Bummer.
A while back, I asked, "Where's Flea?" The question was asked in response to the mysterious disappearance of his blog a couple of weeks ago, leaving only a blank Blogger blog. Flea, as you may remember, was one of my favorite physician-bloggers. A pediatrician, he consistently provided pithy and interesting commentary on life as a solo practice doctor, his battles with emergency room physicians who don't call him when his patients show up in the ER, and various other issues, not to mention the occasional tussle with antivaccination loons. His disappearance seemed related to a malpractice suit filed against him, as I speculated when I asked my question.
I really hate being right (although in this case it doesn't take much savvy or skill to be right). In fact, it's worse than I imagined for Flea. Basically, his blog left him little choice but to settle his malpractice suit:
As Ivy League-educated pediatrician Robert P. Lindeman sat on the stand in Suffolk Superior Court this month, defending himself in a malpractice suit involving the death of a 12-year-old patient, the opposing counsel startled him with a question.Was Lindeman Flea?
Flea, jurors in the case didn't know, was the screen name for a blogger who had written often and at length about a trial remarkably similar to the one that was going on in the courtroom that day.
In his blog, Flea had ridiculed the plaintiff's case and the plaintiff's lawyer. He had revealed the defense strategy. He had accused members of the jury of dozing.
With the jury looking on in puzzlement, Lindeman admitted that he was, in fact, Flea.
The next morning, on May 15, he agreed to pay what members of Boston's tight-knit legal community describe as a substantial settlement -- case closed.The case is a startling illustration of how blogging, already implicated in destroying friendships and ruining job prospects, could interfere in other important arenas. Lawyers in Massachusetts and elsewhere, some of whom downloaded Flea's observations and posted them on their websites, said the case has also prompted them to warn clients that blogs can come back to haunt them.
Now, there's been a lot of wailing and gnashing of teeth over this and about what it means for physician blogs and bloggers. (Kevin, MD has helpfully provided a link roundup of reactions here and here, as did Eric Turkewitz, a personal injury lawyer.
As much as I liked Flea's blog and, I suspect, would like Flea/Lindeman himself if we were ever to meet in person, my take on this is that this was entirely a self-inflicted wound on Flea's part. In that, I agree with Symtym. No, it wasn't Flea's blogging per se that inflicted the wound. Other than his blogging about the trial, there was really nothing in his blog that did anything other than reflect how much Flea cared about his patients; the worst that could be said was that he was capable of a level of snark similar to mine. Given that, I doubt Flea's non-trial posts would have made much, if any, difference in his case, were they to be revealed to the jury.
Rather, it was the way Flea blogged about the legal proceedings and pre-trial preparation themselves as they were going on. Even though his posts about the case led me to want to cry out, "Preach it, Brother Flea!" (particularly the post where he pointed out how he was told by a jury consultant that juries decide cases more on their perception of the doctor's character rather than the facts of the case), at the same time I wanted to grab him by the collar and shake some sense into him for being so dangerously open about his lawyers' defense strategy and his jury preparation before the trial was settled. Clearly, Flea's faith in his continued anonymity was seriously misplaced. As I've learned, having been "outed" many times, a pseudonym does not in any way guarantee anonymity. You can bet that if I were ever sued, there would not be a peep from me on this blog about it while the legal proceedings--or maybe never at all. (Although no doubt the trolls who "outted" me would try to embarrass me with the information.) By posting this, Flea apparently destroyed any claims to attorney-client privilege about his defense strategy, as Turkewitz points out:
The issues I raised, in the event plaintiffs' counsel discovered his blog, ran to the risks of losing his attorney-client privilege for all such communications. If this happened, he could be cross-examined on how he was coached by his defense team to act in front of the jury and the advice they gave him. He also ran he risk of his own insurance carrier trying to disclaim coverage if it thought he was hindering the defense.
Shortly after, he took down three blog postings (Med-Blogger, On Trial For Malpractice, Takes Down Trial Posts), asserting he was superstitious and didn't want to jinx things that were going well. Then he took down the entire blog, without explanation (Med-Blogger Flea, Previously Live-Blogging His Trial, Takes Down Entire Site).
