To many active on social media the saga of Dr. Eugene Gu, from #Resistance figure to accused rapist, is a long and strange one that holds some lessons for many physicians in the social media age.
Dr. Gu's pedigree is illustrious: undergrad at Stanford, medical school at Duke. His story starts at the latter institution where he won a prestigious fellowship- the Howard Hughes Medical Institute. His research involved transplanting human fetal organs into rats whose immune system had been suppressed. The concept was to question if fetal organs could be grown in animals and prepared for eventual transplant into humans, a feat which could significantly alleviate the organ shortage. It was controversial when first reported, and Dr. Gu was later subpoenaed by the Republican-controlled congress as part of an investigation sparked by misleadingly edited videos of researchers supposedly selling fetal tissue.
When he was subpoenaed, he had started his surgical residency at Vanderbilt. Soon after the subpoena, he made a social media post featuring a picture of him taking a knee to "protest white supremacy". It was made in the hallway of a Vanderbilt hospital, in a Vanderbilt white coat, and promptly went viral. A patient's family saw this post, and promptly banned him from treating their child, in a series of Facebook posts which also received significant publicity. Vanderbilt first admitted suspending Dr. Gu for the posts, then backtracked and denied that anything had happened.
Dr. Gu began to publicly document increased hostility towards him by the program, including negative evaluations, and negative interactions with his residents, incidents of physical altercations with other residents, and hilariously, nurses putting the discarded milk cartons he stole out of the patients' food refrigerators on his desk.
By way of explanation, everyone, including nurses, steals food from patient fridges at the nurses' station. The items in it are never in shortage, and after 6 hours operating without food, drink, or a break and only 10 minutes before your next case the cranberry juice out of the SICU fridge is liquid gold. For the nurses to call Dr. Gu out on something everyone does means they really didn't like him.
He was eventually fired by Vanderbilt, and Dr. Gu did not take up Vanderbilt's request to release them from confidentiality and fully disclose all correspondence and documentation of what led to the request.
For these posts, Dr. Gu became a darling of the left-wing, with over 100,000 followers, and wide name recognition. Some medical professionals started to wonder: anyone who manages to piss off the attendings enough to get negative evals, his fellow residents, and the nurses is often truly special, and not in a good way. But Dr. Gu retained wide support, and Vanderbilt was felt to be in the wrong. Still, a post calling out the entire medical profession for the July effect, a supposed phenomenon in which new interns starting on July 1st make mistakes which harm or kill patients, lost him significant support. (Many studies have refuted this phenomenon. Fully trained attending physicians supervise their services most closely in July, before reducing their supervision as appropriate towards the end of the academic year). His tweet was felt by many to be both inaccurate and scare-mongering. He began to block people who criticized his comments, including me. (Here are the only two tweets I ever made involving him, to let readers judge my comments). Also around this time, a right-wing twitter user revealed that his divorce records include allegations of domestic violence, a fact retweeted by the President's son, Donald Trump Jr.- an example of doxxing.
Then the story takes a turn for the absurd. A medical satirist has a profile picture of an ophthalmoscope (a common medical instrument, which happens to be black-colored) dressed up in a wig and mustache. This was called out for being blackface by an unknown account who supposedly was Dr. Gu's ex-girlfriend. This alt was revealed to be Dr. Gu in disguise. And once that revelation was made, a medical student ex-girlfriend of Dr. Gu revealed that this alt-account had pried into her life for months, sharing sexual details and harassing her for details as well. She also accused Dr. Gu of acts tantamount to sexual assault, if not rape. Dr. Gu soon responded, claiming HE was the one sexually harassed, and that the real reasons for his actions was that he found the medical student unattractive but was too immature to say so- and that the alternate account was originally created to help him deal with right-wing trolls. He has lost a significant amount of support, though some remains. Needless to say, his response has been widely criticized, and the medical student has received significant support from many in medical social media.
While many will dismiss this entire tale as simply one of a terrible person finally getting his due, there are lessons here for many physicians, particularly those who are highly active on social media. First and foremost, associating your views with those of your institution is a dangerous game. Wearing our white coats, or trendy black jackets and stethoscopes, taking pictures inside ORs while gowned, all of it will increase the popularity of a message. But it has a side effect: the institution where one works will be associated with that message and must decide if it supports your message or not. Particularly for hospitals, which must appease politicians of all stripes at the local and national levels for funding, that can be risky proposition- and no hospital wants to increase their level of risk.
Getting involved in arguments online is also a risky proposition. I must confess that I have found myself getting involved in animated discussions on twitter and other mediums, but rarely do these ever find themselves getting productive. And words said in the heat of the moment will often be regretted later- nothing ever disappears off of the internet.
And finally, it should serve as a reminder that there is no guarantee of anonymity online. Dr. Gu probably never expected his secret alternate account to be revealed, and a review of his tweets under the name has produced some exceptionally embarrassing ones. Ultimately, I try to conduct myself online the way I would in real life, because it all reflects upon me, and really upon the entire medical profession.
Dr. Gu's tale is a tragedy. His research accomplishments and pedigree held a lot of promise- and all of it wasted by his foolish, unethical, if not criminal actions. His actions will likely result in no one trusting him with either a patient or a research position ever again. We should not celebrate his downfall, but rather use it to reflect and improve ourselves.
