Hot or Not?

Physical attractiveness has certain advantages. Not only do you get to go on more dates if you’re good looking, but research by social psychologists such as Dion, Berscheid and Walster shows that you’re more likely than your less attractive fellows to be perceived as intelligent, pleasant, warm, well-adjusted, sexually proficient, and competent. The benefits of attractiveness start early. Karen Dion, for example, has found that the way that we judge the behaviour of young children is influenced by their physical appearance. Bad behaviour of children perceived to be attractive is more likely to be explained away as a temporary aberration than it is on the part of children perceived to be unattractive. The benefits extend into adult life. Did you get good marks at college? If so, then perhaps you were helped by your looks. Landy and Sigall have found that identical essays will receive significantly different marks depending upon the perception of the attractiveness of their authors. Needless to say, better looking means better marks.

There is an interesting point to be made here about the lives we  live in the virtual world. One facet of internet communication is the absence of many of the cues that we rely on to make judgments about people in the everyday world. If someone has the looks of a supermodel, then likely it won’t be an issue in email communication in quite the same way that it is in a face-to-face situation. Perhaps, then, there is a sense in which communication in cyberspace, especially when one considers that cues to do with sex, age, social-class and race are also frequently absent, is less distorted than it is in everyday life.

However, the internet has not escaped our obsession with beauty. For example, have a look at the web site Hot Or Not? It is a matchmaking service with a twist. You upload a photograph of yourself to the web site, then other visitors to the site are able to rank, on a scale of one to ten, whether or not you are “hot”. A visit to this web site will be enough to dispel the myth that we don’t agree about what constitutes attractiveness. If we didn’t, then each person would score more or less the same mark – because of the effects of averaging over a large number of votes – but they don’t, which goes to show that beauty is not solely in the eye of the beholder.

A more extreme version of the Hot Or Not? phenomenon emerged a few years ago on the LiveJournal blogging community. LiveJournal allows users to create online communities, which are organised around particular topics. The Nonuglies community was established for beautiful people only. To join, it was necessary to post a picture of yourself on the community to see if existing members rated you as a beauty. If they didn’t, then they would tell you so. Bluntly. Here is an example:

You are one ugly bitch [shudder] . You are practically the epitome of ugliness. Double chin, horrid braces, no eyelashes, limp, boring hair, big ears, absolutely no color, shapeless eyebrows, no fashion sense…

Why bother mentioning such gratuitous and crass nastiness? Partly because the Nonuglies community was incredibly successful. It is credited with being the inspiration for a huge number of spin-off communities, including communities for teenagers, gays, lesbians and couples. Morever, there are also communities that are devoted solely to chatting about the Nonuglies phenomenon.

But also because the existence of communities such as these raises a number of interesting philosophical issues. The members of the Nonuglies community were criticised for their cruelty. It was pointed out that many of the people who were judged to be ugly were very young, possibly vulnerable, and were quite likely to be hurt by the criticism and abuse which came their way. The response to this criticism tended to be that people know what the community is for before they post their pictures, so if they don’t want to have their looks criticised, they shouldn’t get involved. However, the problem with this response is that it just isn’t clear that the fact that a person accepts the possibility that they might be hurt justifies the act of hurting them. For example, many people will consider a wager which involves a toss of a coin and a fifty-fifty chance that a person will either receive £1,000 or be electrocuted to be morally suspect, especially if the person taking on the wager has a strong need for the money.

It is an interesting point about closed communities on the internet, such as Nonuglies, that there is no real possibility that dissenting voices will be heard. Gordon Graham makes this point in his book, The Internet: a philosophical enquiry. He argues that the internet encourages the formation of pure confluences of interest.

Surfers have the opportunity to seek out kindred spirits and to pass over the sort of reforming and refining influences that operate in the normal processes of learning.

If Graham is right, then given the centrality of attractiveness in the non-virtual world as a source of esteem and kudos, it was probably inevitable that some of the beautiful people of the world would band together to form a community such as Nonuglies in an attempt to reclaim a birthright threatened in the virtual world by the fact that cyberspace is normally blind to the body beautiful.

Ivan Noble

This happened more than twenty years ago. Nowadays it doesn’t require a trip to the library to scare yourself witless; just a few mouse clicks will do it. Ivan Noble, who recently died of brain cancer, documented his two year struggle with the disease on the BBC Online website. His third entry, titled ‘Net Terrors’, written shortly after his diagnosis, tells how he was browsing the internet at four one morning, when he came across a site where a patient with the same tumour had asked a doctor how many people with their condition were still alive three years after diagnosis. The reply was ‘none’. Noble, quite sensibly, decided that, for a while at least, he was going to stay clear of medical web sites.

