Then tell them to shut the f*ck up
The glabella's right here by the way [cringe]
Welcome back to another nightshift, except this time I’m home so let’s hope the kids don’t
wake up...again. Jimmy Kimmel’s show had the most cringe-inducing segment featuring doctors
and nurses this week, which wasn’t just an epic fail, it was exactly the kind of stuff
that really undoes good work the vast majority of healthcare professionals are trying to
do. So I thought I’d do a quick video, it’s another unscripted one I’m afraid so probably going to be a
rambling and incoherent mess even though tbh I’ve had a lot of these thoughts in my head for
a while - if you saw my video about the ‘yay science’ crowd, I threatened another video
I don’t know why I used that verb, yes my videos are a threat, to your mental wellbeing,
a follow up video about debunking and countering misinformation, so consider this it.
Before I get to the Kimmel clip, the wider issue I wanted to talk about is who should
scientists and doctors be countering? Who should debunkers be debunking? And how should
they do it? That may sound like a dumb question - they
should counter anyone who is peddling pseudoscience, right? In short, yes, it is always good to
attempt to counter misinformation, but that would be an all-consuming, never ending job.
So one must prioritise. And how do you do that?
This is where I admit my own shortcomings as a science communicator online. I’m quite
impatient. My subspecialty has a reputation for impatience, interventional cardiology
is a field with instant results, and I certainly fall into that category, I don’t have the patience of a saint, but
many of my medical peers on social media do. People who calmly and patiently explain why
even the most wild claims are not true. I really admire them. I couldn’t do what they
do. I have to pick my battles with the limited amount of time I have.
Let’s start with a non-medical example. Flat Earthers. To the vast majority of people
it’s completely doolally. I don’t think THAT many people really believe it. Now there
are a lot of trained professional physicists on YouTube. Should they spend their time debunking
flat earth beliefs? I don’t know. I can’t imagine it’s very intellectually stimulating,
but flat earth debunk videos are tremendously popular.
But of course flat earthers are unlikely to cause themselves or others harm. When it comes
to health it’s different. Remember those happier times when none of us had heard of
COVID? I’d often get asked to ‘debunk’ various crazy health fads. And a few things
went through my mind each time.
First thought - some of these would be very funny. Some theories are bonkers and the people
endorsing them so delusional and often criminal, that it would make for a very entertaining
video. I love watching masters like Captain Disillusion dunk on some video fakery or someone
taking bogus climate science to pieces in a funny way. But when we make sarcastic videos
or mock people, we’re unlikely to be convincing people whose minds aren’t made up already.
Don’t misunderstand me, I’m not saying it’s wrong to do that, I’ve absolutely
done it. But you’re preaching to the choir, it’s not changing minds.
Second thought - do I NEED to make this video? Do normal level headed people really need
me to tell them cow urine is not a wonder drug? Do they need me to say don’t drink
bleach? Surely the only people who believe this are so far gone, this video is pointless.
If something is so ridiculous, I guess this is like the flat earth analogy, a debunking
video can only take the form of “this is complete madness”, and hence won’t convince
anyone.
Third thought - would I actually be drawing more attention to some of these? Some are
very mainstream and harming a lot of people, but some of the stuff I’m sent is really
fringe. Like some twitter account with 50 followers or a website no one goes to. Would
I end up promoting (amplifying) it? I see this online a lot, people find somebody shouting their quackery
into the void, nobody’s listening to them, and highlight them to their much larger audience
so they can all go hahaha isn’t this person stupid. But had they not done, no one would’ve
seen that quack anyway.
And fourth thought, logically following that - would my time be better spent debunking or challenging something else?
So how should we decide that? Should we prioritise the most damaging lies? How is that defined,
by most people harmed? By most dangerous treatments?
I don’t know. Sorry I think this video is going to end up me just saying I don’t know
repeatedly. Educational youtube. Should doctors spend their time explaining why homeopathy
doesn’t work, or take on more subtle misinformation, like bias or fraud in journals? Should they
write blog posts about why essential oils won’t cure cancer, or expose major financial
conflicts of interest inherent to the medical industry? They’re all important. You could
argue the latter two in each pair adversely affects more people. But it’s much harder
to get those points across. And the former will definitely be more popular online. People
love watching quacks getting dunked on, and us content creators love getting likes. But
I am not going to say one is more important than the other because all of them could result
in lives being saved, no exaggeration. So there’s no snobbishness here from me, I
just find it interesting how social media lends itself to more attention being shone
on some types of misleading information and less on others. There are lies hiding in plain
sight that are hugely damaging, I’m not always sure that focusing so much on alternative
medicine is the best use of everyone’s time.
