 6 a.m., I hear from the room, “Shut up, you stupid monitors! Shut up! Stop beeping!” …drunken pause… “Wait. Don't shut up.” …drunken pause… “If you shut up, that means I'm dead.” How does he achieve that ee cummings-meets-Joe Friday tone? It is how he writes naturally. In fact, that is one piece of advice he has for bloggers: “Blog in a conversational tone.” Other hints: “Avoid saying things you wouldn't say in person. Respect the privacy of others. Be succinct.” “I post irregularly,” Dr. Winters said. “So I don't put pressure on myself to always produce daily content.” Dr. Roberts concurred. If you make it a daily task, “it can stop being fun,” he said. As for future bloggers, Dr. Roberts thinks there will be many. “There is a kind of life cycle in blogging,” he said, explaining that it goes like this: Build a blog. Say what you need to say. Run out of steam. “You start writing out of passion or interest, and you may run out of time,” he said. When that happens, the blog may “peter away,” even when the writer doesn't. After all, by that time, somebody else may have a blog, where a former blogger can continue to comment and vent indefinitely and whenever it is convenient.