Radiotherapy and Twitter, what’s your opinion!


Even Donald Trump is not bigger than this medium

With the world under the grip of an even bigger wave of a new variant coronavirus, many country’s health services in meltdown and their populations in the throes of further severe lockdowns, Donald Trump has just had his twitter feed suspended while his supporters, under his guidance ran riot in the US Capitol building as they now fully believe in his own ‘fake news’ about stolen elections! 5 people, including an unsuspecting policeman died.

Pic: Protestors storm the US Capital

Aside from the regular news programs on TV, Twitter has become for many not only their source of information but also the default place they go to put over their views or disagree with others. This is not a place for the faint hearted as without warning you can be publicly shamed by thousands simply by having an alternative opinion.

Without doubt Twitter is an extremely divisive, angry place at times but does it really have the impact that we might wish to use it for, especially in radiotherapy?

Is it really just a virtual ‘speaker’s corner’ that when younger I used to frequent while on trips to London, simply for some entertainment in Hyde Park where people spouted their views standing on ‘soap boxes’ and others disagreed, usually very vocally. The difference being that on Twitter you can’t really walk away unless you permanently close your account, block people from following you or mute their points of view.

Pic: Twitter is a powerful medium, in the right hands

Twitter becomes a tool for ‘Independence’ despite desperate healthcare issues

Here in Scotland for example, Nicola Sturgeon is an extremely populist leader of the SNP and First Minister of the devolved Scottish government whilst overseeing Europe’s worst drugs crisis per head of population, presiding over poorly performing health and education services, with one of the world’s worst Covid death rates along with allowing the virus to rip through care homes and kill many unprotected elderly residents at the start of the pandemic.

However, despite this alarming (to many) background her popularity has paradoxically increased dramatically in the past year, largely based on her performance on regular BBC Scotland TV updates as a ‘leader to trust’ but also by having a very popular Twitter feed with 1.4m followers. This is often used to put over ‘nationalist’ rhetoric on the need for a further independence referendum, the polling levels of support for this potential event and other equally divisive and separatist views on Brexit and re-joining the EU.

Most key issues of the day including fishing, vaccination and lockdown have become deeply politized and of course as ever, very divisive.

If you dare to question the ‘nationalist view’ you will quickly see how divisive this platform can be despite the fact that an independent Scotland by default means further potentially irreparable division among all Scots, and not necessarily between Scotland and Westminster which is usually the focus for most bile even though Boris Johnson holds the keys to the holy grail of a further referendum.

Now Nicola has ‘revved up’ her forces, like a dog with a bone they will now likely not let go, even if it seems to some to the further detriment of the Scottish economy, now reeling from lockdowns, no tourism, rapidly rising unemployment and with an outcome that some say could end up being similar to the events in the US discussed above when Donal Trump revved up his followers to try to stop a vote on the election results being adopted. I hope not but the Yes/No arguments are becoming increasingly acidic.

Many respected opinions (from inside and outside Scotland) state that it would be far better for this to be delayed for a few years at least but that is not on the agenda of the great majority of her followers. After all, some people have stood on. the border with England wearing Hazmat suits and carrying signs demanding closure of this boundary, similar to Trump’s wall in Mexico perhaps and asking the English to turn around and go back where they came from.

Pic: If English, please keep away!

I do find myself expressing my thoughts very carefully on Twitter to avoid being shamed myself. However, this is unlikely to really help even though expressing them makes me feel much better especially if others ‘like’ them, although this is complicated by the fact that I actually voted for Nicola! Only time will tell whether Scotland goes it alone and thrives, let’s see.

You can shame the Government into action on twitter

Another feature of Twitter is that the more followers you have the more ‘powerful’ your opinion or message is seemingly judged and sometimes this can have an instant effect as with the campaign by Marcus Rashford to shame the UK government to offer free school meals to vulnerable children. He has been awarded an MBE for his efforts that only started a few months ago and is having a big impact.

Pic: Marcus Rashford shamed the Government into action on Twitter

However, one downside of having lots of followers is having to feed them regularly, just as in real life they become hungry for more information and so it is easy to go from hero to zero on Twitter if you slow down your tweet levels or say the wrong thing. Public shaming is prevalent on this medium and many followers are simply ‘stool pigeons’ hoping to catch you out or jump on you when you fall.

People usually like to follow you based largely on their interest in your subject matter but often use this to make their ‘following’ list mirror how they want people to see and judge them. It’s a bit of a virtual ‘catwalk’ for some and it is very easy to get a feel of a Twitter users political, vocational and general interests just by reading the “tweets and replies” section of their profile.

Professor Karol Sikora lead the way, keeping cancer patients in the headlines

Prof Sikora started his Twitter feed from scratch in March 2020 as he felt that cancer patients would be ‘thrown under the bus’ as the NHS become overwhelmed with Covid19 cases and quickly his followers grew to over 340,000, including many MPs and so pretty impressive from a standing start.

