Medicine Surgery

A bit of fallout

Late Thursday night, I posted a full-out rant about what I considered to be an incredibly unfair and stupid generalization of the bad behavior of a single surgeon to an overblown and hysterical indictment of medical students, doctors, and surgeons by a fellow ScienceBlogger, posted on his own blog and on Feministe. Fellow ScienceBloggers Mark Hoofnagle and PalMD posted similar criticism, all of which, in my humble opinion (or IMHO, in Internet-speak) were justified. One thing I didn’t mention was that I debated for a while whether or not to post my criticism, because the reputation and previous typical online behavior of the blogger in question, PhysioProf, were such that what I expected back was an all-out, profanity-laden counterattack. At the time I wrote my rant, quite frankly, I wasn’t sure indulging my anger was worth having to deal with the inevitable nastiness that at the time I predicted to be the likely fallout of such an all-out frontal attack on PP’s idiotic comments. Indeed, I partially wrote it on Wednesday night and held off for a while, at which point I decided to finish it and post it.

Surprisingly, the fallout was completely different than what I expected. The blogger in question, PhysioProf, has issued an apology–of sorts. It’s a grudging and seemingly half-hearted apology, but an apology, nonetheless. My sense of fairness demands that I recognize it and link to it. There are, however, two aspects of this that I’d like to address briefly.

First, quoth PP:

And that is why I am so concerned about the behavior of the “tattoo surgeon”. I do see an issue with paternalism, arrogance, and omnipotence in the profession, and I do not see the behavior of this surgeon as being solely attributable to a “lone bad actor”. Bad acts occur in a context, and I believe that to at least some extent, the medical profession includes a context that makes bad acts like this one more likely.

If that’s all that PP had said–and said in those words or similar–I highly doubt that I or any of the other physicians blogging for ScienceBlogs would have gotten particularly upset. I would have disagreed, but the above would have been a basis for reasonable discussion. However, as you recall, that’s not what he said. Instead, he used that one incident (which, by the way, I have yet to see any physician other than the idiot surgeon who did it through his lawyer defend with anything more than a very weak “he shouldn’t be thrown in jail” kind of defense) to generalize to the contention that “that this kind of attitude-that physicians are gods, not mere mortals, and wield power over other human beings that no one dare question-is inculcated in them from the very beginning of medical training” and that “surgeons are the worst, they cut people’s fucking asses open with sharp knives, and they are basically used to functioning as dictators in the operating room. These leads to the development of attitudes which makes perfect sense in light of the practical demands of surgery.” Such language precludes reasonable discussion.

Before your irony meters explode seeing me write something like this or you accuse me of rank hypocrisy, I would point out that I usually reserve my not-so-Respectful Insolence™ for people who have truly shown themselves on a consistent basis to be far beyond reasonable discussion. Think David Kirby, J. B. Handley, Casey Luskin, Dr. Michael Egnor, or the veritable panoply of quacks who prey on patients. True, I probably go overboard from time to time, but at least I usually stay in the same order of magnitude for what is required. I may occasionally blast the proverbial rabbit with a 50-caliber machine gun, so to speak, but PP has a distressing tendency to take such rabbits out with thermonuclear weapons–which is exactly what he did in this case and does far too often.

Finally, I must point out some queasiness I have developed upon rereading one of the criticisms by blog bud Mark Hoofnagle:

I also can’t believe how stupid this attack is from someone in PP’s position. Only a complete moron would hazard their job on the tenuous anonymity of the internet, and insult the people he interacts with on a daily basis. I know who PP and DrugMonkey are in real life, as do many other bloggers, not because they’ve told us, but because it’s impossible to maintain a truly anonymous internet presence.

And, in the comments. Mark said:

PP, the “I really do love my medstudents” gambit will not save you this time. You have insulted your colleagues, students and peers on a freaking blog. How dumb are you? Didn’t you read the manual called “things never to do on the internet unless you’re completely insane”?

Although Mark’s absolutely correct and has also stated that it was not his intent to threaten to “out” PP, in retrospect I see how those statements could easily be interpreted as just that. I don’t believe Mark would do such a thing, and I’d hate to think that PP apologized because he was afraid that Mark would out him. In a bit of self-examination, I can now even see how a statement to PP that I made in the comments could be so interpreted:

If you really “care deeply” for your medical students, as you claim you do, you sure do have a most unusual way of showing it. Ask yourself this; What would those medical students you claim to care for so deeply think if they found out what you’ve been writing about them on blogs?

I didn’t mean it that way, and if PP interpreted that way, I, too, am sorry. Given that I use a pseudonym and am (sort of) anonymous, it would be hypocritical in the extreme for me to threaten to “out” any blogger. I would never do such a thing except under very extreme circumstances: for example, if it were necessary to expose truly criminal activity, prevent a serious crime, or prevent someone from coming to harm, and in retrospect I see that I probably went too far. I also point out that I truly didn’t know who PP was when I wrote my original post, although, as I said, I did have a pretty good idea of what university he is faculty at. That was true. Subsequently, yesterday I figured it out. It’s not as easy to figure out who PP is as it is to figure out who I am, but it’s not all that difficult, either. Those of us who blog under pseudonyms must always remember that anonymity on the Internet is a pretty porous defense, and the longer one blogs under a certain pseudonym the more clues accumulate that permit people to penetrate that pseudonym. That’s one reason I’ve contemplated for a while whether I should just “out” myself and be done with it.

The bottom line is that, as far as I’m concerned, this incident is over. Everyone appears to have had their say, and I see no good reason to thrash the incident out beyond this. Others may disagree, but I don’t plan on bringing it up again, barring unforeseen circumstances. Time to move on.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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