Dozens of medical and legal bloggers had commented on the live-blogging of the trial, as well as the subsequent, unexplained disappearance of the popular, award-winning doctor-writer.
Worse, apparently, Flea never told his own defense team about his blog. It's not a matter of not being "compelled to renounce anonymity." That's a moot point, because anonymity is almost impossible to maintain, particularly if someone is persistent enough or willing to throw some resources at the question. It's a matter of not telegraphing your defense strategy for all to see.
My bottom line on this is simple. The case of Flea is not the dire signal about the demise of the medical blogosphere that some have been making it into and that I briefly fell for. Rather, it's a wake-up call about reality. The First Amendment guarantees us freedom of speech and allows us to speak with anonymity. However, just as it does not insulate us from being offended by other people's speech, it also does not insulate us from the consequences of what we say publicly. Flea was not forced to settle based on the facts of the case; the jury never got to hear most of the facts of the case. Nor did Flea lose because the jury found that he had failed to live up to the standard of care and thus committed malpractice. He lost because he had publicly undermined his own case by writing about it before it was over. I suspect that, in the future, any physician blogger sued for malpractice will be wise enough to save the blog posts about it until after the final verdict is rendered (and there will be another case; most doctors are sued at least once in their career these days, and there's no reason to suspect that physician-bloggers are in any way immune). It may not seem right; it may be a detestable situation, but it's the way things are.
Flea, I hope you don't think I'm being too hard on you. I loved your blog, which suggested to me that you're a great guy and talented and caring pediatrician who didn't really deserve to be the next scalp to be added to the plaintiffs' law firm's disgusting trophy page. I hate to see this nastiness befall you. However, you really have no one to blame but yourself for the outcome of your case. If it weren't for your blogging about your pre-trial preparation while the case was being litigated, you might well have been vindicated. Now, we'll never know. Rants throughout the medical blogosphere about the plaintiffs' attorneys using your blog against you do not change this. As slimy as their tactics may seem to non-lawyers at times (and, yes, I do have a little sympathy for the view that their "outing" of Flea was blackmail, pure and simple) attorneys do have a duty to do their utmost within the law to win their clients' case. Once the plaintiffs' attorneys discovered Flea's blog, they would have been failing in that duty if they didn't use that information. You gave the plaintiffs' attorneys the weapon with which to destroy your case--handed it to them on a silver platter, actually--by making your blogging relevant to your case an opening up a strategy for them to exploit that would not otherwise have existed.
I really hate to say it, but, sadly, it's true. The only good thing that will come of this is that physician-bloggers now have an example of what can happen and are not likely to make the same mistake again. Here's hoping Flea can pick himself up, dust himself off, and continue to provide quality care to his patients.
I don't know that I'd place quite so much blame on Flea. I don't blog, but I think that if I did, writing about everything pertinent to it would become a matter of habit, and certainly the medicolegal environment of pediatrics was one theme of the blog. I can't quite blame him for taking the position that, having done nothing wrong, he shouldn't have to take extraordinary measures to hide his views. A dang shame, the whole thing.
Oh, and Dr. Lindeman, if my kids are ever sick in Boston, I'm totally bringing them to you.
Thats awful. As someone who thankfully avoided any legal embrolio re: blogging I know that its nerve-wracking to have the work you love be used against you.
Flea, in his mind, was attempting to bring transparency to a really horrible situation. The worst he could be accused of was being naive.
Too many law-related posts lately. Give a lawyer a vacation from reading about law, why doncha! ;-)
Orac said: "...particularly the post where he pointed out how he was told by a jury consultant that juries decide cases more on their perception of the doctor's character rather than the facts of the case."
I'd have to disagree with the factual accuracy of that statement, though the message is a great one for any defendant or witness to hear. (Not incidentally, it also tends to persuade even the defendant with great facts that paying a jury consultant is essential.) In essence, it says "Don't make the people in whose hands your fate/believability lies think you're an a**hole." As helpful as that advice is, my personal feeling based on experience is that most people give jurors' abilities to understand the facts of a case far too little credit.
isles said: "I can't quite blame him for taking the position that, having done nothing wrong, he shouldn't have to take extraordinary measures to hide his views."
