The Attack of...Social Media

I'm listening to the radio while I work out, and the host for this morning's show is Ayesha Rascoe.  She had as a guest another NPR contributor named Ayesha Harris.  Ayesha Rascoe called this "The Attack of the Ayeshas."

The topic was "social media," and the problems it causes.  It's easy to think of "social media" as facebook, Twitter, Instagram, Tik Tok, and maybe some others.  The Ayeshas fleetingly noted that the whole internet is a kind of social media.  Frankly, it occurred to me that a public blog like this one is, or can be, an example of a kind of social media.

One of the noteworthy, and toxic, features of social media mentioned by the Ayeshas was anonymity.  (If you hear sirens blaring, so do I.)  I have been part of online communities in which many participants use aliases.  One of those communities was a doctors' site called SERMO.  I did a post about anonymity (the use of aliases) on SERMO, and there were hundreds of comments.  One I will never forget came from an unidentified doctor who said that if s/he had to reveal her or his name, s/he wouldn't comment.  S/he would say things under cover of an alias that s/he wouldn't say if s/he had to identify her- or himself.  And that's a big part of the problem.  I would never in a million years make a public comment under cover of an alias.  If I have something to say, you're entitled to know who's saying it.  If I can't bear to let you know, then I should keep my mouth shut.

Getting back to the internet as social media, it is very common that a patient I treat will ask me, or tell me, about something they looked up (they think it's an important discovery, and they've armed themselves with information and facts) online.  I am very clear with them about this.  I tell them I will beg them, on my knees, if necessary, not to look things up online.  They don't know who said it, what that person's real credentials and expertise are, why the person said it, and certainly not if it's true.  If my patients want psychiatric advice, they should ask me.  That's what I'm here for.  That's what they pay me for.  And if they feel they can't trust me and what I tell them, they should find someone who seems to them more trustworthy.  Of course, if they think that all of my training and experience can be duplicated by looking something up online, then they have another problem besides the one for which they consulted me.

In the medical world, there are people called drug detail people.  They're young, employees of the drug companies, and their job is to meet doctors, and tell the doctors why they should prescribe such-and-such new drug.  I call these people drug cuties or drug hunks, depending on their gender.  I don't know what, if any, credentials or training they have, but they're not hired at random.  They're hired for the appeal the drug company thinks they'll have.  They have a rap they give, which includes various kinds of thin information (including allegations like "this drug is approved for X, but I've been hearing from many of your colleagues that they're finding it also shows effectiveness for Y, which would of course be an 'off label' use"), reprints of articles, and the offer of samples.  Generally speaking, I refuse to talk to them.  But I do remember an interaction with one guy about 20 years ago, and he showed me a reprint of an article.  I recognized the lead author's name, because he was a very well known psychiatrist, but the journal that published this paper was what we call a "throw-away" journal.  I asked about that.  This psychiatrist could get published anywhere.  Why was his paper in a two-bit journal?  The drug detail guy said he didn't know, but he'd get back to me.  Not in about 20 years, so far.  I later became aware that drug companies pay well known doctors a fee to allow the drug company to list the doctor's well known name as the lead author on a paper with which the doctor had no involvement.  Later than that, a former editor of the highly esteemed New England Journal of Medicine revealed that drug companies pay journals to publish papers (which might otherwise not have met the editorial standards of the journal).

I'm just giving you medical examples, but the "social media" problem is vastly more pervasive and insidious than that.  And there's less and less anyone can trust.  "Anonymous?"  Don't make me piss my pants.

If you have something to say, feel free to say it.  And grow up, and take responsibility for what you say.  I do.  If you don't have the nerve to be associated with and responsible for what's in your mind, then keep your mouth shut.  No one gives a shit about you and your drivelings.