Document Type : Research Paper
Author
Assistant Professor, Department of Sociology, Faculty of Social Sciences, University of Tehran, Tehran, Iran
Abstract
The expansion of the virtual space and communication networks has changed Iranian society by providing a sphere for constructing personalized narratives of the social lifeworld. Physicians are a social class with a dubious presence in the virtual space, especially on X. The genealogy of medicine is known as an institution professionally entwined with ambiguity, authority, and authenticity. On the other hand, the modern world is characterized by deconsecrating and demystification. The current research is a netnography that relies on verstehen to understand the physicians’ twits on the X social medium in 2023. The four dominant conceptual patterns extracted in our thematic analysis include the emergence of the patient subject and the interpellation of the doctor, fearfulness about the emergence of traditional medicine that de-monopolizes health, the physician’s constructs from mafia to the martyr of health, and the unactualized alienation of the physician. Overall, the expansion of virtual social media has accelerated the physicians’ disempowerment and demystification as a result of which the sacred, ambiguous aura around the physician has encountered a call to the center, providing the reflexive narration of the physician, his lifeworld, and his problems.
Keywords: Reflexivity, Virtual Space, Physician’s Lifeworld, X (Twitter), Iranian Society.
Introduction
Today, social media and the virtual space compete with the physical world as one of the main spheres of modern life. Providing people with shared interests to gather around each other via the possibility of visual and written dialogue, the virtual space has introduced new experiences of constructing and narrating the self. Despite their widespread filtering, Telegram, Instagram, and X are among the most popular social media in Iran. Among other social classes in Iran, physicians have a distinct presence in X as an elite social medium.
As an expert institution, medicine is of high status, authenticity, authority, and income. In cosmologic worldviews, disease and medicine are connected to mythical and metaphysical beliefs as well as concepts such as destiny, magic, and enchantment, while in the theological worldview, they pertain to God’s wrath and atonement of sins, and in popular culture, they are connected to healing and miracle (Salehi, Zokai & Ekhlasi, 2019; Adam, Herzlich, 2006; Masoudnia, 2010; Svenaeus, 2021). In Islamic beliefs, the physician is revered as God’s hand that heals (Mohaghegh Damad, 2016; Sadr, 2011; Kiyani, 2012). With such a genealogy that rivals bordering professions such as Traditional medicine, medicine finds mysterious, latent characteristics that distinguish it from the non-physician others while even the emergence of modern medicine has not removed the sacred, metaphysical, mysterious aura that it is traditionally endowed with. Following widespread social changes, medicine and physicians have faced a call to the center and to self-narration in the communicative sphere that social media provides. Though the process is global in scope, it pertains to specific Iranian particularities that go back to the simultaneous paradoxical claim of traditional medicine to scientific and Islamic originality and the duality of the science/medicine vis-à-vis culture and politics in the Iranian polemic society.
Research Question(s)
In this research, we answer two questions: what is the physicians’ narrative of medicine and their lifeworld in the X (Twitter) social media? How is this narrative framed and in what conceptual pattern is it interpreted?
Literature Review
Following the deinstitutionalization and detraditionalization of all traditional and premodern institutions, and the limiting and threatening of the validity and authority of meaning and images constructed by them (Martuccelli, 2002; Martuccelli and de Singly, 2012), the physician and medicine as the legacy of both tradition and modernity that carry an aura of ambiguity, magic, and sanctity are no exempt from rethinking and reconstructing their images and narratives. The process of disempowering medicine found momentum with the initial attempts at understanding it as a science with material, earthly, and learned skills around the body (Salehi, 2019) that in the late 20th century faced uncertainties about the novel medicalization methods (Starr, 1982), critics of the pathogenicity of modern medicine (Illich, 1976 and 1975) and the capability of modern medicine in healing in contemporary society. With medicine’s authority under challenge, the subject of medicine was interpellated in the sense that the physician was summoned to give an account of himself as an opportunity open to the once impossible experience of realizing the individual self as the reflexive self (Martuccelli de Singly, 2012). With the physician called to the center to self-narrate, social media turned into a major context for the narration of the physician’s social lifeworld.
Materials and Methods
The theoretical approach of this research is verstehen, the field and object of the research are chosen using netnography (Kozinets, 2006), and classic thematic analysis is used for the analysis of findings. The field includes the twits of 50 Iranian general practitioners and professional doctors (male and female) in 2023 in the X social media that center on narrating their experiences and analyses relevant to medicine in Iran.
Results
The emergence of the patient and the interpellation of the physician (the increased medical knowledge of the patient, state’s intervention in providing cheap medical services, insurance agents and the evaluation of the physicians’ merits), fearfulness of the emergence of traditional discourse and the demonopolization of medicine (criticizing the university for legitimating traditional medicine, criticizing the state for defining policies in favor of Islamic medicine, delegitimizing the outdated methods of traditional medicine as the instance of fraud), the construction of the physician’s image in the two extremes of mafia and health martyr (the profit-making nature of medicine and its desanctifiication, self-interested medicine as against the historical and cultural genealogy) and the physician’s unactualized self (the experience of medicine in the cleavage between reality and the constructed image, boredom in the experience of medicine, the lack of context for practicing the learnt knowledge and the resulting alienation in the personal experience of physicians) are the dominant meaning patterns in the analysis of twits.
