Oh, I Like That

A Solid Alternative to Googling Your Symptoms ft. Casey Gueren

Episode Summary

If you’ve ever had a question or concern about your health or body and turned to Google for some answers, only to feel very “wait WHAT” upon seeing the results, this episode is for you!

Episode Notes

We sat down with our former co-worker, health journalist Casey Gueren, to chat about her new book It's Probably Nothing: The Stress-Less Guide to Dealing with Health Anxiety, Wellness Fads, and Overhyped Headlines. We talked about health anxiety in the age of COVID, as well as how to make sense of everything we read online about health and wellness. There are tons of practical tips from Casey and the experts she talked to for her book. If you’ve ever wondered about the supplements you keep seeing all over FitTok, wondered whether to believe that new health trend or study, or have a tendency to assume every minor pain or skin thing you experience is a rare and deadly disease, do we have a treat for you (this episode).

This episode was produced by Rachel and Sally and edited by Lucas Nguyen. Our logo was designed by Amber Seger (@rocketorca). Our theme music is by Tiny Music. MJ Brodie transcribed this episode. Follow us on Twitter @OhILikeThatPod.

Things we talked about: 

Episode Transcription

Rachel: Welcome to Oh I Like That, a podcast about things we like and occasionally things we don't. I'm Rachel Wilkerson Miller.

Sally: And I'm Sally Tamarkin. And I'm Sally Tamarkin. Happy, humid, sweaty, north-eastern Friday to you, Rachel.

Rachel: It's Friday Junior today, isn't it?

Sally: Really good point.

Rachel: I was like, Friday Junior, you're going to say.

Sally: Nope, you're right. That is the day of the week it is. So I guess my vibe check is that I'm a little bit confused about where I am in space in time which--

Rachel: Wow. After we did this incredible organization episode, we're now turning around and proving we can't even remember what day of the week it is.

Sally: I'm an incredible mess. I'm a chaos person. I have a visual journal, but I never know the date. Rachel, what's your vibe?

Rachel: My vibe is Thursday before I'm taking a trip, and it's the first trip I've taken in more than a year. Almost two years, actually. So it's like laundry and errands and packing, and just thinking about everything that we need to do to get on the road on Saturday. So the vibe's good, but just lots on the to-do list today.

Sally: Nice. I love a good pre-trip to-do list.

Rachel: Yeah, me too. And what's your vibe?

Sally: My vibe is, well, in part it's what day of the week is it? And then the other part of it is, I'm actually very excited because we have a special episode today. We have a guest for the very first time. And so my vibe--

Rachel: The very first guest.

Sally: Yeah. My vibe is excited for the guest, who I'm just going to talk about now, if that's okay, Rachel?

Rachel: Yeah.

Sally: Okay. Today, we are talking to our friend and former co-worker, Casey Gueren, who is the author of It's Probably Nothing: The Stress-Less Guide to Dealing with Health Anxiety, Wellness Fads, and Overhyped Headlines. It's out now, and we will have links in the show notes to where you can pick it up. Casey is the former Executive Editor of SELF Magazine and has been a health writer and editor for the last decade, holding positions at BuzzFeed, Cosmopolitan and Women's Health. You can follow her @CaseyGueren on Instagram and Twitter. And we will have those links in the show notes.

Sally: Casey, welcome to Oh I Like That.

Casey: Hello. So happy to be talking to you today.

Sally: We are thrilled to have you. So we're going to talk about this new book that you wrote. I'm really excited about it for a couple of reasons. One reason I will disclose is that I did the sensitivity read on it, and it was... I learned a lot and it was incredible. So I've read it. But I'm also really excited because I'm a health anxiety person. I mean, I'm an everything anxiety person, so let me not act like my health anxiety is above any one of my other anxieties, but it has a ton of amazing service in it. And I recently re-read parts of it to prepare for today, and now Rachel has read it.

Rachel: Yeah, I read it last week. I thought it was great. I highlighted so much of it. I've already been talking about it to my girlfriend. I am very excited to talk with you about it today, because there were so many things that I loved about it, both as your friend and somebody who's worked with you, there were things that made me laugh out loud, but also as somebody who could very well have picked up this book and bought it because I think it's super helpful, and I don't want to say it was made specifically for me, because I don't think my health anxiety is maybe as bad as other people's. But it's not zero, and so there was a lot of really helpful advice in here. And I think it will be helpful to a large audience of people. So I'm just so thrilled that you wrote it.

Sally: Okay, so Casey, for our listeners who have not read it yet, can you talk a little bit about the project of the book, what you were trying to do with it, why you wanted to write it and so on?

Casey: Sure. So I wrote this book -- started it pre-pandemic, finished it mid-pandemic. And yeah, this was something that... it was a bit of a passion project, as much as you can be passionate about your own anxiety. And yeah, first of all, definitely an equal opportunity anxiety person. This is not just for people with health anxiety [laughs] but people that kind of overthink to an extent that it really does interfere with your life. And because so much of my career has been in health and wellness reporting, I felt like I had this unique perspective as someone who's both covering this and also deeply stressed out about it every day also. And noticing that just the way that the media and the wellness industry was contributing to that anxiety, both my own and everybody else's, as evidenced by the content they were clicking on. So I figured this could be helpful for people. And that was again, before we all started freaking out about every little tightness in our chest or any little sore throat. So I can only imagine that more people are going to relate to it now.

