Comments of a Newcomer

Off and on I have been a member of Toastmasters. I found myself teaching at the university level and not a very good teacher. This was interesting because I spent a lot of my time teaching. When I looked around I didn’t find many of my colleagues very good at teaching either. This was around about the time Canadian universities adopted the University of Kentucky's Teaching Improvement Project System, (TIPS) which actually set about training medical faculty to teach better. So I wasn’t the only person who noticed the problem. Before the TIPS program, medical faculty had generally followed the See One, Do One, Teach One model of medical education.

As I have been moving around a lot, I found ToastMasters a useful way to get to know people in new communities while building skills. There are many good aspects of Toastmasters clubs. They provide a supportive group of people providing helpful suggestions, a chance to practice different approaches with a non-medical audience and some excellent training materials. There is also a sort of group think that varies depending on the club. This is recognized by ToastMasters as a common phenomenon relating probably to the forming of group norms. So one of the things ToastMasters encourages is for newcomers to give comments. They encourage members to listen carefully to newcomer comments. Such comments may not usually be couched in the best possible way but are honest reactions that are invariable useful. The listeners job is to extract the kernel of truth in the comment.

In this tradition, as a newcomer to the medical blogosphere, I have a couple of newcomer observations to share. I think it is a wonderful thing to have a medical blogosphere. I stumbled on it quite by chance. Somebody posted a short notice about Tundra Medicine Dreams blog on the Listserve of the Society of Rural Physicians of Canada. It was the first blog I visited, I loved it and still do. If you have ever lived and worked in aboriginal communities in the north, Tundra Medicine Dreams along with the TV shows, Northern Exposure and North of 50, are going to be on your list of life time favourites. In no time at all I wanted to do my own blog.

I haven’t been around the blogosphere much, hardly at all compared to most of you. I discover new spots regularly that amaze. Moof does something about domestic violence and mentions a previous site and the history of how sexual abuse is recognized and dealt with comes tumbling down. There is a wealth of material on here for case studies. Flea, a pediatrician, handles a quandary of a child who receives the wrong vaccine in the best possible way and loses a family from his practice.

Now I am no blog expert when it comes to either content or process, except in the sense that X is the unknown quantity and spirt is a drip under pressure. I can’t even add to my Blog Roll without major template problems that last for weeks. So I offer my comments as a raw and green newcomer, one who really doesn’t yet understand all the group norms.

I have noticed that medical bloggers who by their own admission say frank, critical or sarcastic things seem surprised, Mexican Medical Student here and Barbados Butterfly here, that some readers react negatively. Some even create a whole reactive blog about a negative comment. This may be followed by reassuring noises from their loyal readers saying what a wonderful person they are, etc. So one gets the impression, intended or not, that one is not supposed to make anything less than laudatory comments at all. These are two blogs that interest me, so maybe that makes me more sensitive.

It’s true for all of us that we don’t hear negative feedback well, if at all, unless it is couched as a suggestion for change. But this approach to dissent is not conducive to the kind of creative civil society dialogue, as espoused by Jane Jacobs, that we need to encourage these days. I even caught myself trashing the look of a web site of an anti-evolutionist because of the black background which makes it unreadable.

As my father would say, "That, Borneo Breezes, is a lazy person's argument!"

For people to change, we need to cultivate a diversity of opinion. There are lots of different, strongly-held opinions about almost everything as the recent blogs at Parallel Universe and other places about male circumcision make glowingly apparent. Blogs provide a good place to have such discussion, hear dissenting opinions and respond to them. They are even a good place to rant and listen to other people rant, especially if they are humorous. I didn’t think about this when I started to blog, but I can see now that the discussion that blogs sometimes generate through their comments is perhaps as important as the piece. This in fact makes it better than newspapers, my current fetish.

Moof has done a great job on stimulating discussion about euthanasia. More is needed along this line. And we have all got to develop a thicker skin. We are not talking to just our friends who agree with us or even our friends who don’t agree with us, we are opening it up for everybody. Obviously there need to be some ground rules, indeed it looks to me like some have already started.

My second comment is about the need for a medical meta-blog. A meta-analysis is an analysis of epidemiology studies about a topic. A meta-conversation is a discussion about a conversation. A medical meta-blog would be a blog about the medical blogs. Grand Rounds may have been started with something like this in mind, but the recent ones I have seen, seem to be descriptions about a weekly array of what’s available. Now, it is a very useful service, a great boon to medical blogging and bloggers and a wonderful way to initiate non-bloggers into the medical blogophere. A medical metablog would do some critical analysis by topic or issue or category of blogs. If it was by one of the medical bloggers, it might have to be anonymous because of the problem noted above about critical comments. It could be anonymously rotated. I could see a pithy review being syndicated to newspapers. It might help break through the glass ceiling of the internet. There could be money in this idea for someone. What do you think?