هبوط از قلعه سلطانی؛ فهم زیست جهان پزشکی در توئیتر (ایکس) (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
گسترش فضای مجازی و شبکه های ارتباطی با ایجاد تغییراتی در جامعه ایرانی، به ساحتی برای ساخت و روایت خود و زیست جهان اجتماعی تبدیل شده است. پزشکان از قشرهای اجتماعی هستند که حضوری پرسش برانگیز در فضای مجازی و به ویژه شبکه ایکس دارند. تبار تاریخی پزشکی به عنوان نهادی دارای پایگاه حرفه ای در هم تنیده با ناشناختگی، اقتدار و اعتبار بالا است؛ درحالی که خاص بودگی دنیای مدرن تقدس زدایی و اسطوره زدایی از هر امری است. این پژوهش به روش مردم نگاری مجازی و در رویکرد تفسیری تفهمی به تحلیل مضمون توییت های پزشکان در سال 2023 در شبکه ایکس پرداخته و چهار الگوی معنایی غالب را شناسایی کرده است که عبارتند از برآمدن سوژه بیمار و استیضاح پزشک، هراس از برآمدن طب سنتی و انحصارزدایی از درمان، برساخت تصویر پزشکی در دو قطب مافیا و شهید راه سلامت و خودِ پزشک تحقق نیافته. به طورکلی، با گسترش شبکه های ارتباط مجازی، فرایند افسون زدایی و اقتدارزدایی از پزشک و پزشکی شتاب بیشتری گرفته و هاله قداست و رمز و رازوارگی پیرامون نهاد پزشکی با فراخوانش پزشک به مرکزیت رو به رو شده که در فرایندی بازاندیشانه خودِ پزشک، زیست جهان پزشکی و مصائب آن روایت می شود.Overthrown from the Kingdom Palace; Understanding the Lifeworld of Medicine on Twitter (X)
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.
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