Sally: Okay, so we've talked a little bit about those of us who have health anxiety, but I feel like this book has a broader audience, Casey. So can you talk a little bit about who this book is intended for?

Casey: Yeah, so this book definitely isn't just for people with health anxiety, though I think that you'll obviously get a lot out of it. It's also just for people who engage with wellness and health stuff on a day-to-day basis, which I feel like is so many of us. Like, if you've bought a wellness-y product off Instagram or if you've been confused about some of the health headlines that you're seeing, if you are someone who Googles your symptoms a lot, if you're someone who is just trying to figure out who and what to trust in the health space, if you have questions about that stuff, I feel like this will be really helpful because it's kind of that crash course in navigating the information and misinformation about your health online.

Rachel: Yeah, I think when I was reading it, I could definitely see, "Oh, I'm very much the person that you're describing." Just, a person who has a moderate interest in taking care of myself. And there were times when I was reading it and I was like, "Wow, this would be so good for a college student or even a high school student who's sort of just learning about their body and how to take care of it." And then I was like, "No, it's not just for young people, it's for all of us because this is just really helpful and valuable information." And I think it would be great for a young person, but it really feels like it's for everyone. It's everyone with a body who's trying to keep it healthy. So going back to the pandemic for a second, I would love to hear you talk a little bit about how COVID changed your plans for the book. And obviously a lot of this is more relevant as we all began to Google, "Is it allergies or is it COVID?" And all these things. But when you were writing, how did that influence -- did you add things? Did you leave things out so you could focus on things that felt more relevant? How did it affect your process?

Casey: Yeah. So I started writing this book in October 2019 when I got the book deal. And it was due October 2020. So March 2020, April 2020, I had already done a big chunk of interviews for this, I already had my outline, I had what I wanted to say, and then COVID happened. And I'm trying to figure out, "Should I even mention this? Is this going to be a blip? Is this going to be something people even want to hear about and read about again when this book comes out in 2021?" Naive me is like, "2021, no one will be talking about COVID." Like, "What is even the point?" Then as summer 2020 rolled around, and I'm still primarily stuck in my tiny apartment in Queens and this is not going anywhere, I realized, okay, this is actually a really great example of why we need to invest more in health literacy. Why we need the tools to navigate between information and misinformation. And resources for people who are already freaking out about every little symptom and are now probably doing so much more frequently. So I figured, okay, I do need to fold this in here, but in a way that it's not a book dealing with COVID anxiety. Which it's not.

Sally: Yeah, I feel like by the time I saw it, all the COVID stuff was in there and it felt important and relevant, but not dominating. And I also think that I feel like getting through the pandemic and learning a little bit more about interpreting the headlines and interpreting what the media says about studies is an invaluable skill. So if you're going to learn it at any time, why not do it during a pandemic and take it with you for the rest of your life? Okay, so speaking of every little symptom, so one of the things you talk about in the book is basically using Google to look into symptoms, but doing so kind of in an informed, responsible way. And one of the things you say is, first of all, maybe don't do this all the time. But if you are going to Google, here's how to find good trustworthy information. One of the things I think we both really liked is when you said that Googling symptoms is like gambling. Can you explain that concept a little bit for our listeners?

Casey: Yeah, so obviously, all of us Google our symptoms. Like, I think that if you don't Google your symptoms, I don't trust you. But if you are someone who is constantly reassurance-seeking online, whether that is Googling your symptoms or trying to get more and more information to appease some health worry or concern that you have, that's something that experts refer to as a safety behavior that we see a lot with health anxiety, other types of anxiety, OCD, panic disorders, things like that. So it's a really common thing that obviously exists on a spectrum, and you can sometimes do it a little too much. What I wanted to talk about in the book is the fact that, why do we do this? Why are we like this? And it made me think of a concept that I learned back in college when I was getting my undergraduate degree in Psychology, and I had to take a conditioning and learning lab, which was literally teaching lab rats how to do things, and it was terrifying. As gross as you can imagine. And so we were learning how behavior is often predicted by either reinforcements or punishments. And with reinforcements, it's kind of like when you think about training your dog, which is something I'm trying to do right now [laughs] and getting a reward every time you do something. And so in this case, with reinforcement, it can be either positive or negative. So it can be positive reinforcement, getting something good that makes you want to keep doing it, or negative reinforcement, taking something annoying or uncomfortable away. And then that's going to still make you want to keep doing it. And in the case of Googling your symptoms or trying to Google away some of your health worries, that's what's referred to as negative reinforcement, because you're removing that aversive stimulus, which is your anxiety at that moment. You're getting kind of a short-term relief, even though obviously it just makes you keep doing it. And the other part of that is the reinforcement schedule. So obviously, every time you Google your symptom, you're not necessarily getting like, "You're fine," or, "You're dying." It's usually somewhere in between. Sometimes it makes you less freaked out and sometimes it makes you more freaked out. But the fact that you don't know is very similar to what we know about why people go back to slot machines. When you're gambling, you win sometimes, you don't win the other times, but you keep doing it because you might get that reward. And that's kind of like us going to Google each time. We don't know what we're going to get, but there were times that we felt less stressed when we sought reassurance online, so we're going to keep doing it because we might get that result the next time.

