#5 Blowing the Qatar out of your nose

Swearing on hypocritical growth

In the glorious 5th edition of this newsletter:

• Why has the channel gone cold?

• ADHD and working to a schedule

• World Cup hypocrisy

• Why I’m chill about twitter

• Sponsorships and lordships

Where have I been?

Did I start my last newsletter off by saying it had been a very long time since I last sent a newsletter? Then did I immediately follow that by saying I am not apologising, because no creator should have to apologise for not creating? Sounds like the kind of banal fluff I’d say. I could check, but not only am I not apologetic, I am extremely lazy as well. If, however, I did not start the previous newsletter in such a manner, then consider this one started in that way. Splendid.

Incredibly, this is only the second newsletter of the year. Even by my standards, that is poor form. The channel has also been languishing. A comment on my last video read something like “always great when Dr Francis remembers he has a youtube channel”, which made me chuckle but is far from the truth. In fact, I have a great desire to make videos, but life is making it challenging right now, and recently I have felt something new – genuine frustration at being unable to make time for videos. I felt I could slot it around things better before. I won’t bore you with the vagaries of being a dad, moving house, or working in the ever-more-chaotic NHS, where Parkinson’s law becomes a cruel joke as the work relentlessly expands. However, I thought sharing my experiences of public speaking might be of interest, especially to those of you whose brains might work similarly to mine.

I decided to say yes to a bunch of speaking engagements over these last few months. I normally have to refuse about 90% and operate a system I have for almost everything in life – ask “will this be interesting or unusual?” Then again, I’m very fortunate to get interesting and unusual invitations from time to time. At one end, I did my first corporate gig at a trading company, to an audience of quants and super nerds. Imagine a ‘Talks at Google’ kind of thing. I had never charged for a talk before so I asked a fellow nerdy YouTuber who does a lot of them what he charges. Of course no one ever answers that question but I at least got a range. But when they asked me what I charge, I clean forgot all that advice people give you about “whatever number you’re thinking of, double it” and when they agreed way too quickly I knew I’d blown my chance to match the £135,000 Boris Johnson charged for a 30 minute speech last month. Some of my friends make very comfortable livings as almost exclusively after-dinner speakers. While still kicking myself that I didn’t take this company to the cleaners by adding another two zeroes on, they took me out for dinner and very generously asked me to choose some wine. When I chose what I thought was a rather nice Argentinian red, the sommelier leaned in and subtly said to me “sir, your party has a minimum spend of £2000, you can choose a nicer one”. Why did I go into medicine again?

At the other end of the spectrum I did a TEDx talk up in Newcastle, where I was delighted to be on the same billing as a scientist whose predilection for sarcasm and cynicism makes me look like an amateur, Dr Sabine Hossenfelder. Take a look at some videos we made together last year. In between these two talks were lectures to doctors and school children, keynotes at conferences, podcasts, interviews, and my first attempt at doing a 45 minute Netflix-special-length science comedy set at a big show called New Scientist Live.

I regret signing up to all of them. Which is not to say I didn’t have a great time at each, nor that I didn’t work with lots of lovely people. I did, and I did. But I realised how much I prefer the medium of video. Previously if I had a few free minutes, I could write, or edit. I can get into the frame of mind necessary almost instantly, even if I just have 20 minutes free before bed. But with these talks hanging over my head, I found it impossible. For one, I was asked to provide my talk months in advance. I replied “guys, I write everything the night before, this is just how I work”. And I was left in conflict between wanting to prepare in advance to make sure I gave a good performance, vs how I know I work best. But instead of just allowing myself to prepare things later and continuing with my life, I found myself unable to work on any videos as I thought I had to spend my precious free time on preparing for these interminable talks. But the mutually exclusive self-initiated pressure meant I didn’t write any talks, nor did I write any videos, and instead found myself watching Andor or getting back into chess. Plus, I realised most fellow speakers at the big public-facing events are flogging books. So why was I even there?

The talks are all now done (until the next one – but for the first time ever, I’m going to allow myself to recycle a talk. If you’re in Belfast I will hopefully be visiting early next year), and I feel a weight has been lifted. Lo and behold, I am now writing something I want to write. This newsletter! And with this has come the realisation that this newsletter should be more unfiltered and less polished than perhaps I’d originally intended. I don’t know if this sounds familiar to many people, but it was a good lesson for me in working to my own schedule when I can.

Striving for pearls

The World Cup has started. You either have no interest, or are already saturated with coverage. Forgive me for adding one thought, which is in response to comments on that just-as-toxic-as-twitter app, Instagram, where people were saying that criticism of Qatar is either anti-Muslim or anti-Arab, because there was not this level of outrage when other imperfect nations hosted the World Cup. In fact, there were vocal criticisms of Russia’s treatment of LGBTQ+ people, and there were criticisms of the conditions for Brazil’s workers and of the country’s environmental record, but the outrage definitely is at a greater level this year. I am more than willing to believe some people are critical of Qatar because of prejudice. But to pretend this the main reason is to ignore the glaring corruption in FIFA as Qatar bribed their way to this World Cup, that Qatar has a negligible native population, no footballing culture, a climate that mandated moving the tournament to winter, it is a place where homosexuality is illegal, women hold few positions of power, human rights are routinely abused, and this World Cup’s carbon footprint is without comparison. It’s a farce. But I bring it up for one reason, to agree that there is some hypocrisy amongst Western critics.

