Views & Reviews From the Frontline

New kids on the blog: new media and medicine

BMJ 2010; 340 doi: (Published 21 April 2010) Cite this as: BMJ 2010;340:c2145
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

    In the past clinical entries were short and illegible, because doctors’ handwriting is notoriously poor. This was explained by their being pressed for time, but for me it is because I could spell only the first three letters of most medical conditions so blurred the rest. Fountain pens were given as presents, adjustment made with whitening fluid, and final copies sent by post. But in the 1990s came word processors with spellcheckers, cut and paste, and infinite redrafting. This allowed me to start journalistic writing. And in 1995 I licked four envelopes to the leading magazines for general practitioners and posted my article idea—“Let me through”—of vaguely rude parodies of doctors (see box). By return of post I received four rude but amusing rebuffs. But I kept on writing because writing is therapy, and with the advent of email I could send the same article to multiple publications for rejection.

    But the media are changing. The internet has spawned blogs, microblogs, podcasts, and YouTube and social networking sites, and you can even simply establish your own website. This is both egalitarian and immediate: everyone is a potential journalist and publisher. Some of the result of the explosion in new media is great, but much is tedious, obsessive, phoney, irrelevant, ill considered, and insulating. Will it herald a new era of medical journalism and radicalism?

    The internet has gone mainstream and is now viewed as an essential public utility. It is so important that legislation is afoot to control file sharing and protect copyright. Bloggers are under threat of libel, and their anonymity is challenged. Advertising money is shifting online, and money always dictates control. New electronic platforms that mimic traditional print formats, such as e-readers and Apple’s iPad, will deliver online subscriptions to magazines and newsprint. With blogging, enthusiasm will stall, with authors bored of writing and readers boring of reading. Anyway, people gravitate to the familiar, most likely to the web pages of the old media: these traditional outlets are accountable for content and accuracy but also have a reputation to lose. New media may soon look a lot like an onscreen version of the old.

    But I am just an overindulged old world hack on the wane. The new media are a good thing, because in the past history was written by the privileged few. The new media in all their guises are at least the diary of the people. They offer writing therapy to doctors and the opportunity to upload a different version of the official sanitised version of the NHS. And I hope that they will reveal some new hacks to the old media moguls, who will let them through.

    Let me through

    Jesus, trust me to open my big mouth: “Yes, I am a third year medical student at the Royal. Blah, blah, blah. Yar, very hard work but really interesting, learning loads. Blah, blah, blah. I guess you just get used to it; blood and that stuff doesn’t bother me. I was doing this operation with one of the junior house officers last week . . .”

    I was sitting talking a fair amount of bullshit, pissed of course. “Doc” shoes scuffed to shit, “ethnic” coat (which “ethnic” I’ve no bloody idea), Labour badge (“Yar, I think doctors get paid too much; I’m going to give some of my money to the nurses when I qualify”). NHS specs (well not really, in fact £100 of pure designer sex), hair short around the side and floppy on top. Anyway relatively cool by standards in my class at uni, I even have friends who are arts students. My attempts at a working class accent were winning; it amused my surgeon father anyway.

    Well wouldn’t you just bloody believe it. Some sod has a fit in the pub. “You’re a doctor: go and do something. Everyone let him through he’s a medical student.”

    Well I knew nothing about “fits,” having skipped all the first aid lessons. I remember that getting the patient’s tongue out of his mouth was imperative. It was extremely difficult trying to sit him in a chair first of all. Then to try to open his mouth was impossible. In the end I had to resort to trying to punch his mouth open as I had seen in a western once. Christ my hand hurt the next day. I reckoned he was going to have to see a dentist some time soon. Anyway the ambulance crew arrived just as I had managed to get hold of his tongue. I was smiling and holding it proudly when they approached.

    “You stupid bastard.”


    Cite this as: BMJ 2010;340:c2145

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