The High Cost of Free Speech

Why I'm taking a hiatus

“Freedom of Speech” by Norman Rockwell, published in The Saturday Evening Post in 1943 (source)

“The best lack all conviction, while the worst

Are full of passionate intensity”

— William Butler Yeats, “The Second Coming” (1920)

Dear Readers,

I have been writing this newsletter since 2022, publishing just over 150 articles in that time. All Science started as a creative outlet when I was stuck in a rut at my last job, then grew as I got the courage to leave and strike out on my own as an independent consultant. The non-compete I was under for two years made finding full-time work difficult. However, as the rejections from institutions not covered by that contract piled up, and continued after it ended, it became clear that the non-compete was not the only thing holding me back.

I am still looking for a full-time job that is a good fit. I’ve applied to numerous roles in academia, diagnostics, and pharma without luck. Some of the NO’s were for senior-level positions that were admittedly a stretch. Others were entry-level pathologist jobs.

Discussing my career over the holidays, my dad asked: Do you think your writing could be contributing? Not long after, I got confirmation that my Substack was part of the reason I was turned down for at least one position. And I had previously walked away from a contract at a different company that essentially prevented me from speaking or writing.

I certainly haven’t been shy about weighing-in on controversial topics in vetmed, from educational issues like midlevel practitioners and the mass expansion of new vet schools, to criticizing test mark-up and labor practices in private practice, to providing unbiased analysis of diagnostic tests that overpromise and underdeliver. I’ve talked about the risks of rushing to adopt unregulated AI in diagnostic imaging. And of course, I have been vocal about the harm the new administration is doing to US foreign aid, higher education, and scientific research.

In these columns, I have often tried to mimic the style of literary science journalism that characterized pieces in The New Yorker, Harper’s Bazaar, and The Atlantic. A classic example would be “The Cost Conundrum” by Dr. Atul Gawande in 2009, which catalyzed the push for the Affordable Care Act. While I don’t want to compare myself directly to such a brilliant author, my hope was to be a part of the zeitgeist, to educate and entertain, sparking critical discussions about difficult matters. Some essays featured a little edge or snark, but I always aimed for professionalism and balance, with claims supported by facts and research. In my opinion, you would find more inflammatory language in a typical CNN story.

Alas, I am not a writer for one of those august publications, I’m just a humble veterinarian firing off emails to a small audience. I doubt my essays have changed any minds or votes—most of my subscribers already agree with me, and the folks who are opposed probably don’t read my work (though I’ve increasingly received hate mail and slurs since last November). Some articles that take days or weeks to write get opened by a mere 1/3 of my subscribers with little to no engagement. The VPA bill passed in Colorado by a comfortable margin. New vet schools continue to be announced and class sizes keep expanding. Questionable diagnostic products continue to sell like hotcakes, aided and abetted by well-paid “Key Opinion Leaders.” Hell, I have family members that openly cheer for the party that is gleefully burning down the federal government and causing direct harm to me; what hope do I have of convincing a stranger if I can’t win over my own relatives???

Earning money was never the primary goal for this newsletter, but I did hope it could become a supporting revenue stream to supplement my speaking and independent contract work, which are volatile and susceptible to periods when caseloads fall in a weak economy (…like now). Sadly, it’s become clear that All Science will never generate a significant portion of my income.

I should say that I could make a lot of money on Substack if I wanted to… I’m bombarded with daily emails offering to pay me to embed affiliate links for sports gambling and CBD supplements. Some companies have asked me to write articles uncritically promoting their products. Contrarian physicians like Vinay Prasad earn six-figure subscription revenue on Substack by pushing harmful misinformation that contradicts best practice guidelines. Plenty more randos make a comfortable living publishing anti-vaxx, homeopathy, and other pseudoscience content. Unfortunately for my bank account, I couldn’t bring myself to sell my integrity for any of those “opportunities.”

Since my writing seems to have a negligible influence on any of the issues I care about, and it does not generate significant income, the main impact seems to be putting a target on my back and making me a persona non grata in the industry. My writing is likely more threatening to companies in the private sector, but in the current political climate of fear and intimidation—see the bullying of schools like Columbia and Penn—it is only a matter of time before more university administrators get gun-shy about any potentially controversial posts. For all of the talk of so-called “wokeness” and “cancel culture,” in my experience, the main thing that gets you cancelled is simply having an independent opinion that threatens someone’s business interests.

So what am I going to do about all this? I’m taking a hiatus from writing through the end of April. I was already scheduled to travel for three weeks next month, so the timing made sense. For those few readers with paid subscriptions, I have paused billing (and existing free subscribers will not be able to upgrade). While it’s true that stopping now won’t magically erase the memory of my past work, perhaps this will limit the damage. As they say, “when you’re in a hole, stop digging.”

How long will I be off? TBD. I’m going to take the next five weeks to do some soul searching on whether I will return to writing, and if not, whether I will keep my archives up or pull the whole site down (things live forever on Google…) If I do resume publishing, it will likely be with a different, narrower focus.

To my residents: I’m sorry.

Folding to pressure is not a great lesson to teach you. Unfortunately, life is not an afterschool special, and sometimes you have to “take the L.” One person alone cannot go toe-to-toe with these huge organizations, certainly not when they lack the power or resources to fight back. I don’t have a huge pool of “F@$% you money” to fall back on, I have an underfunded 401k and $400k in student loans that look increasingly dicey. It would be great to see individuals and organizations who actually do have the privilege and resources to stand up for what’s right, but they seem unable or unwilling at the moment.

Remember that your professional reputation is your most precious resource. While you should always act with integrity and follow your own moral compass, know that vetmed is a small field largely controlled by a handful of powerful groups. Our leaders like to talk a big game about mental health and “Not One More Vet,” but many folks think nothing of casually destroying someone’s career through a whisper campaign. It may be wise for you to follow Aaron Burr’s advice from Hamilton: “Talk less, smile more.” Pick your battles. Be strategic. Have more powerful senior folks lead the way.

To everyone else: If this ends up being my last piece, I want to say a heartfelt thank you to all who read my weekly email ramblings. Writing this newsletter was truly a labor of love, and I hope you found some value in my words.

Until next time,

—Eric