"...

to promote and elevate the standards of

journalism in the United States"

-Agnes Wahl Nieman, the benefactor of the

Nieman Foundation.

NIEMAN REPORTS
AT HARVARD UNIVERSITY

Vol. XLVII, No.4

Winter 1993

Publisher Bill Kovach Editor Robert Phelps

Assistant to Publisher Lois Fiore Design Editor Deborah Smiley
Business Manager Carol Knell Technology Advisor Lewis Clapp
Editorial Assistant Marjorie Leong

Nieman Reports (USPS # 430-650) is published monthly in March , June , September,

October and December by the Nieman Foundation at Harvard University, One Francis
Avenue, Cambridge, MA 02138.
Telephone: (617) 495 -2237
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Copyright © 1993 by the President and Fellows of Harvard College.
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NIEMAN REPORTS
TH E NI E MAN F OUNDATION AT H A R VA RD UNIV E R S ITY

Vol. XLVII No.4 Winter 1993

Covering Health Issues

We've Come a Long Way Since Blue Cross ... Victor Cohn ........ ........ .......................... .. 3
Confessions of a First-Year Medical Writer ... Sheryl Stolberg ............. ... ....... ................... . 6
Tsunami, Wavelets and Medical News .......... Bob Meyers ............................................ 8
'Perky Cheerleaders' ..................................... John Crewdson ....... ..... .......................... 11
The Press'sPortrayal of Mental Illness .......... Susan G. Lazar, Glen 0. Gabbard and
Elizabeth K. Hersh ........... ....... ..... .... .. ... ,.>17
View From the Nurses' Station ..................... Bernice Buresh ....................................... 23
Violence-Biggest Medical Problem ............. Margaret DiCanio .............. ..................... 26
The 'War' on Drugs ....................................... Lloyd D. Johnston .. .. ..... .. ...................... 29
Washington Hodgepodge .... .. ...................... . Dana Priest ... .. ... .. .................. .. .. ............. 32
State House Views .... ..... ... ........ ... .................. Mike Meyers, Tom Detzel, Jim Simon ,
and Betsy Liley ....................................... 34
Checking on the Players . .. . .. .. . .. .. .. .. .. . .. ... ... .. .. Charles Lewis ...... .. .................................. 37
Case for Reporting Medical Alternatives ....... Sid Kemp ................. ........ .............. ;.. 40

Chill Wind From the Kremlin

Nicholas Daniloff ........ .. .......................... 44
Beyond Objectivity .. ..... ..... ... ... ....... ... ..... .. .... . Jay Rosen ....... ..... .. ..... .... .... .. ..... ..... ... .... .. 48
Public Journalism-An Early Attempt ........... Billy Winn .. .. 54 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 . . . . 0 0 .

A Year Later, Campaign Continues Robert D. Deutsch and Selden Biggs 000000000000000 57 .oo . .

WINTER READING

The Roar of the Crowd .. .. ........ .. .. .. .......... .. ...... .. .. Michael]. O 'Neill .. ................ ........ ............... 66
President Kennedy .. .................... ...... .......... ......... Richard Reeves .. ......... ......... ................ ... ...... 67
Quality Time? ... ... ........ .... .. ............ .. .... ...... .. .... .. ... 20th Century Fund ...................................... 68
Liste ning to Prozac ......... 00 . . . . . ... . . . . Pe ter D. Kramer ...................................... .. ... 69
. . ..... . . . ... . . . . . ......

Leaving Birmingham .. .... ...................................... Paul Hemphill .......................... ....... ............. 70

Fly Fishing Through the Mid-life Crisis ............... Howell Raines .... .... .............. ... ...... .. ...... .. ..... 72
Muddy Boots and Red So cks .... .. .. .......... .. .... .. ..... Malcolm W. Browne ................ .. .. .. .. ............ 74
No thin' but Good Times Ahead ..... ..... .. ..... .. ........ Mo lly Ivins ...... ... .... .... ......... ....... ... .... .... .. ... ... 75
An Autobiography ......... ........... ...... ... .... .... ...... .. ... Richard Avedon ....... ..... ........ ................... ..... 76
A Justice for All .... .......... ..... ..... .. ....... ....... .. .. .... ..... Kim Isaac Eisler .... ... .................................. ... 77
C URATOR OOOOOOOOOO OO OOOO OO OOOOOO O OOO O OOO o ooo ooo ooo oo OOOO O OOOOOOOOOOOO 2
O MBUDSMAN 0 00 0 00 00 0 00 0 00 0 00 0 00 0 00 0 00 00 0 0 .. 00 0 00 0 00 0 00 0 00 00 0 0 00 0 00 78
RESPONSE 0 0 .. 00 0 .. 00 0 .. 0 .. 0 00 0 .. 0 .. 0 .. 0 0 0 00 0 00 0 0 0 0 00 0 00 0 00 0 .. 0 .. 00 0 0 80
NIEMAN N OTES ....... .. .......... o o . oo oo • • oo . . . . . . o o . o o • o o • o o • o o · · 82
1993 IN DEX .... 00 . . . 00 . . . . 00 . . . . .. . .. . 00. 00 . 00 ...... 00.00 •• 00 00.00 88
The cover pho to o f a cancer patie nt in Los Angeles was take n by Stan Grossfeld.
 CURATOR'S CORNER

'Truth Cannot Be Occupied'

BY BILL KovACH

the way Kemal puts it. "My monthly should be a force for showing the com-

T
he journalists of Sarajevo reckon
the beginning of the siege of salary translated to hard currency mon humanity amidst racial and ethnic
theircityfromApril5, 1992, when wouldn't exceed $10 a month. And we diversity."
a young girl was killed by a sniper. From spend most of that and our own per- In the end the seminar and award
that day to this the staff of the newspa- sonal savings to buy newsprint or oil for ceremony became an object lesson for
per Oslobodjenje (Liberation) has en- generators." today's journalists frenetically search-
dured the deadliest conditions ever The staff of Oslobodjenje learned ing for a short cut to a renewed sense of
faced by journalists. how important their work was to their community need and purpose in jour-
One reporter was shot by Serbian community on June 21last year. nalism.
killers while sitting at his typewriter and "It was when the whole building was When a thing is reduced to its es-
dragged into the street by his feet. A under fire. No one would expect a pa- sence, as the survival of Oslobodjenje
photographer taking pictures of a bread per to appear out of that flame the next is, true values are revealed. Kemal
line died when shrapnel from a mortar morning. But our staff was preparing Kurspahic, an unassuming man whose
struck and killed her. Snipers have the paper while helping the firefighters. leg was shattered in an auto crash trying
wounded more than 20 others of the The fire was extinguished at 6 a.m. and to avoid sniper bullets, reminds others
newspaper's staff. Yetastaffof70, work- our presses started five minutes later. more jaded and practical of those val-
ing seven-day shifts, has never missed When the paper hit the streets that ues:
an edition of their paper. morning, I believe that our readers and • In what he and others are willing
With justifiable pride the paper's 46- citizens of Sarajevo saw it as a sense of to pay to earn the right to freely
year-old editor-in-chief, Kemal personal achievement, a personal vic- publish the news and views of
Kurspahic, told a Nieman seminar how tory. And I believe that is true. For their community.
the staffofBosnians, Serbs and Croatians putting out a paper each day in Sarajevo
• In the strength his newspaper
found the will to continue working from under these conditions serves as an
demonstrates of the power of
the rubble of their building. Like thou- encouragement to everyone. We are
simple words of truth.
sands of others they could have aban- mutually encouraged-we by our read-
doned their community and their news- ers and they by us ." • In the mutual and reinforcing
paper to seek safety outside the war Another member of the newspaper's commitment of him and his staff
zone. staff, Zlatko Dizdarevi, recorded the and the community to public
"We have never considered not do- following reaction of one reader: interest journalism.
ing what we are doing," he said. "It is a "God, it's great to know they hate They are values which journalists in
unique professional experience. Our you so much that they're willing to use the United States today would do well
paper is sometimes the only source of up all that ammunition, over so many to contemplate as public interest jour-
information for our readers. We have a days, justto hurt you. Imagine what you nalism has difficulty holding a place in
duty to keep them informed." must have done to them, for them to the "practical" world of news-is-just-
What inspires them, he said, is the consider you so important. ... " another-commodity.
need to keep certain values alive in the Kemal Kurspahic came to Lippmann As Kemal Kurspahic describes the
midst of madness. One is that the "truth House to receive the 1993 Louis Lyons mission of Oslobodjenje, it is driven by
cannot be occupied" or crushed. An- Award on behalf of himself and his staff. very practical considerations:
other is to "represent the idea of a His seminar was more than ample evi- "Our paper is proof everyday that
culture of tolerance-which is exactly dence of the "courage and integrity" freedom of expression cannot be si-
what the opposition wants to destroy." which the award was created to honor. lenced by guns and cannons, and a
And these journalists who put their The conversation with Kemal Kurspahic multiethnic community cannot be killed
lives at constant risk work virtually for also justified the conclusion in the cita- by terror. " •
free. tion that, "The Nieman Fellows .. .honor
"We pretend to earn money as a the staff of Oslobodjenje for reminding
paper and to be paid as journalists," is us that journalism, in any situation,

2 Nieman Reports /Winter 1993

 HEALTH

We've Come a Long Way Since Covering Blue Cross

Despite Improvements in Coverage ofMedical Economics

There's a Lot ofRoom for Better Articles

BY VICTOR COHN

ealth! Suddenly it's a Big Story. media were getting out the message of though handicapped here, has displayed

H Not many years ago, as a na-

tional science and medical re-
porter on The Washington Post, I had to
the tough choices and sacrifices
needed-the fact that true health care
reform must mean some pain, a fact
simpler, often highly imaginative coun-
terparts.
Just the same, half of the Kaiser-
struggle to get a health care story on politicians still shun-former Surgeon Harvard respondents said the media
page one. Or page 31. Now, at least at General C. Everett Koop said, "I think
this writing-journalism has a short at- they're carrying the message of the last
tention span-health care reform is alive person they talked to ."
and yowling on the nation's front pages I think the situation is a bit better
and the Evening News. now than in Koop's assessment. But
It's about time. I remember a conver- will the story, the true story, the truly
sation around 1975 with a New York deep examination, remain on page one
Times medical writer who was deriding or even page 31 a few years from now
some hinterland writer: "He has to cover when some kind of reform has-prob-
Blue Cross." As long ago as the late ably-been enacted and there's only
1940's, when I got into the game, a few slow, and we hope steady, slogging
of us were covering Blue Cross and the toward access for all, cost control and
economics of medicine as well as the quality care? This will be the test of
atom and the scalpel, the "wonders" future health coverage, whether by
and "miracles" and "breakthroughs" of medical and science reporters or by the
science and medicine. But-mea political writers, the current sometimes
culpa-most of our reporting of the trenchant, sometimes wildly off base
medical wonders indeed omitted their Come Lately's to the subject.
costs, or whether the nation might be What of present coverage of the health
better off vaccinating kids and treating care debate? Without question, a lot of
the poor rather than developing multi- it is first rate.
jillion-dollar wonders. Most Americans still don't under-
As recently as 1985 ethicist Arthur stand the Clinton proposal or its essen-
Caplan wrote that "sadly absent from tial components: managed care, man-
the list of [medical] stories receiving aged competition, health alliances. Not
extensive coverage are those examin- more than a fifth to a third of the public
has "heard of' and "knows the mean- Victor Cohn retired.from The Washington
ing the financial and organizational revo-
ing" of these terms, according to a Kai- Post October 1 after 25 years. In that quarter
lution sweeping through our health care
ser Family Foundation-Harvard study. century he was science editor, then national
system." In the fall of 1991 Newton
True, these concepts are compli- medical reporter, then senior writer and
Minow, director of Northwestern
cated, and so is the Clinton reform. columnist in The Post's weekly Health section.
University'sAnnenberg Washington Pro-
True, no large number of Americans Currently he is a research fellow at
gram, and Fred Cates of Indiana Uni-
can name their Senators or Representa- Georgetown University, working on a book
versity could still complain that, despite
tives-there's always a great reservoir on medical care. His classic "NEWS &
floods of words about health care prob-
of public ignorance. True, print media NUMBERS: A Guide to Reporting Statistical
lems and "cures," there was still too
in particular have used many charts and Claims and Controversies in Health and
little deep and knowledgeable report-
displays, many of them superb, to ex- Other Fields" is in its fourth printing and
ing. Asked in that year if he thought the
plain the health care proposals, and TV, widely used in journalism schools.

Nieman Reports I Wimer 1993 3

 HEALTH

had done only a "fair" or "poor" job of organization of any size that does not his first heart pacemaker at age 25 . Now
explaining "what the different health have a pretty much full time health and he 's wearing his fourth. They were in-
care proposals mean" to them and their medical reporter, this in contrast to the fected! The miracles aren 't always
families ; about a third called it "good ;" day in 1947 when, a young reporter at miracles."
only 10 percent called it "excellent." The Minneapolis Tribune, I showed up Reporting hopeful news without rais-
(Another survey of five major dailies at the American Medical Association's ing false hopes is difficult and some-
found that over a four-month period annual meeting to be greeted by report- times impossible. We can say loud and
only 12 percent of all stories dealt with ers from New York, Chicago and the clear that the payoff may be years away
the potential impact of reform on indi- like saying, "You're fromMinneapolis?" or the wonder isn't a wonder for all, and
viduals and families .) The respondents Medical reporters are more conscious the sick and suffering will still grasp at
gave the media better marks for report- of the ethical and economic implica- the straw. But we must at least say these
ing the politics of reform-the old ball tions of their reporting. Reporters of things. High up, not in the umpteenth
game-than for telling them how the technology, medical and otherwise, paragraph.
proposals may affect them. Obviously, more often take account of any effect on
1V in particular should try harder, since the environment or individual health. Part of the problem is
only 17 per cent of respondents called We may therefore pat each other on over-hyped reporting of
newspapers their "most important the back. Briefly. Back-patting does not results in animals.
source of information on health care lead to improvement, and there is plenty
reform ." Seven per cent named maga- of room for improvement. The late Nate Haseltine, a crack Wash-
zines. Thirty-five per cent named net- To wit: ington Post medical writer into the
work television. There is still too much extolling of 1960's, said "Mice are not men," and
Obviously, there is still a job to be new medical miracles without a count generally refused to report on animal
done. Obviously, information will have of the money or other impact. And research , since more often than not the
to be repeated and repeated if it is to there's frequently a medical tear-jerker animal breakthroughs lead to no hu-
sink in. There is still plenty of time. The with no broader context. man cures. Nate's caution has gone by
debate will go on for months. Here's a bit I saw on Washington 1V the boards, partly because of today's
This said, I think there is a problem news (like many I've seen in print). A huge new concerns-AIDS,
that is even more important. wan boy sucks a lollipop, and the an- Alzheimer's-with millions of persons
Reporters are properly putting every chorman says, "This little boy is waiting eager to hear of any progress and with
claim of the Clintonites under the mi- for a transplant that could help. But reporters, editors and news directors
croscope and finding lots of flaws . This he's shut out from a government pro- willing to exploit the "tantalizing" and
is what they should be doing. But the gram. More at 11 ." "promising" results that "may" lead to
reports should also make it clear that Dr. Jay Siwek, editor of the American cures. Sometimes.
the present system is an unsustainable Family Physician, has said: "When you
failure , and that there can be no pos- report on kids who need transplants, Some years ago, tongue
sible reform without flaws, whether ala and the fact that they've got to have only partly in cheek, I
Clinton, something more conservative $50,000 or $100,000 for the operation, said there are only two
or like plans in Canada, Britain, Ger- does this kind of emphasis affect what kinds of medical stories,
many or wherever. There is a grave happens in this country? Does the New Hope and No Hope.
danger that true reform will sink under money we spend on transplants mean
the present fierce barrage of criticism, thousands of kids won 't get immu- New Hope and No Hope get on page
reportorial and otherwise. nized?" one or the Evening News. The in-
What of the great bulk of today's betweens get buried or ignored. The
medical and biomedical reporting, the Doctors complain that main reason is obvious. News is about
non-economic reporting? over-enthusiastic report- extremes.
There are many pluses. Having e n- ing raises patients' ex- But there are other reasons too. When
tered journalism more than five de- pectations beyond the it comes to running for page one or
cades ago and having written my first possible. They're right. making the Six O'Clock News, the best
medical story more than four and a half among us, let us face it, sometimes
decades ago , I can testifY that American Stories about new wonders too seldom overstate or understate. I was once asked
journalism, including science and medi- include the possible side effects or other by a Harvard researcher, "Does compe-
cal journalism, is far better than ever, qualifications . Kidney and heart trans- tition affect the wayyou present a story?"
that the young people entering the field plants, kidney dialysis, electronic pace- I had to answer, "we have to almost
are far better educated, by and large, makers-all extend lives, all often fail. overstate, we have to come as close as
and that there are large amounts of fine Even when "successful, " all can be hard we can within the boundaries of truth
reporting on papers large and small. to live with. A Maryland woman once to a dramatic, compelling statement. A
It's also getting hard to find a news phoned me to say, 'My son had to have weak statement will go no place. "

4 Nieman Reports /Winter 1993

 HEALTH

We thus tend to oversimplify. We other tumors. The clamor for the drug ure ."' And: "I [am not] comfortable
may report, "A study showed that black began with exuberant comments by with being sacrificed for the sake of the
is white" or "So-and-so announced researchers ... Their results were magni- 'public's right to know."'
that ... " when a study merely suggested fied in the news media ... But as large Some years ago many of us knew that
that there was some evidence that such studies scrutinize taxol's effects ... the physicist J . Robert Oppenheimer was
might be the case. We may slight or omit enthusiasm has tempered. " Taxol does dying of cancer. No one reported it
the fact that a scientist calls a study not yet extend or improve life. until his death. I am not sure that would
"preliminary." Meanwhile, a wry note: The Wall happen today.
We tend to rely most on "authorities" Street Journal's Jerry Bishop has noted Nor am I sure that we always temper
who are either most quotable or quickly that "most of the efforts that win the our medical reporting with understand-
available or both, and these often tend Nobel prize for medicine are never re- ing. In 1974 First Lady Betty Ford had
to be those who get most carried away ported in the media." breast surgery, widely reported during
by their unconfirmed but "exciting" a period when there was a good deal of
data-or have big axes to grind, how- TV. With a modest num- other news about breast cancer. It was
ever lofty their motives. The cautious ber of exceptions, it is all widely read, and at The Washington
person who says, "Our results are in- far behind the best print Post we received many laudatory let-
conclusive ... I don't know" tends to be media in maturity, with ters. But one woman wrote: "Some-
omitted or buried someplace down in most of its medical re- times I think you do a great disservice to
the story. ports mere short bursts. your readers. While you might be doing
As a result, one can make a long list some good at her expense by blazoning
of sensations that have so far proved This is not to say that some brief para- Mrs. Ford's operation, do you ever con-
less than sensational. graphs in print-a growing phenom- sider the harmful effect? I am referring
In the 1970's, the potential anti-can- enon-are any better, or that most print to the statistics where it was stated that
cer drug interferon was hailed on front readers read more than a headline and 38 percent of women with cancer cells
pages , TV news and gaudy the first few paragraphs, if that. Still, in the nodes did not live five years after
newsmagazine covers. NBC's John TV's 30-second to two-minute reports surgery and 62 percent did not live for
Chancellor called it "possibly one of the commonly lack context or caveats, 10 years. I am a cancer patient under
miracles of the age." The upshot today: though this would often require only an care at NIH. Until I read your paper I
it helps in some cancers, it may still turn added phrase or sentence. had thought my chances were very good
out to be important, but it is not yet a TV's truly excellent medical report- of leading a normal life. Of the many
miracle. ers-they definitely exist-are far out- doctors I have seen, none has ever
The mid-1980 's saw a flurry of im- numbered by the callow and inexperi- thrown such a poor statistic at me.
plants of so-called "artificial hearts ," enced on a multitude of local stations. Thanks a lot! "
dominating the medical news, though Take Washington's local TV staffs. They Certainly, we must report the facts
none could pump blood on its own like are probably among the nation's best, and statistics, favorable or otherwise.
a genuine heart and all were connected yet I recently listened to a panel of But we can also report that length of
to bulky external machinery. None Washington medical reporters , two of survival is always a range , and averages
worked, if the test of what works is life. them from leading TV stations. One had don't apply to individuals. We can, with-
When National Cancer Institute doc- been on the medical beat for "less than out violating truth, try to give hope.
tors in 1985 treated their first patients a year," the other for 14 months. Enough. The coming years, the years
with interleukin-2, a substance intended Public television? A different animal. of drastic and perhaps grueling changes
to turn white blood cells into anti-can- The TV magazine shows? Some are fair in the delivery of health care, whether
cer agents, a typical headline said, 'Killer and thorough, some score highest in or not there is federally mandated re-
Cells Highly Promising," giving the im- one-sided prosecutorial zeal, high hype form , will require better medical re-
pression that a new era was nigh. "Prom- and high ratings. porters than ever, reporters asking and
ising" is still the best that can be said of What about compassion? searching for the answer to the crucial
this and many other compounds her- Journalists-okay, not medical jour- question: are patients being well served?
alded with much fanfare. nalists-compelled tennis ace Arthur Back in 1985 ethicist Caplan, bemoan-
Just weeks ago a front-page story in Ashe to reveal unwillingly that he had ing the lack of coverage of the hard
The New York Times reported, with AIDS. We must report the illnesses of economic and social questions , said in
rare candor, the fact that "Just a year ago important office holders . The public despair, "If it's not buzzing, beeping or
taxol, a new cancer drug, was on the has a right to know anything that affects humming, no one's going to cover it."
verge of approval. .. Expectations were official performance. But, as Ashe said, Let that be history. •
running high ... The drug was thought "I am not running for some office of
to offer salvation to desperate women public trust, nor do I have stockholders
with ovarian cancer, and possibly to to account to. It is only that I fall under
patients with breast or lung cancer or the dubious umbrella of 'public fig-

Nieman Reports I Winter 1993 5

 HEALTH

Confessions ofa First- Year Medical Writer

BY SHERYL STOLBERG

T
o begin with, this was not a job I and trials of everyday living that, in their quish the role of the outsider. In fact, I
asked for. I was minding my own telling, make newspapers come alive. rather relish it. I think it is what keeps
business, perfectly content with A medical writer? I groaned. Why did me fresh .
my lot in life when, one year ago, my they want me to become a medical Confession number two: I think it is
editors at The Los Angeles Times asked writer? It will be a promotion, they weird that medical writers rely on other
me if I would take the medical beat. At assured me. A more prestigious job. A publications-medical journals-to get
the time, I was covering the county beat that is national, even international, their news. Every beat has its infrastruc-
criminal courts, a job I had held for a bit in scope. You'll write mostly for the ture. In local government the City Coun-
less than a year. But my specialty, in front page. You 'll travel. All of this cil meets and makes decisions (or, in
truth , was in not having a specialty at all. sounded vaguely as though my editors some cases, avoids making decisions) .
In my nine years as a reporter, I had had a problem and I was their solution. In the courts a prosecutor files charges.
covered the usual fare: fires, earth- But I don't know anything about medi- The biggest breaking developments in
quakes, hurricanes, riots (well, okay, cine, I protested. My last scientific en- the quirky world of medicine are often
riots aren't usual, even for reporters deavor was dissecting a frog in high contained in peer-reviewed academic
unless, of course, one reports in Los school biology. You're a good reporter, journals, the most prestigious of these
Angeles.) In this work I found variety, as they countered. You'lllearn. being The Journal of the American Medi-
well as tales replete with the triumphs Since then, I have written about AIDS, cal Assn. and The NewEngland]ournal
cancer, tuberculosis, smallpox, cystic of Medicine. (I used to think that medi-
fibrosis, polio, yellow fever, the flu. I cal writers had an easy ride onto the
have tackled violence as a public health front page, rewriting other people's
issue, dipped into the abortion debate work. In fact, deciphering these bloody
and dabbled in managed care. I have articles is the toughest part of my job.)
interviewed the dying, and those who Each week, these journals arrive, sev-
have been spared death. I have watched eral days in advance of their publication
doctors perform gene therapy on a date, on the desks of news people across
three-day-old who was born with an the country. And each week, the same
immune system that did not work. I ritual takes place: Reporters, seeking to
have spent long hours poring over biol- understand these incredibly dense and
ogy texts, trying to comprehend cellu- complicated articles, look to doctors
lar immunity and neurotransmitters and and scientists to make sense of them.
DNA. I have encountered doctors and The only trouble is, the people we call
medical researchers who were wonder- for comment don't get the journals in
fully patient with my sometimes simple advance. This puts me in the uncom-
questions, and others-including a fortable position of having to fax the
(now former) ranking official at the experts the articles I am asking them to
National Institutes of Health-who be- evaluate, with the hope that they can
came nasty, condescending and in one read the study and digest its contents in
case furious when I revealed that my time for me to make deadline. This is
background was that of a reporter, and standard operating procedure in medi-
not a scientist. cal reporting. Everyone knows this is
I have learned. Oh, have I learned. how things work. I've never had a scien-
SheryL StoLberg joined The Los AngeLes Times These, then, are my observations-! tist complain about it. But I don't think
in 1987, after fo ur years as a reporter with like to think of them as confessions- I'll ever get used to it.
The Providence (R.l) journal-BuLLetin. She is after 12 months on the job. They are Confession number three: I don't
a 1983 graduate ofthe University ofVir- disconnected at best, the thoughts of an return phone calls from public rela-
ginia. She Lives in HoLlywood Hills with her outsider looking in. And so perhaps my tions people, even though my answer-
husband, photographer Scott Robinson. first confession should be that, as I grow ing machine offers the standard line,
into this beat, I don't intend to relin- ''I'll get back to you as soon as I can." It's

6 Nieman Reports /Winter 1993

 HEALTH

not that I have anything against PR dards) about whatever strikes my fancy. mer weather.) And I had just come back
people. It's just that there are too damn There is little rhyme or reason to what from the International AIDS Confer-
many of them. My predecessor, Robert I pick, other than that I find the topics ence in Berlin the month before. I spent
Steinbrook, announced on his answer- compelling and think they are impor- 10 hours on a plane with a bunch of
ing machine that he did not return PR tant. "What qualifies me to make these AIDS patients. Of course, they were all
phone calls. I thought that was tacky. determinations?" I exclaimed in frustra- infected. The TB germs were winging
But at least he was honest. I simply tion to a colleague early in my tenure. their way around the plane. (Hadn't the
spend my days figuring out creative To which he replied: "Who better than Centers for Disease Control been inves-
ways to hustle PR people off the phone you to make them?" tigating airplane outbreaks because of
as quickly as possible, or better yet, to Confession number five : This sum- poor air circulation?) I knew I didn't
avoid these phone calls altogether. mer, I became afflicted with medical have AIDS . ButTB-therewas a disease
Frankly, I am somewhat astounded at you could catch just by breathing! And
the sheer size of the medical public not even know you had it! I stuck my
relations establishment. It seems that "Just wait," they said, head in the sand for a while and finally
every doctor in the country, not to men- went to the doctor for a test. No, I don't
tion universities and corporations, must
when I took the beat. have TB.
have his own PR person. On any given "You're going to think Confession number six: There really
day, about two dozen faxes, all unsolic- is a cure for cancer. As the crazies know,
you have every disease
ited, cross my desk. Enough mail arrives I'm just part of the conspiracy that re-
to fill a carton, much of it containing you write about." I fuses to report it. Also, AIDS is a govern-
pitches for stories I will never write, laughed at them. Not ment plot. Oh, you weren't aware of
such as the one offering an interview this? Just talk to my faithful readers;
with a New York plastic surgeon who me, I'm no they'll explain it all.
specializes in lengthening penises. ("Pe- hypochondriac. Then Confession number seven: Speaking
nile elongation surgery offers 70 per- of conspiracy theories , I secretly sus-
cent increase in organ size, according to it hit, during an pect there is an unwritten agreement
Dr. Ordon," the press release proudly interview with a among scientists to say nice things about
proclaims. ) Or the one touting a study one another's work. Why is it that Dr.X
being conducted at the University of doctor for a lengthy is always so quick to say that Dr. Y's
Southern California on the health ben- magazine story on research, to be published soon in a
efits of the Orbotron, a giant gyroscope- journal of great prestige, is an "interest-
like contraption whose makers tout it
tuberculosis. ing, important, critical, exciting" (take
as "an exhilarating ride for both amuse- your pick, any flattering adjective will
ment and fitness ." And then there are do) development? Why do I get the
the dreaded PRgimmicks. For example, writer's disease. Everybody said it would feeling that, when X's work is pub-
four science and medical writers at the happen. 'Just wait," they said, when I lished, Y will undoubtedly return the
Times (and plenty more across the coun- took the beat. "You're going to think gracious compliment for the benefit of
try, I am certain) received toy trains you have every disease you write about." a reporter's eager ears?
toting a package of beans and the latest I laughed at them. Not me, I'm no Now, my final confession: I have a
antiflatulent drug. Attached to the loco- hypochondriac. Then it hit, during an distinct, and very serious, philosophy
motive were the lyrics of a children's
jingle: "Beans, beans the musical food,
the more you eat the more you toot ....
I have a distinct, and very serious, philosophy about
" Need I say more? this beat. I have decided that, if I am to accomplish
Confession number four: It drives
me nuts that I am setting the agenda for
only one thing as a medical writer, it will be to bring
what our readers learn about medicine. a human dimension to my stories.
There is so much to write in this field, so
much to choose from, that it is impos-
sible for any one person to cover it all. interview with a doctor for a lengthy about this beat. I have decided that, ifl
Of course, some stories are dictated by magazine story on tuberculosis. His am to accomplish only one thing as a
the developments of the day. But by patient was hard to diagnose, he told medical writer, it will be to bring a
and large, I write lengthy stories (gener- me. She came in with just one symp- human dimension to my stories. Too
ally mine run in the neighborhood of 60 tom: night sweats. Night sweats! My many medical stories are written for
to 70 column-inches, although a proftle mind began to race. I had awakened in scientists only. Medicine, more than
I wrote of Jonas Salk ran 160 inches, a sweat the night before. (It couldn't any other topic I can think of, touches
long even by Los Angeles Times stan- possibly have been due to the hot sum- continued on page 39

Nieman Reports I Winter 1993 7

 HEALTH

Tsunami, Wavelets and Medical News

journalists and Experts, Riding in Different Boats,
Fail to Communicate With Each Other

BY Bos MEYERS

n 1984IjoinedTheSanDiego Union 1988 I ran a computer search on stories reporting.

