A few days ago, upon awakening but before my brain was fully alert, I was reviewing the events of the previous few days in preparation for the new one. At one point I tried to remember a conversation I had had with a colleague about three days prior, but I could not quite remember the specifics of our discussion. “No big deal,” I thought to myself, “I’ll just Google it.”
Almost immediately, I recognized the folly of this thought. Obviously, there is no way to “Google” the events of our personal lives. But while impractical, the solution was a logical one. If I want to know any fact or piece of information, I Google it online. If I want to find a file on my computer, I use Google Desktop. All of my email conversations for the last five years are archived in my Google Mail account, so I can quickly find correspondence (and people, and account numbers, and emailed passwords, etc) at the click of the “Search” button. No wonder I immediately thought of Googling myself.
A recent article in Science claims that the permeation of Google and other search engines into our lives—and now onto our smartphones and other portable gadgets—has not only made it easier for us to retrieve information, but it has also changed the way we remember. In their experiments, three cognitive psychologists from Columbia, Harvard, and UW-Madison demonstrated that we are more likely to forget information if we know that we can access it (e.g., by a search engine) in the future. Moreover, even for simple data, we’re more likely to remember where we store pieces of information than the subject matter itself.
The implication here is that the process of memory storage & retrieval is rapidly changing in the Online Age. Humans no longer need to memorize anything (who was the 18th president? What’s the capital of Australia? When was the Six-Day War?), but instead just need to know how to access it.
Is this simply a variation of the old statement that “intelligence is not necessarily knowing everything but instead where to find it”? Perhaps. An optimist might look at this evolution in human memory as presenting an opportunity to use more brain power for processing complex pieces of information that can’t be readily stored. In my work, for instance, I’m glad I don’t need to recall precise drug mechanisms, drug-drug interactions, or specific diagnostic criteria (I can look them up quite easily), but can instead spend pay closer attention to the process of listening to my patients and attending to more subtle concerns. (Which often does more good in the long run anyway.)
The difference, however, is that I was trained in an era in which I did have to memorize all of this information without the advantage of an external online memory bank. Along the way, I was able to make my own connections among sets of seemingly unrelated facts. I was able to weed out those that were irrelevant, and retain those that truly made a difference in my daily work. This resulted, in my opinion, in a much richer understanding of my field.
While I’ve seen no studies of this issue, I wonder whether students in medicine (or, for that matter, other fields requiring mastery of a large body of information) are developing different sets of skills in the Google Era. Knowing that one can always “look something up” might make a student more careless or lazy. On the other hand, it might help one to develop a whole new set of clinical skills that previous generations simply didn’t have time for.
Unfortunately, those skills are not the things that are rewarded in our day-to-day work. We value information and facts, rather than substance and process. In general, patients want to know drug doses, mechanisms, and side effects, rather than developing a “therapeutic relationship” with their doctor. Third-party payers don’t care about the insights or breakthroughs that might happen during therapy, but instead that the proper diagnoses and billing codes are given, and that patients improve on some objective measurement. And when my charts are reviewed by an auditor (or a lawyer), what matters is not the quality of the doctor-patient interaction, but instead the documentation, the informed consent, the checklists, the precise drug dosing, details in the treatment plan, and so on.
I think immediate access to information is a wonderful thing. Perhaps I rely on it too much. (My fiancé has already reprimanded me for looking up actors or plot twists on IMDB while we’re watching movies.) But now that we know it’s changing the way we store information and—I don’t think this is too much of a stretch—the way we think, we should look for ways to use information more efficiently, creatively, and productively. The human brain has immense potential; now that our collective memories are external (and our likelihood of forgetting is essentially nil), let’s tap that potential do some special and unique things that computers can’t do. Yet.
Thought Broadcast 
As a Myers-Briggs INTP, this is the way my memory has always worked — mapping to categories and schema rather than facts.
It’s always left me at a loss in conversation, though, because I have trouble producing the factoid but I can remember the implications and the source. (This makes me terrible at telling jokes.) Going to the Web for backup has made me seem much more competent memory-wise.
No junk, you really search IMDB during movies? Do you think cinematic suspension of disbelief is headed for the dustbin of history as well?
Its not just google of course, and I think a lot of the tech makes people more careless, lazy and ‘able.’ I hate to sound like a fuddy duddy but what happens when the computers crash or the handheld calculator? Kids are not learning how to do math in thier heads or even by hand. Some schools just stopped teaching cursive writing. Maybe less brain disk space taken up by facts gives more room to make the creative connections?
(I was at doc last week. He was writing his EMR’s for me and some other patients when the office computer system crashed. He said with some anger, “Now I’ll have to write the notes by hand.” and yet it was not long ago, has it been a year even(?) when that was how they were all written but now it is an inconvenience (despite his acknowledging before it crashed that it took longer to enter the info into the comp.) I love google. I love being able to be in a cov=nverstaion with someone and able to say let me google it to add to the conversation but I notice I am attending less to the actual conversation. For sure something for me has been lost (and to the person on the other end.)
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“How do I use the Physician Nexus Chat?
To see who is online:
Click on the tab to open the chat window. At the right hand side you will see who among the members are available to chat. Members who are logged in to the site will automatically appear in the chat window. Here, you can also do the following by clicking on the member’s tab: you can view the member’s profile page; you can send a gift; you can engage in a private chat.”
Ooooh! Private chats! And you can get gifts! I’d do this if I were you, Steve!
Hmmmm, who provides the gifts? And do you get to see lots of ads, too? Wonder who might be doing the advertising?
I wrote a little reply to this on my blog. I think that medical education, at least in the first two years, has not caught up with the technology. There’s still plenty of forced rote memorization, and through that we are missing an opportunity to “develop a whole new set of clinical skills that previous generations simply didn’t have time for.” While I am a person who subscribes to the “don’t memorize what you can look up” philosophy, and I would much rather spend time putting information into schemes and trying to understand the why of things, sticking to my guns on that point would have led to failing out of medical school (or at least failing Step One). I don’t think that this is a good thing. Why should we force medical students to learn things in a way that is totally different than the way that they will actually use them? Given a limited number of hours between the first day of classes and the first day of internship, would they be better spent working through and really understanding complex topics with a pharmacopeia in hand, or memorizing drug interactions and metabolic pathways? I think the latter. And I know that I have found the latter far more rewarding as a student. Hopefully the way that we teach this information will catch up with the way that we use information going forward.
Sir,
Do not worry; soon you can “google it!” Google all the tim is googling you. Please, this is my story:
I was writing an email, using my gmail, like this: “my heart aching for you” at the side bar an ad appeared as, “DVD for cardiovascular gym training from Amazon” I added, ” I can’t sleep far from you” an ad came as, “natural alternative herbals for comfortable sleeps from … drugstore” I continued as, “I have become accident prone” an ad came as “injury and accident lawyers from This & That co.” Is this a private love letter? Now, this is hilarious: I typed, “No, I cannot go to bed alone tonight.” It came, “… Agency, your local socialisation agency in Leatherhead.” They even know where I am living. They know my house number, even my food diet. In spite of all these, still, I spend ten hours at the computer everyday revealing more and more of me. This is a brave new world. Almost, I am losing sense of privacy like ants who pass all the contents of their memory to each other. They are acting similar to cells in our body when exchanging information but can move far from each other. They are mind-less entities.