Respectful Insolence

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.

Comments

  1. #1 DLC
    July 26, 2008

    The surgeon who left the offending rub-on tattoo deserves to be criticized for it, but I thought PhysioProf went over the line. And with that, I too will leave off this topic.

  2. #2 Erik
    July 26, 2008

    I was ready to let the whole thing go thinking that PP had rethought his postion after he posted the apology you linked to. I’m still going to let it go now even though his triumphal braying on his own blog would suggest that his actual remorse is pretty limited. So I’ll just conclude that further engagement with PP is a waste of time. I think it’s important for people to see the full scope of PP’s behavior when evaluating future posts by him.

  3. #3 Colugo
    July 26, 2008

    I think the disproportionately defensive, self-righteous, career-threatening reaction to PP’s post on the threads on denialism blog supports PP’s case better than the tattoo incident itself.

  4. #4 PhysioProf
    July 26, 2008

    It’s a grudging and seemingly half-hearted apology, but an apology, nonetheless.

    This is grudging and half-hearted?

    In re-reading the post, I see that it was written in a way that was overly hyperbolic and generalized even for PhysioProf.

    And for that, I am genuinely sorry. As bloggers, we always try to create controversy and argument, but I see that in this case I went too far.

    What more would you or anyone else have me do, other than recant my considered opinion? Commit seppuku? (BTW, I appreciate you writing this post.)

  5. #5 Dianne
    July 26, 2008

    Frankly, I found the “apology” more disturbing and offensive than the original statement. Particularly the “but I love my medical students” gambit, which came across, to me at least, as a cross between the “but some of my best friends are black” gambit of the racist and the “I only hurt you because I love you so” gambit of the abuser.

    The whole controversy also reminds me of this xkcd cartoon. Guilt by association and stereotype. One physician did something stupid, arrogant, and criminal. How does this relate to whether the average physician is likely to be any or all of the above? If PP had used that anecdote as a springboard to talk about more concrete evidence of a problem, I’d have been reasonably impressed (I have my own complaints about medical education and am far from regarding it or the culture of mainstream medicine as perfect). But just “this surgeon put a tattoo where he shouldn’t and I have a grudge, therefore all doctors are arrogant” didn’t impress much. Nor did an apology for being “overblown”. PP, you weren’t just overblown, you were wrong. Or at minimum, you didn’t make your case in a convincing manner. How about apologizing for that?

  6. #6 Scrabcake
    July 26, 2008

    < > That was just funny. I mean, for god’s sake, it’s a wash-off tattoo, and he just cut into her! I mean, I’m trying to understand the outrage here…guess she felt violated. But she just had surgery–that’s pretty damn intrusive.
    Americans really do have a stick wedged up their collective asses.
    That being said, I think one of the norms you have to obey in this culture is that you don’t joke with people you don’t know, because, at least in American culture, people assume that anyone they don’t really know is out to hurt them, and will take everything you say as a personal insult or violation unless you actively try to prove otherwise. To not obey that norm speaks of a lack of social awareness that should be a requirement in people performing such a personal act as surgery.

  7. #7 Luna_the_cat
    July 26, 2008

    Scrabcake, that precise issue is addressed here, better than I could ever do — please, go read.

  8. #8 Dave L
    July 26, 2008

    I think the disproportionately defensive, self-righteous, career-threatening reaction to PP’s post on the threads on denialism blog supports PP’s case better than the tattoo incident itself.

    Exactly Colugo, as well as Mark H’s prickish comment to PP’s apology post accusing him of being scared, it not being a ‘real’ apology, whine whine. At least he’s got the gonads to post any sort of apology; I can probably count on one hand the number of those I’ve seen on SB since it’s inception.

  9. #9 Marilyn
    July 26, 2008

    Orac,

    I sometimes wonder why you don’t “out” yourself too since so many of the anti-vaccinationists have already done so, not that it’s any of my business.
    Have you seen the ABC News “expose” on how the American Academy of Pediatrics and others receive funding from pharma, including vaccine manufacturers? They name a particular doctor, but I had never heard of the guy, because I don’t follow the debate that closely. The thing that seemed silly is that the idea that vaccines are safe is a matter of consensus, not just the view of one particular doc or organization.
    Marilyn

  10. #10 Marilyn
    July 26, 2008
  11. #11 ebohlman
    July 26, 2008

    Marilyn: Orac explained some years back that he doesn’t use his real name on this blog because he wants potential patients doing a Web search on his name to hit his professional pages rather than his hobby pages (like this blog).

  12. #12 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  13. #13 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  14. #14 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  15. #15 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  16. #16 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  17. #17 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  18. #18 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  19. #19 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  20. #20 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  21. #21 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  22. #22 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  23. #23 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  24. #24 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  25. #25 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  26. #26 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  27. #27 Michael of New York Nu YORK
    July 26, 2008

    We are not a piece of fruit to be
    labeled however temporary by a
    Medical Doctor.
    I get so annoyed at those bugger labels
    on my daily apple.