Information Table of Doctors and their Pages in X Communication Network
Medical Verification/ Medical Number
Medical Expertise
Gender
X Account
Number
Followers - content of tweets
Neurosurgeon
Male
@kazemo_sarp
1
Followers - content of tweets
Surgeon
Male
@pedipayam
2
n.m.: 134915
General Physician
Male
@RLaripour
3
n.m.: 21194
Neurologist
Male
@drbabakzamani
4
n.m.: 22513
Vascular and Trauma Surgeon
Male
@MrZafarghandi
5
n.m.: 91913
Oncologist
Male
@OmidrezaieDr
6
Followers - content of tweets
General Physician
Male
@k_md_29
7
Followers - content of tweets
General Physician
Female
@Drshahrzad80
8
Followers - content of tweets
General Physician
Male
@drcitalopram
9
Followers - content of tweets
General Physician
Male
@sheykholtabib
10
Followers - content of tweets
Orthopedist
Male
@Mahmouddream1
11
Followers - content of tweets
General Physician
Male
@khodesheh
12
n.m.: 149053
General Physician
Male
@smmirkhani
13
Followers - content of tweets
General Physician
Male
@Azimut1400
14
n.m.: 77415
General Physician
Male
@SMoattar
15
Followers - content of tweets
General Physician
Female
@thecatloverrr
16
Followers - content of tweets
General Physician
Male
@MahdiR86388324
17
Followers - content of tweets
General Physician
Female
@negarmr96
18
Followers - content of tweets
General Physician
Male
@litt_lebowski
19
Followers - content of tweets
Knee Surgeon
Male
@rasulghm
20
Followers - content of tweets
Internist
Male
@Dr_reza_safaei
21
Followers - content of tweets
General Physician
Female
@faryadbseda
22
n.m.: 104691
Anesthesiologist
Male
@e_bastan
23
Followers - content of tweets
General Surgeon
Male
@RPORED4/ RPO
24
Followers - content of tweets
Neurologist
Male
@Naseh Mohi
25
Followers - content of tweets
General Physician
Male
@rhamed32
26
Followers - content of tweets
Neurosurgeon
Male
@sm_sinuhe
27
Followers - content of tweets
Surgeon
Male
@Mahmouddeream1
28
n.m.: 31395
Neurologist
Male
@JavadAmeliMD
29
n.m.: 108208
Breast Surgeon
Male
@drhamidahmadi
30
Followers - content of tweets
Radiologist
Male
@legendoffall_
31
Followers - content of tweets
Cardiologist
Male
@rezaaa1986
32
Followers - content of tweets
General Physician
Male
@NimaValiollah
33
n.m.: 129155
Anesthesiologist
Male
@Amirhos10096134
34
Followers - content of tweets
General Physician
Male
@poetofdoctors
35
Followers - content of tweets
General Physician
Male
@ehsan7j
36
n.m.: 140597
Internist
Male
@dfereydoonzadeh
37
Followers - content of tweets
Internist
Male
@cinnora60
38
Followers - content of tweets
General Physician
Male
@CardiacTabib
39
Followers - content of tweets
Renal Surgeon
Male
@father64699029
40
Followers - content of tweets
General Physician
Male
@abolfazl_hm
41
n.m.: 55904
Renal Surgeon
Male
@aliboskabady
42
Followers - content of tweets
Eye Surgeon
Male
@mojtaba81305517
43
Followers - content of tweets
Endocrinologist
Female
@Drabandokht
44
Followers - content of tweets
General Physician
Male
@sarmadnou
45
n.m.: 129153
Ophthalmologist
Male
@abdulrahimami11
46
Followers - content of tweets
Urologist
Male
@monsoeursepehr
47
n.m.: 118864
General Physician
Male
@mahdiarSaeedian
48
Followers - content of tweets
General Surgeon
Male
@usiriss
49
n.m.: 161611
General Physician
Female
@Kamranifaeze1
50
Conclusion
With the expansion of the virtual space, the presence of doctors for protecting their authority, constructing meaning, and maintaining change in social intersubjectivity is inevitable. This presence is a shift from a monologue communication, neglecting and not listening, to dialogue with oneself, threatening others, and limiting the power of medicine. In a metaphoric sense, the physicians were, in their cultural and historical genealogy, the inhabitants of impenetrable fortresses whose doors were closed to outsiders. The hegemony of medicine entwined with myth, magic, and metaphysical matter had made the physician needless to speak out himself. With the advent of social changes and the demystification and desanctification of medicine and the physician, however, the foundations of the fortress trembled, and the physician was summoned to the center. He should have come down from his castle to an equal footing with others to narrate his medical lifeworld and himself. The expansion of the virtual space has led to the formation of the network society which is an accessible, non-hierarchical, intimate, and equal space against the traditional society. Talking of himself in the virtual space and criticizing medicine in the intersubjectivity of Iranian society, the physician attempts to preserve his authority while at the same time presenting a more real image of himself to give a diverse, varied image of medicine that dismantles the traditional homogenized image.
Keywords
Main Subjects
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