Defining Human Experience: The Medium and the Message

Before becoming a pediatrician, Dr. Michael Rich, Director of the Center on Media and Child Health (CMCH) at Boston Children’s Hospital used to work in Hollywood and Japan as a film director and writer. In Japan, he apprenticed for famous director Akira Kurosawa, learning the art form of authorship and narrative from one of the best storytellers ever. With his return to Hollywood came a realization that the American entertainment industry was less about story than about spectacle and so Dr. Rich embarked on a career change into medicine, specifically pediatrics.

It may seem a gargantuan transition, but when you pull back the not so thick layers behind the nature of the work of a doctor and that of a director or storyteller, there is a unifying thread that focuses on the human condition and why we behave the way we do. “The narrative is our most basic form of communication,” Dr. Rich explained. “And it is through narrative that we can achieve intimacy with people and their experiences.”

During his time at Harvard Medical School, however, Dr. Rich witnessed how some medical students had difficulty truly empathizing and understanding the people they were helping. “They didn’t know how to relate with people,” said Dr. Rich. “In many ways, required pre-medical academics insulated them from the human experience. The scientific method pushes doctors into isolating and identifying the biomedical problems to be solved, rather than seeing and understanding living, breathing, thinking individuals with rich and complex lives.”

The pioneering visual anthropology text, Through Navajo Eyes, inspired Dr. Rich to launch a method called the Video Intervention/Prevention Assessment (VIA) as a means to better understand what kids living with various chronic conditions experienced. “I really wanted to see and understand the child’s experience of illness from the inside out,” Dr. Rich said. By giving camcorders to children, Dr. Rich and his team were able to observe and feel the patient-centered illness experience that hadn’t been explored before. Findings from VIA not only transformed the way physicians took medical histories and developed treatment plans that were more aligned with patients’ lived experience, but VIA participants got better when given the opportunity to express and share how they lived with their illness. Now VIA visual narratives are more than research data. They are central to Children’s at Home (C@H), secure social media sites dedicated to young people who share a diagnosis. On C@H, they can be their authentic selves, create connections and build a community of peers where their condition had previously isolated them. Most impressively, children with chronic conditions realize therapeutic benefit from crowdsourcing solutions to challenges, seeking help from and, especially offering help and mentorship to those who share their lived illness experience.

At a time when pediatricians were starting to focus on negative influences of media use on child health and development ranging from obesity to aggression to academic struggles, Dr. Rich was using the same media in positive ways to give voice to suffering children, listen and respond to their stories, and build human connections. In his mind, the evidence on how media affect human health needed to be considered in a far deeper way, clarifying the negative impacts of media use, but exploring positive uses as well. It was clear that media were not going away, and that children and families were not going to stop using them. With this, the Center on Media and Child Health (CMCH) was launched.

CMCH is focused on conducting research and bringing together studies from around the world to better understand the influence of media on developing minds and bodies. By taking an evidence-based public health approach, CMCH seeks to reframe the long-standing values-based debate about media into a health-focused discourse on relative risks and potentials of media.

CMCH is considering the complexity of media and the various facets that affect child development. They take into consideration various contextualizing factors including socio-cultural and economic changes, the individual’s development from childhood through adolescence to adulthood, rapid evolving technology, and the transformation of human behavior over time. Outcomes data on the media we use and how they use them are compared and contrasted with evidence from a wide variety of disciplines that reveals how we build resilient and creative minds through face-to-face interactions, manipulating physical environments, and free play.

In investigating, translating, and innovating media in relation to child health, CMCH has found that media effects are real, but they are incremental and cumulative. Digging deeper into how communication technology is affecting the human condition and behavior, Dr. Rich and his team have embarked on long-term studies that look at positive and negative effects over the course of child and adolescent development. Currently they are following the media exposure and health outcomes of 3,000 kids and families from all backgrounds across the province of Alberta, Canada. In the end, “We hope to produce a multi-dimensional data set that can be cut through with various types of queries, from “Does playing violent video games increase the risk of aggressive behavior?” to “Can social media use be protective?” says Dr. Rich.

CMCH hopes to generate knowledge about who we are and why we behave the way we do in our screen-saturated environment, developing insights and recommendations that can drive our use of interactive media in healthy directions. With a better understanding of how media are positively and negatively affecting how children’s brains develop, engineers and designers will be able to conceive and construct healthier technology for the future.