Curbside Consult with Dr. Jayne 4/1/24

I’ve spent the last couple of weeks catching up on some reading, after my library “hold” list went rogue. I typically keep several dozen books on hold but in a frozen status so that I sit at the top of the wait list and can release them when I’m ready.

For some reason, a cluster of them released unexpectedly, dropping on top of my already planned reading. Unfortunately, at my library there isn’t a way to send a book back to the hold list once it’s in transit, unless you want to start over at the end of the line. I dutifully picked up my books and dug in for some intense reading, since you can’t renew them if others have them on hold and I wanted to make sure I was able to read them all. One of the books was “The Chaos Machine: The Inside Story of How Social Media Rewired Our Minds and Our World” by Max Fisher.

Being in healthcare and taking care of adolescents, teenagers, and young adults, I’m acutely aware of the impacts social media has had on these groups in recent years. Even before the societal disruptions of the COVID pandemic, research tied use of social media to sleep issues, which are in turn associated with depression, memory issues, and poor school performance. As we became physically isolated during the pandemic, many young people turned to social media to fill the void, with varying results. In many communities, cyberbullying has been on the rise, and concerns about social media have increased to the point where the US Congress is stepping in.

“The Chaos Machine” is full of meticulous details, many of which are pulled from interviews with Silicon Valley executives, social media experts, gaming experts, academics, and those who have been negatively impacted by social media. It references scholarly works, court records, and other primary sources that tell a story that most of us can’t even fathom. Given the subtitle, I expected it to dig heavily into the physical and psychological impacts on individuals with the concept of world impact as an abstract. I’ve read about the impacts on social media on US politics but wasn’t aware of many of the details the book provides about how the technology has directly impacted other countries, such as Myanmar and Brazil.

Parts of the book are difficult to read, including descriptions of online mobs threatening whistleblowers with violence ranging from swatting to rape or murder. Even more difficult to read are the descriptions of indifference by social media executives when confronted with evidence that their products are causing harm. Surprise, surprise, internal Facebook documents from 2018 reveal that systems were intentionally designed to deliver “more and more divisive content in an effort to gain user attention & increase time on the platform.” The book covers the rise of medical misinformation on social media and some of its harms, but having been a frontline physician, it doesn’t really explain the magnitudes of harm that we see when people use social media for medical advice.

Especially interesting was the description of the growth of Silicon Valley, comparing it to the Galapagos Islands as far as providing a unique evolutionary environment for technology development. However, instead of the isolation leading to the development of unique animal species, it led to “peculiar conditions” that “produced ways of doing business and of seeing the world that could not have flourished anywhere else – and led ultimately to Facebook, YouTube, and Twitter.” I see some of the same conditions in healthcare IT, where people still believe that you can just throw money at problems and somehow they’ll get solved, and where the people calling the shots often have only a rudimentary understanding of how healthcare is delivered in the US.

The book takes a walk down memory lane, talking about strife that took place in 2006 as Facebook introduced its News Feed. It was one of the first documented episodes of internet outrage becoming action, complete with protesters and the side outcome of dramatically expanding user engagement. “The Chaos Machine” covers the so-called casino effect, where social media platforms use the human dopamine system to hook users with intermittent variable reinforcement. It chronicles the rise of social media “like” buttons, which provide additional reinforcement through validation from other users.

I don’t’ want to give away the rest of the book, but I think it’s worth the read. I would recommend it for anyone who is trying to raise children in this crazy world and who thinks it’s OK to just let them play on a parent’s phone or that it’s a good idea to help a child falsify their age to obtain a social media account.

I met a new neighbor whose children attend a Waldorf school, which holds the philosophy that “exposing children to computer technology before they are ready (around 7th grade) can hamper their ability to fully develop strong bodies, healthy habits of discipline and self-control, fluency with creative and artistic expression, and flexible and agile minds.” In thinking about adolescent patients, I’m supportive of this stance, although I know that for parents it’s a nearly impossible battle unless the rest of the “village” around your child is similarly aligned. In thinking about some of the adults I know, it might have been a good idea to keep them away from social media even longer because they’re apt to behave badly even though they’re of age and should know better.

The book was a fairly quick read, as well as something different from my recent binge reading of murder mysteries and detective novels. Next on the list are two novels from Stacy Abrams, followed by chef Iliana Regan’s memoir “Burn the Place.” I enjoy reading about strong and determined women who have made their mark in industries that aren’t supportive. If it’s a good read, her second book “Fieldwork: A Forager’s Memoir” also threw itself out of my rogue hold queue. After that will be “Symphony of Secrets” by Brendan Slocumb, which I’m auditioning for a potential book club selection. If you’re in a book club with a sassy CMIO, you might want to hold on reading that one for now just in case.

What kind of books do you read when you have free time? Or do you accumulate a list or stack that you might never make it through? Leave a comment or email me.

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