Why would *not* posting his views (including uncomplimentary remarks about the jurors who'd be asked to decide his case, and revelations of confidential trial strategy - all this without mentioning it to his own lawyers) on a blog for the world to see in the midst of his trial be considered "extraordinary"? I might instead apply the term "extraordinary" to the degree of bad judgment Dr. Lindeman appears to have exercised.
"As helpful as that advice is, my personal feeling based on experience is that most people give jurors' abilities to understand the facts of a case far too little credit."
I remember when the Laci Peterson case was huge in the news, several of the jurors who were interviewed afterward said they convicted him because "he was cold" and "he didn't seem to care", not that they thought the evidence against him was particularly compelling.
factician said: "I remember when the Laci Peterson case was huge in the news, several of the jurors who were interviewed afterward said they convicted him because 'he was cold' and 'he didn't seem to care,' not that they thought the evidence against him was particularly compelling."
A man loses his young, pregnant wife, yet doesn't seem to care about it. Isn't this apparent lack of caring something that you would use in evaluating whether to believe he'd killed her? Why wouldn't you expect the jurors to do the same? Also, though it's almost trivial to point out, the fact that some jurors did not mention various items of evidence to reporters afterward doesn't at all mean they failed to consider that evidence during deliberations.
I was on the jury for a criminal trial. As the "facts" of the case were discussed in the jury rom, we invented for ourselves a little narrative that explained how it all fit together and what each piece of evidence or testimony meant. After it was over, I discovered that we had all fundamentally misunderstood one important piece of testimony. We all thought the witness meant to say A when he was in fact saying something else all together. The entire experience made me very wary about claims that juries can actually understand all of the testimony presented to them. If they make a factual error, it is likely that no one there will ever pick it up.
Jurors can't make factual errors because it is jurors who are the "deciders of fact". By definition, what ever they decide the "facts" are, cannot be changed.
It is "trial by combat", with hired champions, the opposing lawyers. Anything that is not "illegal" is allowed.
What a moron. I knew this guy wasn't too bright after my first email correspondence with him. It went like this and I quote:
Me: As a pediatrician, how are you so sure that YOU have not harmed children via an unsafe vaccination schedule?
Flea (aka Dufus P. Lindeman): As a troll, how do YOU know I'm a pediatrician?
Me: (quoting from his own blog profile)
Flea is a pediatrician in solo practice in the Northeast U.S.
Did you lie on your blogger profile? Duh. Wasn't too difficult to figure out. Nice picture.
-----------------------------------------------------------
What kind of a moron can't figure out that people are actually capable of reading a blog profile and making assumptions about it.... This man had a very rude and condescending attitude throughout his blog. He was nasty to the ER people and nasty to some of his patients' parents. He would mock parents for bringing their kids in directly to the ER without consulting him first... Now, we can see why some may have done that. I read enough about him to know that I never would have trusted this person with my kid.
This is especially troubling to me as my daughter was diagnosed with type 1 diabetes at the age of 11 months. While I have no idea about the circumstances surrounding the episode itself, I find myself so grateful that my child's pediatrician was able to diagnose her correctly (despite the fact that the emergency room personnel were unable to do just that the night before she was diagnosed and sent us home -- where my daughter could have died).
P.S. Dear Dr. Flea... Since you are none too bright... VACCINES injure children.
He obviously recognzed you as the antivax fanatic that you are and gave you the response that you warranted, Sue.
I read Flea's blog for the better part of a year. He was a good writer, had a sarcastic wit, had some thought-provoking things to say.
He's obviously a smart, well-trained doctor. My impression was that he cared a great deal about childhood conditions/diseases and how to treat those properly, according to the latest medical information available.
Nonetheless, I occasionally had the impression that Flea wasn't altogether interested in the actual children that he treated, nor their anxious parents. Particularly the latter.
On the other hand, Flea did make housecalls and accept Medicaid patients, something that I admired.
