Book Bans and Doctor Bans

Petty Censors Need Better Hobbies

This is a column of mine published last year in EM News.

https://journals.lww.com/em-news/fulltext/2023/05000/ignoring_trolls_is_itself_censorship.3.aspx

Ignoring Trolls is Itself Censorship

Leap, Edwin MD

A new species of book banner silences ideas with the threat of being cancelled or fired

Every year, the American Library Association recognizes Banned Book Week. Their motto says “Books Unite Us. Censorship Divides Us.” I like that. It's a well-constructed, concise, and powerful statement.

Over the years, of course, lists of banned books change. Doubtless this has been true since the printed word was first etched into stone, put on papyrus by scribes, or came off that magnificent (and troublesome) development, the printing press.

Most physicians, being highly educated people, find the idea of book bans to be vulgar and uncivilized at best, dangerous at worst. Throughout our decades of intellectual preparation, we come to see that the free exchange of ideas is a net positive that should be defended.

I find book bans generally to be a waste of time that could be better spent developing ideas and arguments against the books with which we disagree. Perhaps that would be better stated as against the ideas with which we disagree. A book, after all, is an idea or collection of ideas put into print, bound, and sold to the populace.

Seeing books as ideas that must not be banned presents us with a problem, however, because physicians are increasingly more than happy to shut down ideas they find disagreeable and become a new species of book banner through the transitive property of ideas. Ideas are the content of books. Some ideas must be banned. Ergo, it would be reasonable to ban books as well. One might extend that to say it would be reasonable to ban some people from whom problematic ideas emanate.

A Censorial Lather

I wrote a column a few years ago about the importance of the free exchange of ideas in medicine. (“The Dangers of Groupthink.” EMN. 2018;40[1]:1; http://bit.ly/3JBVchm.) I had been at a meeting in an academic center and asked faculty members if they knew people who had been fired over their ideas. Hands went up all over the room. I was not surprised. Readers have messaged me for years to say, “I'm glad you wrote that column on (insert controversial idea). If I wrote it, I would have been fired.” This is validating for me but also troubling. It should be concerning for everyone.

Things became worse with the advent of social media and Twitter in particular where one might say something controversial (or merely “like” something controversial or follow someone considered unacceptable) only to find fellow physicians worked into a censorial lather, firing off missives to the employers of transgressors, insisting that they be terminated for their Neanderthal ideas, likes, or affiliations.

Then along came COVID-19, and the knives truly came out. The right kind of physicians on the right side of history who knew all the right things were quick to shut down the wrong kinds. All that was necessary was for offenders to say ridiculous things like, “You know, this virus might have been generated in a lab.” Banned. “Masks might not be as useful as everybody thinks.” Banned. “Hey, maybe natural immunity is as good as vaccination.” Banned. And anyone suggesting alternative therapies or expressing doubt about vaccination could be reported to their state medical board, have their license imperiled, or at least be told that to continue saying such things would result in termination from their jobs. (Great idea in an era of physician staffing shortages, but orthodoxy must be preserved, I suppose.)

Physicians who sought to ban other physicians may have felt that they were defending science or the masses. Or it may be that they were living out the dreams they had been cultivating for years and were finally empowered to enact against those colleagues they considered too far from mainstream thought.

A Scarlett Letter

There is a dark intoxication with that kind of power. “I'm going to get you fired” is an incredible threat to a physician who has tried to stay inside the boundaries, follow the rules, pay off debt, and care for loved ones all while caring for the sick and dying and worrying about litigation.

The highly regulated world of medicine makes firing, even a truly unjustified firing, a thing that must be explained for the rest of one's career. It is a Scarlet Letter that never goes away. But that is a small thing to those who know that they are right and who are safely (or so they believe) ensconced in bastions of correct thinking.

The problem is that ideas change. It turns out that the COVID lab leak theory may have been true, that natural immunity is probably pretty good, and that masks may not have been all that we hoped.

Will there be lavish apologies? Restoration of jobs? Remuneration? I doubt it. Those who canceled and banned others over the years (for whatever reason) will simply scrub their online accounts and go to ground, defended by their fellows as having simply “done their best with the information at hand.”

But I will say this. Those who spent and spend their time policing ideas, canceling colleagues (over COVID or anything else), those who banned ideas and people and would ban books too, well, there's a name for them.

They're tyrants. Every time we bend to them, we censor ourselves and bend to tyrants. And I hope they remember that the pendulum always swings.