Downton Abbey: A Mountain of Viewer Tears Leads to an Incredible Online Discussion about Maternal Health

Warning: if the January 27, 2013 episode of Downton is still on your DVR- this post contains spoilers!

From the looks of twitter this week, I am not the only person who was devastated by the loss of Lady Sybil on Downton Abbey.  She died of Eclampsia shortly after giving birth to her daughter.  In my house, there was complete silence while we watched Sybil convulsing and struggling to breathe.  After she died, our horror and sadness quickly turned to anger.  There were two doctors in the room (one of whom made the correct diagnosis)- how could this happen?

As I contemplated this question, I was fascinated to see how this story line impacted the public health messaging that started appearing on twitter.  I recognized a few trends:

Making the connection to current women's health issues and debates

There has been much concern about men making decisions about women's healthcare- for example, the comments in 2012 about the definition of rape and the ongoing abortion debate.  Since Sybil's death was largely the result of poor decisions about her health (made by her father and the fancy male doctor consulting on her case), I saw the following post on this topic over and over again:

 

Identifying a Teachable Moment:  Preeclampsia and Eclampsia Specifically

Like many organizations, the American Public Health Association (APHA) followed up on Monday with this message:

Identifying a Teachable Moment:  Maternal Mortality and Maternal Health Broadly  

I saw many links to organizations such as Every Mother Counts, which focuses on global maternal health advocacy:

In addition to the discussion on social media, many news outlets and foundations also took the opportunity to post information on their websites about the condition that killed Sybil.  For example, ABCNews wrote, "Eclampsia Death in 'Downton Abbey' Highlights Pregnancy's No. 1 Killer".

I would love to see some evaluation data to follow this teachable moment.  Some questions that I have:

• How many people searched for Preeclampsia and Eclampsia following the episode?  (As a side note, this episode aired months ago in the UK- was there a similar searching pattern?)
• How many physicians/midwives/clinicians received inquiries from patients following the episode?
• Beyond knowledge- did this episode change any clinician behaviors?  Did they go back and review a suspicious case after seeing a reminder of the severity of this condition?  Did they perform a more comprehensive screening?

What do you think?

What other evaluation questions should we be asking?

What other trends did you see in the discussion on social media (or in person) following this episode?

More about → Downton Abbey: A Mountain of Viewer Tears Leads to an Incredible Online Discussion about Maternal Health

"Friends Don't Let Friends Drive Drunk": How Soon is too Soon to Find the Teachable Moment in the Death of Ryan Dunn?

"Friends Don't Let Friends Drive Drunk". A memorable tag line from the 1990s, found in many drunk driving prevention public service announcements (PSAs).

Early Monday morning, June 20, 2011, Ryan Dunn and a passenger were killed in a car accident in Pennsylvania. Ryan appeared in all three seasons of "Jackass" on MTV, as well as their movies.

Shortly after the news of Ryan's death broke (along with preliminary reports of speeding and photos of him drinking at the bar hours before the accident), Roger Ebert tweeted "Friends Don't Let Jackasses Drink and Drive". Although Roger did not "intend to be cruel"- he "intended to be true", there was a lot of backlash to his play on the old PSA tagline. Ryan's friends and colleagues from "Jackass" tweeted their anger in response and popular celebrity blogger Perez Hilton posted that Roger responded insensitively to Ryan's death. All felt that it was too soon to hold Ryan up as an example of the dangers of drinking and driving.

So the question I pose is: How soon is too soon to capitalize on a "teachable moment"?

Teachable moments are important in public health. They let us identify a time when our audiences will be more open to prevention education/intervention because they will see its relevance to their lives. Often the identification and sustainability of teachable moments are supported by media reports on the health/lives of celebrities.

As this week has moved along, more information has been released about the accident that killed Ryan Dunn and his passenger. His alcohol level was approximately twice the legal limit in Pennsylvania (0.196%) and he was traveling at a very high rate of speed (estimated at 132-140 mph) at the time of collision. Therefore, there is clearly a lesson to be learned here- about speeding and about drinking and driving. But much of these lessons our audience already knows. If you drink and drive- you could die (and/or kill someone else). If you speed- you could die (and/or kill someone else).

So maybe the lessons have to be broader. Apparently Ryan had a history of speeding and driving under the influence. These factors put him at risk. What could he, his friends, his family, the courts, the bar done to prevent this tragedy? What about the bystanders? His friends at the bar...employees at the bar...his friend who ultimately got into the car...could someone have stopped him from driving? What are the lessons you find in this story and how/when should they be communicated?

More about → "Friends Don't Let Friends Drive Drunk": How Soon is too Soon to Find the Teachable Moment in the Death of Ryan Dunn?