The tweet was an obvious troll, by a fake doctor with a profane name.

“When Trump supporters come to my office at the Mayo Clinic, I love misdiagnosing their healthy pregnancies as ectopic so they have to abort their white fetuses,” Twitter user @DrNifkin wrote last week.

Since then, the Mayo Clinic has debunked the hoax more than 100 times to Twitter users like “@CovfefeCarrierAR15,” “@PickASlur,” and InfoWars writer Paul Joseph Watson.

Obviously the Mayo Clinic employs no such doctor. Instead, outraged conservative accounts were responding to a troll account riffing on a meme that pre-dates the Trump presidency. The joke follows a predictable format: Twitter users announce that they “love” their job where they go to improbable lengths to inconvenience Trump voters. The jobs are fake and the tweets are obvious variations on an old meme, but the backlash from Twitter conservatives is real.

The hoax shouldn’t have been hard to spot. “Nifkin” is a slang term best defined by Urban Dictionary. DrNifkin describes himself as a “parody” account in his biography and tweets things like “civility is pooping into your hand and throwing it.”

“DrNifkin” said he was trolling for a reaction. “I had written a similar tweet a few days earlier that got no traction so I reworked it,” he told The Daily Beast. The Mayo Clinic quickly clarified that the tweet was a hoax and that no one of that name worked there.

But InfoWars-adjacent Twitter users presented the tweet as real. “I really truly hope this is just a horrible joke,” InfoWars editor at large and conspiracy theorist Paul Joseph Watson tweeted above a screenshot of the original tweet. “Sick sick stuff.”

InfoWars contributor Laura Loomer went further. “This is the most evil thing I have ever seen on Twitter,” Loomer tweeted. “Don’t let ANYONE tell you that we aren’t at WAR with the Democrats. They are absolutely evil.”

Their followers and others bombarded the Mayo Clinic with tweets demanding Dr. Nifkin (again, obviously not a real doctor) be fired. It wasn’t the first time a similar tweet had inspired a Twitter headhunt.

DrNifkin’s tweet was modeled after a hoax that began a month before the 2016 presidential election, when then-candidate Donald Trump was stoking fears of voter fraud in advance of what was predicted to be his loss to Hillary Clinton. That’s when @RandyGDub, a popular “Weird Twitter” personality, decided to parody Trump’s claims.

“i love working at the post office in Columbus, Ohio and ripping up absentee ballots that vote for trump,” Randy tweeted in October 2016.

“A couple people saw it and I thought it was over,” Randy told The Daily Beast. “Then Scott Baio found it and started tagging the FBI or whoever.”

Conservatives piled on, never mind that Randy’s Twitter biography lists him as living in California, or that his feed is full of similarly obvious jokes, or that the U.S. Postal Service issued a statement clarifying that Randy was not a postal worker. Fringe-right site The Gateway Pundit picked up Randy’s tweet as fact, publishing the tweet under the headline “POSTAL WORKER Brags Online About Destroying Trump Ballots.” Larger conservative outlets like the Drudge Report, and radio host Rush Limbaugh subsequently picked up the story, which eventually found its way to Ohio’s secretary of state.

The hoax quickly became a meme. When a Twitter user went semi-viral with a tweet “I love working in the admissions office at Kent State University in Kent, Ohio and putting every conservative students college application through the shredder,” the university issued a statement denying the tweet.

During the Western Conservative Conference, a March event featuring Sheriff Joe Arpaio and Project Veritas founder James O’Keefe, a woman who does not work at the convention center used the meme to joke about giving conference attendees estrogen pills.

“I love my job at the Phoenix Convention Center Starbucks and I love slipping my spare estradiol pills in the coffee of anyone wearing a #WesternConservativeConference lanyard,” the Twitter user named Lauren wrote in a tweet that was quickly picked up by Breitbart and similar outlets. O’Keefe posted a tweet implying that he had sent an employee to film the Lauren at Starbucks (where she did not work).

“Someone in a hate and glasses with a strange looking lapel pin may have ordered something from you recently and you mentioned this,” O’Keefe tweeted. “Do you remember that? #ProjectVeritasIsEverywhere”

“.@Starbucks EMPLOYEE ILLEGALLY DRUGGING CONSERVATIVES!” Laura Loomer tweeted, adding that she had called a local terrorism task force and “Chances are she will be arrested for an act of domestic terrorism.”

Approximately two weeks after her joke tweet, police visited Lauren’s home, she told The Daily Beast.

“It was more or less a warning not to do anything like that again,” she said. “He said they had gotten calls the day of and several people told the police they felt the effects in their coffee. But I think within a couple minutes they figured out it was a dumb joke.”

DrNifkin, who said he was trying to provoke a reaction, said responses to his tweet have fallen into several categories.

“1) thanks and praise,” Nifkin said. “2) people shouting that it’s fake and a troll as though they are master sleuths who cracked the mystery of the abortion doctor 3) people who say they’re not sure it’s fake but that even if it is i’m awful 4) people telling me i’m evil and will burn in hell 5) people who contact the mayo clinic for responses 6) people who tag every form of law enforcement possible including jeff sessions 7) the people who think i should be killed and 8) the people who threaten to kill me themselves.”

Shortly after writing the tweet, he found it referenced on a far-right forum, under a thread encouraging readers to “dox this n----r.” Forum-goers browsed a list of Mayo Clinic doctors and guessed, without evidence, that DrNifkin was an award-winning doctor who originally studied medicine in Nigeria. People replied that they were reporting that doctor to the FBI and a medical board.

Meanwhile, InfoWars fans pushed their own conspiracy based on the screen name DrNifkin had used during the month Melania Trump made no public appearances.

“My Twitter nickname during that month Melania was out of sight was Daed Si Ainalem, which is ‘Melania is dead’ backwards,” he said. “Just a play on the common joke that Melania was missing because she died. When the name was discovered people either A) assumed I was Muslim and therefore a terrorist or B) they realized what it was backwards and tried alerting the Secret Service.” As of Monday, the Mayo Clinic was still replying to angry Twitter users who demanded DrNifkin be fired from his nonexistent job.

Randy, the meme’s original architect, said it didn’t matter whether those users truly believed the tweets. “Conservatism is an ideology of perceived victimhood and they run everything in this country so they need something and the grifters like Paul Joseph Watson know this too,” Randy said. “He knows the tweets are fake/jokes but it keeps his audience enraged.”