Sally: So as an expert in psychology, I wanted to just add something to this theory that I'm sure will be in college textbooks soon.

Rachel: [Laughs]

Sally: I feel like if you're someone who sort of obsessively Googles your symptoms or does it a lot, even the panic that results from that can be a thing that you're looking for. Maybe unconsciously, but as someone who has at different times in their life been sort of powered by that worry and that panic, a lot of times if I'm Googling something, if it's like, "You have nothing to worry about," I'm not going to believe it. And if it's like, "You probably have six months to live," I'm going to be like, "I knew it. I have six months to live." And then that becomes the thing that I get really upset about. So I just wanted to say, just that one extra thing that makes it an attractive thing to do, even though it feels bad, you still get something out of that bad feeling.

Casey: Yeah, something that I heard from experts in researching for this book was that people with anxiety, any kind of anxiety, often have an intolerance for uncertainty. Which, I felt very attacked when I heard that because I was like, "I cannot deal with it in any sense, no matter what we're talking about." So that makes sense. And I think that goes back to what you're saying with, you're just looking for some kind of reassurance. It doesn't necessarily have to be reassurance that you're fine. It's just something that makes it... that you're not starting at square one and that every option is possible. Like, you have a little bit more information. But again, you don't know necessarily if that information is true or helpful or just kind of feeding the flames. But yeah, it's kind of lowering your overall uncertainty.

Rachel: So speaking of just sort of spiralling and panicking and Googling, you have some tips in the book for people who tend to spiral over their weird body things that appear suddenly. And you kind of talk about this in the book, that bodies just do weird things sometimes. Some days you just have intense headaches and you're like, "I don't think I've ever had this before." Or a weird skin rash. Or a couple of weeks ago, I was brushing my teeth and I was like, "Is that always what my tongue has looked like? Is this new?" And I started to panic: "What if I have... what if these are cancerous lesions?" But I think that's how my tongue always looks. But one of the tips that you have in the book that Sally and I both really, really liked is the 24-hour rule, which we both thought was so, so smart. So we'd love if you could talk about that a little bit.

Casey: Yeah, so the 24-hour rule is basically for all of those times that you're like, "Has my blank always looked like that?" [Laughs] Which is something that I ask myself probably at least once a week, for sure. Yeah, it's essentially planning another time to worry about this. You're not trying to distract yourself, you're not trying to dismiss your thoughts or not trust yourself. You're just saying if this is still something to worry about, I can worry about it tomorrow. And I spoke with an expert recently for an article where they really reinforce this by saying that a lot of the stuff that we freak out about when it comes to health anxiety is often not stuff that manifests and kills us in a day. And I was like, "Fair point. "

Sally: A great point.

New Speaker: So that weird mole or the weird surface of your tongue can wait a day. The sore throat can probably wait a day. Obviously, this does not include things that are, you know, if you're bleeding, if you're on fire, if you are really needing care right now, and only you can kind of know what that threshold is, obviously seek medical care. And that's what gets so confusing because obviously if you've ever had a panic attack, you know that that comes with that severe urgency of "I need care right now." So I'm not saying that this is a super easy line to draw. And right now it's even harder, right? Because we can say that sore throat can wait till tomorrow, but if you are maybe going to be around people and you want to make sure that it's not COVID, I don't think it's crazy reassurance-seeking to get a COVID test.

Rachel: Right.

Casey: So again, it's not super clear cut, but if it's just something that you are like, "I am now consumed by thoughts around this symptom or this physical thing that I've noticed," try giving it 24 hours. I have often found that I either forget to even come back to that worry 24 hours later, or when I do, I'm like, "Oh yeah, no, I think that's actually fine." Because a lot of times you're just ruminating, you're just catastrophizing. And if you're not, then that's when you can feel a little bit more confident going to get care.

Rachel: Well, I feel like you kind of said this, but with those things that are not going to kill you in 24 hours, I think if you're trying to figure out what the line is like, "Should I seek care?" I think the question is kind of, "Well, what care would I even seek in the next 24 hours?" If you're experiencing something that could be a sign of a stroke, the care you're going to get you actually can get. But if you're just looking at your tongue and wondering, "Is my tongue okay?" The thing that you're probably going to do is Google and stress, and there isn't actually action you can take on it. So it's like, "Well, you would have to wait 24 hours anyway." So yeah, you could make your doctor's appointment right now, but there actually really isn't anything to do. So it's actually fairly easy if you kind of think about, "Okay, what action could I even take now?" It becomes a lot more apparent. "Oh yeah, this is actually something that I should take action on." And you have the question in the book of, what's your emergency, which is often you'll be asked if you call 911 or an emergency room. And I think that kind of applies here too. What's your emergency? Is there an actual emergency, or can this be talked about at a doctor's appointment in a week? And in a lot of cases, it's going to be the latter.