Dr. Gu's pedigree is illustrious: undergrad at Stanford, medical school at Duke. His story starts at the latter institution where he won a prestigious fellowship- the Howard Hughes Medical Institute. His research involved transplanting human fetal organs into rats whose immune system had been suppressed. The concept was to question if fetal organs could be grown in animals and prepared for eventual transplant into humans, a feat which could significantly alleviate the organ shortage. It was controversial when first reported, and Dr. Gu was later subpoenaed by the Republican-controlled congress as part of an investigation sparked by misleadingly edited videos of researchers supposedly selling fetal tissue.
When he was subpoenaed, he had started his surgical residency at Vanderbilt. Soon after the subpoena, he made a social media post featuring a picture of him taking a knee to "protest white supremacy". It was made in the hallway of a Vanderbilt hospital, in a Vanderbilt white coat, and promptly went viral. A patient's family saw this post, and promptly banned him from treating their child, in a series of Facebook posts which also received significant publicity. Vanderbilt first admitted suspending Dr. Gu for the posts, then backtracked and denied that anything had happened.
Dr. Gu began to publicly document increased hostility towards him by the program, including negative evaluations, and negative interactions with his residents, incidents of physical altercations with other residents, and hilariously, nurses putting the discarded milk cartons he stole out of the patients' food refrigerators on his desk.
By way of explanation, everyone, including nurses, steals food from patient fridges at the nurses' station. The items in it are never in shortage, and after 6 hours operating without food, drink, or a break and only 10 minutes before your next case the cranberry juice out of the SICU fridge is liquid gold. For the nurses to call Dr. Gu out on something everyone does means they really didn't like him.
He was eventually fired by Vanderbilt, and Dr. Gu did not take up Vanderbilt's request to release them from confidentiality and fully disclose all correspondence and documentation of what led to the request.
For these posts, Dr. Gu became a darling of the left-wing, with over 100,000 followers, and wide name recognition. Some medical professionals started to wonder: anyone who manages to piss off the attendings enough to get negative evals, his fellow residents, and the nurses is often truly special, and not in a good way. But Dr. Gu retained wide support, and Vanderbilt was felt to be in the wrong. Still, a post calling out the entire medical profession for the July effect, a supposed phenomenon in which new interns starting on July 1st make mistakes which harm or kill patients, lost him significant support. (Many studies have refuted this phenomenon. Fully trained attending physicians supervise their services most closely in July, before reducing their supervision as appropriate towards the end of the academic year). His tweet was felt by many to be both inaccurate and scare-mongering. He began to block people who criticized his comments, including me. (Here are the only two tweets I ever made involving him, to let readers judge my comments). Also around this time, a right-wing twitter user revealed that his divorce records include allegations of domestic violence, a fact retweeted by the President's son, Donald Trump Jr.- an example of doxxing.
Then the story takes a turn for the absurd. A medical satirist has a profile picture of an ophthalmoscope (a common medical instrument, which happens to be black-colored) dressed up in a wig and mustache. This was called out for being blackface by an unknown account who supposedly was Dr. Gu's ex-girlfriend. This alt was revealed to be Dr. Gu in disguise. And once that revelation was made, a medical student ex-girlfriend of Dr. Gu revealed that this alt-account had pried into her life for months, sharing sexual details and harassing her for details as well. She also accused Dr. Gu of acts tantamount to sexual assault, if not rape. Dr. Gu soon responded, claiming HE was the one sexually harassed, and that the real reasons for his actions was that he found the medical student unattractive but was too immature to say so- and that the alternate account was originally created to help him deal with right-wing trolls. He has lost a significant amount of support, though some remains. Needless to say, his response has been widely criticized, and the medical student has received significant support from many in medical social media.
While many will dismiss this entire tale as simply one of a terrible person finally getting his due, there are lessons here for many physicians, particularly those who are highly active on social media. First and foremost, associating your views with those of your institution is a dangerous game. Wearing our white coats, or trendy black jackets and stethoscopes, taking pictures inside ORs while gowned, all of it will increase the popularity of a message. But it has a side effect: the institution where one works will be associated with that message and must decide if it supports your message or not. Particularly for hospitals, which must appease politicians of all stripes at the local and national levels for funding, that can be risky proposition- and no hospital wants to increase their level of risk.
Getting involved in arguments online is also a risky proposition. I must confess that I have found myself getting involved in animated discussions on twitter and other mediums, but rarely do these ever find themselves getting productive. And words said in the heat of the moment will often be regretted later- nothing ever disappears off of the internet.
And finally, it should serve as a reminder that there is no guarantee of anonymity online. Dr. Gu probably never expected his secret alternate account to be revealed, and a review of his tweets under the name has produced some exceptionally embarrassing ones. Ultimately, I try to conduct myself online the way I would in real life, because it all reflects upon me, and really upon the entire medical profession.
Dr. Gu's tale is a tragedy. His research accomplishments and pedigree held a lot of promise- and all of it wasted by his foolish, unethical, if not criminal actions. His actions will likely result in no one trusting him with either a patient or a research position ever again. We should not celebrate his downfall, but rather use it to reflect and improve ourselves.
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