Community ClicksWhen med students post patient pictures
Some of my Facebook friends are medical students who post cell phone pictures of patients with what these friends believe to be comical maladies, with captions like “A 5-foot-9 Hispanic male walks into a bar .?.?.” under a picture of a patient with a piece of rebar piercing his abdomen.
The postings don’t include faces or names but still seem questionable.
Doesn’t this violate patient privacy?
— Name Withheld, New York
Were these soon-to-be doctors engaging in such gallows humor only among themselves, it might be seen as a harmless way to cope with deeply disturbing situations.
But although these med students rightly strive to disguise their human punch lines — no, sorry, their patients — that is insufficient.
It is essential that those photographed are not identifiable to others, of course, but it is also important that the patient does not recognize himself online.
A doctor should not embarrass a patient or otherwise add to his discomfort, a likely outcome should the patient encounter such an image.
The chances of that happening increase as the injuries depicted grow more grotesque and less commonplace.
How many 5-foot-9 Hispanic males are impaled with reinforcing rod?
It will not improve the doctor-patient relationship when that Facebook image goes viral and the patient learns the doctor treats him like a cartoon.
A doctor that I consulted acknowledges that battlefield humor can be a benign response to harrowing circumstances but tells me in an e-mail that “public displays of such humor on the Internet, along with photos that even if not identified could be identifiable, are inappropriate and unprofessional.”
There is a deeper problem.
Rather than simply giving doctors sufficient emotional distance to function effectively, this sort of horsing around might harden their hearts, making them less able to regard a patient as fully human.
Such a transformation is not inevitable, but it is worth considering, particularly in a doctor’s training.
And many med schools do consider that, says the doctor I consulted: “At my own institution, our anatomy professor has paid great attention to this issue right from Year One, when students confront their cadavers in the gross anatomy lab, with a series of well-conceived educational efforts.”
Unauthorized repairs
While visiting from out of state, my father-in-law generously paid for some expensive repairs to my car.
After he put away his credit card, he asked if I would mind if he wrote this off as a business expense to his trucking company in another state.
Flustered, I scolded him not to tell me if he was going to break the law.
Should I have also made the shop refund his money and paid the bill myself?
— Name Withheld, Oregon
You are appropriately reluctant to participate in your father-in-law’s little scam, but you’re not in a position to demand much from the repair shop — probably not the removal of a charge from someone else’s credit card.
The person you must persuade to let you quit the gang and go straight is your father-in-law himself (assuming he wasn’t just making one of those jokes that isn’t quite a joke).
I concede that it can be awkward to challenge someone you hope will pass you the gravy at the next family dinner.
But it is disconcerting that you scolded your in-law not for being dishonest, not for involving you in dishonesty, but for telling you what he was up to.
You might strive for more than preserving your ignorance in a satisfyingly pristine state.
