Russel Saunders over at The League of Ordinary Gentlemen has mocked up a hospital record for Bruce Wayne. It reads remarkably like an actual medical history, which shouldn’t be surprising given that Saunders is a physician. But it winds up getting at a few legal issues about which some comment is merited.
First of all, reading this document should demonstrate, in part, just how hard it would be for a superhero or supervillain to maintain a secret identity. We talked about the difficulties inherent in alter egos about a year ago, but actually looking at what a medical record for a superhero might actually look like just drives the point home. If you go to the hospital, people do ask questions, and health care professionals are trained to ask uncomfortable questions about unexplained injuries. This is partly for the safety of the patient, as a lot of domestic abuse goes unreported until someone shows up at the hospital, and even then it can take some real prodding before the truth comes out. But it’s also partly for public safety reasons, as many people who wind up with unexplained injuries, especially things like gunshots or knife wounds, are involved in something slightly less than legal a lot of the time. While the doctors and nurses who actually provide medical care don’t usually care about whether someone was injured while breaking the law, police departments routinely call emergency departments and hospitals to see if suspects likely to have been injured have turned up.
Second, even though medical records are protected by privacy laws like HIPAA, once this information is out there it doesn’t just go away. If an enterprising Gotham City DA ever suspects that Wayne is up to something untoward, he can get a warrant for Wayne’s health records. All of this information—including the little speculative note at the end of the record—will come out, all of which will put a DA that much closer to putting the pieces together. Wayne may be able to account for his whereabouts in some cases where Batman is known to have been involved, but if he shows up at the hospital every time Batman does his thing, that gets harder to explain. Similarly, a person who sues Wayne for unrelated reasons may well be able to get access to Wayne’s medical history, assuming it’s within the realm of permissible discovery. This could, in turn, lead to other connections being made and investigations started. Hacking and other unintentional leaks are another way the information could become public. And like with WikiLeaks, once information is out there it’s hard to make it go away.
Third, there’s the issue of payment. Wayne is listed as self-pay, which is entirely plausible given his particular position. But what about Dick Grayson and Jason Todd? Or Selina Kyle? Or Frank Castle? Or basically any other more-or-less normal guy with a dangerous sideline, no healing factor, and a masked identity? How are they paying for their medical care? Insurance? Certainly not from their employers, and even if they were, that means that some claims adjuster out there is getting regular reports of outrageous physical trauma. Phone calls are going to be made. Self pay? Do these people even have jobs? If not, where are they getting the money for all of this? If they’re paying, someone is going to start asking how, and if they’re not, the hospital is going to start getting pissed. Again, attention, which is bad news for anyone trying to maintain a successful, secret alter ego. Field-medic-style first aid isn’t really a solution here, as even if our heroes never go to the hospital for the traumas they suffer, they’ll still probably wind up stopping in for something eventually, at which point even a minimal probing of their medical history or a cursory imaging study is going to reveal unexplained past injuries. Questions will be asked.
So good on Saunders for a plausible take on what a document like this would look like. It’s a valuable bit of added realism that comic book writers would do well to consider.