I as an assistant city editor in charge

of among other things, its medical,
science and AIDS coverage. Most of our
about the medically uninsured in Cali-
fornia and the southwest, and discov-
ered that nothing more had been done
By analogy, for the longest time we
have been covering the fish in the sea,
and ignoring the tsunami rolling under
reporting was on the breaking aspects about the story anywhere except for a us on its towards the shore. Certainly,
of those critical issues, and we did a brief or two about funding services for on health, that was the case when I was
pretty good job of staying tightly the uninsured, or a mention of legisla- riding the desk in San Diego. We cov-
wrapped to the curve of the news (re- tive committee meeting looking at the ered the hell out of every example of
porters Rex Dalton, Warren Froelich subject. City Editor Rick Levinson got physician malfeasance, every mom with
and Cheryl Clark get much of the credit me the green light to dig into the story, a handicapped baby, every new splice
for that). and we produced a good-sized three- of the genetic code. But we were miss-
In 1987, seeking to broaden my own parter than ran each day on A1. ing the bigger story underneath-that
understanding of the issues and get That was our first full-length crack at
ahead of that relentless curve, I ac- a topic the experts knew was dragging
cepted an academic-year fellowship at the health system down, and that today
the Harvard School of Public Health is the engine driving reform of it.
(modeled, in fact, on the Nieman pro- My concern is this-why were we
gram). While studying in Boston I (and others) so late in understanding
learned for the first time of the prob- this major issue, and why were the
lems associated with the 3 7 million professional people who lived with this
medically uninsured Americans-the thing every day so unable or unwilling
financial impact on hospitals providing to move this knowledge along to us? Or
last-minute emergency room care, the were they aware that this was what we
drain on provider agencies, the risks in wanted?
individuals in having nothing but a There were roughly 3 7 million people
frayed safety net to rely on, etc. I learned without health insurance in the early
also aboutthe profile of the uninsured- 1980s, 37 million without it in 1988
that many of them are young, working when I wrote my series, and about the
in start-up businesses, in high tech in- same number today ("Of the estimated
dustries, in areas where labor unions 37 million uninsured Americans about
are weak, and that most of them are 85 percent are already employed," re-
working people and their spouses and ported Los Angeles Times recently.)
dependents. Thus we as journalists have gone from
All of this was news to me-l had total ignorance of it as a story to accu-
never heard of this before. I'd gone to rately citing it as a major factor in re- Bob Meyers became director ofthe Washing-
lunch with hospital administrators, p.r. forming health care. ton journalism Center in juLy, 1993. Prior to
types, business people, university What happened? The answers reflect that he was director ofthe Harvard journaL-
people-and none of them had ever I think on the nature of the news gath- ism Fellowship for Advanced Studies in
said to me, "hey, here's this issue that's ering and dissemination process as we Public Health. He has been a reporter at The
about to wreck the system, you guys practice them today, and foreshadow Washington Post, an editor at The San Diego
should do something about it." what we must do in the future. The Union and has written two books with
When I returned to the paper in mid- lessons are not limited to health care health-related themes, "Like Normal People"
and "DES: The Bitter Pill. "

8 Nieman Reports /Winter 1993

 H EAL TH I
the hospitals where these folks got gered by reporters on deadline who Why does all this matte r?
treated were going broke, that the na- want a 15-minute summary of work Because the news industry and infor-
ture of medicine was changing because they've spent five years developing. mation delivery systems are changing
of economic reorganization, that the But in the other boat are the journal- faster than you can say Internet and
"miracles" of modern medicine (how ists who are genuinely trying to provide Interactive CD Rom. Forget about flat
our secular age loves miracles!) were simple and concise answers to complex newspaper circulation, fragmenting
costly, not necessarily available to ev- questions, who may have some training network news viewership, or even 500
eryone, and maybe the benefit wasn't in the field but probably picked up most cable TV channels full of reruns of "I
worth the risk. of their understanding from the act of Love Lucy" and "Leave it to Beaver. " The
Why were we (why was I?) missing covering the story itself, and who even future that is not very far away is going
the roll of the tsunami? when they can spend some time on a to include some method of getting us
I think the answer may lie in a discon- piece wish their sources would speak "Bill & Hillary's Health Care Facts," "The
nect between people in two boat on top English. Need we mention the editors New York Yankees/Brooklyn Dodgers
of the rolling tidal wave. In one boat (to in the boat (this is a very big boat) who World Series Games-As They Should
have a tough time getting away in order Have Been Played," and the virtual-real-
to ask sources a few independent ques- ity interactive CD Rom full color version
To come back to our tions of their own, who have five or six of "Everything You Wanted to Know
topic of health reporters to handle and as well as se- Aboutlsotopes,AssemblyKitlncluded."
nior editors who like raising questions If we want to stay relevant as journal-
reform-if 3 7 million ex cathedra and who themselves have ists, much less employed, we will need
medically uninsured to consult with the front office types to provide something that can't be ob-
whose favorite wall decorations are pic- tained through lists, assemblages and
people are such a big tures of something called the bottom technology-driven what-if scenarios.
deal in the mid-1990's, line? We will need to make that connec-
To come back to our topic of health tion between the two boats, so we can
how come we as reform-if 3 7 million medically unin- report on the tsunami as well as the
general-interest sured people are such a big deal in the wavelets around us.
mid-1990's, how come we as general- I sometimes think that one reason
journalists didn't interest journalists didn 't know about p eople don 't like us very much is not
know about them in them in the mid-1980's? Where were that we are inaccurate (by and large
the mid-1980's? Where the academics and think tankers and we're not) or that we are slanted and
deep thinkers who could have guided biased and have our own private agenda
were the academics us? Were we asking the right questions? (no and no and no again) .
andthinktankersand Were we hearing the right answers? Rather, I think some people don't
Today, of course, the combination of like us all that much because we 're not
deep thinkers who political strategy, health policy discus- relevant on the really big issues. Yes, we
could have guided us? sion and strong press coverage has in- give them ball scores, whether of poli-
troduced the concept of the uninsured tics or field hockey, and we're doing a
Were we asking the Americans into the social vocabulary. better job of covering high school sports
right questions? Were The presence of 3 7 million uninsured and giving voice to those who have no
people has been identified as a major other way of being heard; yes we hold
we hearing the right factor in rising health care costs and as the feet of politicians to the fire and
answers? a major policy issue for the Clinton gnash our teeth about how to get out of
administration. The fear oflosing health feeding frenzies and whether we obsess
care coverage has been identified as an so much over a public figure 's private
continue the analogy) are the number-
important reason voters with insurance life that we help keep qualified people
crunchers, policy wonks, and scholarly
are now concerned about voters with- from public office.
researchers whose very job it is to moni-
out insurance. (However, many But the biggest gripe I've heard in
tor the big picture, chart its movement
misperceptions still abound: According this incarnation of my career is that we
and recommend course changes and
to a random sample survey of 1,200 only fish an inch deep in a mile-wide
directions. They use technical language
people taken in October 1993 by the lake. The information about the medi-
which is not journalist friendly-which
Kaiser Family Foundation and the Har- cally uninsured population was there
is often regarded as OK in their field
vard School of Public Health, only 14 five and 10 years before the subject
because they are wary of the press,
percent of the responde nts said that became the centerpiece of an
concerned about having their data badly
uninsured Americans were found in Administration's principle domestic
presented, annoyed at being asked to
working families , whereas the reality is policy-could we have provided it ear-
simplify it and not amused to be bad-
that 88 percent of them are). lier? The consequences of the banking

Nieman Reports I Winter 1993 9

 HEALTH

code regulations that led to the S. & L. search journals all quoted each other or way to enhance the news organization,
scandals-could that have been pushed assumed the number as a given. Finally not feared as a platform from which the
earlier or more vigorously? I've been someone gave me the name of one journalist will jump ship. Short-term
reading a lot lately about the claimed researcher who had crunched the num- professional development programs
negative impact of illegal immigration, bers in a federal office in Washington. should be regarded as a way to hone in
but I've seen only a few articles (like the She didn't return my calls for weeks on on a subject, enhancing the journalist's
one in The New York Times) about the end and when I finally did reach her she knowledge base and enriching-or con-
gave me so many qualifications for the fusing-knowledge as to what all the
overall number that I finally had to say, answers are.
But the biggest gripe in exasperation, "Couldn't we just say You don'twant a confused or indeci-
it's 3 7 million at any one time?" and she sive reporter out there covering the fire,
I've heard in this finally agreed that we could. but I think it is wonderful when journal-
incarnation of my Nevertheless, we-as reporters, but ists come back from a conference sud-
especially as mid-level and senior edi- denly uncertain that they have all the
career is that we only tors-will need to spend a great deal answers, because they have just been
fish an inch deep in a more time thinking about the direction exposed to so many different well
of the rolling tidal wave called news thought-out points of view.
mile-wide lake. The than is usually done now. We will need The alternative to deeper fishing in
information about the to establish, or enrich, our lines of com- the sea of knowledge is that more and
medically uninsured munications to the universities and think more of us will become dissatisfied and
tanks that can give us a big-picture, leave the profession, more and more
population was there deadline-free perspective. readers and viewers will turn to MlV-
five and 10 years before The medical and legal and other pro- style news shows or computer data
fessions require their practitioners to bases, and the wonderful and exciting
the subject became the take continuing education courses-to and even rewarding job we have always
centerpiece of an keep their skills sharp, to learn the loved-providing in small or awkward
latest thinking. Journalism should do or even fitful ways the knowledge that
Administration's the same. Long-term academic fellow- people need to conduct the democ-
principle domestic ships programs should be regarded as a racy-will be lost. •
policy-could we have
provided it earlier?
A HOLIDAY GIFT SUGGESTION
ways illegal immigrant families tend to
For the Journalist Who Has Almost Everything
·bring in all the kids and uncles and
aunts and sisters to work in the family
business, and when they buy a home in
Nieman Reports
the inner city they use something called
Please enter a subscription to Nieman Reports, published quarterly with occasional
"family money," described as money
special issues.
collected in cash from family members,
some of whom apparently are here ille- _ 2 yr. USA $35 _ 2 yr. International $55
gally. Isn't that another way of saying _ 1 yr. USA $20 _ 1 yr. International $30
illegal immigrants are stabilizing neigh-
borhoods? If true, that's not a bad story. Bill me.
None of this is easy, of course. We as _ My check is enclosed.
an industry are diverse and indepen-
dent and bottom-line conscious, and
clearly blame cannot be assessed against Name -----------------------------------
the media when facts and circumstances Address _________________________________
are reported and don't sink in to the
City _____________ State _ _ Zip Code _______
public consciousness.
Nor do the academic and research-
Country---------------------------------
ers make it easy-or even possible. In
1988 I spent days on the phone trying to
Nieman Foundation at Harvard University
track down the actual source of that 3 7
One Francis Avenue
million uninsured number-the re-
Cambridge MA 02138-9561

10 Nieman Reports /Winter 1993

 HEALTH

'Perky Cheerleaders'
By Accepting Research Reports Without Adequate Checking
Science Writers Do a Disservice to the Public

Drink deep, or taste not the Pierian spring-

Alexander Pope

BY jOHN CREWDSON
Wistarwas undeterred. A couple ofyears convention by interviewing delegates
later the doughty institute was back in outside the hall, or write about poverty
t the beginning of 1989, a vener- the news. This time it was a more fash- and racism by interviewing a sociologist

A able Philadelphia research orga-

nization, the Wistar Institute, re-
ported that Multiple Sclerosis might be
ionable complaint, Chronic Fatigue Syn-
drome, that was associated with a mys-
terious AIDS-like virus. Although the
who had visited the ghetto.
As the Wistar story suggests, scien-
tists are particularly dependent on fa-
caused by a virus similar to the AIDS Wistar scientists hadn't yet published vorable publicity and they have become
virus. The report made news across the their latest discovery-this break- adept at manipulating the press. Scien-
country. Many papers used the Associ- through was reported in a news re- tists as a group are no more or less
ated Press account, which quoted a lease-once again the story was a smash. honest than politicians, and like politi-
Wistar scientist who said he had found Earlier this year, when those findings cians they have a compelling motive to
signs of an AIDS-like virus in MS pa- were shot down by the Centers for shade the truth. Politicians exaggerate
tients. Neither Science magazine, the Disease Control, hardly anybody no- their accomplishments to get re-elected.
American journal where the report ap- ticed. Scientists exaggerate theirs to get re-
peared, nor any of the news stories it What passes for news has changed funded . To go on doing whatever they
engendered, mentioned that Wistar, in dramatically over the past quarter-cen- do, scientists need more money every
collaboration with the world-famous tury. News in the 1950's was mostly year. Whether it comes from the federal
AIDS researcher, Robert Gallo, had an- what powerful white men said and did. treasury or a private foundation , next
nounced essentially the same "finding" In the 1960's the news envelope ex- year's money depends on this year's
four years earlier-in Science's princi- panded to include the existence of what discoveries. Given the dismal state of
pal competitor, the British journal Na- Scammon and Wattenberg called the biomedicine, chances are good that the
ture . Or that the Nature report had unpowerful and unwhite. In the 1970's, average researcher hasn't discovered
been disproved, in rather short order, thanks mainly to Watergate but with no much of anything lately. The rent, how-
by several other laboratories. The Sci- small debt to David Wise's pioneering ever, must be paid, and so non-discov-
ence report fell just as flat-at last count reporting on the CIA, news became not eries and marginal discoveries and prob-
more than 20 laboratories have been only what government said but how it lematic discoveries are spiffed up and
unable to find any trace of the sus- really worked. All of this was undoubt- published in journals like Science and
pected virus in patients with MS-but edly to the good. Sometime in the early Nature , which sell them to the mass
1980's, however, journalism went too media as energetically as any big-city
far. With the space program and the tabloids compe ting for circulation. It is
growing environmental consciousness clearly a seller's market. The science
john Crewdson is senior writer for The came the recognition that science and writers who ignored Wistar's history of
Chicago Tribune based in Washington. He technology, especially medicine and dubious discoveries also failed to no-
served previously as a national correspondent health, also were news. But the journal- tice that the institute's increasingly des-
for The Tribune and as the p ap er's National ists who ventured in to this realm found perate publicity grabs paralleled both
News Editor. Prior to joining The Tribune in themselves deprived, for the first time , its worsening financial straits and the
1982 he was a national correspondent for of the basic tools of reporting, their ultimately unsuccessful struggle of its
The N ew York Times and, befo re that, a own eyes and ears. Unable to make septuagenarian director to keep his job.
reporter in that paper's Washington Bureau. their own judgments about such tech- Rather than scorn the science writer,
Crewdson won a Pulitzer Prize in 1981 for a nical matters, they found themselves we must pity him. His editors are prob-
series on illegal immigration. dependent on scientists to tell them ably former foreign and political corre-
what the story was . It was as though spondents who don't care much about
reporters could only cover a political science beyond the prospects for a bald-

Nieman Reports I Winter 1993 11

 HEALTH

ness cure or a vaccine for AIDS. To get cancer-causing viruses. At the moment tion in a first-rate journal is no guaran-
page one space on Sunday, the science the cheerleading is reserved for stories tee of anything. The rule is now often
writer must make his stories as simple about human gene research. Having ignored, a victim of the intense compe-
and dramatic as the news from uncovered a spate of putative genes tition for science stories and the advent
Mogadishu. "AIDS Death Toll Skyrock- ostensibly linked to various conditions of science by press release.
ets" will do it every time. So will "Gene and diseases, the geneticists are now Because scientists and science writ-
for Baldness Found" or "Vitamin E May closing in on the gene for breast cancer. ers are so dependent on one another,
Prevent Cancer." But not "Philadelphia The announcement of that discovery most science writers are far closer than
Institute, Wrong Twice Before, Desper- may be made before this article ap- other journalists to the people they
ate For Funding, Claims Another Un- pears, and it promises to be a scientific cover. Science writers moderate and
proved Link Between Virus and Dis- Fourth of July. All but ignored are the take part in panel discussions at scien-
ease." Complexities get filtered out, and warnings from Ruth Hubbard, the first tific meetings. They allow scientists
the headline becomes "HIV-Like Virus female biologist to receive tenure at about whose research they write to edit
Tied to Fatigue Syndrome." Harvard, and a few others that human their articles before publication. They
This owes less to malevolence than genetics is not so simple. Someday these even belong to the same distinguished
naivete . Science writers may be the last stories will evoke the same mirth as the societies; several well-known medical
innocents. Among journalists they are tales of cancer-causing viruses. journalists are members of the National
certainly the last optimists. Foreign cor- Apart from making science look good, Academy of Science's exclusive Insti-
respondents know there will always be the science writer wants to look good tute of Medicine. Editors who would
starving babies in Africa. Political writ- himself. To do this he needs good sto- never allow a political reporter to serve
ers know there will always be congress-
men on the take. Science writers be-
lieve in science. They believe science Because scientists and science writers are so
can put men on Mars, can cure cancer
and baldness, can feed those African
dependent on one another, most science writers are
babies. When Professor Schmidtlapp far closer than other journalists to the people they
says he's discovered something big, the
science writers, their collective belief
cover. Science writers moderate and take part in
reaffirmed (and their own stature en- panel discussions at scientific meetings. They allow
hanced), don't draw their guns and scientists about whose research they write to edit
make him put his cards on the table.
They don't flyspeck his raw data, don't their articles before publication. They even belong to
check his funding sources, don't scruti- the same distinguished societies ...
nize his previous articles for mistakes.
They don't interview his enemies or call
his lab technicians at home for an off-
the-record assessment of the great man's ries, preferably before they hit the jour- as a delegate to the Democratic conven-
work. They like science, they probably nals. But here, too , he is different than tion don't seem to mind similar con-
admire Schmidtlapp and they're excited other reporters. For regular reporters flicts in their science departments, pos-
by the prospect that he 's right. So they the best stories are the ones the politi- sibly because they don't consider science
just ask him how to spell whatever it is cians and bureaucrats don't want them writers real journalists. And it's true
and write it down. to have. But if Schmidtlapp thinks he's that the modern science writer prob-
Not only do science writers like sci- found a cure for cancer he's hardly ably was trained not as a reporter but as
ence, they want their readers to like it going to keep quiet about it. The only a scientist or a doctor, something news
too, or at least to understand how im- question is which reporter will get the organizations imagine lends credibility
portant science is. The best of them, first crack. The best stories a science to their coverage of these topics but
Natalie Angier of The New York Times, reporter can get are the ones somebody which also accounts for a remarkable
understands this, and rightly identifies wants to put out. To get there first he willingness to take things on faith . Jour-
herself and her colleagues as "perky needs continuing access to the most nalistic instincts are developed by daily
cheerleaders." The early NASA report- important scientists-a need that in- contact with blowhards, poseurs, rogues
ers were the precursors of her genre, creases in direct proportion to the in- and knaves, by covering the cops and
which is why that agency's monumental significance of his organization. Most the city council or working night re-
problems remained a secret until the serious newspapers used to follow a write . "If your mother says she loves
Challenger blew up. Equally perky were rule that scientific and medical informa- you, check it out," isn 't taught in gradu-
the medical writers who filed front- tion couldn't be published until it had ate school.
page reports in the early 1970's describ- appeared in a reputable journal. If the In fairness to the science writers,
ing the dramatic hunt for non-existent Wistar story is any guide, even publica- nobody's really asking them to check it

12 Nieman Reports /Winter 1993

 HEALTH

out. The national editors and news edi- and margin of error along with the a real and a psychic difference between
tors who put the paper together don 't polling results . It was a start, but when 5,000 children and 2,400. Such over-
know the right questions anyway, and it it comes to AIDS The Times still has statements skew our ability to assign
isn't so important that these kinds of trouble with numbers . More than once priorities according to relative risk, our
stories actually be true as that they might during 1992 the paper told its readers biggest public policy failing. The dan-
as well be true . Do they look authorita- the number of American women with ger is particularly acute where, as with
tive? Does everyone who is quoted have AIDS was 24,323 (the real number at AIDS, there is no competing constitu-
an M.D. or a Ph.D.? Are they associated the end of that year was a little over ency. Every story about children with
with reputable (or reputable-sounding) 9,000 according to the CDC computer's AIDS includes such arresting pictures
institutions and organizations? Are both AIDS data base) . When The Times re- of those small, sad faces that no one can
sides of the issue represented (assum- ported a few months later that some possibly be against AIDS babies. What
ing there is a second side)? Are the 300,000 Americans "had AIDS ," the other health-care problem, the faces
appropriate hedge words employed? number of living AIDS patients was seem to say, could possibly be as ur-
Then the story is better than true . It's about 120,000. Last year The Post re- gent? The answer is just about anything.
defensible. And if the prediction it's ferred to "the country's 230,000 AIDS Of all the things that kill America's chil-
built around ("Doctors Think Artificial patients,"whentherewerereallySO,OOO. dren, AIDS is near the bottom of the
Heart Will Revolutionize Medicine") A few days later another Post reporter list-during the last six months of last
doesn't come to pass, how can the story mentioned the "nearly 5, 000 U.S. young year, more children in Los Angeles died
itself have been wrong? When the de- children and teenagers who have AIDS" from ingesting iron supplements than
parting Iraqis set fire to Kuwait's oil (the actual number was then fewer than from AIDS. Thanks mainly to attention
fields it was presented as a potential 2,400). from the media and Congress, pediatric
ecological disaster of the first magni- No doubt such mistakes derive in AIDS gets the bulk of the research
tude . No doubt many readers remain money. Last year AIDS killed about 400
under the impression that considerable children a year in this country, or one in
damage was done to the earth and its 75 ,000. Sudden Infant Death Syndrome
atmosphere. They'd be happy to learn Can it be a coincidence killed more than 5, 000 infants, or better
that an extensive marine survey found than one in 800. Last year's federal
that petroleum residues in the Persian
that nearly every grants for research on pediatric AIDS
Gulf were lower than before the war- article about AIDS totaled $112 million. The total for SIDS
probably because of decreased tanker was $6 million.
overstates the
traffic during the fighting-and that the By now most Americans know some-
level of atmospheric hydrocarbons was magnitude of that one who has, or had, AIDS , so stories
no worse than on an average day in the horror, most often by about AIDS have a substantial reader-
northeastern United States. According ship. Fewer readers pay close attention
to myvideotext database, the only Ameri- confounding the to reports on superconductors and
can paper to fully report this good piece number of living supercolliders, or to the sort of gee-
of news was The Wall Street Journal, whiz science writing about tectonic
which also covers science more criti- patients with the total plates and black holes that fills Science
cally than any other American publica- number of cases ever Times, The New York Times 's weekly
tion. science section. They care very much,
The science horror story of the mo- reported? however, about medicine and health .
ment, of course, is AIDS. Can it be a Most reade rs are keener to know
coincidence that nearly every article whether Vitamin E prevents cancer than
about AIDS overstates the magnitude of part from genuine confusion about epi- what's happening in Mogadishu, and it
that horror, most often by confounding demiology. But are The Times and The is in the realm of what matters most that
the number of living patients with the Post so easily confused about other journalism fails its readers most often.
total number of cases ever reported? stories? Every reporter knows there is In October of 1993 the leading British
This happens not just at smaller papers an unwritten journalistic license to over- medical journal, The Lancet, reported
and wire services but at The Times and state the facts, or at least not to triple- that fetuses which had been scanned
the Washington Post. The cumulative check them, in the service of a noble frequently during pregnancy with ultra-
effect is to magnify the AIDS epidemic cause. Without that license, the missing sound weighed less at birth than those
beyond proportion. Some years ago, children hysteria of a few years back which had been scanned only once. A
The Times began a program of what it would never have occurred. Among typical account of this report appeared
called "precision journalism." This was journalists who write about AIDS , the in a number ofU.S. papers. "Overdoing
in an era when opinion polls were pro- prevailing notion seems to be that sinr:e it?," the item began. "Moms-to-be, Aus-
liferating, and the program consisted AIDS is an immense human tragedy, it tralian researchers have found that fre-
primarily of reporting the sample size can't be too immense. But there's both quent ultrasound examinations may

Nieman Reports I Winter 1993 13

 HEALTH

restrict a baby's growth. In a report in jor problems with the interpretation" patients and his own biometric research ,
the British medical journal the Lancet, of their findings. Harris may be uniquely qualified to
John Newnham of King Edward Memo- So how should the science writers assess the impact of questionable medi-
rial Hospital in Perth, Western Austra- have handled the Lancet ultrasound cal research on patients. "[T]he Ameri-
lia, found that pregnant women who story? By recognizing that it wasn't a can psyche," he writes in his just-pub-
had five or more ultrasound scans were story. Not only is the ultrasound ques- lished book, "Deadly Choices," "is under
more likely to have small babies at birth." tion far from being settled, but the siege by a well-equipped army of scien-
Well, not exactly. What the Austra- statistics from Australia also suggest it's tific experts, government officials, pub-
lians actually said was that while re- not yet a valid question. For the report- lic health specialists, corporations, and
duced birthweights in some of the fre- ers who wrote what looked like authori- journalists, whose heavy-duty arsenal
quently scanned babies might be the tative accounts of the Lancet article, it consists simply of words." With each
result of exposure to ultrasound, they was another day's work. Had they been pronouncement, Harris writes, the pub-
might also be "a chance effect" unre- asked, the editors who printed those lic "grows increasingly hard-nosed and
lated to the sonograms. The doctors stories would no doubt have said they wary. My own patients have grown so
said they couldn't be sure because their were serving their readers. But how skeptical that they reject the latest health
study hadn't been intended to answer were readers served by abbreviated, pronouncements out of hand."
that question. The data had come as a misleading and unnecessarily alarming Readers shouldn't enter the examin-
surprise. There were other cautionary reports of what the Lancet's own edito- ing room uninformed, but being armed
notes, but these were missing even from rial called "at most an interesting hy- with this week's LMF doesn't make them
the stories published by most bigger pothesis for further study?" What ser- informed. Had the Lancet ultrasound
papers. No article mentioned, for ex- vice was performed for pregnant story been done properly-had it in-
ample, that a number of previous stud- mothers who began to worry that they cluded all the necessary caveats and
ies had found that scanned babies might have harmed their unborn chil- background and pointed out all the
weighed more at birth than unscanned dren? Or for obstetricians who found holes and anomalies and contradic-
ones. Or that the smaller weight differ- their waiting rooms filled with patients tions-it simply wouldn't have been a
entials weren't evenly distributed across needing reassurance? story. It only passed the story threshold
the spectrum ofbirthweights-notwhat When women read that by leaving out the important parts. This
would be expected if ultrasound was at mammograms before 50 are inconclu- is not to say there's not an ultrasound
fault. Or that while ultrasound has been sive and unnecessarily risky, they an- story to be done, only that this one
in general use for two decades, average guish over whether to have one. Men wasn't it. Perhaps ultrasound is damag-
birthweights have gotten progressively read the paper and worry that a vasec- ing unborn fetuses. Or perhaps it's a
bigger, not smaller. Or that the Austra- tomy will increase their chance of pros- worthless and expensive procedure for
lian babies scanned only once had suf- tate cancer. Is margarine really as bad women with low-risk pregnancies. Or,
fered three times as many fatal birth for you as butter? Do high-fat diets re- most likely, perhaps it's a useful tool for
defects as the five-scan babies. ally lead to breast cancer? What about detecting ectopic pregnancies and chro-
Only Newsday pointed out that the heart attacks and pattern baldness? Does mosomal birth defects that also gives
average difference in birthweights was Kudzu extract really cure alcoholism? expectant parents a harmless (and rather
less than an ounce, or took the trouble These stories, which are invariably pre- amazing) first look attheir unborn child.
to interview Dr. Newnham, who men- sented to the reader as the Latest Medi- If the ultrasound story is worth doing,
tioned himself that the tiny weight dif- cal Findings, can have a substantial im- it's worth figuring out the answer your-
ferences he observed might be due to pact. It was the LMF, as these things self.
chance. Only The Wall Street Journal have become known, that virtually fin- But how can journalists reach con-
took note of a National Institutes of ished off Perrier in America, nearly put clusions on medical questions? Report-
Health study, published the month be- apple growers out of business and gave ers aren't scientists; even the few who
fore , which concluded that ultrasound the oat bran, olive oil and broccoli in- hold medical degrees don't see any
was harmless. Only the Journal men- dustries a new lease on life. Except to patients, and the news organizations
tioned that the Lancet editors had com- broccoli growers and Chinese restau- they work for don't have laboratories or
missioned an editorial critical of the rants, whether eating broccoli helps clinics. Even if they did, isn't it the
Australian study-an increasingly com- prevent cancer is a trivial question, but journalists' credo that we just report
mon dodge by publicity hungry jour- stories that cause people to put off the news? Yes, and it's precisely be-
nals who want to avoid criticism for needed or useful medical procedures cause of that credo that reporting on
running controversial articles. Unfortu- or to doubt their doctor's advice are not most complicated issues, not just in
nately, the Journal reporter got the point inconsequential matters. Jeff Harris is a science, has been reduced to providing
of the editorial wrong. She described it physician who holds a Ph.D. in eco- readers with a synopsis of positions
as agreeing with the Australians, whereas nomics and joint appointments at Har- staked out by competing groups. No
it was actually devoted to pointing out vard Medical School and MIT. As one matter what the topic, there is a govern-
what the editorialist politely called "rna- who divides his time between seeing ment agency and at least one private

14 Nieman Reports /Winter 1993

 HEALTH

linguistic code is broken it becomes FDA, which approves medical devices,

It's tinle for a new much easier to see what's going on, has reams of information on the perfor-
assuming one can also add and subtract mance and characteristics of every brand
credo, one that and has some measure of common of ultrasound machine (including those
permits the reporter to sense, curiosity and skepticism. Under- that were just recalled by a major manu-
standing statistics and the theory of risk facturer because of substandard qual-
give his readers the
is also helpful, but these are no more ity) .
benefitofsornebody complicated than health care financing It's the personal computer that does
else's expertise-his or the federal deficit or other things most to level the field. Until recently
reporters write about every day. What's huge databases could only live inside
own. mostly needed, however, is a healthy mainframes. But computer technology
infusion of what used to be called inves- is now so advanced that an astronomi-
tigative reporting but which is probably cal number of numbers can fit in a
council, institute, academy or associa- better described as primary reporting. regular desktop model. All data, and
tion that will be happy to provide the When I first came to Washington 20 particularly government data, has tradi-
busy reporter with a digestible sum- years ago, reporters like Morton Mintz tionally been run through the policy
mary of the facts. Washington is so well- and Stan Penn had raised this kind of carwash before it gets to reporters, by
organized these days that finding some- journalism to a high art. Returning after which time it has been scrubbed and
one who will take a countervailing a 10-year absence I am struck by how shined beyond recognition. Now most
position on anything usually requires a little of it takes place here anymore, in reporters have the means at hand to
single phone call. Because the resulting any field. What official Washington most interpret this data themselves. We're
stories present both sides, they look resembles now is a fine restaurant, just beginning to tap the information
balanced. But since both sides are put- where reporters are permitted to order potential of these machines, but it's
ting their own spin on the facts, they anything on the menu but not to in- already clear that the new precision
give the reader no help at all. Dr. spect the kitchen. They don't seem to journalism is computer journalism. No
Schmidtlapp of the Ultrasound Insti- mind, probably because it's nicer lunch- reporter who has the CDC's AIDS data-
tute says ultrasound is perfectly safe. ing with the assistant secretary while he base on his screen could easily confuse
Dr. Newnham down in Australia isn't so lays out the facts than hanging out with the number oflivingAIDS patients with
sure. The reader is welcome to choose the waiters and the cooks-even though the number of reported cases.
between them. it's the waiters and the cooks who know There's more to the science story
No wonder people have stopped what's going into the food. than science. But when we put science
reading newspapers. As an antidote to Developing the wherewithal to do news in a box of its own called the
the yellow journalism that character- the ultrasound story right will take some science department, the ways in which
ized many newspapers early in the cen- work. Start by reading everything in the science, medicine, health, technology
tury, down-the-middle reporting has literature and talking to every researcher and the environment-the
been a good and necessary thing. But who has published an article on the technoplex-touch the rest of the world
the world has now grown so compli- subject. Talk to lots obstetricians, those are obscured. For those of us under 50,
cated that "On the other hand ... " and who use ultrasound every day and those the interface between business and the
"To be sure ... " represent a disservice to who don't use it at all. Learn how technoplex probably will become the
the reader. No reader can hope to reach birthweights are measured, what a ran- most important story of the second half
an informed opinion on complicated domized trial is, what "p" values mean of our lives. Because science reporters
issues from stories that reduce com- and how to formulate a null hypothesis. don't understand business and most
plexity to an arm-wrestling match be- Already this puts you ahead of the game, business reporters don't understand
tween Schmidtlapp and Newnham. It's since even some researchers don't un- science, at the moment it goes virtually
time for a new credo, one that permits derstand the last three. Then do what uncovered. The LMFs, for example, prac-
the reporter to give his readers the they call a meta-analysis: get everybody tically never mention that the research
benefit of somebody else's expertise- else's data and analyze it yourself. The behind them is usually paid for by some-
his own. federal government collects data on one with a vested interest in the out-
Reporters who don't know a quark everything, and by law must give you come. Nearly all studies showing that
from a quartz wristwatch are convinced most of what it has. TheN ational Center oat bran lowers cholesterol were paid
that science is beyond their compre- for Health Statistics has an amazing for by Quaker Oats, the chief benefi-
hension, but it's not. It's just that sci- collection of data on babies, dead and ciary of the ensuing oat bran hysteria.
ence is in serious need of alive. The CDC has extraordinarily de- Oat bran, like broccoli, isn 't a life or
demystification. Scientists never use tailed records on the incidence of birth death matter. But the widely reported
words of one syllable when three or defects, including Down's syndrome study touting tPA, a synthetic antico-
four will do (aliquot="part," and other chromosomal anomalies that agulant used to treat heart attacks, was
neoplasm="growth," etc.). Once the ultrasound is supposed to spot. The paid for by Genentech, which makes

