What the Internet Has Made Obsolete & Cool Health Care Hacks

When you are on the phone in a noisy environment, you probably cover your other ear to hear the phone better. Bad idea. This episode reveals a better way to help you hear someone in that situation. https://www.oklahoman.com/article/3206007/strange-but-true-improve-clarity-of-phone-calls It’s hard to imagine life without the Internet today – still we have lost a lot of things to the Internet. Maps, handwritten letters, the big thick rolodex, even our solitude has disappeared and given way to the digital age. Listen as my guest Pamela Paul reveals many of the ways the Internet has changed our lives and how we spend our time – some good, some not so good. Pamela is editor of The New York Times Book Review, host of their Book Review podcast and author of the book, 100 Things We’ve Lost to the Internet (https://amzn.to/3ob6M7m). I am sure you have experienced some medical symptoms and then looked them up online to better understand and perhaps diagnose and treat whatever was wrong. After all there is a lot of helpful health information online that could be useful to you. However, HOW you use that information is really important according to cardiologist Dr. Kapil Parakh author of the book Searching for Health: The Smart Way to Find Information Online (https://amzn.to/3CORNVP). Listen as he offers some great strategies to help you better use the online resources to help you stay healthy. Your ability to remember someone’s name when you meet them can be a self-fulfilling prophecy. In other words, if you think you are good with names, you probably are. Your belief plus a few other simple strategies can make you much better at remembering names. Listen and I’ll tell you what they are. Source: Scott Hagwood author of Memory Power (https://amzn.to/3H8xBl3). PLEASE SUPPORT OUR SPONSORS!!! INDEED: Get a $75 SPONSORED JOB CREDIT to get your jobs more visibility at https://Indeed.com/SOMETHING Support our show by saying you heard about Indeed on this podcast. Terms & conditions apply. SHOPIFY: Sign up for a $1 per-month trial period at https://Shopify.com/sysk . Go to SHOPIFY.com/sysk to grow your business – no matter what stage you’re in! MINT MOBILE: Cut your wireless bill to $15 a month at https://MintMobile.com/something! $45 upfront payment required (equivalent to $15/mo.). New customers on first 3 month plan only. Additional taxes, fees, & restrictions apply. HERS: Hers is changing women's healthcare by providing access to GLP-1 weekly injections with the same active ingredient as Ozempic and Wegovy, as well as oral medication kits. Start your free online visit today at https://forhers.com/sysk DELL: Dell Technologies’ Early Holiday Savings event is live and if you’ve been waiting for an AI-ready PC, this is their biggest sale of the year! Tech enthusiasts love this sale because it’s all the newest hits plus all the greatest hits all on sale at once. Shop Now at https://Dell.com/deals Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Mike Carruthers?

  If you listen to Something You Should Know regularly, you know we talk about sleep quite a bit here. And one of the things I've learned from those conversations is just how important a good night's sleep is. And I've always been someone who loves his sleep. So I was intrigued when I heard about Beam Dream. It's a delicious nighttime drink formulated to help you fall asleep faster, stay asleep, and wake up refreshed. It contains ingredients like reishi, magnesium, L-theanine, epigenin, and melatonin. They have lots of great flavors. I tried the cinnamon cocoa flavor, and I love the idea of having something warm and delicious as part of winding down at night.

• 0:45Mike Carruthers?

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• 1:29Mike Carruthers?

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• 1:41Mike Carruthers?

  Today on Something You Should Know, what most people do wrong when they're having trouble hearing someone on the telephone. Then, while the internet is great, it has rendered many things obsolete, like the home phone, maps, and the Rolodex.

• 1:56Speaker 01

  It's so interesting about the Rolodex because of what the Rolodex used to symbolize. It was a power thing. And what it symbolized is that idea of you are who you know. And now, you're not who you know. We all know everyone.

• 2:10Mike Carruthers?

  Also, a simple and effective way to remember names when you meet someone. And the best ways to use the modern healthcare system to your advantage.

• 2:20Speaker 02

  Many insurance companies, for example, and even doctor's offices have triage lines where you can just speak to a nurse who can walk you through what's going on. There's options for a telemedicine visit and you could have somebody over a video call talk you through whatever you're dealing with.

• 2:35Mike Carruthers?

  All this today on Something You Should Know.

• 2:39Mike Carruthers?

  I imagine most of us shop for clothes online, at least some of the time. And there's always that little mystery. Is what shows up at your door actually going to look like what you think you ordered? We've all had that experience. I know my wife has ordered dresses that look beautiful in the pictures, but when they arrived, eh, not so beautiful. Cheap looking, disappointing. And that's one of the reasons we've become such big fans of Quince. When we order from Quince, we are confident we're going to get something really nice. The quality is consistently good and the prices are surprisingly reasonable.

• 3:19Mike Carruthers?

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• 3:59Mike Carruthers?

