No, Not Even the ‘Small Things’ are Okay

I live in a small town, which is something I both love and hate, at varying times. (Ask me how I feel about it this time tomorrow.) One of the consequences of living in a small town is that everyone knows everyone else’s business, or thinks they do, which can amount to the same thing. If you’re, say, disabled and queer, a lot of people will talk about that because they think that’s okay to do, and a variety of colourful and entertaining rumours will circulate as a result.

One thing people around me seem to think is really bizarre is my desire for privacy. I ask that people not talk about my disabilities or my general health with other people, and this is rarely respected. Thus, I hear through circuitous ways about the strange things are people are saying about me, because in the small town game of telephone, someone mentioning that I looked peaked in Harvest Market on Friday will turn into me being taken into the ER in convulsions by Sunday night. You can imagine what happens when people have actual medical information about me.

What people usually say when I say ‘hey, I would really prefer that you not disclose information about my disabilities or my health to third parties’ is ‘oh, but it was just a small thing.’

Except that there is no such thing as a ‘small thing.’ People who know what medications I’m on, for example, could look those medications up and find out what conditions they are commonly used to treat. Thus, someone saying ‘oh, I saw s.e. at the pharmacy the other day picking up some [prescription drug]’ is not disclosing a small thing. That person could be providing highly compromising information, actually, because once people go home and look it up, they encounter a lot of misinformation and they map that over to me. Maybe I’m not even taking the drug for the reasons they find on WebMD, but they’ll decide I have [disorder] without talking to me or asking me for any information (probably in awareness that if I haven’t told them, there’s a reason for it) and since there’s a lot of stigma about it, they’re not going to view me the same way. They won’t interact with me like they used to. They will think I’m unreliable and untrustworthy. Despite years of evidence contradicting these beliefs, that’s how they will start thinking of me.

People in small towns squirrel away information and they revel in having secrets that can be teased out of them. How often do I have conversations with people where they talk about other people and they say ‘well, you know, ever since the diagnosis, she hasn’t been the same’? What they want me to say is ‘ooooh, what diagnosis?!’ Or they want me to say ‘oh yes, I know, she has cancer, it’s so sad.’ What they don’t expect is ‘I’m not really comfortable talking about that when she’s not around, can we talk about something else, please?’ I don’t play the game of secrets and this tends to make me rather unpopular, because I’m not interested in using information about other people as a tool for entertainment, amusement, or simple social advancement.

In a small town, there is no such thing as a small thing. Not when everyone knows each other, not when identifying details are pretty easy to figure out. If a doctor mentions treating a patient with a distinctive tattoo or an unusual name, everyone’s going to know who that person is. The doctor doesn’t have to say ‘I’m treating John Q. Public’ for people to know. Most care practitioners up here are aware of that and they are really careful when it comes to protecting the privacy of their patients, but the same doesn’t extend to people who are not doctors, who can gossip freely amongst each other.

I hear the strangest stories about people, the result of compilations of ‘small things.’ Many of these stories I know to be patently untrue and others are unverifiable unless I talk to the person, which I usually don’t want to do because I often don’t know the person very well and also because if that person hasn’t volunteered this information, it’s not my business. In some cases, very rarely, they are true, but I’m still not interested in discussing them, because, again, not my business. People seem absolutely astounded when I suggest that they stop spreading rumours about people or when I say that I’d really prefer that they not discuss personal medical information involving anyone other than them.

I’ve had people tell me I ‘obviously don’t care about [person]’ for asking them to stop talking about that person’s disabilities or medical conditions. For suggesting that, rather than speculating on the ‘small things’ and what they could mean, breaching privacy, faith, and trust with their supposed ‘friends,’ they shut up.

By 1 December, 2010.    medical practice  ,  



5 Comments

  1. I live in a very small town and know exactly what you’re talking about, especially the way people are astounded when you won’t gossip. I work in the pharmacy and our confidentiality policy has to be really, really specific and watertight. We still had an incident with an angry customer who thought we had leaked information about her surgery to a staff member’s relative, which led to a very unpleasant round of staff interviews. (The person I’m fairly sure it was denied it, but she hasn’t done it again, which is something, at least.)

  2. I am in complete agreement with you. I don’t like people to know a lot about my diagnosis (fine with saying spinal arthritis) because otherwise people think they know what they can to do “fix” me and that “I’m doing it all wrong.” And very personal info gets out–have been embarrassed by that. Living in a really small town–like 200 to 1200 people–been there, and the gossip is exactly as you say. Sounds like you are a really good friend, and a better one, not to engage in speculative gossip.

  3. A-friggin’-men.

  4. Had the small-town thing happen to me when I was 19– I had a work-related injury at a job in another county, went to see my hometown pediatrician (hadn’t found an adult doctor yet), and two days later my mother had a distorted version of what happened, and called me in a panic. So, my family (and maybe others) were given inaccurate and upsetting information, AND my privacy was violated. Multiple fails.

  5. i lived in a place so tiny it was a hamlet, with not even 100 people. there was a couple of men who moved in next door to my grandmother-in-law and those POOR THINGS have had no end of what you mention. They’re obviously up to something, because they *always* lock their door. They don’t like to gossip, so they are snobs. They must be lovers, why else would two men live together? They are up at all hours, are they on drugs? They actually installed a security camera, what do they have that’s so important?
    I don’t care. It’s their business, not mine. I just feel terrible for them ending up in a place populated by nosey old women.