It had been my intent to sign back into Sermo the first day of Hanukkah, leaving me with an absence of a few months. It's the longest I've been away, not even a lurker, and had no interest in being a lurker on return. At one time Sermo absorbed a lot of my free moments, and even my productive ones. I would engage in discussions, make fast quips, use the Endocrinology cases that people posted and commented upon to teach my residents on elective with an analysis of the various comments that individual respondents would make, some expert, some less familiar. Like much social interaction and media, an element of echo chamber became increasingly apparent. The best scholars both in clinical medicine and in general erudition had moved on. In retirement I could have depleted all day there, but as my electronic colleagues became less endearing, I gave myself a limited hiatus which concluded yesterday.
My time back was intentionally brief. Much like you cannot tell the difference in your kids from one month to the next but their aunt who has been in the hospital can, that's what I found. Scrolling back about 5 days, the subjects and posters had changed, mostly for the better. Libtard this and libtard or related sloganeering that so dominated titles of recent years, did not appear in any meaningful volume. At my exit there were a handful of folks who I thought might be trolls, probably not paid to pitch the political hardball five times a day but self-motivated to see how much of an electronic gathering they might generate. The physicians I would walk across the electronic street to avoid had disappeared. A few frequent flyers remained, a fellow who was still between jobs when I left, a fair number of physicians still moping about administrators and insurance companies who'd done 'em wrong, a lot of stuff that might come out verbally at a Medical Staff Christmas party. I engaged in a few of the conversations, one by a lady who had taught herself to read. I was taught to read in two different alphabets but would have failed if I had to do it on my own. One conversation involved the demise of the prestige that once accompanied the MD or DO degree. True enough, but I decided a long time ago that my self-esteem did not depend on my possessions and my diplomas are my possessions. My knowledge and skill are shared, and seem to have been appreciated right through retirement.
There were people creating threads who I did not recall from months past. One had the nom du plume tushi, a fellow from a developing country. The censors are apparently more tolerant than the state motor vehicle divisions who might have censored that from their vanity plate roster.
Being there had very little emotional impact. Not offensive. Not an echo chamber. Better than when I had left but without the return of the dozen sharp minds of years back whose comments I made a point to read.
An obscure but important book about recapturing a waning Jewish organizational culture in America came out about ten years ago, Getting our Groove Back by Scott Shay, a rather well-to-do NYC banker of Orthodox background. He devoted a chapter to the attrition of Conservative Jewish affiliation, regarding the loss of the middle as one of the great American Jewish disasters, which it probably is, no matter how self-inflicted. I think the departure of the best and the brightest who contributed their articulate analyses to clinical and non-clinical aspects of the American medical pageant approaches a disaster for the American medical community. The forum remains but its previous glory does not with no means of recapture, other than maybe hiring their real scholars and conversation makers as the more beneficial trolls paid to post. Every bit as self-inflicted as the leadership generated attrition of Conservative Jewish institutions but a public loss just the same.
Have I passed through the exit door for the last time? Probably not, though even though the offensive posters seem gone, beneficially provocative replacements needed to enhance an attractive physician forum don't seem all that highly desired.
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