It’s Thursday 3am. I’m awake. I can’t lift my right foot. I do the obvious thing. I google. “Why can't I lift my foot?” 20,300,000 results. My consultation continues:
Google: Did you hit your leg?
Me: No
Google: Crush your foot?
Me: No
Google: Severe head trauma?
Me: Nope
Google: Neurodegenerative disorders that cause foot drop
Me:... Oh god
Memento Mori
The Latin for ‘remember you have to die’. How can I forget? To be reminded of the immanent is an everyday thing with me. I’m not a philosopher. I’m a hypochondriac.
Like many of my hysterical brethren, I often think of my own death and the events leading up to it – something that part of me believes is happening right now. And no matter what you or anyone else tells me, I won’t believe otherwise.
Which is why I turn to the only thing I trust to give me the truth. Dr Google.
So often has a twinge equalled cancer or a cut the beginning of Necrotising Fasciitis. I’ve diagnosed myself with afflictions I can’t even pronounce, focusing on the worst possible condition from the exotic to the obscure, because there is always ‘that slight chance’. Google ‘NHS misdiagnosis’ and you’ll see what I mean.
And of course technology maybe, just maybe, is making this worse. Add the world wide web to hypochondria and you get ‘cyberchondria’, a term coined by the UK’s The Independent newspaper to describe “the excessive use of internet health sites to fuel health anxiety.”
I understand digital self-diagnosis is far from perfect, but why would that stay my hand? A simple search can produce a smorgasbord of conditions to fret about. As an example, WebMD’s symptom checker app (on every hypochondriac’s smartphone, trust me) generates more than 50 results for ‘cough’, from the common cold to oesophageal cancer. Something similar happens when you search ‘foot drop’.
All of this places a strain on my relationship with my GP (physician). Below, a brief account of our last meeting:
GP: So what’s the problem?
Me: I think I have MS
GP: How do you know?
Me: I have foot drop – look
GP: OK, let me have a look at you
Me: It’s not my leg, I wasn’t in an accident, so it must be MS
GP: Or it could be a trapped nerve in your lower back
Me: But from what I’ve read on the internet and according to my DNA test, I have an above average chance of having MS
GP: (sigh) Well let’s take a look at your back first and then I’ll refer you to a physio
Me: But I NEED to see a neurologist!
GP: What you NEED is a therapist!
You’ll be unsurprised to hear I haven’t seen him since. He’s been avoiding my calls or is always “with another patient.” I’ve been handed over to the doctors who provide part-time cover, which means I hardly see the same person twice. Which is probably best for all of us.
Typically I’ll want to see someone about one condition, then end up talking about three more. I once made an appointment for a discomfort in my lower intestine (colon cancer, obviously) and ended up examining a questionable mole (melanoma), a suspicious rash (Lyme disease) and my badly behaved knee (Ehlers-Danlos Syndrome).
My name is Dustin, and I’m a Google Patient
Rather than being called a ‘cyberchondriac’, I prefer the label ‘Google Patient’, a more helpful way to describe my special kind of millennial hypochondria. Those of us in the group display certain special qualities:
- being obsessive about information
- knowing our own health records (and for some of us, also our DNA sequencing)
- asking lots of questions.
And according to recent research in the Harvard Business Review,* the prescription to meet our needs is relatively straightforward: provide clarity and order; give us detailed information during the consultation, and in brochures and on websites; and be transparent about medical outcomes and risks.
There’s a pressing need for this, not least because cyberchondria costs. In September 2017 researchers at Imperial College London estimated that trips to hospital clinics for internet-induced health anxieties cost Britain’s National Health Service (NHS) £420 million a year in outpatient appointments alone. Right now, the medical establishment is conflicted about how to respond. In the UK the Royal College of General Practitioners (the GP regulator) recently recommended that people consult Dr Google before visiting a GP as part of their new ‘Three before GP’ policy, to ease pressure on surgeries.
And yet the body continues to complain about patients having used Google prior to consultations in 80% of cases.
The dilemma is real: do you empower patients in the hope this helps to alleviate pressure on health systems, or does directing them to search medical information online lead to panic and anxiety?
Solutions like cognitive behavioural therapy, which the NHS does recommend in certain cases of medical anxiety, seem excessive as large-scale responses. In reality the vision for the medical profession should be one where digital diagnosis truly empowers both patients and healthcare professionals, through establishing a stronger connection between both. Technology should become a platform to facilitate the conversations that reduce fear and ease anxiety long before a gammy foot causes far more worry (and cost) than it is worth.
As the internet de-mystifies medicine for patients – as Dr Google potentially becomes sentient – doctors will have to become more human.
Oh, and my foot drop? Turns out it was an inflamed tendon.
*https://hbr.org/2017/11/how-design-thinking-is-improving-patient-caregiver-conversations