Nieman Reports I Winter 1993 15

 HEALTH

these questions? Because it's our read-

What official Washington most resembles now is a ers whose lives are most affected by the
answers, and because there isn't any-
fine restaurant, where reporters are permitted to one else. Congress keeps the executive
order anything on the menu but not to inspect the honest. The executive keeps big busi-
ness honest. The courts keep journal-
kitchen. They don't seem to mind, probably because ists honest. Among the many fields of
it's nicer lunching with the assistant secretary while human endeavor, only science is virtu-
he lays out the facts than hanging out with the ally exempt from external oversight.
There 's no supreme court of science to
waiters and the cooks-even though it's the waiters punish researchers who embroider their
and the cooks who know what's going into the food. data or the journals that hype their
irresponsible articles. Science has no
mechanism for alerting us when, as in
the Wistar case, a widely reported piece
tPA. An earlier study showing that tPA's given it control over whatever commer- of science turns out to be wrong. The
principal European competitor was just cial inventions might have derived from mainstream science journals, which ar-
as good was financed by European in- Wistar's "discovery. " The continuing guably ought to be leading the way, are
terests. The ongoing battle in the medi- dispute between the NIH and the little more than house organs. The prin-
cal literature between two of the princi- French, trivialized by the science writ- cipal American journal, Science, is pub-
pal drugs for hypertension is financed ers into a contest between Gallo and lished by the American Association for
by their respective makers. Only re- Luc Montagnier for credit for the dis- the Advancement of Science, a lobbying
cently have some journals begun re- covery of the AIDS virus, is really a organization to which most scientists
quiring researchers to declare their struggle for the control of what will belong and which makes its money from
sources of funding in print, but even soon become a billion dollar patent on charging them to attend the meetings
when they do it's in a footnote or an the AIDS blood test. Science stories and symposia it puts on. The only pub-
endnote. All the stories I saw reporting almost never mention patents, although lication that covers science critically is
that coffee doesn't cause bladder can- it is now a near-certainty that a patent the New Scientist, a British magazine
cer neglected to mention that the au- application has not only preceded, but that is not much read in this country.
thors of that study were paid by the has helped determine the contents of, The failing of American journalism is
National Coffee Association. Maybe cof- any "breakthrough" biomedical research about more than failing to have kept
fee doesn't cause cancer. But it's curi- paper. Despite the millions of words science honest. It's about failing to have
ous that no LMF's ever seem to contra- written about cold fusion, only Gary become as sophisticated about what
dict the interests of the funding Taubes's recent book, "Bad Science," goes on inside the technoplex as about
organization. Is this because, con- explains the degree to which that cha- finance or politics or world affairs. Ulti-
sciously or unconsciously, scientists rade was driven by patents and lawyers. mately, the technoplex isn't about sci-
meet the expectations of those who pay The same visions of corporate wealth ence anyway. It's about vital questions
the bills? Or is it just a coincidence that that kept cold fusion alive beyond its of public policy, about how enormous
the only major study showing that oat time are behind research on an AIDS sums of public money are spent, about
bran has no effect on cholesterol was vaccine and the human genome patent how lives are saved and lost and how
financed by the NIH? scandal yet to come. But look deeper. those lives are lived. The technoplex is
There are plenty of non-science re- Which authors of the journal article that too important to be left to reporters
porters in Washington and elsewhere made this morning's front page own who like science, reporters who are
who recognize conflict and corruption stock in the company that makes the more interested in why volcanoes ex-
when they see it. They know what a rat new drug they praised? Or, to take it to plode and how bumblebees mate .
smells like, they know how to follow a place the SEC's insider trading task Would you make Tom Clancy your Pen-
money, and they know where the Secu- force has not yet gone: which of the tagon correspondent? •
rities and Exchange Commission is. It's scientists to whom the journal sent the
because they don't do science that hardly article for confidential pre-publication
anyone has begun to comprehend the review is parking 10,000 shares in his
full impact of patents and the stock sister-in-law's brokerage account? The
market on the course of scientific re- question that must now be asked about
search. Among the many unreported every LMF is almost never asked : is this
aspects of the Wistar story was the fact principally about making people well,
that, a few days before the publication or is it principally about making money?
of the institute's first article, the NIH Why should journalists, and particu-
applied for a patent that would have larly newspapers, be the one to ask

16 Nieman Reports /Winter 1993

 HEALTH

The Press's Portrayal of Mental Illness

Public Misconceptions Find Their Ulay Into the Media
- A Primer on Needs and Treatment

BY SusAN G. lAzAR,
GLEN 0. GABBARD AND
ELIZABETH K. HERSH

n the days following Vincent Foster's grams. The press was relieved when public's low level of awareness of men-

I suicide, reporters were filled with

self-reproach. They wondered if they
had been too harsh with him and had
hints of Foster's depression and per-
sonality quirks emerged.
They should not, however, feel san-
tal illness was mirrored in the reporters
who, with only a few exceptions (such
as Alison Bass of The Boston Globe),
indirectly helped create a cruel political guine because in the early days and did not consider the presence of de-
climate that caused the suicide of a weeks following Foster's death report- pression. More importantly, in their
dedicated, talented and sensitive man. ers missed an important opportunity to treatment of mental illness as a dirty
This question was debated in endless educate the public about the perils and secret, they subtly contributed to the
articles, editorials and TV news pro- prevalence of mental illness. In fact, the sense of shame and stigma that makes it

Susan G. Lazar, M .D., is Clinical Professor Elizabeth K Hersh, M.D., is on the clinical Glen 0. Gabbard, M.D., is Medical Director
ofPsychiatry at the George Washington faculty at Georgetown University School of ofthe C.F Menninger Memorial Hospital in
University School ofMedicine and is on the Medicine, Department ofPsychiatry, where Topeka, Kansas, and Clinical Professor of
faculty ofthe Washington Psychoanalytic she is assistant director ofthe Women s Psychiatry at the University ofKansas School
Institute. She has co-authored a textbook on Affective Disorders Clinic. She is a practicing ofMedicine- Wichita. He is the author or
psychotherapy and served as a consultant to psychiatrist and psychoanalyst. editor of 10 psychiatric books and over 100
the Mental Health Work Group ofthe White scientific articles.
House Task Force for National Health Care
Reform.

Nieman Reports I Winter 1993 17

 HEALTH

so difficult for a man ofFoster's prestige Depression was finally discussed in 45 Million Suffer
and position to request psychiatric care. depth in a front-page New York Times Mental Illness Yearly
A review of articles in The New York article fully three weeks after Foster's
Times during the two months following death following the revelation of his In an elegant 1993 epidemiological
Foster's death tells much about the atti- anguished notes, an op-ed piece on study, Darrel Regier from the Division
tudes of the press. In the initial reports depression and an editorial detailing of Epidemiology and Services Research
written by seasoned journalists, shock, that eight out of ten suicides are driven and other colleagues at the National
confusion and dismay abound . Col- by depression. It had taken three weeks Institutes of Mental Health (NIMH) in
leagues, friends and experts were ques- Bethesda, Maryland, determined that
tioned. However, psychiatrists, who approximately 45 million adults in the
every day evaluate the suicide potential United States suffer from a diagnosable
of their patients, were notably absent
Misconceptions about psychiatric disorder each year.
from the list of experts interviewed. mental illness and its In a given year, one in five adult
Indeed, in the early weeks the question Americans, or 3 5.1 million, have a men-
of mental health was not even seriously
treatment are
tal disorder other than substance abuse.
considered. The words depression, de- sustained by Ten percent of American adults abuse
spondency and brooding appeared fleet- widespread myths and alcohol or drugs and one-third of these
ingly, and then only to be denied. substance abusing patients also suffer
Depression began to be seriously prejudice, some of from another mental disorder. Of the
considered in The NewYorkTimes more which f"tnd their way mental disorders, anxiety disorders,
than a week after Foster's death. Jour- (such as phobias and panic disorders)
nalists behaved like heartbroken family into the media. are the most common, affecting 12.6
members for whom the awareness of percent of the adult population. De-
mental illness stirs guilt, denial and pression affects 5 percent. Schizophre-
anxiety. In the end, however, readers to move the inquiry out of a cloud of nia, probably the most severe form of
were denied the chance to appreciate ignorance and denial. Immediately mental illness, affects 1.1 percent, or 2
that the recognition of mental illness thereafter, the story virtually disap- million people.
affords protection and the opportunity peared except for a few letters to the The effects of trauma in our society
for treatment. editor, a well-buried but excellent piece take a serious toll and have been found
Furthermore, serious errors of treat- on suicide, and an inquiry into Foster's to lead to post-traumatic stress disorder
ment were reported without reflection. state of mind. (PTSD) , dissociative disorders and bor-
For example, it was repeatedly men- The New York Times was not atypi- derline personality disorder. The statis-
tioned in front page news stories that cal. In one of the most thoughtful news- tics are sobering. Nearly one-third of all
antidepressant medication was pre- paper pieces on the subject, Tom Vietnam veterans suffer from PTSD at
scribed long distance for Foster by a Rosenstiel ofThe Los Angeles Times did some point. These veterans have at least
family doctor from Little Rock. Perhaps a database search of the more than 100 twice as much divorce, homelessness
if journalists had not been paralyzed by articles written in the two weeks follow- and alcohol and drug abuse as those
their fear of mental illness, their innate ing Foster's suicide and found only 12 without PTSD. They have horrifyingly
curiosity would have stirred them to ask articles in newspapers and magazines high rates of violent crime and almost
whether this was standard procedure. that mentioned mental illness. half are arrested or in jail at least once.
This question was addressed in The Both historically and more recently They are also five times as likely to be
New York Times only two and a half in the context of debate about national unemployed and over three times as
weeks later in a letter to the editor in health care reform, the nature and mag- likely to have multiple chronic health
which a psychiatrist discussed this "dan- nitude of the nation's mental health problems as veterans without PTSD.
gerous but common practice. " That it is needs have been grossly misunderstood Almost 40 percent of inner-city resi-
indeed dangerous to treat someone by the general public. Misconceptions dents experience severe trauma in some
suffering from depression without evalu- about mental illness and its treatment form and nearly a quarter of those trau-
ating their suicide potential is obvious are sustained by widespread myths and matized ultimately develop PTSD. One
in the present context. It may also be prejudice, some of which find their way third of American females experience
dangerous to allow the reading public into the media. Drawing from a grow- some form of sexual abuse such as in-
to believe that nothing more is gained ing body of clinical and epidemiologi- cest, date rape or molestation by strang-
from psychiatric consultation than a cal studies, we offer a more factual ers. A history of childhood abuse is
prescription. A therapeutic relationship picture of mental illness and its gross found in over half of prostitutes and
often provides a lifeline to despondent undertreatment, despite the efficacy and male sexual offenders . Childhood
people during the weeks or even months cost effectiveness of care. trauma has also been found to be a
that it can take before antidepressant significant factor in the development of
medication becomes effective. both dissociative disorders and border-

18 Nieman Reports /Winter 1993

 HEALTH

I ine personality disorder which affect 5 dromes. Most substance abuse patients renee of major depression for up to 82
percent and 3 percent of the popula- can be treated in intensive outpatient weeks which is enough to carry a women
ti o n, respectively. programs. through a period of pregnancy and
Children and adolescents also suffer When hospitalized patients are stabi- nursing.
from mood disorders. Three percent to lized in an inpatient setting, generally Borderline personality disorder is the
6 percent of the adolescent population after a few days to a few weeks, they can most common of severe personality dis-
have recurrent and severe mood disor- be moved to partial hospital settings orders. Many of these patients were
ders, and suicide is the second leading where treatment can be provided much abused as children. These patients of-
cause of death in adolescent males. more cost-effectively. A small subgroup ten have suicidal depression, substance
Eating disorders , such as anorexia of hospitalized patients, who are ex- abuse, intense anxiety, chaotic personal
nervosa and bulimia nervosa, are also tremely suicidal and refractory to treat- relationships and difficulty maintaining
increasing in children and adolescents. ment, or who are unremittingly psy- consistent work. They may also have
Anorexia nervosa patients have a mor- chotic and impulsive, require more brief psychotic episodes. Controlled
tality rate between 5 and 20 percent. In extended hospital stays. clinical trials have demonstrated that
addition, 9 percent of all children and Patients suffering from schizophre- patients who receive at least one year,
adolescents have anxiety disorder. nia often require repeated hospitaliza- but preferably two and a half years, of
The cost of mental illness and sub- tions during relapses. These patients intensive psychotherapy fare substan-
stance abuse is staggering. A study done also require regular outpatient appoint- tially better than patients who receive
at the University of California at San ments with a psychiatrist for medica- only the limited care proposed in the
Francisco estimated that the cost of tion management, as antipsychotic Clinton Administration's health plan.
mental illness is $273 billion per year. drugs are crucial in the prevention of Patients with borderline personality
Based on projections of 1985 data into relapse. Many of these patients also do disorder have a 9 percent suicide rate.
1988, this figure includes $129.3 billion much better if they receive ongoing When they are treated with only 20
for mental disorders, $85.8 billion for psychotherapy. outpatient psychotherapy visits a year,
alcohol abuse and $ 58.3 billion for Depressed patients have greater limi- they remain very disturbed, often sui-
drug abuse. The costs include treat- tations offunctioning than patients with cidal, have difficulties functioning at
ment, reduced productivity, mortality arthritis, diabetes, hypertension and work and make much more use of emer-
and law enforcement expenditures on heart and lung disease. Indeed, they gency room, medical and surgical care
crime. Because these data were gath- utilize general medical care three times
ered before the beginning of the crack more often than non-depressed pa-
epidemic, they are undoubtedly gross tients. Sixty percent of patients with
underestimations. major depression have recurrences. 72 percent of the
These patients have a significant fre- persons suffering from
quency of suicide attempts. Hospital-
Treatment Needs ization is required when suicide is a substance abuse or
In and Out of Hospitals significant risk. Both medication and psychiatric disorders
psychotherapy are effective treatments,
While much more of the psychiatric but for different symptoms of the ill- receive no treatment
treatment of the most severe psychiat- ness. Medications work on the appe- for their illness.
ric illness was once based primarily in tite, sleep and mood disturbances while
inpatient settings, the de-institutional- psychotherapy helps with the interper-
ization movement in the 1950's and sonal, social and work problems.
1960's began emptying state mental The decision to use medication vs. and two and a half times as much inpa-
hospitals and transferring treatment psychotherapy or a combination of both tient psychiatric care as patients treated
responsibility to community mental involves a clinical judgment. For ex- intensively and continuously in outpa-
health centers. Nowadays, services range ample , since depression is more com- tient psychotherapy. Furthermore those
from inpatient units, partial hospital mon in women, with the highest inci- patients who do receive at least two and
settings (such as day hospitals and half- dence during the childbearing years, a half years of intensive outpatient psy-
way houses) to outpatient care. and many antidepressants carry a risk to chotherapy reach a much higher level
Patients who require hospitalization a fetus or nursing infant, psychotherapy of functioning, are in a better mood and
include those who present a danger to is very important for pregnant or post- are much less suicidal. They may con-
themselves or others or who have seri- partum patients. There are also patients tinue to need psychotherapy intermit-
ous symptoms that impair their func- who cannot take medication due to tently even after the two and a half
tioning and are unresponsive to outpa- medical conditions and many patients years.
tient care. Alcohol and drug-abusing who simply do not respond to medica- Patients with PTSD or a history of
patients need inpatient care when they tion. Research demonstrates that psy- severe trauma and abuse suffer from
suffer life-threatening withdrawal syn- chotherapy alone can prevent recur- anxiety, depression, persistent night-

Nieman Reports I Wimer 1993 19

 HEALTH

mares and terrifying flashbacks. They pression is three times as common with untreated mental illness use medi-
also have emotional numbing and alien- among medical inpatients and twice as cal and surgical resources, diagnostic
ation symptoms that only respond to common among medical outpatients studies, emergency rooms and office
outpatient psychotherapy which often compared to the general population. visits at higher rates than those without
needs to continue from six months to Psychotherapy reduces anxiety and de- mental illness. Many p ersons with gas-
two and a half years. Studies have pression in medical patients and re- trointestinal problems or recurring
shown that the need for psychiatric duces pain by as much as 50 percent. In headaches have underlying psychiatric
hospitalization only declines after in- addition, a recent study demonstrated symptoms that a nonpsychiatric physi-
tensive outpatient care. Medical and that depressed patients recovering from cian may not detect. For example, in
surgical expenses for physical symp- a myocardial infarction have a fivefold women with functional bowel disor-
toms related to emotional distress also higher mortality rate compared to those ders there is a 44 percent prevalence of
without depression. An innovative pro- a history of sexual or physical abuse.
gram of diet, exercise, and a year of Over four-fifths of these patients have
group psychotherapy has been demon- never confided this history to their phy-
Health maintenance
strated to reverse coronary artery dis- sicians. A host of studies document that
organizations, which ease more effectively and at a much access to appropriate mental health
are the cornerstone of lower cost than angioplasty (which costs treatment substantially reduces overall
$10,000) or coronary artery bypass sur- medical costs.
the Clinton plan, have gery (which costs $40,000). The fact that most insurance policies
historically limited Half of all cancer patients have a cover mental illness poorly is an impor-
psychiatric diagnosis , and psychiatric tant reason that the majority of men-
psychiatric services intervention with such patients may tally ill Americans remain untreated.
and have not been produce remarkable results . In one Only 2 percent of insurance policies
study of metastatic breast cancer pa- provide outpatient psychiatric cover-
"user friendly" to the tients, once a week group psychotherapy age at the same level as outpatient medi-
poor and to those with for a year actually doubles the long- cal services, and only 20 percent cover
term survival as compared to those pa- inpatient psychiatric services to the same
severe mental illness. tients who did not receive group degree as inpatient medical care. Much
therapy. Malignant melanoma patients of this disparity is related to ongoing
who received group psychotherapy also prejudices against the mentally ill that
decline only after an intensive course of had longer survival than those who did exist in our society. In a 1989 survey by
psychotherapy. Medication has not been not. the Robert Wood Johnson Foundation,
particularly effective for many of these 58 percent of those surveyed believed
patients. that mental illness may be caused by
Many emotionally ill children and Lack of Access lack of discipline.
adolescents need extended psycho- To Treatment Alarming Many benefits managers, insurance
therapy. Antidepressants are not effec- industry executives and nonpsychiatric
tive in depressed adolescent males, One of the most alarming findings of physicians do not believe that psychiat-
making the availability of psychotherapy the NIMH study by Regier and his col- ric treatment is effective. This major
crucial. Intensive psychotherapy also leagues was that 72 percent of the per- misconception is an important source
leads to a fivefold decrease in mortality sons suffering from substance abuse or of inadequate insurance coverage. It is
of anorexia nervosa patients. Without psychiatric disorders receive no treat- also not supported by the facts . A 1993
ongoing outpatient treatment, these ment for their illnesses. Of the remain- report by the National Advisory Mental
patients require repeated and costly ing 28 percent, only about 40 percent Health Council in the National Insti-
medical hospitalizations for tube see a professional trained to deal with tutes of Mental Health documents that
feedings and for the physical sequelae mental health problems, such as a psy- the success rates for treatments of ma-
of the illness. Medical care alone is not chiatrist, a clinical psychologist, or a jor psychiatric disorders are equal or
successful in reversing the illness, which psychiatric social worker. Forty-three superior to those for major medical
then becomes chronic and entrenched. percent take their problems to illnesses.
Anxiety disorders also require psycho- non psychiatric physicians, and another Finally, one other reason for limited
therapy with psychotropic medication 15 percent join self-help groups or sim- accessibility may be the method of men-
as an adjunct. ply seek out advice from family mem- tal health care delivery. While the Clinton
A comprehensive account of the bers or friends. Administration's health care reform plan
mental health needs of the public must Besides the tragedy of unnecessary has the laudable goal of universal cover-
include psychiatric services for the medi- human misery and suffering, another age, experience has shown that univer-
cally ill in addition to those suffering unfortunate result of untreated mental sal coverage does not mean universal
from "pure" psychiatric disorders . De- illness is higher medical costs. Patients access. Health mainte nance organiza-

20 Nieman Reports /Winter 1993

 HEALTH

tions, which are the cornerstone of the cally based mental illness should be to 30 per year and insists on 50 percent
Clinton plan, have historically limited treated by psychotherapy and biologi- co-payment. To some extent, these limi-
psychiatric services and have not been cally based mental illness should be tations are due to a myth that psycho-
"user friendly" to the poor and to those treated with drugs. Such distinctions therapy is only used by the "worried
with severe mental illness. A Rand Cor- no longer hold up . In a recent study, well" and is a luxury that we cannot
afford. The fear of overutilization is not
supported by studies designed to inves-
tigate that concern. In a Rand Corpora-
... even the Clinton plan limits the number of tion study published in 1986, only 4
percent of an insured population given
psychotherapy sessions for most patients to 30 per
generous psychotherapy coverage ac-
year and insists on 50 percent co-payment. To some tually utilized the services. Of those
extent, these limitations are due to a myth that patients who received psychotherapy,
the average length of the treatment was
psychotherapy is only used by the "worried well" and 11 sessions.
is a luxury that we cannot afford. Despite widespread skepticism about
the efficacy of psychotherapy, many
studies have shown that the average
patient treated with psychotherapy is
poration study demonstrated that the obsessive-compulsive patients success- better off than 80 percent of untreated
poorest and sickest depressed patients fully treated by either psychotherapy or patients. The efficacy of psychotherapy
do much worse in prepaid health care medication showed the same improve- is comparable to that of psychiatric
plans such as health maintenance orga- ments on a special kind of brain scan. medications. Some of the illnesses that
nizations compared to fee-for-service the Domenici plan would deliberately
plans. In prepaid plans, they do not exclude as not "biologically based" are
receive adequate care and actually be- Psychotherapy Cuts nonetheless very costly conditions .
come more impaired over time. Pri- Costs Dramatically Borderline personality disorder can only
mary care physicians, who often func- be effectively treated by consistent psy-
tion as "gatekeepers" to psychiatric There is also a strong economic argu- chotherapy over a period of 1 to 2 years.
services, frequently fail to diagnose and ment for providing generous outpa- If psychotherapy is interrupted because
often underrefer and undertreat de- tient benefits for psychotherapy cover- of arbitrary insurance limits of 20 or 30
pression. age. A meta-analysis of 58 controlled sessions per year, these patients will
The age-old mind-body problem has studies demonstrated that psycho- show up at emergency rooms with an
created controversy within the field of therapy resulted in a 10 to 33 percent overdose on medication and will end
psychiatry and thus has confused the decrease in utilization of medical ser- up in intensive care units, or require
general public. The mental health pro- vices, with an average reduction of 1.5 inpatient treatment, all of which are
fessions are divided in their attitudes days of inpatient care . In a study of much more costly than psychotherapy.
toward proposals that would limit cov- patients with multiple physical symp- There are similar cost offsets from ex-
erage to "severe" mental illness only, toms, psychiatric consultation resulted tended psychotherapy for a number of
i.e. , those thought to be brain-based or in a 53 percent decline in health care other diagnostic groups.
"biological" in origin. Senator Pete charges. A compelling recent study of
Domenici has introduced such a bill CHAMPUS, the insurance program for Some Reporters
that has drawn support from some military dependents and retirees , dem- Singled Out for Praise
mental heath groups, but opposition onstrates that the provision of readily
from others. The division of disorders accessible outpatient psychotherapy as The coverage in TheN ew York Times of
into "biological" or "psychological" ill- medically indicated without artificial lim- Vincent Foster's suicide serves as a mi-
nesses is, however, increasingly scien- its realizes dramatic cost savings in psy- crocosm of the way many reporters deal
tificallyuntenable. Most mental illnesses chiatric inpatient costs. For every extra with mental illness. However, a few
are caused by a confluence ofbiological dollar spent in the expansion of outpa- reports in the nation's major newspa-
and psychological factors. For example, tient psychotherapy, four dollars are pers and periodicals have clearly shown
studies of major depression show that saved in inpatient costs. an impressive grasp of the complexities
genetics play a substantial but not over- Despite these impressive cost-offset of psychiatric needs and the shortcom-
whelming role in the development of studies, coverage for outpatient psy- ings in the delivery of mental health
this illness. Recent stressful events are chotherapy remains limited in the vast services.
in fact the most important trigger. majority of policies. Indeed, even the Perhaps most notable among these
It was once thought that psychologi- Clinton plan limits the number of psy- reports are those by Alison Bass of The
chotherapy sessions for most patients Boston Globe. In two articles onApril6

Nieman Reports I Winter 1993 21

 HEALTH

and on April 28, 1993, she delineated efits." This article reviewed Rand Cor- the tab for Prozac-popping boomers"
the serious effects on patients who can- poration data as well as other psycho- (October 4, 1993). In the same issue,
not obtain adequate benefits. In the therapy research to criticize the inad- Eleanor Clift contributed an article en-
second article, Ms. Bass outlined the equate mental health care of most titled "The Gender Wars," which de-
case of a victim of childhood sexual scribed the argument within the Ad-
abuse who developed anorexia nervosa ministration about the extent of mental
but was denied the longterm psycho- health benefits as a fight between "the
therapy she needed. Ms. Bass went on One widespread girls ' team" and "the boys' team." Clift
to critique the common policy of most concluded, "But on Capitol Hill, the
HMOs, which is to refuse to provide
problem is the boys are still in charge."
extended psychotherapy under any cir- adoption of a sarcastic, Another problem is a lack of depth
cumstances. She reported, "However, a and sophistication in reporting mental
trivializing or
growing body of research indicates that health issues such as a September 18,
effective outpatient psychotherapy saves demeaning tone about 1992 story by Judy Mann of The Wash-
money by cutting down on costly hospi- mental health needs. ington Post. While this is a compelling
talizations and overuse of medical ser- account of a psychotic illness and its
vices, including, for example, doctor's treatment needs, it also described
visits for psychosomatic complaints. One schizophrenia as "a brain disease" and
large-scale study, for example, found HMOs. A similarly sophisticated and listed various physical and genetic
that veterans with psychiatric problems wide-ranging piece appeared on May causes, completely leaving aside the
who obtained psychotherapy were far 24, 1993 in U.S. News & World Reports important emotional symptoms of the
less likely to use subsequent medical titled "Does Psychotherapy Work?" by illness and contributing to a growing
services than similarly troubled veter- Erica E. Goode and Betsy Wagner. Rob- and inaccurate impression that psycho-
ans who did not receive therapy." ert Pear ofThe New York Times has also ses are solely physical illnesses which
Two Boston Globe editorials under- reported knowledgeably in a series of need only physical treatments. This one-
scored Bass's presentation, and on articles on the range of mental health sided conclusion would then leave out
March 17, 1993 one editorial said, "The services needed and the supportive re- the psychosocial treatments that have
mental health system appears weakest search findings, most notably on June proven to enhance recovery in schizo-
during pre-and post-hospitalization care 10, 1993. And, on July 4, 1993, The phrenic patients.
and in outpatient service." On May 3, Washington Post published an insight- Perhaps the worst and most damag-
1993 another Boston Globe editorial ful article by Dana Priest in which she ing coverage about mental health flows
stated, "The folly of such limited cover- discussed the expected limitation of from the attitudes that mental health
age is obvious. For many patients the mental health benefits in the Adminis- needs are neither serious nor impor-
cutoff in treatment leads to worse psy- tration package, despite the docu- tant and that psychiatric care repre-
chological states and even physical prob- mented success of several programs in sents a middle or upper class self-indul-
lems requiring costly hospitalization. " containing and even saving costs while gence. Such sentiments have been aired
Shari Roan in a September 30, 1993 providing generous psychiatric services. in Time magazine which called mental
Los Angeles Times report documented The plight of the homeless mentally health care "another expensive subsidy
the reception by mental health advo- ill who are given little or no services and for the middle class" on September 20,
cates of the limited mental health ben- who often end up in jail was docu- 1993 and in The New Republic which
efits in the Administration's health care mented by Ronald Taylor of The Los on April 26, 1993 said, "Hillary Clinton
package. She presented the history of Angeles Times on September 10, 1992 is ... insisting that treatment for mental
stigma and neglect of mental health and in The New York Times by Philip J. illness be guaranteed all Americans. This
needs and detailed how the benefits Hilts on September 10, 1992. Carole would create an endless stream oflargely
will care for different groups of psychi- Feldman, also ofThe Los Angeles Times, ineffectual spending unless 'mental ill-
atric patients. She also noted that "Some wrote a July 4, 1993 piece documenting ness ' were defined with an austerity she
consumers also fear that limits on out- the serious difficulties other patients seems unlikely to muster." Prejudiced
patient services will leave them with face with limited mental health services. and inaccurate statements such as these
inadequate care." Unfortunately there are other times in the media destroy public support for
Other well-informed reporters in- the media miss the mark. One wide- care of the mentally ill, the most unrec-
clude Sandra Boodman of The Wash- spread problem is the adoption of a ognized, underserved and politically
ington Post who wrote a cover story for sarcastic, trivializing or demeaning tone vulnerable group of American patients.
that newspaper's weekly health section
on August 3, 1993 titled "The White
about mental health needs. One such
example is a reference to mental health
•
House is Banking on HMOs as a Way to benefits that appeared in a Newsweek
Reform Health Care-But Many HMOs summary of the Administration plan:
Today Skimp on Mental Health Ben- "Healthy Generation Xers will pick up

