Dr. Brennen McKenzie 288

Photo by Heather Lussier

As a blogger on science in veterinary medicine, Dr. Brennen McKenzie receives nasty comments along with support from readers. He has learned not to respond emotionally to the hate.

The internet is a two-edged sword if ever there was one. It has brought the gifts of rapid access to information, the ability to express ourselves and find a sympathetic audience, and the chance to build communities with people around the world. It has also given us new ways to deceive and attack one another. New communication tools enable the best and the worst of our behaviors. Just as creativity, community and altruism are features of online life, so are tribalism and bullying, deception and crime.

For 11 years, I have written the SkeptVet Blog. What started as a place to post scientific evidence-based topic reviews and client-education materials that I created for my own use as a small animal general practitioner has grown into a science-advocacy and education effort that includes social medial channels, YouTube videos, and even an old-fashioned book.

Writing the blog has been enriching for me. I learn a great deal from researching the topics I write about, many of which are suggestions from readers or clients, and this knowledge supports my work as a clinician. I have connected with veterinarians, students, pet owners and other like-minded people in a loose virtual community with a shared interest in science-based pet care. The blog has drawn positive attention, led to opportunities to write professionally, to teach, to share my views and concerns more widely through media interviews, and hopefully to make some small but meaningful contribution to the veterinary profession and animal welfare.

The blog has drawn negative attention, as well. I receive a steady stream of comments, emails and occasionally letters or phone calls objecting to my views. Some objections are thoughtful, informed disagreements, and I welcome these. Whether the participants end up changing their minds, I strongly believe that civil and substantive debate is healthy and necessary for personal intellectual growth and for the improvement of human understanding in general. Because we all have potent and insidious cognitive biases and blind spots, science is necessarily a community process. The understanding of nature that we achieve through science, and which has so greatly transformed and benefitted our lives, requires disagreement and debate, even conflict. By challenging and testing each other's ideas and beliefs, we learn as a community.

Unfortunately, the majority of the negative feedback I get for my blog is neither civil nor substantive. Much of my writing involves critique of so-called alternative medicine. In the early days of my blog, I naively thought that such practices could be evaluated dispassionately in light of scientific evidence, just like any other medical therapy. If a treatment was implausible, lacked reliable supporting scientific evidence, or had even been shown clearly not to be effective, I assumed saying so would be received as a useful contribution to the ongoing evolution of veterinary science and medicine. Disagreements about evidence, I thought, would be collegial and eventually resolved to everyone's satisfaction by better data. I am honestly a bit embarrassed that I knew no better then, but thanks to the accessibility of my online writing and the rapid feedback made possible by the internet, I learned quickly.

Taxonomy 320

Credit: BMJ Open

Researchers examining public criticism of science communications created a taxonomy of communicators' common negative experiences. Their findings are presented in the paper "Establishing a taxonomy of potential hazards associated with communicating medical science in the age of disinformation" published July 5 in the journal BMJ Open.

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It turns out that criticizing the evidence or rationale for unconventional therapies is often seen as a direct attack on the personal life experience or world view of those who employ or believe in these therapies. Rather than a dispassionate debate about evidence, the interactions that follow are often highly emotional and personal. A recent survey of science communicators and advocates in the domain of human medicine has established a loose taxonomy of the negative responses such individuals receive.

This matches quite well the feedback I have received over my blog. Many respondents dismiss my critiques without engaging the evidence for them by accusing me of ulterior motives, usually financial; suggesting I am part of a conspiracy to suppress natural therapies; questioning whether I am actually a veterinarian or even a real person; or simply presenting the evidence of their own personal experience and daring me to disprove it. I have had letters and calls to my employer demanding I be fired, spurious complaints of copyright infringement that required me to temporarily withdraw articles on my blog, threats of legal action, public disclosure of my name and both work and home addresses, and threats of physical abuse. Some comments don't address my arguments at all but just call me names, tell me I should quit writing or practicing medicine, or simply wish for my death.

