Monday, September 19, 2011

Seeing the Value of Graffiti

Blogging is not writing. It's just graffiti with punctuation.
--Dr. Ian Sussman, in Contagion

I went to see the new movie Contagion the other day. Over all, it was a decent flick. It was much more refreshing than other disease-based disaster movies, like Outbreak or The Andromeda Strain, in that the crew worked hard to get the science right. Also nice was that when characters died from the virus, there was no drawn-out "I'm dying; oh, the pain" dialogues with other characters. Like a real virus, death was heralded by serious awareness-hampering things like seizures. There were some quibbles I had with the film, but I'm not going to go into a lengthy review. Others have already done that far better than I could. Besides, I don't want to give any spoilers for those who have yet to see it.

Instead, I want to focus on that quote up at the top of this post.

The line was from Elliott Gould's character Dr. Ian Sussman, a professor and researcher in infectious diseases, as anti-vaccine crank alt-med blogger, self-styled journalist and supplement huckster Alan Krumwiede (Jude Law) harangues him as Sussman leaves work. That line, I think, nicely encapsulates the opinions of many people around the United States, and probably the world over, who don't really "get" what blogging is all about. Some bloggers take that comment as a compliment, a badge of honor, since graffiti is an art form that can last significantly longer than most blog posts. To the average person, though, it would probably seem the witty insult that it is; like graffiti, many blogs are little more than nonsense cluttering up the (less than) pristine walls of the internet.

For the average person going about their daily lives, ignoring the blogosphere probably will not have a significant impact on them. They might miss out on some intriguing philosophical discussion, learn some cutting-edge science or just find out a new recipe to throw into the dinner meal rotation. In short, they probably are not going to ruin their lives by dismissing blogs as nonsense to be ignored.

That's a dangerous attitude, though, for individuals in the public health realm. It might not be risky for them, personally, but it can have a rather insidious impact on society. In the movie, Krumwiede claims to have millions of "unique" visitors to his site every day. As Orac notes, his character is not dissimilar to Mike Adams, who has a popular web site with hundreds of thousands of followers and who has many a product to hawk from his online store. Public health officials who view blogs like his as trivial, believing that they have little impact, do their organizations and their mission of promoting public health great disservice.

There are certainly administrative sorts out there who think that when people have questions about health, they go to their doctors and actually listen to them. Certainly, that seems like common sense. You're sick; you go to the doctor; you listen to the doctor; you get better. That they might go online to find information and read (gasp!) blogs seems absurd to them. They seem to believe that handouts and fliers are an effective means of educating people about health topics. I'm not quite certain whether this attitude is born of luddism or from a sort of arrogance that assumes people listen to doctors because doctors "know best."

Suffice to say that while fliers and the like can reach some people, it is not particularly effective in the online age. A more sophisticated approach is called for, one that takes on the task of answering people's questions in new, innovative and multi-pronged ways. People are becoming more and more accustomed to turning to the internet and the wisdom of random strangers, personal stories and such to find the answers to what ails them. They want answers that are easy to find, easy to understand and reassure them that everything will be okay. Public health institutions need to meet their needs. Right now, people like Mike Adams and, to a much lesser degree, Age of Autism, have the edge on marketing their ideologies and, especially in the case of Adams, their products. Science- and reality-based information needs to be ready to hand in a manner that is easy to understand and satisfies the emotional aspects of patients' quests for answers. The goal shouldn't be to persuade the die-hard conspiracy theorists, but rather to reach people before they get to that point.

Sadly, there are individuals in public health who just don't get it and who will not move forward. As I said when discussing this topic with some friends recently, "a large organization, whether it be a university or a Federal government, technologically advances only as fast as the biggest luddite in management will allow." Officials will ignore such an insight to their peril and to the detriment of those they are supposed to serve.

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