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• 4:22Speaker 03

  Something you should know. Fascinating intel. The world's top experts. And practical advice you can use in your life. Today. Something you should know. With Mike Carruthers.

• 4:35Mike Carruthers?

  That's me. Welcome to Something You Should Know. There's something I bet you've done, I know I've done. You see people do this all the time. And that is, you're talking on the phone in a noisy environment. And so, in order to hear the person on the other end of the call better, you cover your other ear. Or you put your finger in your other ear to block out the noise. Which seems to make sense, but it doesn't really help, as it turns out. The reason it's hard to hear is because that ambient noise around you is going into your mouthpiece and coming back out in your ear that's held up to the phone. And it's mixed in with the other person's voice on the other end of the call.

• 5:20Mike Carruthers?

  And that's why it's so difficult to hear what the other person is saying. So you're much better off muting the phone, or covering the mouthpiece of the phone while the other person is talking and you're listening. You'll be able to understand what the other person is saying much better than sticking your finger in your other ear. And that is something you should know.

• 5:45Mike Carruthers?

  Think about all the things the internet has done for you. What it allows you to do that you could never do before. It's truly remarkable. You can look up anything. You can send a message to anyone. You can play games. You can work. You can talk. You can share. On and on and on. On the other hand, there are many things the internet has taken away from us. The encyclopedia, the Rolodex, the kitchen phone. Even the ability to disconnect from the world. It's something Pamela Paul has taken a fascinating look at. Pamela is the editor of the New York Times Book Review. She's also host of the New York Times Book Review podcast, and she's author of the book,

• 6:29Mike Carruthers?

  100 Things We've Lost to the Internet. Hi Pamela, welcome.

• 6:33Speaker 01

  Thanks for having me.

• 6:34Mike Carruthers?

  So why do you think this is important to discuss? What the Internet has taken away? I mean, it could seem that you're just kind of pining for the good old days before the Internet, but the Internet has given us so much. Why focus on what it's taken away?

• 6:51Speaker 01

  Well, it's hard not to think about the Internet all the time because it infuses our lives in every way. But I think that when we do think about the Internet, we're often in forward motion, right? We're like, wait, what is this new thing? How does this new thing work? You know, does everybody else have this new thing? Should I download that app? Should I check out that website? I think what we do less frequently is kind of pause and say, wait a minute. What did I do before I split the check with Zelle with all my friends? Like, how did we do this? What was the method? How did I know what was even in my bank account before I could just go online and check my account?

• 7:32Speaker 01

  So I wanted to pause and rewind a second and kind of just stay in that place and figure out, like, what is it that we used to do?

• 7:44Mike Carruthers?

  Something that the Internet has replaced that we used to do, and it's hard to imagine we used to do this, is like, let's say you and I go to the mall together and you go your way and I go my way because we want to look at different things. Well, how do we meet up? How do we meet up later to go home? And, you know, now we just text, okay, I'm done, I'm over at the food court, meet me there. But before, you had to be very precise. I'll meet you at, you know, 9:30 in the food court and we'll go home then.

• 8:19Speaker 01

  All of that is gone. And it's interesting that you talk about like, well, how did people like meet up at Disneyland? Or like if one person was going on the line to get the tickets, like, how did they communicate that to the person who thinks they're meeting, you know, at the front of the theater, whatever it might be? Like somehow, we all got by. And yet, it's incomprehensible to us. I mean, one example, which I think is really interesting, when parents talk about why and when they allow their children to get their own phone. The reason, the thing that breaks them is, well, my kid is now commuting or going to school on his own. And so I want to be able to reach him or her.

• 9:02Speaker 01

  I want to know where she or he is. I want to be able to say, like, hey, guess what? The piano teacher canceled. You don't have to come home for your lesson, or whatever it is. And the fact, the idea that you might not be able to communicate with your child at that point is so incomprehensible to so many of us parents, that it's frightening. It's frightening to think, like, someone might not be able to get in touch with me at any moment.

• 9:32Mike Carruthers?

  Another thing that I don't like about the internet, that it has taken away from everybody, is the ability really to get away, to, you know, go away for the weekend, or go on a vacation, or just go away for a couple of hours, and nobody knows where you are. You're just gone. That sense of solitude is always, you're always being nagged, you know, what am I missing? Who's texting me now? And it's really hard to have that.

• 10:01Speaker 01

  And it's hard on both ends, right? And so it's hard for you, the person who's trying to flee, you know, the world. And it's Really hard for the outside world to disconnect with you. Like, the idea of being unreachable is now essentially a slap in the face. Like, no one is ever unreachable. And it's interesting, you know, when you watch movies or TV shows and everything is built around the idea that either you can reach someone at any given moment, and the only reason why you can't is if they ignore you, you know, and they dismiss the phone call. But here's the other part of it, which is that even if you do disconnect, even if you

• 10:44Speaker 01

  are some superhuman and you're like, you know what, just not gonna turn my phone on, or maybe I'm even going to leave it at home. The problem is, you still know it's there. You know, you still know there are lots of people reaching you. They're just hitting like a wall of silence. And that knowledge just affects that idea of getting away that we all miss.

