I’m a big believer in the importance of continuous learning—every day, at least one thing new, and usually several. During this just-finished Legislative Session, to rephrase Lewis Carroll, I’ve learned far more than 6 impossible things before breakfast! Those of us who have engaged deeply in following and struggling with the menu of bills have formed new and surprising coalitions, especially among women. Turns out conservative and progressive women alike don’t cotton to having the government up in our uteri. We managed to make enough noise to hold off a fair amount of damage. Yay, us!
Advocates protested a deadly plan to close state mental hospitals with no good safety net in place and were at least partly successful. We may have saved Medicaid (stay tuned), and thus our entire state healthcare system, from collapse. Not everything went the way we wanted it, but a lot did. It’s important to take some time to notice that speaking up does make a difference.
I also had a personal lesson or two that forced me to reevaluate my role doing this blog. When I started it a couple of years ago, my main purpose was (and is) to advocate for single payer, Medicare for All, in our country. I’ve branched out into other areas that sometimes seem far afield, but they aren’t really—everything winds up connected to the whole of healthcare reform. We need to understand how reproductive rights work, for instance, and how to protect them, in order to make any national insurance system a good one. We need to understand how our current Medicaid systems work, and what would happen if they dissolved, to see how intrinsically the healthcare fates of the rich and the poor are intertwined. And we need to ponder carefully the difference between legislation of insurance coverage (good) and legislation of specific medical protocol (bad), so that we don’t make similar mistakes on a national level.
At the beginning, I did not consider myself a journalist—just an activist blogger. If you read the comments in the dictionary link I just gave, you will notice a certain contempt towards bloggers from some journalists. A surprising thing happened this spring that made me wonder what journalism really is. I ran smack up against a conflict of interest that prevented me from writing about some topics. My reaction, not necessarily the conflict, was what surprised me—I was unexpectedly distressed, to the point I got a bit of writer’s block. There were things I wanted so much to say to you, and I could not do it. I had to shut my trap.
It felt like a betrayal, as if I had abandoned my duty. I had come to see the blogging as a sort of ministry. The trigger for my “gag request”—it was a kind request and not an order—was the piece I wrote describing first-hand a meeting with several of our state legislators. I had never imagined so many people would read and share that post, based on my previous numbers. Apparently it caused a fair amount of anger, and not just towards me but towards the category of pediatricians in general. I was told the biggest problem was that the specific individuals I named were not the ones behind the proposed gutting of Medicaid and were actually trying to help us. I was told by one person that “your name has become synonymous with the negativity about that meeting.” I was asked very nicely by smart people to please hush up on some topics for the rest of the session. I did, mostly.
Even though I clearly stated in the post that it was my own report and opinion, independent of any organized group or board, some readers took my words to be representative of state pediatricians. I doubt it would have mattered if I were not a dues-paying member of our state AAP (American Academy of Pediatrics) chapter—the fact remains that I am a pediatrician. It’s such an integral part of my identity that my family has been known to call out “Dr. Abston” in a crowd when I didn’t turn my head to “Mom” or “Pippa”. I never pretended to be unbiased about that—if I’m a journalist at all, I’m a very amateur citizen journalist in the advocacy journalist genre. But I had not expected my identity to present such a challenge.
For awhile I wished I had done the blog anonymously. I use my real name for several reasons, the main one being that it forces me to be fully accountable for what I say. I even thought about starting a new blog, under an alias, to say the things I can’t say as myself. But I decided that would be a mistake.
Professional journalists have specific ethics and employment rules meant to prevent such conflicts of interest. Here’s a list from the New York Times—scroll down to the part that talks about community involvement. If I wrote for NYT, I’d have to drop my membership in the AAP, NAMI, PNHP and several other organizations. Does that work? Is it really possible to report in a neutral manner? I suspect not, because humans just aren’t like that. I’d almost rather our news people go ahead and spit it out—“I’m a Democrat”, “I’m a member of the NRA”, “I donate to Politician X’s campaign”—so we would know where they stand and where they might be inclined to both bias and self-censorship.
So here’s the deal: I’m biased. So are you. I’m part of groups who care about several different things, and sometimes those interests will collide. I’m not going to go undercover, but sometimes I will have to keep silence even when it makes me feel like I’m going to pop. I’ll ask advance forgiveness of various affiliations for my loose cannon nature, because I’m sure it’s not the last time I will inadvertently cause trouble. I’m just like everybody else, a hot mess of a human, and I’m not going to pretend otherwise. Maybe next year I’ll try parachute journalism.