Casey: Right. And I even use this, because I'll often feel like, "Do I have a UTI? Do I have a yeast infection?" Any little physical symptom to me in my head often goes to the medical arena of "Oh, this is something I need to figure out and treat right now." And then you do kind of spiral, where I'm like, "Oh man, if I have a UTI then am I going to have to start antibiotics, and that's going to be annoying for this trip I have to take." And you just spiral. And so for things like that, if you can give it 24 hours and you know it's not going to snowball your actual medical symptoms, I've found it to be really helpful.

Rachel: This is one of my strongest takeaways from the book of just like, I'm going to use this in my everyday life quite often.

Sally: Yeah, so actually kind of not unlike a 24-hour rule in that it's a really actionable tip and something that I -- actually, my therapy journey has included this practice. You talk a lot about putting your thoughts on trial in moments when you're sort of starting to spiral or catastrophize. Can you talk about what that means and how someone would go about putting their thoughts on trial?

Casey: Yeah, so that's something that, it is part of cognitive behavioral therapy, or CBT. So a lot of people who have been in therapy can recognize this, but it's often called Socratic questioning. And it's essentially trying to distinguish between your thoughts and feelings and facts, which can be some of the hardest things for people with anxiety. And so you're thinking, what evidence do I have that this is happening? What evidence do I have that this is not happening? Have I thought this in the past? Was I right? Things like that, that just kind of help you zoom out from your spiral of thoughts and try to fact-find a little bit. And I think the biggest caveat that I would give here is that, do not use Wi-Fi to help you answer these questions. Do not go searching. Because it's exactly what we were talking about before. You will find something on the internet to confirm those deep-seated fears that you have already in your head, so this is more about, what evidence do I actually have in front of me right now? Or that I can think of that this is actually happening. And to Rachel's point, what would I do about it if I did have this? And so again, it's just something to stop yourself from spiralling in that moment.

Sally: So this to me is the thing that I'm taking away from the book as the thing I want to be doing all the time, and it's a thing that -- and here I will talk about my cancer journey, it's a thing that I use a lot just as someone who's a catastrophic thinker, but specifically last December, I had kind of a cancer scare. And it turns out that I'm totally fine, but there was a whole lot of stuff that had to happen before it could be determined that I didn't need more treatment or more surgery. And it was like every step of the way, I was getting more and more encouraging information about like, "You know, you did this genetic testing and you don't have these mutations, so, that's really good, and we did this imaging and this looks good," until finally it was like, "Okay, we know for sure you're okay." But every step of the way, I was still so scared, as I think anyone who's gotten a diagnosis of something really scary like cancer can relate to -- once you hear that it kind of takes away the idea that like, "Oh, that can't happen to me." And so I would spend a lot of time spiralling, and the only way I was able to get out of it -- I can't really put my thoughts on trial myself, I need to outsource the prosecution because I spiral too much, but one thing I did was I would say to my partner, I would be like, "Okay, here's why I think that they actually have missed all this stuff, and I'm definitely dying of cancer. There was this imaging and they probably missed this thing and I had this conversation with this doctor, but I didn't ask this thing, or they answered this question partially, but not fully, and so now..." And in those moments, I really couldn't kind of regulate myself, but when I talked to Andrea about it, she was able to say, actually, the thing that you just said, Casey, where she was like, "This is a thing that you have thought many times and you've always been wrong." She was able to… she's the reasonable person, and that's what my therapist calls it basically, ask a reasonable person to weigh in on this, because in that moment, I'm not reasonable. So Andrea, as a reasonable person, can be like, "All of the evidence that you have, all of the data that you have, do not point to the fact that they've missed something and you actually are dying of cancer." Anyway, so all that is to say, I found putting your thoughts on trial really, really, really helpful, and sometimes if you have someone in your life who you can outsource that reasonable person status to, I highly recommend getting involved with that.

Casey: Yeah, one of my best friends and I text each other pretty much at least once a week with something like this, and it can just be really helpful to kind of balance those ideas off somebody else. And it's funny, we joke that we could copy and paste our responses just back to each other. So I think at some level, you do know when you are spiralling and having that catastrophic thinking, but you do need another person to tell you that sometimes.

Rachel: Yeah, I think that's right. So you talk a lot in the book about the mind-body connection and the way people saying like, "It's all in your head" or "Have you tried yoga" is often used to dismiss very real pain or other physical symptoms, which I think a lot of us are very aware of the this sort of way that healthcare providers historically said like, "You're not sick, you're just depressed," and they've been wrong. But you also write that our mental health does play a role in our physical health, and things like stress, for example, can worsen a bunch of other conditions. I think you did a really good job of explaining why we should take our mental health into account when we're experiencing something physically, and I was hoping you could give our listeners some guidelines on how to think about this, because I don't actually think that this topic gets a lot of attention from health journalists.