So many pearl-clutching commentators online (Persian Gulf pearls, naturally), who lament the modern slavery present in the Qatar, are the exact same people who holiday in Dubai on a regular basis. Who go shopping in Abu Dhabi. Take lucrative tax-free contracts in Saudi Arabia or Oman. We’ve even seen the sorry rise of influencers promoting tourism to these petrostates.

The exploitation and brutal conditions are not limited to within Qatar’s borders. The kafala system operates in many countries. I have always particularly struggled with fellow British South Asian friends who consider Dubai their playground. By far the majority of the workers, who slave away in infernal conditions, who have their passports confiscated, who are beaten regularly when working as domestic help, who are crippled with ‘recruitment’ debt and not paid months on end, who are treated as third class human beings, who come all the way in order to support their families, and end up paying with their lives; are from India, Bangladesh, Pakistan, Sri Lanka, and Nepal.

The ‘Deaths of Migrants in the Gulf’ report by Vital Signs makes for horrific reading and estimates 10,000 Asian workers die in the six countries that comprise the Gulf Cooperation Council every year. A compelling short video about it is below.

About half the deaths are unexplained. The journal Cardiology highlighted that hundreds of young fit Nepalese men (the study was led by a team in Nepal) between the ages of 25-35 years old have their causes of death recorded simply as ‘cardiac arrest’ (this is not an accepted cause of death in most countries, as a gunshot victim and a cancer victim both die of cardiac arrest, everyone does. It sheds no light on the precipitant). The study made the fairly obvious conclusion that the deaths are not only due to excessive heat exposure, but that about half could be prevented with simple protection measures. The Gulf nations choose not to enforce these.

Some of us have been talking about this obscene system for two decades. I have people close to me with roots in the Gulf and have discussed this with them too. I am no one to judge decisions made in the 70s or 80s, when opportunities were limited elsewhere and the world was very different, but this is all widely known now, and yet professional people, who have well-paid jobs at home, flock there. I am glad more attention is being shone on state-sanctioned slavery – sanctioned by both the Gulf countries, and the workers’ home governments. They turn a blind eye to their citizens being abused and killed because they know this army of workers that keep Qatar and Dubai working, send a steady trickle of money back home. Governments all over the world care little for individual lives. It is correct to highlight inconsistencies in public reactions (such as the outpouring of support for Ukranian refugees but not Syrian), and no country is innocent of profiting from disenfranchised and impoverished workers, but no countries in history have come into so much wealth so fast, and been built upon the backs of armies of entirely imported labour so quickly.

Edit: I wrote this and then watched John Oliver’s recent (very good) segment on the same topic on Last Week Tonight and I’m afraid if you watched that before reading this, they’re alarmingly similar! Well, I guess nerdy British guys with pointy noses and receding hairlines all think the same way.

Twats

The last thing you need is another Twitter hot take. With yesterday’s news that Elon Musk won’t allow Alex Jones back on, but has already reinstated people like Donald Trump and Andrew Tate, it is clear that it was never about freedom of speech. There is no terms of service that bans Jones but allows other conspiracy theorists or abusers. He simply wanted to change the political bias on Twitter, and frankly he’s spent £44 billion of his own (and Saudi) money to do that, so that’s fair enough. Twitter definitely did have a bias. It might have aligned with yours, it might not have. Ultimately, everyone has a line.

The last few weeks have caused me to reassess the landscape. People bleat on about the left and the right, but from my standpoint the warring factions appear remarkably similar, they both have an uncontrollable hard-on for authoritarianism. I’m hardly the first to observe that right and left ceased to have much meaning a while ago, and now represent tight clusters of beliefs with far less variance than in days gone by. Intolerance is the great unifier, and none of the belligerents can see it.

My natural tendency to love drama and not really get overly attached to anything has meant I’ve found it all highly entertaining, but I have been moved by friends who are genuinely sad about Twitter’s possible demise. Friends who have derived great enjoyment or benefitted from twitter. I certainly have. I was interviewed recently for an article about Twitter for the BMJ and I was full of praise for what it offered the medical community. It has hugely improved my career (my proper job, the one where I go to work in a big building full of sick people) in many profound ways. But, even #medtwitter morphed through the pandemic into a facet of the ‘hellsite’ that people refer to Twitter as. Ugly behaviour from doctors and scientists through the pandemic has been shocking and disappointing to see.

So, much as friends who deeply value the communities they’ve built on twitter – as do I – lament the chaos it finds itself in today, I can’t claim to be particularly troubled. Of course, I’m as vain as the next verified user and I’m incensed that commoners can now pay $8 to join my hallowed ranks, especially because I changed my name to ‘8 Dolla Ro’ and Twitter won’t let it change it back, but I guess I just don’t care that much. Moreover, I have so many things I would rather spend my time doing – like writing this! And of course, making videos. I saw a post the other day saying that people aren’t remembered for having some zesty tweets, but for more tangible works like pieces of art, videos, books, shows.

