TikTok Eye Doc Prescribes Jokes With a Sarcasm Supplement

Will Flanary finds the funny in the potentially fatal. Cancer, cardiac arrest, handling health insurance bills, he wants us to laugh at it all – and then take it seriously.

Better known as his online alter ego, Dr. Glaucomflecken, the Oregon ophthalmologist has built a big following with his candid tweets about life as an eye surgeon, his snarky-but-entirely-relatable TikTok videos about the absurdities of health insurance, his sometimes-searing accounts of his own brushes with death—and the occasional really gross eyeball photo.

Flanary landed in the space where humor and life-threatening illness intersect in 2012, when he was in his fourth year of medical school. At 25, married and with an infant daughter, he had given up his former part-time gigs as a standup comic to focus on school and family. Then he woke up one morning with a lump in his testicle (or, as he puts it, he noticed that his testicle had grown another testicle). Suddenly he was plunged into a swirl of surgeries, scans, injections, blood draws, and endless phone calls with health insurance reps. To manage his anxiety and grief, he started telling jokes again.

Flanary has been telling jokes ever since, through a cancer recurrence and, more recently, a sudden cardiac arrest. (His wife, Kristin, who saved his life by performing CPR until paramedics arrived, was worried that the cardiac arrest might have affected Flanary’s cognitive abilities. So she tested him by deleting all the social media apps on his phone. When he was able to download the apps, remember his passwords, and start tweeting again within three days of the event – while still in the ICU – she figured he was probably okay.)

Today, Flanary’s Twitter feed (250,000 followers) mixes educational threads about how to select over-the-counter eye drops with TikToks (another 310,000-plus followers) starring himself in various roles, including struggling medical student, supercilious attending physician, and officious health insurance bureaucrat. (His 5-year-old daughter made a recent cameo as a perplexed patient facing an enormous, unexpected medical bill after “Dr. Daddy” removed a tiny splinter from her finger.)

Off-line, Flanary, 35, was recently named one of Portland’s top medical providers by Portland Monthly Magazine. He also speaks frequently at medical schools and conferences across the country.

In a recent telephone interview from his Portland-area office, Flanary spoke with Elizabeth Austin about the psychological benefits of humor, the challenges of making jokes during a pandemic, and Donald Trump’s (inadvertent) gift to ophthalmology comedy. By the way, glaukomflecken (yes, with a k) merely means glaucoma flecks. (Also, as it happens, NPLB’s founder and the non-profit’s now-executive editor met in Dr. Glaucomflecken’s Twitter comments.)

NPLB: Did you choose ophthalmology because the terms “flashers and floaters” had so much comedic potential?

Dr. Flanary: I chose ophthalmology because I love to sit down. Actually, I always tell people that I chose the easy way out with ophthalmology, because I can actually look at the things that I'm diagnosing, with my own eyes. People who go into internal medicine are the brave ones, because they're actually diagnosing things they can't see. That just seems really hard to me.

NPLB: As an ophthalmologist, how did you feel when you saw Donald Trump look directly into a solar eclipse?

Dr. Flanary: It was like the comedy gods just reached out and handed me this beautiful blinding light. That was comedy nirvana.  It also just perfectly encapsulates Trump as a person, right? I mean, of course he's going to look at the eclipse.  But it's always wonderful whenever you have events that enter into the public consciousness. That was the golden age of ophthalmology comedy right there. For a couple of weeks, everybody was talking about eyes. It was amazing. Then it quickly went away, and everyone forgot what an ophthalmologist is. But for that brief period of time, it was very exciting for all of ophthalmology.

NPLB: Why do you spend so much time on Twitter? And when you’re on Twitter, what do you feel like you should be doing instead?

Dr. Flanary: Twitter started out for me as a way to do comedy because I didn't have time to do stand-up comedy any more. Over time, I started developing relationships on Twitter with other healthcare professionals, and I also started doing more education on Twitter. That’s really when it started to snowball, when I started to combine comedy and education. I started getting more offers to speak at conferences and grand rounds and academic institutions. At this point, Twitter is almost like a side business for me. It’s not just jokes. I feel like I'm providing ophthalmology education. So now I feel like it’s a bit more important for me to stay active on Twitter.

NPLB: Who follows you on Twitter, and why?

Dr. Flanary: At least half of my audience – probably much more like 75 percent – is medical professionals.

I think Twitter is uniquely suited for medical professionals, because the exchange of ideas is such an important part of medicine – going to conferences, journal articles, and just the day-to-day interactions in academic teaching hospitals. It’s all about learning and idea dissemination. Twitter just makes it so much easier for people to connect immediately with each other from all different specialties across the entire world.

"People’s right to live and be healthy should not be tied to the profits of somebody else. It's an awful situation."

NPLB: In your lectures to medical students, why do you claim that rheumatology is a hoax?

Dr. Flanary: I have a few things I joke about a lot. One of those things is how, as an ophthalmologist, my understanding of general medicine isn’t what it used to be. The joke is, instead of understanding it, I just say that it’s all a hoax, that none of it is real. Things that I don’t understand scare me, is the crux of it.