Perhaps the most outlandish and creative attack I have seen is a video made by social media personality and alternative health activist Rodney Habib, in which special effects were used to make me look and sound demonic while the narrator suggested my writing was contributing to the problem of suicide in the veterinary profession. Not exactly dispassionate and substantive debate.

My methods of responding to these attacks and coping with them have changed over time. I initially set up the blog in a way that did not draw attention to my identity because I felt the arguments I made should be evaluated on their merits and on the evidence, not on the basis of my credentials or how readers felt about me personally. When I began to get angry responses and attacks, I considered attempting to continue the blog with true anonymity. This is a cumbersome and imperfect process, and I ultimately decided it was impractical and not worth the effort. While I still encourage readers to focus on my ideas rather than on me, whether they support or oppose those ideas, I don't make any serious effort to hide my association with the work.

Another of my early reactions to criticism was to respond in kind, with personal and emotional defenses. However, this approach has never proven productive, and it fundamentally conflicts with the philosophy and ethos of my work. Several critics of my writing whom I have met in person have been surprised to find I don't actually enjoy conflict or argument. I prefer civil and respectful debate based on the understanding that both parties share the goals of finding the truth and improving veterinary medicine. Responding with anger to angry attacks undermines my own goals, and it isn't enjoyable or healthy for me personally, so I have largely learned to avoid it.

That has left me several options for handling the practical and emotional aspects of responding to negative feedback. Operationally, I moderate comments on my blog, and I don't allow responses that are abusive or devoid of any coherent argument to appear. A number of online science and news organizations (such as Popular Science magazine and National Public Radio) have disallowed commenting altogether because trolling and flame wars often prohibit legitimate, meaningful discussion and amplify misinformation. I haven't gone this far, as I find many interactions with readers valuable, but I am under no obligation to provide a platform for people to attack me personally or promote misinformation or their own agendas, so I don't.

In terms of the psychological impact of the attacks I receive, I have found humor and intellectual curiosity the most effective means of diminishing the negative effects these sometimes have on me. I archive all abusive comments and messages, and I periodically post collections of these, which illustrate the taxonomy of the abusive, or which are simply funny and entertainingly bizarre (2011, 2015, 2018). This is in the spirit of Jimmy Kimmel's Mean Tweets feature, and it is a great way to take the sting out of some of the more egregious online vitriol.

I am also interested in how to communicate science and challenge pseudoscience effectively, so I view the negative comments I receive as a lens through which I can study the ecosystem in which science communication operates. There is a growing body of research literature investigating how science education and conflicts between scientific and antiscientific world views play out online. Studying negative feedback is part of the process for learning how to manage such communications around science and medicine more effectively.

Ultimately, I keep writing, and facing the ire this generates, because I feel an obligation to contribute, to participate in the messy process of improving veterinary medicine and building human understanding. The internet makes it easy for a small number of loud voices to dominate discussion and create a false impression of how widespread or accepted their views are. Scientists have an obligation to promote and defend the work we do and to help the public see the value of it.

I am fortunate to receive positive responses to my work on occasion, and these go a long way toward balancing the hate mail. The supportive messages I receive also remind me that one reason to continue my work is to let others who share my passion for science and science-based veterinary medicine know that none of us is alone. The work we do matters and is appreciated, even if the positive voices aren't always the loudest or easiest to hear.

About the author: Brennen McKenzie, VMD, is a small animal general practitioner in private practice in California. He has a keen interest in evidence-based medicine, and in 2015 he completed a master's degree in epidemiology through the London School of Hygiene and Tropical Medicine. Dr. McKenzie has served as president of the Evidence-based Veterinary Medicine Association, he writes a monthly column on evidence-based veterinary medicine for Veterinary Practice News, and he is the founder and author of the SkeptVet Blog and associated social media channels. He also teaches veterinary students and undergraduates, lectures at continuing education meetings, and recently published his first book, Placebos for Pets: The Truth about Alternative Medicine for Animals.