Myth-busting medics

Priya Kulasagaran learns about a group of doctors who are working to dispel misinformation one tweet at a time.

Dr Khairul Hafidz Alkhair has seen some of the strangest medical claims floating around on the vast reaches of the internet. A particularly memorable recent one, which made its rounds in the early part of this year, involves paracetamol and vultures in India.

The story starts with a cursory explanation of the Parsi death ritual; rather than burying or cremating their dead, they would instead lay the bodies in the open to be consumed by birds of prey. Supposedly a decade ago, the Parsis realised that these birds of prey, namely vultures, were dying off as there were not many of them left to consume the dead bodies. Upon investigation, blame pointed to people’s consumption of pain-killers such as paracetamol. The theory, you see, is that paracetamol can stay in one’s liver for so long, even after death, that these birds were being ‘poisoned’ by accumulated amounts of that medication.

“Which is complete nonsense of course,” says Dr Khairul during a press session on medical myths earlier this year. “First of all, paracetamol has a half-life of two hours, meaning that it gets metabolised by your body really quickly. This is why the maximum recommended dosage is up to six times a day. If paracetamol can stay in your body for years and years, then you only need to take one tablet every few years — it’s practically like a vaccine then! But don’t get me started on the myths about vaccinations going about…”

What is interesting about this hoax was that it was already widely debunked the last time it surfaced in 2011. Dr Khairul believes that one reason for this story’s endurance is that it deals with a medication most people are already familiar with. “Everyone knows what paracetamol is, it’s not some fancy or unknown drug. I guess that’s why people are more likely to circulate it, because they can recognise it and so it feels immediately relevant,” he says.

Another reason might be just the way people tend to communicate with each other and source for information online. “You see this a lot with social media, the same old myths being recycled every so often. You might think that you did a good job stamping it out the first time, but in reality you may have only reached a certain group of people. Then a new group of people find it and you have to debunk it all over again,” he adds.

While there is a hint of resignation in his voice, regarding this seemingly endless task of pushing that same boulder up the hill over and over again, this is what Dr Khairul devotes a bulk of his time and energy into — busting medical myths via social media.

The rise of Dr Google

It is an understatement to say that all of the world’s knowledge is at our fingertips. Rather than making a trip to the doctor’s office, the first step for many people is to either do a web search for their symptoms, or even crowdsource for answers from their social media circles. What may be overlooked in this great age of information is the old adage that a little knowledge can is a dangerous thing. This is particularly true when any individual with a working internet connection can easily post inaccurate facts, or even blatantly misleading information.

Back in 2014, before the phrase “fake news” became a part of regular conversation, Dr Khairul decided that something needed to be done about all the health misinformation he was seeing online. Through his own Twitter account, he started what he called ‘Twitter clinics’ to receive feedback and questions from the public.

“As doctors, we shouldn’t see our roles as strictly being at the hospital only. We need to go to where the masses are to educate them; if they’re on social media, that’s where we need to be as well. Plus, if we don’t offer people credible medical sources to seek information from, they are going to rely on more dubious people spreading the sorts of myths that can be harmful if taken seriously,” he says.

After a year or so into his project, as he amassed followers in the tens of thousands, Dr Khairul soon found himself struggling to cope with volume of questions being thrown at him. “I was easily receiving 100 to 200 questions a day from my followers. On one hand, I was very humbled to see so many people responding and seeking my help. But at the same time, I was taking four to six hours a day just to answer their questions. I realised that I needed more medical professionals to get onboard,” he says.

In late 2015, he put up a call-out on his Facebook page for more like-minded professionals to join his cause — 10 days later, MedTweetMy was born. The team now has some 50 health workers from 36 disciplines, ranging from dentistry to physiotherapy, who all voluntarily offer their time to field feedback from the public. To further solidify their mission to engage the public and stem fake medical news, the group formally registered as a non-governmental organisation in April last year. The team has also published a book, Perang Melawan Mitos, which compiles a list of the most frequently asked questions they have received.

“The main objective of the group was to educate the public and make sure they were getting the right medical information from the right sources,” explains Dr Khairul. “One of the things we had to make clear was that we were not replacements for people actually going in to see their doctors; what we can do online is answer general medical enquiries, as well as address issues being circulated on social media.”

Growing into passion

Interestingly, as Dr Khairul stridently advocates for better patient education, he initially did not even think of having a career in the medical field. “I had ambitions of taking up astrophysics in university,” he shares. “But fate led me to the medical line, and from there, I learnt to love my profession, and develop a passion for it to this day.”

He has also now set his sights on going into policy-making as a way to improve the health of everyday Malaysians. “Policy-making has been an interest of mine since the beginning. I’ve been given the opportunity to be part of the Non-Communicable Disease unit, so this is my chance to learn more about how policy works. My hope is pursue a Masters in Public Health in the future, and learn more about policy issues,” he adds.

For now, Dr Khairul is continuing his fight to dispel myths, which seem to crop up all too easily. “I’d classify the kind of myths we get into three types. One are the old truisms passed down from previous generations, like how bathing at night purportedly fills your lungs up with water. The second type are related to cultural myths, such as saying that if you feel a heavy weight on your while sleeping, it must be caused by a djinn who is pressing down on you (This is in fact a common symptom of sleep paralysis). Lastly, are the more “modern” myths, like how drinking water while standing will supposedly ruin your kidneys,” he says.

With old wives tales and newer sensational stories circulating among society, it is no wonder that people are drawn to the MedTweetMy team for accurate guidance. “I don’t think netizens are unwilling to look for information, but rather the problem is that they are not sure of where to look or who to refer to,” says Dr Khairul. “So some either have not had their misinformation corrected, or even refuse to believe the truth despite the evidence, and this is how wrong facts get spread. It just takes a click of a button to ‘share’ or ‘retweet’ to make a piece of information go viral. Sensational information is also a lot more ‘sharable’ than the boring old truth.”

He adds that his, and the MedTweetMy team’s, approach is to remain calm and professional when addressing questions from the public. “There are some who just don’t agree with what we are saying, so what we try to do is avoid being confrontational even if they factually wrong. My experience with social media has taught me that when passing on knowledge, one shouldn’t be arrogant nor cynical. If you explain well, and politely, with God’s grace they will eventually receive your message in good faith,” he says.

Another challenge the MedTweetMy team has may be familiar to other professionals who offer public access to their expertise online; requests for consultations then and there. “I have to stress that ethically, we cannot simply offer our consultations through tweets and social media posts,” says Dr Khairul. “A doctor needs to see the patient for a physical examination before we can give a formal diagnosis and treatment.”

In the end, he adds that good communication is crucial for doctors to help their patients – online and offline. “My advice to young doctors is that communication is a core component of our profession. You have to learn how to communicate not just with your peers, but with your patients as well.”

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