January 16, 2008

"Every time you post, recite the following to yourself as though it were a mantra: 'I am cutting rope with which to hang myself....'"

Advice to doctor bloggers, from Robert Lindeman, the pediatrician who blogged his own malpractice trial and then had his blog — which he'd been writing under the pseudonym "Flea" — exposed and used against him on cross-examination.

IN THE COMMENTS: Eric Turkewitz, whose interview with Lindeman appears at the link, writes:
I don't think I'd use detachment as the word for what he was doing. Rather, he seemed to be obsessed by the death of the boy and the idea of being blamed for it, perhaps understandably obsessed. And that seems to be what clouded his judgment.
Although I didn't use the word "detachment" — a commenter who calls himself "althouse too" did — I did write about "Flea" back here and posit a "disconnect between the writer taking a pose for literary effect and the real-world person." The doctor himself had characterized his blogger persona as a "cocky bastard."


marklewin said...

I would advise anyone who anticipates or engages in forensic activities (no matter the profession) to be very, very careful about blogging and there presence over the internet. I'm not an attorney and have not stayed at a Holiday Inn Express, but if I was a lawyer and anticipated having to examine someone or their work in a forensic context I would certainly search the net for information they provide. And if they have a blog......I would scour it, looking for material that would support my positions.

reader_iam said...

Is this really a sly, humorous, metaphorical note to yourself?

Or part of the curriculum of the Althouse blogiversity (ever consider adding "blogiversity" to your tags, btw?)?

Elliott A said...

The arrogance displayed by blogging his own trial and his apparent detachment from the procedings (for why would he blog if otherwise) make your warning lost on this type of individual.

Peter Hoh said...

cutting rope or braiding rope?

Swifty Quick said...

The arrogance displayed by blogging his own trial...

That succinctly states my impression of him too, as it was before reading this interview. But now I see that in his blogging he just made a miscalculation. He underestimated the capacity of motivated people to find out who is who on the net. Nothing more.

Eric Turkewitz said...


I don't think I'd use detachment as the word for what he was doing. Rather, he seemed to be obsessed by the death of the boy and the idea of being blamed for it, perhaps understandably obsessed. And that seems to be what clouded his judgment.

Peter V. Bella said...
This comment has been removed by the author.
KCFleming said...

I read about this case awhile back.

'Twas pride that done him in. Hubris. It raised my "what the hell were you thinking?" response.

I disagree that malpractice suits carry any greater risk for those who blog. Malpractice isn't about error or judgement or mistakes or fault. It's a tax on doctors levied by lawyers, without representation. The proceeds are not shared with the public at large, and the effects are not to change physician medical behavior, but instead to practice overcautiousness, in word, deed, and testing. Or it warns off potential practitioners (hence the dearth of obstetricians and neurosurgeons).

What "Eric Turkewitz, The Turkewitz Law Firm, New York, NY" fails to admit is that his personal injury and medical malpractice litigation is entirely a nonproductive siphon, a transfer of wealth from doctors to him, and a little to his clients. I'd feel better if he simply charged me $500 annually not to sue me, and be up front about the shakedown racket.

The only useable advice he could give about avoiding malpractice suits is don't become a doctor. It's what I told my kids and my kid's friends. And they didn't. Some are becoming lawyers instead. Yay. (Two of them in particular would have been good docs. But what's the point, when the Turkewitzes of the world hold sway?)

Peter V. Bella said...

This guy hung himself on his own petard. Sheesh. I wonder what his attorney said when this came out? After reading the interview I would agree it was arrogance. If there was no blogoshpere, he would probably have been giving interviews to any and all and issuing press releases.

The last time I was sued involving my profession, my lawyer threatened me. He told me flat out that if I even dreamt of saying anything to anyone he would personally effen kill me. I believed him. But that’s another story.

Ann Althouse said...

Eric, "althouse too" isn't me -- just someone else with the same last name.

Maxine Weiss said...

I'm very confused by "althouse too".

I'm afraid I can't tell the real Althouse apart from "althouse too".

Please contact Blogger to have "althouse too" removed, so we can end this confusion.

Meade said...

I wonder in which of the two professional fields - law or medicine - does most malpractice occur.

I'll bet it's law.

Maxine Weiss said...

When a lawyer commits malpractice, you lose money.

When a doctor commits malpractice, you lose your life.

Synova said...

(Remove althouse too? How silly. If it's your name you get to have it.)