He even did a Q&A with RadPro on his Twitter experiences in June and during the pandemic. You can read it here: http://www.radpro.org.uk/2020/06/08/q-and-a-with-professor-karol-sikora/

His concerns turned out to be very prescient, while his messages of hope, and advice to cancer patients and to his followers to get symptoms checked earned him the nick-name ‘The Positive Professor’. His deep knowledge of cancer added to his professional opinion that T-cells would play a key role in immunity from Covid19, which recent research has shown to be fundamentally correct, meant he grew a very loyal band of followers who retweeted much of what he said while new adversaries within the media, medical and scientific fields started to question why he was on TV and in the press all the time and they weren’t!

Time and time again, social media trundled out the same few ridiculous stories and so that as with Donald Trump, fake news eventually becomes some form of ‘virtual reality’. Professor Sikora always took time to put people right on these non-newsworthy items but that must become very tiresome eventually and so the block feature on Twitter would certainly have played its part!

However, blocking people creates Twitter opponents who then start their own veil of negativity and this tends to grow and become even more divisive. As ever, Twitter polarises views on almost every subject from Brexit to Covid19 policies but when it comes to attempted shaming, people on twitter seem to be overcome by group madness and just can’t help but join in.

As an example, recently on new-year’s day, Professor Sikora was subject to what to all intents and purposes looked like a ‘Twitter coup’ initiated by Guardian journalist and author Owen Jones and supported on Twitter by ‘celebrities’ such as Piers Morgan, an adversary to Professor Sikora from day one and others.

This appeared to be a concerted attempt to try to undermine his reputation on this forum. The news article shared on Twitter was entitled “Giving people false hope about the pandemic isn’t ‘balanced’ – it’s dangerous” and suggested that he was somehow telling people things that they simply wanted to hear.

Once again, the article focused largely on the same old themes and on Twitter people tried to validate their points of view by bringing up the same fake news that had already been dealt with on numerous occasions and many months earlier. A kind of vicious ‘social media’ circle had well and truly started!

As we all know, at the end of the summer things had improved and life returned to some kind of normality. Infections were low and the death rate dramatically declined. We were all ‘eating out to help out’ and the initial lockdown seemed to have worked, levels of herd immunity were growing and vaccines were under development by many firms. T-cells were working, £12b was spent on a ‘world beating’ test, track and trace program, drugs such as the low cost and readily accessible steroid dexamethasone prevented serious illness and the virus was in retreat. Schools reopened and many thousands of students went back to college, travelling all over the country.

However, a new super-spreading mutant variant of coronavirus was about to evolve in Kent and cause havoc just in time for Christmas!

I am not sure that anyone saw this coming or at least its dramatic effect on infections and death rates although there are some advisors, scientists and many others who suggest on Twitter that without a policy of ‘zero-Covid’ this will keep on happening for example lockdown, release, variant and lockdown, release variant etc until we are all living in caves! Some even seem to want this to happen as some form of punishment for us not following their rules or to prolong their brush with scientific national fame!

We’ll see, but as I write the latest vaccines are being given at great speed and so there is light again at the end of the tunnel for all of us however our UK economy lies at the edge of the abyss, as does our mental health and our children’s education but we will leave that discussion for another day.

The ‘#CatchUpWithCancer’ campaign

There is no doubt that Professor Sikora’s Twitter feed and messages to cancer patients have saved many lives and this work is now being furthered by the #CatchUpWithCancer campaign under the remit of Professor Pat Price who is using her Twitter handle @RTherapy4Life to hold the government to account along with Action Radiotherapy and even RadPro when we can help pass on the message to our readers on the huge impending cancer crisis and lack of investment in state of the art radiotherapy services, an area that it should be said that Professor Sikora has had much success in with Cancer Partners, Rutherford Health and Proton Therapy to name a few.

Many high-profile MP’s are now backing this campaign, keeping radiotherapy and cancer services in the media glare. BBC1 Panorama also exposed the cancer crisis on national TV recently, ably led by Deborah James (@bowelbabe) who has put a cancer patient’s perspective firmly in the spotlight on TV and importantly Twitter and with much success where she has over 24k followers!

The catastrophe awaiting cancer services and patients due to our NHS becoming totally Covid19 orientated is now getting far worse than the we could ever have envisaged at the start. Between Professor Sikora and Professor Price, cancer patients and radiotherapy services are simply not allowed to be forgotten.

As 2020 came to an end, RadPro asked Karol Sikora some further questions in a second exclusive Q&A session on his experiences to date and one final one on our own specialist field of radiotherapy and these were some of his replies:

Q. What are your latest thoughts, good and bad about using Twitter now some 10 months since starting?

A. It’s a bizarre medium – not very friendly. And full of self-important people who are up themselves. I’ve caused a few twitterstorms where people descend on you like locusts with fairly hateful messages. The worst one was when I pointed out that most Covid deaths were in people over 80 years old. I was compared to Dr Shipman.

