Just a Physician

For those of you still on the absolute dumpster fire known as Elon Musk’s Twitter, there has been some recent discussion (to put it nicely) over whether I am, indeed, a physician. This effort has been led by one Paul D. Thacker who writes the Disinformation Chronicle newsletter on Substack and contributes to the Brownstone Institute, “the spiritual child” of the Great Barrington Declaration.

For the Thacker uninitiated, there is a 2015 blog post written by an editor of his from his intern days titled “The Once Promising Journalist Who Became a Sadistic Troll” which discusses Pulitzer Prize-winning science reporter Amy Harmon’s coining of the phrase “a thacker of trolls.” He’s gotten significantly worse since then, especially during the pandemic.

As others have pointed out, Thacker et al’s brief obsession with my not pursuing medical training beyond medical school is deeply ironic given his working relationship with Great Barrington Declaration signer, DeSantis Public Health Integrity Committee member, Norfolk Group member, and college friend of Peter Thiel, Dr. Jay Bhattacharya.

Like me, Bhattacharya graduated from medical school with an MD and pursued a non-clinical career. It’s just that he did that a whole 24 years before I did and has presumably never been in a COVID-19 ICU room like I have.

Having graduated with my MD from an accredited medical school, I meet the American Medical Association’s definition of a physician and have been called one in my very few mentions in the media. Having similarly graduated with his MD, Bhattacharya — who is listed as a physician on his contributor page at the Brownstone Institute — also meets this definition. Neither of us is a licensed physician and I’ve never misrepresented myself as one.

The other night over dinner, I had a laugh about this intended smear with my best friend from medical school, an anesthesia resident who has grown accustomed to my insane stories from outside of Hospitalandia over the past three years. She knows as well as anyone that, while I always wanted to help people, I never actually wanted to be a doctor. I only became one in a failed attempt to achieve my lifetime goal of my troubled physician mother’s acceptance. And then a pandemic hit.

As I’ve been open about in my foray into very niche public consciousness, my undergraduate degree is in music and I studied classical vocal performance while singing in as many choirs as I possibly could. I loved it and I gave it all up cold turkey to try to prove to my harshest critic that I was worth something. Damn, was that a whole lot of school to prove a point, but I am nothing if not ferociously stubborn.

I’ve always been creative and enjoyed writing, which is something I started doing a lot of for myself in the chaos and confusion of my third year of medical school. That was when the COVID-19 pandemic hit the U.S. — and the federal response was completely mismanaged by then-President Trump and Jared Kushner in the service of their politics. Thacker’s pal Bhattacharya played a role in that, see here and here.

My wrong place, wrong time story was made worse by it having taken place back in my home state of Wisconsin at my mother’s medical school and residency alma mater.

In addition to being a hub of pandemic polarization thanks to MAGA stooge Sen. Ron Johnson, Wisconsin played a central role in the Black Lives Matter movement with police shooting Jacob Blake in the back and radicalized Illinois teen Kyle Rittenhouse crossing state lines with an assault-style rifle shortly after the police murder of George Floyd in neighboring Minnesota.

Blake was treated in the main hospital of my medical school just outside of Milwaukee, a city ranked as one of the worst places for black people to live. As a small gesture of support, some medical students and I donated water bottles to the daily BLM marches that passed by my apartment during a heat wave.

The echoes of “I can’t breathe” in the streets of summer 2020 came as people of color were disproportionately the ones dying in the hospitals of COVID-19 because they couldn’t breathe. By 2022 the demographic of COVID-19 deaths would flip because politics.

Instead of the come together moments that the pandemic outbreak and the BLM movement should have been for the nation, MAGA politicians and their allies in the far-right media ecosystem hijacked and warped the narrative to fuel white populist rage, adding conspiracy kerosene to the flames as needed. 

It was around this time, as I was entering my final year of medical school, that my mother started down her path to radicalization on social media.

She had moved from the suburb outside Milwaukee where I grew up to rural Wisconsin prior to me matriculating at her medical school and reopening conversation after years of estrangement. I think she believed that getting out of the Stepfordian McMansion Hell of my hometown and closer to her roots — she grew up on a dairy farm in the MAGA stronghold that is Washington County — would be good for her.

It wasn’t. She was isolated and the drinking problem she had had since I was a child came back with a vengeance, not that she would admit it. And, instead of enjoying the peaceful, natural beauty of the woods and lakes of central Wisconsin, she spent a lot of time on Facebook.

Despite being a brilliant radiologist with an impressive first generation college graduate, farm-to-fortune story, she was deeply insecure — almost to a childlike degree. Decades into her quest for validation and frustrated that all her hard work hadn’t yielded her a happy life, she started mouthing off online, making sure people knew that she had had a hard life which also mattered.

