Well, this is an easy one. Medical professionals are bound by confidentiality laws. You may not disclose patients' stories with identifying details unless you have their written permission (check with a lawyer for details in your state).

The famous story "Sybil," about a traumatized woman from the Midwest with multiple personality disorder, was based on a patient who was not called Sybil and probably did not come from the Midwest, and may not have been a woman.

Yes I would but not until I'm done writing thr story since I am very visual and I ca see all this in my mind as I write, and I see it with th characters that are involved. In the end the names can be changed very easily with the FIND program on your computer. so enjoy the writing process, be free and creative and button things up afterwards to PROTECT THE INNOCENT.

As a medical practitioner there are legal liability issues to just spilling it all. You could loose your license... and more. Much, much more. Screw over your patients, they are legally entitled to screw you.

That stuff about discretion being the better part of valour? What it really means is... how much are you seriously willing to loose? But then, your publisher (if your agent hasn't already) will slap you down when you talk crap about the creative necessity of using real names. That's just the writer part. The medical practioner part? Don't you know already?

Why not post YOUR real name so people know better than to trust in you?

(Or is this a fake letter because Cary got a tell-all e-mail from Rick Santorum?)

And then get it down on paper. That is the real job. You can worry about this other stuff later. And, live happily ever after.

Every artist is a cannibal, every poet is a thief...

-- from the U2 song 'The Fly'

If you take the Truman Capote route of dishing on people's dark secrets, while never allowing yourself to be real and fallable, you're going to lose friends. If you write about people like a gossip columnist no one is going to be happy about that.

But, if you write about your life and are honest about yourself within your work and include your friends at the same time, I think this is fine. Many writers, like my personal favorite Raymond Carver, have used this to great effect. The reason Carver works so well is that he is never away from his humanity, even when he's writing about a drinking binge or cheating on his wife.

Just the fact that you are asking the question indicates that you are trying to be ethical. Good for you. However, medical people are held to a very high standard regarding patient privacy. VERY HIGH! You had better think about this long and hard. You could breech the medical knowledge that was shared with you in a professional setting and open yourself to the loss of licensing and lawsuits.

These are litigious times and frankly, you will be walking a tightrope. Can't you think of something else to write about?

If you think this is the way to go in your writing, you had better be very, very careful. You stand to lose a lot, career wise and friend wise and patient wise.

First of all, you act and sound like a medical professional, which you are clearly not. Secondly, if you regard these folks as your "patients" and they share the same perspective, then it would not be ethically proper for you to use them and exploit their situations. They would recognize themselves and feel that others would too.

The fact that you are looking for others to tell you this is okay is another glimpse into that you really already know you should not do this.

People are going to think they're characters in your story, even if they aren't. If you write a book about a character with your background, age, educational background, etc., everyone will assume it's autobiographical. The character's parents will be very much like his or her real life parents, etc. Why else, the logic goes, would a writer write it in the first place?

So do what Anne Lamott suggests in "Bird by Bird," change details. And if it's a male character, make him minimally endowed. Then he'll be less likely to come forward.

How about change YOUR name?

I dated a writer. He was fascinated with my life story and since we were together, I was flattered and indulged both myself and him. A year after we broke up, he was published and he wrote a lot of my story in his book-- it was a large portion of the book and identifiable.

My bad judgment in dating a (particular) writer does not justify this. Hell, dating him was punishment enough.

It was my story. Mine. I lived it. He stole it.

People we knew read his book and recognized me. People sided with me without even hearing my outrage. He lost his creditability in a small yet vocal circle. He looked like a crappy uncreative writer, which he was not.

While I still feel used by him in a very personal way, he lost. The fact that he lost does not even make me feel vindicated, since he got the best bits of the story wrong anyway and we ultimately both lost.

Most fiction is motivated by something that really happened to real people, but if that serves as much more than a prompt for one’s own creative additions, an armature upon which to build, then not only is there the risk of hard feelings or liability for defamation, but much of the pleasure of the creative pursuit is forfeited. It’s painting by numbers. Anyway, something that “really happened!” – the beginning writer’s protest to a critique that the piece is either boring or unbelievable – rarely exhibits the deliberation, characterization, and dramatic structure that make a piece of writing a story.

Too, the scenario described appears to be one in which clients or patients have submitted to some kind of medical or health treatment. The relationships are personal and confidential. There is necessarily an element of vulnerability, which should not lightly be exploited.

Perhaps no one more than a writer has such a limitless resource of material with which to work. Take advantage of that. Characters who never were, doing and saying things that have never been done or said quite that way before, are auditioning all the time for a role in your story. Get to know them.