In the beginning, I hated posting. It was 2006, and I was 12 years old. Too late for AIM, too young for Facebook, and too scared of MySpace (around this time, a cop had given an in-school presentation on how the platform would imperil us to sex traffickers), CarePages.com was my first social network. The site offered a unique service: Through a free and private forum, I could apprise friends and family—interested parties from any ring of my life’s orbit—of my health status while I underwent treatment for rapidly advancing lung disease. I would post, and my subscribers would fill the comments underneath. Like eating my vegetables, it was an obligation I resented. But my parents insisted that our followers wanted to hear directly from me, and walking to the hospital’s computer center provided a rare excuse to leave my room. The site’s tagline, just below a creaky graphic reminiscent of Matisse’s The Dance, prompted users to “connect, share … care.” The dream of the poster made manifest: I share, you care.
In 2018, while working on a book project about this period of my life, I retrieved a PDF archive of my account from the site’s remaining administrators (after a series of acquisitions, CarePages.com was closed at the end of 2017). Reading through that record—514 pages spanning six years—I came to see that my posting skills were whetted in the gauntlets of the CarePage. My computer time could be limited by a treatment schedule or by other waiting patients, so I learned to compress days of activity into a few sentences. A post’s tone, whether the news was good or bad, could be set in the first line. I favored scenes and stories—a doctor was rude, a nurse woke me up, an IV blew—over rote lists of activity because they gave posting a feeling of necessity. I delegated the longer updates to my mother.
What struck me most is how the more I posted (a sign, I think, that I was enjoying the task), the more frustrated and volatile my posts became. Looking at the archive is like watching the platform meld with my experience of perpetual illness: My expressions became increasingly ragged as I spent more time with a disease characterized by painful and labored breathing. Eventually, though, the site outlived its purpose, as websites do. My illness stabilized, I got older, and this specific form of posting lost its appeal. My last CarePages entry was in 2012 at the age of 18, more than five years before the platform would go dark.
In the years since, my relationship to posting has transformed. Like many media freakos and engagement addicts, I now spend much of my computer time on Twitter. Elon Musk’s ownership has sent some users in search of new alternatives, drab recreations of the original product. But a fresh URL will not solve the many problems of the financialized internet, nor can it fix the habits of fractured communication drilled into us by years of tweeting, subtweeting, dunking, lurking, and shitposting. In its early days, CarePages was tied to individual hospital systems and thus closer to its user base, but a series of acquisitions that began in 2007 shuffled it into the hands of health tech and digital media companies that saw it less as a niche service for good and more as a commodity to round out a portfolio. It wasn’t until these acquisitions began that I felt the intrusion of moderation. One assumes that these sales ultimately led to the site’s end—the value proposition doesn’t quite square with the growth demands of a modern conglomerate. A platform’s demise is not always a sign of community illness; sometimes it’s a cure. In the anticipatory obituaries for Twitter, party metaphors abound, but the platform’s slow death seems like a good chance to practice one of life’s most important social skills: knowing when to leave.
One of my favorite posts from the archive begins: “Good Afternoon. What’s so good about it?” It’s a Twitter-like provocation, assuming a position just to have something to refute. As I got comfortable with CarePages, I relaxed into jagged, adolescent humor, signing entries with quotes from Dane Cook, Family Guy, Tenacious D: staples of grubby aughts boyhood. After a while, the site became my primary outlet for tension and grievance. I stewed over hospital-related indignities, my skin could turn tomatoey at exertion because of my condition, and I spent most days in states of partial undress under the hospital gown. In short, from a young age I was posting mad, red, and nude. In the hospital, I felt like I had no control over my life, and no privacy. The CarePage, with its text box open all hours, became a rare site for self-assertion. I commented on my roommates (“a little guy with a big mouth”), my surroundings (“the shades on the window are broken and the light is blinding”), and the doctors (“All we’re doing is waiting. Waiting on idiots”). Venting became a kind of medicine.
Like so many social media platforms of today, Twitter chief among them, CarePages.com was powered by misery—without sickness, the website had no users. Talk of vomit abounds in my posts. Physical pain, too. But mentions of “home,” as in “We’re going home,” number in the hundreds. Comments noticeably increased under posts that were overtly positive, markedly so for ones about leaving the hospital. Many of my least pleasant posts—including one the site actually censored for its “negative content”—received no comments at all. Not surprising, but people didn’t much care for the struggle; they cared about the success. Despite it being a truly private page—readers had to be invited by email address—there were limits to the CarePage poster’s sacred autonomy. The homepage for the site’s predecessor advertised it as a place to “exchange messages of support, without intrusion.” Later, it introduced a feature called “Inspiration: Profiles in Courage,” spotlighting triumphant patient stories. The website cultivated an ambient positivity that extended to its moderation and content policies, as if it hoped to steer the outlook and lives of each patient it claimed to be agnostically hosting, remaking the illness experience in its image. I was doomed to grind every bit of misery into something shiny and digestible if I wanted engagement. (This was complicated by the fact that the platform was one of my only windows to normal adolescence. If my posts could induce friends to comment, they might furnish me with updates on the world I was desperate to rejoin.)
