Eric Tian

In March 2019, I read Share Your Work! and started writing online under my real name. Since then I have published 591 blog posts, (this being the 592nd) with topics ranging from running, religion, medicine, study, poetry analysis, gaming, and happiness. Writing every week has been one of the most important things I do: It acts as windscreen wipers for my ideas, gives me a creative output and has led to me meeting some amazing people.

However, writing under my own name has caused issues over the years. The first began in MD2, when I found out that a colleague had reported one of my posts to the clinical school. In a long email, which cc’d the clinical dean and clinical coordinator, I was told by a staff member to take it down. The post was a de-identified story of a patient who had given me permission to tell their beautiful story. To avoid any confrontations, I complied, yet a few months later I found out that the clinical school was still continuing to monitor my posts. For what exactly I don’t know – but from that day on I developed a paranoia of being censored.

In MD4, I realised that more of my colleagues were aware of my blog than I had anticipated. While WordPress tells me I get around 2000 readers a month I figured they were mostly strangers as I don’t talk about my writing often. But one day in a hospital lift, a friend casually mentioned they found my blog and liked what I wrote. There were about ten other people in the lift including doctors I knew. It was a kind and encouraging comment – except the night before I had written a heavy piece on regret and mental illness. Part of me wished I had bared my soul slightly less.

More recently, I have read reports of fellow bloggers in medicine getting in trouble for their writing, the most notable being Slate Star Codex (now rebranded as Astral Codex Ten) written by psychiatrist “Scott Alexander” who was threatened to be doxxed by the New York Times. In a follow-up article, he tells his story:

Maybe I should explain more of my history here: back in the early 2010s I blogged under my real name. When I interviewed for my dream job in psychiatry, the interviewer had Googled my name, found my blog, and asked me some really pointed questions about whether having a blog meant I was irresponsible and unprofessional. There wasn’t even anything controversial on the blog – this was back in the early 2010s, before they invented controversy. They were just old-school pre-social-media-era people who thought having a blog was fundamentally incompatible with the dignity of being a psychiatrist. I didn’t get that job, nor several others I thought I was a shoo-in for. I actually failed my entire first year of ACGME match and was pretty close to having to give up on a medical career. At the time I felt like that would mean my life was over.

So I took a bunch of steps to be in a better position for the next year’s round of interviews, and one of the most important was deleting that blog, scrubbing it off the Web as best I could, and restarting my whole online presence under a pseudonym. I was never able to completely erase myself from the Internet, but I made some strategic decisions – like leaving up a bunch of older stuff that mentioned my real name so that casual searchers would find that instead of my real blog. The next year, I tried the job interview circuit again and got hired.

But I still had this really strong sense that my career hung on this thread of staying anonymous. Sure, my security was terrible, and a few trolls and malefactors found my real name online and used it to taunt me. But my attendings and my future employers couldn’t just Google my name and find it immediately. Also, my patients couldn’t Google my name and find me immediately, which I was increasingly realizing the psychiatric community considered important. Therapists are supposed to be blank slates, available for patients to project their conflicts and fantasies upon. Their distant father, their abusive boyfriend, their whatever. They must not know you as a person. One of my more dedicated professors told me about how he used to have a picture of his children on a shelf in his office. One of his patients asked him whether those were his children. He described suddenly realizing that he had let his desire to show off overcome his duty as a psychiatrist, mumbling a noncommital response lest his patient learn whether he had children or not, taking the picture home with him that night, and never displaying any personal items in his office ever again. That guy was kind of an extreme case, but this is something all psychiatrists think about, and better psychiatrist-bloggers than I have quit once their side gig reached a point where their patients might hear about it. There was even a very nice and nuanced article about the phenomenon in – of all places – The New York Times.

I realised that the situation Scott described himself in ten years ago, is exactly the situation I am in now. Psychiatry is a specialty that fascinates me, one I am seriously considering applying for in a few years, and the issues he faced I can see myself facing as well. In the full article he describes examples of creators in different fields, from police officers to transgender writers to Chinese tech enthusiasts facing similar problems. Is this a systemic problem, a question into how social media can interfere with work? Probably – but that is a topic for another time.

TLDR?

This post ended up being longer than anticipated. To summarise, there are a few reasons why anonymity is important to me. The first is professional: I want to avoid having future work employers, colleagues or patients finding this too easily and potentially damaging a professional or therapeutic relationship.

