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.