I don't know what would motivate someone to write a blog about being sued unless it was to help his or her case, in which case you'd use your name and not a pseudonym.

I wonder if there is a difference in expectations about pseudonym use between relative late-adapters and those of us who have been on-line since before Gore invented the internet.

I know one person who carefully and deliberately uses a pseudonym for herself and her children in order to hide from someone stalking her family (which may be a habit rather than a necessity by this time). She's used the same set of names for the more than decade that I've known her. That *is* her name, her identity, and her reputation.

I use a pseudonym but like most people I know or meet that also use one it's not anything like deep-cover. My real name is no more secret than an author who has one name on the book cover and a different name on the copyright notice on the second page where anyone can see it.

And it's still *me*. It's my name and my reputation.

The idea of using a pseudonym to create a "not me" persona in which I could act like "not me" and act in a way that would not attach to *my* reputation?

That's just weird.

And in the end, as this story of the doctor illustrates, it just doesn't work that way.

Which is why I wonder if it might be a mistake more often made by people new to the concept.

KCFleming said...

When a doctor commits malpractice, you lose your life.

That overstates it. Death from malpractice is in fact rare. Malpractice suits are more often for disablity and missed diagnoses (without death. A patient who is angry with their physician prior to an alleged incident and patients in poor financial condition are more pertinent factors in whether they sue than any injury.

Lawyers who commit malpractice kill, too. Death sentences from poor representation, jail sentences from same, where the innocent is incarcerated and assaulted in prison.

Lawyers can cause you to lose your entire livelihood, reducing you to penury. And, as a result, suicide.

Anonymous said...

Mugger: Your money or your life!
**long pause**
Mugger: Well??
Jack Benny: I'm THINKING!

Elliott A said...

althouse too will be back with a different name. While I am new to this forum, I have been using this for a long time, mostly to annoy my son. I never intended to confuse fellow bloggers or muddle Ann's message.

Ann Althouse said...

Pogo, both of my parents died from medical malpractice and in both cases, the law was such that the doctors could not be sued. This is a sensitive subject with me.

Ann Althouse said...

My mother's case involved a failure to diagnose cancer (over a long period of time), and my father's case involved a perforated colon during a colonoscopy which the doctor failed to notice. (My father did not have cancer.)

KCFleming said...

This is a sensitive subject with me.

I am sorry to hear that happened. There are no words for it.

It's a sensitive subject for me, too, as is obvious. Mistakes were made with my parents as well, leaving one disabled.

I don't think malpractice litigation remedies it, howevermuch it feels necessary. Innocent docs get smashed and guilty ones don't pay the price all too often.

Today a patient placed a micro-recorder in front of me and asked, "Do you mind if I tape this?" Imagine my hesitance to speak frankly, and my impulse to order overmuch, just to be sure. Imagine the extra notes I made documenting this aggressive meeting.

I imagine I will not stay in medicine very long.

Goatwhacker said...

I read Lindeman's (Flea's) blog and comments well before he was "found out". He was indeed a good blogger although pretty inflammatory, and not just about the court system. He did show very poor judgment by making his comments too identifiable and that's what did him in.

What bugs me about this case was that it was "won" not on the basis of Lindeman's medical judgment or skill, but because he was foolish and posted on a blog.

Ann Althouse said...

Pogo, thanks.

Anonymous said...

Ugh, I'm very sorry to hear about your parents, Ann. Terribly tragic. My own mother died at 48 after a doctor gave her a massive overdose of blood thinner by mistake. I was 19 at the time. Our family decided not to even think about suing because (1) the doctor was also my mother's boyfriend. (My parents had been divorced for many years.), and (2) we thought it more important to get on with our lives.

In any event, sorry to hear about the tragic loss of your parents. I guess we need to enjoy life while we have it. And in that spirit, let me thank you for your blog and the pleasure you bring to the many, many people who read it.

Ann Althouse said...

Verso, I'm terribly sorry to hear that. 48 is much too young to die, and it must have been terrible for you to deal with at age 19. I remember how painful it was for me when a grandparent died when I was that old.

Chip Ahoy said...

pedant alert
A petard is a small explosive used to breach castle walls. Sometimes they backfired, the whole thing being Medieval.
end pedant

KCFleming said...

Bill Murray almost said once "Don't blog angry." So Ann, my apologies.

Bad day.

Ann Althouse said...