The second is personal: I tend to tell stories from my childhood and life and have decided I am no longer comfortable sharing this publicly. Obviously there are content creators that share similar, if not deeper, stories than I do, but very few use their real names and are in medicine with ethical landmines of patient confidentiality and medical professionalism. The memoir This Is Going To Hurt, perhaps the best known book on this topic, had to overcome enormous legal negotiations in order to be published.

The third is mental: Since my experiences above I have felt trapped in what I can or cannot share on this site. In 2019 and 2020 I would tell organic stories that fascinated me, but recently I imagine my posts being read by a colleague or employer and heavily filter my thoughts. For every post I put out there are about three drafts that get canned as I’m not sure if they are “professional enough”. I feel like a bird that used to fly freely that now finds itself caged. It would not be hyperbolic to describe this as suffocating.

This last point is my biggest counter to the argument: “Well who cares? We are all dead and forgotten in a few centuries anyway. Stop overreacting and write what you want – you are not that important.” I am aware that our time is finite and that is exactly the point: I want the limited time I have to be spent writing freely without these professional consequences or mental barriers that come from using my real name.

So what happens now? Truth is: I’m not sure. From today, this will be the last post on this site for some time while I figure out what to do. One option is to disable search engine indexing on this site to not appear so easily on Google. Another is to purchase a new domain name and redirect traffic to that site where I will write under a pseudonym. A similar consideration is to move my posts into Substack under a different name. The most drastic option is to take this site down completely or to make the posts private, though this is one I am considering the least.

One thing is certain: I will continue to write. Though I am very average, the art brings me immense joy and meaning and opened doors I never thought possible. However, for this to be sustainable I require a level of anonymity that this site currently does not provide.

For the people I have flown this topic by: thank you for your support. You know who you are. For the few readers who have spent any time read my musings, I am humbled and hope they were worth your time. I don’t take it for granted, and I promise I will make it up to you when I decide on a path ahead. If there are any updates I will put them here.

My name is Eric Tian, and I love you all very much. Take care.

I was out for a stroll this morning when I passed a mother dropping her son off at the school entrance. She knelt beside him, put on his backpack, smoothed his shirt and said,

“Make a great day.”

It seemed like such an odd statement – we are all used to have a great day – but this shift from passive to active voice struck me as important. By using “make” instead of “have,” this mother reminded her son of his own agency and power to shape the day ahead. To will things into the world rather than let things occur passively.

As I continued walking, I glanced back. Perhaps it was my imagination, but I could have sworn her son stood a little taller than his classmates, shoulders back, as if ready to tackle the world.

The Van Gogh museum includes a short section on the Dutch impressionist artist:

“After his death, Vincent became the archetype of the ‘mad, genius’ artist, whose art was said to be a direct expression of his affliction. That image is false and reduces Vincent to his illness. His mental vulnerability was part of who he was.”

I like this a lot. Though the artist might stir up images of his removed ear, admission to psychiatric hospitals or his gunshot wounds, the man was far more than his mental illness. He was, amongst many things, a devoted brother, friend, and champion for the working class. In his work, he demonstrated his intense love of nature, peasants, landscapes, still life and more. His later mental anguish was a chapter of his intense life, but far from the whole story.

Archetypes, while memorable and poetic, are usually imprecise.

Clearly a troll but wildly entertaining.

The other day, I needed to use a restroom and went into the nearest building – an Italian restaurant selling pizzas. I asked one of the waiters if I could use their restroom.

“Hmm,” he replied, considering. “We usually only serve customers, but sure thing, Chinaman.”

I laughed and thanked him, but suddenly a stern voice cut through the air:

“Isn’t that racist?”

I turned to see a middle-aged white woman in a pink hat glaring at the waiter. “You can’t call people that,” she continued. “This is the twenty-first century.”

I stood bewildered. The term hadn’t bothered me at all – so why was this stranger jumping in to claim offence on my behalf? Was this what people called the “white saviour complex”?

By now, other diners were turning and noticing. The waiter shifted uncomfortably. I quickly tried to defuse the situation, explaining that I wasn’t offended and thanking her for her concern. Though she returned to her seat, she shot another disapproving look at the waiter.

While I appreciate people standing up against racism, this felt like a strange case of someone being more offended on my behalf than I was myself.

One thing I’ve noticed while reading non-fiction: the best writers tell really good stories.

