Sunday, November 05, 2006

Six Month Anniversary

Tundra Medicine Dreams is six months old tomorrow. When I look back over how much I have written and posted since then, it seems so long ago. The blog, and my thinking about it, have evolved over that time, though that may be more evident to me than to TMD readers.

My initial intent was to be totally anonymous, to have no identifiable information about myself on the blog, to tell no one at the hospital about it (except my Clinical Director, for legal reasons). What was I thinking? I don’t live in a high-population area, marginally distinct from other high-population areas (i.e. urban Midwest) where anonymity is possible and even easily achieved. I live in a small community that is very different from most of the rest of the world. Word gets around here; anonymity in the hospital would be difficult to maintain.

And in the blogosphere? Probably there as well. When I hosted Grand Rounds in September, Nick Genes asked me in the pre-Rounds interview how important anonymity was to me. I had to admit that it had become less important than it initially seemed when I first started writing Tundra Medicine Dreams. He pointed out that a web-saavy clinician in the lower 48 could probably figure out who I am.

As a result of Nick’s interview with me on Medscape, Tundra Medicine Dreams and The Tundra PA came to the attention of The AAPA News, the twice-monthly news magazine of the American Academy of Physician Assistants. They wanted to run a story about me, but insisted that they must use my real name and identify me as a Fellow of the Academy. I took a few days to think about that, and to discuss it with Dutch. It meant “coming out” and I had to decide if I were ready for that. He felt that it was time, and he encouraged it. The News is distributed to the 60,000+ PAs who are members of the Academy, and once the story runs (possibly this month) any vestige of anonymity will be vaporized. I wonder if a tsunami is about to crash over me.

With these events as background, the six-month anniversary of TMD, and the start of winter, which is always a time of introspection for me, the blog has been much on my mind lately—even more than usual, if that is possible. Its voice (my voice), its direction, its presence as an entity in the medblogosphere, and where I want it to go in the next six months. The huge question is just how personal and self-revealing I want to be.

Several commenters have stated recently, both on the blog and in private email, that they want to know more about me, my background, my friends, my personal life. There has been a request for photos of me on the blog, which I have so far carefully avoided. The concept of fame is not one that I can apply to myself at this point in my life; but I recognize that, because of Tundra Medicine Dreams, I have become a personality that is known to people beyond the circle of individuals that I have actually met. Who I am and what I am doing is interesting to them, and some of them want to know more. What I have to decide is how much more I want to tell.

When I started writing TMD, my orientation to my own “voice” on the blog, as the narrator, was that I was creating a persona. The other characters I have introduced—Dutch, Henry, Joan, Michael and Luke, Betty, Andrea, numerous health aides and patients—are also personae. They are my creations, based on real people. I have thought of these creations as sort of a Sub-Arctic Lake Wobegone Tales, or Spoon River Anthology. My friend Traveling Doc (of Borneo Breezes) suggested in an email that if TMD is going to become a book—it might—then I should enlarge upon these characters, realize them more fully. I am thinking of doing a series posts, the TMD Kusko Anthology perhaps, that would do just that. Going in this direction means that I may be absent from Grand Rounds for a week or so (*sigh* I love what Tuesdays do to my sitemeter). Feel free to leave your thoughts in the comments. Reader input is always encouraged, considered, and appreciated.

Happy six month anniversary, Tundra Medicine Dreams! You have changed my life; you have allowed me to think of myself as a writer.



Anonymous Anonymous said...


Sunday, November 05, 2006 2:23:00 PM  
Anonymous Anonymous said...

My opinion: it is important that you not reveal any more of your personal life than you simply want to. Good blogs are incredibly intimate, anyway, and some readers seem to begin to assume they have a right to know more and more personal details. Where does it stop? And do we not owe someone whose gifts we are allowed to enjoy exquisite good manners? You owe us, really, nothing more than to continue this beautiful, informative blog!

Sunday, November 05, 2006 2:56:00 PM  
Anonymous mpb said...

Known identity and writing a book are two important considerations for anyone in the public eye, especially now with the much greater ability to store and find info (Internet). Even so, Internet info doesn't come to those who don't seek it. Maybe it is an overrated fear. (In risk communication the more up front an agency is, the less rumor).

I experienced something similar at Los Alamos National Laboratory and Los Alamos, NM. I had an opportunity to represent people, through my work, who could not speak of their own classified work. This was a great responsibility but one which I took up as a way to repay the folks I worked with who took time out to help me learn (the non-scientists and non-PhDs asked the hardest questions) and to do the research (for example, the custodians would leave front left legs of whatever they hunted or trapped so I could analyze the environmental chemistry).

A small town is a great way to learn how to do science interpretation and community-involvement.