Right now, I feel sorry for him and his family. It's unfortunate that he didn't discuss the nature and content of his blog with his lawyer. (Was he required to legally? I don't know).
"He obviously recognzed you as the antivax fanatic that you are and gave you the response that you warranted, Sue".
The response that I was warranted after asking a simple and polite question? He's wasn't intelligent enough to figure out how someone knew that he was a pediatrician when it states that fact on his blog header. Talk about a moron... I mean, please, the guy goes on to discuss his legal matters as they are happening on a public blog... Thinking he was being all secretive because he chose to use hide under the name of 'Flea'. I knew that the intelligence of our doctors had gone way downhill but that is simply amazing.
So, again, what did we learned today... Flea is a moron... I could have told you that months ago when I could tell that he didn't have the slightest clue or inclination to learn about the dangers of vaccines. I would wonder if that poor boy who died after not being diagnosed properly had had any vaccinations in the previous 6 months or so... I certainly wouldn't doubt it.
I really enjoyed his series on vaccination and diseases that we don't see too much anymore because of it. That said, I read this article, and thought, "What an idiot!" The casual misogyny didn't really impress me too much, either, and was something that I'd suspected was lurking under his writing for quite a while (and was pretty much confirmed when I read his post on abortion).
It's a shame this happened to him, really, but I won't be rushing back to read another incarnation of his blog if he gets one, which is also a shame, because at one time, I really was a fan. :(
Sue,
Nice of you to pile on. Why don't you go back to convincing parents to risk their kid's lives, k?
Renee, what gave you the impression that Flea isn't "altogether interested" in his patients and their parents? If he weren't interested, why would he have written so often about his efforts to convince them not to overmedicate and not to rely on emergency rooms? If he didn't care, he could just have written pointless antibiotic prescriptions on demand.
He was pretty blunt about these matters on his blog, but it's possible that he kept his patience and tact for personal dealing and then vented on the blog. Regardless, though, it seems to me that he'd confront parents because his concern more for his patients and their families outweighs the comfort of letting things slide. I'd prefer that to someone who puts on a good show of solicitousness but doesn't worry much about outcomes.
I very much doubt he'd be required to keep his lawyer informed of what he does, but in any matter that could affect the trial I shouldn't doubt it'd be considered a good thing.
Interrobang, I'm not square behind Flea's social policy either, but that wouldn't stop me from reading. I do mostly read those whose views resemble my own, but sometimes we can find new insights in others of differing opinion. For example, if Scott Hatfield didn't associate with the rowdy atheists of Pharyngula, we'd be that much poorer for it. I'll grant that, on the other hand, if Sue didn't come back to inject her bile, I wouldn't have to scroll around it to read content.
I agree with your post: Flea blogged recklessly and dug his own grave.
I can only imagine that his blogging was a venting of frustration about the trial. Blogging is fun and perhaps even 'therapeutic', but sometimes it's best to just be quiet.
So now vaccines cause type I diabetes too. Astounding.
Vaccines cause every disease known to humankind--at least, that's the message antivaccination loons seem to be giving.
"Nice of you to pile on".
Piling on? No, mousey, I'm not "piling on". I already stated that I do not know the circumstance involving the suit that he was involved in... so I was not piling on in the sense of kicking the man for making an error/not diagnosing the child (other than to say that I am extremely grateful that my own child's pediatrician was able to do so). There are mistakes made. Sometimes tragic ones.
I will, however, "pile on" as others here have done by stating what a foolish idea it was for him to "discuss" his malpractice suit on an "anonymous" blog. Dummmmb! I will also "pile on" in discussing the fact that he was seemingly oftentimes seen as an obnoxious doctor who of course knew-it-all. Ridiculing parents left and right. Not exactly a character trait that one would like to see in a pediatrician... For that, I will pile on... and you know... he deserves it.
Again, however, I will say... I do feel pain for him and of course the family involved in the suit. Certainly that was a tragedy all around.
"So now vaccines cause type I diabetes too. Astounding".
