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This past week I truly experienced a high as a blogger as one of the most heartfelt posts I have written, “The Flames of Burnout Have Risen Again,” was promoted by two major outlets, by the beloved fellow blogger, Physician On Fire, and Doximity (one of the largest medical communities for physicians).

In a single day, I had more pageviews than I had in a couple of months when I first started out blogging.

Even better was that this trend continued for multiple days and reached tens of thousands of eyeballs.

Better still was the fact that the first 11 commenters on the post were all supportive and giving positive vibes back to me.

I was truly on blogging cloud 9.

Unfortunately what goes up must come down and that happiness sort of eroded as more information came to light.

It began late that night when I got a notification on my phone that another comment was written (as many of you know, I really try to have a quick turnaround with a reply when you comment on my blog).

That notification signaled the 12th commentator and his 2 cents.

My descent back down from cloud 9 was initiated.

Don’t Feed The Trolls!

When I first started blogging I was given sage advise by my blogging brethren to develop thick skin and by no means engage with people “fondly” referred to as internet trolls.

I could not think of a more appropriate moniker than a troll, a mythological creature that is “rarely helpful to human beings,” and often depicted under bridges trying to knock people off the true path.

The troll’s mission is to get engaged in flame wars (how appropriate given the burnout theme of the post) as they relish in mocking/belittling others.

A troll gets great satisfaction and often accolades from others in the troll community when they victimize someone who they feel is inferior to them in every way.

Sounds like something prepubescent kids or lower IQ individuals would gravitate towards, right?

Unfortunately it saddens me to say that apparently the troll community has members from all walks of life, including physicians.

 

 

I did not know this person was originally a physician as I could not gather than from the name given, but was quickly made aware of it in the response to my original reply (I know, I know, I shouldn’t feed trolls, but I felt like I had to defend my home turf a little bit (you can see the full interaction in the comment section)).

 

 

That is exactly the words someone suffering from burnout wants to hear, “quit whining.”

I thought physicians were compassionate caring people with great empathy.

It is funny that a person who operates on hearts does not seem to possess one of his own.

Like Moth To Flame.

I thought I was done with the negativity but boy was I wrong.

I started getting messages from fellow bloggers offering support and that they were sorry I was getting brutal comments from my post.

Since the only negative comment I had read on my post was the one I referenced above I thought that they must be even more sensitive than I because I did not find it particularly brutal and it was just that one comment, not plural.

But then I get a comment on my site from none other than the White Coat Investor himself (which is a rarity as I think he only commented once before when I first launched the site so I knew it was big deal to get a second).

He helped me put 2 and 2 together by saying that the brutal comments were actually being posted on the Doximity page itself (and not my website).

Now the smart thing, armed with this information, would be to avoid going to Doximity altogether and seeing the brutality for myself.

And I was indeed smart……..for about 2 hours.

Curiosity, which can indeed kill a cat, got the better of me and, like moth to flame (yet another tie to burnout), I found myself in the crosshairs of multiple physicians across multiple specialties whose sole purpose was to belittle me and make light of my situation among other things.

Mean Girls, MD edition.

Growing up I knew what it was like not to be in the “in crowd.”

I was the only Indian boy in my class throughout grade school and up until 9th grade when I moved to California from Louisiana.

I was the chubby kid on the sidelines or one of the wallflowers at school dances all the way till college.

I was considered a “late bloomer” and only came into my own during residency (although my daughter jokes that I never bloomed at all).

Even the specialty of radiology is often considered the red-headed stepchild of medicine, with its members toiling away in darkened rooms of the basement while the “cooler kids” do their thing upstairs.

But I never felt hatred towards me or my specialty before.

At the time of this post there were 26 comments across multiple specialties that really dug into me.

It is sad that someone could be judged without truly knowing the situation.

Because you have to be a physician to be able to see the actual comments, I thought I would share some of them here to my non-medical folk so you can see that sometimes that white coat is hiding a black heart (and will give my thoughts in the following section).

[For those physicians who want to see the actual comments, you can check it out on Doximity here.]

 

My thoughts.

Ouch.

It truly is sad that members of a profession that is touted for helping patients could turn on a hurting fellow “colleague” like a pack of wolves.

I use the term “colleague” quite loosely as there was nothing collegial in these interactions (and of course by the likes to some of these comments, there were many more that apparently shared the same sentiment as the original poster).

It seemed like they were giving each other high fives and relishing on someone else’s misery.

Troll Tidbit 1:

Trolls apparently come from every specialty (which I specifically highlighted in the images), including pediatrics, a field renown for caring practitioners of little ones.

Troll Tidbit 2:

It seems like it always boils down to a pissing contest.

I get it.

We have been conditioned our entire lives to be ultra competitive.

To become medical students we had to push others back down into the primordial soup so that we could lift ourselves up into a coveted medical school slot.

Competition continued in medical school in order to be selected for the “desirable” medical residencies.

But we are all attendings now.

What more do we need to compete about?

That you do more work than I do and are not burned out? (and honestly I think I got misinterpreted about my workload by many which I will address later)

Have we gotten to the point that we have to belittle other doctors who feel like tapping out with a lesser workload than yours?

What is there to win in this competition?

Trust me:   All participants in the burnout race are losers.

There are no winners.

Troll Tidbit 3:

So no one should complain because there is always someone who has it worse?

This one floors me.

So now I should just suffer in silence because there are other people in the world that have it worse off than I do?

I know I am lucky to live in a first world country and these are my first world problems, but they are still my problems and they still affect me.

How bout turning down your thermostat to 40 degrees in your home in the middle of winter then and not complain?

Because I guarantee you there is a homeless person out there who is managing to make it through the night in those conditions under a park bench.

