ER Goddess: Four Social Media Terms Learned the Hard Way : Emergency Medicine News

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ER Goddess

ER Goddess

Four Social Media Terms Learned the Hard Way

Simons, Sandra Scott MD

Emergency Medicine News 42(10):p 22-23, October 2020. | DOI: 10.1097/01.EEM.0000719064.96350.2f
    social media, cancel culture, doxing

    We've all inadvertently upset someone with words taken out of context, not meant in the way they were received, or expressed in an emotional state. In the good old days, before social media, we could apologize, clarify, and move on. Now, as those of us who are decidedly unpolished and imperfect know all too well, one poorly thought out tweet or Facebook post can invoke disproportionate amounts of wrath.

    EPs who venture onto social media for educational resources and networking opportunities are held to ultrahigh expectations of professionalism and, increasingly, political correctness. If we say something deemed offensive or express a dissenting viewpoint, the repercussions range from insulting remarks to calls for our resignation. Retribution for one poorly thought out utterance has never felt as harsh as it does now. What changed? These four terms, which have reshaped social media in 2020, answer that question.

    1. Call-out culture: a way of behaving in a society or group in which people are often criticized in public, for example, on social media, for their words or actions or asked to explain them.

    Call-outs are allegedly a way of doing social justice work. Though calling out someone privately and face-to-face in a respectful way can lead to constructive conversation, call-outs online tend to involve publicly shaming those whose views differ. In the game of moral one-upmanship, it becomes too easy to forget that a person, not an idea, is being ripped to shreds. Showboating in front of online audiences of hundreds or even thousands, online attackers behave more viciously than they would in real life. The biggest culprits tend to be anonymous accounts who smear others' names without revealing their own identity. An EP who says the wrong thing can easily become the target of individuals with a chip on their shoulders.

    President Obama recently got it right when he said call-outs can do more harm than good. “[I]f I tweet or hashtag about how you didn't do something right or used the wrong word or verb, then I can sit back and feel pretty good about myself, cause, ‘Man, you see how woke I was. I called you out.’ That's not activism.” (New York Times. Oct. 31, 2019; Call-outs merely give the illusion that one is effecting change when that's often not the case.

    2. Pile-on (n.): an argument or attack by a large group of people against one person or a much smaller group.

    Even well-intentioned, respectful criticism can devolve into a virtual tar-and-feathering. Hiding behind a keyboard, a cannibalistic clickmob creates a frenzy of judgment and condemnation for the “wrong” of objectionable remarks. My fellow EMN columnist Edwin Leap, MD, endured hundreds of people impugning his character in a Twitter pile-on. When I asked him about the online mob, he said, “These folks attack just for the joy of being in a large group of like-minded bullies. I guess it is kind of a perverse validation. It's especially sad in an age when we are concerned about physician mental health and burnout.”

    Yelling at someone in tandem on social media may be one of the easiest ways to demonstrate solidarity, but amplifying one single mistake to this degree inflames rather than educates. Human beings are simply not built to handle hundreds of people criticizing them and calling them names, so the mental health sequelae alone can be devastating.

    Pile-ons don't just affect their target; they create an enormous onlooker effect. When we witness others facing the wrath of the digital thunderdome, we become fearful of being targeted ourselves. The pile-on directed at Dr. Leap made me want to lower my head and adjust my expressed views so I didn't stick out and ruffle feathers. The onlooker effect of online pile-ons chills and stifles everyone's expression.

    3. Cancel Culture (n.): a way of behaving in a society or group, especially on social media, in which it is common to completely reject and stop supporting someone because he has said or done something that offends you.

    Cancel culture is about punishment. Social media vigilantes dole out retribution by vengefully attempting to negate a person's voice or damage his reputation enough that it interferes with his ability to be employed. Such targeted retaliation was aimed at K. Kay Moody, DO, MPH, the founder and a moderator of the 22,000-member EMDoc Facebook group. This summer a vindictive post denounced her group and urged members to “add to K. Kay Moody's inbox with messages calling her out on her white fragility.” Her “wrong” was trying to moderate discussions to keep them supportive and kind.

