Becoming a medical dataset: The digitization of modern existence in England

One of my first tasks on returning to England after 15 years in Hong Kong was to reregister with my village health clinic. In order to do this, I had to fill out an exhaustive questionnaire to determine my basic state of health. Since then, I have been bombarded by requests/demands for blood tests, various cancer screenings, heart rate and blood pressure monitoring.

This is partly due to my advanced age (over 60), as well as the lack of any National Health Service (NHS) records for me over the last two decades. In order to fill in the gaps, I offered to provide my medical records from doctors in Hong Kong but this proved to be a remarkably complicated and time consuming process. In order to get my Covid-19 vaccinations recognised by the NHS app, for example, I had to travel to London (one hour on the train) and locate one of the few hospitals in the capital authorized to scrutinize non-UK vaccination certificates.

A referral letter from my eye doctor in Hong Kong vanished in the village clinic’s paperwork but thankfully Hong Kong is much more efficient and one phone call was all that was needed to get the necessary documents sent over again.

But basically, my medical database has had to be built up again from scratch, and this experience has coloured my view of the medical profession here. During the ten years when I last lived here around the turn of the century, I had one general practitioner who I could visit as and when necessary, which thankfully was not very often. She did not have a great bedside manner but at least she knew who I was. Nowadays, most consultations have been with anonymous doctors over the phone who are responding to the immediate test results before them without any knowledge, context, or apparent interest in my previous medical history.

I have no problem with the individual doctors, the system in which they operate clearly gives them little room for in-depth or holistic consultations. And I understand that they need data to make an informed opinion. It is just that I find the whole process dehumanising.

Sheep in the field adjacent to my village health centre

I suspect however that I am in minority here. I know many people who are more than happy to collect as much medical data as possible through wearable devices that monitor heart and breathing rates, sleep patterns, steps taken, calories burnt, skin temperature, blood oxygen and glucose levels. As Fitbit says, its trackers are “slim, sleek and packed with stats.”

I can understand the need for such monitoring if you have a serious medical condition but for generally healthy individuals, it seems a bit excessive, even dare I say it unhealthy. An obsessive focus or reliance on medical data, just like social media data, reduces human existence to a bunch of numbers, and that erodes one’s ability simply to feel. And it seems that many elite runners in the United States now agree with me.

Then there is the obvious danger that all this data is being collected and processed by the tech companies that provide the devices. They may assure that your data is safe but do you really trust the word of a profit-driven corporation in a world where all data is a commodity for sale? Just look at what car companies do with drivers’ data.

This obsession with health monitoring is not new however. Well before the emergence of smart watches, even smart phones, I shared an instructive night out at an oxygen bar in Hollywood with a group of New-Age devotees. My companions’ obsession was bodily and spiritual purity, which as Mary Douglas has demonstrated in Purity and Danger: An Analysis of Concepts of Pollution and Taboo is a condition as old as human existence.

In order to obtain purity, my companions told me, first you have to monitor all the potential hazards around you; hormone enriched meat, alcohol, exhaust fumes, tobacco smoke, as well as unspecified negative energies. They seemed to regard the world around them and the people in it as essentially poisonous, and their life was a constant battle to counteract these threats. Any slight ache or pain was regarded as an imperfection that needed eradicating.

Likewise, many devotees of modern technology regard failure to meet their fitness goals as a sign that they need to work even harder on obtaining those goals, rather than just accepting perhaps that they are getting older and need to slow down.

One thing that is painfully obvious to me is that I can no longer cycle up the steeper hills in the valleys around my village that 20 years ago I could manage without too much effort. My bike rides are much more leisurely these days but this has the advantage of being able to better appreciate the ever-changing scenery around me. Now, I often stop to take a look at the wildflowers, the fruit trees, the sheep in the fields or just smell the air. Previously, I might have kept peddling in a bid to match my best time on a particular circuit. Today, as long as I feel my heart rate is elevated for a while and my leg muscles are getting a workout, that is sufficient. I really don’t need a comprehensive data readout after every ride.

I realise that I may come across as an analogue relic in a digital world, I prefer cash to digital payments, and human interaction rather than chat bots. I do accept that technology has its advantages, it is just prudent to remember that there is always a flip side.

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