Our Chronic State of High Alert
Alfred Sommer, MD, MHS
There is little evidence that cell phones cause cancer, but plenty
of reasons to be concerned that modern telecommunications might
affect our mental health.
There was once a time (about 15 years ago) when correspondence
was remarkably orderly and digestible. Letters from Burma could
take a week to arrive, while those from California could take even
longer. No need to rush a reply: Who knew how long the original
had taken to reach you? Time provided an opportunity for thought
and common civility (as in, "How are the spouse and kids?").
Then the fax arrived. You and the sender both knew exactly when
a fax was received — simultaneously with when it was sent. Faxes
were sufficiently novel (and long distance phone rates sufficiently
high) that their arrival demanded an urgent response — if "urgency"
wasn't needed, it wouldn't have been faxed! The great communications
race was on, but few of us recognized it.
Enter e-mail. I began using it, largely for internal communications,
about 12 years ago. It seemed a quick and efficient means of communicating
with a specific individual for a specific purpose, mostly on a limited
intranet shared by a few others in the same institution.
Six years ago, e-mail traffic began to take off. At first, e-mail
seemed not only innocuous, but a real time-saver. Faculty and staff
could send me a quick note about an issue, and I could respond when
I was free, eliminating two to six fruitless telephone tags.
The real revolution began only two years ago. "Snail mail"
disappeared — which would have been fine if e-mail had simply replaced
it. Instead, e-mail changed the entire nature of written communication.
First, you didn't just e-mail the principal correspondent; you also
e-mailed 12 potential "respondents" and their 200 closest
friends. Why leave anyone out of the loop when a simple click of
the mouse could capture the universe? The sheer magnitude of e-mail
rose dramatically. Five years ago, the School processed 20,000 e-mails
a day. Last year, it processed 350,000 a day. It's true that my
first Wang word processor could generate "personalized"
form letters and "bcc"s by the dozen, but the tendency
to involve this radical new capability was held in check by the
need to feed the printer, sign and fold each letter, and address
and stamp each envelope.
The second consequence of the e-mail revolution was to increase
dependency. People perfectly capable of making the most complicated
decisions suddenly became dependent upon the advice of dozens of
colleagues and the agreement of their titular boss. This is reminiscent
of claims that the invention of the telegraph brought down the British
Empire: People in the field needed to consult with London before
making any decisions, something that had been impossible when letters
took three months to circle the globe.
The net result? Another quantum jump in the quantity of e-mail traffic.
How in the world does one cope with 100 or more e-mails a day? I've
absolutely no idea, but it dominated discussions at a recent meeting
of deans of schools of public health. I am certain we will soon
enjoy a plethora of self-help books on the subject.
If e-mail were not bad enough, it's been joined by the cell phone.
Personally, I have mine off except when I need to make an
urgent call. But that hardly helps. One is constantly surrounded
by these chirping, musical machines; and by train passengers engaged
in (generally) boisterous descriptions of their latest business
plans, meals, or life conquests.
The bottom line? We are tethered to an overwhelming volume of communication.
Attempts to find a time and place for thought and deliberation are
often thwarted by others. Except for remote mountaintops, there
is virtually no escape from incessant messages, whether they are
your colleague's latest thoughts, your fellow passenger's stock
picks, or the inevitable dinnertime solicitations.
If extreme shyness ("social anxiety syndrome") is the
newest "major mental health problem," allegedly afflicting
10 million Americans, what can we expect of our frazzled society
when its mental health is next assessed? I remember what it was
like to be on call as an intern, sometimes for as long as three
days at a time. We are all now "on call" around the clock:
24 by 365.