22 Nieman Reports /Wimer 1993

 HEALTH

View From the Nurses' Station

Too Little Attention Is Paid to Care ofPatients
Compared With Medical Treatment

BY BERNICE BURESH

ast summer, when surgeons at twice about this one, and decide to

L The Children's Hospital of Phila-

delphia decided to separate the
Lakeberg "Siamese " twins, the event
enlarge its frame from medical spec-
tacle to real-life health care. The con-
tent, the types of news sources and the
comprised the elements of a medical time period immediately expand.
super bowl. Described as "surgical wiz- In this health-care version, the reader
ardry" by The New York Times, the and viewer are taken not only to the
operation by world-class doctors in- operating theater, but also to the pedi-
cluded the win-lose risks of all great atric intensive care unit, where Angela
contests-only one conjoined twin, if is cared for around the clock by critical-
lucky, would survive because there care nurses in the cardiothoracic wing.
weren't the two hearts needed to sup- There, and in talks with nursing ethi-
port both lives. cists, the emphasis subtly shifts from
Reporters covered the medical drama prognosis about the duration ofAngela's
by rounding up experts for both pre- life, to the quality of her remaining life.
and post-event handicapping. Those The nursing sources explore what kind
who argued for no intervention were of disabilities the infant has and will
quickly superseded by surgeons who continue to have if she survives, and the
could give scalpel-by-scalpel details of type , quantity and cost of the ongoing
the five-and-a-halfhour operation. Con- care that she will need, not just the
troversy also shaped the post-event price tag on the surgery. Some nursing
analysis.Journalists sought out medical ethicists also pointedly qu es tion
ethicists who questioned both the pri- whether the operation conferred greater
orities of the game plan and its costs, benefits on the learning curve of sur- Bernice Buresh is director ofthe Women,
especially at a time when the inequities geons than to the well-being of the Press and Politics Project, an independent
of the medical system are being widely patient. Nurses and social workers raise research and education group in Cambridge.
debated. questions about what was done to sup- She has been a reporter for The Milwaukee
Of course family players were part of port the Lakeberg family through this Sentinel and a correspondent and bureau
the event. Attention shifted from the horror and their attempts to arrive at chieffor Newsweek. She taught courses she
mother, Reitha Lakeberg, who had decisions at every stage. Expanding the developed on women and the press at Boston
pressed for a high-tech solution to the frame on the story this way makes care, University, Brandeis University and the john
tragedy, to the father, Kenneth, who as well as treatment, visible. Not at all F Kennedy School of Government at
had gotten into trouble with the law. coincidentally, the roster of experts in Harvard. She has been a fellow in both the
Follow-up articles reported the condi- this version now includes many women, Knight Program at Stanford and the joan
tion of Angela Lake berg, who survived. instead of mostly men. The story is also Shorenstein Barone Center at H arvard.
Then the story passed from the scene, more textured, real and continuing. In journalists can obtain the project's listing of
ready to be replayed in the event of the its more limited medical frame , the fo- nursing sources by calling (617) 491-0003.
infant's death. cus is on cleaving the twins, a frame
When a story with all the right dra- shaped by the familiar and thrilling "fix-
matic elements comes along, no jour- it," or "find-the-magic-bullet, " motif.
nalist even has to think twice about how Now, with care being brought into bal-
to cover it. But suppose we do think ance with "cure," the story is more on-
going, and a lot more reflective of the

Nieman Reports I Winter 1993 23

 HEALTH

real issues in health care. tinct from medicine. Patricia Benner, how to cope with the illness. They also
As this story illustrates, journalists Professor of Physiological Nursing at help patients to deal with death and
generally bring a bias to reporting of the University of California at San Fran- dying.
health care. They see medicine as syn- cisco, who has articulated the skill and Despite nurses' central role in keep-
onymous with health-care. This bias is knowledge embedded in caregiving, ing people with AIDS alive and func-
quite understandable in its origins. It is puts it this way: "Physicians focus on tioning, and despite the many nursing
not just the marvels of modern medi- disease-the manifestation of aberra- specialists in universities and other in-
cine that have permitted physicians, tion at the cellular, tissue, or organ stitutions working on primary care, in-
who make up 10 percent ofthe health- level-while nurses focus on illness- fection control, community-based ser-
care work force, to so thoroughly domi- the human experience of loss or dys- vices for children with AIDS, and the
nate health care discourse in the media. efficacy of nursing care, to name just a
The depiction of doctors as the propri- few aspects, nurses are not among those
etors of the healing arts has depended By the very nature of routinely quoted as expert sources in
just as much upon organized medicine's AIDS coverage. We have seen occasional
tough and uncompromising political nursing, nurses spend feature stories on AIDS nursing, but
campaign for dominance waged far more time with nursing specialists are not integrated
throughout most of this century. into the day-to-day reporting on the
The consequences, however, of jour- patients than biggest disease issue of our time.
nalists' refracting almost all health-care physicians do. If readers and viewers were to see
issues through the prism of medicine health care depicted as more of a col-
undermines the accuracy, balance and
However, the complex, laboration of cure and care, they might
fairness of reporting on health care, multidimensional care be in a better position to make choices
and it limits the views, and ultimately about their own health-care needs. For
the health-care choices, of readers and
they deliver to patients example, people today live longer than
viewers. Now, while the whole eco- and to patients' ever before with complex problems for
nomic and social contract regarding which there are no cures . But there
families is rarely
health care is under scrutiny, it is time have been remarkable advances in care.
for journalists to reform their attitudes included as part of the One of the most pressing questions of
and practices in reporting on this sub- reporting on health- our time is how care-not just medical
ject. treatment-will be organized and pro-
One way to start is to subject the care issues. vided.
Clinton health security plan, as well as Ever since the advent of the Diagnos-
rival plans, to analysis of how they will tic Related Groups a decade ago, finan-
affect the entire scope of health care, function ." cial pressure has been on medical insti-
not solely medical care. This means By the very nature of nursing, nurses tutions to shorten hospital stays, which
more reporting on the quantity and spend far more time with patients than in reality means curtailing the length of
quality of care we can expect from the physicians do. However, the complex, nursing care. Since most health-care
nation's largest health-care profession, multidimensional care they deliver to journalists concentrate on medical treat-
which is, of course, nursing, not medi- patients and to patients' families is rarely ment, this part of the story gets missed.
cine. It also means more information included as part of the reporting on Patients are being discharged "quicker
on how reforms will affect the working health-care issues. and sicker," often without nursing pro-
conditions and livelihood of the 2.1 For example, one of the tragedies of visions and with nursing needs beyond
million registered nurses in this coun- our time is that medicine has so little to the ability of family caregivers to pro-
try, not only the nation's 600,000 physi- offerpeoplewithAIDS. However, in the vide.
cians. hospital, the clinic and at home, the No wonder some see Dr. Jack
A fresh look means revealing one of work of AIDS nurses has a direct bear- Kevorkian as a savior. Although nursing
the best-kept secrets of our time-the ing on the longevity and level of health researchers and clinical practitioners
content of contemporary nursing. The of patients. Advances brought by nurs- have made great advances in promot-
research that my colleague, Suzanne ing research and technological devel- ing healing, and providing comfort and
Gordon, and I have done indicates that opment permit nurses to administer pain management, for those living with
few journalists understand the critical sophisticated therapies both inside and cancer, Alzheimer's disease , AIDS and
role that nurses play in health care, nor outside of the hospital, as well as to other chronic or terminal illnesses, these
are they aware of the advances in nurs- monitor for side effects and to help care developments don't often make
ing practice, education and research patients fight opportunistic infections. the news. To learn about them, one has
within the last 20 years. Moreover nurses educate patients to speak systematically with nursing
Nurses are not the handmaidens of and their loved ones about the illness, sources, not just medical sources, and
physicians. Nursing is a profession dis- medications, treatment programs, and read nursing journals, not just medical

24 Nieman Reports /Wimer 1993

 HEALTH

publications. they do, Moyers once again refuses to up to 90 percent of primary care needed
Instead of journalists seriously ex- see the work as nursing. "That's what by children, and 80 percent required by
ploring nursing and caregiving, we see medicine 's about today," he concludes. adults, and do it with equal or better
too many instances of even our most For the last two decades, the canoni- quality than physicians and at less cost.
respected reporters and news organiza- cal belief has been that when more In some ways, nurse practitioners
tions obliterating or misconstruing nurs- women become journalists, more are closest on the health-care continuum
ing in the news through their own mis- women will appear in the news. There to medicine. For the most part, the
conceptions about what goes on in is some indication that women journal- media discussion of the role of nurse
health care. ists might more readily than men jour- practitioners under health reform deals
A stunning example appeared in a nalists interview women physicians .. with the degree to which these nurses
health section story in The Washington But in our research, with rare excep- mimic physicians, rather than with the
Post two years ago on the revolutionary tions , we have not found that women approaches they might, because of their
changes in how children's experiences journalists are more open to covering education and training, bring to pri-
of pain are understood and treated. nursing-a profession that is 97 per- mary and preventive care. Coverage of
"The revolution had an unlikely cata- cent female-than men journalists. these nurses also does not reveal much
lyst," the reporter wrote, and then de- Women journalists, although more sen- about the vast majority of nurses whose
scribed the path-breaking research by sitive to issues that affect women, tend work may differ significantly from that
"a nurse at the University of Iowa Hos- to define expertise in the same way that of physicians.
pital," without ever naming her. The men journalists do . To be sure, nursing has not pro-
article did name and quote pediatri- This may help explain why the 1993 moted itself adequately. While all the
cians and other specialists, however, edition of the Women, Men and Media journalists I know complain about the
and refer repeatedly to "doctors" re- study at the University of Southern Cali- slick packaging and spin doctoring that
searching, understanding, and treating fornia and New York University still goes on, particularly within health care
pain. shows a vast disparity between the rep- these days, those who do not compete
The reporter clearly did not know resentation of men and women in the adequately on the public relations front
that a nurse was a highly likely, rather news. A study of the front pages of 20 stand little chance of being discovered
than an unlikely, source of research and newspapers indicates that 85 percent of by intrepid reporters. And nursing has
planning for children in pain. Nurses the persons referred to or solicited for another problem. It is usually ignored
have been in the vanguard of develop- comment were men. The group's sur- or even undermined by the public rela-
ing scales to measure and assess pain, vey of national network news programs tions staffs of medical centers and uni-
and to reduce pain through both drug shows that 75 percent of the persons versities, who regard their own jobs as
and non-drug interventions. They are interviewed were men. promoting medicine and medical
very involved in a current health-care A reason for this lopsidedness is that schools, rather than nursing and nurs-
concern-the routine under-medica- journalists are defining women-par- ing schools to the news media.
tion of post-surgical patients, and the ticularly in health care, education, and As a case in point, although nursing
possible effect of pain delaying recov- social work, where they are the major- is crucial to the survival of the Lake berg
ery. ity-out of the news by failing to treat infant, there are no references to nurses
In another example, reporters for their work as though it mattered. The or nursing in the news releases sent to
The New York Times, in a four-part way for women to get into the news is to me by the Children's Hospital of Phila-
series on caring for the elderly, failed to be as closely identified with those posi- delphia.
quote a single nurse, and then con- tions and activities that journalists have In an attempt to redress this imbal-
strued nursing homes as places where already decided are newsworthy. ance, the Ms. Foundation for Education
one might expect "medical attention." Indeed, the one way that nurses have and Communication, Inc. gave our
People usually go to nursing homes, of been let into the news lately is as pro- group a small grant to put out an inter-
course, because they have nursing viders of the primary and preventive disciplinary directory of nursing experts
needs. care that is so lacking in this country. for health-care reporters. Since the ad-
Even the smartest people can get The overspecialization of medicine in vent of the current women's movement
confused about what to expect from the United States is calling attention to nearly 25 years ago, this kind ofRolodex
nurses. On national television we see the 25,000 to 30,000 nurse practitio- project has proved to be a useful tool to
Bill Moyers, in his highly regarded se- ners (as well as other advanced-practice women's groups trying to get a voice in
ries, "Healing and the Mind," observing nurses such as certified nurse-midwives the public discussion.
nurses at work in a special care nursery and certified registered nurse anesthe- But as we all know, journalists can
in Dallas's Parkland Hospital, and then, tists) who have all along been meeting find sources when they are motivated
clearly impressed with their skill, ex- health-care needs in those inner city to do so. What is required now is a
claiming: "You're more than nurses, and rural areas under served by physi- willingness to cover the activities, ad-
you're more than technicians." When cians. A number of studies show that vances, politics and even failures of a
the nurses try to explain to him what nurse practitioners can safely deliver profession central to health care. •

Nieman Reports I Wimer 1993 25

 HEALTH

Violence-Biggest Health Problem

BY MARGARET DICANIO

he American media shares with lence like any other story. "The Dow worked his way up through lesser com-

T adults in the United States are-

sponsibility for ignoring the soar-
ing toll of violence in the nation. Vio-
Jones Average Rose Two Points. Father
Bludgeons Family and Kills Self. The
Sox Win in the Bottom of the Ninth."
missions to the final big scene.
Under the guise of objectivity, cover-
age of the controversy about violence
lence, a global public health problem, Limitations of time and space have been on TV and in movies and videos has
has been left to criminal justice systems permitted to trivialize violence and make been bland. Although numerous stud-
to struggle with virtually alone. it appear normal. ies have confirmed a strong relation-
In its special responsibility to sup- Normalization of violence by both ship between violence on the screen
port America's democratic way of life, the media and the entertainment indus- and subsequent behavior, the enter-
media coverage of violence has been try makes it an option to solve a prob- tainment industry regularly emerges
negligent. As fear of violence narrowed lem. Where once a disagreement be- unscathed from encounters with those
the scope of citizens' daily activities, the tween family members, friends, or concerned with the fate of children.
media failed to sound an alarm. Broken neighbors might end in a yelling match Anyone who has ever been around
glass, dirty streets, burglar bars on win- or, at worst, in a fist fight, now it ends children or young adults has seen them
dows, burglar alarms in homes and cars, with a permanent solution-one con- imitate behavior. Recent horror stories
and downtowns deserted after dark sig- testant dead, the other in prison. Daily about imitation concern several young-
naled the erosion of everyday freedoms. box scores on victims and novel killing sters who were injured or killed while
Yet like a happy frog in a pan ofwarm- methods used move news ever closer to lying down in busy highways, emulat-
ingwater, content to sit until it is cooked, violent entertainment. ing a scene in the Touchstone movie
the media too often treated violence as Media coverage of violence in the "The Program." One 17-year-old sur-
just another commonplace item to fill suburbs and in rural areas creates class vived being hit by a car, but according to
up column space or air time-not a divisions by ignoring the level of vio- his doctor, the accident "almost sepa-
problem to be debated and solved. lence outside inner cities made evident rated the upper half of his body from
The media has ignored the threat by rape and domestic violence data. the lower trunk."
violence makes to democracy in three Typical stories imply that violence in While media objectivity may mean
ways: hackneyed daily coverage ofcrime; such communities is a surprise. The presenting both sides, it should not
failure to dig beneath the surface in community will "never be the same," mean giving both sides equal weight,
order to interpret events; and omission and the violent person, after a lifetime when they are not equally weighted.
of stories that needed to be told. of virtue, suddenly ran amok. Even a The tired notion that curbing violence
Banal daily treatment of violence is little digging is likely to find that the amounts to censorship ignores censor-
evident in print headlines and in lead- person, usually male since the majority ship that is already in place. Life is a
ins to broadcast news that treat vio- of violence is committed by males, has constant selection process: to sleep or
wake; to walk or drive; to marry or stay
single; to have a cheeseburger or a
Margaret DiCanio, a freelance writer and salad. Editors, journalists, and produc-
sociologist, is the author of"The Encyclopedia ers now censor nonviolent fare because
ofViolence: Origins, Attitudes, Consequences" they contend that the public has an
(Fax on File, 1993). She has a Ph.D. in appetite for violence.
Sociology from the University ofFlorida and Violence imposes its own kind of
writes most often about science and social censorship by curbing daily decisions.
science. For fun, she writes fiction. Before she The householder stops walking the dog
began writing full time in 1986, DiCanio after dark. The woman college student
had been an admissions officer in a women s never uses the library stacks when she is
prison, a mental hospital psychologist, a social alone. The inner city parent does not let
worker for the elderly, a sociology professor his or her child out to play. The tourist
and a director oftwo mental health agencies. changes an intended destination or stays
DiCanio and her daughter, Teddi, a photog- home. Using the specter of censorship
rapher and writer, live in Marblehead, MA, to cut off criticism of violence as enter-
and have collaborated on six science year- tainment has resulted in a cumulative,
books. national loss of freedom.

26 Nieman Reports /Winter 1993

 HEALTH

When children have a greater chance comparable to those for cancer, mental the issue of violence against women.
of dying from a drive-by shooting than illness, circulatory disorders and other The bill died and was reintroduced sev-
from plaque in their arteries, parents threats to life. The only national body eral times. The hearings and the repeat-
might as well let their kids eat greasy charged with violence research is a little- edly killed bill received limited atten-
junk food-maybe even stay home from known division of the Centers for Dis- tion. The bill was resurrected and
school. The nation's appetite for vio- ease Control (CDC). incorporated into the Violent Crime
lence, like its appetite for fat, needs to Perhaps it is unfair to blame the me- Bill and Enforcement Act of1993, which
be curbed to preserve the lives of its dia for a failure to notice the absence of Congress passed in November.
children and its future. a concentrated research effort into the Based on his 1975 National Insti-
nature of violence and its prevention tutes ofHealth-sponsored research, the
Failure to Interpret when social scientists and politicians National Family Violence Study, Dr.
were not clamoring for attention to the Murray Straus, co-director of the Uni-
Interpretive stories about violence are issue. However, the media does de- versity of New Hampshire's Family Re-
scarce. The daily look-alike headlines serve blame for their actions when CDC search Laboratory, estimated that 1.6
and look-alike stories have helped to tried to mount a study into the biologi- million American women are seriously
perpetuate a sense of futility and doom. cal basis of violence. Without looking assaulted each year by a spouse or boy-
Progress toward a solution for the esca- any deeper, the media beat a drum friend . In 1985 he increased the esti-
lating epidemic is stalled by a notion about the possibility that the study might mate to 1.8 million. According to the
that violence is inevitable, a notion that focus on minorities, thereby effectively FBI's Uniform Crime Reports, there were
the media have seldom questioned. As killing the project. an estimated 102,560 reported forcible
long as a phenomenon is considered Even a little introspection would have rapes in 1990. In 1979 sociologist David
inevitable, not much progress can be suggested that there was another side Finklehor, an expert on domestic vio-
made toward a solution. to the issue. While there are few ad- lence, estimated that 25 percent to 33
Yet solutions have been found for equate explanations for violence, there percent of American women and 16
other seemingly inevitable threats to is no question that some violence is percent of American men had been vic-
human life. During the mid-19th Cen- rooted in biology. tims of sexual abuse as children.
tury, epidemics periodically killed thou- Anyone who has ever been close to a In some areas of the world, women
sands. But scientist John Snow, the fa- person subject to mood swings or who are held in such low esteem that they
ther of epidemiology, didn't accept has ever been hung over can't help but never reach adulthood. Children do
cholera as preordained. He suspected a recognize that body chemistry plays a not fare much better than women in the
connection with water. To confirm his role in behavior. The media's focus on world or in the media. Stories concen-
suspicion, Snow collected information the possibility that biological factors trate on violent youngsters being tried
about the residence or workplace of related to violence would be found only in adult courts and whether they should
identified cases within a high-incidence in minority communities ignored what receive the death penalty. Overlooked
area of London. He plotted the data on is happening in suburbs and rural areas is the sad state of juvenile courts and
a map and interviewed households and ignored the history of white mi- holding facilities.
where cholera had struck. He linked norities in the United States. Foster care in many states is in
cases with a particular water pump. shambles, but the media does little to
Although the germ theory had not Untold and Barely Told encourage middle-class parents to take
yet been confirmed, Snow's work re- enough children out of the system to
vealed that the problem was not a fate Untold stories abound . Despite a lack give it breathing room. Some bureau-
that simply had to be endured. More of understanding about the root causes cratic child welfare systems might not
importantly, he established that a phe- of violence, a great d eal is known about welcome the intrusion of middle-class
nomenon does not have to be fully the conditions that encourage it to flour- parents, but their presence might do a
understood to make effective behav- ish. Small underfunded programs to lot to break the gridlock. Media stories
ioral changes. ameliorate such conditions struggle to about children are more likely to be
Some observers believe that knowl- survive all over the United States. A few about a shortage of babies for couples
edge about violence has not moved hours spent at the library with "The who want to adopt and about the won-
much beyond the level of biological Encyclopedia of Associations" reveal ders of in vitro fertilization.
knowledge in Snow's era. That's an hundreds of them , but stories about Population density as a factor in vio-
oversimplification. Knowledge about them are scarce. It is easier to write lence has received almost no attention.
violence exists, but it is scattered in another standard story about the latest The human population numbered ap-
small studies that are not coordinated atrocity and the mounting body count. proximately 5 million in 8000 B.C. , 500
with one another into any kind of over- The Senate Judiciary Committee held million in 1650 A.D., 1 billion in 1850,
arching theory. To create that kind of hearings in 1990, shown on C-Span. Its 2 billion in 1930, and passed 5.3 billion
coordination, the nation needs a Na- chairman, Joseph Bielen of Delaware, in 1990, increasing at an annual rate of
tional Institute of Violence Research, introduced a bill intended to address 95 million a year.

Nieman Reports I Winter 1993 27

 HEALTH

Increases in population raise many

questions. Is violence a result of closer
proximity, which provides more occa-
sions to come into conflict? Does vio-
lence appear more prevalent among
the poor simply because there are more
of them? If violence is more prevalent
among the poor, are they now setting .:tqlet het khow,that we
an example for the more affluent? Will ""'"~"~t.v• · CiOl~ernnu?~tt
and Community happen.'~
the violent children of baby boomers, a! tbeHarvard School ofPublic Day after daythere's a nomi,cid.e.
as predicted, burn out after age 24? at a semina.r forNieman Fellows response is .w e're going to get
Given journalists' concern about the .~s.coo1. ~ police. ,we~· rt~. gcJtn.g.t,o .lcJC~C.tlltis. Jldd ~l:io
value of the First Amendment, a scarcity maybe for.two lifetimes. And you
Commissioher of Public Health raise those quesUons. We treat that as
of stories about the many journalists
cam~ to you, a group of journalists, that's prevention. . ·
around the world who have been tor- I'm waiting on a·crime prevention plan
ndlsaid, "We.'regoing to initiate a new
tured and/or killed because of their or bill or activity that focuses on -··~~·~"
c.al:lllp~tigrlto I'educeJung cancer. We're
professions is surprising. Journalists in get rid of as muCh h.:u'tg cancer as ing to the needs of kids who are at risk.
Colombia have been frequent targets of we can. And what we're going to do is And focu.ses on some o{theattitudes
the Medellin drug cartel. seqd our thoracicsll,rgeons tB Germany tB behaviors. t-.ltttle bit is happening
Corporate crime does not receive ra!fi and then to ~Witzedand aridthetl the country.7.)vith .an Attorney General
nearly enough attention. A decision to hey're.going to hav~ an intensive retreat that's talking about prenatal care. And
keep a faulty design in an automobile .t n Utall. We're going to have the best with other secretaries who are really
·· in th{! wor~d; And we're going. to of pulling this thing together. But I
ultimately kills many more people than
monitors i~Jhe operating that journalists have to raise some
does a teenager with an assault rifle, but hard questions. Because we tend to
the teenager is an easier story to cover. And We'Je g9ing to get platinum
...... o.m:;tct:.. And w¢ are going to make 'that if somebody is tough on crime, by
Michael Milken left prison with his mil- raising the sentences., or having every
gurcompl!c:;atiqnrate for lung
lions intact to teach university students. is the lowest . possibl~ in the jUvenile tried aS an adUlt, that that's
A teenager is discharged to hang out on to do it. And that's a myth.
the corner. ould susp¢ct tfi.a t tfie [article) the Not onlyqoes itnBt work in
The economics of corrections needs :next day would read something like health model, ·but we had a decade of.··
emphasis. The construction costs for a "S91IllJlissiot1et ofl'l.lblic.Health oil; of trying it. In 1980; iq the United States, ·
tpllch:':Plan.to reduce lung cancer focuses there were a halfof milfion people ' injail~~~
prison bed range from $50,000 to
~p.ti~~l)r on treating lung cancer. Has no and prisons across the country. In. l990; •·
$100,000. The cost of keeping a pris- there. were a million. We doubled the
phms for reducing smoking, or keeping
oner locked up is about $25,000 per m.lmber of people injails andpiisoris iri
teenagers from beginning to smok~: And
year, more than it takes to keep a kid in ifshe expects that we're going to spend a the decade frolJl. '8() to '90. And violeqt
a reasonably good college. But there is crime weqt up 12 percent in that dec;de.·
not much to show for the money. Al-
though many education and treatment
programs are known to be effective, the
typical prisoner returns to society illit-
characterize tyrannies. Yet, in the mid- following injuries adds to the bill for
erate and unable to hold a job, without
1980's, the prison population of the medical care and lost wages.
his emotional problems having been
United States, a democracy, surpassed No one who experiences violence,
treated.
those of South Africa and the Soviet whether living in the city, the suburbs,
By 1995 about 1.5 million people
Union. the country, or prison is ever the same.
will be behind bars, with another 2.5
The impact violence has on the eco- Posttraumatic stress syndrome is a wide-
million on parole or probation. Despite
nomics of health care is seldom ad- spread, costly affliction that affects not
the building boom of the 1980's, which
dressed. Accidents, suicide, and homi- only victims and their families, but also
made prison construction the fastest
cide are the leading causes of death health care workers, police, and correc-
growing item in many state budgets,
amongAmerican teenagers. Intentional tions personnel who mop up in the
prisons continue to be badly over-
and unintentional (accidental) trauma aftermath of violence.
crowded. Many potentially violent pris-
is the leading cause of death among If they only would, the media could
oners are turned loose to make room
those under age 44, killing an average do much to change the violent climate
for nonviolent drug offenders sent to
of 140,000 people a year, effectively of thought that is crippling the nation
prison under mandatory sentencing
curtailing decades of earnings. Emer- and the world. Continuing to normal-
laws.
gency care costs for gunshot wounds ize violence by presenting it as an op-
A few journalists have pointed out
are estimated at a billion a year and tion is like yelling fire in a crowded
that vast prison systems traditionally
rising. A lifetime of rehabilitative care theater. Everyone's right is trampled. •

28 Nieman Reports /Winter 1993

 HEALTH

The 'War' on Drugs

Media Pay Lopsided Attention to Cutting Supply,
Too Little to Reducing Demand

BY LLOYD D. jOHNSTON

ince Richard Nixon first declared to virtually all other industrialized coun- ally other drugs in part for symbolic

S war on drugs in the early seven

ties, drug abuse in the United
States has provided a rich bone for the
tries, and in comparison to previous
drug epidemics in this country. It has
been a phenomenon of great impor-
reasons, both as an act of defiance of the
predominant societal norms and as a
symbolic ritual of solidarity (most obvi-
media. That richness has derived in part tance to government, and in many years ously embodied in the passing of the
from the multi-faceted nature of the has been cited by the citizenry as the joint). Our own research and that of
drug abuse issue: political, moral, legal, most important domestic issue facing others has shown that the use of LSD
sociological, psychological, philosophi- the nation. It also has been an extremely and marijuana, in particular, was corre-
cal, medical, and so on. Five presidents controversial national issue, dividing lated with the other behaviors and atti-
later, the nation continues its struggle not only those of different ideologies tudes comprising the counterculture
with the issue, and the media continues but also those of different generations. orientation, including opposition to the
to cover it, though somewhat more It is little wonder, then, that the media war.
episodically in recent years. has paid so much attention to the sub- As the Vietnam era passed and the
Clearly an unusual thing occurred in ject over the last quarter of a century. counterculture movement faded into
the country over the last 25 years in that Perhaps it is useful to note the under- history, the drug epidemic continued
a significant proportion of the popula- lying changes in the phenomenon of relatively unabated, as if out of sheer
tion came to use a wide variety of drugs, illicit drug use over the years before forward momentum. Today it primarily
which had long been illegal and which considering the role of the media in it. reflects hedonistic, not symbolic behav-
in the mainstream of the population Of course, some illicit drug use is en- ior. It also reflects a propensity to en-
were considered immoral. This was an demic. Heroin had been used by fringe gage in deviant behavior, as it always
unparalleled epidemic in comparison groups in the population for decades has to some degree .
before the great expansion of the drug By the end of the seventies and into
epidemic into mainstream America in the eighties, major elements of the epi-
Lloyd D. johnston has testified on substance the late sixties, but most of the drugs to demic began to lose momentum. Among
abuse many times before Congressional enter the scene-marijuana, LSD, am- youth, marijuana use began to decline
committees, written more than 100 papers on phetamines, and cocaine-were practi- in 1979, amphetamine use in 1982,
the subject and has been a consultant for the cally unknown to the generation of the cocaine use in 1987.
United Nations, the Council ofEurope and silent fifties and early sixties. Then two The role that the media have played
the White House. The 53-year-old research things of great consequence happened in the unfolding of this national drama
scientist holds an MBA in organizational during the sixties. First, a philosophy of is almost as complex as the problem of
behavior from Harvard and a Ph. D. in inner-directedness began to catch on, drug abuse itself. Recall that, for the
social psychology from the University of and young people adopted drugs as most part, the silent-fifties generation
Michigan. He is currently chair ofthe useful vehicles to explore the inner self. was unfamiliar with many of these drugs
Steering Committee ofthe Substance Abuse Second, the Vietnam war expanded rap- and unaware of their psychoactive po-
Center ofExcellence at the University of idly, and along with other historical tential. When the epidemic began to
Michigan. events of the time like Watergate, gave gather steam in the late sixties, the
rise to a great deal of youth alienation, media played an important role dis-
which in turn gave rise to the counter- seminating information to the public
culture movement. This youth alien- about these drugs and their alleged
ation was a powerful catalyst to the benefits. Timothy Leary and other pro-
drug epidemic. The movement adopted ponents of drug use received maximum
the use of marijuana, LSD and eventu- air time and the naivete of a generation
of young Americans was forever lost. In

