CITY CITY BANG BANG
The Trouble With Doctor Google
The internet has been an invaluable tool during the times of the pandemic. Marooned in our little socially-distanced islands, we have retained contact with the outside world through digital means. At an uncertain time, when the world and the experts that we depend upon to keep us alive have all been in learning mode when it comes to this new global threat, the ability to stay up-to-date with all the developments in the world of medicine and healthcare has been extremely useful. The facility of being able to speak to doctors and consult them over video has made a huge difference at a time when personal contact of any kind is best avoided.
Closer to home, at a time when the second wave has highlighted just how ramshackle our healthcare infrastructure is, the only help available to people who have been helplessly hunting for oxygen, vital medicines and hospital beds has come in the form of digitally-powered networks of good Samaritans. Strangers across cities have worked tirelessly in real time to try and help those in desperate need.
And yet, there is the flip side too. A lot of the information going around is false and worse, motivated. Untested remedies, fanciful conspiracy theories, unscientific advice all abound. Easy and instant access to healthcare information is a boon in so many ways, but equally, it also serves to heighten panic and encourage self-medication and self-diagnosis.
It is easy to mistake information for knowledge and worse, expertise. A search engine is a rabbit hole of stress into which we dive headlong as we keep ferreting out more layers of information till we reach the direst point on the spectrum. Every headache becomes a potential stroke, indigestion turns into an impending heart attack, and virtually any imaginable symptom pursued long enough turns into cancer. There is a perverse need to believe in the worst, an almost competitive sense of direness that one ends up chasing. The internet has been the single greatest catalyst for mass hypochondria.
The problem is not just with the users, but also in the way that healthcare information is organised and presented. Try and search for a relatively commonplace symptom like ‘swollen lymph nodes in the neck’, and among the first results that get thrown up is ‘malignant lymph node neoplasm’, meaning cancer. And this is by no means an isolated example. Apart from instances where the search engine throws up the most dreaded option first, there is the more common occurrence of it listing a series of possible conditions with no indication of what is more common and what is exceedingly rare. By presenting each ailment as an undifferentiated list, it implicitly accords the same probability to each option, thereby inducing anxiety.
It is interesting that almost all the popular medical sites suffer from the same problem. It makes one wonder if this is a feature or a bug, given that user engagement is likely to be much higher, the more serious the ailment one thinks one has. Apart from the stress that this generates, there are other consequences too, with patients insisting on more expensive and often needless tests, so convinced they are that the doctor is missing something potentially serious.
So many times, one’s certainty that one is a few months from dying of something horrible gets punctured the moment one sees a doctor, who is often hurtfully disdainful of one’s well-researched case about the hopelessness of one’s situation. While it is certainly a matter of relief when that happens, it does not deter us from behaving exactly the same way the next time around. Psychologically, it is difficult to stop oneself from diving into the murky waters of search engines even when one is fully aware of the dangers that it poses.
The gap between practical experience and theoretical knowledge is particularly large when it comes to medicine. Theoretical knowledge is no substitute for clinical experience, which is why so many times one’s selfdiagnosis is so woefully wrong. The doctor looks at the whole picture, and draws on experience that superficial reading simply cannot replicate, and arrives at a diagnosis using a very different mode of analysis than the one used by googlehappy amateur researchers.
Unlike other areas, where access to what was hitherto seen as expert knowledge can be liberating and empowering, when it comes to medicine, the situation is much more complex. At one level, having a more informed set of patients who are able to receive and implement expert advice knowledgeably can be an advantage. In a few cases, this kind of direct access can help individuals identify serious problems early and potentially save lives. On the other hand, for the vast majority, what it does is create stress and in some cases a fear of going to the doctor and getting diagnosed, so convinced is one that one has a terminal problem. One can only imagine the damage it would inflict particularly in countries where access to a doctor can take weeks or months. The agony of stewing in one’s naive certainty, while awaiting real diagnosis can be debilitating.
As our pandemic experience tells us, both having too much information too readily available and not having enough to go on are problematic. We are flooded with information of all kinds, proven and unproven, which has made dealing with the pandemic that much more difficult. On the other hand, so much is still unknown about the virus and our efforts to contain it.
At a time like this, it could be argued it makes sense for us to fear the worst, for that is what might well be what ends up protecting us. Equally, it is important to keep a sense of perspective about the virus to prevent us from being turned into paranoid emotional wrecks. Perhaps the best course is to limit our information to only that which is immediately useful, and to use Google to figure out which show or movie to watch next.