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.