Nieman Reports I Wimer 1993 29

 HEALTH

the intervening years other drugs have and when people usually start to get
come along (e.g. crack, ice, ecstasy, into trouble with the drug. The survey If past drug exper-
PCP) and were similarly "advertised" to data did not tell an alarming story, but
the population through rapid and ex- the casualty statistics did. Reporters, of
ience were to be used
tensive media coverage. course, went for the latter, leaving the to disqualify people
Because early coverage of the epi- country with the mistaken impression
from high office, as
demic was so sensational and selective, that cocaine use was climbing rapidly in
I think the media inadvertently gave the the early eighties when, in fact, preva- some have suggested,
impression that "everyone was doing lence rates were fairly flat . there would be very
it" among American young people, and Admittedly the underlying phenom-
thus helped to shift the perceived norms enon was a complex one, and the long few in this generation
in the late sixties. For example, if a high lag time between initiation and trouble still eligible to serve
school somewhere in the country con- fooled many academics, as well. As late
ducted a drug survey and found 60 as 1981, "experts" saying that cocaine
percent of its student body smoked pot, was a clean drug were quoted in the
the story reached every paper in the national media: you could not die from losing; of easily discernible enemies
country, but a school survey showing an overdose; you could not become and friends; of the appropriateness of a
little or no use received virtually no addicted to it. military or police response. The media
coverage. In 1969, when my colleagues The media's special attraction to the were attracted to the drama implied by
and I completed the first national sur- alarming announcements sometimes the metaphor and for decades have
vey of drug use among males in the benefits society, of course. A new prob- kept that conceptualization alive.
senior class, we found that only 25 lem quickly gets both public and gov- For a number of years, most experts
percent indicated any experience with ernment attention. The media helps to in the drug field and many law enforce-
marijuana or any other illicit drug. set the agenda, and, of course, some- ment people, including many police
(Males, incidentally, have higher rates times what is happening in reality really chiefs and FBI directors, have realized
than females.) Drug use among Ameri- is alarming. When our research team that the drug "war" could not be won
can young people was clearly exagger- , reported in 1975 that 6 percent of high on the battlefield of supply control; that
ated in the early years. school seniors were daily marijuana was just a holding action. The real solu-
During the mid- to late seventies, smokers, both media coverage and pub- tion lays with reducing the demand for
one got the impression from much lic reaction were strong. When that drugs. However, media emphasis on
media coverage that the drug problem prevalence rate nearly doubled in the the two classes of activity-demand re-
was improving, perhaps because use following three years a sense of alarm duction and supply reduction-has
was not as public and florid as it had set in. These reactions helped give rise been uneven and lopsided. War games,
been in the Vietnam years. According to to a number of activities which contrib- sinister cartel leaders, moguls like
survey data, however, use actually con- uted to a rapid reversal of this trend: Manuel Noriega, cops and criminals on
tinued toclimbsteadilyuntil1979, when research on the effects of marijuana was the streets of our cities-the exciting
two-thirds of each graduating high rapidly expanded, television specials stuff dramatic stories are made of. Never
school class admitted some experience and special news segments about mari- mind that the real solution resides in
with illicit drugs. (An interesting aside juana and its effects were initiated, and the more mundane activities of educa-
is that fully 80 percent of these graduat- a grassroots parent movement began to tion in the schools; education in the
ing classes admitted illicit use by the grow. family; counseling of early users and
time they reached their late twenties , Many times over the years the media treatment of advanced users ; coopera-
including 40 percent who had tried spotlight has shifted across drugs . At tion among parents; constructive use of
cocaine. If past drug experience were to different times, the preponderance of the media, and in the social organiza-
be used to disqualify people from high coverage has been on marijuana, LSD, tion and mobilization of communities.
office, as some have suggested, there speed or methamphetamine, cocaine, I doubt that 2 percent of the total media
would be very few in this generation and crack. The spotlight shifts, of course, coverage of America's struggle with
still eligible to serve.) toward the emergence of new prob- drugs over the last 25 years dealt with
During the first half of the eighties lems and away from the continuation or these issues, even though a consensus
cocaine prevalence amongyoungAmeri- diminution of old ones . emerged years ago among those in the
cans was fairly level, but the casualty Another vital role the media has know (both inside and outside of gov-
indicators (use of drug hotlines , over- played in relation to drugs has been in ernment) that it is in these domains that
dose emergencies, overdose deaths, helping shape the nation's choice of a the true solutions lie. (Many electronic
demand for treatment) kept rising. This broad strategy for dealing with them. and print reporters and editors have
divergence came about because there is Perhaps Richard Nixon cast the die in known it, too .)
a natural lag of four to seven years using the metaphor of a war, which Television has played a particular
between the initiation of cocaine use carries the connotations of winning or role here with its desperate and endless

30 Nieman Reports /Winter 1993

----- ------------------------------------------
HEALTH

search for graphic drama in the news . role in bringing about this seriously when contenders for Congressional
How many times have you seen a raid flawed and distorted policy response seats were challenging each other to
on a crack house in some American through their increasingly desperate urinalysis in what became known as "jar
city-any city? The plot is totally pre- search for entertainment, rather than wars." Following the intense coverage
dictable, almost numbing: the batter- what is right or even accurate. A harsh of these events, the dangers attributed
ing ram, the noisy rush of police, the assessment, but one which I firmly be- to these drugs by young Americans
soared, and their use plunged.
Social norms for use also shifted con-
currently, probably as the result of the
The media has played a major role in bringing about changes in perceived risk. Throughout
this seriously flawed and distorted policy response the eighties marijuana use became less
acceptable; cocaine use became less
through their increasingly desperate search for acceptable in the last half of the eight-
entertainment, rather than what is right or even ies. I believe the media, particularly
through their news programs and news
accurate. A harsh assessment, but one which I itrm.ly specials, contributed significantly to
believe. When our news organizations become these constructive outcomes. Many of
the changes in young people's attitudes
shallow, so eventually do our people, our politicians and beliefs about drugs are really quite
and our policies. dramatic.
Recognizing the power of the media
in general, and of advertising in particu-
recovered drugs, the bundles of money, lieve. When our news organizations lar, the media and national advertising
the weapons seized and the handcuffed become shallow, so eventually do our agencies began working together in the
suspects. Great entertainment, lousy people, our politicians and our poli- late eighties to play an intentional and
policy. Those dealers are replaced by cies. constructive role to reduce drug use .
others before the videotape can be trans- While the media may have given in- Through the Partnership for a Drug
mitted. advertent emphasis to the supply-side Free America they have collaborated to
The print media have done their strategy, let me add that they also have produce and deliver a sophisticated
share, too. In the heyday of use, some played, often unwittingly, an important advertising campaign against drugs. Our
national news magazines averaged at and constructive role in the demand research shows that young people are
least two cover stories a year, and many reduction effort. Those of us who do very aware of these ads, find them cred-
feature articles about drugs. Those few research on drug use have demonstrated ible and report that they have made
articles, concluding that the supply re- that use goes down when the perceived them less likely to use drugs.
duction effort is probably futile, never- dangers of a drug go up. In the early Until 1992, it seemed that drug use
theless spent nearly all their column days of the epidemic, the dangers of was going in the right direction, thanks
inches reporting it. Acceptance of an many illegal drugs were unknown. As in part to these media efforts. However,
outside editorial piece suggesting that experience cumulated, many of the in 1992, we saw the first evidence of a
our policy was on the wrong road was adverse consequences began to emerge, turnaround in use among eighth grad-
nearly impossible. and the media heavily covered them . A ers, that is, in the newest group enter-
The approach of news as entertain- great deal of media attention (as epito- ing adolescence. This change serves as
ment has, in my opinion, helped to mized in the 1979 NBC one-hour televi- a reminder of two things: first, our
distort the national response to a very sion special, "Reading, Writing, and struggle with drugs is never over and
serious problem. Even politicians who Reefer") was paid to the possible dan- second, each new generation of young-
know that demand reduction was a gers of marijuana in the late seventies, sters has to learn what earlier ones
better solution are deathly afraid of and use fell substantially as young learned about drugs, or else they will
being called "soft" on drugs . The end people began to understand that mari- get to learn the hard way, by experi-
result is that they keep favoring the juana use , particularly heavy use, can be ence. The media will continue to play
cops-and-robbers supply reduction ef- dangerous to the user. Similarly, as the an important role in this unending
forts predominantly featured in potential dangers of overdose and ad- drama, whether by intention or not. I
America's media. Recall that 70 percent diction became clear for cocaine and hope that in the future it is a role which
of federal resources go for supply re- crack in the mid-eighties, use declined. is more self-aware and perhaps less self-
duction, and only 30 percent for de- Peak media coverage of cocaine's ef- indulgent. The stakes are too high for
mand reduction, primarily treatment. fects occurred in 1986, when profes- our media to opt for entertainment
That is the way it was under Reagan and sional athletes Len Bias and Don Rogers over good, insightful reporting in the
Bush, that is the way it still is under died as a result of cocaine use, and news.•
Clinton. The media has played a major

Nieman Reports I Wimer 1993 31

 HEALTH

Washington Hodgepodge
Administration Attempts to Control Suppress, Put Spin
On Health Care News Lead to Chaos

BY DANA PRIEST

t is 10 p.m. Saturday night and the public opinion polls or, in some cases,

I Washington-based health care re-

porter has the White House's latest
financing options and its calculations
exhaustive and helpful information
about some corner of this debate.
From the start, the White House built
on private market savings spread out on a figurative stone wall around the Old
the dining room table. Somewhere in Executive Office Building, where more
the first appendix of the second docu- than 500 experts and Congressional
ment, somewhere around the section aides toiled. Names were secret, they
on "administrative loads," her mind wan- told us . Titles were secret. Jobs were
ders to a little lecture Representative secret. Salaries were secret. For the most
Jim McDermott delivered the day be- part, the blockade was effective in mak-
fore to Health and Human Services Sec- ing it more difficult to learn what the
retary Donna E. Shalala. White House was up to.
"We want you to take this message But it was far from impossible.
back," the Washington Democrat said Between January 25, 1993 and Nov.
at a Congressional hearing. "You have 1, 1993, for example, the principal health
to be able to explain, easily" the cost to care reporters at The Washington Post,
individuals, businesses and the govern- The New York Times, The Wall Street
ment. "If you can't do that for us, then Journal, The Los Angeles Times and
we can't do it for our constituents and USA Today wrote a total of 575 health
we're not going to vote for something care stories, according to a byline search.
we can't explain." That does not count hundreds of other
Obviously reporters do not have con- stories written by other reporters.
Dana Priest has been a reporter at The stituents, but they have readers and And with each new front-page rev-
Washington Post for eight years. She was an editors who demand readable stories elation, top White House health advis-
assistant editor on the foreign desk, then a about health care reform and rightfully ers grew increasingly angry, sometimes
beat and generaL assignment reporter on the complain if they do not get it. belligerent, toward individual report-
Metropolitan staff She has covered federaL From the day President Clinton an- ers. Some journalists were sternly lec-
employee issues and generaL assignment for the nounced the creation of the Task Force tured or yelled at after their stories
NationaL desk, where she currently writes on National Health Care Reform, until appeared, others were insulted over
about the nationaL health care debate. Prior now, the White House health care team the telephone. One recalls receiving a
to joining The Post, Priest reported for The has made an inherently difficult task phone call from a White House aide that
St. Petersburg Times, was a freelance journaL- much harder. They have acted like the went something like this: 'There's a
ist and was a market researcher for an Keystone cops, trying to control, re- mistake in your fourth paragraph, but
internationaL consulting firm. She is a press or spin the facts one day, handing I'm not going to tell you what it is."
graduate ofthe University of California at out information the next, only to find Small papers found it nearly impos-
Santa Cruz. they have misspoken and must spend sible to get their calls returned at all
the rest of the week clarifying. from the so-called "war room" in the
Meanwhile, hundreds of skillful in- bowelsoftheOldExecutive Office Build-
dustry CEO's and Congressional aides, ing.
each pushing a particular view on health Once the first news stories on the
reform, go out of their way each day to task force began to appear, the health
supply reporters with "expert" studies, team hid staff telephone directories-

32 Nieman Reports /Winter 1993

------------------------------------~~~ ~ -

HEALTH

presumably so they could not be given there are literally hundreds of ways into was considering a value-added tax to
to reporters-locked their own work- the health care debate, it was not hard fund the plan. This was no surprise to
ing documents away in a reading room finding something new. us, we had written previously that a VAT
and made staff members copy by hand When a competitor broke a story, was one of several financing options,
anything they wanted to retain. A few said Edwin Chen of The Los Angeles but never a heavy favorite. "A trial bal-
task force members left in disgust be- Times, "there was an odd kind of loon," snickered editors and political
cause they felt the treatment was child- non pressure. This story was so compli- reporters, who wrote that day's story
ish. cated, nobody could get it all. It was from the White House news briefing.
Later, when both The New York easy to say, 'well, that was one part of it, Government obfuscation and secrecy
Times and The Washington Post led let's wait to get our own story."' is obviously nothing new, but on this
their May 22 editions with different The result was a hodgepodge of news story it has taken on an air of absurdity.
renditions of the first meeting in a round before the preliminary draft was leaked, When the White House finally de-
of high-level decision-making sessions which mainly reflected the kind of in- cided to begin substantive briefings,
led by President Clinton, the White formation individual reporters could they were on background and they were
House substantially reduced the num- get their hands on. ridiculously, maybe even dangerously,
ber of invitees to future meetings, to the Which brings me to my pet peeve: short, if accurate or explanatory report-
exclusion, some high-level aides said The Trial Balloon. ing is what they were after. It was as if
later, of people who really needed to be Contrary to the tired "conventional the briefers cracked a door, shouted
there. wisdom" that thrives in Washington, out a partial sentence, slammed it shut
At the same time, there was a sort of this has not been a story of trial balloons and then left it to us to complete the
chaotic, "unmanaged competition" and purposeful leaks, with some excep- sentence and its context.
among newspapers that, taken together, tions. It has been, as far as I can tell, one One of the most bizarre scenes was a
produced a fairly confusing picture of that required a fair amount of basic briefing held in the Old Executive Of-
what was new and what was important journalist commodities: digging, per- fice Building amphitheater. More than
on any given day. It is probably a good sistence and relationship-building. 30 reporters spent an hour asking Ira
thing that most of America reads only There was a perception (among edi- Magaziner questions about subsidies,
one newspaper. tors and colleagues) that if you stood health alliances and how big business
"In terms of competitiveness, on a out at 17th and G," where the Old would fit into the new plan when, for
scale of one to 10, this was a 10," said Executive Office Building sits, said Chen, no apparent reason, the chief White
USA Today's Judi Hasson. "one of these task force people would House health care spokesman, Robert
One day a paper would lead the come out and say, 'pssst' and hand you Boorstin, cut the discussion off and
paper with something and several weeks a document. No one knows how hard tried to get Magaziner out the door.
later another paper would blast the we worked. It may sound self-serving, Magazinerwas immediately surrounded
same story on the front, written with but it's true." by a dozen reporters wanting clarifica-
the kind of freshness scoops often have. The presence ofhundreds of interest tion on how an employer mandate
Sometimes, last paragraphs in one groups, each with an axe to grind or an would work and other technicalities.
paper's story became the lead some- angle to push, sometimes made things And as he struggled to answer the ques-
where else the next day. Or micro-facts easier. But, for the most part, especially tions, which he clearly wanted to do,
buried in a feature were rewritten as in the beginning, most members of the Boorstin yelled at the crowd to let him
news by the paper down the block. health care task force believed they were go. Magazinerwas still talking as he was
On October 22, for example, The on a mission and were petrified to talk literally being pushed out the door.
WallStreetJournal'sHilaryStout, broke about it. At other times, the problem was sim-
an important story on a decision by I recall getting HHS health expert ply, as McDermott pointed out, "You
Clinton to limit government subsidies Judith Feder to come to the phone one have to be able to explain, easily ... Ifyou
available to low-wage workers and small day, early on. Her voice was so filled can't do that for us, then we can't do it
firms. But most other newspapers her- with panic that barely had I gotten out for our constituents ... "
alded the news five days later, based on my first question, before she told me After many elements of the plan had
Congressional sources who were briefed she was hanging up. Chen recalls his been in print, the White House decided
by the White House the day before editors thinking he had it made when a to hold its second substantive briefing.
Clinton presented his bill. The compe- group of California health experts ar- It was on a weekend day and lasted an
tition was a little unusual too. rived to work on the task force. To the unrushed two and a half hours. Twenty
While sometimes papers would do a contrary, none ever helped him out. reporters sat around a conference table
second-day chase of a story someone "I think they were really good sol- and asked anything they wanted of
else had broken, more often than not, diers," he said. Magaziner, Feder and Princeton Uni-
they did not. Instead, said several re- Some of my colleagues rolled their versity professor Paul Starr.
porters, there was just increased pres- eyes April IS, the day all our papers ran The problem was that all three had a
sure to produce more stories. Since front-page stories that the White House hard time explaining the most basic

Nieman Reports I Winter 1993 33

 HEALTH

concepts, like which firms, exactly,

would qualify for government subsi-
dies. When Starr tried to answer a ques-
State House Views
tion about how married couples work-
ing for separate employers would get
coverage, his explanation was so in-
comprehensible that the room burst
into laughter.
In the midst of attempts by Magaziner
and Feder to explain the same, report-
ers formed clusters among themselves
trying to decode and rephrase for one
another what was being said. At the end
of the briefing, five of us stood in the
hallway exchanging telephone numbers BY MIKE MEYERS
in the event we got stuck translating the
briefing.
t a media briefing this summer, many interests are building bends in
"That's never happened before,"
laughed Chen.
My favorite example of how absurd
the White House media non-strategy
A Senator Dave Durenbergerwaved
a copy of The Star Tribune report
on the problems with health care and
the road, is a challenge.
A recent tussle with the Mayo Clinic
is a case in point.
became was the fact that the first on-the- asked if everyone in the room had read I asked a Mayo public relations staffer
record briefing held-a hastily called it. He wasn 't trying to peddle the article. how many administrators worked at
event on a Sunday afternoon-was to He wanted to pummel it. the clinic. The answer, which came a
respond to a series of critical stories few days later, was a number that
Seems the authors-Washington Bu- dazzled. By her count, Mayo had three
about the plan that were based on a
reau Chief Tom Hamburger and I-had administrators for every doctor.
leaked preliminary draft. Here we had
trampled over an orthodoxy in Minne- The Star Tribune printed the num-
the White House refusing to go on the
sota: The notion that Minnesota health ber-only to have the Mayo call to de-
record about the actual plan, but will-
care is so efficient and cost-effective mand a correction. Mayo doctors were
ing to respond to an unofficial prelimi-
that it's a model for the nation. The angry. What do all those bureaucrats
nary draft that they refused to acknowl-
article questioned that thesis and, in do? The doctors demanded an explana-
edge. It felt like chasing a ghost.
the process, suggested Canada's single- tion from Mayo's top executives. They
White House spokesman chastized
payer plan might be a better model for quickly got one. The figure, according
us for pointing out how strange this
saving money and delivering better care. to the person who supplied it, was a
seemed, another example of the inside-
Durenberger, who coincidentally is mistake-a number that included jani-
the-beltway cynicism, they said. But the
near the top of the list of recipients of tors, computer technicians or anyone
American public apparently had doubts,
political contributions from medical and at the Mayo who wasn't a doctor.
too. In a Washington Post poll pub-
insurance company PAC' s, railed against Okay, what is the correct count of the
lished0ct.12, threeweeksafterClinton
the thesis of the article, the newspaper number of administrators on the Mayo
addressed a Joint Session of Congress
and the authors. payroll?
on health care reform, 8 out of 10 people
Therein lies a problem for Minne- Not available, was Mayo's reply, along
questioned said they did not think
sota reporters writing about health care. with assurances that the Mayo is not
Clinton had a plan.
From the Mayo Clinic and nationwide burdened with thick layers of bureau-
Now that it has been released, the
HMO's with headquarters in Minnesota cracy. But a Mayo official undermined
White House's inept handling of its
to the Fortune 500 companies forming that argument by saying the clinic could
own information has become the sub-
alliances and to the legislators in the St. not even provide an estimate of how
ject of front-page news. Shalala recently
Paul capital concocting their own health many administrators are on the payroll.
told a Congressional committee that 40
care system remedies, the state is packed Counting them, he said, would take
percent of Americans would pay more
with people with strong feelings about- too much time. •
for health premiums under the plan; a
and vested interests in-what happens
dozen White House officials, from the Mike Meyers is national economics correspon-
next in health care. It seems as if every-
President on down, spent 10 days try- dent for The Star Tribune ofthe Twin Cities,
body is calling with invitations to news
ing to re-explain that bombshell. covering the winners and losers in the
briefings, luncheons, CEO interviews-
The number is now 30 percent-and economy around the country and occasionally
or in the case of Durenberger, an am-
counting. •
b~sh-aimed at influencing the course around the world.
of news coverage.
Getting the story straight, when so

34 Nieman Reports /Winter 1993

 HEALTH

BY ToM DETZEL

t the Guard, we have a comfy

A
focus of a national debate about health
package of medical, dental and care ethics. From a reporting perspec- BY jiM SIMON
vision benefits that costs report- tive, it also tended to frame the story as
ers and editors about $3 a week out of a political and government problem
pocket-less than most of us spend on hen it comes to covering

W
rather than an individual one.
take-out coffee. How have we done? Our files are health care reform, editors
The benefits are nice, but they pose stuffed with pieces about a state com- are a good test audience. On
some un-comfy questions about our mission that decided which medical my paper, most are easily bored by
coverage of health care reform: Can we procedures to jettison, about haggling legislative politics. They grow nearly
really relate to the day-to-day anxiety of with the governme nt over a Medicaid comatose about anything lumped un-
a family that's lost their insurance? Of waiver and about the political debate der the label "reforming the .system."
old people who can't pay for the drugs over funding and employer mandates The bill that passed the Washington
they need? Of single moms who sling in the Capitol. While these are all im- Legislature last spring was one of those
beers for a few bucks an hour but can't portant stories, they reveal our institu- rare measures that nearly matched the
get Medicaid because they earn too tional bias. spin doctors' hype. It capped premium
much? Missing were compelling portraits of prices, required all businesses to insure
Looking back, I'm not convinced the uninsured, the afflicted who might their workers and promised universal
that we've tried hard enough to get the be cut out of the plan, the small busi- access by 1998. Initially though , we
story from perspectives outside our ness owners getting squeezed, the pro- struggled to convince our desk that this
own, from the same kind of real-people viders who will have to deal with an really was significant stuff, that this leg-
view that's worked so well for us on onslaught of new unhealthy patients. islation was for our readers just as im-
health care stories outside the topic of Because of delays won in the Legisla- portant and more likely to become real-
reform. ture, reform is not yet a reality in Or- ity than what President Clinton was
Reform became news here in 1989, egon, and it might end up being over- proposing in the other Washington.
after the state decided not to fund a taken by a federal plan. A feature story I wrote about an ob-
bone marrow transplant for a young Our coverage plans have evolved, scure fundamentalist sect lobbying to
Portland-area boy, Coby Howard. Leg- though . We've recently hired a new be exempted from the law wound up
islators had quietly cut funding for some reporter experienced in medical writ- on page one. A detailed question-and-
transplants, shifting the money into ing and have made health care a full- answer piece explaining the new law
prenatal care for the poor. Health care time beat, significant for a paper our and its winners and losers was burie d
rationing-healthy babies vs. costly ex- size. We intend to look critically at the inside .
perimental surgeries-was an immedi- local health care industry as the field of In health care reform, to an extent
ate, sensational reality. Senate Presi- players girds for reform. And we plan to unmatched by most issues I've covered,
dent]ohn Kitzhaber, a doctor, decided produce fewer stories about the pro- the details-even the deadly boring
to take the resulting debate about ra- cess of reform and more stories about ones-make a difference. And so our
tioning a step further. Under his Or- how reform will change people's lives. attempts to simplify and humanize what
egon Health Plan, everyone under the
poverty level would get Medicaid cov-
• the future might look like by focusing
on one patient, a doctor or a hospital 's
Tom Detzel is Assistant City Editor for The
erage, and businesses would cover the bottom line almost inherently become
Register-Guard in Eugene, Oregon.
rest of the uninsured-about 15 per- misleading.
cent of Oregonians. How do you explain how "health
The catch: Paying for the plan meant care purchasing cooperatives" for busi-
dropping Medicaid coverage for treat- nesses or "practice parameters" for doc-
ments with little benefit or extraordi- tors will affect the majority of readers,
nary costs. This made rationing an ex- who already have insurance coverage
plicit state policy and made Oregon the they're satisfied with? For that matter,

Nieman Reports I Wimer 1993 35

 HEALTH

how do you explain reform of a frag-

mented system that no one can de-
scribe in the first place?
One of our shortcomings was the
failure to better critique the highly
speculative vision of how this "man-
aged competition" system would work,
particularly cost-saving figures that were
being tossed out.
In the Legislature, there was remark- BY BETSY LILEY
ably little dissent from the new ortho-
doxy of managed competition-no
ermont is one state leading na- • Get the reaction of average Vermont-

V
matter the seeming incongruity of over-
hauling the system by leaving the pri- tional health care reform . The ers who are the ones whose lives will
vately insured, employer-based system governor, Howard Dean, is a be changed and who will pay to make
in place. So stories about alternatives, physician and was an integral player in change happen.
such as a Canadian-based system, had President Bill Clinton's health care re-
I culled a new Rolodex of sources
little edge. form efforts.
from a variety of sources: letter writ-
But I think our coverage improved as Health care reform in the Green ers, people at public hearings, people
we felt our way through the issue. We Mountain State began in 1991, as with expertise in other areas such as
talked about doing lengthy projects on grassroots groups organized strong sup- taxes. It would have been easy to just
where the health care dollar goes or port for a single-payer system. The 1992 quote the usual suspects.
long overviews about where reform Legislature created a three-member
might lead. Health Care Authority charged with It's tough to quote average]oes and
We opted instead, almost without designing two systems: a single- and Janes. In general, Vermonters know
planning, for more reporters doing multiple-payer system. what they want out of reform. Yes, they
more stories from more points of view. Covering health care reform has been want to continue the high quality of
Eventually we stopped treating this as a challenge here because of the interest care they have now. Sure, they want to
just a medical story or a political story of our readers and their knowledge of eliminate unnecessary administrative
that ended with the passage of a bill. We the subject. Vermonters know their expenses . But details-an employer
now have one reporter writing about Quebec neighbors enjoy universal cov- mandate with subsidies that kick in when
ethical issues like rationing. For the first erage and lower costs for prescription an employer has spent 12 percent of
time, we cover health care as a business drugs and other medical expenses. But their payroll on health care-overwhelm
and economic story. they also know Canadians shop inVer- the average guy. •
We have a long way to go, particu- mont because of their own nation's
larly in covering the insurance industry. high taxes. Betsy Liley is based in the Montpelier Bureau
And instead of just running victim of The Burlington Free Press, the largest
I outlined two goals:
stories about families without insur- Vermont newspaper. She has covered the State
ance or cancer patients denied experi- • Make sense of the jargon . House for the last five years, including health
mental treatment, we did slog through Vermont, like Clinton, is building a care reform, which is expected to be the biggest
the details. new health care system around what legislative issue this year.
We bored some readers, but I think the bureaucrats here labeled an Inte-
we underestimated others. Listen to grated System of Care. I've used that
talk radio or read letters to the editors. terminology only a handful of times.
What's remarkable to me is how literate Instead, 1 have referred to networks
some of the public has become on health of health care professionals includ-
care reform in a short time. • ing dietitians, chiropractors, doctors
and hospitals.
jim Simon is a reporter in The Seattle Times
state capitol bureau. He has covered regional The same was true for the word pro-
health care issues and the politics of medicine vider. The word doctor is not inclu-
for the last five years. sive enough. Health care encom-
passes nursing, mental health,
nutrition, exercise and so on. So, I
began using the term professionals
(even if some people might call their
caregivers quacks).

