How I Am Weaning Social Media

 I have spent the past year weaning myself off social media. Social media websites such as Facebook and Twitter have come under fire of late for very good reasons. We’ve long known that the incentive model at Facebook has resulted in an outrage economy, fueling clickbait headlines hinting at conspiratorial nonsense and encouraging harmful commentary from people who set the skew on the Dunning-Kruger curve. This is not a healthy way to engage with the world and learn of it. The moldy cherry on top is that Facebook clearly prioritized engagement and algorithmically driven entombment in echo chambers without taking seriously the massive harms it knew it was causing.

I hadn’t really used Facebook of late as anything other than a way to keep track of old friends, but I did use Twitter many hours a day as a way to stay abreast of breaking news as well as seeing hot takes about the current political climate. The immediacy of getting breaking news while simultaneously getting seemingly insightful commentary on said news was an addictive way of roiling oneself. I became a bit sickened by the “Twitter villain of the day” phenomena - hordes of anonymous online people dogpiling onto people who posted a dubious opinion, a punishment that becomes wildly disproportionate to the sin. One person versus a million bad-faith anonymous criticisms is a devastating way to cultivate the most bitter sides of all people involved. I participated in the dog piles on an infrequent basis. On reflection, I did not like who I was when I joined these piles. Earlier this year, I quit Twitter permanently.

This left an information vacuum - I no longer had an outlet for obtaining news, so I now needed a substitute. I would like to share how I now get my news, and I hope this may help some of you wean yourself off social media should that be what you want.

My first thought went to an RSS feed aggregator. For the uninitiated, RSS is an acronym for either RDF Site Summary or Really Simple Syndication, depending on who you ask. A RSS feed is internet-based formatting that allows an aggregator program to collect and display posts from various websites into one page. I use the https://feeder.co/ website to collect a bunch of news into one place, but you can search “RSS aggregator” on your search engine of choice to see other options.

My feeder.co homepage. The leftmost column is display options/settings. The second column shows how I organize my feeds. The third column is the feed of headlines. The large space on the right displays the news story highlighted in the feed.

 

I prioritize print media over video. While video can provide context with graphics or footage, I generally find that print is more efficient with information. I can read a news story much faster than videos can usually convey said news, and print media can usually afford to put more information per news story than a video can within certain time constraints. Additionally, video news (especially 24 hour cable news networks) may have guests who have no relevant expertise discuss the news (such as people from politically motivated think tanks) while print media seems more likely to actually have input from relevant experts (likely due to the level of commitment needed to provide a quote for a newspaper via telephone or email versus actually having to go to a studio and talk on camera).

I have only one or two national news organizations I have put in my feed to avoid repeating headlines or overexposure to depressing news. I like NPR, so I included their national news feed in my aggregate. Otherwise, I have included local newspapers for my political news. Our local newspaper in Covington is the St. Tammany Farmer, a subset of The Advocate (https://www.nola.com/). While I wish St. Tammany Farmer were truly independent, the editor sent me an email after I paid for a subscription assuring me “We are locally owned, so we don’t have to answer to anyone except our subscribers and our advertising partners.” A lot of local newspapers across the country have been ravaged by private equity firms more focused on profit than good journalism, so supporting a local independent newspaper is important.

Many professional organizations also have RSS feeds, so I aggregate publications from several medical journals, regulatory agencies, and certain news organizations that cover healthcare-related news.

I also aggregate news related to hobbies or interests. I love technology and video games, so I added the RSS feeds from The Verge and Polygon. I am interested in urbanism and how it relates to human health and climate change, so I added the RSS feeds of several news outlets and activist organizations that cover these topics. 

Collecting all these feeds into one place has allowed me space from social media, a place where I can process news on my own terms, without the distressing commentary offered by strangers.

ZDogg MD: Sorry, Not Sorry

Surviving in medicine is frustrating. The system is overburdened, the hours are long, our work is saturated in bureaucracy, and we are facing a growing wave of public opinion that does not trust our work. Keeping a veneer of professionalism and focusing on the humanitarian value of medicine becomes increasingly hard as the days pass. Fortunately, laughter is a great medicine (I've been told). And what better medium exists for generating laughs than musical parody videos?

Well, I think there are many better ways. But this is what we have. Musical parody is inescapable. Ever since audio and video editing techniques became more accessible to an audience whose sense of musical parody has been defined by Weird Al, we've been drowning in music videos whose redone lyrics either don't fit with music that wasn't designed for it or worse - is compromised by it.

The medical community has its own musical parodist, and I want to talk about one of his videos today.

TREAT YOURSELF

Zubin Damania, more commonly known as ZDoggMD, is the most famous purveyor of medically-themed musical parody. Per his bio on his website, "As a way to address my own “burnout” and find a voice, I started producing videos and live shows under the pseudonym “ZDoggMD” that have since gone epidemically viral." Over 200,000 people have subscribed to his channel. He posts music videos of his various parodies as well as the ZDoggMD show, various live streams, and the Doc Vader series.