• 11:08Mike Carruthers?

  Related to that, and it's the first thing in your book, is boredom. And I'm fascinated by this, that anytime anybody feels bored, they just go pick up their phone and either play a game, or send an email, or send a text, or whatever. Nobody's just allowed to sit and be still, because nobody thinks that that's a good thing, that you've got to fill up every moment with something. And if there's nothing, there's always the internet.

• 11:34Speaker 01

  Right. And the internet is everything. The internet is diversion, it's entertainment, it's information. And the truth is, the reason why boredom is, I mean, boredom is boring. You know, it's not all great. But the reason boredom is important, or experiencing that emptiness, is that you have to stop all of the input in order to generate output. You need those empty moments in order to come up with ideas of your own, in order to be creative. And I, you know, there's a reason why you might come up with ideas when either you're driving, like on a long highway, and it's not that exciting, or you're in the shower, and you pretty much know how to clean yourself by now, so your mind can wander. That's because there's nothing else coming in.

• 12:20Speaker 01

  There's no new exciting information, so you come up with ideas. And we used to have those moments far more frequently when we were in the backseat of the car, for example. But now, what we do during those empty moments, and I'm as guilty as anyone, is like, you're like, "Oh, I have 12 minutes to wait for the next train. I am going to play Spelling Bee and get, you know, Queen Bee status, or I am going to read all the headlines in the news, or I'm going to listen to that podcast. I'm going to go to the next chapter in the audiobook I'm playing. I'm going to rise to level five in whatever game that I'm into. I am going to check my Facebook slash Twitter slash Instagram slash Snapchat." We essentially use up all of our time.

• 13:04Speaker 01

  And the time that goes unused, it almost feels, at this point again, like a kind of dereliction. Like, what am I doing with, you know, with myself if I'm not doing something?

• 13:17Mike Carruthers?

  One thing that the internet doesn't seem to have taken away like you think it should is books. There is some resistance to reading. And for me, I mean, I would much rather read a real book than to read an ebook. And, you know, plenty of people read ebooks, but there does seem to be some resistance, that people still like books.

• 13:42Speaker 01

  People do like books. You know, look, just like video didn't kill the radio star, ebooks did not kill the print book. It's really nice to hold that object in your hand. It's really nice to be able to collect a book. It's nice to flip through a book. You know, there are advantages for some readers of reading on a device, and those advantages are not insignificant. Like, for people who have vision problems, you can enlarge the type. And then for people who might have other learning challenges, it's sometimes much easier to listen to a book online, you know, via Audible or whatever it might be, or to have a visually enhanced text. So like, there are definitely pluses.

• 14:26Speaker 01

  But for me, and I think for a lot of people, it's that Sort of tangible tactile experience of turning the pages. It's being able to flip and say, wait, how many, how many pages left in this chapter? You know, it's looking at illustrations. It's checking out the index. It's looking at the inside flap.

• 14:49Mike Carruthers?

  Yeah, it's, it's being able to hold a real, physical thing. And something else that you mentioned that, that I haven't thought about until I saw it in your book is the Rolodex. And I imagine you can still buy a Rolodex, but I don't know anybody that would use it. But there was something about having a Rolodex and it was like, you know, if you had a lot of cards in it with names and phone numbers on it, that that was, that was real cool.

• 15:17Speaker 01

  It's so interesting about the Rolodex because, you know, it's a couple of things. One is obviously it's, it's an actual physical item, right? And I have one on my desk too. And it's like covered in dust. I mean, I haven't stuck a card in there in years and yet I can't bring myself to throw it away. So there's the physical thing. And then there's just the idea of what the Rolodex used to symbolize. It was a power thing. If you went into like the office of, say, a big Hollywood agent or a senior vice president at an investment bank, there might not be just one Rolodex, but like three Rolodexes. You know, and there were those different kinds. You had the actual like flip old fashioned circular Rolodex. And then you had the ones that were like the long rectangular Rolodexes that lay flat.

• 16:00Speaker 01

  And what it symbolized is that idea of you are who you know. And now you're not who you know. We all know everyone. If you want to be connected to Beyonce, by all means, you go and follow her. We can all be linked to someone. We can be quote unquote, their friend with a certain amount of ease, or at the very least, one of their followers. It's just not that big a deal to know anyone anymore. In fact, now it's harder not to know someone. One of the ways in which this manifests during my day to day work life is as an, as the editor of the New York Times Book Review is that we're trying to assign books ideally to be reviewed by people who don't. Don't know the author.