Lastly a question for our dedicated radiotherapy readers:

Q. What do you think will be the most important breakthrough in radiotherapy treatment in the UK in 2021?

A. Better working practices in precision radiotherapy. SABR, the MR LINAC and Proton Beam Therapy all need much closer interaction between radiographers, physicists and doctors. Otherwise their advantage will be lost. Creating the right platform is challenging and requires a lot of effort but is essential for success.

You can read the complete Christmas Q&A here:

http://www.radpro.org.uk/2020/12/15/the-radpro-christmas-twitter-q-and-a-with-professor-karol-sikora-10-months-on/

So you’ve been publicly SHAMED – A book by Jon Ronson

Pic: The 2015 book cover on social media shaming.

Shaming on Twitter has become something to avoid if at all possible if you value your health, wellbeing, reputation and your job! In this book Jon initially discusses how some academics created a fake ‘infomorph’ or spambot account for him on Twitter making people think he was a ‘foodie of poor character’ but with only 20 followers, including some people that he actually knew!

Even though he appreciated it was fake it riled him for many months and there was little he could do until taken down under duress after shaming the instigators into action.

There is also story about a young woman who just before boarding a flight to Africa tweeted to her 120 followers that essentially ‘white people don’t get AIDS’ and disembarked hours later as the No I trending account on twitter with 1.2m searches on Google for her name! She had intended that the message was as a way of highlighting how people are mis-informed about this disease but it came over simply as racist.

This book is a must read if you want to avoid the wrath of people on twitter especially if you tweet, in Jon Ronson’s words a ‘badly worded joke to your one hundred or so followers’ and it goes viral!

Eventually she lost her job and as the author suggests ‘a life had been ruined…just for some social media drama’. He also argues that every day a new person emerges as a hero or villain and that we behave on Twitter not as we do in real life.

I guess the ‘blue-tick’ verification on twitter that is now routinely used by popular, famous or celebrity people who don’t want fakers to look like them and spread misinformation works while others use very obviously fake or parody accounts to poke fun and mimic famous people which are worth following and often more interesting than the person they are copying!

Pic: Twitter blue tick account verification

Anyway, why not get the book, it’s a good read! It was written in 2015 but still very valid today with lots of stories of Twitter making mincemeat of many peoples’ lives, careers and character wrongly or rightly and explores how people behave very differently in groups. One chapter neatly explains how and why the protestors at the US Capitol likely behaved the way they did but over 5 years before they actually did it!

This brought me around to thinking about the opposite to group shaming and how we react to it. When Princess Diana died, people who didn’t know her at all, turned up in London in their hundreds of thousands to ‘mourn’ her death and lay flowers. This form of mass national grief was pre-Twitter but shows the power of people behaving alike but in the safety of their swarm.

Recently, the ‘clap for carers’ initiative every Thursday once again turned into a mass-participation event, driven by a united desire to thank NHS workers but also perhaps with a craving to show others that you actually do care and if you didn’t do so then your neighbours would know! This phenomenon was Twitter driven and was for some a type of ‘shame avoidance’ I guess but fizzled out when wave 2 hit and when clapping for nearly everyone affected by Covid19 seemed to be a step too far.

Mathew Syed, the Sunday Times 24th January 2021 article – ‘Piers Morgan’s idiotic rants reduce subtle arguments to soundbites’

In this article Matthew Syed describes Twitter as a ‘digital cancer whose catastrophic influence on our consciousness has yet to be fully grasped’ when discussing the impact of Piers Morgan on his TV news show and his Twitter feed in that he can be seen to be a ‘temporary hero to the deluded souls for whom he becomes a cheerleader’ and that his themes are not important unless they are ‘topical and divisive’.

This is another example of the impact of an unexpected ‘humiliation’ on this medium as Piers, I am sure did not see this coming. Once again Twitter deeply polarises opinion and the comments have certainly hit a nerve from what I can see and the fall out on Twitter is now pretty corrosive from his followers who either like or dislike him. But one thing’s for sure, love him or loathe him, he won’t change or take this too seriously.

I am sure if at all interested you will take a look online!

You can read the article here (behind a paywall I’m afraid or free for first timers) as it also starts with references to the live TV debate with the Lord Sumption and Deborah James fracas about the value of individual lives and the catch up with cancer campaign hence including it in this blog:

Read more: https://www.thetimes.co.uk/article/piers-morgans-idiotic-rants-reduce-subtle-arguments-to-soundbites-d2zpchbjv

Virtual exhibitions, meetings and social media coverage

Back in 2011, RadPro created the first, as far as we know, virtual radiotherapy exhibition and meeting called RadPro EXPO. We created virtual stands for all our partner companies and organisations and had an exhibition map/floor plan that contained the booths and 4 participation zones: papers and posters, presentations, video and webinars along with a coffee zone with free coffee vouchers to be won. The idea was that you did not have to travel to attend this show and could access it at any time from the comfort of your home, hospital or office and anyone could join in.

