So, at some point or another, most people who know that I blog AND that I am a resident in Medicine will often ask why I blog about the stuff I do, or perhaps, why I *don’t* blog about medical stuff. Since its up on Crunchnotes, I thought I might as well just blog about it right now.

I blog about tech related matters, journalism, marketing, web2.0 matters, design and other miscellania because its interesting to me. In fact, I’d like to think that I’m a guy who’s got lots of interests, and while Medicine is one of them, its not all of them.

Blogging tickles my brain in a way that is difficult to express in Medicine. It allows an outlet for creativity, analysis and opinion in a frank and honest (and sometimes snarky) way about topics that I have a fascination about.

Medicine means something different for me entirely. Although there is always the academic and intellectual challenge of it all, I find that the most rewarding parts of it are the ways that it allows me to connect with patients. Its not always easy, but when I get a chance to reflect on things, its the thing I really find worthwhile.

While I’m on the topic, this past month, there was a rare intersection of blogging and Medicine that I came upon, as I ran into a blog of a patient I was taking care of that was being done while I was actually care of the patient!

You know, we always harp upon blogs being about “conversations”, and how important it was to have “comments”, and certainly I’ve been a shrill voice in that dialogue as well.

Anyway, I retract that now.

This past month I was working on the ward of a Palliative Care service, where we helped people with the symptoms of cancer, so that they enjoy the time they have left with their friends and family.

Josh was one of my patients. He is dying of leukemia.

Josh’s family maintains a blog at joshuasprogress.blogspot.com, whose origins were primarily to keep the small town they hailed from in touch with his progress. Only recently have they opened it up to the public, and with it, we were able to get a glimpse into what living with a terminal illness is like for Josh and his family.

It opened up a side to him that I was never fully able to appreciate as we were so focused on his symptomatology. And it was so rare to get an almost “live” report on how things were doing from his end of things. We’d try something one day in response to how he was doing, and later in the day, you could tell what his and his family’s opinions really were on our efforts.

It was both refreshing and humbling at the same time.

I don’t think many patients or families could essentially “live-blog” this stage of a patient’s journey with Cancer. I think it may have to do with a combination of things, but probably the most important was the fact that they had lived with cancer so long that they had become accustomed to it. More than that, though, it seemed like both Josh and his parents had come to gain a measure of peace in accepting what the outcome of his illness was — and they worked with us to make sure that Josh still had a measure of control over whatever time was left in a way that he felt was important.

Josh’s blog doesn’t have comments.

I’m not sure if they’re really all that necessary.

Josh’s blog is a rare and unique glimpse into how a patient and a family deal with all of the issues around cancer, particularly at this late stage. I don’t know of many families that would be able to blog about an illness during the illness itself. But I think that perhaps one of our hospital chaplains described it best, when she described Josh and their family’s sense of peace as a state of “grace”.

You know, blogs are all kinds of things to all kinds of people. Most of the time they ARE conversations. And sometimes its appropriate that we don’t blather on, but simply listen what people have to say, because its that important.