• 16:42Speaker 01

  And, you know, back in the day, in the before times, that used to be something really simple. You'd be like, "Do you know the author?" "No, never met him." But now, they might say, "Well, I don't know the author of that book, but we're Facebook friends, but I've never met her." Or, "I've noticed that we have 157 connections in common on LinkedIn, but I don't think I've ever met her." Or, "We once texted, but it was a group text and it wasn't direct." So what does it really mean to know someone anymore?

• 17:13Mike Carruthers?

  We're discussing all the things we've lost to the Internet and why it's important to discuss them. My guest is Pamela Paul. She is author of the book, 100 Things We've Lost to the Internet. Well, here's something you should know about your bones. We all hear about calcium and vitamin D, and they're important, but there's another ingredient in healthy bones that hardly anybody talks about: collagen. Think of your bones like a building, right? Collagen provides the framework, while minerals like calcium help give it strength. Here's the problem, though. As we get older, our bodies naturally produce less collagen. That's why I was interested in Native Path Bone Health Collagen.

• 17:58Mike Carruthers?

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• 18:41Mike Carruthers?

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• 19:08Mike Carruthers?

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• 19:50Mike Carruthers?

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• 20:34Mike Carruthers?

  So Pamela, one of the things you talk about is you say we've lost humility to the internet. So what do you mean by that?

• 20:42Speaker 01

  Well, look, the internet encourages us to kind of strut, to like show our plumes and our feathers and to say like, "Look at my kid. Oh wow, I just did this. Look at how many friends I have. Look at all my connections. Let me tell you about my latest job promotion." And one thing we know also is that on social media, people respond best to faces, to photographs of other people as opposed to objects. So that really also encourages the idea of selfies and sort of constantly photographing yourself and documenting yourself.

• 21:19Speaker 01

  In a way, it turns us all into reality TV stars. Like, we're all kind of lightly performing. And again, I don't think it's that we're all jerks or show-offs, but it does kind of reward that behavior. And the other interesting part of that, we're also all kind of celebrities too. And what I mean by that, it's not the fun way. It's not like the rich and famous and powerful way. It's the downside of celebrity way, which means that anyone can say anything about us at any time, and we basically can't control it. And we can be seen by anyone at any time, and we can be talked about by anyone at any time.

• 22:01Speaker 01

  And something that we do can go viral and be commented endlessly on YouTube, and we don't, you know, have any control over that. You're not in control of the fact that everyone else is photographing you, is commenting on you, is turning you, videotaping you, turning you into some kind of meme. I mean, it's interesting. I was talking to a friend, and she has a family relative who suffers from mental illness. And this person is posting about my friend online, and posting photographs and telling stories about her that are not true. There's really not a lot you can do about that in this country. And that's kind of frightening. It feels like you're out of control.

• 22:45Speaker 01

  Well, that's the downside of celebrity. That's what celebrities have always had. You know, they've had stalkers and people who say untrue things and write rumors and, you know, print terrible stories about them in tabloids. It's kind of turned us all into celebrities as well. So that's not the humility part of it, but that's just kind of another extension of the fact that we are all observing and being observed and commenting about one another at all times.

• 23:13Mike Carruthers?

  One of the interesting things is, this is particularly interesting to me because I have this useless ability to remember phone numbers. And You used to have to remember people's phone numbers. I could, I used to have friends and my grandmother and everybody's phone number I could remember. Nobody remembers phone numbers anymore because there's no need for it. And I bet it would be hard for people. It's just, I think it's a skill probably that you have to practice to do.

• 23:44Speaker 01

  Oh, for sure. I mean, I can tell you my phone number growing up, 944-7091. My best friend was 944-6327. I don't know what my daughter's phone number is. I mean, you could put a gun to my head and say, "Call her." And if I didn't have her name, you know, on Saved in My Favorites and, you know, could just click there or Ask Siri, I would not be able to reach her.

• 24:06Mike Carruthers?

  And also, and this is another one in your list, the kitchen phone. We used to have a kitchen phone. And that was like, that was like the place. I mean, everybody talked on the kitchen phone. Now, nobody talks in front of anybody else.

• 24:20Speaker 01

  Yeah, the kitchen phone was the portal to the house. That was the only way that anyone could get in without walking through the front door. And for someone to get in and to go through that portal, there was often a gatekeeper. So if someone was trying to reach your brother, maybe you or your mom would pick up the phone and you'd say, "Who's calling?" And now you knew. And you knew how long they talked for, and maybe you could listen in to have the conversation. And all of that is lost, you know? It used to be that you had the kitchen phone, right? And it had that long coil, like, and that coil would always end up kind of twisted and going in the wrong direction. And once it like had sort of gone the wrong turn, you could never get it back. Do you remember that?

• 25:05Speaker 01

  Like, you'd spend that time playing with that coil while you were on the phone, trying to untwist it to get it to go right again.

• 25:12Mike Carruthers?

  Yeah, you used to have that. Remember, you used to have to hang it, like, stand on a chair and hold it way up high so it would unwind itself.