Casey: Yeah, this was so tricky. I almost didn't get into this a lot in the book because I think it's a really fraught concept, and it's really hard to get at sensitively. But we all have heard these stories of people who went to a dozen doctors and no one could tell them what was wrong, and then finally that thirteenth doctor diagnosed them with something and gave them the relief that they needed a year or so ago. And we know that this disproportionately happens to women and minoritized groups, but I know as someone with health anxiety, as someone who's researched health anxiety a lot, I also see the flip side of that, that those were those stories that fueled the fire for me. Those are the stories that you think about when to Sally's point, sometimes you'll be sitting there thinking, "Well, what if the doctors miss something." And we're always going to have that thought in the back of our minds, but I think that thought gets amplified the more that we do hear these stories, and again, they're happening. That's a really frustrating reality, but they do reinforce us to keep Googling, keep doctor shopping, keep trying to find an answer and distrust the information that we're being given from the hopefully reliable sources. So I don't think there is an easy answer here, I think it's more about accepting that both of these things can be true, and that this unfortunately does often lead to a lot of misdiagnoses, but that also you can have very real physical symptoms that are not necessarily medical in nature. If you've ever had a panic attack, you know that to be true. And the more that we pay attention to these symptoms, even if they aren't really telling us anything dangerous is happening in our body, the louder they become, and the more that we can kind of spiral in our anxiety around them, potentially even causing more of those fight or flight symptoms that are more uncomfortable, more noticeable. So, I wish I had the easy advice for how to know if it's mental or physical or dangerous or no big deal. But I think just being aware of that really uncomfortable paradox is important, and you're right, I don't think it's something that gets talked about a lot, it's often people being on one side or the other.

Rachel: One of the things that you wrote in the book was just about how much stress alone can exacerbate real physical symptoms, and I think, Sally, we talk a lot about migraines and how stress can trigger migraines, and I think that's a perfect example of like, you're having a migraine. You are, but it's also helpful to stop and reflect before you decide the migraine is something even worse: am I under a lot of stress right now? And I think just applying that, is stress a trigger in this physical thing I'm experiencing? Which applies to so many things, anyone who's had, you know, a terribly nervous stomach knows this or has even felt short of breath -- a lot of these very real physical things can be triggered by stress. That's one of my takeaways from the book, is stopping to ask, "Am I under extra stress right now?" Because so often the answer is yes, and I think we kind of try to dismiss that like, "Yeah, I'm stressed. I'm stressed because I think my head's about to explode." And it's like, sure, but maybe you were also really stressed before that because of something at work or with your family or whatever. So, to me, just recognizing stress as a sole trigger to stop and ask about when I'm experiencing something physical. It's wild how many things, when you do Google your symptoms, they'll say "Stress, it could be stress, it's worse if you're stressed," and it's like, "Oh man, it really just is that, huh?"

Casey: Right. I hate all of those lists where it's like, twelve reasons your hair is falling out. And it's like, cancer is on one end of the list and stress is on the other. And you realize that this person knows nothing about you, they are writing this for the masses and that kind of information is not super helpful.

Rachel: Yeah

Sally: So a big part of this book, Casey, is about how to have a little bit more literacy with learning about health through the media. And you do talk about Googling symptoms, but also reading what journalists say about a study or a symptom or a vaccine or whatever. And I'm thinking about that now, particularly as we talk about that balance of understanding the mind-body connection, and for me personally, wanting a doctor or a healthcare provider who's going to acknowledge and understand that that's a thing, but also not dismiss what I'm feeling physically, because I'm probably just stressed out or something like that. And I think that one of the reasons it can be difficult to hold those two things at once is because, now, I don't know about you two, but I didn't really have a class that told me about having a body and like, here's what happens, here's something you should get checked out, here's a thing that happens that might feel new or strange but is actually fine. And so basically you're just out here in the world reading headlines. And frankly, when someone says they have a supplement that's going to do a thing, you're like, "Alright, well, I'll try that." Or perhaps you see enough people saying that a vaccine isn't safe, you're like, "Well, I'm not going to take that vaccine." And so I feel like all of this stuff is wrapped up together. So in conclusion. [Laughs] Casey, tell me, I'm really interested in how you approach the question of, how can people get better and more skilled at being critical consumers of health information in the media?

Casey: Yeah. [Laughs] That would be great. Yeah, so health literacy is something that I did a lot of research into for this book, and it's an issue that researchers and experts in health literacy have been looking at for a long time, and it's kind of frustratingly slow going. And some of the experts I talked to told me that part of that is because changing the health literacy of a population is a huge undertaking, but it should really be the responsibility of the people putting out the information. The doctors and health organizations that are putting out pamphlets and website copy and any kind of communication that's going to tell you more about a vaccine and why you need it and things like that, but it is also a lot on the media to make this kind of information really accessible. I learned way more about my body and about sex and about psychology from Cosmo and Seventeen and YM back in the day than I did from my health classes or a doctor or anything. And that's kind of what made me want to go into this, because I felt like the media does have this huge responsibility in meeting people where they are and giving them information that's a little bit more accessible and entertaining. The flip side of that, of course, is that with information and health information specifically being so democratized across the internet, it's really hard to figure out what's legit and what's not. So a big part of the book is just giving small tips for differentiating between legitimate and not so legitimate sources of information. And that's really boring, but I think it's work that we can flex that muscle a bit more. It's looking to the sources of everything, it's looking to see what the primary source of information is. Is this coming from one person who is saying that they've treated dozens of patients with this? Cool. Is there any peer-reviewed randomized controlled research to back it up? It's knowing the difference between a doctor who is telling you to shun the big health organizations that aren't talking about this and trust them instead. Again, it's not a perfect science, but I think a lot of it is just kind of being a conscious consumer, being a little bit more skeptical of the health messages that you're getting everywhere, and kind of always asking that question like, "Okay, but how?How is this going to reverse my cancer? How is this supplement the same as antibiotics?" Just always digging a little deeper and not relying on just a person or an anecdote to tell you that this is something that works.

