Dear blog, my patients are nuts. Signed, anonymous

At the drive-up pharmacy, you hear the woman complaining about the size of her Lipitor co-payment. Then you spy a half-eaten Big Mac languishing on her dashboard.

Let's say you are in line at the drive-up pharmacy. Through your open car window, you hear the woman ahead of you complaining about the size of her Lipitor co-payment. Then you spy a half-eaten Big Mac languishing on her dashboard.

The scene might yield a “Guess what happened today” story at the dinner table for most of us. But for the writer-physician behind the blog White Coat Rants, it inspired a covert photo-op of the burger in question, followed by some bon mots in a blog.


“I like being able to give someone an unexpected smile,” said the anonymous scribe behind White Coat Rants, who revealed in an interview that he's 40-ish, practices emergency medicine in the Midwest, and enjoys martial arts.

At 1,200 to 1,800 hits per day, White Coat Rants is one of the most popular in a growing genre of anonymous blogs written by doctors and other health professionals. Some of these bloggers like to comment on medical news of the day; others enjoy analyzing the media's coverage of medical news. Some talk about politics or their personal lives. Most, like White Coat Rants, feature amusing encounters with patients.

There was the patient on Coumadin who feared she had blood clots on her fingers, but merely forgot to wash her hands after changing her printer's ink cartridge. Or the 18-year-old with ringworm who had a speaker wire taped to his chest “to keep the aliens from finding me.”

“I enjoy writing about patient interactions the most,” said Dr. White Coat. “I also try to write about things that show the human side of people who work in health care. Not just doctors, but nurses and EMTs that I work with as well. We all like to laugh and joke around; we feel sad; we get frustrated just like everyone else.”

Nurse K, a reader who has her own ED blog, Crass Pollination said she likes White Coat Rants because the writer “seems like a nice fella, writes well, writes frequently, and has the subtle, biting sense of humor of someone who works in an ER.”

While often LOL (laugh-out-loud) funny, White Coat Rants isn't all levity and yuks. Serious topics arise, like when Dr. White Coat encountered an ED patient whom he had pegged as a narcotic-seeking drug seller, only to learn she had brain cancer.

“This is a perfect example of what emergency physicians and nurses go through every day. Where do we draw the line?” he wrote. “It scares the hell out of me that a prescription I write could someday be sold to my own kids and start them on the road to drug addiction. Yet it scares me just as much that I could let another person suffer in pain because I was too afraid to write her a prescription for narcotics.”

It's this very sort of struggle, along with the day-to-day variety and oddity of the ED, that seems to inspire emergency doctors and nurses to start blogs more than professionals in other areas of medicine. Dr. Rants himself became interested in blogging by reading other ED blogs, he said.

“Some of the things I have read on medical blogs have changed the way I practice medicine,” Dr. Rants said. “And posting my thoughts and responding to arguments gives me a fresh perspective. Kind of like a ‘grand rounds' on my own Web site.”