How much should we share about ourselves online?

This millennial lady rejoins social media

When I was in medical school, I published my first professional essay: I wrote a Modern Love column for the New York Times about getting into a bus crash in Tanzania with a guy I had a huge crush on.

I had been nursing the essay for years, tinkering with it when I was frustrated with my medical school courses. Finally, with the help of a writing group, I got the courage to try to get it published. When it was accepted, I was thrilled.

Except I was afraid to tell anyone about it. I felt like talking about it during the editing process would jinx my chances of the essay actually making it to publication. When it finally came out, I took a perverse pride in waiting for friends to read it, notice the byline, and then contact me: “I can’t believe you didn’t tell me about this, Mara!”

The beautiful image that accompanied my very first piece in a professional publication.

I remember when I went in for a meeting to prep for my residency applications with the dean of students at my medical school, an intimidating figure I had never talked to one-on-one. He looked over my CV, and pointed to the Modern Love essay.

“Oh, you’re that girl,” he said, his tone inscrutable. Was it admiration? Or was it distaste, that I had written about a premarital fling in a national publication? (And yes, he called me a “girl.” I remember it vividly. It was 2014. Times were different, right?)

There was — and is — part of me that felt proud to share such an intimate story with the readers of the New York Times. If an editor there thought my writing was interesting, well, then wasn’t it? It gave me confidence to start pitching my work elsewhere, to write what I knew with a steady voice.

But I also felt weird about a piece of my romantic history being out there, on the Internet, for perpetuity. Over the years, various authority figures and buttoned-up colleagues have commented on the essay, which always brings with it a nagging feeling of impropriety. Did I share too much? Did it compromise my professionalism as a doctor?

And these days, as I think about growing this newsletter and writing a book that has some really, really personal stuff in it, I’m sharing more online than ever.

When it comes to writing about myself on the Internet, how much is too much?

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When my Modern Love piece came out in 2014, I didn’t really promote the essay on social media, like I would today.

I had been off of Facebook for several years, after reconsidering the zeal with which I posted hundreds of photos of the same parties during my college years. I was an early Facebook adopter, one of the “early access” users who saw photos of everyone in my dorm before I even met them. Then, when freshman orientation finally arrived, I had to pretend I had no idea who they were, that I hadn’t been looking at all their photos and reading their LiveJournals for months beforehand.

After I graduated, I got grossed out by how many hours I spent assessing the whereabouts of ex-boyfriends online, and I impulsively quit Facebook. Still, to this day, I haven’t been back on the platform.

I was proud of being off of social media. It felt chic, to be above the fray.

Then, I started creeping back on.

I started using Twitter more seriously during a journalism fellowship I did at NPR, after I finished my residency training in family medicine. This was the heyday of #MedTwitter, when Twitter felt like an exciting place for doctors to connect across specialties and learn about new research. I posted all my NPR pieces online.

Using social media in this way felt very professional. I had all my academic credentials listed on my profile, and I used a headshot of me in my white coat. I wasn’t particularly good at Twitter, although I gained a considerable following from my NPR work.

Throughout my time on Twitter, I felt ambivalent about it all. The whims of the Twitter mob scared me. I’d witness petty infighting between medical Twitter personalities — yes, really — and watch other doctors, with academic appointments and real patient panels, get slammed by hundreds of thousands of users for one dumb misstep. (All that seems quaint, now that Twitter has devolved into a true cesspool of hate.)

But I also yearned for success. I would feel a pang of envy when I looked at the chutzpah of other doctors who managed to post their intelligent-seeming takes on the latest medical research, who got book deals and NYT op-eds because of how big their audiences were. I envied their achievements.

I also envied the certainty with which they wrote, the fact that they didn’t need permission to share their work. Social media could be freeing. It was exciting to see writers not have depend on the whims of big, stodgy publications to write with confidence.

To be clear: those bid, stodgy publications do so much great work. In particular, I think the work of original reporting is critical to democracy. You can only sit back and pontificate about the news on your social network of choice if there is news to write about. We need trained, well-resourced reporters on the ground, finding out what’s going on and holding truth to power.

That’s why I subscribe to the Philadelphia Inquirer, the New York Times, and am a member of our local NPR station WHYY. (And I should probably add some others to the list!) These outlets are critical to a functioning society.

I’m happy whenever I have my writing published in a major publication; I am not pretending I’m above it. But I’m rejected much more often than not, which is unfortunately the norm for most writers. And I can’t afford to wait around to have these publications pick me. I have work to do.

So lately, when all of my friends tell me how great it is to delete Instagram; when every day I read another essay on Substack about “How I Quit Social Media,” — well, that’s when I’m leaning in.

Hear me out.

I joined Instagram just last year, with a specific goal in mind. I was working on a book proposal, and I knew I’d need to have some kind of “audience” to be able to sell it. I wasn’t trying to attain influencer status, but I wanted to see what was going on there and be findable on the app. Then, I rejoined Bluesky, where all my Internet doctor friends migrated after Twitter imploded. I tread carefully, aware that anything I post could be seen by my boss — or worse, my mom. (Hi, Mom, if you’re reading this!)

Here, on Substack, is where the magic is happening. Through the newsletters I read, it’s been thrilling to discover a world of thoughtful, original writing. There’s so much expertise and curiosity on Substack that simply isn’t represented in traditional publications.

Writing here, for you: Well, I’m doing it because it feels good to write, and because it makes me better at it. It is a challenge to turn the kernel of an idea — something that frustrates me in my primary care clinic; something I notice in my neighborhood — into a cogent piece of writing.

Still, the onslaught of intimate information one can access with the opening of an app — well, it’s a lot, and I worry about crossing into that territory myself.

Where is the line between brilliant personal writing, shared online, and grotesque over-share? What about the line between writing that helps us see our shared humanity, and writing that feels like a therapy session? (And not in a good way.)

It’s bewildering, what the algorithm feeds to me. On Instagram in particular, intimacy is prized: Videos of women eating, videos of women exercising, videos of women crying, videos of women in bathrooms, in bed, in cars, in kitchens. It feels like glimpsing someone through a window, lit up inside their house when I’m walking outside: shockingly private, and shockingly banal.

For Chief Complaint a few weeks ago, I wrote an essay about the gender-affirming care I provide for transgender patients, and how it’s transformed my thinking about my own identity as a cisgender, straight woman.

After I hit publish, a dear friend and fellow writer sent me an email telling me she had really liked the piece. I wrote back to her, thanking her for her compliments. But I also told her that I felt myself holding back.

Attacks on trans people harm all of us

Gender is both very public and very private, and it felt scary to share more with an audience of strangers. If I had been writing for a mainstream publication, might I have pushed myself further and shared more?

There’s something validating in knowing that an editor wants to read my personal thoughts, and on Substack, I just don’t have that kind of pre-publication feedback. But on Substack, I also have more freedom.

I’m still figuring all of this out. There’s no right answer. One woman’s gross over-share is another woman’s truth being spoken, aloud for all to hear, on the Internet. But there’s one thing that’s clear: I’m grateful for the community of readers and writers here who are figuring it out with me.