Orac is the nom de blog of a (not so) humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
I would be remiss if I didn't mention that I recently noticed that one of my favorite medical bloggers, Flea, had completely deleted his blog. There's nothing there. It's gone, except for a blank Blogger blog. Apparently, too, Flea's not alone, as Kevin, MD points out.
I'm going to miss Flea, but I understand why he might have done it. As he had documented in the weeks leading up to the disappearance of his blog, he was being sued for malpractice. Indeed, I was amazed at how honest he had been about some of the pretrial preparations he was undergoing. It was great reading, but probably ill-advised, and I bet that his lawyer put the kibosh on his blog pronto after finding out about it.
All of this puts a bit of a chill in my heart. Even though I blog under a pseudonym, lots of people know who I "really am," thanks to cranks who were willing to put a lot of effort into to plowing through Usenet postings from the late 1990's to find some posts where I had (in retrospect) foolishly linked my name with my present 'nym. Had I been a bit smarter or less oblivious to the lengths to which cranks would go to "out" me, I might never have continued the "Orac" 'nym into the blogosphere when I first started my blog, thus allowing a means of linking it to my real name. My only consolation was that I know for a fact that it must have taken the first "outer" a lot of work to dig up this information, as until about two years ago the only way to link me to my blog without knowing my "real" name was to plow through ancient Usenet archives from the late 1990's to find the link between me and my 'nym.
However, fear of legal threats or HIPAA violations is exactly why I only rarely ever blog about patient encounters anymore. I used to do it a lot, but decided that it was too big a risk. Now I mostly confine myself to commenting on science, alternative medicine, and various non-medical topics that interest me. Even though some of my older posts about patient encounters were heavily altered in order to make it virtually impossible to connect the story with the patient that inspired it, it's too big a chance to take. If I were to be sued now, an opposing lawyer might be able to try to impeach my personality and embarrass me using some of the sillier things on my blog (the EneMan or Hitler Zombie posts, for example), but he wouldn't be able to try to dredge up information about how I took care of patients or try to paint me as someone who doesn't care or violates HIPAA.
Flea, wherever you are, godspeed.
Comments
Yeah, case histories with HIPAA tend to make an eruptive mix. Possibly, with written permission, you could post something, but IMO your instinct about staying hands-off, postwise, is likely the safest.
I wonder, though, if an offense lawyer might try what you're thinking about indicting you via your online persona -- depending on the jury, that could turn out to be a massive tactical mistake.
There's an entire generation of net-savvy people who know better than to take blog posts as being genuinely indicative of the authors' personalities, and who would likely see anyone trying to raise such an argument as having essentially no credibility.
It only works for right-wingers because they command such a massive groundswell of religiously-deranged halfwits.
Posted by: Warren | May 21, 2007 3:15 PM
Yes, being a public personality means anything you say may be used as evidence against you - a chilling thought.
Posted by: sailor | May 21, 2007 3:41 PM
Especially since rationality is considered an extremist, insane point of view in the public eye.
Posted by: Bronze Dog | May 21, 2007 4:18 PM
"since rationality is considered an extremist, insane point of view in the public eye."
Exactly!
Take a lesson from the article you posted about the atheists being wrongfully charged with a crime, and making "ability to believe an atheist" part of the jury selection process.
A "fair" jury for Orac would have to believe that a rational approach to life is not insane and is at least as valid as one based on faith. Because Orac has offended so many wooists, all wooists would have to be excluded from the jury.
The trial would be a cake-walk.
Posted by: daedalus2u | May 21, 2007 7:44 PM
Somebody who goes by Flea has been guest blogging over at feministe.us lately. It strikes me as unlikely that they are one and the same, but I'm not familiar with the gentleman, so it might be.
Sorry for the lack of clickability. Stupid html.
Posted by: Alex | May 21, 2007 9:11 PM
Your comments call to mind the New Yorker essays and books by Atul Gawande which seem to address issues in surgery with great candor, although he always changes the names and circumstances enough in his case histories to hide the true identities of the characters, or so he claims. Does anyone who follows Orac, or Orac himself, have any opinions on Gawande's writings? How closely do his descriptions hew to the experiences of other physicians?
That said, I recently finished his first book and am reading the second now (and will shortly tackle Jerome Groopman's "How Doctors Think"). Although I'm no physician, and not even a scientist, nothing Gawande's written surprises me. My late sister was a physician, a renal specialist, and she'd related similar accounts before succumbing to melanoma a decade ago. And it was from her, and a couple of college classmates who went into medicine, that I know all too well that physicians are human just like the rest of us, with the same failings. So when one of my doctors examines me, I try to keep that in mind.
Posted by: Keanusk | May 21, 2007 10:12 PM
How is a blog post discussing a specific case, sans names and identifying information any different than a case history published in every medical journal everywhere as they do all the time? Do they get permission from every patient that they publish anonymously about? I wasn't aware that was necessary as long as the names and other info were removed or changed.
Posted by: PlanetaryGear | May 21, 2007 10:33 PM
Yes, being a public personality means anything you say may be used as evidence against you - a chilling thought.
Oh, hell, you don't have to be a public personality.
The reich-wing love to "out" folks as a form of intimidation.
Posted by: Graculus | May 22, 2007 2:34 AM
There's an entire generation of net-savvy people who know better than to take blog posts as being genuinely indicative of the authors' personalities, and who would likely see anyone trying to raise such an argument as having essentially no credibility.
It only works for right-wingers because they command such a massive groundswell of religiously-deranged halfwits.
Alas, this is not true. It works for both right-wingers and left-wingers, and it has no relationship to the audience's religion -- nor even to their net-savvy-ness. Heck, just going by what I've seen on the net itself, I'm pretty sure that you're wrong: net-savvy people are no less immune to the underlying logical fallacy. In fact, they are if anything even more prone to it -- it's a mainstay of flamewars.
It is the ad hominem argument, and we've all seen how common it is on the 'net.
Posted by: Calli Arcale | May 22, 2007 10:42 AM
Calli -- Good points. Particularly about the flame wars. Hadn't thought of them.
You're probably right about the religion thing too; I tend to engage in my own ad hominem (ad deum?) attacks from time to time.
Posted by: Warren | May 22, 2007 11:40 AM
The Flea at feministe is also the Flea at One Good Thing (also Offsprung); she works for a Corporate Box and owns an online sex shop -- not the same person, I'm afraid. It looks like the Internet is full of fleas.
Posted by: debgpi | May 22, 2007 11:41 PM
Alex, the Flea at Feministe is a totally different blogger, not Dr. Flea.
Posted by: Mary | May 23, 2007 1:02 AM
Holy crap. THIS is what happened to Flea.
Posted by: Mary | May 31, 2007 8:56 AM
Oh dear dog. Mary, thanks for spotting and posting that....
Posted by: Luna_the_cat | May 31, 2007 10:12 AM