How healthcare professionals can navigate a digital world we don’t yet fully understand

Every October, I receive dozens of messages commemorating the victims of the Tree of Life Massacre in Pittsburgh, where 11 of my neighbors were murdered while worshiping at the synagogue across the street from my home.

It is the synagogue where my children went to Hebrew school, and where my wife and I were married, the spiritual thread running through the Jewish community of Pittsburgh.

I am part of this community. I’m also the former president of Allegheny General Hospital, where the killer was treated after his arrest.

That’s why I get the grades every year. Messages of resilience and empathy – of all colors and creeds – demonstrate the endurance of the human spirit.

That these memories are delivered via the miracle of digital communication is an irony that does not escape me. By all accounts, the anger that drove Robert Bowers to kill these worshipers in 2018 was fueled by this same online infrastructure, born in the belly of social media platforms where vitriol is rewarded via algorithms and violent fantasies are broadcast around the world.

Unfortunately, we are once again faced with this same type of heartbreaking violence. The details are different – black Americans in Buffalo, New York, and school children in Uvalde, Texas – but the effect is similar: a community has been assaulted by a disgruntled young man whose sense of reality has been twisted and whose online fingerprints foreshadowed the murders.

Increasingly, real-world social voids are being filled with digital connectivity. For many, that means more time in Zoom meetings. But for some, isolation has meant finding common cause in the dark corners of the internet. Buffalo supremacist radicalized online; the Texas gunman announced his plans ahead of time in direct messages online and posted disturbing photos of the guns on Instagram.

With so many of these murders, the common denominator is often mental illness exacerbated by irrational grievances and fear of “the other”. These symptoms have always existed, cultivated by our darker national impulses, but they are metastasizing much faster in the digital age.

These crimes are a manifestation of hate, mental illness and access to firearms. But they are also, in my opinion, the worst possible symptom of our increasingly digital lives.

We are seeing these symptoms earlier and earlier. Last fall, the American Academy of Child and Adolescent Psychiatry and two other organizations issued an emergency statement: Emergency visits due to behavioral health crises in children increased between 2019 and 2020, in all age groups.

It’s an alarming trend, partly attributable to the way our children are consuming social media.

As for adults, it’s been clear for over a decade that social media and internet addiction can harm our physical and mental health. Beyond the internet’s direct impact on behavioral health, digital forums have undermined the health profession itself. Misinformation, conspiracy theorists and charlatans with the online public have all colluded to erode the collective trust that is the foundation of our healthcare system.

What seems to be holding up, at least for now, is the cornerstone of our profession, the sacred trust between patient and clinician. But these days, even that trust is being tested. Patients search online for cures that match their political ideology, not their symptoms. For the past two-plus years, every emergency department in America has seen patients who deny the existence or seriousness of the very thing that put them in the hospital, COVID-19.

Obviously, all is not black. The digital revolution has brought about significant innovations for our industry – telehealth and video visits have literally saved lives during the pandemic, for example. Yet these tragedies remind us of how much we still have to learn about these powerful mediums and the challenges they pose to medical professionals and those in our care.

So what should we do about it? In our role as healthcare providers, the best thing we can do is stick to the scientific process, accept uncomfortable answers, and be honest with ourselves, our colleagues, and our patients. When we admit what we don’t know and dive into research, we maintain our independence and credibility.

That’s the long game. In our personal lives, however, we can act more immediately: Be kind to one another. Lead your organizations with empathy. As Fred Rogers, one of Pittsburgh’s most famous sons (and a pioneer in child behavioral health) might have suggested, be a good neighbor.

In working to rebuild the Tree of Life as a center for dialogue, our multiethnic, interfaith coalition of Pittsburgh neighbors has often revisited the words of Genesis 1:1: “God said, ‘Let there be light; And there was light. God saw that the light was good, and God separated the light from the darkness.’ ”

When it comes to digital communications, we may not be able to completely separate light and dark. But we must recognize that both exist and seek to better understand their impact on our health, because our patients, our profession and our society trust us to do so.

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