PracticalDermatology

Well there you go, sports fans! So much for 2020. So much for the exodus of sanity. And so much for…never mind, not much has changed so far, has it? Maybe our hair, weight, energy, and temperaments have fluctuated to some degree, with the hopes of a new year to bring a reset or at least an attempt at “Dry January” that probably didn’t last a week. But as Phil Collins once asked in a video, “So how does it end?”

With the virtual reality we have now become inserted into, one step away from The Matrix or Oceania—take your pick—we have had to accept some new cyber versions of ourselves on meetings and other virtual interactions. Live group meetings and gatherings are now rare, but the few that have taken place definitely lifted spirits, not to mention ended up more productive than staring at and tuning out the same old heartless screen.

Think back over the last year. Was there a meeting or virtual encounter that you were on where someone just absolutely lost it? I mean completely became absolutely unglued and turned the meeting upside down? I doubt it! In these days of video police (or Big Brother himself) with everything being recorded, the offender probably would have been given the virtual hook and taken off the broadcast. This is a far cry from a real meeting, where everyone feels the vibes and the occasional meltdown is received with combinations of entertainment, contempt, and eventually some sort of resolution after what needed to be said was said…and in some cases some candy shared to alleviate the “hangry.” But, now, the offender would eventually be labeled “The Bad Guy” and not invited back or given some time in the penalty box: two minutes for disagreeing, five minutes for yelling, and a misconduct for not pandering. Often forgotten is the reason for the outburst, which maybe with a different delivery, could possibly have been for the global good instead of personal gain.

Think about the old days—like 2019—in any group or committee, advisory setting, or even in the clinic, there’s always someone with a short fuse, a closeted hothead with a tripwire nobody can predict, the one nobody wants to say the wrong thing around. But what about the one who gets things done without waiting for approval, who has a foot on the gas and gets the task off the board without any credit, or who doesn’t waste time earning the devotion of the crowd but stays behind the curtain without the accolades? These are two different versions of the Bad Guy—everyone else remembers the ruckus they create but often takes the results for granted.

Today, the Bad Guy no longer gets any kind of pass and has to stay buttoned up. But at what price? What really needs to be said gets buried, a potential improvement doesn’t see the light of day, and, unlike the days of meetings in person, some things just don’t get done. Sadly, the potential for the lack of initiative dilutes decision-making, which could impact innovations, financial outcomes, and even the direction of an organization. Think of the difference that a healthy but productive live debate can make, where consensus can be made with simple body language or even a handshake—things our virtual world deprive us of. Is there no arena left for the Bad Guy? Are we in an era of censorship, of cancel culture—one step closer to McCarthy 2.0—where it’s better to just stay in your seat and hope to learn the secret handshake?

In this new world with the demise of the meritocracy, the Bad Guy is afraid what they say will be twisted by perception or interpretation, and accused of not being politically correct, resulting in a dreaded “-ist” suffix being added to their reputations. We walk on eggshells and bite our lips rather than contribute, even if that contribution involves telling people what not to do to avoid making mistakes. It has become our new normal to be afraid to disagree and speak up, and now that the line between opinions and philosophies blur with facts and groupthink, there is no place for the Bad Guy anymore, even if, under the mask of the Bad Guy is really a Good Guy who just wants to stay true to the cause without the risk of being bullied or deselected. Can we no longer have constructive debates that may lead to new approaches?

Clearly my days as the Bad Guy are behind me. After years of mockery of pharma’s Buzzword Bingo, I just got off of a virtual conference where dermatologists referred to themselves as “HCPs” and “Providers!” Congratulations, “Mr. Corporate,”—whoever you are—you brainwashed the best and brightest, taught them your language, and maybe won the battle of groupthink. But hopefully not.

I long for the days when we can just be doctors and can just be ourselves. When we can truly dialogue, in person, have healthy disagreements, and move forward together recognizing our common goals. Let’s hope those days aren’t gone for good when the real Bad Guy, aka SARS-COV-2, gets vanquished and we can get back to being ourselves.

“This to just remind you…all is meant to be…”