A love letter to the brave keyboard warriors who skim a headline, feel a feeling, and immediately start typing.
Welcome. If you’re reading this sentence, I have terrible news: you are already disqualified from being one of my most enthusiastic commenters. My most passionate reviewers never make it this far. They read the title, felt a strong emotion in their thumbs, and are, at this very moment, drafting a 400-word manifesto in the comment box while still on the homepage.
Bless them. They are the reason I have engagement metrics. Because here’s the thing about writing anything on the internet with the words “vaccine,” “dentist,” “anesthesia,” “gender,” or “pharma” in the title: you don’t need to publish the article. You only need to publish the title. The rest of the blog is basically a decorative garnish, parsley on the plate of discourse. Nobody’s eating it. They came for the parsley-adjacent outrage.
The Comment Section Speedrun
Allow me to walk you through the typical journey of my most devoted non-readers.
Second 1: They see the title in their feed.
Second 2: They decide who I am, what I believe, what I vote, what I drive, what I feed my children, and whether I should be allowed near a stethoscope.
Second 3: They begin typing.
Second 4: They hit post.
Second 5: They block me, in case I try to defend myself with something inconvenient. Like the article.
It’s a beautiful ritual. Very efficient. Zero calories burned on reading.
A Quick Tour Of What They Think I Believe
Depending on which title triggered them, I have been informed, with great confidence, by people who did not read the piece, that I am: A raging anti-vaxxer or government shill for vaccines. A shill for Big Pharma. A tool of the dental-industrial complex. Anti-trans (from a piece asking whether we have enough long-term outcome data to be handing out interventions like Halloween candy). Pro-trans agenda (same piece, different skimmer). Anti-anesthesia (from a piece questioning whether toddlers need to be knocked out for routine procedures that used to involve, you know, a papoose and a lollipop). Pro suffering children (also same piece, incredibly). A conspiracy theorist (from evidence-based articles with citations). Not skeptical enough (from the same articles, by different people, on the same day).
It is genuinely a marvel. I contain multitudes. I am, apparently, every villain in every movie, sometimes simultaneously, often in the same comment thread.
The Actual, Boring, Unsexy Truth
Here is the thesis of this entire blog, which I will now bury on line 43 of a 1,200-word post so that only the six of you who read this far will ever know it exists: I am pro-science. I am not automatically pro current recommendation. I know. Shocking. Grab a fainting couch. Someone alert the group chat. Science is not a bumper sticker. It is not a team jersey. It is not a hashtag you slap under your bio to signal that you are one of the Good People. Science is a method, a slow, boring, often frustrating process of asking whether the thing we’re doing actually works, whether the harms outweigh the benefits, and whether the evidence supports the confidence with which we’re screaming at each other.
Sometimes the current recommendation is excellent. I will happily defend the measles vaccine until I lose my voice, and then I will defend it in interpretive dance. Sometimes the current recommendation is a leftover from 1987 that nobody has bothered to re-examine because re-examining things is expensive and inconvenient and might make somebody’s revenue projections sad. Both can be true. At the same time. In the same specialty. In the same week.
And here’s the part that gets lost between the title and the comment box: my entire purpose in writing this blog is to help parents make informed decisions and, wherever possible, prevent unnecessary harm and unnecessary procedures in children. That’s it. That’s the whole mission. Not to burn down medicine. Not to scare you off your pediatrician. Not to sell you a supplement. Just to give you enough real information to ask the next question, the one that occasionally saves a kid from a procedure, a prescription, or a diagnosis they never actually needed.
The Sacred Cows I Have, In Fact, Personally Milked
For the three of you still reading, hi, I love you, please tell your friends, here is a partial list of things I have written critically about on this very blog, which my most vocal critics apparently believe I have never touched:
Big Pharma pricing, marketing, and disease-mongering. Yes, the same industry I am accused of shilling for. I have receipts. Literally. In the citations. Which nobody clicks.
Big Diaper. Yes, that is a real thing I have written about, and yes, it is exactly as absurd and exactly as lucrative as it sounds. A multi-billion-dollar industry has convinced two generations of parents that a product designed to hold human waste requires seventeen SKUs, a subscription plan, a scented “overnight” variant, and a diaper genie that costs more than a toaster. The genie also needs proprietary refill bags. Of course it does.
Dentistry that treats every baby tooth like it’s the Hope Diamond. Sealants for everyone, crowns on primary molars, general anesthesia for a filling, cool, cool, very normal, definitely not a business model.
Medical specialties that procedure their way to prosperity. If you have a hammer, everything looks like a nail. If you have a cath lab, a scope, or a surgical suite, everything looks like a billable encounter.
Way too much anesthesia in kids for things that used to be done with a topical, a distraction, and a competent adult in the room, or did not need to be done in the first place.
Gender care that has outpaced its own evidence base, particularly for minors, particularly in the absence of the kind of long-term data we would demand for literally any other pediatric intervention.
The COVID vaccine recommendation for healthy, low-risk children, which, say it with me, is not the same as being anti-vaccine, anti-science, anti-child, or pro-plague. It is the same evidence-based, risk-benefit thinking we apply to every other intervention in pediatrics, or at least the kind we should be applying.
Notice a pattern? The pattern is: I follow the evidence where it goes. Not where the guild wants it to go. Not where the algorithm wants it to go. Not where the cool kids on either political team want it to go.
Why This Post Exists
This post exists because I have finally accepted a truth: the people who most need to read my blog will never read my blog. They will read the title, decide which tribe I belong to, and comment accordingly. I could publish a blank page under a spicy title and get identical engagement.
So this is for the rest of you. The weirdos who scroll. The freaks who click. The absolute deviants who read to the end and then brace yourselves, check the sources. You are my people. You are why I do this. You are also, statistically, not going to leave a comment, because reading has apparently made you thoughtful, and thoughtful people are famously bad at internet. That’s okay. I see you.
A Modest Proposal
Before you comment on the next thing I write or the next thing anyone writes, try a wild experiment. Read it. All of it. Including the boring middle. Including the citations. Including the part where I say the nuanced thing that doesn’t fit on a bumper sticker. And then, if you still disagree, comment away. I will happily argue with you. I love arguing with people who have actually read the thing.
The rest of you? Keep doing what you’re doing. My engagement numbers thank you. My blood pressure does not.
If you made it to this sentence, congratulations, you are now legally required to leave a comment saying “I read the whole thing” so I can identify you in a crowd and buy you a coffee. The rest of you: I’ll see you in the notifications, screaming about a paragraph that does not exist.