The trouble with Dr Google

Things have been a bit tough of late, the bad economy is starting to bite, and you’re feeling the pressure. To top it all, your body has been acting strangely in ways it never has before. Your muscles twitch in funny areas for hours at a time, you tire easily, and you have fleeting pins and needles in your limbs. Over the weeks these symptoms have become worse. The last straw comes when you notice it is getting harder to swallow your food without thinking about it.

You do what any overworked but doctor-shy person does in a free moment — you consult Dr Google. He takes your request in a fraction of a second. You learn the muscle twitches are called fasciculations. You enter “muscle fasciculations, muscle fatigue and swallowing difficulty” into the Search window.

And Dr Google offers suggestions straight away. Every site on the long list brings confirmation. Some of them know exactly how you feel, and what your symptoms are. You have motor neuron disease at least, or perhaps, if you are lucky, multiple sclerosis. While the latter conjures up visions of being wheelchair bound at your kids’ weddings in a decade or so, eating your wedding cake by a tube, the former strikes terror into your heart. You read the median survival rate for motor neuron disease is between three and five years. Death comes by drowning in your own spit. Some people live longer. You read that Steven Hawking is one of the “lucky” ones. He has a brain to entertain himself, a job where he thinks all day, and all sorts of fancy machines to talk and stay alive. You have two young kids, a job that needs you to be healthy, a family, a spouse.

The diagnosis knocks you off your feet. Every day that passes your symptoms increase. Your appointment with a neurologist, pushed ahead of the normal waiting time by a worried family doctor, is still three weeks away. You cannot get to sleep at night. When you do, you wake in the early hours, sometimes due to the twitching of muscles in your legs, or in your face, or in your groin. You were stressed before the diagnosis, now your anxiety goes through the roof.

Your kids pick up that something is wrong, but there is a conspiracy of silence at home. No one else must know. The possibilities are not to be discussed until the diagnosis is confirmed. You begin to wish multiple sclerosis upon yourself rather than motor neuron disease. For three long weeks a sense of impending doom hangs over your household.

When the long dreaded but highly anticipated neurologist’s appointment finally arrives, the result is a dramatic shock. You are incredulous, disbelieving. “Anxiety?”

“That’s all?” you ask in shock. “But I feel so terrible!” Exactly. Anxiety does that to people. A wave of profound relief and feeling foolish washes over you. It takes a long time to convince yourself that your real, live, speaking, laughing neurologist is correct.

How could Dr Google be so wrong?

For a start, Dr Google does not know anything about you. He has not asked you any questions. You asked him, “What could cause such and such?” And he provided an answer. But this was not information tailored to your history, environment, and the socioeconomic and external pressures on you. The fine nuances of your symptoms, dissected and probed by your real neurologist suggested the most likely diagnosis during the history. Dr Google did not even examine you.

Dr Google does on occasion suggest correct diagnoses when asked the right questions — social media is full of these stories. But the stories like yours do not really reach the media, and so there is no real way of knowing how often Dr Google’s diagnoses are as wrong and as potentially damaging as yours was.

What should you do? For a start, from now on put your trust into real live doctors where you can as an initial step, with Dr Google as a reference after a diagnosis if you need one.

Could you sue Dr Google, as you would a live doctor, for wrong diagnosis, pain and suffering?

Good luck with that. Dr Google’s work address, to which you must have the court papers delivered, is not listed anywhere.

Even on Google.

This post first appeared on www.KevinMD.com, arguably America’s leading social media physician voice, in August 2011. It was one of the top ten posts for that year.