"Doc Gurley" Brings Humor to Serious Health Issues

Nicholas Genes, MD, PhD


April 29, 2008

It's hard to manufacture opportunities for improvement when you're the doctor at a homeless clinic. It's harder still to get ordinary people invested in care for the indigent. But Dr. Jan Gurley (aka "Doc Gurley") has done just that, writing on her blog with a combination of humor and pragmatism.

I caught up with this remarkable physician recently to ask her about her activities.

Dr. Genes: I like your musings about being called "Doc" vs "Doctor," but how would you like me to address you?

Dr. Gurley: Calling me "Doctor" is just fine. In fact, I'll answer to pretty much anything shouted at me -- except my ultra-secret first name, which doesn't register in my brain as me. I have one of those "double-barreled" Southern names (you know, like Bobbi Sue or Jimmy Joe), but no one ever called me anything but Jan, my middle name. The real problems began when I applied for my medical license; my residency said "Jan Gurley" had completed internship and my medical school said "R-- Gurley" had finished medical school. I received 2 form letters from the California Medical Board, each explaining that, unfortunately, neither version of me was qualified for a license. It took me 8 months to sort that one out, which is one of the main reasons I keep that first name secret as much as possible. Besides, everyone should have an alter ego; you never know when you might need to be a superhero.

Jan Gurley hosts Grand Rounds
At Posts from an Insane Healthcare System
April 29, 2008

Dr. Genes: You launched your blog around the same time that you had an article published in Salon last fall. Was this a coincidence, or did being in Salon somehow lead you into the world of medical blogging?

Dr. Gurley: The Salon article, "Honey, I Shrunk My Breasts," was a fun piece to write. It deals with the issues of doctors "claiming" diseases by attaching their names to them, and the types of diseases doctors want to claim. I noticed that, unlike the Tanner stages of breast development, no one wanted to claim the stages of breast shrinkage -- so I did. I created the Gurley Stages of Breast Regression.

The fact that I started blogging around that time is pretty much coincidence. I got a contract with Penguin for my book, Dodging Death, and realized that during the many years -- literally -- that it takes for a book to hit the shelves, I could write articles and grow a blog audience. I tend to write 3 kinds of pieces: (1) more in-depth or provocative articles, which I send to established publications; (2) fun, practical thought pieces, often in reaction to something in the news, which I post on my blog; or (3) instruction-type humorous pieces about how to recognize, and deal with, unusual symptoms or problems, which are chapters in my book.

One of the advantages of publishing today is that there are many wonderful outlets, which can build on each other. For anyone interested in writing, despite having some quick success in the field, I too send out pieces cold and hope that someone will pick one. The key is to not get too discouraged and keep working on your writing. Just like phlebotomy, the more you do it, the better you get, and the less painful it is for everyone involved.

Dr. Genes: You mentioned that you're working on a book, Dodging Death. Is it similar in tone to your blog posts -- which is to say, often lighthearted but grounded in reality?

Dr. Gurley: Dodging Death is a humorous book of serious healthcare advice -- just as you described it. I believe passionately in the Spoonful of Sugar approach to medical information -- sort of like if Jon Stewart demon-possessed the body of Marcus Welby. Stodgy material is hard for many of us to take in, especially in large doses and especially if the topic is one that can generate anxiety or fear.

Dodging Death is designed to help everyday people who, more and more, are sitting at home either neglecting a quirky symptom because they don't know what it means, or don't know what to do when something like painless jaundice occurs, because they can't get through to ask in a timely manner. The problems with our healthcare system have gotten so extreme that even people with significant amounts of money (and decent insurance) are dealing with serious issues of access that can make the difference between living and dying.

Dr. Genes: Who are your readers?

Dr. Gurley: The audience for my blog has grown rapidly and in a very encouraging manner. One of the reasons I find it encouraging is because I feel that there is a lack of certain kinds of voices when it comes to health reporting, both nationally and internationally. My BOGUS awards (for truly flawed health news that gets a huge amount of uncritical reporting) was the first topic to go international; the London Daily Mail picked up a piece I wrote in response to a widely reported "news" item that claimed that there would be 2 distinct human species in 10,000 years.

Dr. Genes: As someone who works in a homeless clinic and is a former Schweitzer Fellow, have you found a role for blogging and other electronic media in helping disadvantaged patient populations?

Dr. Gurley: My article about how to give a personal holiday gift to a homeless person (Gift Guide for the Undeserving Homeless) was very rewarding to get published, because I know from working at the homeless clinic that it actually made a difference to people on the street. I'm hoping it will become an annual gift guide, right along with the Neiman-Marcus and Oprah extravagant gift round-ups!

I find that the pieces that do best (and with Google Analytics you can actually see how many people from which country visit each article) are the ones that are less navel-gazing (yes, sigh, I think we're all guilty of it from time to time) and are more about practical issues of pressing concern. Or ones that bring out the best in people, like the Homeless Gift Guide. The article Should You Get Circumcised In Honor Of World AIDS Day? had a lot of international traffic. There is a tremendous need for reasoned, thoughtful, evidence-based news/advice given in a humorous or digestible style.

Dr. Genes: What are some of your favorite posts?

Dr. Gurley: How to Break Bad News is an article I wrote that I wish I could give to every medical student before internship, because it's the lecture given by the wonderful surgeon, Dr. Judah Folkman, each year to endless medical school classes at Harvard. I wrote the article after I heard the news that Dr. Folkman died this year. He is rightly famous for many achievements, but his lecture on this topic has probably touched more lives than any one other thing.

Second, I got tremendous response to the How To Avoid A Death Like Heath Ledger's article -- again, I think the reasons are because the article provided practical advice at a time when there was a lot of fear-mongering in the news, as well as appealing to people who want to know what to do in a situation like that with someone they love. Sure, many people identified with Heath's overdose, but many people also identified with the poor maid who heard him snoring loudly a couple of hours before his death and tragically didn't do anything. That's a horrible position for anyone to be in, and that's one thing that the article addresses.

Finally, there has also been a large audience for the article New Episode of Lost - The Tampon!, which is more like the chapters of my forthcoming book than my usual blog posts. The idea for this topic came from the wonderful Rachel at Women's Health News, who had an article and lots of comments about what to do when a tampon goes missing inside. Practical, fun, provocative -- those are the goals of my writing. I aim to write the kind of piece that people feel better, instead of worse, after reading.

Dr. Genes: Readers will feel better when Jan Gurley hosts Grand Rounds at her blog, Posts from an Insane Health Care System. Join her as she highlights the best in online writing from fellow physicians, as well as nurses, students, researchers, administrators, and patients.


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