So, I’m not making a big song and dance about quitting twitter or moving to mastodon as I don’t really want to do either (I am @medcrisis@mastodonapp.uk if you are so inclined but I literally haven’t even tried to use it yet), I am just going to try to quietly allow this to bring more value to my life, not less.

And on the subject of videos, we’ve developed a new system over at Nebula. Originals have existed for a while, and represent those beautifully made specials from many of my favourite channels. I haven’t made an Original yet simply due to time. Nebula Plus is content that’s available only on Nebula, so for me that has been unedited interviews I’ve done, and a few bonus videos too. And the new category is Nebula First, which I am aiming to stick to from now on. Or maybe from January. You know me, always shifting the goalposts. This means my Nebula channel will always be one video ahead of my YouTube channel. That’s the plan anyway. Nebula subscribers will see all my videos ad-free (as they do now), ahead of YouTube. If you haven’t subscribed to Nebula, you can get a subscription free when you sign up for CuriosityStream as well, by visiting www.curiositystream.com/medcrisis and signing up with the code ‘medlife’.

Grease me up woman, I’m a laird

It took me a while to feel comfortable saying the last line of that previous paragraph. Advertising doesn’t come naturally to everyone. But I know I’ve never promoted anything dishonest, harmful, or low quality. In the case of Nebula, I couldn’t be prouder. Plus, I feel very able to sleep at night knowing that the most expensive thing I’ve ever promoted would cost a customer about $25. I preface what I’m about to say with the preceding disclaimer simply to show that I have changed my views on sponsorships, and do not wish to be judgemental about others. But. We all know sponsorships come in all shapes and sizes.

Whether it’s Raid Shadow Legends or FTX spots, we’ve perhaps become inured to your common or garden gaming channel or scammy financial advice/self help guru channel promoting something awful, but recently some of my favourite channels, reputable, smart creators, have been advertising something called ‘Established Titles’. You might have seen these spots. You can buy a wee plot of land (I mean, 1 sq ft) in the Scottish Highlands so that you can call yeself a Laird, because that’s tradition in Scotland, they claim.

Di they think ahm buttoned up a’ tha back?

A bit of 10 second detective work revealed they are a company called Galton Voysey, based in China, and amusingly you cannot access their website from a Scottish IP address, which isn’t at all a tartan red flag. 

They’ve been throwing so much money around recently that even little old me was offered the chance to hawk their pdf certificates of ownership (not legally binding). They went so far as to compliment my Scottish accent, which was my first clue that they have not, in fact, ever even visited Scotland. A friend once bought me a plot of land on the Moon, which is about as much use to me as an Established Titles plot is to you, because not only do you not actually own it, as it is too small an area to be officially registered, but the T&Cs stipulate you cannot do anything with it. The added incentive on their website is that they will plant a tree (can you plant a tree every foot?!) but an investigation by a Scottish company found no evidence that any trees have been planted. They do have a page on trees.org, a trustworthy tree-planting company, but the page says nothing except some cookie-cutter copy.

Medlife Crisis (8 dolla Ro) @MedCrisis

If you watch similar kinds of youtube channels to me, you might've noticed quite a lot of people being sponsored by something called 'Established Titles', who have clearly really been splashing the cash on influencers lately. But...is it just a scam?

Some influencers are paid extremely handsomely by companies, for one reason – the relationship with their audience. The parasocial relationship between creators and their fans can be exploited. There is a reason that creators with the strongest bond to their audience charge the highest rates: Trust. While I take a different approach and maintain an indifferent aloofness (and suggest you do the same to me), I do take very seriously the fact that some people do trust what I say on the channel. I make it clear I have never taken money from a health-related company. I do not sell supplements. I do not sell medical products. I receive no money from pharmaceutical companies. I hope this means that people know that when I say something about medicine or science, I am being honest. I may be wrong, but I am not swayed by money. How people can listen to a podcast host breathlessly praise brain-boosting supplements for five minutes before an episode, then take him seriously as a neutral objective neuroscientist (or whatever) immediately afterwards, is beyond me.

So, it’s a bit concerning when creators promote iffy products, even if they are not trying to be serious educators, because it erodes trust. If you are a creator, do think long and hard before taking a brand deal. Once you lose people’s trust, it’s much harder to win it back.

If you want to hear me talk more about creators, parasocial relationships, brands, oversharing and various other mambo jumbo, I recently was on Nebula CEO Dave Wiskus’s podcast ‘NDA’.

If you’d rather hear about wearables and hype, check out my chat with Dr Danielle Belardo on her podcast Wellness: Fact vs Fiction

I’m sure I’m supposed to sign off newsletters in some snappy way, or end with a CTA (call to action…jfc), but I’ve never been able to think of a catchphrase I liked, so I’ll just say see you next time. And a Merry Christmas and Happy New Year if I am as late with the next issue as I think we all know I will be.

– 8 Dolla Ro