I have been grappling with this idea repeatedly, and it isn’t the last word on the subject. I might be revisiting it in the future. Twitter makes for some interesting conversations at times, but one must keep in mind that those are merely snapshots of thoughts. It can never replace the medium of a blog, and I have said it repeatedly, Twitter is just a mechanism for an advertising platform that markets itself as a place for “interaction”.
In the vast landscape of thoughts and conversations, a quote represents a figment of a “memorable incident”. The only thing that usually stands out in our often dull life is an outlier. For example, a mangled car accident heading to work sparks conversation at work. However, those outliers cannot assume significance for the rest of us. I am not particularly interested in the car accident or the importance you may attach to it.
Likewise, when people mention social media in the mainstream press, they are usually recanting their experiences that serve as outliers. The success of social media is to push their outliers in the newsfeeds, which trigger the primal urges to “spark conversations”- in effect, channelling your internal keyboard warrior. Although you are only training their algorithm to serve you with better advertisements.
I stumbled on a thread “discussing” about the proton therapy. Let’s just agree for once that proton therapy is now proving itself to be a political hot potato. It is “scandalous” because of the immense costs upfront but not enough patient population that can afford it to sustain even the running expenses. It is usually compensated through co-pays or other insurance mechanisms.
What will be the benefits for the cohort for whom we are fighting? We are all looking at the “benefits” from the prism of “randomised control trials”, but they are unlikely to be conducted. Remember, that for too long, the “pioneers” had dissed the idea of using “trials” to ram through the acceptance of IMRT. It came with the caveat of increased uncertainties but the promise of sparing the critical organs at risk. We did achieve the peak OAR discussion in 2010 after QUANTEC but ignored the elephant in the room- radiobiology.
Fundamental research in radiobiology languishes- do we even have working models to show that modulated radiation has the same set of responses coming from the micro-irradiator? We forget that IMRT was meant for dose escalation with a “spin-off” benefit for sparing the critical OAR’s. The data on secondary cancers will require at least three decades to mature, but the “low-dose cloud” continues to hang around. (CyberKnife doesn’t even account for that). Protons have the associated influx of neutrons.
Will Twitter allow any nuanced, balanced reasoning of the arguments? I am not sure how people will react to my own provocative statements mentioned herein. I am all for the march of technology, but intended benefits should come with acceptable harms.
The idea of social media is divisiveness in its core. The best way to reason out any argument is to have a private conversation with the individual but remember that the decision-making tree is incredibly complex. The sum of benefits from pushing proton therapy, for example, is usually a mix of hubris-perverted incentives, or motivations to be a “trail-blazing influencer”.
Twitter only serves to amplify those complex issues without simplifying or rationalising the problems under discussion.
It brings us to the next logical conclusion- should we use Twitter or not? There is no easy answer to it because I can’t map your decision-making tree for you. Blanket recommendations don’t work. In my case, I have linked the blog to Twitter for better visibility. Opinions, unfortunately, don’t change the chaotic world. My opinion will definitely not impact it!
(I blog because it helps me to discover the intricate cross-connections between different issues. This post was triggered by a surprisingly balanced article on Financial Times)
RadOncNotes 