She got plenty of pushback from people my age, particularly my friends of color. I tried to explain to her offline why her posts were offensive and why this moment was a time to listen. I shared with her journal articles and opinion pieces on systemic racism – a focus of the public health research I was involved in as a student – as well as songs like “Sweeter” by Leon Bridges, “I Can’t Breathe” by H.E.R., “Mississippi Goddam” by Nina Simone, and “Strange Fruit” by Billie Holiday.

It did nothing, as she was singularly focused on exacting revenge on those who dared accuse her, the good doctor, of any form of racism and I was really angry with her. As ever, pride went before the fall and, boy, did she fall. She lashed out at people, including the biracial daughter of her best friend, with a viciousness few knew to be inside her. I was well acquainted with this side of her, of course, as her eldest daughter who frequently called her out on her bad behavior while I was growing up.

This incident — and her newfound hatred for all things “woke” — provided the activation energy to send her to fulminant MAGA radicalization. She would go on to torch relationships with many friends and family members as she spiraled out of control. The last time I checked in on her online activity she was posting 2020 election denial memes, but I stopped looking as it was too embarrassing and painful to watch.

I had spent so many frustrated years trying to force her to get help for her problems, despite the pretty horrific emotional and sometimes physical abuse she dealt me. In the end, I couldn’t get her approval and, worse, I couldn’t save her from herself.

I also couldn’t save myself from the part of me that is her.

Just like I followed her into medicine, I followed her off the cliff of sanity into the dark world of MAGA conspiracies, trying desperately to understand what had happened to her and fight back against the flood of shit that was ripping apart families and society at large — and literally killing people.

It was my own personal Naomi Klein Doppelgänger-esque exercise in internet masochism, made worse by the fact that 1. my doppelgänger shared my DNA and had really damaged me and 2. I was very naive and on my own. (Kids, do not try this at home.)

I reserve a certain absolute disgust for the physicians — especially the women physicians — who have spread divisive and deadly lies in service of this far-right political movement hellbent on destroying not only faith in science but our American institutions. And I’ve been disturbed by the deafening silence of governmental institutions and medical governing bodies in the face of this attack on truth and reality.

My friends from medical school spent their intern year — universally understood as the worst year of medical training — dealing with the avoidable tragedy that was the Omicron BA.1 winter mass death event that America has seemingly moved on from just fine. In our society’s collective desire to put the pandemic behind us, I don’t think we talk enough about what a toll this has taken on healthcare workers — the ones in the hospitals, not the ones barking on Fox News or in right-wing Twitter echo chambers, like Bhattacharya.

And I’ve both observed and experienced firsthand the frightening abuse of the increasingly radical COVID-19 era anti-vax movement thanks to inaction far higher up the chain than me, an unfunded but stubborn nobody.

I was appropriately angry going into this, but the deluge of death threats combined with the access I got to the deeply disturbing HART leaks hardened me. I lost the measured approach with which I stepped into the public discussion around vaccines in 2021. I had wanted to speak to a younger demographic using my insight from Midwest pandemic medical school and a heart made of equal parts vulnerability and humor. But I became full of rage because this shit is so, so dark.

Additionally, as my male colleagues are quick to point out, I get a level and form of hate that they don’t because I am a young woman and I can tell you it is completely crazy-making.

However, in the fall of 2022 there seemed to be some cause for hope as a bill seeking to motivate disciplinary action from the stagnant California Medical Board went to Gov. Gavin Newsom’s desk. While the physicians in the advocacy group I had networked with who had worked on the bill-turned-law celebrated, my life turned upside down.

Shortly before Newsom signed AB2098 — an affront to the Brownstone Institute crowd, which triggered a well-funded right-wing legal opposition and went on to be unceremoniously repealed the following year — my mother went into the hospital, as a patient.

By the time we were notified, she was non-decisional with both her liver and kidneys failing due to alcohol abuse and the delicate physiological interplay of those organs. She couldn’t remember her own birthday but could remember who the president was, Joe Biden, and that she absolutely hated that.

She died in our medical school’s hospital on October 15, 2022, aged 62.

Almost a year into my advocacy and personal investigation into what happened to my mother, I came to understand how people like her are vulnerable to disinformation campaigns. I understood how toxic but can’t-look-away addicting these environments can be. I realized there probably was more to her childhood that she didn’t tell me about that made her the way she was.

And even though our last interaction was her joining in on the internet’s cacophonous chorus of hate for my advocacy with a vitriolic public post, I forgave her — for not just that but for thirty years of hurt. I loved her in spite of her and I held out hope until the bitter end that she could get better and be better. I knew she never wanted to hurt me or anyone else.

But I couldn’t tell her any of that because she was gone. For good now.

