In a Toronto film studio, illustrator Liisa Sorsa is carefully drawing the femur and the tibia on a three-metre-long white board. "That okay with you?" she asks Mike Evans, the family doctor who is standing at her elbow, overseeing the creation of a public-health video about what patients should expect from joint-replacement surgery. She has already rendered his bespectacled face and gap-toothed smile on the white board. In fact, she and director/producer Nick de Pencier have turned her version of Evans's cheerful face into something of an Internet sensation.
De Pencier's and Evans's first public-health video posted on YouTube, entitled 23 and a Half Hours, has gone viral. The original version has received more than three million hits since it was released 14 months ago. It is reaching hundreds of thousands more in French, Spanish and Italian, while the Arabic-language version launched in June was the fifth most-watched video that week and has now reached almost two million views.
Featuring a chatty talk from Evans, illustrated by cheery whiteboard illustrations drawn before our eyes, the nine-minute video offers a miracle cure that slices through rates of diabetes, obesity, high blood pressure and depression: half an hour of walking. Its sly and suspenseful buildup to a piece of commonsensical information, coupled with its intimate, friendly tone, stops viewers in their tracks and makes them rethink their day.
Making a peer-to-peer hit out of a lengthy public-service announcement, 23 and a Half Hours is also turning on their heads both Internet wisdom about viral videos, and the model of earnest public-health advertisements that preach rather than entertain.
Partly through luck, partly because of Evans's public-health philosophy, the filmmaker and the doctor have discovered a truism of dissemination on the Internet – that users trust information they share with peers rather than information that comes to them from above. They are now putting it to use as they release videos on more topics, including acne, stress, insomnia, concussion and the efficacy of New Years' resolutions, all now getting tens of thousands of views on the Dr. Mike Evans YouTube channel.
The idea for the original video came to Evans as he thought about how to break down the silos that exist in medicine. "People say I need a cancer screen, I have to eat fibre, I have to lower my cholesterol," Evans said, explaining his holistic approach. "So I asked: What is one thing you can do? I sat in a room for two weeks and did the research."
What he came up with was a small amount of gentle, daily exercise. The public has responded to this simple message (backed by various studies cited in the video) in the millions, refuting received wisdom that no one will watch a YouTube video longer than three minutes.
"The success took us by surprise and we had to go back and forensically figure it out," Evans says of their first video.
"It talks about how not to die: That has a big constituency out there," de Pencier adds, with the same subtle humour that comes through in the original video.
Evans and de Pencier, a noted cinematographer and documentary producer whose recent credits include Manufactured Landscapes and Act of God, are family friends who have known each other since earliest childhood. Their collaboration comes out of many cups of coffee spent discussing how they could adapt Evans's ideas about public-health education to de Pencier's medium. Evans, who sees himself as a curator of health information for patients in the age of Dr. Google, had worked with Sorsa on some comic books about cancer care. He and de Pencier had discovered white-board animations on the Internet (they perfected the technique, shooting Sorsa drawing, and then speeding up the image by 3,000 per cent). All they needed was the right health topic, so Evans hit the books and found his miracle cure.
"We did an interesting call to action," Evans reflects. "Can you limit your sleeping and sitting to 23 and a half hours a day?" Their funding for the original 23 and a Half Hours came from the Li Ka Shing Healthcare Education Centre at Toronto's St. Michael's Hospital, where Evans works. More recently, he and de Pencier have tapped organizations such as as the Centre for Addiction and Mental Health to fund a video about quitting smoking, while the Holland Orthopedic and Arthritis Centre is a partner on the one about joint replacement.
The paradox for Evans and de Pencier is that health organizations want to disseminate information about very specific diseases or problems, while the film producers want to focus on broader topics.
"I can get money for atrial fibrillation, but there is no society that is going to fund one on stress, acne or insomnia," Evans said, explaining the producers funded those videos themselves. They have melanoma and inflammatory bowel disease on their lineup and have been approached about doing autism, but it is taking some work to put together a group of partners who will support a weight-loss project.
A YouTube video offering a half-hour rule for weight loss could easily attract millions of hits; a video on the joints is more likely to get tens of thousands.
"This will be used by a certain person in a certain situation. It's more prescriptive," Evans says of the day's work on joint replacement. "We talk about things going viral. This is more likely to go bacterial."