Rachel: You gave a really good example in the book about early on in COVID when they were talking about how many people the flu kills every year, and you were kind of saying, this was in a major media outlet, and this was a doctor who's citing this number, and it was such a good example because you walked through, "Okay, I found the stats from the CDC, so I could find the original study." And you really, really broke down why this wasn't actually a primary source and how... I don't want to say how easy it is because I don't think that's an easy thing for everyone to research, but it's such a great example of how this can happen and why this is so difficult. And it's hard because it's hard to do that on everything, and it's hard when you're hearing it from a source that feels reputable to you. If you're hearing something on Good Morning America or from somebody at the FDA or the CDC, you kind of think, "Okay, well, that's reputable. I don't need to check into this." And sometimes people checking into that, that's how we get a run on Ivermectin. So it's a tough thing to balance, but I think it's worth reading the book because I think it's hard to explain all of this in a podcast, but I think you do a really good job of explaining in the book how to go through this and why it matters.

Casey: Thank you. And again, I don't want people to think that they have to do it every single time they're getting any push alert to their phone of like, "Oh, I need to dig ten layers deep into this." No, but if you are using this information to, in some way, seek care, not seek care, put something in your body, change your health habits in some way, I do think it's worth finding out where does that information come from? So, it doesn't have to be something that you do all the time, but when it matters, check into the sources.

Sally: Yeah, and there have been a bunch of times over the course of the pandemic where someone will share a link with me, someone will email me something, or it will show up in a group chat or something, and it's something that indicates a big change. Now we think that it's airborne, now we think we don't need masks anymore, now we think the vaccines do this or do that, and those were like, whatever. There's a thousand articles every single day about COVID, but there have been only maybe a handful of moments over the course of the pandemic where there was a really important piece of information that was going to potentially change people's habits with respect to just safety protocols, and those were the ones that I would sit down and be like, "Alright, let me click all these links, let me see where all these sources are from." I was reading studies and shit like that, and then also sometimes you just text your friends who are health journalists who you trust and you're like, "Explain this to me." But for anyone who doesn't have those, the book really does have really actionable tips that aren't a headache to implement, but will also just make you feel like you kind of know what's going on and help you figure out what you can trust in, what you should be a little bit skeptical of.

Rachel: I remember actually in our group chat during the pandemic, the story that was like, "A new study shows that 250 people got sick from an elevator." And, Sally, within three minutes, you were like, "Okay, so here's the thing. One person got sick from this elevator and then that person left the elevator and then went and got all these other people sick, but it wasn't like the virus lingered in this elevator while 200 people came through." Which is how the headline was written. And it was like, oh, okay, so this is a thing that we can immediately... and I don't remember what website it was, I think it was on Apple News though, I think it was reputable enough that, our group chat isn't -- they check the source first, so it passed that level, but you were able to sort of easily allay everybody's fears. And so it really isn't that much more research necessarily, it's just a couple of extra clicks to see how it holds up.

Casey: It's often reading more than the headline.

Rachel: Yup.

Casey: And I know again, even that is a really big chore for a lot of us, we are busy, but I would say almost all of the time, the headline is not going to be telling you the whole story.

Rachel: Yeah, I think that's right.

Sally: I think the other thing that makes things confusing is that there's a lot of aggregating that goes on, so you'll see the same five talking points in hundreds and hundreds of articles, because it's someone's job to publish a certain number of posts by a certain hour of the day. And the way they do that is they Google around and say, "Let's see what people are talking about." And so they're like, "Alright, people are talking about this, so let me publish this," and now you've added to the snowball of what people are talking about, and it kind of just goes from there.

Casey: Yeah, that's also something that I included in the book, working in wellness media for a decade, I wanted people to understand a little bit more about the way that media gets made, and these quotas that we're under and rising traffic goals and falling budgets and how all of that just affects the content that gets out there. And I think that learning a little bit more about that, while frustrating and scary, and hey, it's frustrating for those of us who work in it too, it really makes you be a little bit more on guard with the messages that you're exposed to. And I feel like when I tell people a little bit more about that, they're less likely to just see a headline and be like, "Oh, so tequila does make you lose weight, because I saw that headline." They're a little bit more on guard to be like, "That's probably bullshit."

