By Josh Katzowitz, WCI Content Director
[Editor’s Note: This is the second column of a three-part series on physicians who became social media stars. Part 1 focused on how doctors have created millions of fans while making a huge impact on social media. Part 3 will arrive on October 23.]
In a previous job, I covered the world of YouTube. A half-decade ago, YouTube was THE place where the best-known social media stars lived. Millions and millions of people imbibed daily videos from Jake and Logan Paul, PewDiePie, Liza Koshy, and James Charles, and controversies poured down from the heavens every day. It was a world where a YouTuber’s personal soap opera of a life was consumed and dissected every time a fan or troll clicked the play button.
And it had real-world consequences. Not just for the content creators who could make millions of dollars from all the controversy and then be cut off from the platform for inconsistent reasons or be canceled by a disgruntled fanbase, but also for the people (like me!) who wrote about them.
Several years ago, I wrote a series of articles about PewDiePie, the most popular individual YouTuber in the world. He has 111 million subscribers, but he’s also had a huge number of controversies, including posting videos that featured Nazi imagery and dropping racist slurs while playing video games.
In 2018, I wrote an article about his beef with YouTube and its ad revenue system. It was an objective, mundane story, but he took great offense and proceeded to vilify me in a subsequent YouTube video that was viewed by, the last time I counted a couple of months after the video first appeared, more than 5 million people.
PewDiePie, whose real name is Felix Kjellberg, plastered my photo on his video, literally making me look like a devil, and called me out by name (hey, at least he pronounced “Katzowitz” correctly!), and in response, his legions of fans littered my Twitter timeline with insults, threats, and anti-Semitic images and videos for several weeks.
I didn’t feel intimidated. But I certainly felt disturbed. By the apparent randomness of PewDiePie’s anger, by the sheer number of people who descended on my Twitter timeline, and by their abject cruelness.
I’m not a social media superstar, not like the doctors I wrote about last month who have hundreds of thousands of followers on TikTok. But no matter how popular you are, no matter how much good you’re trying to do, no matter how many positive vibes you’re trying to put out into the world, there are real downsides to being a physician on social media.
It can sap you of your energy. It can cause you to share too much of yourself. It can do damage that’s both visible and unseen. It can wear you down.
Doctors like Vicki Chan, Tommy Martin, and Ali Rodriguez post on TikTok to be informative, to be educational, and to be funny. But not everybody appreciates that.
TikTokers Dealing with Personal Attacks and Insults
Chan is an ophthalmologist who first rose to TikTok prominence when the pandemic hit, and she began posting videos trying to dispel the COVID misinformation while also extolling the virtues of masks, how to wear them, vaccines, and why to get them.
Despite her growing popularity—she now has 418,000 TikTok followers—some people bashed her. She mostly posts informational videos as she dances to the latest trending music, shows off her fashion sense, and discusses her dual role as a doctor and mother. But that hasn’t stopped some from hurling insults at her, especially when she gets a little political.
After one commenter made a racial slur, this was her response.
@vickichanmd Replying to @dahird Replying to @dahird Replying to @dahird Reply to @dahird #almondshapedeyes #doctorlife
Chan had to develop thicker skin earlier in her career when she began direct sales marketing on Facebook. She had to fight through and learn to deal with negativity to move forward in that side gig. She’s taken those lessons and applied them to TikTok today.
“It doesn’t matter what anybody else says,” Chan told me. “Their opinions are not opinions I value anyway. That troll is not someone who has my respect.”
Chan said the people on TikTok seem to be nicer than those who are enmeshed on Twitter and that site’s never-ending toxicity. She called TikTok a “more light-hearted place.” But inject a little Roe v Wade discussion into the app, and that lightheartedness gives way to a heavy-handed response.
“When that was overturned, I was very clear on it,” Rodriguez, an OB-GYN who has more than 1.5 million TikTok followers and who teaches about anatomy and sexual health, told me. “I made posts on Roe v Wade, and when the election was going on, with some of the stuff Donald Trump was doing, people knew my political stance. I’ve made several posts on abortion rights and access to birth control. The majority of people give me their support. But I obviously get hate from it.”
There are other consequences as well. The day Rodriguez posted about abortion and about how, as she put it, “abortion IS healthcare,” she said she lost thousands of followers in a heartbeat.