  28. #28 Woobegone
    July 27, 2008

    “I think the disproportionately defensive, self-righteous, career-threatening reaction to PP’s post on the threads on denialism blog supports PP’s case better than the tattoo incident itself.”

    Well only if you think that medical bloggers are representative of doctors. Is PhysProf a typical Physiology Professor?

    Anyway, this is a storm in a teacup anyway – much less fun than woo-related stuff.

  29. #29 Dan
    July 27, 2008

    I had some doctors that thought they were holy then the thou. I dumped them. But I would not think to paint the whole lot of them because of it. That said, Orac is an A-hole. But he is a good enough A-hole, that I keep coming back and reading whatever voluminous sewer comes from his mouth (keyboard). Just kidding and ribbing.

  30. #30 DavidCT
    July 27, 2008

    I think anyone with any real curiosity about Orac’s real name already knows it. I would just as soon he kept the pseudonym to help me remember which site I am on.

  31. #31 S. Rivlin
    July 27, 2008

    When I, in a book and in comments on another scienceblog, exposed some badly behaving scientists, it was PP who became indignant, questioning the accuracy and authenticity of my revelations, and insinuating that science and scientists are better than the rest of the mortals. Moreover, in many of his posts and comments, PP appears to be as pompous, if not more than, some surgeons.

  32. #32 Chelonian
    July 27, 2008

    I have no great love of medical professionals who act like they sprang fully formed from Jupiter’s thigh. I once overheard an MD prof saying Biology degree students were the washouts who weren’t good enough for medical school. I’ve seen and heard that sentiment echoed here and there, albeit in milder forms sometimes, and as a biologist myself, it hasn’t particularly endeared me to the MD species. But I’ll gladly put that sort of behaviour down to the fact that MDs are a group of humans, and like any other group of humans some of them are arrogant jerks. That doesn’t mean they’re all that way.

    Hmm. Actually, I wouldn’t be surprised if the prevalence of arrogant jerks was higher among MDs, especially surgeons. And to a certain degree (not including Dr. Tattoo) I think that’s perfectly okay.

    Think about it. What do surgeons do? They cut people open. How scary is that? Seriously, cutting into a living, breathing human being, fiddling about with internal organs and so on? How sure of yourself would you need to be to do that?

    If ever my time comes to go under the knife, I know I’d prefer to be operated on by a competent arrogant jerk than by someone modest and self-effacing who won’t have the guts to do the necessary job on mine.

    Now, I realize that arrogance doesn’t equal competence. But I do believe that for a significant majority of surgeon types, arrogance is a inevitable corollary of competence, either as a byproduct, or indeed as a marker of the kind of character who has what it takes to do a difficult, high-pressure job that deals in life and death on a daily basis.

  33. #33 NM
    July 27, 2008

    This topic is so boring it brings me to tears.

    One surgeon does something stupid that he shouldn’t have done that was emotionally harmful to one patient which he then should have apologised profusely for having done.

    One usually decent blogger, who likes to say the word fuck a lot, makes a rank generalisation about physicians (confusing them with surgeons constantly).

    In other news the sun came up this morning.

    Orac, I honestly don’t know why you did bother posting anything. It’s beneath you and it gets nobody anywhere.

  34. #34 Orac
    July 28, 2008

    It’s my blog, and I felt like writing about it. I need no other reason.

    I’m happy that you have such an elevated opinion of me that you think my writing about such things is somehow “below” me, but I decide what is and is not below me. If the topic bores you to tears, no one’s forcing you to read every post. Feel free to move on to the next one or just not read today; there’ll be good stuff tomorrow. Or, at least, I like to think it’ll be good.

  35. #35 A Thrombosed Roid
    July 28, 2008

    totally atilt, On occasion I have even been knifed in the posterior nether region (upon request, though the body was a bit Demanding about it) by those not carrying MD or Surgeon’s credentials.

  36. #36 Sandy
    July 28, 2008

    At the risk of yet another ad hominem attack:

    I think the disproportionately defensive, self-righteous, career-threatening reaction to PP’s post on the threads on denialism blog supports PP’s case better than the tattoo incident itself.

    And:

    I had some doctors that thought they were holy then the thou. I dumped them. But I would not think to paint the whole lot of them because of it. That said, Orac is an A-hole. But he is a good enough A-hole, that I keep coming back and reading whatever voluminous sewer comes from his mouth

    I couldn’t agree more… I still believe the self righteous indignation displayed by Orac et al in response to PP’s original blog entry is rather telling.

  37. #37 NM
    July 28, 2008

    Fair enough. It’s your house. My frustration was that the story continued to roll through too many of the med-related SB blogs. I guess I’ll just go back to lurking rather than commenting.

The site is undergoing maintenance presently. Commenting has been disabled. Please check back later!