赛博疑病症：信息过载带来的医疗焦虑
我们都有过这样的经历：在网上搜索自己可能患有的症状。也许是皮肤上的痣、咳嗽，或者是头痛。但十分钟后会发生什么？我们对自己可能患有什么病并没有变得更清晰，反而更加困惑和担忧。我们都在谈论快乐，但当我们为了健康问题而在网上搜索，并面临这些挑战时，我们又怎能拥有快乐呢？每天有高达**十亿（A billion）**次关于健康的搜索，而且这个数字还在上升。我曾担任 WebMD 的首席医疗官。在 WebMD，座右铭是“更好的信息带来更好的健康”。作为一名医生，我坚信这一点：我希望你变得见多识广，希望你获得赋能。但面临的挑战是，信息并不等同于知识。还记得 TMI（Too much information: 信息过载）这个词吗？现在人们还这么说吗？通常我们会用来形容什么？我们会用来形容某人给了你太多个人信息，让你感到尴尬，甚至有点焦虑。然而，TMI 同样也存在于健康领域。当你搜索自己的症状时，获取过多的信息实际上会引发焦虑，甚至可能带来危险。
在建立这种认知防线前，让我们先看看盲目相信网络信息的真实代价。两年前，我遇到了一位病人。这是一个真实的故事。我叫她玛丽，这当然不是她的真名。玛丽来就诊是因为她患有耵聍栓塞（Cerumen impaction: 耳道被耳垢阻塞的常见病症）。有人听说过这个吗？基本上就是你的耳朵被耳屎堵住了。这非常普遍。然而，玛丽在网上搜索了一下，她确实看到了一些信息，说听力丧失可能会导致痴呆症。因此，她非常担心自己的听力下降，尽管这种情况才发生了一天。她还读到，过多的耳屎可能是感染的迹象，但我可以告诉你，事实并非如此。但她当时非常执着于把耳朵里的耳屎弄出来。她读到，如果将过氧化氢（Hydrogen peroxide: 常用的消毒抗氧化剂）与水等量混合，效果会非常好。但是，她做的是把它放在微波炉里加热，然后滴进耳朵里。显然，她之所以来到诊所，是因为她的耳道被严重烧伤了，非常红，非常发炎。我对她说：“玛丽，为什么？”也许我不该这样问，但我当时确实是这么说的：“为什么？”她说：“我在网上看到的。我以为这不会有什么伤害。但事实并非如此。”这就是我们面临的挑战。
Original English Source
(Video) (Music) (Typing) [Cerebral aneurysm] [Meningitis] (Typing) [Can I die from a brain tumor?] (Typing) [Can an aneurysm kill you?] [Last Will and Testament] How many of you have felt like that, right? It's human nature. We all have searched for symptoms that we might be having. Maybe it's a mole on our skin, a cough that we’re experiencing or a headache. And what happens after ten minutes? We don't become more clear on what we might be having. We're more confused and more concerned. So we're talking about joy. But then how can we have joy when we’re searching about our health, and we're having some of these challenges? As I said, we all do it. You know, I used to come out and ask people, "How many of you have searched health conditions online?" Now I say, "How many of you have searched for health issues today?" Because I want to share a statistic with you. A billion. A billion, nine zeros. That's how many search on health there is every single day. And it's actually going up. And when you put it into context -- how many is that every hour? Every minute. And up until recently, I was the chief medical officer at WebMD. And many of you likely ended up at WebMD. And at WebMD, the motto is better information leads to better health. And as a physician, I firmly believe that. I want you to become informed. I want you to become empowered. But the challenge is information isn't knowledge. Remember the phrase TMI? Do people still say that? Too much information. Typically, we would say it about what? We'd say it about someone's giving you too much personal information. Makes you feel awkward. Maybe a little anxious. Well, TMI also is around health. Too much information, when you're searching for your symptoms, actually can create anxiety, can actually be dangerous. So I saw a patient two years ago. True story. I'm going to call her Mary, that wasn't actually her name. But Mary came in because she had what's called cerumen impaction. Anyone ever hear that? Basically means your ear's clogged with wax. It's very common. Now Mary had searched it online, and she saw, rightfully, that hearing loss can lead to dementia. So she was very concerned that she was having decreased hearing, even though it was only for a day. Very concerned about it. She also read that too much earwax could be signs of infection, which I'll tell you, that's not the truth. But she was very focused on getting the wax out of her ear. So she had read that hydrogen peroxide is actually pretty good if you mix it equally with water. But what she did was she microwaved it, and then she put it in her ear. And obviously she came into the office because she had a burned ear canal, very red, very irritated. And I said to her, "Mary, why?" And maybe I shouldn't have said it like that, but that exactly is how I said it. "Why?" And she said, "I read it online. And I thought it wouldn't hurt. But it did." And that's the challenge.