On the other hand, I was stalked occasionally; my name was one of several included by anonymous disgruntled employees against their supervisor.

We usually have books written by teachers (or modern missionaries) who spend a few years (or months) in rural Alaska then go on to fame and relative fortune elsewhere. It is a far worse phenomenon among Southwestern Pueblo communities. Fortunately, you have deliberately avoided that in your blog writings (such a refreshing change.) If the book gets published, please be sure to explain how you accomplished that for others to learn.

Sunday, November 05, 2006 4:07:00 PM  
Blogger Dreaming again said...


Sunday, November 05, 2006 4:56:00 PM  
Anonymous Anonymous said...

Happy six months, TMD.

And do whatever is comfortable. You have to live your life.

Sunday, November 05, 2006 5:41:00 PM  
Anonymous Vijay said...

Congrats on the completion of 6 months of consistently good writing.
I am a blogger who started blog-life anonymously in circumstances that are very similar to yours. Though I live in a fairly populous city (about 300,000), the percentage of internet users and bloggers is miniscule. There are only two medical bloggers from my city that I know of. Since nobody seemed to notice over a 6 month period, I realized that there was no point in remaining anonymous. Nothing has changed after I 'revealed all.' :)
That may not be the case for you.
So do it (The Revelation) if you think you can handle the aftermath - the fame and ?prosperity.
And Amen to what Anonymous above me said. Please "continue this beautiful, infomative blog!"
Best Wishes.

Sunday, November 05, 2006 7:00:00 PM  
Blogger Dr. A said...

Congratulations on six months. I'm one month behind you. I'm six months in December.

I'm struggling with this as well. I've received e-mails asking personal information. No mean messages, just curious about who I am, what I look like, etc.

I've went back to some of my initial postings as to why I started blogging in the first place. And, it's not for fame; it's just to write and maybe be heard be someone.

I'll be curious to follow how your "coming out" goes, because I may be in a similar situation sooner than I think or want.

Sunday, November 05, 2006 8:47:00 PM  
Anonymous ozziedoc the 4th yr med student said...

Happy Six Months!

Monday, November 06, 2006 10:39:00 AM  
Blogger #1 Dinosaur said...

Congratulations on your six month-versary!

I agree with Anonymous above. Just because people want to know more about you does not obligate you to oblige.

Keep in mind that renouncing anonymity is like losing your virginity: you can only do it once. So make sure it's something you really want to do, and/or that the time and manner is of your choosing.

Monday, November 06, 2006 6:27:00 PM  
Blogger Al said...

Dang, its flat there.

Monday, November 06, 2006 7:10:00 PM  
Anonymous Anonymous said...

Come to think about it, I'm almost at 6 months myself. Your writing is wonderfully evocative and descriptive; an inspiration. Maybe the extra three weeks is what does it: I'm not there yet. Keep it coming!

Monday, November 06, 2006 7:45:00 PM  
Blogger TheTundraPA said...

Thanks to all for your thoughtful and helpful comments. I think I was having some Full Moon moments there on Sunday.

The article on me was published in the AAPA News on Oct. 30th. I have not received a hard copy of the issue yet, but was able to read a PDF version (they did a really nice job) on the organization's website today. Available to members only.

So perhaps I'm giving up anonymity by degrees; only my professional colleagues will know.

anonymous--thank you. really.

Monday, November 06, 2006 11:09:00 PM  
Anonymous Anonymous said...

Congrats on 6 months! I came across your blog when a friend in Philadelphia sent it to me. I live in Bethel and it's interesting to see your side of things in this town.

As far as anonymity, I agree - do only what you're comfortable with. Congrats on the AAPA article! :)

Tuesday, November 07, 2006 1:34:00 PM  
Anonymous neoPA said...

Congratulations! I found you through the AAPA article which I received today. This is an amazing blog which I will continue to follow. I've only started reading but will continue most definitely!!

Tuesday, November 07, 2006 2:19:00 PM  
Blogger TBTAM said...

Congratulations! Six months of consistently great writing. Here's to another 6, and another, and another....

Thursday, November 09, 2006 3:53:00 PM  
Blogger Borneo Breezes said...

When I first read your blog (and didn't know how to access archives) I just assumed you'd been doing it for years!
Even authors who are "out" rarely tell all, maybe even never, and mix up the real and the fabricated so it is seamless. I once heard Alice Munroe admit she wasn't sure sometimes which was which. Isn't that wonderful!
Congratulations on your anniversary!

Friday, November 10, 2006 8:13:00 AM  
Blogger Ambulance Driver said...

Dancing rodents!

Thursday, November 15, 2007 6:09:00 PM  
Blogger The Tundra PA said...


Friday, November 16, 2007 7:45:00 AM  

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