13 October 2017

Studying medicine at the university of Google


The pictures that meet my eyes are ghastly. Protrusions the size of raspberries on a sad-eyed german shepherd, pink nodules like little peas on the snout of an anxious state, an ulcerating lesion with lumpy bits on the nose of a salivating poodle.

It’s enough to make me feel very ill.

But not as ill as when I start reading the various differential diagnoses the helpful search engine also supplies me with. From the benign-sounding canine acne (who knew) and acral lick dermatitis, to the alarming sounding dracunculiasis, and the even worse-sounding brosarcoma.

I’m considering booking my dog in ASAP to the local vet, but only after trying some remedies suggested by the online community of dog lovers first.

I’m sure my dog is as relieved as I am when the lump disappears of its own accord within a week. Who knows why? Maybe spontaneously, or maybe because of the wolfsbane applied by the waning light of a gibbous moon, as suggested by the website: Dogs Lumps Anonymous. Or maybe it disappeared because it was being anxiously poked at by my concerned youngest child every night. Perhaps it decided to just give up and go away because it was sick of the jabbing fingers.

So why do I get so annoyed when patients front up after having had a symptom for two months – armed with an impressive wad of online research – only to look anxious when told their benign tumour is actually a malignant lesion?

These days, patients are not patients, they are “consumers”.  And they are consumers who are voracious for online advice, content and reams of information without context or relationship to their real conditions.

Yes, I will indeed be asked to write on the pathology request the demand for the MTHFR gene test, the homocysteine levels, and also serum rhubarb, as suggested by the patient’s online search. And all bulk billed, of course.

And did I know that the MTHFR variants, C67T and A1298C are profound causes of miscarriage, frequent viral illness, depression and also naughty children? And that the application of two hours of intense study on the internet, trawling www.crackpot.com.us and www.noRCT.net.uk will indeed find “facts” to substantiate absolutely anything?

And not to mention that old chestnut still making the rounds from www.shonkypseudoscience.com about the MMR causing autism. How I do love that one.

And if patients stupidly persist and take the advice from well-meaning health professionals and inflict the MMR on their child so that he or she develops the dreaded autism, www.makemeamillion.com.nk will tell me what I want to know in terms of curing it in just one IV treatment of stem cells.

But only if a substantial sum of moolah is handed over first, plus airfares for the whole family, no questions asked.

Desperation breeds frantic keyboard searches.

A family friend was diagnosed with pancreatic cancer at a young age. Her anxious friends found the cure-all on the internet. It was a wonderful freezing treatment, in China! Guaranteed to fix that pesky tumour with the application of freezing and thawing cycles and the judicious use of a rubber hose down the throat for good measure. Not one round of treatment, but three, necessitating the transport of an extremely unwell lady to China and back several times, vomiting all the way, in extreme pain, wasting time she could have spent with friends and family using available palliative care. All in vain.

The story did not end well. Except for the recipients in Hangzhou for the welcome influx of US dollars –  no renminbi, thank you – and only cold hard cash will do.

But now I see a flaky patch with no hair on the top of the dog’s scalp.

Where’s that search engine bookmark again for www.whatsthatdogrash.com?

Dr Dawn Oi is a GP in metropolitan Melbourne who hones her literary skills by writing referral letters all day