赛博疑病与算法回音室的迷局
这种被网络信息反噬的现象，催生了一个全新的群体。还记得“疑病症患者”（Hypochondriac: 过度担心自己患有严重疾病的人）这个词吗？那些一有症状就把每个症状都想象成最严重疾病的人？现在我们有了一个新词，你可能听过，叫做赛博疑病症患者（Cyberchondriac: 因在网上搜索医疗信息而产生无端健康焦虑的人）。你上网查阅——我总是觉得赛博疑病症患者就像破案专家一样，因为他们会审视每一个细节，把所有东西都放大，而且总是做最坏的打算。我十二岁的儿子就有那么一点赛博疑病症。今年夏天，他脚上长了个水泡，因为他非要穿一双对他来说太大的科比足球鞋，他坚持说自己需要这双鞋，结果磨出了水泡。几天后都没有愈合，开始看起来有点像感染了，我妻子就带他去了急诊。医生做了培养，给他开了抗生素。那天晚上他们回到家，我问他：“怎么样了？”他对我说：“你知道吗，这可能是 MRSA（耐甲氧西林金黄色葡萄球菌）。”我想：“对于一个十二岁的孩子来说，这真够聪明的。但 MRSA 还是比较罕见的。”他接着说：“而且这种抗生素对它没用。”就他找到的信息而言，他是对的。第二天，我接到了医生办公室的电话。确实是 MRSA。我在想，我要怎么告诉他呢？但事实就是如此，他也确实需要更换抗生素。我的观点是，有时候你在网上搜索到的信息是正确的。往往都是正确的。但你必须将其放在具体的背景中去理解。就在上周，我妻子刚恢复去健身房锻炼后，膝盖有些疼痛。我儿子走过去对她说：“可能是‘跳跃膝’（jumper's knee），”也就是髌腱炎。根本不是那么回事。只是因为她刚开始锻炼，所以膝盖有些不适而已。
在这些具体案例的背后，是更深层的系统性信息扭曲。我理解这种现象。在生成式人工智能（Generative AI: 能够生成文本、图像等新内容的人工智能系统）、ChatGPT 和 Google 方面，这些都是强大的工具。但它们不知道你的病史。它们无法为你做体检，在很多方面，它们反而造成了更多的混乱。我要探讨的是，这本质上是一个“清晰”与“困惑”的问题。如果你想拥有快乐，如果你想利用症状检查器、网络和人工智能来更好地了解自己的健康状况——而且我确实希望你获得赋能——关键在于你要获得清晰度，而不是陷入困惑。而这可能充满挑战。网络上充斥着大量的错误信息，而算法往往会将你引向不准确的信息。Instagram 上的信息流往往是由算法和你搜索的内容驱动的。我有一个小儿子——那是我的大儿子——我的小儿子非常想要一只金毛寻回犬。所以我的 Instagram 信息流里全是金毛犬，以至于我觉得好像每个人都养了一只金毛犬。同样的情况也发生在健康信息上。由于我曾在 WebMD 工作，本身也是一名医生，和许多人一样，因为血脂高，我正在服用他汀类药物（Statin: 一类用于降低血液中胆固醇水平的药物）进行一级预防。我喜欢阅读其他医生的信息流，我看到有一群心脏病专家说，你其实不需要服用他汀类药物。它真正应该靠饮食和运动来控制，而且他汀类药物实际上会增加痴呆症的风险，而不是降低。现在的我，作为一个行医二十多年的医生，我了解关于他汀类药物的数据，但我竟然开始想：也许我真的不需要服用他汀类药物。接着，我收到了更多医生的推送，都在说不需要服用他汀类药物。我想，这肯定不对劲。于是我怎么做呢？我深入调查了一下。我发现许多谈论这个话题的医生都在推销某种特定的产品。其中一些人的医疗执照还有过问题。但是算法会将你引向你已经接收到的同类信息。这会让情况变得更加复杂，因为这本质上归结为一个信任问题。
Original English Source
Remember the phrase hypochondriac? People that have symptoms and every symptom is always the most serious? Well, now we have this phrase, you might have heard it, cyberchondriac, right? You go online -- I always feel cyberchondriac should be like crime solvers because they look at every detail, everything is magnified, and it's always the worst-case scenario. My 12-year-old is a little bit of a cyberchondriac. So this summer he had a bit of a blister on his foot because he needed these Kobe cleats that were too big for him, but he insisted he needed them, and he developed a blister. It wasn't healing after a couple days, it started to look a little infectious, and my wife took him to urgent care. They cultured it, they gave him an antibiotic. They came home that evening, and I said, you know, “How did it go?” And he says to me, "You know, it could be MRSA." And I thought, "That's pretty clever for a 12-year-old. But MRSA is still kind of unusual." And he said, "And this antibiotic doesn't cover it." And he was right in terms of the information that he found. Now, the next day, I get a call from the doctor's office. It's MRSA. (Laughter) And I think, how am I going to tell him that? But it was, and he did need to have the antibiotic changed. And my point is, sometimes the information you search is correct. Often it is. But you have to put it into context. Now, just to be fair, my wife had some knee pain, just last week after starting back up at the gym, and he goes over to her, and he says, "Could be jumper's knee," which is a patellar tendonitis. It's not. It's just, she just started to work out, so now her knee is bothering her. But I get it. These are powerful tools in terms of generative AI and ChatGPT and Google. But they don't know your history. They can't do a physical exam, and in many ways, they're causing more confusion. What I talk about is it's really the issue of clarity versus confusion. And if you want to have joy, if you want to use symptom checkers and the web and AI to understand your health better -- and I want you to become more empowered -- it is about having clarity versus confusion. And that can be challenging. There’s a lot of misinformation out there, and algorithms often drive you to inaccurate information. So ... The feeds on Instagram are often driven by algorithms and what you search. So my younger son -- that’s my older son -- I have a younger son who very much wants a golden retriever. So my Instagram feed is loaded with goldies, [so] I think everyone has a goldie. Or