• 25:19Speaker 01

  Totally, totally. Periodically, you had to kind of let it go and then let it like, and like, uncurl. And that was really fun. I also remember chewing on it, which is, I'm sure, really dangerous and toxic.

• 25:30Mike Carruthers?

  Well, I asked you this at the very beginning, and I'm gonna bring it up again. Because here we are joking about the kitchen phone and unwinding the cord and remembering all this very nostalgically. But what's the point of that? I mean, those things are gone. They're gone. So let's move on.

• 25:48Speaker 01

  Well, I would say a few things. First of all, absolutely. It's not all bad that these things are lost. Some of these things that are lost are good and bad. For one example of that is, you know, being the only one. So being the only one, that could be a good thing. That could be a bad thing. But on the internet, you're never the only one. You can always find out. Like, let's say your really cool, original hobby is taking old, like, soda bottles and water bottles and constructing enormous sculptures of birds out of them and photographing them in these beautiful landscapes. And you think, I am the only one on the planet who does this. But you go online, and chances are, you'll find dozens of people who do the same weird craft or hobby that you do.

• 26:33Speaker 01

  And not only that, but they've been doing it for longer, and they do it much better than you ever did. If you have a child, and he's born with a rare genetic disorder, and in the old days, it would be really impossible to find other people to talk to about what that experience was like, to give each other recommendations for treatments and doctors. Now, you can immediately find a community of people online who you can commiserate with and exchange information with, and that's amazing. So I'm not saying that all of this is terrible and that all of it is negative. Like, some of it is pretty good.

• 27:10Mike Carruthers?

  You know, and some of it is pining for the... Because like, one of the things you talk about is the, you know, record albums. But the fact is, record albums sucked. I mean, they scratched, they warped, they were terrible, they would sound crappy, and even CDs would skip. And, you know, yeah, I kinda miss them, but I don't really miss them.

• 27:30Speaker 01

  Ah, see, okay, I agree with everything you said, but I also like just the smell of that record and like and the and the just the fun thing of like putting the needle onto, you know, placing that needle. Like, I do remember when they all then became automatic and then it was like that was a very fancy thing to have a stereo where the needle kind of automatically landed in the right place. But so I do miss aspects of records. And what I miss, again, beyond the physical thing, is maybe just the patience of listening to the full side of an album and not skipping ahead, not immediately, you know, replaying something because you didn't want to have to get up off the sofa and like move that

• 28:11Speaker 01

  needle back, but just allowing for the experience of how the artist and the producer decided the order of the songs, the way in which they wanted to have you hear it and listening to it. And remember, like, the idea that you would invite friends over or your girlfriend or whatever it might be, and just to listen to records or to listen to a new album. So that part I kind of miss.

• 28:35Mike Carruthers?

  Yeah, when you think about it, and as we've been discussing here, there are so many things that have disappeared really very quickly, and all because of one thing, one thing being the Internet. I guess that's what makes this so fascinating. Pamela Paul has been my guest. She is the editor of the New York Times Book Review, and she is author of the book, One Hundred Things We've Lost to the Internet. There's a link to that book at Amazon in the show notes. Thanks, Pamela.

• 29:04Speaker 01

  Thank you so much, Mike. It's been really fun.

• 29:07Mike Carruthers?

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• 30:32Mike Carruthers?

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• 31:16Mike Carruthers?

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• 32:03Mike Carruthers?

  I bet whenever you have a question or a concern about some health or medical problem or some symptom you're having, you head to the internet to see if you can find out what it is and what to do about it, or if you should go see the doctor. And there certainly is a lot of information on just about any health-related topic you can imagine, online. But some of the information may not be so accurate, some of it seems conflicting with other information, you may see something online that sort of sounds like what you have, but not really what you have. So what you do with all that information you uncover online really matters, according

• 32:45Mike Carruthers?

  to cardiologist Dr. Kapil Parakh, who is author of the book Searching for Health: The Smart Way to Find Information Online and Put It to Use. Hi, doctor, welcome to Something You Should Know.

• 32:58Speaker 02

  Hey, thanks so much for having me.

• 33:00Mike Carruthers?

  So what's your sense of how people use the internet to get health-related information and what they do with it? What's your sense of the lay of the land?

• 33:10Speaker 02

  In terms of overall, like, search patterns, health-related searches make anywhere from 5% to 7% of all internet searches. And if you look at the studies around this, it's hard to quantify exactly how much, but what you find is, some percentage of people are actually able to use it effectively. Some people have better numeracy or health literacy than others and are able to use that information to advocate for themselves. But many others either get misdirected, or confused, or, in the worst-case scenario, they sort of end up making a decision that's potentially harmful to them.

• 33:46Mike Carruthers?

  Do you sense that people use the internet to diagnose themselves, as opposed to gather information so maybe they can discuss it with their doctor? Or are they using the internet to replace their doctor to self diagnose?

