Here are all the answers

By Shevlin Sebastian| Express News Service | Published: 19th February 2019 09:40 PM

KOCHI:  ‘Manju, a 26-year-old IT professional working long hours in Kochi, developed a nagging pain in the centre of her chest. She didn’t have the time to consult a doctor, and so did what many people do in such situations - search the internet for a solution. Her Google search left her convinced that all of her symptoms pointed to terminal heart disease and that her days were numbered. 

She was no longer able to focus on her project, became irritable and frequently showed up for work tired from lack of sleep. She was already worried about how her dependents would cope with her absence.Alarmed at her change in demeanour, Manju’s colleagues took her to a doctor. After taking a detailed history including questions on her lifestyle, her doctor ordered a couple of blood tests and told her that she had acidity from irregular meal timings and excess consumption of cola. Within two weeks, Manju was back to her cheerful, healthy self.

Manju’s story is a typical case of ‘cyberchondria’, defined as the excessive use of internet health sites that fuel health anxiety. The difference between Google and doctor, in this case, was that while the internet provided Manju with a long list of the possible diagnoses, the doctor was able to dig out pertinent lifestyle clues from her history using medical knowledge, correlate with the past experience of similar patients, and arrive at a single diagnosis.’

This is an excerpt from the article, ‘Who is better: doctor or Google?’ from the book, ‘Think Like Your Doctor’. It has been written by the gastroenterologist, Dr Rajeev Jayadevan, the deputy medical director of Sunrise Hospital. The book, which has been published recently,  has been received well. The writing is simple and accessible, and the book makes for an easy read. 

It is a compilation of articles that Jayadevan had written for a vernacular online platform. The subjects include memory loss in old age, a user’s guide on painkillers, information overload, the truth about cooking oils, and first-aid tips. Meanwhile, in his job as a gastroenterologist, Jayadevan sees a lot of liver disease. And he is not surprised. Because a significant number of Malayali men are heavy drinkers. “About 50 percent of liver cirrhosis cases in Kerala are caused by drinking,” he says. “Many of them are unable to stop drinking because they are addicted.”   

And the amount of money and effort that goes into the treatment, it ends up devastating a family’s finances. “It is a self-inflicted blow,” he says. When he came to know that most had started drinking in their teens, he started going to schools and colleges to urge them to stay away from alcohol and drugs. This is what he tells the students: “I am not here to tell you what to do. I am here to give you precise information from my personal experience as a doctor about what happens when you drink too much or take drugs. Now you can look at this information and decide what you want to do.”

Through his interactions, Jayadevan discovered the astonishing fact that the average age when men start drinking is 13. “According to published data, 25% of our high school boys are using alcohol,” he says. “It is a major issue.” 

Another issue is the lack of exercise. Jayadevan knows of elite sportsmen in college, who once they finished their studies, stopped exercising, and became obese. “Their mothers want them to be fat,” he says. “Society, too, wants them to become fat. As a result, by the time they are 30, they have been diagnosed with diseases A, B, C and D. These used to be diagnosed earlier at 50 and 60.”

Another problem is that online users tend to believe everything that is published on the Internet. “There are articles which state that having garlic or ginger juice is good for health,” says Jayadevan. 
“It might sound plausible, but there is no hard evidence to prove it. People can be very gullible, but it can have devastating consequences.” 

Once, there was a widespread rumour that the juice from the bilimbi (chemeen pulli), which grows widely in Kerala, is good at reducing cholesterol. Many people put a large quantity in the blender, made a juice and drank it. Unfortunately, it was full of oxalate. “All the oxalate clogged the kidneys and it shut down irreversibly,” says Jayadevan. “Some were lucky to get a transplant, while others had to go into dialysis for the rest of their lives.”   

The Kochi-born Jayadevan did his MBBS and MD from Christian Medical College, Vellore, in 1995. He went on to study Clinical Epidemiology and Public Health at Erasmus University, Rotterdam, Netherlands. Later, he was awarded the MRCP  from the UK in 1996. He also obtained Medicine and Gastroenterology (Fellowship) from New York Medical College. Thereafter, he spent three years in the UK and 10 years in the US. As he wanted to take care of his ageing parents, he returned to Kochi ten years ago. Asked whether he likes his medical job or writing, Jayadevan smiles and says, “Both bring me joy.”

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