Brave New Blog

During my recent silence I spent a lot of time thinking about the original vision I had for being a rural family doctor. In this vision, I provided full-time primary care, including inpatient coverage for all my patients, whether they were kids, old people, or laboring women. I was going to be a salt-of-the-earth, old-fashioned family doc who was present for birth, death, and the messy interval between the two. For a brief period--about a year--I lived a close approximation of this vision, and although it was a rewarding and happy time, various factors ultimately led me to transition to full-time hospitalist work.

Anyway, the various transitions I've made over the past few years raised a number of unexpected difficulties, including the direction this blog was to take. When I first decided to take up blogging again, I was committed to the Dream of Family Practice and to providing a rural perspective to the medical blogosphere. I wanted to reveal the various aspects of a rural family doctor's practice and personal life, and thus the blog was originally quite narrowly topic-focused and had a generally informational and pragmatic tone. I wanted the blog to be useful to readers, and it was gratifying when medical students and other family doctors wrote to me with questions about rural practice and how to prepare for the kind of life I was leading.

As the DoFP gradually unwound, I found myself confronted with an uneasy impostor phenomenon. This blog had been established upon my life as a full-spectrum rural family doctor, and as time passed, major chunks of that identity were falling by the wayside: first, inpatient pediatrics, then inpatient medicine (as a part of primary care, not hospitalist medicine), and finally ambulatory primary care. Sure, I had experience in each of these areas, but I didn't feel justified continuing to write about them as if I were still in the middle of developing professionally within these areas.

More recently, I have come to question the usefulness of my original approach to blogging about rural life. Even now, I receive emails asking me whether I would choose this life again. The answer to that question is truly enormous and encompasses things completely unrelated to the practice of medicine, and now I realize my topic-focused and pragmatic blogging barely touches the tip of the rural lifestyle iceberg. How useful is this approach, then? Hm.

Then there are my own dreams and priorities. Noo's critical illness last summer abruptly underscored What Is Really Important in Life, Because Life is Brief and Unpredictable. Now that she is recovering nicely, and we have made important changes in our lifestyle to ensure her well-being, I have had more time to inventory my own goals. The outcome of this deliberation is this: I am going to dedicate my creative energies towards the fulfillment of my primary identity as a writer. Because this was my original dream, and even though medicine evolved into a related set of important goals and identities, the eight-year old part of my spirit still says, Yeah, well, that's all nice but--I'm a writer. And she will not be censored. Trust me, I've tried.

What this means for this blog is a partial retreat from its original topic-driven pragmatism towards a less predictable, in-the-moment creative abundance of posting. I'm going to share progress in writing projects, both traditional written work as well as mixed-media visual journaling I have been pursuing in an effort to express some experiences which simply don't reduce well into linear written form. And I'm going to keep writing about my occasional professional triumph, and daily professional embarrassments, as I go along, but only as the mood takes me. On days when I feel pragmatic--and there are many--you'll get case reports, Birth Stories, and career low-downs, but on days when I am seized with the image of frogs singing in my neighbor's field, you'll get a photograph, or a round snippet of thought which the song itself revealed. In this way, I think you'll get a true glimpse into this rural family doctor's life.

Comments

[family doc]

I'm just glad you're back -- I almost deleted the link b/c I had given up on your coming back to blogging. I'm a family doc and appreciate your perspectives on medicine but I'll try reading non-doctor things too!

[Celeste]

I hope there will be more Dr. Santell stories, too. Your perspective is wonderful.

[Gillian Chan]

Once a writer, always a writer . . . I look forward to following your creative voyage.

[Mary Clark]

Welcome back to writing. The writer is indeed a difficult creature to suppress. Writing and providing therapy for patients with acquired neurological conditions are merging, and feeding each other, more all the time for me. Good luck and I'll be reading.

A speechie in Scotland

[A Daring Adventure]

That sounds positively wonderful.

You are a very multi-talented person. Your blog has always been rich in your humanity, even when you were somewhat limiting it to the medical side of things. I think that opening up the subject matter is a FABULOUS idea and look forward to reading more about you outside of purely the medical sphere.

And yes, you are a fabulous, fabulous writer. I think you could write about anything... how to build a bookshelf or wash a drinking glass... and make it entertaining and humorous.

[Scanman]

Welcome back to blogging!
Wish you'd come back to twitter too, @ruraldoctoring :)

[rlbates]

Looking forward to it all. Perhaps even some updates on your knitting.