In that I pass on about 99% of the things I read, though, chances are slim that I’ll want to represent these friends and/or their friends. I always make that as clear as possible up front, but awkwardness often follows when I tell them that I’m not interested. Of course, I always try to do it in the best of ways (not right for me, the market for fiction is very tough (which it is), etc.) without lying or being phony.

A few months ago I met a woman at a party. Over the course of our conversation it became clear to me that she was a friend of a friend whose novel I had read and passed on some months before that. (She has a common first name, as do I, and we didn’t use surnames in introducing ourselves.) I felt bad not telling her, and she was telling me about how excited she was about her novel getting picked up by a literary agent. We were getting along fine, and she was cheery due to her recent success, so I thought it would be okay to say something (and I also felt bad about not giving full disclosure). When I told her who I was and that I’d read her novel, she instantly became very frosty and didn’t speak another word or look at me the rest of the night. It’s difficult when people respond like this, but such are the risks.

In reference to this case, Cedric, I wonder if you think that Barnaby was looking to you, as a friend, to be less disapproving of his high-risk threesomes than his previous doctor may have been. Do you think he may have felt that it would be harder for you to caution him in a way that he would have to take seriously?

And . . . Taco Bell? Really? Come to LA and go to some good taquerias. You’ll never go back to the TB again.

Scott: I don’t think many doctors would deny their services to friends–especially, of course, if that doctor is the friend’s only option (in that case it would be clearly unethical). Some doctors I know have their friends as patients. Others discourage it. I think I’ve come to realize that for me, it’s simply too hard to separate the two roles. I guess other doctors are much more adept. It’s certainly my issue. But in a big city, with a ton of doctors, it just doesn’t seem necessary to have to confront it.
Moreover, it rubs both ways. When I randomly run into patients in public (e.g., in line at the post office), many of them are very uncomfortable. (Others have yelled, “I got your letter than I don’t have chlamydia! It made me so happy!”)

MarleyFan: I guess the issue extends to other professions as well. I don’t know how a religious leader in a small town could hear intimate/disturbing confessions from a congregant and then try not to under- or overcompensate in future interactions.

SSW: Your patellar reflex is hot! And, by the way, I actually love giving medical advice at any time to any friend. I just don’t want to be their doctor and have responsibility for my treatment plans.

Dave: If an upscale restaurant chain like Chi-Chi’s can have a hepatitis A outbreak (Pennsylvania, 2003), then even a chain of delicious Taco Bells can have a little E. coli once in a while. You know it tasted good before it caused the explosive diarrhea.

Bryan: You can still sue. I know a good lawyer.

this was an intense post. and reminds me that i’m not sure how i feel about the fact that you steadfastly refuse to be my dr. you would be so good, and i already ask medical advice in social settings, so how awkward could it be?

re: marleyfan’s comment about small town doctors not having the luxury of professional anonymity — when i was in highschool i had my doctor (who also happened to be a family friend) remove an obnoxious oil cyst. later he took the stitches out too early and it made a nasty scar. that’s what sucks about friends for doctors. you can’t sue.

your posts always make me admire you (and my other dr friends) more, cedric.