However, there is one group of people who cannot stay clear of such sites. They are the internet hypochondriacs; or, as they have been called, the cyberchondriacs. In the past, hypochondriacs would scour medical dictionaries and the like in order to track symptoms and self-diagnose; now they interrogate search engines and visit online forums. It’s a growing problem. An American study in 2003, found that eighty percent of adult internet users had at some time used the net to research illness related subjects; and some six percent use it for that reason everyday. According to Dr Trefor Roscoe, a GP and computer specialist, doctors are now being inundated by patients with cyberchondria or ‘internet printout syndrome’, as it is also called.

Of course, there is nothing new about hypochondria; the syndrome has been recognised since the days of the Roman physician Galen. But the problem with the internet is that it meets and fuels the hypochondriac’s obsessive need for health-related information in a way which no other medium has managed. Brian Fallon, the co-author of Phantom Illness: Recognizing, Understanding and Overcoming Hypochondria, is in no doubt that in this regard the internet has made things worse for the person suffering health anxiety.

The trouble is compounded by the fact that the information on the internet is unregulated. This is the perennial problem for anybody who uses the internet for the purposes of research. Information is frequently deprived of the authority which makes it reliable. Therefore, if you’re suspicious that the tingling in your limbs means that you have multiple sclerosis, it is a certainty that in time you’ll find someone on a health forum willing to confirm your suspicions; or, if you’re feeling tired, and suspect that it might be the sign of some serious illness, it won’t be long before somebody suggests that you have lupus or some other weird autoimmune disease.

Fallon advises his patients to stay clear of the internet: ‘In a loose sense, a hypochondriac becomes almost addicted to looking up information, examining himself, and getting reassurance from other people. Checking just makes things worse.’ Ivan Noble also struck a cautionary note:

It is wonderful that so much information is available and that patients can be as well informed as they want to be. But it is very difficult to filter that information. It is not possible to start to search the net and hope to see only encouraging news. Along with the details of therapies, diets and clinical trials, there is cold, clinical information out there about how many people die and how they die. Link leads to link and it is easy to terrify oneself like I did.

Hypochondriacs beware, then; the internet can seriously damage your mental health.

Related Post: I’m an internet hypochondriac.

In fact, my hypochondria went into remission for most of my teenage years. I did have multiple sclerosis briefly one morning, but it turned out to be no more than pins and needles caused by spending the night lying fast asleep on one arm. And then there was glandular fever, but since I really did have that, it doesn’t quite count. Mind you, my self-diagnosis of leukaemia proved to be somewhat wide of the mark.

Unfortunately, this period of relative calm came to an end with a dieting fiasco in my early twenties. I had been getting a bit podgy – too many cakes, rather than liver disease – so I thought a diet was in order. It went well. I lost four pounds in ten days. Very encouraging, except I promptly convinced myself that weight loss meant stomach cancer, and contrived to stuff myself silly over the next week just to prove that I could put the weight back on again. I could. In spades.

This kind of madness has continued off and on for the last twenty years. But recently it has taken a disturbing new turn. For I have discovered that the internet is the hypochondriac’s best nightmare. It all started with a game of squash, heat exhaustion and a doctor’s visit.

“You’ve overheated,” said the doc, obviously noting my fevered brow.

“Why’s that then?” said I, forgetting that I had just played squash in one hundred degree heat.

“It’s a hot day,” somebody said, rather contemptuously I felt.

And if only things had been left there. But, oh no, the doctor just had to pipe up with, “Well, almost certainly that’s it, though there are some very rare conditions which can cause overheating. But there’s no need to worry about them, and I’m not going to tell you about them anyway, because it’ll only frighten you.”

Well what the hell did he mean by that!? I just had to find out. And that’s when it occurred to me, use Google! So I typed in “hot flushes”. Menopause, it replied. I contemplated this possibility for perhaps somewhat longer than a man in his early forties ought to, but even I couldn’t quite believe that I was going through the change. So what else might it be? Tamoxifen? Nope. A tumour on the thyroid gland? Ah, that was more like it, but they’re usually benign, so not too scary. And then I saw the words guaranteed to precipitate a hot flush in any self-respecting hypochondriac. Pancreatic cancer.

Pancreatic cancer is not an illness which tends to have a happy outcome. So, needless to say, I immediately became convinced that I was suffering from it. But what to do? I was much too scared to do further research on the net. And anyway what was the point in finding out how much time I didn’t have left? And then I hit upon a harebrained scheme. People with fast acting terminal illnesses must notice physical decline pretty quickly. So why not set myself a daily physical test – like 2000 metres on a rowing machine – to see whether I got any worse at it? If in a month I hadn’t, then I was probably home clear.

