David E Bratt, MD

From the very be­gin­ning, two things about the in­ter­net both­ered me: in­for­ma­tion and "friends."

I be­gan to use the In­ter­net as my per­son­al en­cy­clopae­dia in 1996. At first I print­ed out every­thing I want­ed, re­fus­ing to be­lieve that I would con­tin­ue to have most­ly free ac­cess to pe­ri­od­i­cals and re­search find­ings that, up to that time, were on­ly avail­able ei­ther at a cost or at a med­ical li­brary. Med­ical li­brary meant dri­ving up to Mt Hope and ask­ing some sour li­brar­i­an to get an ar­ti­cle for me. Most of the time that en­tailed wait­ing a month or more for the pe­ri­od­i­cal to ar­rive. Try­ing to tele­phone the EWM­SC was a waste of time, a sit­u­a­tion that has not changed and in­cludes any hos­pi­tal, clin­ic or nurs­ing home in the coun­try, pub­lic or pri­vate.

That ac­ces­si­bil­i­ty to med­ical in­for­ma­tion re­mains for me the sin­gle best thing about all the var­i­ous forms of com­mu­ni­ca­tion that the In­ter­net of­fers. Poised on a tiny is­land in the south Caribbean far from the cen­tres of med­ical ex­cel­lence, with­in min­utes I could have the opin­ions and ev­i­dence-based best prac­tices of any med­ical or­gan­i­sa­tion or ex­pert I choose.

It was dif­fi­cult to be­lieve. I had the world's in­for­ma­tion on my desk. The in­for­ma­tion came with a cer­tain ca­chet. It was mod­ern. It was ro­man­tic. There was a glow at­tached to the glow­ing screen that made every­thing seem big­ger, bet­ter than mere­ly read­ing a print­ed page. If it was on the com­put­er screen, it had to be good, true, be­liev­able and ac­cu­rate.

Yet, as time went by I be­came in­creas­ing­ly con­cerned about the re­li­a­bil­i­ty and ac­cu­ra­cy of some of the in­for­ma­tion I was get­ting. When I clicked on sub­jects I knew about, I would oc­ca­sion­al­ly find er­rors and state­ments that had no ba­sis in fact. Many of these sites ap­peared sud­den­ly, ex­ist­ed for months or years then as sud­den­ly dis­ap­peared.

At some sites there were ob­vi­ous con­flicts of in­ter­est. Breast­feed­ing in­for­ma­tion on pages that were spon­sored or worse, built, by com­pa­nies that sold for­mu­la, with ad­vice, sub­tly or not, guar­an­teed to turn off women or moth­ers who want­ed to breast­feed. Ar­ti­cles on fi­nan­cial plan­ning writ­ten by a bank ex­ec­u­tive and spon­sored by a bank might not nec­es­sar­i­ly have my in­ter­ests at heart.

I slow­ly came to the re­al­i­sa­tion that this new-found source of in­for­ma­tion was just like any­where else and any­thing else. It was like life. It could not be trust­ed. As Thomas Fried­man said re­cent­ly in the New York Times, "the In­ter­net is an open sew­er of un­treat­ed, un­fil­tered in­for­ma­tion, where....skep­ti­cism and crit­i­cal think­ing must be brought to every­thing one reads and ba­sic civic de­cen­cy to every­thing one writes." Just like life, one had to be care­ful and crit­i­cal and skep­ti­cal of any­thing put up un­less one knew the prove­nance of the ar­ti­cle in great de­tail.

Cruis­ing the In­ter­net was like strolling down the West­ern Main Road in St James on a Fri­day af­ter­noon and be­ing stopped by peo­ple I did not know and be­ing told that the gov­ern­ment was go­ing to de­val­ue or there was an out­break of ty­phoid fever in Paramin or the Bri­an Lara sta­di­um was go­ing to open in Feb­ru­ary. Who would ever be­lieve that? So why do we be­lieve any­thing we see or read or hear on the net? You have to take every­thing with at least a grain of salt and look around for con­fir­ma­tion from some­one you trust, not an easy per­son to find in T&T.

It was a sim­i­lar sce­nario with the Face­book "friend" sit­u­a­tion. I start­ed off with five or six "friends" who were all peo­ple I knew or trust­ed. Sud­den­ly "friends of friends" want­ed to "fren" me and in the be­gin­ning it felt good. It was ex­hil­a­rat­ing. Peo­ple want­ed to be "my friend." Soon I was get­ting mail from all over the world, from peo­ple I knew noth­ing about but who were in­ter­est­ed in telling me all about their lit­tle lives. I felt I was part of a world wide or­gan­i­sa­tion of like-mind­ed peo­ple.

Yet I knew noth­ing about most of them ex­cept what they told me and all of that was good and light and un­re­al. Life was amaz­ing for every­one. It was too much. It was im­pos­si­ble for every­one to be so chirpy and hap­py, all the time. Some­thing had to be wrong. Peo­ple had to be ly­ing or at least ex­ag­ger­at­ing. Peo­ple had to be liv­ing imag­i­nary lives. Lives of bliss where they were suc­cess­ful and con­tent­ed and loved.

This could not be true. I had enough ex­pe­ri­ence as a doc­tor to know that there are many sides to a sto­ry, the one you are told, the one you find af­ter the phys­i­cal, and the truth. Young peo­ple have dif­fi­cul­ty un­der­stand­ing this. It takes years of be­ing fooled re­peat­ed­ly. If they reach the age of 50 with­out un­der­stand­ing that the world is filled with gra­da­tions of greys and not black and white ab­solutes, then they have big prob­lems.

It was a night­mare. The sce­nario in St James again came to mind. Would I be friend­ly with some­one un­known who came up to me in the street, greet­ed me like a long lost friend, stand up and lis­ten to their sto­ries about their suc­cess­es, so­cial, sport­ing and sex­u­al? So what was I do­ing in­ter­act­ing with all of these peo­ple? So off I went.

I now have a Face­book pro­fes­sion­al page where I put up my ar­ti­cles or re­search find­ings I trust, but I warn you, do not be­lieve every­thing you see there. Use your com­mon­sense.