The Irish Medical Times - Auntie Intelligence Versus Artificial Intelligence
Recently, I attended an extended family gathering, inevitably the women folk found ourselves around a big table catching up. Talk turned to family members who couldn’t be there due to illness. One by one we diagnosed them, debated a treatment plan, decided on the best hospital, the appropriate doctor, and who would break the news to them. Of course it was concluded that no news would be broken because “Ah sure, there’s no talking to them!”.
A passing husband who overheard our inter familia multidisciplinary team meeting commented “Oh, is this a meeting of the consultants?!” There was a pause as we all looked at him, then at each other, laughed, then got straight back to consulting. Little did he know, he’d be dissected next.
In a time when people are turning to chatbots for diagnoses, have the Irish been doing that for years, except the bot has taken the form of an auntie or neighbour or random stranger.
I attended a Pilates class recently, before the exercising commenced I planned to nab the teacher for a quick sidebar and fill her in on some trouble I’d been experiencing with my sternum. When I approached her and mentioned I was having some breastbone issues, a head popped out from behind her, another class attendee who looked at me, then my sternum and urged “Go on”.
I very quickly and quietly told the teacher (and the random interloper) the woes of my sternum - cancer, radiation, open heart surgery, and recent pain. Before the teacher had a chance to speak, the interloper interjected, “Oh, I know what that is, my husband had that, he died and came back. Ah, he’s grand now, the heart finds a way to keep going. I’ll stay beside you during the class.”
I wasn’t particularly looking for reassurance or a diagnosis, I was just trying to explain that my sternum was tender and I’ll have to modify certain pilates moves, which the nodding teacher understood. However, I was surprised at how nice it was to think this random person cared, whether it was driven out of curiosity, kindness, helpfulness, or good old fashioned interference.
In a recent New York Times article they talked of how a patient attended an ER with facial droop only to be sent home. When she got home she typed ‘Facial droop, facial pain, dental work’ into a chatbot and was provided instantaneously with a potential explanation of Bell's Palsy, requiring urgent treatment. She returned to the ER with her Chatbot pal’s diagnosis and indeed Bell’s Palsy was confirmed by a human doctor. She was given steroids and antivirals and went on to improve.
I wondered what my family round table, with not a sniff of a medical degree, would have made of her symptoms if she had come our way. We would have heard her out, asked a battery of questions, some indirect ones such as “Where did you get your coat? Isn’t it lovely altogether!”. Sidebar “Look at the coat on her and the weather outside, sure she’s not dressed for the weather at all. She’ll catch her death. And that belt hanging down is definitely going to snag in a car door and she’ll be dragged through the streets. It’s no wonder she’s looking to go to hospital, I’m surprised an ambulance isn’t following her around already. Surelookit, say nothing about the coat.”
My aunts would have explored her family heritage until a connection was found with someone deceased. We would have ripped to shreds the establishment that gave her short shrift, declaring them “Disgraceful. I wouldn’t go near the place if I was on fire.”
Then our organic large language model would kick in, we’d start sifting through the stories from our collective database of people we knew, stories we’d be told, conversations we’d overheard on a bus, books we’d read, time spent in hospitals ourselves, and information we’d gleaned from just staring at people. All of this would be processed at rapid speed as we cross referenced her symptoms for a match. Within seconds we’d have a Bingo!
“Didn’t yer man who lived in number 77 wake up one day with a face like a melted frying pan. Everyone thought it was a stroke, but his sister in America (who used to work as a receptionist for the FBI, that’s another story), she knew it was Bell's Palsy.”
There would be a flood of furious head nodding as the diagnosis was confirmed.
Of course social circles, and even chatbots, can often get it wrong. The information it absorbs and spits out may be incomplete and misguided. I find it hard enough to relay every symptom I am experiencing to my real life doctor. I rely on them to physically examine me, watch for non-verbal cues, ask pertinent questions to further the investigation, whilst keeping in mind every detail of my medical history.
Artificial Intelligence and Auntie Intelligence can only work off a handful of surface information provided. So take their recommendations with the pinch of salt and cup of tea it is intended to come with. But chatbots and chat circles are different beasts, there is the wisdom that comes with the lived experience that can’t be captured on a computer screen.
My family in particular have lived through many woeful diseases. Between us we’ve been to all the hospitals, seen most of the doctors, and had nearly all of the illnesses. We’ve spent years of our lives talking to other patients, doing all the tests and operations, having different doctors try different things. A portion of my relatives have now passed on or are in the second half of their lives. Their friend group, or what's left of it, are nearly all patients of one hue or another. So our foray into medical suggestions is not completely without substance.
In a world increasingly exploring the potential of using AI for diagnoses, the enduring value of human connection, intuition and shared experiences becomes evident. While the internet might provide instant answers and offer a wealth of medical information, the wisdom and empathy found within our social circles can provide a unique form of healing and support (and probably a touch of the absurd).
It’s unlikely the people around you can replace the medical help you may need, but sharing your concerns in a safe space can prompt you to move in the right direction. Sometimes the most sound advice comes not from a screen, but from the warmth of a familiar face.
Before conventional medicine there were old wives tales, although mostly debunked as nonsense, there are some that stand the test of time. A spoonful of honey for a sore throat/cough - honey is anti-inflammatory. Cranberry juice will prevent a bladder infection - cranberries are a source of antioxidants. Warm milk will help you sleep - milk contains the amino acid tryptophan and peptides which help regulate sleep patterns.
The next time you reach for your phone to google symptoms, instead, perhaps have a look around for an ‘old wife’. They usually keep office hours at Communions, Weddings, family parties, and can be found at the biggest table, adjacent to the craic and the unfolding gossip.
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