When someone choses to financially support a Substack publication, Substack gives them the option to send a note to its author. Recently, I figured out where those notes were stored, read through all of them, and noticed a lot of readers here recognized what this newsletter set out to do and felt it was accomplishing that for them.
Initially, I didn’t see a reason to share that feedback, but then it dawned on me there were three reasons that justified doing so. Specifically,
1. I’ve always believed the most effective way to “fix” things is not to attack people who are being “bad” but rather to create a positive example others want to follow.
2. Since the rushed and depersonalized nature of medicine makes it impossible for patients to feel heard or listened to (which really bothers me), one of my goals has been to provide a way for the people here to feel heard. Initially, I tried to respond to every commenter and each person who reached out to me through other channels, but as the readership became larger, that was no longer feasible for me to do. This is turn was why I decided to start making monthly open threads like this one where people could inquire about whatever topic they wished to (and I prioritized responding to the threads). By this same logic, sharing some of the notes gives me the ability to show each of those people were heard.
3. Propaganda is often insane, so for it to work, it has to prop-up a distorted version of reality that makes everyone who questions it doubt their own sanity. This mass
Responses like this are incredibly touching to read (and are part of what compels me to keep on putting the work I put into writing this publication). Similarly, I am incredibly grateful your support is beginning to make a few charitable projects me and my colleagues have wanted to do for decades possible (because we felt they were critically important for the world) and because I am able to support them through work I am ethically aligned with (whereas typically one doesn’t fully agree with what their work requires them to do). In turn, it would greatly help me to know which of these comments “spoke to you” as I have made my best guess about the direction everyone wants medicine to move in, but unless I hear your perspectives to, I will innevitably have an incomplete picture.
In the final part of this Open Thread (where you can ask about any unrelated topics which come to mind), I will share the rest of the feedback I compiled over the last week. Additionally, since I’m always receiving questions about who I am (which for obvious reasons I can’t go divulge) I realized that a “compromise” would be to share one of the songs I listen to as I write as it illustrates the presence of mind I am often in as I draft these.
Note: that song was composed by an incredibly talented anonymous pianist who emerged on the internet 15 years ago and then a few years later completely disappeared without deleting any of their accounts—leading some to believe they died suddenly.