I don't understand how this is related to Star Wars

The "Treat Yourself" video is based on the song "Love Yourself" off Justin Bieber's 2015 album Purpose. The song was written by Ed Sheeran in collaboration with Bieber and Benny Blanco. The lyrics feature Bieber singing about an ex-lover whom he dislikes, insulting this person and basically telling her to go f*** herself. The instrumentation of the song is quite clever; the guitar is the only instrument for most of the song. There is a trumpet solo a few minutes in, but Bieber hums along to the solo as if the trumpets were simply something he is hearing in his head. It adds to the musical picture that Bieber paints with the lyric "And I didn't want to write a song". He only wants to put so much effort into thinking about his ex-girlfriend, so all that's there is him and his guitar. Both the music and the lyrics support the song's theme - his ex is toxic and is not worth any effort.

Fast forward to September 2016. ZDoggMD has released "Treat Yourself". The song focuses on patients who are dependent on opiates and how doctors generally think of them. If you watch the whole video or read the description, Zubin shows that he wrote the song as a compassionate plea to help those affected by the opioid crisis. However, I believe the song fails in this regard, for reasons I will highlight now.

The song opens with the following lyrics, portrayed in the video as sung by Zubin:

For all the times that I gave you my help

And still you turned around and dissed me on Yelp,

You say you lost your pain meds. Girl please, what the health.

You never lose your script for lisinopril.

From the very first notes of the song, Zubin is blaming the victim, accusing them of lying, and calling them unappreciative. These lyrics are set to a song that people know was originally being about hating your ex and thinking they aren't worth your time anymore. So both the new lyrics and the musical context over which they've been set an impression: Zubin hates drug seekers. Fast forward to the chorus:

So if you’d like that script for percocet

Then maybe you can go see someone else

And if you think you ain’t an addict yet

Then baby you should go and treat yourself

In the setting of this song, this chorus sounds demeaning, as if Zubin is being dismissive of these patients instead of helping them with their problem.

At this point, defenders of ZDoggMD might criticize this analysis, saying that the point of the video was to set expectations and then flip them. See these lyrics that are over two minutes into the video:

And this opioid crisis is killing everyone

CMS ain’t likely to admit that they were wrong

Chronic pain folks are suffering

Treated like they’re criminals

But now I know, it’s time we fixed what’s going on

This is not the only time Zubin has attempted to pull the rug under his viewers. He has another video, "Blank Script" (set to Taylor Swift's "Blank Space"), in which he portrays a white woman doctor-shopping for narcotic scripts. He spends the bulk of the front end of the song portraying the woman as inconsiderate and a drain on the medical community. He then has one set of lyrics close to the end of the song that suggest the medical community is simply blind to the woman's real psychiatric issues and would much rather label here. I didn't think that subversion was effective there, and I don't think this similar subversion in "Treat Yourself" is effective either.

I think the crux of it is that this isn't truly a subversion; this reads more as a medical community saying the nasty things on its mind then apologizing to save face. The first two minutes (and I do wonder how many people didn't even watch the first two minutes) are explicitly derogatory towards victims of the opioid crisis - it does not frame this derision as anything that could possibly be unjust or damaging until later in the video when it simply says "Actually, yeah. That was mean of us." The mea culpa is then followed by this lyric:

And if you think that pain’s a “vital sign”

Then baby you should go and burn in hell

That lyric addresses the 1995 push by medical organizations to treat pain more aggressively, eventually leading to the prescription opioid crisis. That push was flawed for many reasons; however, the spirit behind the push is still a worthwhile endeavor. Zubin belittling that spirit after empathizing with the chronic pain community seems disingenuous.

Honestly, I understand the urge to make videos such as this. Many aspects of medicine are frustrating, including dealing with population wide addiction when all the old guard wants to teach us is how to shame people suffering addiction. I discuss this frustrations with co-workers all the time, and many parts of that discussion include humor. These discussions are had in private with others whom I hope empathize with the frustration but understand its context within our aim to overall help patients. I suspect these conversations aren't always so generous though. I suspect many healthcare workers overall don't care if those addicted to opioids can't get the help they need to fight their addiction. After all, "They did it to themselves."

To take those conversations and launch them onto a nationally accessible platform where patients can see will normalize our already dangerous tendency to demonize the patient. Tagging a clunky patient-advocacy message at the end of the song does not change the fact that most of the song encourages health care workers to laugh at their patients in public. I get that Zubin's intentions may be good, but I don't think this video was the best answer to our profession's antagonism towards those suffering addiction.

I believe laughter is a great medicine. I also believe we must consider strongly how we wield humor and whom our laughter helps and hurts.