• 34:01Speaker 02

  Yeah, my sense is that, you know, oftentimes people are actually just trying to make decisions. And and the decision is often in the frame of what you said, which is, do I need to go see a doctor? Is this serious? Do I have to go right now? Can I wait a week? Can I try something at home till I feel better? You know, what does this involve? And people use the internet at all stages of their health journey, not just when they have symptoms. So, you know, there are studies that show that people use the internet before going to the doctors, during the doctor's visit, like even the waiting room, or sometimes right even in the in the office, and then after the visit. So not only do people try and make sense of their symptoms,

• 34:43Speaker 02

  but they also try to make sense of the information that they get at the doctor's office and kind of what their condition means and how to deal with it.

• 34:51Mike Carruthers?

  Well, I think everyone everyone has heard the caution that you can't believe everything you see on the internet. And that certainly pertains to health information as well. Do you think that is a big problem, that there is a lot of misinformation on the internet? And that by people having misinformation, that's causing problems?

• 35:13Speaker 02

  It is a fair statement. I think that the challenge is you don't want to throw the baby out with the bathwater. So on the on the one hand, completely agree, not everything online is reliable and you can trust it all for sure. But there is a lot of reliable information online. And I think one of the challenges is that most most people don't have the frameworks to understand how to use it. So let's take your example of you're searching for a symptom to begin with. So when most people search for things online, they're typically looking for one answer. You need to go to a restaurant for dinner. So you look at different types of cuisine, location, maybe price. But then you end up on one one place to go.

• 35:54Speaker 02

  Right? Most doctors actually aren't looking for one answer to explain your symptoms. What we work off is something called a differential diagnosis, which is a list of possibilities of what it could be. You came in with a sniffles, most likely you have allergies, but it could be the flu, it could be COVID, and that little list is my differential diagnosis. And the way I then manage this differential diagnosis is to tackle not just the top most likely thing, which could be like allergies, but the most dangerous thing, which would be something like COVID, and make sure I test for it. So this is just a different framework that physicians use. And by providing these kinds of frameworks, I'm hoping that the book helps people

• 36:38Speaker 02

  understand how to process that information in a way that's closer to how physicians process the information and hopefully empowers them to make health decisions better.

• 36:48Mike Carruthers?

  You know how I often use the internet? And I bet a lot of other people do this, which is in contrast to what you just described, which is a much better way. And that is, I look for information that sounds right. Oh yeah, that's the thing I've got, or that's the symptom I have. And that's where I stop. I mean, I look at that and I go, okay, well, there it is. It's right there, so I'm done. So what does it say to do? And I do that, and I guess that's a problem.

• 37:18Speaker 02

  That's exactly one of the things we advise, right? So one of the key questions we recommend people ask is, what else could it be? And that's not just something, you know, to tell people like yourself, but actually, that's something that medical students are taught. I still remember when I was taught as a resident, you know, I was pretty sure I knew what the diagnosis was, and my mentor stopped me for a second and he said, "That's great. You've got, you think you've got the diagnosis. Now put that aside and start over and think, what else could it be? And then, and then come up with your list of possibilities." There's a term for this, which is, it's called "closing the diagnostic funnel too early." And it's actually a cause of misdiagnoses in medicine.

• 38:01Speaker 02

  And so, you know, this little tool that, you know, of asking what else could it be, could be useful not just to doctors, but also to the lay public.

• 38:11Mike Carruthers?

  Yeah, well, I've heard that advice. To use when you go to the doctor, when the doctor said, "You have a cold," you could say, "Yeah, well, what else could it be?" And ask him to reconsider. Because I suspect often in the doctor's office, you know, you guys are in a hurry. You gotta move to the next patient and you're gonna rush just as likely as I am.

• 38:34Speaker 02

  Absolutely. And that's one of the key things. How do you make use of that doctor's visit effectively? Now, if you come in saying, "Doc, I read this online. I'm pretty sure I have this and I think I need XYZ medicine." It's very hard for the clinician to then try and collaborate with you on that because you've sort of got your mind made up on not just what you have, but what you need. And they sort of have to spend some time first walking you back of, "Okay, well, what is it that you have? What are your symptoms?" And then finally figuring out what's going on. And that takes actually more time and is a relatively inefficient way to do it. Instead, what we recommend is doing some of the doctor's work ahead of time for them. Summarize your symptoms, summarize kind of using the same frameworks that doctors use.

• 39:18Speaker 02

  And then they can quickly look through that and that speeds up their time for data gathering. And then let them do their job and process all the information that you've given them and see if they agree with you or not. And if they don't, they'll let you know. And if they do, then that's great. You've helped them, you know, move things along. But I think there's ways, simple ways that we could, you know, just change that interaction so that it's much more collaborative. And in the end, you know, everyone wants the patient to get better, including the doctor. So it's a win-win all around.

