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We need to talk about X – because gritting our teeth isn’t enough

Dr Julia Grace Patterson by Dr Julia Grace Patterson
14 August 2024
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The social media platform which calls itself X is in a terrible state, and I think we need to talk about it – and Elon Musk. 

Numerous coping mechanisms for X – but are they wearing thin?

It’s always difficult as an NHS campaigner to reveal personal feelings, because we are abused relentlessly online by those who seek to silence us.

An admission that we are affected by this abuse is often perceived as an invitation for more. I’ve lost count of the days when I have opened up Twitter/ X in order to reach the audience of people who care about winter pressures, or the safety of frontline NHS workers, only to be confronted with a barrage of abuse. 

We get through all of this by gritting our teeth, by taking long walks, by telling ourselves that none of this is real; it’s just bots, or misinformed people. We tell ourselves to feel sorry for those people, because it’s not really their fault.

Even as they call us grifters and scammers and frauds and worse, we tell ourselves that they’ve been primed for this.

Primed and ready

Primed by a collection of media outlets that seek to divide, and to inflame hatred between different groups.

Primed by ads paid for by dubious political campaigns, and dubious political actors. Primed, because they have been failed for many years themselves by politicians, and although we’re the punchbag, their anger isn’t really directed at us. Perhaps they are suffering from that particular, horrible, cocktail of a lack of fair pay, a lack of safe housing, a lack of security in their own lives.  So many people are now, after all, because the country is in a complete mess. 

That doesn’t stop it hurting though. I’ve had images doctored to falsify my views. I’ve had my face added to images of things I would never say or do. I’ve had people try to identify where I live.

I’ve worried for the safety of my young children sometimes, because as the flames of hatred lick higher and trolling reaches fever pitch online, there is a genuine concern that someone could take things too far. 

Have I considered leaving social media, removing myself from the arena? Of course; many times. But I haven’t done it, because the work matters too much.

We still have to push back

Our public healthcare system is being destroyed because of the actions of politicians and the long tentacles of influence coming from corporate interests. The service has been underfunded and undermined, the staff workforce have been treated terribly, and privatisation is being enabled to infiltrate the NHS in increasing ways, despite the fact that it does not help patients, it does not help staff, and it does not help the sustainability of our healthcare system either.

Unless we push back, the NHS as we know it will be gone. A two-tier healthcare system is already developing in the UK; one which is seeing burgeoning profits for private healthcare companies while millions languish on interminable NHS waiting lists. As a doctor, this is horrifying to recognise, and I feel very strongly that we cannot tolerate what is happening, we must push back en masse. 

Which brings me back to Twitter, or X, a place which was never easy to interact on, but where the big conversations happened, and meaningful debate, and powerful campaigning work.

Things have changed under Musk

I only joined Twitter in 2020, but quickly found that a lot of people wanted to discuss the NHS and involve themselves in important campaigns to push for safety. The trolling was the backdrop, but it was the backdrop to something much bigger. We reached millions of people, raised awareness, and made a real impact.

Things have changed now though.

It felt like they changed when Elon Musk took over the running of Twitter in late 2022, in ways which were difficult to identify. This is anecdotal, because I can only speak from my own experiences, but It felt like we couldn’t reach a wide audience as we had done before. It felt like the conversation was blunted – as if we would only see the content we vehemently agreed with, or vehemently opposed, and none of the grey areas in between, which are so necessary to inform and enable debate to take place. 

Some people might say that this doesn’t matter; that if one social media platform implodes (as it looks like X might be doing) then we’ll simply find another. But since Musk took over, people have been trying to identify that place.

Where to go after X?

We saw lots of people (including myself) move across to Mastodon temporarily, in the hope that we would find our community there again. But there weren’t enough people who made the move, the platform felt a bit clunky, and it didn’t really work out.

Since then, lots of people have left Musk’s X for Threads, which definitely feels less toxic, but it’s more difficult to see breaking news and so the platform feels less exciting than X used to. I’ve decided to make a go of it on TikTok, which is obviously huge now and growing fast, and we’ll see what happens there. 

But I’d be interested to hear what you think about this situation. The NHS needs campaigners, and those campaigners need a wide network of supporters and interested people who we can speak to. How do you think we should be doing that, and where? 

Featured image via TED – YouTube

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