In Lost Connections, Johann Hari begins each chapter with a case study filled with physical descriptions, quotes, and character development. When discussing how nature affects mental health, for instance, he introduces real people whose lives illustrate the science, bringing abstract concepts to life. Most journal articles are occupied with citing numbers and studies, making them less accessible to the public.

Nearly every popular non-fiction book does this. Sapiens is a story about humanity, not a chronological account of its evolution. Although Yuval Noah Harari doesn’t write anything new, he retells our species’ journey with vivid images and characters. Practically no other history book has done this as effectively.

Even the Bible, the most read book in the world, is no different. How many times did Jesus opt to use parables in his sermons instead of a simple message? “God will always accept you” and “It is hard to be a Christian” isn’t as memorable as the Parable of the Prodigal Son or the Rich Young Man. These stories have lasted across millennia and are retold in sermons across the world today precisely because they embed teachings within memorable narratives.

The potency of stories to share ideas that stick is what gives me hope about fiction’s future. Every novel, at its essence, is a collection of lessons disguised as entertainment. And the more good stories we can tell, the better vehicles for lasting ideas we create.

In the foreword to his short story collection, Yann Martel writes (emphasis mine):

“I got my inspiration anywhere and everywhere. Books. The newspaper. Movies. Music. Daily life. People I met. Memories and experience. And also from that mysterious creative ether whence ideas just popped into my head, unheralded. I put myself in a space of receptivity to stories. My eyes and ears sought them. I looked out, not in; in bored me. I did research with pleasure. Research was my way of learning, my own private university. Nothing delighted me more than to investigate the world for a sake of a story.”

Writing’s greatest gift to me is this same receptivity. When you know you must write, you begin to observe more carefully – to notice sounds easily missed, to seek magic in the mundane. My favourite posts aren’t those with philosophical musings or personal opinions, but those born from chance encounters: a striking moment on the street, or unearthing a piece of history. They are, after all, far more interesting.

And if you are curious, here are some favourites from over the years:

• On Small Kindnesses
• Our Lives and Stories
• Fallen Bikes and Salvation
• Conversations, Empty and Full
• Seat 40J

James Clear on action:

“Dreams are fun when they are distant. The imagination loves to play with possibilities when there is no risk of failure.

But when you find yourself on the verge of action, you pause. You can feel the uncertainty of what lies ahead. Thoughts swirl. Maybe this isn’t the right time? Failure is possible now.

In that moment—in that short pause that arises when you stand face to face with your dream—is the entirety of life. What you do in that pause is the furnace that forges you. It is the dividing line between being the type of person who thinks about it or the type of person who goes for it.

When I really think about it, I want that moment to be my legacy. Not that I won or lost. Not that I looked good or looked like a fool. But that when I had something I really wanted to do, I went for it.”

Opportunity shops, commonly known as op shops, are stores that sell second-hand goods for charitable causes. I have recently been obsessed with them and here are five reasons why:

1. You do not know what you will find. Unlike most retail stores with searchable online inventories, op shops offer unpredictable shopping experiences. The goods on display depend entirely on what people donate and what store owners choose to sell. It is a dynamic, moving force with new discoveries each visit.

2. The goods have a story. This used to be a turn off for me – why wear a stranger’s old clothes? – until I visited a store in Chicago. As I was flicking through some sports apparel, an observant worker pointed out that the shirt I was examining had just arrived today. It was worn by an athlete in the NLB that had grown too small for them but fit me perfectly. Now when I wear the shirt, I feel the strength of a national level baseball player flowing through my veins.

3. They are cheap. Last week, I purchased paperbacks of The Reluctant Fundamentalist, The Black Swan, and Brave New World for just $7. On Amazon, the three would cost nearly $60. As an Asian, discounts make me happy; especially when they are a lucky 88% off.

4. They support worthy causes. Some op shops use funds for community advocacy, others for cancer research, others to fight poverty and inequality. Any of these causes, plus the many more out there, beats buying from online retailers.

5. They create connections. Last week, the customer in front of me was buying a tie when the cashier recognised it as a donation from their coworker. “Barry! Someone snagged your favourite tie!” she called out. Barry, a middle-aged man in a beanie, hurried over and shared stories about the tie’s travels and the meaning behind its design. The conversation ended with the two men exchanging contact information, with the tie’s new owner promising to send photos. A simple secondhand purchase had sparked a new friendship.

Here’s to more op shop adventures.