• 39:48Mike Carruthers?

  So a lot of things people look up on the internet. It's not to prepare for a doctor visit because it hasn't risen to that level. It's not necessary to go to the doctor. It's just, "I kind of want to know what this thing is on my arm and maybe I should put some goo on it." And I'm not gonna go to make a doctor's appointment for it. For one thing, by the time I get an appointment, it'll be gone anyway. So not much point in that. So I just want to know what it is. If you then go to like a reliable, what's considered reliable, WebMD kind of website, are you pretty safe? Is that not a bad way to go?

• 40:29Speaker 02

  I think it's perfectly reasonable. I think what, you know, if you, especially if you stick with the sort of more reliable websites, and we sort of list them out as, you know, authoritative websites like the CDC or the NIH or things like that, but also like hospital websites like NeoClinic, and, you know, certainly places like that, you can take a look. I think, once you do and you come up with your list of possibilities, look through that list and see, is this just, you know, a pimple that I don't have to worry about, or is this a mole, for example, and I have a history of cancer in my family and I should think about, you know, why is this new mole here, and actually follow up with your primary care doctor. The other thing that we mentioned is that it isn't just a

• 41:12Speaker 02

  doctor that can help you, right? So nowadays, there are many other options. So, many insurance companies, for example, and even doctors' offices have triage lines, where you can just speak to a nurse, who can walk you through what's going on. There's options for a telemedicine visit, and you could have somebody over, you know, a video call, talk you through whatever you're dealing with. So I think it's one of those things where if it is likely to be something that's not too serious, and you want to try and manage it at home, that's fine. I think it's, you know, make sure you ask yourself, what else could it be? What are the red flags in this situation that I should be looking out for based on what I've read, so that if these things happen, then I'll escalate this to the next level.

• 41:54Mike Carruthers?

  And what about medications? Because now, and I know I've heard other doctors talk about how they're not real thrilled with the idea that a lot of pharmaceutical companies are marketing direct to consumer, because then the consumer shows up at the doctor's office and says, "Well, I saw this ad for this medication, sounds like it's for me", and it may or may not be, but, but, as you were talking about earlier, the patient's mind is already made up.

• 42:19Speaker 02

  Yeah, no, that's a great point. And I think when I first saw one of these ads, the thing that came to my mind was, nobody comes to my office saying, "Doctor, doctor, the American Heart Association recommends every patient with a heart attack should have an aspirin, and I'm not on one," right? And that's the, that's the conversation we should be having and not with some ad you saw on television. Each disease often has a professional society guideline on what the professional recommendations are for that disease. Think of it as a cheat sheet. So if, if you were coaching a little league baseball team, and you had access to a document where all the, the Major League Baseball coaches had put down their best tips and tricks

• 43:01Speaker 02

  in, in one place on how to, you know, coach baseball, and you had access to that, think how useful that could be in, you know, as you're trying to help out your own little team. So what happens for each disease is the best minds in the country, and sometimes around the world, will get together and write down how they think that disease should be treated. And if you skim these documents, you can quickly pick up that these are the main recommendations, the top line stuff, as it were. And I think that's the sort of conversation to have with your doctor. You say, "Look, I, I came across this when reading and in the guidelines, and it seems like it's, it's relevant for me. What do you think?" It turns out that if you do studies in the US, depending on the condition, 20 to 40% of people, for one reason or another,

• 43:43Speaker 02

  are not on all the guideline recommended treatments. And so I think this is the sort of thing where being a little proactive can actually result in something that could help you manage your disease better.

• 43:55Mike Carruthers?

  So say that statistic again.

• 43:57Speaker 02

  Depending on the condition, about 20 to 40% of people are not on guideline recommended therapies for their condition.

• 44:06Mike Carruthers?

  Why?

• 44:07Speaker 02

  It's a number of reasons. Sometimes it's just error, like human error, forgot to do it. Sometimes it's miscommunication, went to the hospital, stopped this medication, someone forgot to restart it when you were back to normal. Some of it is truly that people have allergies or had side effects, et cetera, because the research, it's hard to parse everything out. But oftentimes, it's just been overlooked.

• 44:33Mike Carruthers?

  So I wonder how this plays into all of this. Before the internet, before information was available on the internet, you'd notice something, or you'd have a symptom, and you'd kind of, you had really no place to go to figure it out without going to the doctor. So you just kind of blew it off, and it went away, and life went on, and, you know, the sun came up the next day, and everything was fine. But now that all that information is available, I wonder how many people get all worked up about little things that they probably don't need to, because they have the access to the information to see what it could be.