36 Nieman Reports /Winter 1993

 HEALTH

Checking on the Players

Newspapers Trail National journal and Legal Times
In Reports on Influence Peddling on Health Care

.,
BY CHARLES LEWIS Washington politics and government,
and Legal Times, another Washington
weekly which most closely tracks inside
residents have unsuccessfully at-

P tempted to enact national health

care insurance throughout this
century. For decades immensely pow-
lobbying issues. Unfortunately, these
two publications are principally read
inside the beltway, which means that
most of America has no idea that
erful, entrenched forces have been reap-
yesterday's government officials are to-
ing billions of dollars annually from our
day reaping huge profits from their prior
seriously flawed system. Given all this,
experience and connections as public
you would think that Washington jour-
servants. The revolving door assures
nalists would be swarming all over the
that their special interest clients get a
influence-peddling power dimension
piece of the health care reform pie.
of the Clinton health care reform story.
The news coverage of health care
Think again. reform lobbying has operated on the
Most of the coverage has been largely unstated but implicit assumption that
stenographic, focusing on the latest the efforts to tailor and shape the Clinton
presidential pronouncements and the plan are just now beginning. However,
ping-ponging Capitol Hill reaction by from the insurance companies to the
Republicans and Democrats alike. And health maintenance organizations, from
column feet have been devoted to at- the doctors to the trial lawyers, from
tempts to explain the exceedingly com- consumer groups to small business trade
plicated plan and its ramifications to associations, the jockeying for influ-
readers -admittedly a daunting task in ence and impact in Washington has Charles Lewis, a former producer for the CBS
this instance. Nonetheless, when the been a mostly hidden, behind-the- News program "60 Minutes, "is founder,
long-awaited Clinton plan was finally scenes whirlwind at least since the weeks chairman and executive director ofthe Center
put forward in September, there seemed prior to Bill Clinton's inauguration. for Public Integrity, a nonprofit research
to be an unabashed journalistic compe- Which brings us to a larger curiosity organization based in Washington. He was
tition for the most adulatory article about the entire health care reform plan: the author ofthe center's study ''America's
possible about Hillary Rodham Clinton. the President himself. How and pre- Frontline Trade Officials, "which led to a
In the hundreds of stories published cisely when did Bill Clinton's thinking General Accounting Office investigation and
by major newspapers in recent months, on the health care reform issue crystal- justice Department ruling. He began his
of course there has been some impres- lize? No journalist has written the de- journalism career at age 17 working nights in
sive although infrequent coverage of finitive story to date, and it is crucial to the sports department ofthe Wilmington
the internecine lobbying warfare which understanding the current legislation News journal. Robert Tsai, Margaret
is being waged over the Clinton reform and the real underlying intentions. Ebrahim, D :.4rcy Morgan and j effrey Cook of
proposal. The Wall Street Journal, for During the 1992 presidential campaign, the Center contributed to this article.
example, has touched on aspects of the Democratic candidates with the most
health care lobbying, but the two pub- carefully developed health care reform
lications that have done the most in- positions were Paul Tsongas and Bob
depth reporting on the health care in- Kerrey-not Bill Clinton. Sometime
fluence game are the National]ournal, from the primaries to the fall campaign,
The Times-Mirror-owned weekly on

Nieman Reports I Wimer 1993 37

 HEALTH

the Arkansas governor metamorphosed commercials, most Americans assume

from a pay-or-play approach to the cur- As regards the political the Clintons are taking on the entire
rent concept of"managed competition." giant industry. Most Americans, from
How? Why? Who "educated" him in that process in Washington, the avalanche of attendant articles when
direction? it is generally the Clinton health plan was announced,
We've all been taught to follow the do not know that the White House has
money, and over the years, long before
unreported that the directed the Democratic Party to mount
Bill Clinton emerged in 1992, many entire health care a multimillion dollar National Health
journalists-namely Morton Mintz of Care Campaign, funded by many of
proposal has caused an
The Washington Post and Viveca Novak those same vested health care industry
and Vicki Kemper of Common Cause extraordinary bonanza interests, including the largest insur-
Magazine-exposed the huge sums of in which scores of ance corporations. Dana Priest of The
money being dumped in the Congress Washington Post first broke this story,
to thwart any attempts at serious health legislative and but there has been little followup on
care reform. And when, sometime after executive branch the general subject of Clinton's use of
his election as President, it became clear the national political party apparatus.
that health care reform would be one of officials to leave in The press has reported that one of
the four most important agenda items droves for the private the big "winners" of the Clinton pro-
during the Clinton presidency, report- posal are the HMO 's. But most Ameri-
ers began to revisit the Federal Election sector, doubling, cans probably don't realize that in re-
Commission and the National Library tripling, and even cent years, the seven largest insurance
on Money and Politics, for the latest companies have been making serious
financial data on the health care indus- quadrupling their acquisitions. ln fact, they own about 45
try. The resulting stories, most exten- salaries. percent of the nation's HMO's.
sively by U.S. News and World Report The point here is that there seems to
(May 24, 1993), have been useful and be little rigorous analysis beyond con-
illuminating, but like most campaign sumer journalism replete with charts
finance data-driven stories, limited in "Your government has the courage, fi- and graphs, all striving to be reader-
scope and linear in nature. nally, to take on the health care profi- friendly and responsive to the central
There has been little attention paid teers and make health care affordable question, "Here's how it will affect you."
to individual health care industry con- for every family." Clinton also casti- But in many ways, the most compelling
tributions and connections to the gated then-President George Bush, "He broad issue surrounding the 1992 can-
Clinton campaign and to the Demo- won't take on the big insurance compa- didate of change and his historic pro-
cratic National Committee, including nies to lower costs and provide health posal still remains largely unanswered:
the Democratic National Convention care to all Americans. I will." just who and what is being "reformed?
and the inaugural gala events. Beyond Actually, the largest insurance com- As regards the political process in
the straight numbers, there doesn't panies are generally supportive of the Washington, it is generally unreported
seem to have been an in-the-trenches emerging Clinton health care reform that the entire health care proposal has
attempt by journalists to study the di- plan. Indeed, they have formed a multi- caused an extraordinary bonanza in
rect personal interactions between million dollar lobbying effort on their which scores of legislative and execu-
health care industry officials and their behalf in Washington called, "The Alli- tive branch officials leave in droves for
paid lobbyists with the Clinton powers- ance for Managed Competition." Some the private sector, doubling, tripling,
that-be, beginning during the campaign of Bill and Hillary Clinton's advice on and even quadrupling their salaries.
itself. health care reform has come from a How many Americans know that a sit-
One of the most interesting elements private organization known as the Jack- ting United States Congressman quit
in the White House lobbying strategy is son Hole Group, substantially funded hisjobonSunday,January31, and went
the way in which the Clinton forces by such insurance companies as Pru- to work the very next day for health
have attempted to fashion the coming dential, Cigna, Aetna and Kaiser. It is insurance interests? Willis Gradison re-
debate as a dramatic David-and-Goliath likely that this "brain trust" group also signed from the House of Representa-
struggle between a progressive, well- receives funding from pharmaceutical tives to lead the Health Insurance Asso-
intentioned new President fresh from companies and other health interests, ciation of America.
the heartland, Mr. Clinton Goes to Wash- but the donor list has been, to date, Which begs the question, who else
ington, pitted against multibillion dol- proprietary. has left, and what exactly are they do-
larvested interests, led by the insurance When Hillary Rodham Clinton ing? This is relatively virgin territory in
industry. At his acceptance speech be- blasted the insurance companies, terms of reporting and the examples
fore the Democratic National Conven- namely the Health Insurance Associa- are resplendent and metaphoric. They
tion in New York, Bill Clinton said, tion of America (HIAA), over their TV range from former Capitol Hill staffers

38 Nieman Reports /Winter 1993

 HEALTH

like Randy Cooper, who was a long- It is a frightful notion to then imagine osity and perhaps our need for enter-
time administrative assistant to Senator how John Q.Journalist is going to really tainment, we sent a tongue-in-cheek
Edward Kennedy and is presently rep- get a bead on the machinations of a letter to 30 or so health care interests
resenting the Pharmaceutical Manufac- $900 billion industry and its conver- who most recently contributed money
turers Association and Pfizer Inc., to gence with the well-heeled Washington to the Democratic Party. We wrote "Be-
former Representative Anthony Toby lobbying community. Beyond that, we cause contributions play such an im-
Moffett who has been hired by U.S. are talking about a policy plan so com- portant role in political campaigns, we
Healthcare. And let's not forget the Ar- plicated its own authors and adminis- are interested in learning the reasons
kansas clan of lawyers who are cashing tration spokespeople don't seem to behind such a generous donation. "
in on their state and their familiarity completely understand it-and that's We received just two responses. As
with the Clintons to peddle for health without a copy deadline staring them in John Carson, director of government
care, such as W. Jackson Williams, Jr. , the face. affairs for the American Podiatric Medi-
Bill Clinton's former law partner and No one said it would be easy. Through cal Association political action com-
close friend who now works for the persistence, perseverance, creativity and mittee, wrote: "The record will show
Federation ofAmerican Health Systems. luck, a clearer picture of the health care that, in addition to [the $15,000contri-
Or former Representative Beryl Anthony plan, from its evolution to its real ben- bution to the DNC, a comparable
who now represents the American Hos- eficiaries, can emerge. In Washington, amount was donated to the Republi-
pital Association for Winston and most of the reporters working this story cans. We strongly believe and support
Strawn. have had to put on heavy boots to wade the political party process."
Again, the fundamental issue is that through the mesmerizing muck so en- Maybe in Washington the color of
this has been evolving now for two full demic to our nation's capital. money is red , white and blue. •
years-the conceptualization and the For example, just to satisfy our curi-
planning, the tinkering and especially,
the lobbying. Hundreds of specific
changes in the Clinton plan were made
in the first six months of the new Ad-
Confessions of a First-Year Medical Writer
continued from page 7
ministration, away from public view and
scrutiny. Why is there an innocent as-
people's lives. The stories are inher- mains perfectly healthy today, except
sumption by reporters that all of this
ently dramatic, and I believe fervently for an occasional bout with the flu.
was purely and pristinely intellectual in
that we as reporters need to capitalize I chose to write his personal story
those early task force months? Most
on that drama, to tell medical stories in against the backdrop of the research,
coverage emphasized how the vested
a way that will grab the attention ofbusy interweaving the two themes but focus-
interests were shut out, not included in
readers . We need to be inclusive, not ing heavily on the artist. I call this "spoon
the elaborate "tollgate" process imple-
exclusive, in our writing. The best medi- feeding the science." A more conven-
mented by White House adviser Ira
cal stories-like the best court stories, tional medical writer might recoil in
Magaziner. The fact is, White House
hurricane stories, riot stories, what- horror. But I am convinced that I
staffers met with scores of lobbyists or
ever-are stories that reveal the trials reached many more people than I would
their clients, and specific changes did
and triumphs of everyday living. have had the story been more straight-
occur in the plan following those meet-
An example : I recently wrote a piece forward. Yes, astraightstorymighthave
ings.
about how AIDS researchers are turn- afforded more space for the fascinating
The most formidable obstacle to jour-
ing their attention to the healthy by intricacies of the research, details that
nalists attempting to write insightful,
investigating why some people have were lost because I devoted precious
incisive articles about this extraordi-
been able to live with the human immu- inches to what some might see as extra-
nary Washington power story is the
nodeficiency virus for as long as 15 neous facts about Anderson's life . But I
sorry state of available public records .
years without developing symptoms, think those concessions were well worth
Lobbying disclosure laws are notori-
and without taking any anti-viral medi- it, especially in a story as technical as
ously weak and unenforced, especially
cations such as AZT. I tracked down one this one. It is of no use to write stories
when it comes to domestic lobbying by
of these so-called "healthy positives": a if people don't read them.
U.S. entities. Thus, the thousands of
San Francisco artist named Rob Ander- As I look forward to my second year
health care-related meetings around
son who had participated in a hepatitis as a medical writer, I am a bit more
Washington between the lobbyists and
study during the late 1970's. The blood confident that my editors' instincts were
the lobbied are virtually all non-
samples that he and others gave for that sound, that a general assignment re-
disclosable. Getting to the bottom of
study were saved and, years later, tested porter can take on a specialty beat such
what is really happening is necessarily
for the presence ofHIV. Anderson tested as medicine and do well. I have plenty
an interview-driven exercise, in which
positive; he can thus trace his infection of ideas to keep me busy. And now, if
the interviewees are not required to
with the AIDS virus back to 1979, long you 'II excuse me, I think I'll get back to
reveal much of anything.
before anyone knew of AIDS. He re- that biology text .... •

Nieman Reports I Winter 1993 39

 HEALTH

The Case for Reporting

On Medical Alternatives

"Now that the quality ofhealth care is gible for such payments as alternative . them from receiving what they
being debated on a grand scale, it is Thus work performed by medical need in time. The movie
important to keep in mind what the doctors, osteopaths, dentists and li- "Lorenzo's Oil" and the lV-movie
censed psychologists is mainstream. "Son-Rise" document true cases of
best in medicine is all about. " parents creating alternatives for
Chiropractic, healing massage, Chinese
-Peter jennings, ABC News herbal medicine and acupuncture are their incurable or dying children.
borderline. The alternatives include a The debate over accelerating ap-
vast array of traditional, shamanic and proval of treatments for AIDS
new forms ofhealing, from the miracles patients and the terminally ill and
BY Sm KEMP at Lourdes to psychic surgery, from the issue of "orphaned" diseases
dietary methods of healing, such as are important examples of this
eter Jennings's "Person of the macrobiotics and juice fasting, to vibra- situation.

P Week" report on October 29 hon-

ored Dr. Holmes Morton, a re-
search geneticist and pediatrician who
tional methods, from homeopathy and
flower and herbal essences to color
therapy-not to mention various newer
forms of here-and-now psychotherapy.
Reporters often play into the existing
power struggle by accepting the main-
stream view of medical alternatives. The
has established a clinic to serve the media has a responsibility not to be-
Amish and Mennonite communities in There is a large, growing and unmea-
come a vehicle for one view in a polar-
rural Pennsylvania. Less than 100 miles sured portion of the population who
away, in Philadelphia, this kind of medi- take care of their health largely outside
cine is mainstream. As a pediatric ge- the American mainstream. Individuals
neticist in the culture he is serving Dr. turn to alternative methods for many
Morton is as much an alternative for reasons:
Mennonites and Amish, who reject • They find no mainstream remedy
modern ways, as Albert Schweitzer was for a chronic condition, such as hay
for Mricans and an acupuncturist is for fever, or a fatal disease, such as
a middle-class American. As Jennings AIDS or cancer.
reported, it is Dr. Morton's personal
qualities that make his alien methods • They cannot afford an allopathic
acceptable. doctor, often because they have
lost their insurance.
Alternative is a relative term but "al- • Alternative care is often less risky
ternative medicine" is a culturally and and less costly.
economically biased term used by "main- • Their values preclude some
stream" allopathic medicine to refer to allopathic practices, such as its
everything else. If we define medicine invasive quality.
as "the art and science of assisting • Their culture prefers other forms of
people's bodies and minds in regaining healing. The new Cambodian Sid Kemp is a general systems theoretician
health ," then clearly all of what is called communites, for example, turn to and engaged Buddhist who seeks to help
"mainstream medicine" and all of what their traditional healers and individuals and communities function more
is called "alternative medicine" are both priests. harmoniously. He makes his living as a
part of medicine. One easy dividing line • They look for a caring or spiritual computer systems consultant, and spends his
between mainstream and alternative component in healers that they do time writing, training in Hakomi body-mind
systems is to designate all medical prac- not find in allopathic medicine. therapy and sharing meditation. He lives in
titioners who can receive third-party • People with incurable or fatal ill- New York City with his wife and editor, Kris
(government and insurance) payments nesses find that the pace of priori- Lindbeck, travels extensively and appreciates
as mainstream and those who are ineli- ties of medical research prevents responses to his work.

40 Nieman Reports /Winter 1993

 HEALTH

ized situation because of their lack of 2. Experts on each side claim to be Two perspectives, a temporal one
understanding of the larger picture. As authorities. A reporter has difficulty in and a multicultural one, may help clarify
we enter the debate on national health checking those claims because each the situation.
care, we need incisive, balanced report- authority is respected within his or her
ing on the complex changes that will domain. If the polarity is not recog- From Alternative
occur. For example, what will happen nized, however, it is impossible to see To Mainstream
to valid forms of psychotherapy that are that neither side has a correct view of
not covered by insurance when other, the whole situation. Yesterday's alternative is today's main-
perhaps less effective modalities, are The polarization in 20th Century stream. Ten years ago the allopathic
available to many more people under American medicine is particularly diffi- view of vitamins was only that the mini-
third-party payment plans? cult because each side feels responsible mum daily requirement or recom-
for the lives and safety of the public, and mended daily allowance of each vita-
Opposing Sides, may feel that the other side is danger- min was necessary to prevent such
Different Languages ous, even murderous. Yet the polite diseases as scurvy or rickets. The main-
language that one hears in the debates stream view now recognizes the role of
Within any living system (including so- for the most part excludes the expres- Vitamin E in healing scar tissue. Vita-
cieties, communities and individuals) sion of the intensity of these feelings. As mins C and E and beta carotene, a
polarizations occur. When these become a result, a reporter often hears very relative of Vitamin A, are antioxidants,
extreme, imbalance results. Polariza- reasoned arguments that indicate the factors which are now proven to have a
tion occurs when two parts that are other side is entirely misguided, per- role in preventing cancer and heart
initially in balanced opposition move haps evil-minded. In addition, many disease . Vitamins A and D also act against
into more extreme positions. Each then professionals have livelihoods (whether cancer. Dosages of these supplements,
denies the validity of the other and practices or research grants) that de- which were used by individuals without
defines itself as holding the correct pend on their side being right, and so sanction of physicians for years, are
position. In fact, the system cannot sur- are under pressure not to develop an now being recommended or prescribed.
vive without both sides, but no one objective opinion regarding complex Meditation has moved from the hip-
within the system recognizes this. In issues. pie movement to the cancer clinic and
societies, polarization develops over When the media do a poor job of some think that marijuana should also,
years, decades and centuries, whereas reporting on alternative medicine, it is since it is the only drug found to reduce
news is reported in days and weeks, often due to a lack of recognition of this the nausea caused by some chemo-
with issues occasionally being covered polarized, politicized situation within therapy agents. The movement from
with some continuity for months. As a the health care professions. This lack of the shelf of the health store to the
result, news reporting occurs within awareness leads to: doctor's prescription pad is not rare ; in
the context of an unresolved polarized fact, it has been going on for centuries.
• Using mainstream medical special-
system. Homeopathy was the mainstream of
ists, the AMA, the FDA, and other
One of the results of polarization is American medicine in the late 1800's,
official and governmental bodies as
that "mainstream" and "alternative" are and it wasn't until the development of
experts in areas where they have
thought of as separate, independent antiseptics, anesthetic surgery, sulfa
little expertise or are biased.
entities with very little crossover. drugs and antibiotics over the course of
In this situation, high quality, accu- • Not looking closely enough at the 100 years that allopathic medicine
rate reporting of the news is a Herculean motives that lie behind the experts' gained ascendancy and came to be seen
task. News reporters are often on tight opinions. as mainstream. We begin to move into
deadlines. Therefore, they seek expert • Reporting on new developments in the realm where the patient's own abil-
opinion, and seek it quickly. In a polar- medicine from the scientific estab- ity to heal and the power of the mind
ized situation, this leads to difficulties: lishment and those from alterna- become more significant, until we reach
1. There are no specialists who are tive healers with significantly the outer edge of "alternative" medi-
unbiased. Anyone making a living in the different slants. cine with channeled information and
field is on one side of the issue or the • Failing to recognize when some- psychic surgery.
other, consciously or otherwise. The thing that is now part of main- Many elements of mainstream medi-
best that one can find is an individual stream medicine was alternative cine began as alternative medicine. The
who has respect for the opposing side. medicine until only a few years majority of the tested prescription
Anyone who actually has a deep under- ago. pharmacopoeia is derived from the tra-
standing of both perspectives is likely to • Falling into the medical/scientific ditional herbal medicine of Europe.
be excluded or denounced by both sides, error of classifying all events as Unfortunately, the decision to market
since each side defines itself by saying either individual cases or proven products in their natural or processed
that the other side is wrong, even harm- scientific studies, and therefore not forms has much more to do with the
ful. recognizing developing trends in economics of production and the poli-
medicine.

Nieman Reports I Winter 1993 41

 HEALTH

tics of FDA approval than with an un- 20 years has been proven relatively inef- that the results of medical research from
derstanding of the medical benefits of fective, costs $25,000-$30,000 per pa- the scientific community passes through
the alternatives. Many people are aware tient and is extremely risky. The alterna- an analogous process, which is derived
that digitalis, a heart medication, comes tive is a lifestyle change that can actually from alternative sources. The proce-
from foxglove, and that Valium is an save the patient money and is more dure is somewhat more formal, consid-
artificial form of the active ingredient of effective. erably more expensive, and carried out
valerian root. Valerian root is in a bitter Our society's bias toward high-tech by biologists, chemists and medical
herb whose taste would prevent over- medicine caused us to approve bypass doctors, but otherwise is very similar.
use of its mild relaxant, and is probably surgery quickly, and wait decades be- In that case, are medical alternatives
safer in its herbal form. The conceptual fore giving equal funding to less costly, developed in the laboratory alternative
split between allopathic and alternative safer alternatives. The media reports medicine, or mainstream?
medicine keeps people from being these developments pretty much along
aware of such options. the lines the mainstream in the AMA My Mainstream
would want. Just a few weeks ago New Is Your Alternative
York Newsday reported on a study of
the comparative benefits of angioplasty Rather than allowing conventional medi-
The movement from over bypass surgery without mention- cine to define the terms reporters use,
the shelf of the health ing Dr. Ornish's alternative. it would be good to see some stories on
Reporters might find it helpful to how Americans from different cultures
store to the doctor's keep this trend in mind: choose medical care. These stories
prescription pad is not would be a good bridge between the
• Ideas from alternative sources and
"miracle cure" stories we get and ar-
rare; in fact, it has traditional medicines of many cultures
ticles about scientifically proven new
are used by those who do not find
been going on for remedy from mainstream medicine.
treatments. How do doctors choose
their doctors? How do alternative care
centuries. • If these remedies are effective for providers choose theirs? What about
the first experimenters, they get docu- Americans of various ethnicities and
mented in alternative venues. economic status?
Even with today's in-depth knowl- • People use them and demand International cost comparisons have
edge of human physiology and bio- grows. become topical in the coverage of the
chemistry, scientists are finding most • Practitioners and companies pro- Clinton health plan. But what about
new drugs by looking to native medi- vide them as alternatives. looking at quality of care? Mexico has a
cine men and women and the plants • These alternatives are tested by the law that says that any medicine or medi-
and animals they use. medical community. cal practice which is approved in its
Twenty years ago, the medical estab- • What was originally a traditional or native country is acceptable in Mexico.
lishment denied any correlation be- alternative idea is validated and becomes As a result, many clinics for cancer and
tween diet and the genesis or cure of mainstream. other disorders that could not operate
either heart disease or cancer. Only in the U.S. have opened across the bor-
Of course, not all remedies survive
alternative medicine, such as the der, often run by American doctors who
this testing process. Some, such as
groundbreaking work of Dr. Nathan could not offer the treatments that they
laetrile, cannot be proved safe and ef-
Pritikin, offered access to wisdom that found most effective. Reporting on these
fective. Others cannot be reproduced.
is now being presented as mainstream. clinics and providing their side of the
Even if we could prove that psychic
Following the same line of research, story and theAMA'sviewofthemas two
surgery is real, we would not know how
Dr. Dean Ornish of California has now valid opposing views would be impor-
to train psychic surgeons. Knowing this
proven, using traditional allopathic re- tant steps in examining ways in which
historical pattern, reporters could iden-
search methods, that occlusion of coro- the FDA may be overregulating medi-
tifywhere a given remedy or procedure
nary arteries can be reversed using only cine to the detriment of our health.
lies on this course (oroffit), and predict
methods that are non-invasive, non-
the likely tests and trials that lie ahead.
allopathic and drug free, including diet, What Can Be Done?
Careful reporting of this type could
exercise and meditation. It is now reim-
actually assist society in speeding up
bursable through some major insur- The media have an important role in
delivery of tested, reliable treatments.
ance companies and provides a less the evolution of medical alternatives.
In addition, reporters can expose ques-
expensive, safer alternative to bypass They can assist in debunking fraud and
tionable treatments and fraud, not only
surgery. At the same time, it has been exposing abuse of power, popularizing
in alternative medicine, but in allopathic
demonstrated that bypass surgery does overlooked alternatives to increase the
medicine as well. Out and out fraud in
not increase life span. Here is a case chance that they will receive research
medicine is rare. It is important to note
where the mainstream option of the last funding, and educating the public to

42 Nieman Reports /Winter 1993

 HEALTH

greater awareness of the existing and

upcoming medical alternatives.
Stories abound of raids on offices of Getting Health Facts From Internet
alternative medical practitioners by Fed-
eral agents, sometimes with guns. M.D.'s

F ,;;=:~~~
who include alternative modalities in S<,:i.med.aids is a moderated group de-
their work seem targeted most often. voted to the treatment, prevention and
Sometimes there are charges of mal- a health-related issue, ·he or she pathology/biology ofAIDS. Just a few of
practice, but there are also stories of the couldn't ask for a better tool than the many.
power of the IRS or FBI being misused Internet. Ifyou want more detailed discussion
to protect the interests of the FDA or the A good place to start is Profnet. It's and some really good contacts, con-
AMA. Are these more than urban folk- the brainchild of Dan Forbush, the As- sider joining a listserv group through e-
lore? I would like to see the mainstream sociate VP for University Affairs and mail. Some listserv groups dedicated to
press examine such stories and either Profnet systems operator at the State medical issues include immune-request
debunk them or give them the status University of New York at Stony Brook. (contact Cyndi Norman
they deserve as examples of misuse of If yop send a query to Profnet [[email protected])) which deals with
federal police power that violates fun- ([email protected]); breakdowns of the immune-system,
damental American freedoms. they will contact university public rela- mhcare-managed health care (sub-
What is it like to be an alternative tions people all over North America"for scribe to [email protected]), or
medical practitioner or therapist in you. Although the service is uneven, it sportspsy-exercise and sports psychol-
America today? What is it like to be a often turns up experts in places you ogy (contact Michael Sachs
medical doctor under the shadow of would never have dreamed of looking, [[email protected]]).
malpractice insurance costs? Stories that or had the time to look. Give Profnet Fora complete listing ofall the health
would bring the human element back about 24 hours to fulfill your request. information on the Net, it's just an ftp
into the debate on the future of Ameri- Gopher provides another valuable request away. Lee Hancock, an educa-
can medicine could balance the more way to hunt people down. Gopher is an tion technologist at the University of
sensational reports of medical abuses information shortcut to resources "on Kansas Medical Center, has prepared a
and miracle cures. the Internet. Once in Gopher, use comprehensive list of health science
The effort of humanity to heal our Veronica to find health-related stories resources available on the networks.
bodies and minds is one of the most and contacts. Veronica is a tool de- The list includes Listservgroups, Usenet
remarkable stories of all times. Some signed to search all Gopher servers and groups, Freenets, Data Archives, Elec-
things have not changed much at all: tell you where you can find the informa- tronic Publications & Health Science
Acupuncture needles have been used tion you want. oriented databases, as well as anony-
since the Stone Age . Others have Newsgroups are another option. mous ftp sites for software applications
changed in utterly unpredictable ways: Newsgroups are similar to bulletin and several new Gopher sites, data-
Modern medicine's single most power- boards, where people leave messages bases and libraries. Hancock's list is
ful tool, antibiotics, was inconceivable for each other. There are several now available via ftp from
150 years ago, because no one knew newsgi-oups devoted to specific health FTP.SURA.NET, Directory: pub/nic FILE:
that germs caused disease. What will issues: l) bit.listserv.mednews provides MEDICAL.RESOURCES.6-1.
medicine look like 100 years from now copies of the Health Info-Com Network Feel free to drop me a line at
(if society and the economy survive to newsletter, 2) sci.med is devoted to [email protected]. -Tom Regan
provide it)? The answers may not come medicine and its related products, 3)
from expensive, high-tech medical re-
search, but from ancient theories com-
bining with modern technology. One
area of research is the effect of light and
preventive care, integration of new, bility to recognize the limited under-
other vibrational energies on the body.
allopathic and traditional care to create standing and prejudice of polarized in-
There is some evidence that natural
holistic healing environments, and fo- dividuals and report on them clearly to
immune response, growth and healing
cusing on the healers in our society. help America become aware of the com-
respond to the presence of light and
other energies in ways we do not clearly
nfe media has a responsibility to report plex truth of our present situation, which
on the alternatives, experiments and is the basis for our future. •
understand. There is a possibility for
abuses in medicine today. A well-in-
developing nontoxic, noninvasive thera-
formed public will operate through
pies that could change the face of medi-
natural processes inherent in society to
cine.
select the best alternatives for shaping
I believe that the media can best
our future. The media has the responsi-
serve the public by reporting on quality

Nieman Reports I Wimer 1993 43

 Chill Wind From the Kremlin
Yeltsin Imposing His Will on Media With Campaign
That Began Before October Rebellion

BY NICHOLAS DANILOFF

'm dining in Moscow on Sunday tackers at Moscow TV headquarters, he these dramatic events, assessing how

I evening, October 3, 1993. It's 8:30

p.m. The telephone rings. A frown
forms on the face of my host, Yelena
says. St. Petersburg is calm. Some people
have precipitated a bloody conflict,
Sobchak says. He implores the listening
Russia's independent press has survived
the latest crisis. I am assessing which
media showed vitality, which displayed
Markova. "Nyet, nyet ... ne mozhet byt' public: There must be no civil war. weakness. Here are some excerpts from
(It can't be)," she mumbles into the There must be elections. my red notebook following Sobchak's
phone, then slams down the receiver. appearance:
"Big trouble!" she announces. "The Today, weeks later, I'm reviewing
rebels have broken out of the Parlia- 11:10 p.m. Channel 1. Commenta-
ment building. They're attacking the tor Nikolai Shvanidze is now reading an
appeal for calm from President Boris
television center at Ostankino. They
Yeltsin.
may have seized control because televi-
sion has stopped broadcasting. This has (I ask myself Why isn't Yeltsin read-
never happened before. This could be ing it? Where is Yeltsin? Has he dropped
the start of civil war!" dead? Suffered a heart attack? Or are
We turn on the TV and surf through his advisors keeping him off the air
the channels. A test pattern flashes across because he is too frazzled? Or because
Channell. A test pattern on Channel2. he would not be able to calm the na-
We try some phone calls. The phone is tion? No doubt they don't want invidi-
dead. ous comparisons with the 1991 coup
I feel tension coursing through my leader, Vice President Gennadi Yanaev,
arms into my forehead. I resist a wave of who trembled noticeably at his one
panic. This is the way revolutions start; and only press conference.)
the rebels go first for the communica-
Vice Premier Yegor Gaidar appears
tions centers.
next. He looks calm. He calls on citizens
Coming to Moscowwas risky, I knew.
President Yeltsin had dissolved the Rus- to protect democracy by surrounding
sian Parliament September 21 quite the Kremlin and the City Council build-
unconstitutionally. The rebel legisla- ing as unarmed human shields.
tors, heavily armed, holed up in the (Again, I wonder: why Gaidar and
White House, the Russian Parliament not Yeltsin? Rally-polly Gaidar was
building. On leaving Boston Septem- once belittled by Parliamentary
ber 29, it looked as ifl could get in and Speaker RuslanKhazbulatovas "a little
out in 10 days. Now I could be stuck in Nicholas Daniloff, Nieman Fellow 1974, is boy in pink shorts. "Later Khazbulatov
Moscow for weeks, maybe months, if director ofthe School ofjournalism, North- called him "a wormlet. "Tonight Gaidar
this is going to be an all-engulfing civil eastern University. He was a United Press , for all his boyishness, is grace under
war. International Moscow correspondent from pressure.)
Within minutes journalistic habit 1961 to 1965, and Moscow Bureau chieffor
takes over. Notes. Whatever happens, 11:50 p.m. Channel 2. A confused
US. News and World Report from 1981 to
take notes. I pull out pen and pad. scene. A disheveled host has gathered a
1986 He is currently organizing a conference
Channel 5, the St. Petersburg channel, group of citizens before the camera.
on the struggle for a free press in Russia to be
is now on the screen and Mayor Anatolii They're urging support for Yeltsin. They
held at Northeastern University March 21-
Sobchak is speaking. Troops loyal to say the fate of Russia hangs in the bal-
22, 1994.
President Yeltsin have repulsed the at- ance.

