I’m Breaking Up With Zoom

David Steensma, MD

Global Hematology Head

Novartis Institutes for BioMedical Research

Cambridge, Massachusetts

Dear David,

A few months before the pandemic struck, we were having dinner in Portland. You were graciously visiting us from Harvard Medical School as the grand rounds speaker at Oregon Health & Science University. You had given a splendid talk about clonal hematopoiesis, and the department was buzzing about it. I was fortunate to be able to sit down with you for a couple hours when we recorded an episode of my podcast Plenary Session. It remains one of our most popular.

Over dinner, David, you learned my dirty, fossil-fuel secret: I was travelling too much. Largely due to the inability to say “no,” I had racked up hundreds of thousands of frequent flier miles, giving lectures at other universities, conferences, and non-profits. As we spoke, David, you sensed my distress, and diagnosed my affliction.

“Sounds like you are sick of all that travel,” you offered.

You were right. I was sick of Ubers, cabs, restaurants, suits, boarding groups, security, and above all else: those damn airlines. As a good doctor, you offered a prescription.

“Sometime in the next year or two, block out 6 months for no-travel whatsoever,” you suggested, telling me about how you once did just this, and found it recharging and revitalizing.

“I will think about that,” I promised, still not believing it could be done.

Then COVID-19 hit.

Well, David Steensma, I hope you are happy. I dutifully followed your prescription, and even came back for a refill. I suspect this isn’t quite what you had in mind, but it certainly did the trick. It cured me of my affliction. But like a lobotomy, I haven’t been quite the same.

I must confess that initially there was a thrill. In March 2020, I had a string of canceled talks, conferences, and panels, and I watched my overbooked and oversubscribed calendar thin out to something quite reasonable. Twenty thousand miles of economy airfare vanished from my schedule, and my legs felt better just thinking about it.

It was more than that really. It was a euphoria. I was free and clear. I had hundreds of hours of my life back. I could do what I wanted!

The feeling didn’t last long. I quickly realized that I hadn’t been granted freedom, but merely put in a new prison. They called it “Zoom,” and soon I found myself spending 4 to 6 hours a day there. It was mindless, insipid, and tedious, and nothing of value was accomplished.

I taught classes on Zoom, gave grand rounds on Zoom, was an invited lecturer on Zoom. I stared out at the audience of black squares — cameras turned off; microphones muted. I made jokes, I smiled, I laughed, but nothing. No response. Silence.

Very quickly, I grew to hate the audience. Who were these monsters, cold and callous, so selfish they would not even show their face? How many were using the restroom while I presented slides? Those degenerates.

I often wondered about the line between sanity and madness. It depended entirely on whether my wifi was working. If you give a lecture to hundreds of people on Zoom, you are a successful academic. If, however, the wifi is broken, then you are instantly a delusional person shouting at a laptop in an empty room. Many days I wondered which I was.

On a couple of occasions, colleagues wanted to have happy hour or meet for drinks on Zoom. Two stiff drinks of whisky, an unnatural banter, and suddenly time was up. “The meeting was ended by your host.” That’s where you find the loneliest person in the world, David. Someone who is drinking alone, with nowhere to be, and no one to talk to.

That’s when it hit me.

Now it’s my time to make a diagnosis, and I am not sure it applies to you, David, but I am confident it applies to all of us: we have had too much Zoom. And I am prepared to issue my prescription: No more Zoom. #ZeroZoom.

Of course, moderation of all things is prudent, but sometimes you need a clean break. That’s why I make this promise: In the near future, I am going to take a 6 month break from Zoom. A total break from interacting in any way, shape, or form in remote video chats.

This means no invited talks, no meetings, no roundtables, no panels. No more “can you see my slides?” “you are muted,” “still muted,” “we can’t hear you,” and “what about now?”

David, I know what you are thinking: Some things have worked well on Zoom: tumor boards, division conferences, faculty meetings. Especially for those of us who work for hospital systems that span several campuses. Let’s not throw the baby out with the bathwater.

Well, I am sorry, David, but I am throwing it all out. Baby and bathwater. 6 months, no zoom, no matter what.

If you want to find me, if you or anyone else needs me, we can meet in person. We can meet for coffee or lunch. We can meet in the hospital, where I will happily continue to round on patients in person, as I have done this entire time.

I would be delighted to have my knees smashed into the seat in front of me for 6 horrific hours in one of those horrible airlines to meet in person, David, if you wish, but, I will be damned if I spend even one minute waiting for my “host to start the meeting.”

If you can’t find me, can’t locate me, can’t pin me down, then I might as well not exist, and you probably don’t really need me anyway.

Certainly, some people in my life will not like my pledge. It may anger my boss, my division, my section, my collaborators, perhaps even my friends. But I am willing to pay the price, David, and I accept whatever punishment they dish out.

Want to exclude me from a research project? Please, exclude me. Want to unfriend me? Please, do. Wish to claim that this will hurt my career, my productivity, or my reputation? Please hurt it! Feel free to retract unrelated papers and delete my appearances on podcasts — you know, content that has nothing to do with this decision. Apparently, that is how we punish people these days. I learned that on Twitter! Tear up my books if it makes you happy — Ending Medical Reversal is now out in paperback! Print a picture of me, and throw darts at it. High-res photos available on my website. I am prepared for my trial and judgement, just as long as it is in person. My executioner can wear the black hood — it’s practically intimate compared to a muted black square.

David, when you diagnosed me as suffering from too much travel all those months ago, you were right, and your prescription would have helped me. But now I am suffering from too little, and I’ve decided, in the proud history of this profession, it’s time for this doctor to heal thyself.

Hope to see you around, but I promise there is one place you still won’t see me: Zoom. I am clicking “Leave,” and I hope never to return.

Sincerely,

Vinay Prasad, MD, MPH

Associate Professor

Department of Epidemiology and Biostatistics

University of California San Francisco

Author’s note: David Steensma did not read or approve of this commentary in advance, and probably is not that interested in what I do.

Vinay Prasad, MD, MPH, is a hematologist-oncologist and associate professor of medicine at the University of California San Francisco, and author of Malignant: How Bad Policy and Bad Evidence Harm People With Cancer.