I don’t work in a 3rd world country in a 3rd class facility because I trained in a first world country, went through the rigors of getting certified in a first class country, and I enjoy the benefits of said 1st class country.

Using this logic, no physician should a right to feel burnout because all our jobs are easier than ditch diggers that was provided as an example by the first MD troll.

Troll Tidbit 4:

What’s in a name number?

I sort of can forgive some of the misconceptions by other specialties when assuming radiology is an easy life just sitting in a dark room and looking at pretty pictures.

What saddened me the most was some of the hate came from my own kind:

Perhaps I am to blame a little for this.

In the original post the only number I posted was in reference to the mammogram component of my practice (I mentioned that I typically read 50 mammograms a day before hell was unleashed and it peaked as high as 74 mammograms in one day during my 3 wk nightmare stint).

I believe that the above commenters (and I know for a fact a commenter on the radiology Facebook group I belong to) assumed that that was all I read for the entire day.

The Facebook commenter mentioned that my volume complaint “must be a generational thing because those described numbers sound like a slow morning to me.”

I then replied he may have misinterpreted my total daily volume and then shared it with him (adding my Xray and Ultrasound numbers to the total).

He replied, “ You nailed it, I thought the post was total volume, that would be a brisk day with all that!”

So to bring everyone onto the same page, the day before writing this post I read 175 total imaging cases (68 mammograms, 46 ultrasound, and 61 X-rays and 1 breast wire-localization procedure).

I would love to see what the above 2 radiologists now think of my day and if it now reaches the threshold in their mind for my right to complain.

I do not even consider yesterday even close to the pain I felt during the peak end of year rush (would not shock me if my daily read surpassed 200 total studies).

And honestly why does the total number matter?

If I get burnt out at 60 studies, I get burnt out at 60 studies.

I don’t have to justify why it happened, it just happened.

We should not make light of someone else’s workload.

I have days where I read 20-25 CT’s and 10-15 MRIs in a day and it is an absolute breeze.

Then I have days where I am completely worn out reading just 12 CTs because each CT happened to be a train-wreck with multiple issues that need to be reported.

Burnout is subjective/qualitative, not numerically based.

Troll Tidbit 5:

Is there some sort of Jekyll/Hyde switch that these clinicians turn off and on?

If a patient came in with eyestrain and complains of headaches and possible burnout, does that very Family Practice doc or Internist highlighted above call that patient “A snowflake? And then mock the patient needing a “‘safe place?'”

How about an overweight patient who is trying to start an exercise regimen and mentions that it is difficult for him or her to jog a mile without getting short of breath?

Do these clinicians mock that patient and say, “Suck it up and put your big boy/girl pants on!  I can run 5 miles without breaking a sweat!”

Or does that very doctor all of a sudden hide his or her true self and morph back into Dr. Hyde and actually treat the patient appropriately because of concern about what that patient could do in a Press Ganey patient survey?

If that is indeed the case, it saddens me that 2-faced physicians exist out there who are only cordial and offer treatment if you are a paying customer.

Troll Tidbit 6:

The hypocrisy of it all.

It truly is saddening that those who have sworn the Oath of Hippocrates can be so hypocritical.

We all know that physician burnout is a huge problem in our society.

Many physicians have committed suicide with burnout assumed to be the causing factor.

These suicides often catch their colleagues by surprise who then say, “If he or she had only let someone know what they were feeling they could have had intervention and been saved.”

But troll-like responses like the ones above only serve to curtail physicians seeking help amongst their peers.

If I am a physician who is burnt out and contemplating suicide do I want to seek help from my peers only to be ridiculed and called a snowflake?   Or that I’m being whiny?  Or that I need to put my big boy pants on?

It is no wonder that these physicians carry out suicide without asking for help because you certainly don’t need to have ridicule added on top of an already unbearable situation.

Shame on us for allowing that to happen.

Troll Tidbit 7:

There are still people brave enough to defend the weakened being picked on by trolls.

Of the 26 comments on Doximity at the time of my post, 25 were derogatory.

But there was 1 that showed a glimmer of hope that not all of us get dragged down to the level of a troll.

 

 

I know that physician trolls do not represent the majority of physicians.

It is a sad part of human nature but as a group we tend to voice opinions about negative things rather than positive things.

I mentioned it in a previous post, “Another Form of SOCIALized Medicine,”that we are far more likely to call a “How’s My Driving” number to complain about a driver rather than to call in a compliment.

It’s just the nature of the beast.

Likewise it is human nature to have negative comments effect you far more than positive comments do.

Parting words.

As physicians, from every specialty, we have so many things going against us.

We certainly do not need to pile on and add to someone’s suffering and even worse then go on to gloat about it.

If you truly went into this field out of compassion for fellow human beings then it should apply to everyone and not just paying patients.

If people truly know the power of words they would be far more careful about slinging them around at people.

One of my favorite physician bloggers, Side Hustle Scrubs, once had a guest post feature on White Coat Investor which ended up being a very controversial post with a lot of hate directed at him.

Shortly after, Side Hustle Scrubs retreated from the blogosphere, his website shut down and never to be heard of again.

Coincidence?

[For those of you that worry the same fate might happen to me, rest assured.   The only thing these comments did was motivate me to write this post.

Because of going through a hellish divorce where my ex-wife and her legal team continued to lob vile accusations at me that literally made me sick to my stomach to hear, it will take a lot more than what the above trolls can say to even penetrate my skin.]

I doubt that the physicians behind the comments above will ever be aware of this post, but I would like to think they will.

I would go over there myself and point it out but honestly there will be no Troll Feeding today from me.

 

Note:

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-Xrayvsn