NPLB: Your related joke, that cytokines are also a hoax, was funnier before we began reading news stories about cytokine storms caused by COVID-19, in which the body’s immune system goes haywire and starts to attack its own cells and tissues instead of the virus. Which leads to my next question: Is it harder to be funny when the world seems to be coming to an end?

Dr. Flanary: The world sucks right now. It’s awful. There are so many horrible things going on. That doesn’t mean people don’t need to have some kind of emotional release. Humor is a healthy way to achieve that. People message me and tell me how much they appreciate somebody out there trying to inject a little levity into what is just an awful situation.

NPLB: On a personal level, do you find that things just don’t seem so funny anymore? How can you laugh at a time like this?

Dr. Flanary: I have always fallen back on humor and comedy as a coping mechanism for anything that happens in my life. That goes back to going through testicular cancer twice, and then my cardiac arrest most recently. Humor is something that’s always given me a reprieve, emotionally and mentally. Whenever things get really dark in my life, I’ve always turned to comedy. No matter how dark things get, there's a place for humor – it’s a human response to stressful situations. When times are so dark, it's more important than ever.

NPLB: Since the very beginning of your medical career, you’ve gone through multiple stints of medical hell. How have your experiences as a patient facing life-threatening illness affected the way you practice medicine?

Dr. Flanary: I think it's only helped me to have had that experience as a patient, including going through insurance struggles and all of that. Sometimes I get irritated when I talk about the insurance things on Twitter, and people respond with things like, ‘Well, imagine how patients feel.’ And I’m like, ‘I am a patient.’

NPLB: Part of being a doctor is the ability to distance yourself from your shared humanity with the patient. If you were thinking, ‘Oh God, I wouldn't want somebody to put a knife in my eyes,’ you wouldn’t be able to do your job. After your own experiences as a patient, how do you avoid over-empathizing with the people you treat?

Dr. Flanary: As a physician, you have to be able to emotionally detach a little bit. I can draw on those experiences as a patient and use them to inform my conversations with my own patients, but I'm still able to do what I need to do.

NPLB: From a patient perspective, do I really want a doctor with a sense of humor?

Dr. Flanary: Yes, you do. I've found that using humor in patient interactions disarms people. It relaxes them. It decreases the stress level in the physician-patient interaction, at a time when there can be a high level of stress involved.

NPLB: If you could put on your patient hat for a moment, what is the funniest thing that a doctor has ever said to you when you asked, ‘How much is this going to cost?’

Dr. Flanary: Basically, what happens if I ask that question – or if I get asked that question myself – it's been a lot of fumbling around.  As doctors, we just haven't been trained to think about costs. So when you ask a doctor how much something costs, it's going to knock him off guard. It’s unfortunate. As doctors, we need more of an open dialogue with our patients about cost, because being healthy at the expense of financial instability is something that we need to be thinking about.

NPLB: Sometimes when I ask a provider what a procedure or pharmaceutical drug is going to cost, they respond with a fairly heavy dose of patient shaming, along the lines of ‘How can you put a price on your health?’ When, of course, that’s the basis of our whole healthcare system.

Dr. Flanary: It’s just the way our insurance system is set up. It doesn't make any sense. Who designed this system? There’s also the whole deductible situation. We get this mass influx of patients toward the end of the year, when people want to get services done before their deductible resets. Why should they have to pay $6,000 out of pocket for a medical procedure in January when it’s free to them in December? It’s just this arbitrary nonsense.  When I talk to patients about when they want to do their surgery, financial considerations often come up. They say, ‘I’ve got to wait.’ I'm all for letting patients decide when they get things done, as long as a delay coincides with standard of care.

NPLB: What was your worst-ever experience with health insurance?

Dr. Flanary: My worst experience with insurance was with Cigna, trying to get my cardiac arrest hospitalization covered. Apparently I should have been more careful about choosing in-network doctors while I was intubated in the ICU.

NPLB: Here’s something that’s not funny: GoFundMe campaigns for healthcare costs.

Dr. Flanary: It’s an indictment of our medical system. The GoFundMe to pay medical bills is a uniquely American thing. It's baffling to other developed countries, and even non-developed countries. All it takes is one giant medical emergency to bankrupt somebody.

NPLB: Here’s a corollary question: Why do you say that health insurance is trash?

Dr. Flanary: Whenever you take something that we see as a basic human need and a basic human right, which is to have healthcare, and then you try to turn that into a profit-building commodity, there's a disconnect. People’s right to live and be healthy should not be tied to the profits of somebody else. It's an awful situation.

NPLB: Do you think the COVID-19 epidemic will change the way the United States provides healthcare? And why not?  

Dr. Flanary: The tiny bit of optimism I have inside of me hopes that it will change, but the pragmatist/realist in me says that nothing is going to change unless we change the incentive structure for these medical insurance companies. There’s a lot of work to do there, and I honestly don't think that the pandemic is going to change it, although I wish it would.

NPLB: I am now placing my hand on an imaginary doorknob, in my best ‘Physician ready to hurry out of the exam room’ impersonation. Is there anything else you'd like to ask, Doctor?

Dr. Flanary: (Chuckling) No, I think we’re good.

Elizabeth Austin is a writer and communications strategist living in Chicago.