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Paging Dr. You

Social media has launched a free-for-all national conversation on our aches and pains. Feel better yet?

Does your toe hurt?

If it does, you have a number of options. You might think about taking an aspirin and ignoring it. You might go to the doctor. Or you might decide to enter the words, “Why does my toe hurt?” into the Google box on your personal computer. This question would yield 17,600 hits, one of which presents a forum on the fascinating query, “Why does my toe hurt my chest?” This question, in case you are wondering, generated a touchingly earnest exchange on the gamer website Giant Bomb, culminating with the reasonable advice, “Stop kicking yourself in the chest.”

Yes, we truly live in an extraordinary age of democratic access to medical information, one where a motivated hypochondriac can swiftly educate himself on everything from shingles to scurvy. This access can also help us to improve our health habits, spot potential problems and provide support to family, friends and the occasional complete stranger. What’s more, social media have given us the means to disseminate our newfound knowledge to millions of others. That’s a lot of people power—and a daunting responsibility.

Our day of medical empowerment has been a long time coming. Over the past half-century, the things that used to be between you and your doctor have been inexorably invited into the national conversation. Perhaps the Age of Uncomfortable Disclosure symbolically began in 1965, when President Lyndon Johnson lifted up his shirt to show America his surgical scar—the “I do” moment in the rocky marriage between medicine and media. In the decades that followed, the circuit of medical information grew to include television correspondents, radio call-in shows, newspaper medical reporters, column-writing doctors, Oprah Winfrey and the cast of Scrubs.

Today, it’s possible at a keystroke to read medical information from the world’s most prestigious institutions. The Cleveland Clinic has an entire continuing medical education encyclopedia online; it’s meant for physicians, but if you’ve got a taste for Latinate explanations of your bodily functions, it’s there for you. At MayoClinic.com, I can read an authoritative explanation of cardiac arrhythmia, see an image of an atrial flutter and watch an animated primer on the circulatory system. Things like this give one faith in the human urge to enlighten our fellow man.

In webworld, though, enlightenment is in the eye of the niche-dweller, and it’s also quite possible to lose oneself in raving hive of conspiracy theorists who believe that polio vaccination is a Masonic plot. A physician friend recently told me that he loves it when patients have taken the time to study up on conditions and procedures—except when everything they’ve learned is completely wrong.

But modern doctors have moved beyond the old-school paternalism that considered mute, unquestioning ignorance a virtue among patients. Patients have real choices to make—would you like your hernia plugged with mesh or just sewn up, sir?—and responsible media can help us make them. The problem is that Web 2.0 has rendered the phrase “responsible media” quaint: Which of your respondents on Giant Bomb will you hold responsible?

But the mainstream media biz won’t get off that easily. Medical-advice websites are already very much part of the media establishment, with all of the commercial tension (and targeted pharmaceutical advertising) that implies. WebMD.com alone claims 60 million unique visitors a month and struggles to maintain a precarious tonal balance between cozy pop medi-friend and serious health advisor. An added challenge for such sites is that people with questions are as likely to consult their user forums as their vetted editorial content: In few areas of the Internet is a knowledgeable moderator as crucial as on health forums, where words really can hurt you.

Meanwhile, “old” media—including entertainment media—still has a tremendous effect on people’s medical knowledge: A 2009 Centers for Disease Control report found that 88 percent of Americans learn about medical matters from television. That includes the sterling information to be gleaned not only from Dr. Phil, but also from that old network stalwart, the medical drama. And in the cycle of medical misinformation, old media and new are intimately linked.

In the spirit of a nation unafraid to do its medical learning at the feet of fictional physicians and anonymous chat-room buddies, let’s demonstrate this interconnection through a hypothetical case study from an imagined episode of a scripted television show:

Dr. Gregory House makes a radical diagnosis and saves his suffocating patient with a jalapeño pepper and a ball-point pen. The most motivated among House’s 12 million viewers proceed to their computers to chat about the treatment. The disease—let’s call it spice deficiency asphyxiation disorder—spikes on Google. Within a few weeks, some poor schlub types in “Why can’t I breathe?” and learns of House’s miracle cure.

(Don’t believe that “spice deficiency asphyxiation disorder” exists? Look it up on the Internet. It’s right there, in this very article.)

Conventional thinking says we’re a cynical nation that holds its media in low esteem. But this idea doesn’t jibe with a population that seeks out, shares and utilizes media information to a degree unprecedented in history. We are, in spite of everything, a trusting country, with uncommon faith in expertise and a lingering belief in the reliability of publicly disseminated knowlege.

This means that we in the media need to do better. Our health reporters must know medicine and statistics and understand research methodology so that they don’t overstate the results of every preliminary study on the newly suspected hazards of oat bran. This requires education, a lot of it: When Timothy Johnson, the longtime medical editor of ABC News, got started in journalism in the early 1970s, he already had an M.D., but he decided that to do right by his viewers he needed to go back to Harvard for a master’s degree in public health. In an influential 1998 lecture to the Massachusetts Medical Society, Johnson raised the hope that if more medical correspondents educated themselves, the media might bring clarity and perspective to the bewildering world of medicine.

But that was before Web 2.0.

Today, we are all medical reporters. As patients, friends and digital confidants, we’ll need to be discerning in the information we seek, critical of what we consume and cautious in what we share. It sounds utopian, but maybe we really can turn knowledge into power.

So study up. The toes of a nation are in your hands.

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