Bhooshan Shukla Profile picture
Sep 17, 2020 10 tweets 3 min read Read on X
#Thread
#Social Media
#Harm #Children

Yesterday I ran a poll about possible harm to children due to internet access and social media.

Please read on about role of one faction in this.

As a doctor, i am careful about what I prescribe to my patients and what I feed to my children.

I know that even lifesaving medicines can have side effects.
As a doctor my job is to weigh risk and benefits of intervention.
Informed decision needs to be taken by parents about any medical intervention.

Adequate information is available about these interventions on internet.
Now compare this with access to Internet and use of social media by children. Though it is not essential for life, it is essential part of what we call life at present.

Are you given any warning about potential side effects?
Do you have a trusted person like doctor to give you information about benefits and harm?

There are multi billion dollar companies involved to get you and your kids on as many media platforms as possible.
And they have your attention and interest.

There is a reason why pharma companies are not allowed to directly market to patients. Because harm can be substantial.
Comparing social media to pharma may be a stretch but harm is comparable or more with social media.

Unfortunately, any discussion about this brings out hoards of techies and libertarians attacking this "sensorship"
They always talk about "potential benefits" and are dismissive of any harm. Much like pharma representative visiting my clinic.

When children are harmed, affected and even driven to suicide due to harms of these media, who is responsible?
How many of these free thinkers make ANY effort to alert public about potential harm to children?

Blood and tears are on your hands people.

You can deny data about harm as much as you want. It is YOU and YOUR CHILDREN afterall.
Just don't talk to me about benefits without clearly accepting the potential harm.

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More from @docbhooshan

Apr 9
#ChildMentalHealth #India

A 13 yr old with severe Obsessive Compulsive Disorder. He has to wash hands to reduce anxiety even temporarily.
It is so bad that his hands are white with painful linear breaks in skin (ulcers).

Referred to a child psychiatrist. Started on single medication (fluoxetine). Cognitive therapy not possible as child lives 250km away.
Excellent response to meds in 2 months.
This should be happy ending isn't it ?

But it is not....
A 🧵-
After those 2 months parents buy the tablet locally and continue for 3 more months and stop using it. All by themselves.

Symptoms come back within a month and they restart meds in half dose on their own for another 6 months. Majority of symptoms go away and some remain.
They decide to stop meds again and same story goes again.

After it all becomes intolerable, they come to me and ask for help.

My first duty after confirming the diagnosis is - to know whey keep stopping the medicine.
1. They can afford it easily
2. There are NO adverse effects of the medicine.
3. Their doctor was available on phone to guide so no issue of costs involved in repeated psychiatrist visits.
Read 10 tweets
Dec 10, 2023
One more suicide.
A young doctor studying at THE most prestigious institution loses life to suicide.
I realised that he was following me on this platform. That realisation makes this even more sad at personal level. Was there any way i could have helped him and prevented the tragedy?

I dont know perfect answers to all these questions.
Attempting to write a few that can be helpful for all young adult students (18-25 age group) -
1. Irrespective of what your seniors tell you, mental health IS important.
It is based on combination of your brain chemistry, your formative experiences and your circumstances. There is no SINGLE cause or simple single remedy.
Getting help from professionals remains single most effective life saver as of now.
2. "Feeling hopeless" is a robust indicator of high suicidality. Anger with or without agitation and consuming intoxicants like alcohol are high risk factors. A combination of these three (hopelessness, agitation and alcohol) is lethal.

Watchout for that in yourself and your near ones.
Read 11 tweets
Nov 24, 2023
A day well spent at Chitale Dairy at Bhilawadi. Thanks to @nikhilchitale and Chitale family.

Their milk and milk products factory is state of the art. Sharing few photographs-
Command centre powered by AI that detects break in pattern and activates action. Image
Packing machines.
A keen eye will notice "Nicrome" a pune based company that pioneered manufacturing of these machines in India @aparanjape rt from
Image
Image
Read 9 tweets
Aug 31, 2023
#Psychotherapy #Reality

One thing that makes therapy relationship different in a beneficial way is privacy.
It is not about "confidentiality " (your information is not shared with others by treating team) only.
Therapy also helps people process their own difficulties in the solitude of their own mind and come up with their own conclusions, processes, emotions. They OWN the solution.

I see this process destroyed quite frequently by well meaning (and sometimes self serving) others in patient's life.

How? Pl read on -
Many adults have friends and family who help them in difficult times. Patients have already discussed their difficulties with these people before meeting a therapist.

For children, parents play a serious supervisory role out of concern and parental authority as well.
When such adults and children enter therapy, their near one's / parents often sit with them after every therapy session, eager to hear what happened in the session and "what did the therapist tell you?"

This is usually done by people who have not experienced GOOD therapy themselves. They are not aware of the importance of privacy to make therapy happen.
Read 12 tweets
Aug 25, 2023
Why is (almost) everybody unhappy about state of healthcare in India?

There is lot of scholarly work and comments about what ails indian healthcare.

I am putting forth my thoughts here. Trying to think at first principle level -
At most fundamental level, govt needs to decide on "nature" of health care.
Is it -
1. Fundamental right of all citizens
2. A social service rendered by doctors and other professionals
3. A professional service
4. A business

Details -
Modern healthcare needs training colleges for professionals, modern equipment, effective medicines, non pharmacological treatments, systems to bring this all together and deliver it, ongoing research about effectiveness of delivery systems.

How does it all tie up?
1. If it is a fundamental right of citizens- govt needs to make all Sarkari components of the system OR buy all components from market by competitive bidding.
Indian govt does the worst possible combination of both.
Read 11 tweets
May 24, 2023
#thread
Good communication skills are seen as key component in medicine. All doctors are expected to explain things to their patients so that patients can participate in decision making.

Mental health poses unique challenges.

Please read on -
Challenges -
1. In India family is actively involved and wants to be kept in the loop. Most patients also accept this cultural reality and welcome it.
A psychiatrist has a job of communicating patient's experiences to the family in a language that they can follow.
It is relatively easy for physical medicine as everyday life examples of mechanical / computer things makes it easy to give parallel examples of organ malfunction.
For mental health, difficulties are with thoughts, emotions, motivation and perceptions. There are few parallels.
Read 6 tweets

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