• 45:13Speaker 02

  There's sort of two extremes that we can talk about. So on one end of it is a condition called cyberchondria, which is sort of cyber for internet, and the chondria coming from hypochondria. And so, you know, if somebody has a tendency to be a hypochondriac, and now they have all this information online, they definitely can get freaked out by it. We actually used to see this phenomenon in medical students a lot. And as a medical student, you read about all these crazy diseases, and then you have a mundane symptom, and you get convinced, "Oh, wait, I read about this disease, maybe it could be this", and you sort of get all worked up about it. And now thanks to the internet, many people can experience that. So there's certainly that part of it. I think there's also a different aspect to that, though,

• 45:58Speaker 02

  which is, if you just search for, you know, "The internet saved my life" or something like that, you'll find a lot of stories of people who were, you know, not concerned about a symptom, but happened to look it up online and found that it was a, you know, oftentimes, for example, women, heart attacks present differently, or when you get blood clots in the legs, it can go to the lungs, it can be quite dangerous. And people look that up, and then realize, "Wait a second, this, this might not be something that I wait for the sun to come up on", and actually seek help. So you certainly see both ends of the spectrum, where the internet does help some people, and we want to increase that. And then, and then where it does cause harm, we want to try and help reduce that.

• 46:41Speaker 02

  And there's some strategies we've put in to help with that part of it, too.

• 46:44Mike Carruthers?

  And those strategies include things like?

• 46:47Speaker 02

  One simple thing you could do is just write it down ahead of time. So if you think about symptoms, human memory is not very good. It's malleable in terms of thinking about symptoms. So let's say you had a discomfort in your back and then you start reading stuff online. You're like, wow, if you have back pain and chest pain, and you start thinking, wait a second, I might have had that twinge in my chest too the other day. And you can actually talk yourself into whatever scary thing you're reading about. So one thing we recommend is just write it down ahead of time before you even start searching and describe it in some level of detail. And then you go online and you try and match your description to what you're reading. And if you didn't write it down, it probably wasn't there.

• 47:30Speaker 02

  And you're trying to like stretch to fit whatever you're reading. And that helps create a little bit of a distance between sort of the symptoms you feel and the stuff you're reading so that you can be a little bit more objective about it.

• 47:44Mike Carruthers?

  What else?

• 47:45Speaker 02

  We also look at what we call epidemiology, which is the distribution of disease. So if you're a 40-year-old man and it turns out that the condition is actually much more prevalent in 70-year-old women, then you know, it's probably unlikely that you have that condition. So trying to understand not just the pattern of the symptoms, but also the kinds of people that are affected by it could help you sort through whether it's more likely or less that you have it.

• 48:12Mike Carruthers?

  Are there things on the internet that to get away from disease and illness, but more about health that you think are worthy of people's attention that will help them stay healthy, not just treat disease? But are there tools, are there things online that you think are really good for that?

• 48:32Speaker 02

  Even more than what you find online, we're seeing an explosion of apps and wearables and other services that are helping people stay healthy. You know, we're in the middle of a revolution, I think. We're just learning how these work and how they can help people in their health journeys. But certainly. I'll give you a simple example. The World Health Organization and the American Heart Association all recommend increasing physical activity. And the problem is, when they make these recommendations, some of which are about 700 pages long, the guidelines are so complicated that most people don't have an easy way of understanding what that actually means in daily life.

• 49:17Speaker 02

  And you can download apps that actually just track your activity levels and translate these guidelines into, you know, other metrics that people can understand readily. And I think that's the sort of thing where by taking good science and turning it into something that's super accessible and consumer-friendly, we can actually help people stay healthier and prevent disease even before it starts.

• 49:42Mike Carruthers?

  Well, given that all that medical and health information is available online, it's really good to get some guidelines and some advice on how to use that information to improve your own health. Dr. Kapil Parakh has been my guest. He is a cardiologist and author of the book Searching for Health: The Smart Way to Find Information Online and Put It to Use. And there's a link to that book in the show notes. Thank you, doctor. Thanks for coming on.

• 50:09Speaker 02

  Okay, fantastic. Really appreciate you having me.

• 50:16Mike Carruthers?

  As we move deeper into the holiday season, you will no doubt be socializing more, maybe going to parties, meeting new people. And the question is, how good are you at remembering names when you meet those people? A lot of people claim they're not too good at remembering names. I think I fall into that group. And according to memory expert Scott Hagwood, there are two big reasons why, and both of them can be overcome. First of all, when you say you're no good at remembering names, that self-talk reinforces the belief, so you just don't try. Start telling yourself you are good at remembering names, and you will automatically get better.

• 51:01Mike Carruthers?

  And we don't remember a person's name when they tell us because we are paying attention. Usually, we're thinking about what we're going to say next. You can only think about one thing at a time, so the person's name never gets into your head. But if you really focus and pay attention, you will remember the name, especially if you tell yourself you're good at remembering names. And that is something you should know. Seeing how you like this podcast, there are probably like-minded people in your life who would also like this podcast. So tell one, two, maybe three of them to give a listen. I'm Mike Herrothers. Thanks for listening today to Something You Should Know.

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