Recently I encountered two of my young adult daughters sitting on the same couch, both staring into their iPhones laughing. When I inquired about what was funny, I came to understand that they were communicating with each other using a social media site through their phones while sitting next to each other. I found this situation nonsensical and beyond my capability to comprehend. My daughters were just as confused at my bewilderment, since this act seemed perfectly normal to them.

I often feel fortunate to be old enough to remember a time before computers and social media. My daughters have never really known a world without this technology. If I wanted to communicate with a friend, my options were limited to writing a letter, the telephone or actually physically traveling to the friend and talking face-to-face. These options all required a certain amount of social skill that was developed through trial and error (far more error if my dating history is any example). Today, my daughters see these options as foreign and as nonsensical to them as having a social media conversation by phone with someone sitting next to you seems to me.

I have been wondering lately about the impact this new electronic communication frontier is having on how our children develop socially into adults. As a professor of anesthesiology at the Uniformed Services University, I interact often with our young colleagues training to be the next generation of physicians and nurses. I have noticed, and confirmed this observation with other professors, that many students today struggle with direct verbal communication. Conversations are stunted, often truncated, and eye contact uncomfortably strained. I also find written communication skills have fallen precipitously from what I consider minimal competence. At the risk of sounding too much like an old curmudgeon, I am wondering if these significant changes in how modern humans interact is resulting in new psychological and physical stressors that our bodies are not necessarily designed to sustain.

While I have been thinking about these communication and social changes linked to the internet for some time, I was spurred into this editorial by recent information from the Centers of Disease Control and Prevention (CDC) that, between 1999 and 2016, suicide rates have significantly increased in 44 states, with 25 states reporting over a 30% increase.1 The article specifically noted “relationship problems” as a factor associated with the upsurge. A quick Google search with the terms “social media and social isolation” reveals a wealth of information connecting extensive use of social media to issues with feelings of loneliness and segregation, particularly in young people. Certainly the unscrupulous use of social media by some young people to degrade and humiliate other peers, sometimes resulting in suicide, has not been a rare news item. I also wonder if the impact of this electronically-induced isolation may contribute to the abuse of drugs and alcohol that plague our society.

I admit that I am no expert in the use of social media, as the giggles from my adult daughters would indicate when they see me struggle with any social site on the internet. In fact, I have personally banned all social media sites from my internet devices after I learned what Facebook was doing with my personal information. While I miss the occasional cat video or messages from friends distant in time and geography, I can access those videos anytime, and, if a friend wants to chat, they know where to find me. Email already seems to consume considerably more of my work and private life than I deem healthy.

I certainly see the advantages of our modern internet-based global information systems. Being able to access the anesthetic implications associated with Charcot-Marie-Tooth disease in the time it takes to write this sentence is absolutely mind-blowing. My effort with this editorial is to suggest there may be a downside to all of this “connectedness” and healthcare providers should be aware of these issues when consulting with their patients.

I am not a Luddite, nor am I ready to surrender my high speed Internet connection and all the goodies attached to it. While I prefer my social interactions the old-fashioned, face-to-face way, I recognize the value and convenience electronics contribute to my life. I recently upgraded the electronics suite on my sailboat and can now effortlessly navigate the Chesapeake Bay, knowing exactly where I am in relation to everyone else on the water with real-time weather overlaid on my screen, as I listen to Jimmy Buffet pumped in by satellite. Life does not suck with electronic-assisted senses at your fingertips. Then again, I remind myself that I am still a human animal, the product of millions of years of evolutionary design free of any electronic enhancement.

Oscar Wilde said, “Everything in moderation, including moderation.” Perhaps an occasional deep dive into social media or other internet landscape is OK. Maybe email really does make me more efficient in my work life, good relationships can start on electronic dating sites and having the Google oracle on hand to answer any medical questions I can think of is essential. I just think we need to educate ourselves, and our young people in particular, on how to take a break from the electronic world.

I often hear the joke, “If you want your computer fixed, call an 8-year-old.” Young people appear to have no problem embracing the benefits of our increasingly connected and online world, but are we arming them with the skills to disengage and spend some time with our natural primitive selves? Is this constant connectedness, while convenient, good for our mental health if we fail to unplug and take a break? What represents healthy consumption of social media and what is unhealthy? I certainly do not have the answers to these questions, which is why I feel this discourse is so important.

I love my electronics, whether to keep in touch with my daughters in college, share a laugh with a friend, avoid a storm on the Bay or blast that cartoon alien. I also love my time away from these things. I passively separate myself from devices during exercise or meals, but recently I have found actively separating and quieting the mind through meditation has worked to reduce modern life stress for me. Interestingly I have been learning to meditate using an app ( on my phone, so resting the mind and taking a break from the internet are not necessarily incongruent. While I never thought I could say these words, Lady Gaga and I have this in common: meditation calms me down.

I am aware that this particular editorial has been somewhat rambling with no clear direction. I feel my difficulties in writing on this subject are indicative of the murky issues surrounding our growing and seemingly insatiable appetite for the internet. There is no doubt it contributes substantially and significantly to the quality of our lives, but in our enthusiasm we should not allow ourselves to be blinded to the seedy underbelly of this technology. As healthcare providers, we need to assist our patients in finding that happy median between the healthy and unhealthy consumption of this technology.

1 Accessed June 11, 2018.