This wasn’t a very clever plan. Its major flaw became apparent some seven minutes after I had embarked on it. Lying panting on the floor in a pool of sweat next to the rowing machine, I realised with horror that I was going to have to repeat the whole process again, just as quickly, the next day. And then the one after that, and so on for a month. At that rate, more than likely I’d expire with a coronary long before my pancreas shuffled off its mortal coil. But did I let this thought stop me? Not a bit of it. The next morning found me astride the rowing machine, eyes bulging with effort, or possibly hyperthyroidism, desperately chasing the clock. Could I match yesterday’s effort? I’m sorry to report that I could not. The clock worsted me by a clear two seconds. Not a huge amount, admittedly, but an obvious indication that my physical decline had begun.

It occurred to me that maybe I ought to call the doctor’s surgery immediately to inform them of my imminent demise. I wasn’t sure they’d be particularly interested, but I figured at the very least that I ought to cancel my flu jab appointment. I could also update them on a new, rather irritating, symptom that had appeared over the preceding few days.

Twitching. Nope, not some strange desire to sit in a field hoping to catch a glimpse of a stray pigeon, though that would have been bad enough, but rather muscles that twitched. A lot. In fact, rather as if a family of hyperactive moles had taken up residence in my limbs. This was not good for my already frazzled state of mind, since it was turning out to be rather difficult to sleep with Moley and his pals skipping the light fantastick in my calves every night.

In normal circumstances, new symptoms are the lifeblood of a hypochondriac’s obsession. There are, after all, few pleasures in life to match the sweet terror of flicking through Gray’s Anatomy to determine whether the pain you’ve just noticed in your knee is a sign that a vital organ is about to give up the ghost. However, on this occasion, I was not overly worried. It was just muscle twitching, which compared to pancreatic cancer surely could not be too serious. So why not Google it? At least that way I could present my doctor with the bundle of research that he always so appreciates when I want him to confirm a particular diagnosis.

Google unfortunately did not share my optimism about muscle twitching. Admittedly, there was mention of anxiety, caffeine and too much exercise – none of which I took to be particularly life-threatening; and I was fairly certain that something called benign fasciculation syndrome was going to be…well, benign. But none of this compensated for the horror of seeing page after page pop up on motor neuron disease, or ALS as I soon learnt it is called in North America. This really was not the best news. It was unfortunate enough to be suffering from one terminal illness, but to be suffering from two, especially when the second one involves a relentless decline into total paralysis, seemed really to be taking the biscuit.

I’d like to say that I contemplated my fate with equanimity – that I cut a rather noble figure as I calmly reminded loved ones of Epicurus’s maxim that ‘Death is nothing to us’. But the truth is my reaction to this new development was more Woody Allen than Epicurus. I became morbidly obsessed with the twitching of my muscles. I would think nothing of spending whole afternoons staring in horrified fascination at the subcutaneous bubbling my calf muscles in particular seemed determined to torment me with; and the merest suspicion that a previously twitch-free zone had decided to join in with the fun would be enough to provoke copious wailing and desperate entreaties for medical intervention.

I am pleased to report, though, that I retained a semblance of the scientific spirit in the series of strength tests I devised to determine just how quickly I was growing weaker. These included: standing on one leg (personal record – 5 minutes 32 seconds); standing on tiptoes on one leg (1 min 15 seconds); standing on tiptoes on one leg in the dark holding a cup of tea (4 seconds); hopping upstairs carrying a large cat (23 stairs). It is true that these tests did not show any dramatic decline in my physical prowess – in fact, if anything I got better at them as time went on – but I was not reassured. No doubt I had a variant of motor neuron disease that would taunt me with the possibility of remission, or even a cure, only to accelerate wildly the moment I began to think that just perhaps I’d be okay.

Obviously, suffering from two terminal illnesses – though, oddly enough, by this stage I wasn’t spending much time thinking about the pancreatic cancer – it was necessary to inform family and friends that I wasn’t going to be around for much longer. It was with a heavy heart, then, that I broke the news to my parents that their beloved son was unlikely to see out the year. It has to be said that their reaction to this bombshell was somewhat underwhelming. My father barely glanced up from the Daily Telegraph, and my mother muttered something about remembering to cancel the television license. Clearly they hadn’t understood what I was telling them. So I explained about my pancreas, and about the twitching, and how all this was terribly bad.

“Oh yes, that twitching, your father has that, and he’s still alive, more or less,” said my mother.

This was unexpected news.

“Show him your calf muscles, dear!”

My father knows better than to ignore a direct command from my mother, so he obliged by rolling up his trousers. It took a little while for me to pluck up the courage to look at his unadorned lower legs, but when I did, I was stunned to see that his calf muscles twitched every bit as wildly as my own.

This was a staggering revelation. It just seemed impossible – such a coincidence! I gave him what I hoped was a look of immense compassion, and then broke the news that he too was suffering from motor neuron disease.

“Oh well,” said my mother,“could be worse, he could have pancreatic cancer as well.”