44 Nieman Reports /Winter 1993

 00:15a.m . Channel2 .Anothergroup Between commentaries, Steve gives Kalinin Prospekt, fire intermittently.
ofcitizenscallingforcalm.Amongthem: directions over the Atlanta-bound satel- On the roof it's like being at the
the popular television interviewer lite feed which is going out live over opera. Great spectacle . Empty
Alexander Liubimov of the Red Quad- Moscow air, thanks to Ostankino TV. Lowenbrau and Fanta cans litter the
rant program, who predicts everything His voice is professionally cool. "I sure roof. To my right, a military attache with
will be all right. "Wewillspeakthe truth could use a cup of coffee," he begs. Ten powerful field glasses calls out: "Black
on the air," he says. "But right now is a minutes later: "I know you're all busy Zil approaching the bridge .... A three-
time for calm. We're all going home to down there, but I could sure still use star gets out .... Marshal Grachev [de-
bed. You do the same. Good night com- that coffee!" fense minister] heading out onto the
rades." 11:55 a.m . Yeltsin's tanks fire 125 bridge .. .. Apparently for talks with a
(Calming words. But how does that millimeter rounds into the top floors of deputation of rebel Parliamentarians.
square with Gaidar's call for a citi- the Parliament building. All Moscow Group of Hare Krishnas trying to ap-
zens' defense of key buildings? Noth- seems to shake, and reverberate. Flames proach the limousine .... "
ing much for me to do, so I'll follow begin licking out of the building; the 3:35 p .m. Radio announces Yeltsin
Liubimov's example.) white facing stone turns sooty black. has imposed a curfew on Moscow. Pub-
Early morning. Sounds of gunfire in Yeltsin's assault troops seize the bot- lic meetings banned. Press censorship.
the streets. It's not safe to go out. I tom four floors of the White House. Rebel Vice President Rutskoi expelled
spend the night on a couch, listening Eight to 12 soldiers killed. At least 105 from the military by presidential de-
anxiously. casualties. One U.S. Marine guard at the cree.
7:15a.m. Crackle of gunfire suggests American Embassy nearby reported 5 p .m . Pow! Ka-pumpf! Pow! Ka-
that fighting is sweeping up our street, wounded by stray bullet. Rebel Vice pumpf! More tank rounds . I'm now in
Mozhaiskii Val, from the Kiev railroad President Alexander Rutskoi and Parlia- the apartment of]im Gallagher, bureau
station. mentary Speaker Khazbulatov reject chief of The Chicago Tribune. Same
8 :00a.m. I call Lisa Schillinger, direc- conditions for talks. building as the CNN bureau. The whole
tor of the Russian-American Press and 12 : 15 p .m . Premier Viktor building shakes. PowKa-pumpf! We see
Information Center, to put off an ap- Chernomyrdin calls for unconditional it all on television in the comfort of the
pointment. "We've been surrounded surrender of the rebels. living room.
by gunfire all night," she says. "I was 1:00 p.m. Channell shows film clip 6:30 p.m. Rutskoi and Khazbulatov
frantic . My daughter didn't get in until from Sunday afternoon: Rutskoi incit- give up , and are whisked away to
9 p .m . I suppose we will be evacuated ing the crowd to attack television cen- Lefortovo Prison. In The Chicago Tri-
in the next 48 hours. I'm not sure I'll go ter. bune bureau I pen a commentary on
though." (So Russian 1V was out on the streets the days' events, and fax it to Boston for
9:00 a.m . A haggard Yeltsin appears Sunday gathering the news. Why didn 't The Northeastern News .. I note that
on Channel 1. He is reading painfully, they show this clip before? Censorship? this time, contrary to the 1991 coup
has trouble controlling himself. It's been Wanted to avoid fanning the flames? attempt, citizens did not try to per-
a bad night. He announces "decisive Or simply disorganization?) suade the tank crews to hold their fire .
measures" to end the crisis. 2:00 p.m. I can't stand being inside In fact, the people applaud each artil-
any longer. Fighting is localized at the lery round-a measure of the popular
(Any government, as any citizen, has
White House, while most of Moscow is disgust with the Parliament.
the right to self-defense. But "decisive
going about its usual business. I call
measures" means blood will be shed, (What irony: in front of this build-
Dean Zassurski at Moscow University
doesn 't it?) ing Yeltsin mounted a tank in 1991 to
Journalism Department to put off our 3
defend Russia's new-born democracy.
11 :10 a.m. Television is now giving a p .m . meeting. He says he is at work and
Today, his tanks have bludgeoned to
summary of last night's turmoil. The willing to meet tomorrow. I high-tail it
death the Parliament's house in the
mayor's office was attacked by armed over to the CNN bureau and by lift and
name of democracy. We learn later
rebels. The broadcast here scoops up ladder make it to the roof.
thatfour journalists, two Western, were
live segments from a CNN broadcast. 2:30 p.m. Claire Shipman is taking
killed and seven wounded.)
My old Moscow colleague Steve Hurst, over from Steve Hurst who looks ex-
8:05p.m. I make my way across town
on the roof of the CNN bureau building hausted. He has been at the micro-
to a dinner in my honor. As I leave
at 7/4 Kutuzovskii Prospekt, is com- phone for nearly 48 hours. I lie down
Kutuzovskii Prospekt, I glance at the
menting. on the black tar roof, gaze over the
Parliament building which is burning
parapet, straight down Kutuzovskii
(Imagine that: Ostankino television like a giant, white candle in the night.
Prospekt to the White House. FourT-80
picking up CNN! They 're not using Life is already returning to normal, al-
tanks on the bridge adjust their can-
their own stuff Don 't they have their though several sections of the Circle
nons; six others are deployed in front of
own crews out on the street? What's Line are not working. I arrive an hour
the Ukraine Hotel. Trigger-happy snip-
going on?) and a half late, and the guests are al-
ers, located in the tall buildings along

Nieman Reports I Winter 1993 45

ready leaving. They are anxious to get paper offices. They met no resistance. censor, Vladimir Solodin, said he was
home before curfew. For the others, censors were dispatched basically taking out articles he felt were
The Law on Emergency Rule, signed to the publishing houses where the inflammatory or embarrassing to Yeltsin.
by President Boris Yeltsin well before newspapers are printed. These censors An arbitrary approach."
the 1991 coup attempt, provides for were recruited from the military and The Yeltsin administration lifted cen-
restrictions on the press as well as cur- from the Inspectorate for the Defense sorship October 7, two days later, pos-
few. The new constitution which the of the Free Press, a section of the Minis- sibly under pressure from the Clinton
President and his advisors have b een try of Information which, oddly enough, administration.
working up guarantees a free press and is staffed in part by officials from the At that point, the West breathed a
bans censorship. But it also clearly au- disbanded censorship agency, Glavlit. sigh of relief. But the Yeltsin adminis-
thorizes restraints on the press under In Moscow's world of antiquated tration expanded the ban on "disrup-
conditions which are left vague. You journalism, while most newspaper ar- tive" newspapers. On October 14, the
can have your cake and eat it too in ticles and headlines are written on com- Ministry of Information announced
Russia. This is definitely not a First puters in editorial offices, the page dum- that more newspapers would be pre-
Amendment society. mies are rushed to the presses at Izvestia vented from publishing: Narodnaya
Censorship becomes obvious on and Komsomolskaya Pravda. Operators, Pravda , Russkoye Delo, Russkiye
Tuesday, October 5, when several news- using hot-lead linotypes, produce type . Vedemosti , Russkiyi Puls, Russkii
papers , including Segodnya and On the night of October 4, government Poryadok, Za Rus , Nash Marsh,
Nezavisimaya Gazeta, appear with blank censors appeared in the composing Natsionalist, Russkoye Slovo,
spots where articles have been removed. rooms, to read copy at the stone. Moskovskii Traktir, Russkii Soyuz, K
Demand for information runs high: Vitalii Tretyakov, editor of Toporu. This action was taken, Soviet-
Nezavisimaya, which normally sells for Nezavisimaya Gazeta, explains further: style, in violation of the Law on the
30 rubles, is being hawked at 300 a copy "I got a call from this censor. Bit of a Press, which requires ,a court hearing
on the streets. shock it was after the freedom we've before a newspaper can be shut down.
Boris Yeltsin has banned a number enjoyed." Criminal proceedings will be instituted
of opposition newspapers and political Dressed in a tweed jacket, Tretyakov for unspecified violations of the Law on
parties. Among the banned are Pravda, is sitting at a desk in his cavernous office the Press, according to ministry offi-
SovietskayaRossiya, Rabochaya Tribuna, a few days later. He looks disconsolate. cials.
Den ', Russkii Vestnik, Russkoye "The censor said, 'I'm taking out two The Yeltsin administration is now
Voskresenya, Glasnost. Predictably, edi- articles. What do you want to put in succeeding in creating "censorship by
tors of these newspapers are howling. their place?"' chill." In St. Petersburg, Alexander
But they show less vitality than liberal "'Nothing! ' I replied. That gave the Nevzorov, the virulent anti-Yeltsinite
editors did in 1991 when their publica- censor pause." commentator, and his program, "600
tions were banned. In that crisis, the Tretyakov, puffing on a cigarette with Seconds" were taken off the air on or-
liberal editors defied the ban to put out an air of resignation, says the censor ders from the Ministry. In Moscow,
an emergency sheet called The Com- told him he would call the Ministry of Liubimov, the liberal commentator, was
mon Paper protesting the coup at- Information to see if leaving a blank dismissed by the chief of Ostankino TV,
tempt. space was permissible. After a few min- Vyacheslav Bragin, who broke a con-
Vladimir Chikin, editor of the na- utes, the censor reported back: "The tract with the Vid TV Production Com-
tionalist Sovietskaya Rossiya, protests blank space is your problem." pany for which Liubimov works.
in interviews that his newspaper never The second night the same thing Liubimov fell from grace for urging citi-
promoted violence and should not be happened . But this time, the censor zens to go home to bed. Disloyalty.
shut down. Viktor Linnik, a former insisted that the blank space be filled . Rumors circulate that the authori-
Washington correspondent and deputy The chief editor says he decided to ties are trying to dismiss Tretyakov as
editor of the Communist Party newspa- insert some graphics which would serve editor of Nezavisimaya Gazeta, which
per, Pravda, says there can be no free as an advertisement for the newspaper has been critical ofYeltsin. About a year
elections if political views are sup- in a space which would remain mostly ago, Yeltsin forced liberal editor Yegor
pressed . Later, Pravda, Sovietskaya blank. Yakovlev out of the directorship of
Rossiya, and Glasnost learn they are not "If they had continued to press to fill Ostankino TV. Program director Igor
exactly banned, only suspended. Their up those spaces, I would have devel- Malashenko resigned, complaining of
journalists may resume work if the news- oped some nonsense articles to alert political pressure from the President's
papers change names, change editors, the readers that we were being cen- office.
and re-register. sored. I couldn't go along with censor- Articles have begun appearing in the
How was Yeltsin able to impose cen- ship, not when it was being imposed in press commenting on current pressures
sorship with such speed? a haphazard manner. Some newspa- for self-censorship. Moscow News de-
To close down opposition papers, pers like Izvestia were allowed to print scribed the lack of respect for journal-
the Kremlin sent armed troops to news- material which we were denied. The ists during the crisis and the brief im-

46 Nieman Reports /Winter 1993

prisonment of several reporters, includ- audience. see how the slaughter at Ostankino
ing one from CNN. Presidential spokes- Since then, the Russian press has would end. They were afraid to make a
man Vyacheslav Kostikov has been quite been debating why Russian television mistake.
direct in calling for self-censorship. He managers were so gutless. TV chief "And as soon as things get tense, they
says that too many analyses have been Vyacheslav Bragin says he was con- will halt in midstep, thinking, should
"provocational." cerned for the safety of women employ- we really run to meet the unknown?
All governments know that radio and ees and sent them home when the at- "Now who wants to say that it's all
TV are key to communicating with the tack began at 4 p.m. Sunday. But he has over?''
people and this is as true in Russia as no clear answer for the criticism that Parkhamenko's article was excised
anywhere else. Over 90 percent of the Ostankino TV could have switched to from Segodnya because any censor
former Soviet population has access to reserve stations around Moscow but could see it could undercut Yeltsin's
television. Well before this latest crisis, did not. An outsider concludes that authority. But Parkhamenko phoned it
Yeltsin struggled with the Parliament Russian television is directed at the top to Radio Liberty, which was pleased to
for control of television and largely suc- by Yeltsin loyalists, not journalists who broadcast it, and The Moscow Times,
ceeded in imposing his fiat. Yeltsin cre- have an unquenchable "fire in the belly." the new English language daily, picked
ated a special mechanism, the Federal These days Moscow television is loy- it up in full the next day. All this is an
Information Service, which supplied ally promoting Yeltsin's constitution and argument in favor of continued funding
presidential guidance to television pro- the elections which have been called for Radio Liberty which the Clinton
gram managers. The Russian Constitu- for December 12. Yeltsin has put a strong administration is cutting back.
tional Court ruled this agency unconsti- hand on television programming and Russia likes "a strong hand," and
tutional earlier this year, but Yeltsin will not soon release his grip. That is Boris Yeltsin has emerged from the
refused to disband it. causing dissatisfaction among TV jour- October crisis as Russia's strongman.
In March 1993, Parliament voted to nalists. Firings and resignations will Russians today are calling his adminis-
create "oversight councils" to try to likely follow. tration "the system of personal rule." A
correct what it saw as the Yeltsin tilt of Russian radio, on the other hand, less polite term used by some is dicta-
TV programs. The political opposition performed more freely than TV during torship: Yeltsin dissolved the Parliament
did not achieve much impact, and this the October crisis. The independent in violation of the constitution, dis-
failure enraged Parliamentary Speaker station Echo of Moscow repeated its banded the constitutional court, and
Khazbulatov even more. Khazbulatov sterling performance of the 1991 crisis rules by decree. True, he has rescinded
persuaded the Parliament to adopt a when it reported troop movements emergency censorship and has called
restrictive Law on Television. Press Min- block by block, minute by minute. On for Parliamentary elections and a con-
ister Mikhail Fedotov resigned in dis- October 5, Echo of Moscow wangled an stitutional referendum. And he hopes
gust in September, saying the clock of interview with Mikhail Poltaranin, who for President Clinton's benediction
press freedom had been turned back had just resigned as Minister of Press when he visits Moscow in early January.
several decades. and Information, with critical words for Boris Yeltsin triumphed in August
During the October crisis, television the censorship regime. Echo stayed on 1991, and again in October 1993. He is
did not distinguish itself by its bravery the air throughout the crisis, as did the best hope for democracy in Russia,
or resourcefulness. The greatest criti- Mayak and Russian Radio. Americans say. But the irony is that the
cism has been directed against the Important too was the role played by Russian newspapers and TV are facing a
Ostankino television center, which went foreign radio stations, particularly the chill wind from the Kremlin. The media
off the air entirely for the first time in its BBC, Radio Liberty, and the Voice of are in greater danger of losing freedom
history. America. Overseas short-wave insured today than at any time since Mikhail
Then, as now, Ted Turner's CNN that the Russian public would get some Gorbachev pried open Soviet society
played an important role in Russian truthful reporting no matter how hard with glasnost. If James Madison was
politics, providing an alternate source the Yeltsin spin doctors tried to sup- right in saying that free debate and a
of information directly from the streets. press or manipulate the news. free press are the guarantees of democ-
With far less equipment and personnel, One example is a censored article by racy, will Russian democracy be still-
CNN stationed teams at key places dur- Sergei Parkhomenko ofSegodnya, who born once again? •
ing the October crisis and provided witnessed the chaos in the Kremlin when
continuing coverage to the world. I the crisis broke. A friend had helped
have since spoken to many in the United him get into the corridors of power.
States who turned on their sets and Yeltsin arrived at his office only at 6:15
stayed glued throughout the whole night p.m. Sunday evening as his civilian aides
of October 3-4. CNN's greatest triumph, shouted helplessly, and the military
of course, came when Ostankino televi- wavered. Parkhamenko painted a grim
sion decided to pick up their feeds to picture of impotence, adding:
Atlanta and ran them for the Russian "The commanders were waiting to

Nieman Reports I Winter 1993 47

 Beyond Objectivity
It Is a Myth, an Important One, but Often Crippling and It Needs to
Be Replaced With a More Inspiring Concept

The following article was One of the simplest ways of under-

adapted from a talk by jay standing objectivity is simply to say that
it is a contract between journalists on
Rosen to the Nieman Fellows at the one hand and their employers on
Harvard University April 15, the other. The contract says this: pub-
1993. lishers, you give us the right to report
the news independently and leave us
BY jAY RosEN alone and in exchange we won't make
too much trouble for you by introduc-
ing our politics into the news pages. So
bjectivity is one ~f ~he i~enti!'Y

0
objectivity is a kind of contract between
ing features of JOurnalism m this group of professionals we call jour-
the United States and perhaps nalists and the people who provide the
the major contribution American jour- plant and equipment for them to do
nalism has made to the rest of the world. their jobs. This contract arose in the
Anybody who tries to think about our 1920's and 1930's as the ownership
way of doing journalism must grapple base of journalism was transformed.
with this concept, which is essential to Editor/proprietors were out and corpo-
understanding the way the American rations were in. So there arose a nego-
press sees itself and the way America tiated peace between journalists and
sees the press. their corporate employers. The name
Now is also a good time to examine of that negotiated peace is objectivity.
the subject because in a lot of different But today increasingly the bosses, the jay Rosen, an Associate Professor ofjournal-
ways objectivity is breaking down. It's a employers, are not keeping their side of ism at New York University, is pursuing the
mechanism that's not operating the way the bargain. They're not allowing jour- concept ofpublic journalism as the newly
it used to . There 's a good deal of anxiety nalists to go out and report the news named Director ofthe Project on Public Life
and confusion about the term among independently because they're much and the Press . He is also an associate ofthe
journalists themselves. Almost every more interested in cutting the cost of Kettering Foundation, where he has coordi-
time somebody in journalism uses the newsgathering and in transforming nated the Foundations public journalism
word objectivity they usually followwith news into a marketing vehicle of one program. Since 1992, he has been media
something like: "whatever that means," kind or another. You see this in both editor ofTikkun magazine, where he has
indicating that there is a conceptual print and broadcast. published numerous essays on media culture.
problem percolating upward. An expression of the breakdown of Rosen s writings on the press and politics have
I'd like to present five ways of under- this contract, a very poignant, direct appeared in The Columbia journalism
standing what objectivity is. This is im- expression, occurred around St. Review, Harpers, The Los Angeles Times, The
portant because objectivity has a lot of Patrick's Day this year at WNBC in New Nation, Newsday, the Quill and elsewhere.
different dimensions. I'll talk about the York. A group of editors and techni- Rosen received his Ph.D. in communication
five and then discuss some of the prob- cians and camera people at WNBC, the .from NYU in 1986. A native ofBuffalo, he
lems that have arisen around objectivity local NBC television affiliate in New had a briefcareer as a reporter for The
and some of the challenges to it. At the York, went on a one-day strike to pro- Buffalo Courier-Express and as an assistant
end, I'll propose a stronger public phi- test the sensationalizing of the local editor of Buffalo magazine.
losophy for journalists-one that would news. They said that all they were al-
engage the press in the task of making lowed to do was the Amy Fisher story
democracy work. and the like. It was a very interesting

48 Nieman Reports /Winter 1993

event. There was no practical effect, but also on the original logical validity of ity as an epistemology has been worn
they did go on strike. David Diaz, a fairly those distinctions. That is, we must away. Objectivity as fairness is a kind of
well known New York reporter, had consider the intellectual problem of accommodation to the intellectual dis-
quit earlier over this issue . The situa- distinguishing something called infor- integration of objectivity as an episte-
tion was a little bit ambiguous because mation from something called opinion, mology. Of course it's also connected
there was also a contract dispute be- of distinguishing facts from values. Al- to our notions of justice. So in a positive
tween these people and the company at most the entire history of 20th Century sense we can see that objectivity, un-
the time they went on strike. thought in the human sciences has
I've said that objectivity is a contract, tended to work against these separa-
but to phrase this contract slightly dif- tions. In fact, it's not an exaggeration to
ferently, it's also an exchange. Journal- say that journalism is the last refuge of ... it's not an
ists gain their independence and in objectivity as an epistemology. Nobody exaggeration to say
exchange they give up their voice . That else takes this notion seriously any-
leads to the conclusion that if the inde- more. Not even in the hard sciences do that journalism is the
pendence gets taken away, then the they really see the pursuit of truth this last refuge of
voice ought to return. That is basically way. Certainly almost every important
what happened at WNBC. So the jour- development in the human and social objectivity as an
nalists there began to speak out for the sciences over the last 20 to 30 years has epistemology. Nobody
right to cover serious public affairs, worn away at the intellectual validity of
rather than simply reproducing stories the journalist's theory of truth . Yet, it is else takes this notion
about Amy Fisher. This very interesting in journalism that this concept remains. seriously anymore. Not
event went almost unnoticed in jour- Even journalists are beginning to lose
nalism. their faith in their own epistemology,
even in the hard
A second way of understanding ob- and I base this on things I constantly sciences do they really
jectivity is as a theory of how to get at the hear journalists say. In fact if there's one
see the pursuit of truth
truth. We might call it the epistemology sentence that I've heard literally hun-
of American journalists. Some would dreds of times from journalists it's this: this way.
even say an ideology. As a theory of how "Of course, no one can be really objec- '*'*fff
to pursue the truth, I would describe tive. But we try to be fair. "
objectivity as a separation theory. It We try to be fair. This is a very genu- derstood as fairness, is the journalist's
states that if you separate facts from ine and a very important statement. But way of pursuing justice.
values, or information from opinion, or if you look at what that statement says, A third way to understand objectivity
news from views, this will permit you to it is in fact exchanging the pursuit of is as a set of professional routines and
know the truth. These separations are facts for a value. What it says is: maybe procedures-that is, a set of things jour-
central to American journalism's image we can't just present the facts, but what nalists habitually do when they go out
of itself. we can do is pursue this very important to report the news. Reliance on official
The usefulness of this theory de- value of fairness. That statement-ob- sources, because they seem to be more
pends not only on an individual jectivity no, fairness yes-is the journal- credible or objective, is an example of a
journalist's ability to separate those ists' way of coming to grips with the fact routine. Objectivity can be described as
things-which can be doubted-but that the intellectual validity of objectiv- a set of these routines. A very common
one would be quoting both sidt:s in a
political dispute. One of the ways that
objectivity gets translated into a routine
The Project on Public Life and the Press is operated by the Kettering Foun-
is through the ritual of balance and the
dation in collaboration with the JohnS. and James L. Knight Foundation notion of both sides having their say in
and New York University. Financed by a $513,000 grant from the Knight the news columns.
Foundation, the Project will push the concept that the press should play a The weakness of balance has been
·. ·more active role in the revival of civic life and the improvement of public noted many, many times: On the one
giscourse. Over the next two years workshops will be held for journalists who hand the Tobacco Institute says smok-
ing is fine and actually improves your
are or want to be engaged in relevant experiments . Two summer institutes
health, but on the other hand the Ameri-
are planned for those who want to deepen the theory and advance the prac- can Cancer Society says smoking will
tice. These events will be hosted by the American Press Institute. Professor kill you. There you have it. That's an
Jay Rosen welcomes suggestions and questions. Write to him at the Depart- extreme case, of course, but the prob-
ment ofJournalism, New York University, 10 Washington Place, New York, lem of on-the-one-hand, on-the-other-
NY 10003. hand journalism shows us that often
balance is a flight from truth rather than

Nieman Reports I Wimer 1993 49

an avenue into truth. It's a way of dis- this morning. This is part of what we the story. The discounting of the advice
avowing your responsibility for the might call the cunning of objectivity. hurt The Times, which was for a time
whole problem of truth . This is why You can look at objectivity, then, as a underplaying the story. Needless to say,
some scholars see objectivity not as a device, not only for devaluing criticism, it was also an important factor in those
declaration of responsibility but as a which it does , but even more inge- years when many people were becom-
way for journalists to escape responsi- niously for producing a form of criti- ing infected without knowing about the
bility for the truthfulness of their ac- cism that is easily devalued. Objectivity virus, which is a public tragedy. The
counts. gets everybody to argue about bias in Times was hurt because it couldn't hear
Objectivity as balance has another the news columns. It causes everybody its own environment talking to it due to
interesting purpose to it that is little to say, "You're not objective. You 're this subtle way of devaluing criticism.
noticed. When you go out and wade biased," which immediately causes a This is a serious problemforsociety,too.
into the political realm in pursuit of journalist to regard that critic as biased, The fourth way of understanding
objectivity-and this is perhaps the most
unusual way of thinking about it-is to
say that objectivity is a technique of
Objectivity gets everybody to argue about bias in the persuasion, a rhetorical strategy. If I
news columns. It causes everybody to say, "You're want you to accept my account of the
way things are, there are a lot of choices
not objective. You're biased," which immediately I have. I can try, for example, to impress
causes a journalist to regard that critic as biased, you with my passion and conviction.
That's one way of getting you to accept
therefore to discount what he or she is saying. This my account. I can try to speak from a
is probably the most nefarious, insidious effect of common tradition, a set of values that I
know you share, which is another way
objectivity. It produces a kind of criticism that is in to get you to accept my account. I can
fact easily and regularly discounted by journalists try to engage your emotions in such a
powerful way that you can't think of any
themselves, which is a way of living without criti- alternative to my account. That's called
cism. demagoguery. I can assemble a theory
of the way things are that is so powerful
and illuminating and clarifies so much
balance, you tend to see the world a therefore to discount what he or she is that you will accept my account be-
certain way. You tend to see it in terms saying. This is probably the most nefari- cause the theory is so effective . And I
of polarized extremes. You listen for- ous, insidious effect of objectivity. It can get you to accept my account by
and hear-the people on this side say- produces a kind of criticism that is in claiming to speak the word of God.
ing one thing and the people on the fact easily and regularly discounted by Now objectivity is a way of getting you
other side saying the opposite. The easi- journalists themselves, which is a way to accept my account by saying, "Look,
est way to produce the impression of of living without criticism. That's the I don't have any passions. I don't have
balance is to take those two extremes point of Sam Donaldson's saying the any convictions. I don't have the word
and run them together. Part of the ad- people on the left say this, the people of God. I don't have any theory. I'm just
vantage of doing that is that you claim to on the right say that. This allows him telling you the way it is, you see, so
be in the middle. So objectivity under- carte blanche to disregard what every- accept it because this is the way it is." It's
stood as balance helps journalists claim body says. That to me is where objectiv- a technique of persuasion which we can
the authoritative middle ground be- ity becomes extremely damaging to the place alongside a lot of other tech-
tween extremes. And we can also say credibility of the journalist because it niques. All these techniques have their
that it causes them to look for those eliminates the possibility of learning advantages and their disadvantages , but
extremes. Furthermore-you know, the from criticism. the journalist's preferred technique of
more I've thought about it the more I'll give you a serious example. James persuasion is to say, I'm just handing
ingenious I think it is-objectivity has Kinsella, a former fellow at the Gannett you the facts. I don't have any invest-
this cunning ability to devalue and de- Center, wrote a book on the coverage of ment in the facts . I don't care necessar-
flect all criticism. Here's how it works: the AIDS epidemic. In this book he ily about the facts . It's not my problem.
"Well people on the right say we 're too showed how the gay community in New I'm just saying this is the way it is. This
liberal, and people on the left say we're York was trying to tell The New York is also, by the way, a technique of de-
in league with the status quo, which Times that it was missing the story. flecting criticism because the way you
probably means we're right where we Because this advice came from gays, it experience any criticism of news is that
should be, right in the middle." I just was in a subtle sense discounted be- people are blaming the messenger, and
heard Sam Donaldson say this on NPR cause they had the most investment in so on.

50 Nieman Reports /Wimer 1993

 Another way to put this is to say that objectivity is an expression of this very who believes in it and for good reason,
objectivity is a way of generating au- noble, but very necessary, hope that a because everything we've learned about
thority in the culture. By authority I political community might proceed the pursuit of truth tells us that in one
mean the right to be heard, the right to down the path of reason when it dis- way or another the knower is incorpo-
be taken seriously, the ability to be agrees rather than through the more rated into the known. Objectivity has
persuasive in your account of things . common route of violence. That's why the further unfortunate effect of alien-
There are a lot of ways of generating you can't trash objectivity, as some ating the American journalist from in-
authority. Journalists do it through this people-particularly some academics- tellectual debate and intellectual con-
means of persuasion called objectivity.
We tend to think of persuasion as some-
thing that belongs on the editorial page. ... objectivity is a way of generating authority in the
But persuasion is constantly being en-
acted through all the devices of journal-
culture. By authority I mean the right to be heard,
ism. Consider something as simple as the right to be taken seriously, the ability to be
Washington, April15- persuasive in your account of things. There are a lot
the dateline that appears in dis- of ways of generating authority. Journalists do it
patches to The New York Times from through this means of persuasion called objectivity.
the capital. In the newspaper published
April 16, they'll say Washington, April
15. The Times I think is the only major are inclined to do. The pursuit of a versation, which is a very dangerous
newspaper left that does this, but why disinterested truth is vitally important thing. In fact, in other political cultures,
does it bother? It's a little technique of to any democratic political community. the separations between intellectual life
persuasion. The dateline says: the re- This is why objectivity is important. It and journalistic culture are not as great,
porter was there. He was there on that encourages us to agree on some things but in America the divide can be a large
date and he's sending us an account so that we can disagree productively on one. Part of the reason is that intellectu-
from this place. That's why you should other things. als familiar with the currents in 20th
trust it. Washington, April15.1t's a little So those are five ways of understand- Century thought just can't deal with
device of persuasion. The news is rife ing objectivity. What are some of the some of the things that come out of
with persuasive techniques of this type problems? Well we've already talked journalists' mouths. (Of course the re-
and you can call the set of those tech- about some of them. verse is also true, but that's another
niques objectivity. First of all, as a contract, the employ- talk.) I know it sounds condescending
Finally, a fifth way to understand ers aren't holding up their end of the to say but some people in academic life
objectivity is as the expression of a very bargain. That means there's now a ques- think it's useless to try to talk with
noble and necessary ideal in a democ- tion out there, and this is going to be a journalists because of this stumbling
racy. That is the notion of a disinter- crucial question in American journal- block of objectivity-also known as
ested-not an objective, but a disinter- ism in the next five years. What are naive empiricism. This is unfortunate
ested-truth. That is, it expresses the journalists going to do in response to because the two groups not only have a
hope that a political community might the withdrawal of this contract? One lot to say to one another but they're also
agree on some facts so that it can dis- thing they can do is turn into adjuncts kind of in a similar position. Neither of
agree productively about others. Ob- of the marketing industry. That's one them can prosper if the values of a
jectivity is one of the culture's ways of option. The other option is for journal- commercial culture are the only values
expressing this hope that the political ists to try to reclaim some kind of public that matter in this society. The two
community will be presented with a support for doing what only they can groups-journalists and intellectuals-
common object, so that members of the do. That is, they have to get the public need to support each other.
community can take different views of on their side, and objectivity is a very Another reason objectivity is break-
that object and be able to disagree pro- poor philosophy for doing that. It's an ing down is that it conflicts with certain
ductively about it. The common object extremely weak way of persuading the other deeply held values in journalism.
is important because we know if people public that journalism deserves a place And it conflicts dramatically. Take, for
disagree about everything, about their in the culture that might otherwise be example, the notion of journalist as
definition of the situation, about what eclipsed by the entertainment machine. watchdog, which is very heavily in-
they regard as a fact, about what's hap- In any event, objectivity as a contract is grained, especially in the elite press . It
pening at the most basic level outside breaking down. That raises the ques- just doesn't fit well with notions of
their windows , if they disagree about all tion what's going to replace it. objectivity because a watchdog is far
of that, they're not going to be inclined Secondly, objectivity as a theory of more assertive than objective. It also
to argue with each other. They're going how to arrive at the truth is bankrupt conflicts with the most basic thing about
to be inclined to kill each other. So intellectually. There isn't anybody else journalism as an activity, which is

