Google plus salt, please

The world we live in is truly amazing. We have the knowledge of specialists at our fingertips. But, as Peter Parker’s uncle told him in Spiderman, with great power comes great responsibility.

One of my more anxious patients got seriously ill recently. She was hospitalised and they started treatment. I spoke to her physician and was satisfied that they had things in hand, so I expected her to be discharged within a few days. I was surprised to hear from her a week later. Her physician was running more and more tests, some of them invasive and painful. My patient’s anxiety was through the roof, so I decided to do a hospital visit.

We chatted for a while. It came out that as soon as the physician left her bedside, my patient would Google what he said. Google is not a good place to go to when you are anxious. By the time the physician returned, my patient’s tension headache was a severe headache. So bad that the physician ordered a lumbar puncture to exclude various complications. Complications which my poor patient was all too aware of thanks to her rigorous research.

I gently pointed out what was happening and she gave her phone to her husband to take home. She was discharged two days later.

I now suggest to my patients not to Google in the acute phase of their treatment. If they have any questions or concerns, they are more than welcome to contact me.

Most chronic illnesses, whether they be psychiatric or medical, are not managed with medication alone. Chronic illnesses require careful attention and lifestyle modifications. Chronic medications often have serious side effects. It stands to reason that the more a patient knows about a condition, the more they are empowered to deal with it.

For the maintenance part of treatment, I encourage my patients to consult with Dr Google. The internet is a trove of useful information and unfortunately, also filled with rubbish.

When trawling the internet for information, the source of that information is important. I do refer my patients to relevant blogs and chatrooms. It can be a great relief to know that you are not alone and to talk to others with similar struggles to your own. But these forums are not known for their scientific rigour. They are like chatting with friends; friends who don’t always give the best medical advice.

When you read reputable journals, like Scientific American or Neuroscience News, you can let your guard down a bit and be a bit less critical of what they say. Their reputations are built on being a bit more scientifically robust. If you want to research a specific topic, then data specific databases are a great place to start. I refer my patients to Pubmed for medical research and PsycInfo for psychological topics.

Charismatic quotes are great because we want to believe them. When Avocado Wolfe says: “when you forgive, you don’t change the past, you change the future”, he is repackaging inspiration. But when he opposes vaccination or cancer treatment he becomes a celebrity quack.

Checking a page’s affiliations can also help you decide how much salt you must add to what they are selling. If you look at the Vaccine Impact site, it immediately links to various advertisements. If you look at the MayoClinic site it does not. Mayo Clinic is affiliated to a prestigious hospital and is not there to make a profit from its website.

Sites like Vaccine Impact have exciting topics like:  “Vaccines linked to decline in mental health and social interactions – A cause of increase in mass school shootings?” If you feel like you have been click-baited, you probably have. Venture further with all your BS radars up. As human beings we tend to agree with what we like. Our own confirmation bias might be our own worst enemy when doing internet research. Just because we like an opinion, does not make it true.

When I do research, I still like to get the opinion of specialists in their field. I encourage my patients to use the internet and me when exploring their illness.

Some sites worth browsing:

• South African Depression and Anxiety Group 
• Cape Town Bipolar Support Group
• Cape Support (mainly for schizophrenia)