While anyone who has had a

1) medical condition and 2) access to Internet in the last five years

probably knows that patients are increasingly using the net (and now google) to diagnose medical conditions, it is only now that the “medial establishment” is starting to recognize or really admit to the reality of this widespread phenomenon and even doing studies on them, such as the one released a few days ago by the BJP Googling for a diagnosis—use of Google as a diagnostic aid: internet
based study. The study sought to ascertain how effective google was as an aid in medical diagnosis. As various new outfits are reporting it is moderately high.

What I love about this study and the corollary reporting is the naive tone they have to assume, transmitting the news as if the public knew very little about this, and would in fact, be induced into surprise!!!!!!!!!! when first facing the new. But in fact, I think it works in the opposite way. The surprise is that they took so long to admit to what was in front of us for many years now.

While the news articles reporting on the study stay within the province of doctors, the report acknowledges, in fact opens with, the fact that patients may be forging the path in Internet-diagnosis. The authors write in their second paragraph:

“It seems that patients use Google to diagnose their own medical disorders too. After evaluating a 16 year old water polo player who presented with acute subclavain vein thrombosis, one of us (HT) started to explain that the cuase of the thrombosis was uncertain when the patients father blurted out “But of course, he has paget-von Schrotter symdnome. Having previously googled the symptoms, he gave us a mini-tutorial.. and the correct treatment for the syndrome. This experience led us to ask “How googe is google in helping doctors to reach the right diagnosis”

Again, what I love about the tone of this opening is that it is as if these doctors stumbled on a great but deeply hidden fact to make a breath-taking discovery, one that, however, since is it is SO very emergent and thus still not *really* verified by Science, they must proceed with great caution, qualifying with phrasees like “It seems that patients use Google to diagnose their own medical disorders too”. I am sure they and most doctors are personally are not so naïve but since this has been something virtually without no official acknowledgment among professionals and in the journals, the genre of writing just requires it to be framed cautiously.

As fun to read are the comments, for they stretch from moral panic:

“The implication that ‘googling’ be an adjunct to proper medical school training, continuing medical education through courses and reading peer reviewed journals is laughable and bordering on dangerous. I am shocked that this has been published by the BMJ.”

to celebration:

“For the modern dermatologist, the internet is indispensible and google is only the start, and for this reason a desktop computer with high speed internet access is an essential tool for all clinicians. Long live the information superhighway!”

While others muse on the broader emacipatory possibilities

“One can imagine the benefit to young doctor in developing country who now have access to a grand medical library in their hands.”

I am especially interested in this very dynamic because it is one pillar propping my next project on psychiatric survivors, which exceeds the particular topic of challenges to psychiatry in its general focus on medical/patient reconfigurations following from Intent-based activism, self-help, diagnosis, and critique. And for those who think I have made a radical departure from my last project, here is where I see one (of two or three) threads of continuity: for patients are generating an enormous amount of “amateur” knowledge, that I think is not unlike the peer-to-peer production of software hacking, and it is a form labor usually accompanied by a strong critique of expertise and other medical practices.

I am now reading some literature on patient activism, like the issue from the February 2006 in Social Science and Medicine that collects 11 articles on patient organization movements. For those who work on this topic, the collection is worth your while and the editorial introduction by Kyra Landzelius is stellar. It is not only written beautifully (which I think is rare for these openings because it is often a rote, unimaginative regurgitation but this was a pleasure to read) but provides an engrossing overview of some new trends and some of the diverging forms of politics that arise from what is really a motley bunch of organizations and contests in patient and anti-patient activsm.

She opens by defining four spheres that shape and inform the forms of contents that are part and parcel of these patient movements, the four being:

1. Revolutionary feats in technoscientific engineering
2. Restructuring of healthcare systems across industrialized nations
3. A Revised contract between science and the public stemming from a criss of confidence in science
4. An upsurge in the articulation and diversification of health activisms (p. 530)

These four are key but I was shocked that there was no specific inclusion—though it comes out plenty in the introduction in other ways—of the Internet. For while I am no techno-determinist, the Internet I think, can’t be ignored for it has fundamentally changed the map and tenor of patient activism, allowing for more rapid connections between various stakeholders, providing a medium by which those officially unrecognized illnesses are given shape and form, and where an ethical cultivation of self-help, self-diagnosis, self-medication, along with copious critique and forging of alternatives is happening, right before our eyes, virtually in real time.

It is the medium by which a new chapter of patient activism is being written and I think it is a real mistake not to give it serious attention and credit. And perhaps one of the most interesting things about it is that it without it, it would leave many otherwise home-bound, sick folks, without a medium by which to engage in political activity or even community self-help, for let’s face it, these take a lot time and energy.

When you are sick and home-bound, for example, there may be a limited number of types of engagements you literally have the energy to partiicpate in and the Internet lowers the barrier of political entry because of its ease and because you can still type away, even when feeling otherwise totally awful… This may be a brute material point but nonetheless, key to understanding the political power of the Internet.

Now of course the question left is will Google capitalize on this and create “Google Diagnosis”?