BUT All the examples I’ve given so far, non medical and medical, are pre-COVID. Of
course, the pandemic changed everything. Now medical misinformation has the potential to
kill more than ever before, and not just the believer, but anyone they infect.
Almost all medics have found themselves having to give public messages of some description.
Some are better than others. There are many ways to get information across, I’m not
suggesting there is one right way, but there definitely are wrong ways.
Which brings me to Jimmy Kimmel’s little segment. I’ll play
a little bit for you.
Something like this reminds me that late night TV shows still exist, I don’t think they’ve
ever been less relevant. Indeed a cynic might say this was a deliberate ploy to get people
talking about the show. But I have a soft spot for Kimmel, he’s fundraised and campaigned
for healthcare change in the US, sharing details of his young son’s heart condition, and
he recently helped Mark Rober raise millions for people with autism and intellectual disability.
And all of these causes are very close to my heart, pardon the pun.
I can see how this happened. You can see the doctors and nurses are reading. This was scripted
by Kimmel’s writers, the gags are painfully typical of non medics attempting to write
medical jokes by looking up “10 crazy medical facts”. They wrote a bit and thought it’d
be funny to get actual doctors to read the lines. But what might seem funny to a non-medic
who already believes that vaccines work and are safe, ie a sassy doctor saying shut the
f*ck up, ends up just sounding painfully embarrassing when said by an actual doctor.
I have a small degree of understanding in how this works. I took part in a campaign
by MediaWise, which is a non-profit that helps people try to avoid misinformation. The video
that I was in isn’t condescending or patronising, and even then the script I was sent didn’t
quite sound right when I said it. From memory it said “listen to the experts, like me”.
Listen to the experts is a good message, one of the saddest aspects of society is how the
press and politicians demonise experts and expertise, but saying “like me” just sounded weird,
so I cut it. It gave the impression of an argument from authority, listen to me, look
at my qualifications, I am right and you are wrong, which I think is the main problem people
have with the Kimmel bit.
I always try to see the other side, so after tweeting about this this morning, I looked
for replies that disagreed and some said this is comedy and anyone who thought otherwise
is a moron. I would be quite interested to know if the people defending this as comedy
would also defend jokes by people like Louis CK or Dave Chappelle or anyone on a Joe Rogan
podcast. You can’t have it both ways, but that’s an aside. Now, as someone that’s
attempted to tell jokes on stage and who is an absolute comedy nerd, believe me I’ll
always defend pushing the boundaries of humour, but a golden rule is you have to be funny.
And doctors using humour to express frustration, which we all know and understand happens behind
closed doors, and by the way I’m not advocating the thought police, I love gallows humour
probably more than most, but it just sinks like a lead balloon on a public platform.
There is nothing less funny than someone saying how great and smart they are and how dumb
you are, which is why stand up comedians are self deprecating. And even if it was meant
as a skit, it’s more than enough ammunition for the anti-science, anti-vaccine, anti-doctor
brigade to hold up and demonstrate that doctors are condescending, rude, arrogant, paternalistic
know it alls. The butt of jokes on my channel are conmen peddling expensive treatments,
evolution, myself, the English language, other doctors or lame ass organs that don’t do
anything. Never the patient.
One of my friends from across the Pond said I was being a snowflake and explained I don’t
fully comprehend how aggressive and reprehensible the anti vaccine crowd is in the States. A
paediatrician online said I was tone policing and lacked expertise. Maybe all of that is
true. My friend asked “do you think being nice and civil will convince antivaxxers”
and I said of course some people simply won’t be convinced no matter what we say, I do think
some floating voters will see sense, and I definitely know that this PSA will convince
absolutely no one and simply reinforce prejudices against the medical community. So it has a
zero chance of helping get people vaccinated and at least some chance of helping those
against vaccine. Right now, I’d say that’s a balance that’s too far, even for the thing
I hold most dear, comedy. Oh and my family, obviously.
Maybe I just don’t like it because doctors come across like complete and utter absolute bellends in the
video and that’s my job.