It's okay, Pogo. I am also sympathetic to the doctors who are sued over unfortunate outcomes. It's bad enough that you're in a position to hurt people, which is punishment enough if it happens, but to be accused of negligence must be very painful, and I'm sure it's often not true. I think lawyers choose which cases to fight based on a lot of factors, and the wrongfulness of what the doctor did is not always the predominant one.

Ann Althouse said...

Let me refer people back to this old post of mine from September 2004:

Instapundit mentions that his grandfather died from complications of early coronary bypass surgery. My grandfather had one of the earliest bypass operations, in, I believe, 1954, and he lived another 15 years as a result. He was fortunate to live in Ann Arbor, Michigan where the surgery was being developed. I'm sorry I don't know the specific history of the development of the surgery. But I remember that my Grandpa Beatty died in 1969, and that the family always said he lived 15 more years because of the new surgery. I remember being a little kid--I would have been 3 in 1954--and seeing my mother prepare to fly to Ann Arbor to see her father, having been told "If you want to see your father alive again," you must come immediately. That said, both of my own parents died in Florida, where, I believe, inferior medical care deprived them of many years of life. In fact, I believe medical malpractice caused both of their deaths. And let me add that no lawsuits were possible. Suffice it to say, I don't cheer when arguments about "frivolous lawsuits" are bandied about. It would be pleasant to believe that there are too many medical malpractice lawsuits, as our President does, but highly disturbing to find out that there are too few. From my personal experience, I feel there are far too few. That said, I also think it is very hard to be a doctor, and mistakes are part of what happens. I am thankful good people go into medicine, even though they will go on to carry the burden of seeing their own mistakes grievously injure people. But there are also people who are not so good, who lay their hands upon human bodies every day. It is easier to whine about lawyers than to think about them.

UPDATE: Regular readers know that I voted for John Edwards in the Democratic primary. This post contains some of the reason why I respect him.

Peter V. Bella said...

My father was a victim of malpractice. I too could not sue. He was rendered and spent the last six years of his life as a quadriplegic.

What I did find out about malpractice is that most doctors are not disciplined or even permantly stripped of thei licenses for egregious or serial malpractice. If they do lose their license, they just relocate to another state and apply there.

It is easier for a lawyer to lose their livlihood than a doctor, at least in Illinois. The medical associations are extremely protective of their members and are given too much free range in their self regulation.

Revenant said...

There isn't necessarily a conflict between thinking that too much actual malpractice goes unpunished and thinking that current malpractice law is overly burdensome on doctors.

Studies have repeatedly shown that malpractice awards really have little relationship to actual malpractice. If, for example, you screw up and a 76-year-old man dies, the jury will probably give you a pass on it. If a young mother dies under your knife through absolutely no fault of your own, you'll get nailed for an ungodly sum.

This is because jurors generally lack the training and/or intelligence to really understand the medical issues involved, and few cases of malpractice are so egregious that they are obvious even to amateurs; as a result, juries tend to award based on the perceive loss to the "victim" rather than based on actual wrongdoing. So doctors end up being discouraged from practicing forms of medicine that involves treating patients jurors will irrationally sympathize with (such as obstetrics), and incompetent doctors of "low-value" patients get away with extreme incompetence. This situation obviously serves the interests of neither the doctors NOR the patients. We need malpractice reform -- for everybody's sake.

AlphaLiberal said...

Wow, Ann. That was quite a post on your experience and views on medical malpractice and "frivolous lawsuits."

Elizabeth Edwards handled Chris Matthews really well on the subject recently. Quite an interview, I think Crooks and liars has it.

(Not what I came to post, but that's fine).

Peter V. Bella said...

Revenant said...
We need malpractice reform -- for everybody's sake.

Part of the reform should be stricter regulation of physicians. Their self regulation must end. Accidents do happen. Unforseen circumstances do occur. But if a doctor has a record of malpractice that is a sign of incompetence. He should permanantly lose his license.

Our government regulates too many esoteric things, yet a profession that determines life, death, or quality of life, they leave to the profession itself to regulate. This is an abomination. I do believe that most government regulation is oneroous, conflicting, and harmful, but in the case of medicine it is warranted.

Revenant said...

Their self regulation must end.

I don't see how this can reasonably be done. How can you determine if a medical procedure was well-done if you don't even know how to perform the procedure in the first place? Especially in a field like medicine, which is still more of an art than a science in many respects.