Surveillance of Health

Every day, I open Reels and get an assortment of medical information. Instagram knows I’m a medical student, that I’m studying for my first board exam, and I’m stressed about it. It spams me with rapid review videos, physicians giving advice in their parked cars after a hard shift, other student’s aesthetic study sessions, etc.

It also spams me with patient-centered information. I particularly receive videos on the POTS - hEDS - MCAS triad, and their alleged overlaps with ADHD/Autism. It’s strange being both a receiver of content on laboratory-value based high level nuance and then these videos on chronic illness using clinical presentations as their diagnosis. I get it, I mean. My joints hurt all the time; my back hurts right now as I study for my exam tomorrow morning. The past few days it’s been my left knee with sharp pains. Usually it’s my ankles every night and morning. I want answers too.

I have to pick in the next 16 months-ish, what residency and specialty I want to pursue. Though I’m considering with an open mind, and have love for so much, my body and its aches are a huge factor in my decision. If this is a chronic level of pain, but it’s stagnant at this level, I can use my tactics and strategies to maybe go into surgery and beyond. But if it’s a worsening condition, if I become more strained, I don’t want to live my life with regret and burn-out, turning a career I pursued out of love and passion from a young age into a role I feel physically disabled by.

It’s all hard on our body; there’s no specialty that’s not within medicine. I feel bad complaining, when I know all of us have joint, back, and muscle pains. The stress and empathy of seeing daily pain… well that’s its own physiologic sacrifice we make.

But on surveillance, America has been entering where it was always headed. I want to call it scary or strange, but it’s really not. I can try to feign surprise if it’s helpful for the narrative. We talk more about authoritarian regimes, art has become focused watchful eyes, and technology & its companies are loudly articulating how to best quantify us.

But my joints ache. I learn so much from my algorithm: new ways to put pillows around my body so I sleep better at night, how others manage when you can’t ask for a chair, and the resounding community of what it feels like. I find myself wishing someone could watch me better than I can watch myself. “Medical students' disease” cheekily is that hyper-analysis of one’s own symptoms as you go through the field’s material. I know I’m an unreliable narrator to my own story, hence you wish for another’s glance.

One’s own health surveillance does rely on having a network and some level of vulnerability. Do you vocalize your aches, write them down? Do you know what’s a supposedly normal or abnormal set of symptoms? I don’t know if it’s my age or what, but I know so many people without PCPs. Without a standard check-in, it’s no wonder people have turned to the Internet (or maybe the Internet is what encourages newly-grads to postpone setting up their health network).

From your birth, there was a point when you recognized there was Another with you (most often your Mother/Father, some type of parent or guardian). Not a conscious realization, but one which probably coincided with the developmental milestones of smiling back, mimicking, etc. That was probably our first interaction with what could be abstracted as a ‘surveillance-state’. Perhaps it feels age-regressive to be placed back into that position, to understand all your words and actions are recorded and at potential to be held against you. In the same bout, a baby cries when their parent is “off-screen”. Is that a trade we make for health awareness and intervention?

Yet, my algorithm only helps me a little. Sure, I have some new pain management techniques, but I see a lot more fear-mongering and strange pseudo-scientific connections being made. I see bold claims by scared people. Perhaps the algorithmic State can accurately detect my stress, but it’s not there to help or alleviate it.