This grief consumed me whole and while I had felt isolated screaming into the void before October 2022, the isolation of late 2022 and 2023 is something I wouldn’t wish upon my worst enemies (and I have collected more than a few of those). The reason I got through it is because of the small group of healthcare workers and independent writers I had formed a chat group with to discuss how to counter misinformation and disinformation.

While MisinformationKills has still been my unfunded passion/masochism project and I do my own stunts, having a team around me brought the quality of the output to a level where it got minor recognition by journalists in the disinformation space. Meanwhile, my little team, which has become its own sort of family to me, has known exactly how fucked up I’ve been, has let me cry and rage, and has fiercely looked out for me.

Last summer I published multiple “real” articles I’m very proud of. And in September I disappeared completely from my meager public following for various reasons, one of which should be rather obvious.

In the complicated grief of last year — both before and after my retreat — I sought meaning in the one place I’ve ever found it: music. I strung songs together into playlists to form narrative arcs I hoped would reveal to myself how I was feeling in my fugue state and might provide me some assurance I was going to be okay. I repeated this exercise a total of eighteen times because there were a lot of feelings to get through. There still are.

In addition to the obligatory Didion read, I re-read Reckless Daughter, the Joni Mitchell biography I love, as well as plenty of Leonard Cohen poetry. I upgraded my keyboard to a nicer digital piano, bought two used guitars, and started writing music for myself. Once I started I couldn’t stop and of all the various forms of writing I’ve done, this is the material I’m most proud of. I shared the lyrics to one of them here a few days ago somewhat cryptically along with an edited version of the first of my playlist diaries.

As much as I would like to say I’ve healed myself the reality is I haven’t and I don’t expect I ever will fully.

I’ve mourned for my mother, the life she should have had, and the relationship we should have shared; I’ve mourned the loss of the person I was and the life I had both before I got involved in this space and before I went to medical school; and I’ve mourned for a collective hurt brought on by the poor leadership of mostly men that got our country to the inconceivable place it is today.

I’ve made some private apologies to people I hurt when I was so acutely hurting, scared, and not at my best. Still, I find forgiving myself for any mistake I make — no matter how small — significantly harder than apologizing to others. Correct me if I’m wrong, but I think this is a woman thing?

And I’ve had to laugh at how much I’ve clearly scared some very powerful people and how they resort to questioning my status as a physician as a pretty pathetic means to discredit me. Frankly, I don’t really even feel comfortable referring to myself as a physician because I never should have become one and wish I hadn’t. But I went to medical school and I’m the one on the hook for that debt, so…sorry?

If they are so afraid of my female rage then good, they should be. Honestly, I’m also afraid of it. But what they should be even more afraid of is my capacity for vulnerability.

I am painfully human. I make missteps and I learn from them (added: meanwhile the same clearly cannot be said for others). I am an open book who wears her broken heart on her sleeve (quite literally, see tattoo above) and I have always been this way. Because I am, first and foremost, a musician — and I far prefer the insanity of art to the insanity of medicine.

I believe musicians and doctors are both healers in their own right — certainly both have helped me — and I like to think that I benefit from having a little of both in my makeup.

I don’t speak out or share this much about myself because I particularly enjoy the attention. I genuinely don’t really know how to handle it and the last seven months have been a needed recalibration for me. I speak out and share because I have to. I have to turn my pain into some force for good, otherwise it will burn me up from the inside out and destroy me like my mother’s pain did to her.

Above all else, I need to make my mother’s life mean something more than her tragic end. My story is only possible because of the sacrifice my mother made in her life that allowed me opportunities she didn’t have to gain a perspective she couldn’t grasp. And, for all her many faults, there was a lot of good in her, too. I need people to know that about her. I need to give her in death what she couldn’t give me in life, which is understanding.

I’ve come to understand her by following her path — to a point — and recognizing how difficult being a female physician still is and how much worse it was when she was a promising young doctor. And I’ve come to understand myself through blazing my own path and catching some of my own burn injuries. Both (sides now) have hurt like motherfucking hell, let me tell you.

Along the way I learned a lot about how our politics actually work, how disturbing it is, and why we, the good country, cannot seem to confront our glaring problems.

We are all hurt in some way — that’s part of what it means to be human — and we would be better served to allow our hurt and humanity to be a uniting force rather than a dividing one. There are many factors at play working as obstacles to equity, but we need to get back to an ability to have an honest conversation as a first step if we are to bridge the man-made chasm between us.

We’ve all been scarred by life and the pandemic when life as we knew it stopped, and while our scars are unique in their size and depth, the scar tissue itself isn’t so different.

But what do I know, I’m just a physician.

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Here’s a playlist about complicated grief and forgiveness. I hope it helps — I know it helped me.

Bonus reading: “Letter to a Young Female Physician” by Dr. Suzanne Koven, NEJM

-Ali