Rachel: Yeah, I think after working with you guys at BuzzFeed I was like, "If a study says in a headline, I'm moving on with my life, I'm not clicking this. I don't care what this study says about chocolate, it just doesn't matter." I think the problem is there ultimately isn't as much health news as some outlets would like to power their health section, and so they're just relying on whatever press release of the day lands in their inbox because that's the only way. The fact of the matter is, so much of healthy living comes down to things that we've known for years and that are not sexy and not exciting. It's just like, "Eat your vegetables. Move your body a bit. Get enough sleep. Don't drink too much." And you can't say that every day or people aren't going to click it every day, so journalists or writers, let's say, are stuck just pulling from the latest survey that proves that chocolate and tequila are the secret to a long life, and it's like, "Okay, man. Sure."

Casey: One hundred percent. And I know you guys and I, we talk about this all the time in media, but I feel like when I say this to people outside of media, they're often shocked and they just haven't ever had to think about it in that way. So yeah, I think that it's just something... media literacy, I think, is as important as health literacy here. If those two things could be taught in high school, I mean also health education [laughs] that would be cool. It would set us up a little bit better.

Sally: I know. I feel like we could have a whole new curriculum. Let's get rid of math and let's just do a whole bunch of useful shit.

Rachel: I was reading the whole chapter about health education for students, I was like, Casey, let's combine your thoughts on Phys Ed and health class with my thoughts on Home Ec, and I think we could really change high schools in a meaningful way. We're cutting some classes out of there, and we're re-thinking. I went through, like, how much math do you really need? And then I was like, "Well, math kind of applies with the stuff we're talking about, because you've got to know fractions and things like that to read the studies." But I just feel like, why not combine the two? Why not learn your math in the context of reading the study? How has no one thought of this? Department of Education, call me.

Casey: Let's change schools.

Sally: Yeah, I think also it's important to note that as we talk about media literacy and being sort of skeptical, I get worried that it might sound like we're saying like, "You can't trust the media, it's all fake news, figure it out yourself." Because that's how you end up having people being scared to get vaccinated, it's how you have people taking Ivermectin and stuff like that, and it's really not that. It's not about a conspiracy to keep us all in some strange place. I mean, there's a lot of terrible conspiracies that are true, but I think the one around "They're trying to keep things from us about COVID, the vaccines are terrible, everyone take Ivermectin," that's not the stance here that I think anyone's talking about. It's more like understanding the really, frankly banal things behind why certain things are published and other things aren't. It's not that interesting. It's like, someone has a traffic quota, a brand needs to make money so it can pay its employees. And so it's not that people are sitting around being like, "How can I mislead people into thinking the vaccines are safe?" It's more like people who don't have experience reading studies and vetting them and talking to experts, those people are creating content. Anyway, I don't want to get too in the weeds, but I just wanted to point that out because I just feel like we're in a really weird time where if you say, "Be skeptical of what you read in the media," then you're one Kevin Bacon away from QAnon.

Rachel: Right. [Laughs]

Casey: Right. Be a conscious consumer of all the messages that you're getting, but more so when you're getting it from the random dude at the diner. You're going to find more processes, more regulations in the messages from content that you're getting at major publications than you are on some random Facebook group still. So yeah, don't mean to imply that like, "You can't trust the media." It's just, be mindful of all the messages that you're getting about your health.

Sally: Yeah. So one of the things that I love about this book, Casey, is that there's a pretty deep and ever-present structural analysis running through it about how difficult it is to access both healthcare and trustworthy information, and I think that really distinguishes your book from a lot of other self-help books out there. It's not just all about what you can do for yourself. It's about like, "Hey, look, we have a system where a lot of people don't have access to quality healthcare. A lot of people don't have insurance. A lot of people experience stigma and discrimination from healthcare providers, or people have had really traumatic experiences with issues of consent. People have trauma around healthcare." And I think that those are really important things that I was really glad to see. And I just wanted to ask you why you felt those were so important to include in a book that's about like, "Here are things that you, the individual, can do"?

Casey: Right, because I don't think it's all things that just an individual can do. I think the wellness industry in so many ways, is the result of cracks in the system. These predatory wellness companies and products are praying on the fact that you have very few alternatives, that you're not getting the care that you need, or it's not being delivered in a way that's convenient or affordable, or it's being delivered in ways that are stressful and discriminatory. So I think that so much of the wellness fads and holistic remedies and stuff like that are capitalising on that. And so I don't want people to feel like they're silly or uninformed or naive if they are buying into the wellness industry and these wellness fads, because I think it's just important to know that this is a result of the reality that you're in. And as much as you can be a more mindful consumer, this is going to take a lot of structural changes that are above our pay grades.

Sally: Yeah, and you have a lot of really nice and, I thought, thoughtful stuff in there about how you are not a burden for feeling like you're not getting this care or having these questions, and that was a really lovely part of the book. It's like, there's nothing wrong with you. This is a really, really shitty system, and especially because we don't have the Rachel and Casey-designed high school curriculum.

Casey: [Laughs] Someday.

Sally: Someday. So yeah, that's one of my favorite parts for sure.

Rachel: All right. Well, Casey, to end things on kind of a light note -- I mean kind of light-ish, if you take out the reality of the situation -- but what is your favorite example of just really bad health reporting?