“Great, I want to weed these people out,” she said. “Those people who send me nasty messages. I just block them. I don’t engage with them, because it’s not productive . . . People feel protected, because they don’t know me. They’re writing from behind a computer. I’m not going to waste my energy.”
Martin has had plenty of experience, especially since the pandemic began, of people trying to get his account banned. Although he has more than 2.2 million followers, many people didn’t appreciate his attempts to talk about the efficacy of the COVID vaccine.
“Obviously, the anti-vaccine is a very large community, and they’ll try to get your account banned,” Martin, a meds-peds attending, told me. “My goodness, my social media account got banned like every other week.”
The learning curve for social media can be steep. It’s not only about finding the page views, learning about how the algorithms work, and discovering what trends and sounds to highlight. It’s also about learning how others can perceive your thoughts, no matter how positive you think they are. For every single video he creates and posts, Martin has to inspect his content from every angle and think about how his words and actions can be taken.
That kind of mental energy can make your chest heavy and your head pound. It can wear you down.
The Mental Energy That It Takes to Post on Social Media
Rodriguez is not shy about talking about her mental status. Sometimes, she’ll go days without producing a new TikTok. Every once in a while, her burnout will blunt her motivation to post. She’s an OB-GYN who is constantly spending nights in the hospital on 24-hour call. She’s talking to her patients about sexual wellness. She's counseling them. She’s fighting through the abortion rights debate.
Sometimes, she needs a break. As she said recently, “I’ve really just been in a rut, with work, with life, emotionally, mentally, just reaching absolute burnout.”
@alirodmd Not that anyone cares but I was spiraling and needed a break have been sharing more on stories 📸 love u #mentalhealth #break
Reaching a point where millions of people follow your every (dance) move requires never-ending motivation. You have to engage consistently. You have to post interesting content (or controversial content). You always have to be thinking of the next idea. If you want to be successful on social media, you can never truly turn off your brain.
Rodriguez said she spends an hour or two per day on TikTok, whether she’s posting, commenting, or replying to others. For her YouTube channel, it might take her four hours on a day off from work to film a video (though she’s now hired an editor).
During a recent interview, Martin looked back at his week of social media usage. TikTok took up three hours of his time; Instagram two hours; and YouTube 41 minutes. That’s a little less than an hour of social media per day, while Chan estimated she spent about an hour per day working on her TikToks.
Why do it, though? Why spend so much time and mental energy on a hobby, especially after they’ve spent years of training and so many hours a day at a rigorous and stressful job?
“If you want to grow, you have to put a lot of time into it,” Chan said. “People might ask why do what you do? For me, it’s a balance. I’m not making a lot of money on TikTok, to be honest. But it’s a creative outlet for me. I enjoy it. It’s where I vent, where I can have conversations about anti-vaxxers. I do think it’s helpful. We educate people. Doctors like helping others. This is another way to do this. I can talk to one patient at a time in my clinic, or I can talk to thousands of people at one time in a video. It’s a very satisfying thing.”
Until somebody takes great offense.
That’s what happened to Dr. Nicole Baldwin, a pediatrician with 44,000 TikTok followers, when she posted a video in 2020 about vaccines and how they don’t cause autism. The video went viral, and those who are anti-vaccine came after her.
As the Cincinnati Enquirer wrote:
“Commenters across Baldwin’s social media platforms insulted her, referred to vaccines as ‘poison’ and suggested Baldwin was being paid to promote vaccination. One commenter wrote, ‘Dead doctors don’t lie.’ People then flocked to her Yelp and Google Review pages, leaving one-star reviews in an attempt to sabotage Baldwin’s ratings.
‘I think in this day and age, Google reviews and Yelp reviews are king,’ Baldwin told The Enquirer. ‘And I think that that is the goal for a lot of these people: to hurt my livelihood, to damage my reputation because I believe something different than they do. And it is frightening.’”
As Chan said, putting yourself out on social media can lead to threats.
“That’s why a lot of doctors don’t do it,” she said. “There’s this possibility. Somebody could go after your license. Somebody could show up at your clinic.”
Said Rodriguez: “I don’t share my exact work location.”