    Denouncements are multiplying exponentially to the point that it's no longer sufficient to punish the sinner. There are often second boycotts of people who support that person. Editors are threatened with dismissal or outright fired for running controversial pieces penned by others. A case in point is the recent firing of a New York Times editor for running an op-ed by a sitting U.S. senator. (New York Times. June 7, 2020; Even if we disagree with the senator, do we want a country where the views of half of the population can't be printed in a paper of record?

    Cancel culture has become concerning enough that the intellectual illuminati of our time collectively signed a letter addressing it. The letter stated that the result of cancel culture “has been to steadily narrow the boundaries of what can be said without the threat of reprisal. We are already paying the price in greater risk aversion among writers, artists, and journalists who fear for their livelihoods if they depart from the consensus or even lack sufficient zeal in agreement. This stifling atmosphere will ultimately harm the most vital causes of our time. The restriction of debate, whether by a repressive government or an intolerant society, invariably hurts those who lack power and makes everyone less capable of democratic participation.” (Harper's Magazine. July 7, 2020;

    4. Doxing (v.): the act of finding or publishing private information about someone on the internet without his permission, especially in a way that reveals his name, address, etc.

    There are zealots on the internet for whom even canceling is not enough. These trolls analyze information posted online by a person so they can discover personal information, like where he works or lives, and then meddle in his life. Screenshots are their favorite weapons. Doxing is scary because it allows a stranger behind a screen to sabotage someone without ever having met him.

    A physician who wishes to remain anonymous made a Facebook post communicating the ACEP-backed position that NPs should not be granted full practice authority. NPs in this physician's practice found the post and escalated it to their employer, and the employer ultimately terminated the physician for “putting the contract in jeopardy” by inflaming the NPs. Too many capable health care professionals have been fired for their social media content.

    This summer it happened to me. A stranger on the internet who didn't like a tweet I wrote contacted my employer to suggest she fire me. She didn't, and has been the subject of call-outs, cancel culture, and doxing herself.

    Using information gleaned from the internet to come after someone with whom you disagree raises serious moral and ethical questions about privacy and free speech. Fortunately, doxing falls under various criminal laws, such as stalking, cyberstalking, harassment, and threats, depending on the state.

    Calling out, canceling, and doxing others make many feel virtuous in their righteousness, but it's turning online communities into cesspools. Who among us never made a mistake? We're all imperfect. We've all said stupid things. The alarming truth is that cancel culture can come for any of us, so we all need to resist it.

    As Christopher Hitchens, an intellectual and sociopolitical critic, said, “[E]very time you violate or propose to violate the free speech of someone else, in potentia, you're making a rod for your own back....” (

    Are we willing to sacrifice free speech in the interest of not being offended? We must push back on cancel culture as if our freedom of speech depends on it because it does.

    (All definitions are from the Cambridge Dictionary, 4th edition, Cambridge University Press; 2020.)

    Dr. Simonsis a full-time night emergency physician in Richmond, VA, and a mother of two. Follow her on Twitter@ERGoddessMD, and read her past columns at

    Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
    • James F. Nowakowski, MD11:08:17 AM Dr. Simons, I am really quite surprised that by now, more than two weeks after publication of your op-ed piece, you have received no comments in return. The silence is deafening. Do people agree or disagree? Or merely have no opinion? Perhaps we’ll never know. Realistically, I suppose this could be viewed in any of, at least, the following several ways: 1) Agreement but feeling there is nothing to add, as you’ve already said it all. 2) Agreement but remaining silent, rather opening oneself to the retribution you speak of. 3) Disagreement but in Silent Protest, electing, in effect, to simply ignore. 4) Disagreement but unwilling to call oneself out openly to be guilty as charged. 5) Don’t really care. 6) Too busy to get involved. Apparently, no one wants to touch this with a 10-foot pole. That being the case, let me be the first to congratulate you for your excellent analysis of our current state of communication, the need for change, and the courage to express it. You have done us all a great service. Hopefully all of those reading will be reminded there are, indeed, distinct parameters for civil discourse if one is truly seeking collaboration in finding the best solution to any difficult problem. Or simply wishing to share thoughts for the betterment of oneself and one’s community. Bravo!