Casey: I have so many. [Laughs] I'll let you guys pick. I mean one of them was definitely all those drug-resistant gonorrhoea headlines that were going around a few years ago, which again, not wrong, but misleading in a lot of ways without a lot of context, not telling the whole story. The CDC was finding these drug-resistant cases by isolating infections in a petri dish. They were looking for this to monitor the way that different antibiotics were working on these cases. It wasn't like people were having chronic gonorrhoea that wasn't going away. This was an example of one of those things that's useful information for other researchers and doctors, doesn't need to be going out to the public every day. We don't need a push alert on that. Doesn't actually affect us right now. Other ones are, as we talked about before, all of those one-off studies. So new study says coffee kills you, versus new study a week later says coffee prolongs your life. Anytime you see, "New study says this," roll your eyes, do not plan on changing your life in meaningful ways. No researcher, no doctor, no expert is going to tell you to change your whole life because you saw a headline on like, "Bacon could cause cancer." So definitely have those give you pause and don't forget about those.

Sally: I think also in terms of starting to build up your media literacy, there are sites that would never publish that. They would never write a story about that. Shoutout to SELF, our former place of employment. One of the reasons I know I don't have to do exhaustive fact-checking of their stories is because I know about what the standards are, and I know that everything is incredibly well-researched and fact-checked. And same with a place like The Atlantic, I've really liked some, not all of the stuff they've done on COVID. So those are places where I can go and feel like there's a baseline of trust I have. Whereas whatever news website that is publishing this thing on a study about how bacon will add years to your life, it's like, make a note that maybe the other health stuff you get from there, you should be thinking a little bit extra hard about.

Casey: Yeah, I'll give a shout out to STAT too. That's one that is just not going to have the bullshit, one-off studies. They're not covering it in that sense. And so if you're looking to beef up the sources that you use that are less anxiety-inducing, that's one of them.

Sally: Nice. And we'll as always have links in our show notes to the stuff that we're mentioning. Okay, well, I hope everyone will get your book, Casey. It is out now and it's called It's Probably Nothing: The Stress-Less Guide to Dealing with Health Anxiety, Wellness Fads and Overhyped Headlines. We will have links in the show notes to all the places that people can get it. It's a great read. I love it. Big fan. Casey, will you stick around to tell us your nice thing to end on?

Casey: I would love to. So three and a half weeks ago, I adopted a sweet little mutt. I think he's Dachshund mix, I don't really know, we're going to do a DNA test and find out. But he's super sweet, his name is Oliver, and he was picked up as a stray, and I can't really imagine that because now he just is a purveyor of soft things in my apartment and is very domesticated. [Laughs] So he's kind of loving life now, and has taken over my couch and my bed, but he's a very nice thing.

Sally: I love this for you because since I've known you, you've been a hardcore dog enthusiast and lover, and I feel like you're stepping into your final form as someone who now has a dog of their own.

Casey: I have levelled up officially, yes.

Sally: Rachel, what is your nice thing to end on?

Rachel: My nice thing to end on is that I'm about to take a trip. So I don't remember if I've talked about this, I think I have, but I'm going to Acadia National Park in Maine, and I am so excited, a little intimidated and nervous, but ultimately, I think it's going to be fine and great because we'll see what happens. If it rains one day, it rains. If we don't get to do every last thing, we don't get to do every last thing. I think it'll just be really exciting to get out of Brooklyn for the first time in nearly two years and to see something new and get some nature, and I've wanted to go to a national park for a really long time, so I'm really excited about this.

Sally: That's awesome. I think the bar is really low for novelty during this pandemic.

Rachel: Yeah. It's so low.

Sally: So I think even just being on the highway will feel amazing.

Rachel: Oh my god, yeah, it's going to be great. [Laughs]

Sally: Okay, so my nice thing to end on is the emoji that's the smiling face with the tear. This is relatively new sometime in the last handful of updates, right? We got the happy but crying emoji, and I find that I use it constantly. And it's different than the sobbing emoji, which I also use a lot, and it's different than the... what do you call the emoji with the big eyes?

Rachel: Oh, yeah, the adorable one, it's like big eyes, it's tearing up but a cute thing.

Sally: It's bashful or something. I don't know. It's a combination of tearing up and touched, bashful. I don't know.

Rachel: Yeah.

Sally: This is like totally its own thing and I'm really into the fact that emoji is now, that we're getting to a place where there are emojis for every single emotion and sub-emotion that exists. And I just think it's really lovely because it's what you send when you want to happy cry. When something is so lovely that it actually makes you tear up. And I just think that that's a nice thing to end on. So that emoji is always in my recently used, and I think everyone should have experiences that make them want to use that emoji.

Rachel: That's a great thing to end on.

Sally: Okay, awesome. So, thanks for listening to this episode of Oh I Like That. Please rate us and review us wherever you listen to podcasts.

Rachel: You can follow us on Twitter @ohilikethatpod or email us at ohilikethatpod@gmail.com. You can also follow us on Twitter. I'm @the_rewm and Sally is @sallyt.

Sally: Oh I Like That is produced by Rachel and Sally and edited by Lucas. Amber Seger, who is @rocketorca on social media, designed our logo.