Drugs!

#2. Send me your questions, forthcoming videos and the demise of medical discourse

Questions please.

I’m still figuring out exactly what form I want these newsletters to take. I’ll probably still be saying that a year from now, so in the interim let’s adopt the Royal College of Surgeons’ motto and just wing it. I write this a few days after it was revealed that Bari Weiss earns $800,000 a year from her Substack newsletter, so I assume I’ll be exceeding that in a few weeks or so. I’m not actually charging any money for my newsletter, so I’m not sure quite how. Maybe one of you will just send me $800,000? Let it be known I’d happily accept $700,000 – that’s the kind of considerate guy that I am.

This week I start consultant (boss) life, which you might recall from issue 1 is a career landmark I’m using to launch this newsletter and the podcast, but also to start exploring more complex or controversial topics, with a degree of seniority (if not sense).

I’ve tried not to shy away from topics that are a bit atypical for medical YouTubers, like death and unethical practices, and I wish to continue this (not least because I’m a clear decade or two older than most medical YouTubers). I deliberately missed the customary point for another Q&A at 400,000 subscribers, because I wanted to mark this milestone at 420k, as it will be drug themed. And as such, I would like your help. Please send me your questions.

I will prioritise newsletter subscribers’ questions as you’re clearly smart and wonderful people, and let the riff-raff commenters on the YouTube community post (that I won’t even make for a few days) fight over the final vacant question slots like the unwashed peasants they are. I know you might be replying from your own email account so please be reassured any questions I read out will be anonymised. As a medical professional, I have a longstanding interest in the topic, predominantly from a policy and research perspective. I will save my thoughts for the video. It’ll be a normal Q&A too, so the questions don’t have to be drug-related. You already know I quite like the silly ones. Send away!

This month’s videos.

I had altogether too much fun with filming things in various stages of beard-growth. It makes perfect sense for one of the videos, but entirely irrelevant to the other one. At this point, I’m just entertaining myself and it’s a pleasant bonus that people watch.

I shot some of the footage for this video about exercise, and how we use it in cardiology, at my old hospital of Royal Papworth in Cambridge. I would love to make more out-and-about videos if I can.

This must be the video I’ve enjoyed making most since starting the channel. I initially thought I’d just do a straight explanation of each chapter in the story of vitamins’ initial discovery but when I realised there’s a bunch of already-very-good vitamin history content out there, I figured I can bring the ‘triple threat’ of my talents to this. The first two, highly dubious; poetry and accents. The last in no doubt: Indian-manufactured hirsutism.

On the topic of accents, I’ve realised no one knows what they’re talking about. I’m under no impression that any of my accents are accurate. However, I have an almost perfect split between Australians saying I did a good job of an old-timey Aussie accent, other Australians looking to ban me from the country for crimes against their culture, Scots saying they’ve heard much worse, and non-Scots saying I’ve usurped Mel Gibson for the prize of world’s worst Scottish accent. Unless Erik Singer himself passes verdict, I’ve decided to do what scientific journals do and only pay attention to the results I like.

A related tweet that I think encompasses much of my frustration behind that last joke:

Prof Nichola Raihani @nicholaraihani

Submitted a paper reporting null results to a mid tier journal. Guess how it went. I literally don’t care at this point but I do feel bad for the first author (who I won’t name here).

The state of medical discourse.

Segueing smoothly onto Twitter itself as a subject, this summer – save a few tweets to promote friends – I took a month off, as I do every now and again. I usually return quite happily, because I have carefully curated an experience that until recently I still found very rewarding in spite of all the hatred directed toward the platform. I mostly use it to converse with other medics, other content creators, and to follow people I find interesting. I don’t use it to work myself into a rage. I’ve been a vocal proponent of Twitter for professional reasons – I credit Twitter with giving me a start in scicomm, online education and directly leading to my YouTube channel. Heck I’ve even written in the British Medical Journal about it. But something has noticeably changed in medical Twitter.

People I previously thought entirely sensible have become belligerent and engaged in ugly arguments. Or they have migrated to extreme views. Academics have shut down conversations with anyone deemed insufficiently committed to their particular ‘side’. The person voted ‘most influential doctor in America’, blocked me for questioning something (without even tagging him). #medtwitter, once a wonderful resource, has fallen foul of the pandemic and become as toxic as everything else. That’s as much as a problem for science and medicine as it is for politics. I’m grateful at least that things in Europe seem less polarised than in the US, but by the same token I really feel for my friends there who are struggling to find some common ground.

Forthcoming topics.

Another heavy subject I’ve wanted to tackle for a long time is assisted dying. The UK Assisted Dying Bill defines this as “prescribing life ending drugs for terminally ill, mentally competent adults to administer themselves after meeting strict legal safeguards”. A nice cheery topic for a pseudo-comedy channel eh?

I’ve also got a rather more fun collaboration with a certain YouTubing physicist coming up. But please be aware, I have no idea what happened to my hair on the day of filming. It’s…quite something. Another major project I’m working on involves filming in a pathology museum. Quite an expensive pursuit, so that might sit on the back burner for a little while (where it’ll join another 153 ideas).

Narcissistic self promotion.

The three-part podcast I mentioned last time, a fun history of the coronary stent that I recorded with some friends, is now out in its entirety! Each episode is only seven minutes, so you’ve got no excuse not to take a listen ;-) Available on all podcasting apps. Like a podcasting Walter White, my own aural batch is still cooking.