Pic: The @MevionMedical 3D virtual stand on the RadPro EXPO. These are manned 24/7 by a chatbot and open 365 days per year!

Since Covid struck, this has now become the default offering for all meetings in radiotherapy as travel disruption, social distancing and lockdowns have all but ended conventional events both here and overseas.

In the words of Oscar Wilde, ‘Imitation is the sincerest form of flattery’ and so while we are happy our ideas were innovative and well before their time, now everyone is doing it!

Before this, Twitter was the main vehicle for allowing ‘anyone’ to attend a national or international congress as the actual meeting delegates in-situ would tweet ‘in-session’ images and text of the presentations, slides and their highlights to all their peers and followers that would be of interest to them.

Now most radiotherapy professionals use the medium to share their research work, report on clinical trial updates or progress of new imaging and radiotherapy techniques at their departments or those of others.

Twitter has also become the main vehicle for announcing radiotherapy webinars and virtual meetings and offering a facility for you to pre-book or participate in the rapidly increasing amount of online events, often arranged by professional organisations, service providers or equipment companies while Twitter polls offer a snap-shot of professional or public opinion of your product or service in a few days.

A quick league table of some selected twitter accounts in our field of cancer care and radiotherapy with approximate follower numbers accurate at time of writing

Name Twitter @ ID Follower Numbers

Macmillan Cancer Support @macmillancancer 670 k
Matt Hancock @MattHancock 388 k
Prof Karol Sikora @ProfKarolSikora 337 k
Cancer Research UK @CR_UK 336 k
Deborah James @bowelbabe 24.5 k
ASTRO 19.4 K @ASTRO_org 19.4 K
Royal College of Radiologists @RCRadiologists 18.7 k
Society & College of Radiographers @scormembers 11.3 k
Elekta @elekta 10.7 k
ESTRO @ESTRO_RT 8.5 k
Varian @VarianMedSys 8.1 k
Dr Richard Simcock @breastdoc 5.5k
Action Radiotherapy @ActionRTherapy 4.4 k
BrainLab @Brainlab 3.4 k
Accuray @Accuray 3.2 k
RaySearch @RaySearch 2.6 k
RTherapy4Life @RTherapy4Life 1.7 k
ViewRay @viewray 1.5 k
Genesis Care @GenesisCare 1.6 k
Rutherford Cancer Centres @therutherford_c 1.3 k
Mevion Medical @MevionMedical 1.1k
RadPro News/Opinion/Blog @RadProWebsite 1.1 k

PS: If you are not on the list, I used 1,000 followers as a minimum and apologies if I missed you but will let people know your account handle if you wish to be included on our Twiter feed and you let me know!

I think that this chart makes some sense in that many companies and organisations have largely similar follower numbers in what is a fairly specialist area unless the general public are interested in you.

TikTok – Dancing Radiographers

Lunched internationally in 2017, TikTok, known in China as Douyin is a video-sharing social networking service owned by Chinese company ByteDance. It is a platform used to make a variety of short-form videos, from popular categories such as dance, comedy and education, that have a duration of 3 seconds to 1 minute.

During the pandemic, doctors, nurses and other NHS personnel decided, probably unwisely to use this medium to create videos, largely coordinated dance moves involving groups of staff and often patients and put these online on Twitter.

I have seen some performed by groups of Radiographers too and while the intention was I am sure meant to show that there was still a prevailing sense of humour and celebration in dark times (especially cancer patients completing their treatment) many users of Twitter essentially shamed these staff by asking why they had time to perform dance moves when patients were dying and then for them to say subsequently that they have never been so busy and stressed out.

I must admit I profiled one Twitter based TikTok dance routine on RadPro suggesting that it was a good idea but having had time to think, perhaps it might send out the wrong message, as even one performed recently by some front-line Doctors singing about their experiences fighting Covid19 has divided opinion as ever with some participants even harassed on line!

Is Twitter really for you?

So to summarise, in radiotherapy Twitter is a useful medium for sharing information about your products and services, your clinical research and development work, your webinars and meetings and other #radiotherapy news (don’t forget to use the hash tag on Twitter) but the number of dedicated followers out there is limited by our specialist sector as you can see on my league table and keeping them all amused, very competitive.

However, if you really want to be heard and involve the general public there are real RISKS involved and so be careful what you wish for!

Duncan Hynd – Feb 2021 ‘A Radiographers Life- a 40 year career in Radiotherapy’