it's on a lot of wellness information. Having been at WebMD and a physician. And like many people in the population, I'm on a statin for primary prevention because of high lipids. And I've been starting to ... I like to read other doctors' feeds, and there's a bunch of cardiologists that are saying you don't really need to be on a statin. It really should be diet and exercise, and that statins actually can increase dementia, not decrease dementia. Now here I am, I've been a physician for 20-plus years, I know the data on statins, and I’m starting to think maybe I don’t need a statin. And then I’m getting more doctors’ feeds that are saying you don't need to be on a statin. And I'm thinking, this can't be right. So what do I do? I dig a little deeper. I see that many of these physicians that are talking about this are selling a particular product. Some of them have had some issues with their medical license, but the algorithms drive you to the same type of information that you're already receiving. And that can make it more challenging because it really comes to an issue of trust. Who can you trust? And it's about that human interaction. Are you going to trust a chatbot or an influencer? Are you going to trust the relationship that you have with your doctor, the nurse, the pharmacist?
健康投资：像对待财务一样审慎
在数字健康信息的洪流中，我们最终必须回归本质的信任系统。你能信任谁？这关乎人与人之间的互动。你是要信任一个聊天机器人或一个网红？还是信任你与你的医生、护士、药剂师之间建立的关系？当你在网上搜索健康信息时——我们都会这么做，这是一件好事，可以成为一个强大的工具，因为我希望你能掌握主动权——我希望你这样思考：当你搜索财务信息时，你会怎么做？你会随便听信一个拥有一百万或两百万粉丝的网红去炒加密货币（Cryptocurrency: 基于密码学的去中心化数字货币），或者投资某种产品吗？不会的。你会怎么做？你会核实那个人的资质，并试图在其他地方证实这些信息。你会思考，这合理吗？我真的能在短时间内赚到五十倍的投资回报吗？我们大多数人会怎么做？我们会去问一个我们信任的人。我们会去问专家，这合理吗？你为什么这样做？因为那是你的钱。那很重要，关乎你的未来。但我认为，你的健康甚至更加重要。对你的未来而言更是如此。
然而有时候，在面对我们的健康时，我们却非常愿意抱着这样一种态度：“为什么不试试呢？”“有什么坏处呢？”我们愿意听任何人的话。你知道的，别人有很好的体验，也许我们也会有。但是，在面对你的财务时，你要有判断力得多。我们谈论快乐。我们谈论健康往往如何增添我们的快乐，或夺走我们的快乐。所以，获得赋能、接受教育固然重要，但接下来你必须迈出下一步，思考与专业人士之间的联系。我认为科技发挥着巨大的作用，尽管有时我觉得可能科技过剩了。我不知道其他人是否同意这一点。但当涉及到你的健康时，你所拥有的最核心的要素是，你需要的是清晰度，而不是困惑。而这种清晰度来自于这些步骤：
- 了解信息发布者是谁
- 核实该信息
- 证实该信息
- 判断它听起来是否合理
然后，去和一个你能信任的人讨论它。谢谢大家。（掌声）
Original English Source
When you think about searching for health information online, and we all do, and that is a good thing and can be a powerful tool, because I want you to be empowered, here's what I want you to think. When you search for financial information, what do you do? Do you just listen to any influencer that has a million followers or two million followers, to do cryptocurrency or to invest in a certain product? No. What do you do? You check the credentials of that person and try to corroborate that information somewhere else. You think, does it make sense? Can I really make 50 times my investment in a short period of time? And what do most of us do? We ask someone that we can trust. We ask an expert, does this make sense? And why do you do that? Because it's your money. And that's important. Your future. But I would argue your health is even more important. Certainly for your future. And sometimes when it comes to our health, we're very willing to have this attitude of, "Why not try it?" "What's the harm?" We're willing to listen to anyone. You know, someone else had a good experience, so maybe we will too. But you're much more discriminating when it comes to your finances. So we talk about joy. We talk about [how] our health often contributes to our joy or takes away from our joy. So it's important that you do become empowered, you do become educated, but then you have to take that next step and think about that connection with a human. I think there's a great role for technology, although sometimes I think there might be too much technology. I don't know if others agree with that as well. But when it comes to your health, the most important element that you have, you want clarity, not confusion. And that comes from those elements of knowing who the messenger is, checking that information, corroborating that information, knowing if it sounds right to you. And then talking about it to someone that you can trust. Thank you. (Applause)