Let me guess, you're a doctor (rollseyes)? Yes, my friend, it is very likely true that vaccines can trigger autoimmune diseases in children (of which as you know type 1 diabetes is one). If you could remove the scalpel from your ass for an hour or two and do some research you may actually learn something of importance.
Oh yeah, Mr. ER Doc in Texas ... The next time that you have a child brought in to you who is under the age of 2 and there is some uncertainty as to what is going on with the child. Your next question (after the exploratory) questions should be ... "Has your child had any vaccinations recently"? I bet that they don't teach you that in Med School... Or do they? Perhaps instead of asking that alarming question to parents, they instead have you look into that on your own from the kids' medical chart. Either way, you need to know that vaccination history. Trust me.
I've seen the likes of many ER's in my life with my older two children... surprisingly little visits here and there after certain vaccinations. There's a shocker. Or not...
"Renee, what gave you the impression that Flea isn't "altogether interested" in his patients and their parents?"
Uninterested with the mothers' concerns. From reading his blog, I often had the feeling that he thought these concerns were silly.
Flea was/is a persona with strong opinions and strong emotions. This makes for great blog-reading. He even referred to his persona in the cached blog as a 'cocky bastard'.
But can the real Dr. Lindeman really be so different from the persona Flea? Could any individual behave in a manner so different from their true feelings and beliefs? I find it hard to believe that the real doctor was able to suppress his inner workings so well that he could come across to the mothers as a calm, respectful, patient person.
Like Interobang above, I too was picking up on Flea's subtle misogyny.
(Interobang, which article are you referring to? The one in the Boston Globe?)
What disturbs me is not whether Flea is arrogant, or naive, or even reckless in blogging. What disturbs me is that apparently he was tried for these "crimes" instead of that for which he was being sued: malpractice. AFAIK, NO evidence of a medical nature relating to the specific case was entered before the case collapsed. It's rather as if I sued a plumber for defective work but he settled out of court with me because I had my attorney divulge in court that he blogged in uncomplimentary terms about my untidy house and the quality of my housekeeping.
One has to wonder about the judge who allowed this extraneous testimony to be permitted in the first place. Flea did not discuss his side of the alleged malpractice story in the blog, he didn't, for example, write something like "I didn't order this exam because", or "I ignored that symptom because", etc. That he ridiculed the jury doesn't mean he committed malpractice and THAT was what the suit was about.
I think cases of this kind, where expert testimony is everything, are not well served by jury trials anyway. They cannot be expected to take on board the required amount of medical knowledge.
"What disturbs me is that apparently he was tried for these "crimes" instead of that for which he was being sued: malpractice".
Ah, no. He wasn't being "tried" for having a blog or being a dope for actually writing in his blog about his current court case... He was asked about, admitted it and then realized that his best bet was to settle the case.
I agree with you completely. This was indeed a self-inflicted wound and I can't imagine what he was thinking other than that he wasn't thinking. It happens. But there are consequences.
"I think cases of this kind, where expert testimony is everything, are not well served by jury trials anyway. They cannot be expected to take on board the required amount of medical knowledge."
Why not? How often do they get it wrong?
Renee asked: "Flea was/is a persona with strong opinions and strong emotions....But can the real Dr. Lindeman really be so different from the persona Flea? I find it hard to believe that the real doctor was able to suppress his inner workings so well that he could come across to the mothers as a calm, respectful, patient person."
Actors, of course, can do this well, but so can all folks. We often have different behavior with our children than with our new sweetheart than with our dogs than with telemarketers. I don't think one has to "supress his inner workings," I think we can SELECT among our inner workings.* One can be calm, respectful with patients and parents, and do so honestly, yet still express frustration and strong opinions. Sometimes you use different personas (personae?) with the same person in different situations. And so on.
I know this is obvious, but I had to say it, to remind Renee of the basics of primate behavior she is well aware of as one socialized with humans.
I would prefer my pediatrician to be intelligent, competent, and curious about pediatric medicine. The rest is gravy. I do not need her to be my buddy, or my child's buddy, I do not need her to be my minister or my child's honorary aunt. If she is a good patient educator, cool, and if not, she must be able to delegate to one such in her office. Most pediatricians are good communicators and nice people, as well, IME.
