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NICHE has a number of followers who comment, but none more inventive than Sajin Young. We doubt Sajin is a real person, but may be a persona based on a character like Sajin Komamura from the anime series Bleach. Whoever Sajin is–it’s unclear whether he, she, or they is the right pronoun, so we’ll use the first–has his own Facebook page and is trafficking in one of literature’s oldest devices: satire, used in this case against Lutheran Health Network (LHN), an organization he perceives to be dysfunctional. Sajin is obviously an insider, and much of what is posted would mean little to persons outside of LHN or Community Health Systems (CHS). But we would not suggest that Sajin is not a serious critic of his target. Given that the City of Fort Wayne is involved in the approval and zoning of CHS’s proposed St. Joseph’s Hospital replacement, that LHN CEO Michael Poore has met with the Mayor, and that both are recipients of healthcare funding, Sajin’s comments are definitely political–as NICHE’s are in writing to educate on matters of public interest. Rarely, however, does NICHE use satire.

Satire is often divided into two styles: Horatian, more light-hearted, and Juvenalian, angrier. We would place Sajin in the former category. He tends to poke fun, see irony, and point out foolishness–often in ways that may only be funny only to his colleagues. He knows the landscape and the culture of CHS, however, and is deeply concerned–while often feigning innocence. There may be many pretenses–pretenses to quality, to growth, to concern, to commitment–but if the Emperor has no clothes, Sajin will say so.

Satire has a long and effective history in facilitating change. Gulliver’s Travels was a satire against the pretensions of English society. Jonathan Swift’s famous tract “A Modest Proposal” –which “proposed” selling one’s young to relieve hunger and the burden of raising them–was a mocking irony against government’s management of poverty in Ireland. The animals in Orwell’s, Animal Farm, and the characters in Mother Goose nursery rhymes are all satiric representations of political characters.

All of this begs the question, should satire be limited on NICHE’s Facebook page, or on Facebook as a whole, for that matter? As a not-for-profit journalistic enterprise, NICHE believes that satire has a place in the conversation. In fact, NICHE would only restrict posts that clearly violate standards of civility or obscenity or are clearly off topic–regardless of the nature of the opinion, and regardless of whether we personally agree with the author.

Certainly, there is nothing funny about the distress of LHN or its parent CHS. However, satire may be an effective antidote to claims of quality that seem divorced from the reality presented by other well-vetted sources. In fact, few would believe Sajin if his take was not so frequently reinforced by others outside of Fort Wayne. When Axios quoted an investor that: “I think the company has a nontrivial chance of defaulting” on debt (…), for example, it only bolstered Sajin’s observations that maybe the St. Joseph’s replacement was really “a fake hospital.”

Free speech is vital to ensuring that conversations about healthcare quality are honest and representative of the facts. If charges are levied against a healthcare entity regarding public matters, therefore–whether by appearance at a City Council meeting, essay, or satire–the proper response is an answer to those claims that allow observers to weigh arguments and reach judgments. In the absence of such answers, these observers are left to wonder who to trust: the satirists or their targets?

(For more on the nature of satire and its place in public discourse, see