During a casual scroll through social media, I often hear the voice of my friend and fellow pediatrician warning, “Do not engage!”
Generally speaking, this is almost always the correct advice. The rise of various social media platforms, the ability to rapidly share information and disinformation, the growing culture of doing one’s own “research,” and the apparent difficulty in separating reputable from non-reputable sources online has created the perfect storm. In medicine, especially in my field of pediatrics, half-truths, and untruths can be incredibly dangerous. While my fellow physicians and I are on social media as moms, dads, daughters, sons, wives, husbands, sisters, brothers, friends, and neighbors—sharing milestones and soliciting advice about daycares, home décor, good eats, and the like—we have also taken an oath to do no harm. Our identity as physicians is inextricably linked to our identity as human beings. And while the line is clear in the office or hospital setting, where our patients come to us for our guidance and expertise, it is notably blurred outside of this environment.
From doting grandmothers sharing photos of adorable infants in unsafe sleep positions to the dangerous recommendation of a honey-infused pacifier for colic in a local mom’s group, the posts, comments, and documented behaviors that make our stomachs churn are not new. What is new since the COVID-19 pandemic is the sheer volume of fiction dressed up to look official and the disregard for evidence-based guidelines resulting in serious public health consequences.
Case in point: An acquaintance texts for advice about her child with symptoms of an upper respiratory infection; I outline the recommendations for isolation of the patient, quarantine of family members, and advise calling the child’s own pediatrician for further guidance and possible COVID testing. The next day, I see a social media post of the same child at a dinosaur-themed birthday party with no less than 20 children and a near-equal number of adults. When I text my acquaintance to follow up, she states that her son is acting fine and she believes this is “just a cold.” She did not call his pediatrician, nor has he been isolated. She goes on to say that her son would have been devastated if he had to miss his friend’s party, stressing that everyone was “socially distanced and masked.” The posted photos clearly depict otherwise. The use of those now well-known buzzwords simply does not forgive the reality of witnessed, unsafe behaviors during a pandemic that has claimed over 400,000 lives in the U.S. alone.
When physicians and scientists are vocal in situations such as these, the perception is often that they have over-stepped and the recipient’s gut reaction is “mind your own business.” For most of us, the impetus to push back against the deluge of misinformation is a matter of truth over fiction and protecting our family, friends, and neighbors as well as yours. In a culture of “you have your opinion and I have mine” and “I have done my own research” as a rebuttal to undeniable facts or data, what is lost is exactly what astrophysicist Ethan Siegel eloquently outlines in his article, ‘You must not “do your own research” when it comes to science.’ The beauty of a scientific fact is that it cannot be disputed. It simply is. To disagree with or reject it is to reject truth.
At the end of the day, my approach has been this: I will give evidence-based guidance when asked and limit unsolicited advice to times when there is risk of imminent danger. Still, that approach leaves plenty of scenarios in the gray zone: a child being placed in a forward-facing car seat when his age and size dictate that he should be rear-facing, an Instagram influencer advertising an unsafe sleep product for a newborn, a Facebook friend sharing an anti-vaccination website fraught with inaccuracies and countless other examples. To a pediatrician like me, what flashes before my eyes when I see these posts and observe these behaviors is preventable illness and injury. I think of the patients I have personally known, who have suffered or succumbed. And so the question remains, in this era of never-ending disinformation, to engage or not to engage?
Alpa Patel Shah is a pediatrician.
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