In her third year of residency, though, Rodriguez learned a valuable lesson about medicine and about how to live her life.
Her chief resident had made what Rodriguez perceived as a negative comment about her work. It was about something trivial she hadn’t done, and she moped for the rest of the day. For hours and days, she couldn’t let it go. “Maybe I’m not good enough,” she thought to herself. Eventually, she realized that while the chief’s comment ran through her head for hours and days afterward, owning the real estate in her brain, the chief probably forgot about it seconds after the words were uttered.
Hours later, the chief is at home playing with their kids. They’re eating dinner. They’re streaming Netflix. But Rodriguez still felt weighed down by the throwaway comment.
Eventually, she asked herself: “Why am I having a pity party while they’re just living their life?”
Rodriguez takes those lessons to social media today. Why let a random anonymous commenter ruin your day, especially when they get to go on living their life? Why let that hateful speech infect your skin and let it infest your mind after the commenter has already moved on to torment somebody else?
“I still think about that to this day,” Rodriguez said. And that lesson learned several years ago continues to toughen her skin and keep her mental strength.
Ultimately, it takes courage to post on social media, especially as your following gets larger and more varied. Dancing to a trending song is one thing. But physicians like Rodriguez, Martin, and Chan–and many others just like them–want to educate and inform. And, at the very least, make a larger impact on the world than they would if they only saw one patient at a time in the exam room.
But social media is tough. Twitter can be toxic. TikTok can be treacherous. Instagram can be irritating. Even Pinterest can be poisonous. Going viral can be virulent.
It’s easy to see why physicians who become social media superstars question whether they have the mental energy and fortitude to fight through the noise and do what they do best: provide the best advice they can, educate the masses, and make content for the good of the world.
“Doing things you love gives you energy,” Martin said. “When you’re doing things that set your heart on fire and fills you up, it’s easier to find the energy.”
Yes, social media can wear you down. But it can also do the opposite.
Money Song of the Week
We’ve been subscribers to the local Broadway series for the past several years, and the highlight for the latest season is Hadestown, the eight-time Tony winner that retells the Greek myth of Orpheus traveling to the underworld to free his beloved Eurydice from Hades. We saw the musical late last month, and it was the best Broadway show I’ve seen in the past few seasons, probably since Come From Away's national tour came to town.
While much of the story focuses on whether the love and musical ability of Orpheus can save him and Eurydice, much of the second act takes place in Hades’ underground world, aka Hadestown. This isn’t necessarily hell—at least not for Hades, who has turned his world into a factory that produces riches for the god while producing misery for his residents. Still, a hungry and desperate Eurydices who comes from nothing can’t help but be intrigued by the possibilities of working for Hades during the song, Way Down Hadestown.
As the cast sings,
“Follow that dollar for a long way down/Far away from the poorhouse door/You either get to hell or to Hadestown/Ain't no difference anymore!”
And . . .
“Everybody dresses in clothes so fine, Everybody’s pockets are weighted down, Everybody sipping ambrosia wine/In a goldmine in Hadestown/Way down Hadestown/Way down under the ground . . .
Every little penny in the wishing well/Every little nickel on the drum/On the drum!/All them shiny little heads and tails/Where do you think they come from?/They come from/
Way down Hadestown/Way down under the ground”
As Genius.com noted, the idea of the song “suggests that money in general comes from Hadestown, similar to the common idiom that ‘money is the root of all evil’ and in “addition to being the god of the dead residing in the underworld, Hades is also the Greek god of everything under the earth, including precious materials like oil, metals, and gems that are dug up or mined. [It] suggests that money and wealth does indeed come from Hades.”
As always, be careful of the devil who comes to you wearing expensive suits and offering fine wine.
Tweet of the Week
If you much prefer the FI in FIRE than the RE part, this is a good tweet for you, from one of WCICON23’s keynote speakers (early-bird registration starts October 10!) .
"I have never liked the word retirement. It doesn’t feel like a modern word to me… Maybe the best word to describe what I’m up to is evolution." — Serena Williams
Love this so much. 😍
— Christine Benz (@christine_benz) August 29, 2022
[Editor's Note: For comments, complaints, suggestions, or plaudits, email Josh Katzowitz at content@whitecoatinvestor.com.]
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