Flea, tnx for the blog.
As for webanonimity: "On the internet, no one knows you're a dog." But they can usually find out.
Skeptyk
*Actually I do not think we have actual free will , but that's another discussion...see D. Dennett, S.Blackmore, John Fischer...
I'll probably get moderated for this, but I don't really care. I've reached the breaking point, and this has to be said. So I'm going to say it here where everyone knows what was said, and can save it to their own PC as proof, and nobody can pretend I said something else:
"Common Sense", I wish I could say something good about you, but I can't.
The content of your posts across multiple topics in this blog consistently paints you as a font of vile ad-hominem bullshit, slander, and unscientific, unsubstantiated comments that make the vilest implications about decent human beings who are trying their best to reduce the burden of suffering in the world. At best, you come across as grossly misinformed; at worst, you come across as paranoid, malicious or both.
I think you should take a good, hard look at yourself, your views and the way you express them, and the beliefs to which you cling. I don't doubt that you consider yourself a decent human being. No doubt most of the people you know think the same. But that is not how you are coming across here. As a fellow reader of, and contributor to, Orac's Blog, I am growing tired of your bitter and nasty attitude to Orac and his supporters. As far as I am concerned, you should support your contentious statements with hard scientific evidence, or cease making them.
Now, now! The antivax parent knew that Flea was a pediatrician because it said so. On the internet!! Didn't you know that you can believe everything you read on the internet?
I personally plan to sue the makers of the influenza vaccination because my two children and I got vaccinated against influenza and that very day on the way back a deer lept out of nowhere and hit my car!!!
Vaccinations cause deer to attack cars!
...Well...it might have been six months later...
...or earlier...
...but my hair dryer broke down right after, too...
...so the vaccination also causes bad hair....
"I think you should take a good, hard look at yourself, your views and the way you express them, and the beliefs to which you cling".
Interesting view, Justin. How is it that your friend Orac can make all the jokes and negative comments that he wishes in regards to the anti-vaccine crazies but you feel the need to preach to me for my views? Please, stick it where the sun don't shine.
Don't fall off that high horse...
"Common sense"
Your second to last sentence, inviting me to insert something where sunlight does not reach, proves the point of my original post.
You attack the person, and at no time do you attack the scientific basis of the opinion they are putting across.
Orac began by attacking the completely UNscientific basis of the opinion you put across, but has been driven to his snarkiness by your bull-headed, foul-mouthed, closed-minded and slanderous attitude. It is not closed-minded to reject a viewpoint which experiment after experiment has shown to be flawed, nor is it open-minded to accept it.
Renee asked: "But can the real Dr. Lindeman really be so different from the persona Flea? . . . "
Actually, the answer is yes and as a parent, I have firsthand knowledge of this.
He is an extraordinarily patient and thoughtful doctor who treats his patients with a holistic approach that takes into consideration how everyone in the family is doing. Not only does he answer all questions thoroughly, he *invites* more questions. He doesn't rush you out of the exam room. He is knowledgeable and intelligent. He's easy to reach by phone and email and makes a lot of information accessible. He makes housecalls for newborns!
How's that for starters?
"Orac began by attacking the completely UNscientific basis of the opinion you put across, but has been driven to his snarkiness by your bull-headed, foul-mouthed, closed-minded and slanderous attitude. It is not closed-minded to reject a viewpoint which experiment after experiment has shown to be flawed, nor is it open-minded to accept it".
You are actually quite incorrect. There is no science to what Orac spouts here in reference to this topic. However, on that note, I must be off... I am thrilled though that I quite literally stumbled upon this discussion regarding "Flea"... what a dope...
The day that "common sense" present any kind of scientific evidence might just be the day that the internet collapeses. Don't worry though people, it won't happen any time soon.
As to the story at hand - there is a reason that I don't blog about work related things, no matter how trivial. It's a bad idea to start forming a habit of writing about such things.
Great and excellent article t's realy helpful. Thanks again.
Wow. Very impressive.
Great and excellent article t's realy helpful. Thanks again.
Wow. Very impressive.