When I think back on my illness, I remember the pain, the abjection, the pleasure I took in using the platform to release anger. But my posts reveal that I was guided toward guileless optimism. Twitter thrives on discord, which is not the same as rewarding a poster’s negativity—engagement comes from the opportunity to chide someone for their misapprehensions or their incorrect attitude. Often when a poster is being roasted for a bad take, I remember the way the CarePage allowed others to tell me—either directly or passively—that I was metabolizing my experience incorrectly.
Veteran posters of any site, but especially Twitter, will recognize this pattern: While flailing to keep your audience interested, you transgress a boundary casually enforced by your readers, one that might have once been invisible. When a post is too personal, or too pathetic, or it misapprehends the balance of humor and viciousness, suddenly you’ve lost them. You recalibrate in the direction of prior success, unavoidably shaping yourself by the platform’s design.
The inalterable message of the CarePage was, forgive the McLuhanism, inscribed into its medium. I only posted when I was sick, so my posts formed an image of me as someone who was perma-sick, perpetually returning to the hospital. In turn, my ability to interrogate my experience became limited by the strictures of the platform: If I was physically unwell, then I should at least affect an air of health and wait for the body to catch up with the mind. Visiting Twitter now feels much the same: Every joke is freighted with implications about the platform on which it was crafted. The whims and follies of the space dominate the conversation. Worst of all, as a veteran poster himself, Musk gives in to urges marked by his time as one of the rabble. The platform increasingly feels like a feedback loop amplifying its own worst impulses.
The last time I posted on my CarePage was during my freshman year of college, when I was temporarily back in my hometown hospital to deal with the long tail of a bout with pneumonia. In aggregate, my health had been improving, a partial explanation for why I was posting less. But as I’d entered adulthood, the CarePage held less appeal. For one, being the only poster to a cadre of followers was boring; I wanted to feel something closer to an exchange. I’d begun tweeting. Also, I didn’t want to be steeped in the affective landscape of illness anymore. I sensed it would be better to spend some time processing these experiences away from the stultifying glare of an audience.
Musk recently declared that inactive Twitter accounts would be deleted, leading to fears that loved ones might lose access to archives belonging to the deceased. The sudden closure of CarePages.com in 2017 caused a similar problem. I was able to retrieve my archive by chance: The support address I emailed about six months after the site closed was mercifully responsive. But others weren’t so lucky. Shortly after the site shut down, one mother told NBC Chicago that she wasn’t able to access the account where she had posted about her seven-year-old son. After he died of brain cancer, the page had been one of her last tethers to his memory. (The internet is full of other former users exchanging tips on account retrieval.) Ultimately, this is how most social media seems to work: We feed them our personal disclosures, the raw material that comprises a platform’s value, yet we and our records can be discarded on a whim.
Amidst Twitter’s recent chaos, my feed has filled with calls to migrate to alternative platforms like Bluesky and Mastodon. All respect to my beautiful friends and followers, but I do not feel the same pull toward the next best platform. Such is the cyclical nature of social media: A website begins as an expression of a want or need, then it reaches an inflection point of popularity or facility and money edges in. Soon, the site’s shepherds are scrambling for perpetual growth. Users are shaped by the platform, the platform is shaped by the dictates of business, and as it fails or (in the case of CarePages) folds, we wander off to the next thing, hoping it will look a lot like the thing we just left. Even the impulse to move to platforms like Bluesky or Mastodon reveals Twitter’s power—we can no longer conceive of a discourse that takes any other shape.
But Twitter’s gradual breakdown might actually be a gift. For the past decade-plus, the website has impacted and sometimes deformed political debate, journalism, criticism, other social platforms, authorship, book sales, media consumption, and what I think when I hear the phrase “gotta hand it to them.” As with my flight from the CarePage, we may now have the chance to move on, not just toggle to duplicate platforms that will inevitably capture the same arcs of reactivity and pique. In reconsidering our engagement with Twitter, we have the opportunity to turn back to discretion, relearn the value of shame, and close off the damaged neural pathways that were formed by the platform’s backward incentives.
Both my first and final CarePage posts ended with a version of the same phrase, a kind of prayer that I frequently spoke throughout my years on the platform, a suggestion that the story of the experience would never fully resolve: “We’ll keep you posted.” That I vanished after the last time I typed it, never posting again, offers a possible course of action to the dejected Twitter user. If Twitter is a party, it might be best to slip out quietly. You can circle the room asking where everybody is headed after, or you can stay till the lights come on, but both options evince a certain desperation. Sometimes a gathering cannot be recreated; instead the energy dissipates naturally. I’m not sure where I’m off to next. I’ll keep you posted.