Nieman Reports I Wimer 1993 51

storytelling. Imagine saying about a fa- languages of The Times. She's doing
mous storyteller in, say, a traditional In fact, Maureen something that's completely different
village, that what made him so wonder- from what Times reporters have tradi-
ful was that he was always completely
Dowd's beat, which is tionally done. The way The Times ex-
objective. It is simply not a characteris- whatever Maureen's plains this to itself is to say, well, we like
tic of a skilled storyteller that he or she Maureen's voice. We 're getting her voice
thinking, is the route
is objective. Yet journalists will simulta- into the paper. That's okay. But what it
neously assert these two things about by which objectivity is means is that what's valuable about
their work. They're objective and they breaking down in the Maureen Dowd is not the facts she
tell us stories. The two values are in assembles but in a way, who she is.
conflict. We see this especially in televi- very citadel of objec- She's valuable as a person to The Times.
sion where there is such heavy empha- tive journalism, The In fact, Maureen Dowd's beat, which is
sis on drama that routines and rituals of whatever Maureen's thinking, is the
objectivity just go by the wayside. "60 New York Times. Right route by which objectivity is breaking
Minutes" is sometimes an example of at the center, it's com- down in the very citadel of objective
that. journalism, The New York Times. Right
Still another reason that objectivity is ing apart. at the center, it's coming apart.
breaking down is that television places That whole problem, voice, raises
heavy pressure on the journalist to ex- that very profound issue of what ought
hibit a compelling personality. When a ist as a person, or persona. to be the voice of the journalist. What
person shows up on our screens to tell In print, also, objectivity is breaking should that voice be like? What is that
us about the world, we want to know down for a lot of reasons . The primary voice? If it's just a collection of preju-
about him or her. That's not true in one is that print journalism needs to dices and random fluctuations of the
print. Wewantto know something about add value in a world where information events of that person's life or their per-
that person, about our relationship to circulates almost by osmosis. People sonality, who cares about that? If jour-
him or her. We want to know what they already know about the news. They get nalism is supposed to have a voice,
care about. The people who are most the news through their skin. They get it what does this voice sound like? How is
successful on television are not the through CNN. They get it through 24- this voice cultivated? Where should it
people who strike the audience as ob- hour radio. So what do print journalists be heard? How should it be heard?
jective. They're successful because do? They used to just give them a sum- Those are some very profound ques-
somehow they engage the audience, mary. What do they give them now? tions, and you can't answer any of those
present a persona that is attractive, cred- Well increasingly it's things like context questions through the rhetoric of ob-
ible, elusive, entertaining, whatever. and perspective and interpretation. As jectivity.
Look at somebody like Bill Moyers and soon as you say that what you 're giving Finally, objectivity is most valuable,
his effectiveness on television. Conser- people is context, perspective, analysis, most indispensable when people need
vatives can wail all they want about his interpretation, you 're out of the realm a fair description of what's going on in
liberal bias, but there's a reason why he of objectivity, and you're into a territory order to engage in a purposeful activity.
is so popular. The reason is that he 's a where the intellectual weaknesses of They need to know what's happening
very American character and his success journalism become very important. in order to take action, make a move,
is due to his ability to project that char- There is no such thing as context with a protect their interests. When business
acter. One can say the same about Mike capital C. There's no such thing as inter- people have investments in, say, Thai-
Wallace or even Ted Koppel. What's pretation with a capital I. You can't land, they need to know what business
effective about Koppel is that he seems supply these things in some simple, conditions are like in Thailand. And
to be prosecuting a discussion based on straightforward way. You can only sup- they'll usually want "objective" reports.
a certain conviction about the way dis- ply them from a certain perspective. That's been one of the traditional de-
cussions should go. And people, if they You need a view of the world. That's mand factors in journalism-informa-
trust him, trust him because they know your added value. tion upon which you can act. But what
he cares about having that discussion, I would estimate that 50 percent, happens if people stop acting? Stop
not about putting people on the spot possibly more, of The New York Times caring? This is a serious problem in the
for its own sake. It's a very different kind 1992 election year coverage went un- political sphere, especially in the United
of style from Sam Donaldson. I think der the banner of news analysis, cam- States. As people become disengaged
that's why even people who have a lot paign memo, reporter's notebook, or from politics, an objective treatment of
to lose by going on the air, will go on the some other "sig" that identifies it as politics begins to lose its point because
air with Koppel when they would never something other than straight report- you're not addressing anybody any-
go on the air with Sam Donaldson. The ing. You cannot explain the presence of more. They've fled the scene. They're
point is that objectivity is undermined somebody like Maureen Dowd in The turning off and going in the opposite
by television's emphasis on the journal- New York Times in any of the inherited direction. They're heading toward pri-

52 Nieman Reports /Wimer 1993

vate life, which is more engaging, more thing that mattered to him. He said, be on their way to a new approach. I call
important to them. So this has led to the "Look, Mr. Buckley I care about this. it "public journalism," a theory and a
argument-and I've argued it in many Now tell me, as a Jew ... " This hints at practice that recognizes the overriding
forums, before many different kinds of what I'm calling the new theory of cred- importance of improving public life. In
journalists- that journalism should be ibility. You demonstrate your credibil- the next few years, it will be critical for
involved in re-engaging people in pub- ity because you're concerned, you care, people in journalism to declare an end
lic life. Objectivity is a very bad, un- you're invested. Therefore what you do to their neutrality on certain questions.
workable philosophy for that task of re-
engaging citizens in politics and public
life. That to me is one of the big chal- ... the solution to the puzzle lies with another impor-
lenges facing journalists right now.
The success that the various news tant term-democracy. As long as journalists assume
organizations have had in sponsoring that democracy is what we have, they'll continue to
this re-engagement came because they
consented to question objectivity. They rely on objectivity, and suffer from its weaknesses.
are in effect developing a new theory of But if they can find a way of seeing democracy as
credibility. The new definition is com-
ing out of the experiments we are see- something we do, or better yet, as something we
ing in the newspaper world in Char- must create, re-invent, re-imagine, then they'll be on
lotte, Wichita, and Columbus, Georgia.
In the old theory, credibility follows
their way to a new approach. I call it "public journal-
from detachment and distance. You're ism," a theory and a practice that recognizes the
credible because you're not involved.
overriding importance of improving public life.
You're not interested, you have no stake.
Under the new theory of credibility,
credibility follows because you're con-
cerned, because you care, because it as a journalist matters. For example, whether people partici-
matters to you what happens in the Perhaps the deepest puzzle about pate or not, whether we have genuine
community. And you gain credibility in objectivity is what should replace it. debate in this country, whether the
the community because you demon- With all its flaws it still expresses certain political system works, whether public
strate that you do have a stake in deeply held and legitimate values: the life draws the attention of citizens,
whether, for instance, the community notion of a disinterested truth, the wish whether political leaders earn our re-
faces its problems or runs and hides. to separate doing journalism from do- spect. As they begin to realize that they
I was watching Gabe Pressman with ing politics, the principled attempt to cannot afford to be neutral on these
William F. Buckley on a Sunday inter- restrain your own biases, looking at questions, they will perhaps struggle
view show. Pressman is a longtime local things from the other person's perspec- toward their own philosophy, one that
reporter on WNBC and Buckley had tive. These are important values for all can replace objectivity with something
just written a 20,000-word article on of us, and particularly for journalists. stronger, and, if I can put it this way,
whether Pat Buchanan was an anti- You can't just wave them away by saying more inspiring.
Semite. He concluded that Buchanan "objectivity is a myth." Still, it is a myth, I'm not sure it's inspiring, but I like
sort of was anti-Semitic but sort of in some ways a dangerous and distort- to tell my students that journalists are
wasn't, either. Pressman is trying to ing one. So what might be a better people who make things. This always
understand what Buckley is saying and myth? Or, to put it another way, what confuses them at first, because every-
Buckley is giving him these convoluted would be a stronger public philosophy thing they've been told states that jour-
answers. Pressman finally says, "Listen for journalists? nalists are people who find things-
Mr. Buckley, as a Jew should I consider I'm more confident about the impor- stories, facts, news. If journalists do, in
Pat Buchanan my enemy?" Normally tance of the question than I am about fact, make things, then their field is an
one would think that if a journalist says, my own answer, butiwouldsaythatthe art, not a science. We might say that
"as a Jew," this undermines his credibil- solution to the puzzle lies with another journalism is one of the more impor-
ity. Brit Hume doesn't say, "as a Repub- important term-democracy. As long tant arts of democracy, and its ultimate
lican, I can tell you today that President as journalists assume that democracy is purpose is not to make news, or repu-
Bush ... " because he assumes that the what we have, they'll continue to rely tations, or headlines, but simply to make
admission would destroy his credibil- on objectivity, and suffer from its weak- democracy work. With that as the
ity. But the interesting thing is that in nesses. But if they can find a way of journalist's declared objective, "objec-
this case, it improved Pressman's cred- seeing democracy as something we do, tivity" may lose some of its prestige. It's
ibility, because he cared about the an- or better yet, as something we must not a loss we should mourn. •
swer to this question. This was some- create, re-invent, re-imagine, then they'll

Nieman Reports I Winter 1993 53

 Public Journalism-an Early Attempt

BY BILLY WINN

olumbus Beyond 2000 was one originated in 1987 with Tom Kunkel, and community leaders to a sympo-

C of the more interesting-and

controversial-community
journalism projects of the 1980's. It was
then the paper's young editor. At the
outset, Kunkel, an Indiana native who
came to The Ledger-Enquirervia Knight-
sium on the city's future. The sympo-
sium, which was well-attended, was held
at the Columbus Iron Works Conven-
undertaken by The Columbus Ledger- Ridder in Miami, simply wished to find tion & Trade Center on June 9, 1987.
Enquirer, a Knight-Ridder newspaper out what the residents of Columbus Ideas generated in this symposium were
with adailycirculatiop of around 60,000, wanted the town to be like at the turn of used to formulate questions for an in-
most of it in Columbus, Georgia and the century. Certainly he wanted The dependent survey or poll conducted by
Musco gee County, a rather isolated com- Ledger-Enquirer to play a constructive KPC Research of Charlotte, NC , a sub-
munity located on the Chattahoochee role in bringing about much-needed sidiary of K-R.
River in the west-central part of the changes in Columbus, which was The Ledger-Enquirer forked over
state on the Alabama border. troubled by geographic isolation, slow $5,000 for the survey, really a random
Columbus is a cotton mill and mili- economic growth, near zero popula- telephone sampling of 411 households
tary base town-Fort Benning is a few tion growth-the young were fleeing to in Muscogee County. Each respondent
miles south of the city-of 180,000, 35 Atlanta and other large cities-low was asked 20 questions, ranging from
percent of whom are black and a signifi- wages, and a functional illiteracy rate "Do you think that Columbus as a place
cant portion Hispanic and Asian-Ameri- approaching 40 percent. But the initial to raise a family is getting better, getting
can, mainly wives and offspring of mili- purpose of the project was simply to worse, or staying about the same?" to
tary personnel. It's a town whose Old find out what the people wanted their "Do you think blacks have the same
South atmosphere lingers despite de- town to be like at the turn of the cen- chance to get ahead economically as
termined efforts by boosters to change tury. whites in Columbus?"
the city's image to Sun Belt South. To get the project started, Kunkel A second and more subjective survey
The idea of Columbus Beyond 2000 invited several dozen local residents was prepared by this writer, a native of
Columbus, who was senior writer for
the Beyond 2000 project. I asked re-
Billy Winn is Editorial Page Editor of The porters and editors in the newsroom
Columbus (Georgia) Ledger-Enquirer, where for ideas, and, drawing on my own
he was senior writer on that paper's Colum- knowledge of the city, put together a
bus Beyond 2000 project in 1987-88. He questionnaire. It was circulated to com-
was a reporter for The Atlanta journal in the munity leaders selected from a mailing
Sixties and has been both a magazine writer list supplied by the Columbus Chamber
and editor. His journalism has appeared in of Commerce. I also personally took
such publications as American Heritage, the questionnaire to ministers, includ-
Argosy, Audubon, Rolling Stone, Atlanta ing black ministers, political leaders
Magazine, Washington journalism Review and people locally prominent in the
and many others. He is currently working on arts. Among the questions posed on
a series ofbooks about the etiology ofracial this questionnaire: "What is the worst
violence in Columbus, his home town. feature of life in Columbus?" "Do you
want Columbus to become larger and
more populous or to remain as it is?"
While the surveys were being com-
pleted, a team of reporters was formed
under the direction of city editor Jeff
Davison. Their assignment was to pre-

54 Nieman Reports /Winter 1993

---------------------------------------------------------------------------------------------------------- - ------

pare a special section dealing with the tried to offer an agenda based on what vice and guidance. In cooperation with
city's problems and prospects. Hun- we had learned from our research and other organizations, and with Ke ttering
dreds of citizens of Columbus were from the people of Columbus. For ex- assistance , the newspaper began to
interviewed by the reporters, who ulti- ample, we recommended greater diver- sponsor a number of town hall meet-
mately worked with a thorough knowl- sification of Columbus's economic base, ings on such subjects as education, teen
edge of the findings of both surveys. more emphasis on road development, problems and the like.
This gave a depth to the interviews that better daycare facilities for working Swift, who is perceived in Columbus
otherwise would not have been pos- mothers, construction of a new civic and by some executives in Knight-Ridder
sible. We knew, for example, that people center and public library, greater in- as both the originator and chief spokes-
considered the number one problem in volvement of minorities in all aspects of man of the United Beyond 2000 idea
the city to be low wages and lack of job city life, more support of the arts by (the Task Force changed its name in
opportunities. They were also con- government and business and aggres- 1990) , began to have a series of "back-
cerned over lack of leadership, racial sive protection of the local environ- yard barbecues" that drew people from
and sexual inequalities, education, the ment. all races and walks of life. Several par-
condition of the roads and the lack of When it was finally published, some ticipants said it was the first time black
adequate recreational opportunities and business leaders said it was too nega- and white leaders had ever met in the
facilities. They also clung to an old tive. Others questione d some of the city in a social setting.
belief that five or six prominent fami- conclusions, particularly those relating Meanwhile, Swift also gave Ledger-
lies, usually identified as owners of the to low wages, race relations (which we Enquirer reporters numerous assign-
local cotton mills, really ran the city and said, accurately, were very poor) and ments on topics suggested by the origi-
made all the key decisions that affected lack of leadership. But most people nal Beyond 2000 research . These
its people. We also knew that the people thought the section was good journal- assignments appeared as one-shots or
who responded to the surveys said they ism and said so. As it turned out, the as long series. They ranged from stud-
were most proud of Columbus's friendly solid, objective research represented ies of the economic impact of the mili-
people, small-town atmosphere and the by the surveys was an important ele- tary at Fort Benning to a four-part series
quality of life the city afforded. ment in ultimately establishing the cred- on what other river communities were
While the special section was in ibility of the package. doing to develop their river fronts. A
preparation, Tom Kunkel suddenly an- Although some of us were concerned special Beyond 2000 logo appeared with
nounced his resignation to go into busi- about the inclusion of an agenda in the each article.
ness for himself, and Jack Swift, The section-to me it represented a subtle Soon the paper's overworked report-
Ledger-Enquirer's managing editor, was but significant change in the project's ers began to feel as if their entire profes-
selected to be his successor. Kunkel intent-we still felt we were within the sional careers had been taken over by
had been so closely identified with the bounds of traditional journalism. This Beyond 2000. Certainly I felt that way.
origin and preparation of the project changed for many reporters however, An attitude survey taken of the news-
that some of us wondered if it might not when it became clear that the paper was room employees at that time revealed
be abandoned altogether after he left. not going to just publish "Columbus tremendous hostility toward the project
At first, Swift did regard the Beyond Beyond 2000: Agenda For Progress," and, say some who saw the report,
2000 project with suspicion. And al- but that Swift, prodded by community toward Swift.
though in time he was to become its leaders, was leading us deeper and InN ovember of 1990, Jack Swift shot
most enthusiastic supporter, he was deeper into an activist role in the city. himself. So closely had Swift been iden-
initially very concerned that some of At first , the reporters merely sensed tified with Beyond 2000 by the paper's
the articles were not comprehensive the change, but soon it was announced management that, following his death,
enough. The result was that Swift re- that a Beyond 2000 Task Force was The Ledger-Enquirer abandoned the
quired additional research and consid- going to be formed , with a steering project. No newspaper news personnel
erable rewriting of the material. What committee, to help implement the Be- remained on the task force steering
had been envisioned as a fairly straight- yond 2000 agenda in the community. committee and the paper ceased spon-
forward project of a few months gradu- Swift assumed a leading role in the soring town hall meetings and the sort
ally stretched into six months then nine formation of the Task Force and the of backyard parties Swift had favored.
months and then a year. By the time the selection of its members, and he was on To date , no more Beyond 2000 stories
special section was published May 29- the steering committee, as was this re- have appeared in The Ledger-Enquirer.
June 5, 1988, 13 months of research porter. However, United Beyond 2000, the task
and writing and hundreds of hours of The pace really picked up when the force , remains active in the community,
reporters' time were involved . Kettering Foundation of Washington although in a greatly modified form
We called the final product "Colum- was asked by Swift to apply its expertise with a much lower profile.
bus Beyond 2000: Agenda for Progress." in community organization to the Be- Whereas some journalists, including
In it, we recommended a number of yond 2000 project. Several of their some editors within Knight-Ridder, felt
much-needed civic improvements and people came to Columbus to offer ad- The Ledger-Enquirer should never have

Nieman Reports I Winter 1993 55

attempted a project of the nature of arion was a key element in reporters, including those not directly
Beyond 2000, far more people in Co- Columbus's getting the 1996 involved in the project. Once resent-
lumbus are disturbed with the newspa- Olympic women's fast-pitch ment to Beyond 2000 had developed in
per for having begun something it did softball competition, a tremen- the newsroom it tended to mushroom
not finish . Others simply wonder why dous coup for the city. into criticism of even of the most valid
we dropped a project that seemed to be • Racial dialogue was reopened in aspects of the project. It would have
having such a positive effect on the the city and friendships were been a simple matter to explain to the
town. formed between blacks and news staff exactly what the purpose of
Over the past 24 months I have re- whites that promise a new day in Beyond 2000 was and why the editors
ceived numerous inquiries about Be- race relations. The significance of felt it was worthwhile. But the fact is this
yond 2000 from journalists around the this accomplishment cannot be was never done.
country. Most want to know the answer overstated in Columbus, a city It can't be emphasized enough, how-
to three questions: Was anything ac- with an active NAACP desegrega- ever, that whereas some reporters said
complished by Beyond 2000? What did tion suit against its school system we went much too far in our involve-
we learn as a result of the experience? and a truly violent racial history. ment in the community, residents of
And where, if anywhere, did we go Columbus criticized us for not having
• A new class of leaders has
wrong? gone far enough. The bottom line is
emerged from the Beyond 2000
The answer to the first question, in that people who subscribed to and read
Task Force. Many of these new
my opinion, is that . a great deal was the newspaper liked Columbus Beyond
leaders are from the city's grow-
accomplished: 2000. Even today, I rarely go anywhere
ing but heretofore silent middle
• The original newspaper project in the community that someone doesn't
class. Many are black or female.
was solid work which has proved ask me why we are no longer sponsor-
Undoubtedly, the Beyond 2000
its value to the community many ing the project. Recently, we have had
project played a significant role
times over. So substantial was several groups of community leaders
in giving these new leaders a
that work that the city govern- come speak to us about what they think
voice.
ment used many of the paper's the paper should be doing. Re-start
• It's a subjective judgment on my Beyond 2000, many of the leaders
original findings in planning its
part, but the city does seem to pleaded.
own agenda for Columbus.
have a new sense of its destiny Projects such as Beyond 2000 tend
• The current mayor, Frank Martin, and a more realistic view of itself to snowball, and what starts as an ambi-
ran on what could be called the as a result of information devel- tious but still quite manageable enter-
Beyond 2000 platform. Although oped in the original Beyond prise can turn into a monster that threat-
Martin is an inexperienced politi- 2000 project, i.e., there is no ens to consume an entire news
cian, he is a determined, progres- substitute for hard data and good operation. For this reason, it is impor-
sive leader who has worked hard reporting. tant to limit the amount of resources
to bring blacks and whites to- What did we learn and what would placed at the disposal of such projects.
gether and to move the city we do differently? Certainly, daily journalistic responsi-
forward economically and so- We probably should not have be- bilities should never be sacrificed in
cially. come so deeply involved in the forma- favor of special projects.
• This year, Columbus voters ap- tion of the task force or taken such an Finally, it could be argued that our
proved a 1 cent sales tax increase active role in the steering committee, greatest failing was in not learning to
that will finance more than $170 although, at the time, none of us saw say no when community leaders asked
million in civic improvements, how we could have avoided doing ei- us to help them with a project. When we
including a new civic center, $30 ther. We were directly asked by many said yes it inevitably expanded our ac-
million in new parks and recre- townspeople to take the lead. If we tivist role. As already stated, we were
ational facilities , and a new declined or tried to get someone else to aware of this and yet we seemed power-
police and fire building. A beauti- do the job, whatever Beyond 2000 less to stop ourselves. Once you admit
ful new Riverwalk now meanders project we were working on at that that you are part of a community, saying
along the banks of the moment usually faltered. The choice no to that community is like saying no
Chattahoochee in the city's seemed to be lead or abandon Beyond to yourself. •
downtown, and a variety of river 2000. We decided to lead.
front development projects are The message is you can't be half-
on the planning board, including pregnant and you can't be half-commit-
a riverboat museum , shops, ted to the type of community journal-
hiking trails, a public marina and ism represented by Beyond 2000.
an 18-hole golf course. More attention should have been
• The sales tax money for recre- paid to the feelings and perceptions of

56 Nieman Reports /Winter 1993

 A Year Later, Campaign Continues
Lessons of 1992 Race Go Unheeded by the Media
And Clinton-Neither Faring Well With Public

Robert D . Deutsch (standing) is Selden Biggs is a Senior StaffMember

Director ofthe Communications and International Policy Analyst at
Planning and Evaluation Laboratory BDM Federal, Inc., in McLean,
(COMPEL) at EBR, Inc., in Virginia, where he provides policy and
Vienna, Virginia, where he consults information systems support for govern-
on public image assessment for ment clients. Biggs conducted his
government and corporate clients. graduate studies in political science at
Dr. Deutsch contributed to the Harvard University where he wrote on
Spring 1992 issue ofNieman Re- communication and participation in
ports, writing on artifice and authen- Communist and other authoritarian
ticity in Presidential campaign countries. Prior to working for BDM,
imagery. He also wrote a series of he taught political science at the Uni-
articles on media images ofthe Gulf versities of California and Montana
War for The Chicago Tribune and and worked as an analyst for the
with Selden Biggs coauthored a series Library of Congress.
ofarticles on Campaign '92 for The
Atlanta journal Constitution.

BY RoBERT D. DEuTscH
AND SELDEN BIGGS

ore than a year has passed that the "medium is the message." But nalism or tabloid news or better ethical

M since the end of the 1992 Presi-

dential campaign and neither
the President nor the media seems will-
neither is faring particularly well in the
eyes of the public and both rightly sus-
pect that the landscape of American
standards. The real dilemma is institu-
tional in nature and technological in
origin. The 1992 Presidential campaign
ing or able to let go of the campaign politics has shifted beneath their feet. marked the beginning of an era where
experience . This nostalgia is under- Marshall McLuhan was half right . The the audience calls the shots in the three-
standable but unproductive when the medium has changed the message but it cornered conversation between politi-
future of the nation is at stake and not has also transformed the audience . cians, press and public. When com-
just the name of the Oval Office's occu- Despite-or actually, because of-the bined with the oddsmaker's mentality,
pant. Despite a characteristic fit of Mon- proliferation of media channels and saturation coverage ofPresidential elec-
day-morning quarterbacking after the presentation formats, the public is sav- tions turns the media into voyeurs, cam-
November election, the Clinton vier than ever about the differences paigns into caricatures and government
Administration's abortive honeymoon between form and content, between into gridlock. The media cannot fruit-
and friction between the White House performance and reality. The audience fully reflect on its own behavior and
and the White House press corps com- has become more sophisticated than prepare for the future without first un-
bined to put retrospection on the back either the nation's leaders or their coun- derstanding the changing environment
burner. Both the President and the press terparts in the mass media. The prob- of Presidential campaigning in particu-
prefer to deal with each other in cam- lem for the President is not the mechan- lar and American politics in general.
paign mode. And both want desper- ics of media presentation and the issue
ately to believe with Marshall McLuhan for the Fourth Estate is not pack jour-

Nieman Reports I Winter 1993 57

Preview then surely by the candidates. For both Second, Presidential elections are
Reporters would like to believe that reporters and commentators, Presiden- governed by an ever-changing set of
everything is contingent-that any event tial campaigns can be the time of their institutions that bias the process in
can change the course of history and lives. favor of certain types of candidates and
that every action can be accounted for. certain kinds of campaign strategies. By
Fate hinges on the tiniest of details, the frontloading the primary season and
The Hidden Logic
most improbable of accidents and the putting a premium on early fund-rais-
Of Presidential Campaigns ing, the electoral reforms of the 1970's
most ephemeral of motives. It is the
reporter's calling to be there when it The outcome of American Presidential and 1980's have effectively excluded
happens, to bear witness to those un- campaigns is determined by the inter- members of Congress from the pursuit
foreseeable moments when history is action ofthree factors: context, institu- of the Presidency and have tilted the
made by individuals both famous and tions and persona. Although the media system in favor of least-common-de-
humble. In a contingent universe every serves as the synapses through which nominator candidates adept at personal
story must be covered as if Deep Throat these three elements interact, the What and financial networking. Rules matter.
were on call waiting and Lee Harvey and-to a large extent-the How of Bill Clinton is President today because
Oswald were lurking in the shadows. If media coverage are governed by the the Democratic primary season handi-
it didn't matter, the reporters wouldn't context of public opinion, the institu- capped the Washington favorites, dis-
be there. tions of Presidential campaigns and the couraged the ideologues, and short-
Commentators, in . contrast, keep public persona of the candidates. Me- ened the half-life of the Gennifer Flowers
score. They give their audiences the dia impact on the course of American story.Journalists do not make the rules,
line-up, second-guess the managers and Presidential elections is less than either but the rules of the game determine the
analyze the instant replays. While re- voters or candidates fear and far less role of journalism at each stage of the
porters act as if there were no tomor- than members of the media imagine. campaign.
row, the future is what makes commen- In the first instance, every quadren- Finally, personality or persona has
tators tick. They are always recapping nial Presidential election takes place in become the focus of both primary and
the past and anticipating the future. a context or climate of public opinion. general election campaigning in the era
Scorekeeping assumes beginnings and The longer the campaign season, the of TV narrowcasting. With the omni-
endings, starting gates and finish lines greater the impact of such external fac- present camera pursuing the candidate
and the ability to track progress in be- tors as the state of the economy and the into the deepest recesses of his per-
tween. The commentators' universe is state of world. Conversely, the longer sonal life, the key issue is voter comfort
causal and linear. Yesterday's results the campaign, the less the impact of the with the two-dimensional image that
determine the morning scratch sheet media in general and media stories in inhabits the television screen. It is easy
and today ' s stumble will affect particular. Where political elections are to forget that Bill Clinton was once the
tomorrow's outcome. The commenta- foreshortened, as in Britain, local events faceless governor of a small state before
tor takes the reporter's scoop and turns or even clever campaign tactics can Gennifer Flowers, the New York pri-
it into useful intelligence. temporarily surmount even the worst mary, the draft and marijuana issues,
Presidential elections are the Prom- and a gig with a saxophone turned a
ised Land ofAmerican journalism. From boyish-looking hopeful into "The Man
the reporter's perspective, contingency from Hope. " Public persona is a jigsaw
Media impact on the puzzle whose overall impact is beyond
is ever present-a tearful press confer-
ence, an incriminating photograph, or course of American any individual's control. Journalists, like
a well-aimed bullet can turn the world the candidate and his handlers, define
Presidential elections the pieces, but it is the public that
on its head. Commentators are also in
their element because the stakes are is less than either interprets the bigger picture.
high, the players are known, the finish voters or candidates In the following pages we explore
line never moves and only the outcome the impact of context, institutions, per-
is in doubt. The quadrennial race for fear and far less than sona, and finally the media itself upon
the White House is a national ritual, not members of the media American Presidential elections. It is
a national emergency. The issues are these elements and their interaction
predetermined and commentators need imagine. that determine the outcome of the elec-
only dope out the results. They may tion season and the impact-if any- of
guess wrong, they may behave irrespon- journalists' behavior and editorial deci-
sibly, they may even rattle the players, of economic or social conditions. If the sion-making. The technology may be
but they cannot change the rules of the 1992 Presidential campaign had been different and the role of the Establish-
game. Most importantly, they will be only three weeks long, H. Ross Perot ment Press may be much diminished,
listened to, if not by the public at large, would be in the White House now. but the situations and choices facing
today's reporters have changed little

58 Nieman Reports /Winter 1993

since the days of Ben Hecht, "The Front countervailing reporting. No single jour- dramas in three acts. Each act has its
Page," and "His Girl Friday." All the nalist or pack of journalists can change own script and each act concludes with
media debates about presentation for- the underlying realities of context. Me- the thrill of survival and the agony of
mats, information-gathering techniques, dia feeding frenzies may be ugly to defeat. Journalists are paid to report on
and journalistic restraint will make no watch, but they rarely have lasting im- the action and comment on the
difference whatsoever without a deeper pact. In retrospect, the Gennifer Flow- storyline, but they are also key players
understanding of the forces shaping ers affair mattered little to a public in the production. Despite media aware-
the actions of candidates, voters, and more concerned with the economy than ness of their dual status, both reporters
media alike. The media, too, is a player and commentators are inevitably cap-
in this drama and needs to understand tured by the contingencies of the mo-
its part. ment and lose sight of the bigger pic-
No single journalist or ture. They turn Presidential campaigns
pack of journalists can into political techno-thrillers and be-
Context come obsessed with the mechanics of
The context determines public recep- change the underlying the candidates' and their own perfor-
tivity to media reporting of the cam-
realities of context. mances. During the heat of the election
paign. In 1992 the voting public was
season, adrenaline triumphs over un-
unhappy about the economy and even Media feeding frenzies derstanding. Journalists are campaign
unhappier about Bush's apparent pas-
sivity. No monthly statistics, apologies, may be ugly to watch, junkies. They continue to inject cam-
paign sensationalism into the endless
or trips to ]. C. Penny would change but they rarely have muddle of national policy-making. It is
their collective mind. It is no accident
that the prospect of Bush's departure
lasting impact. time to go cold turkey and revisit the
plotting of national elections.
from the White House and the upturn
in consumer confidence occurred si-
with personal peccadilloes. 1992 was
multaneously even before the Novem- Act 1: Prologue
not 1988 and neither the tabloid exposes
ber election. The economy was the is- The first act of the Presidential cam-
nor the editorial sophistry of The New
sue and George Bush was the scapegoat. paign precedes the party primaries and
York Times made any difference.
At one level, 1992 was as simple as that. takes place outside the glare of public
The national agenda is increasingly
Elections turn on the voters' sense of attention. At this time, Presidential
impervious to both the moral crusades
mastery over their fate. Elections are wannabes court disciples and financial
and the scandal-mongering of the me-
the rituals by which voters cede a mea- patrons willing to gamble on a long-
dia. The days ofLincoln Steffens, Henry
sure of control over their lives to their shot and able to go the distance. The
Luce, and William Randolph Hearst are
leaders. To fulfill this bargain, lead- currency of the pre-primary season is
past. With hundreds of cable channels
ers-especially symbolic leaders like the neither dollars nor fame , but rather
and outlets competing for attention, no
American President-must exercise that trust. Trust based on personal relation-
media baron or commentator can manu-
control or fail in their ritual obligations. ships is the glue that holds a campaign
facture a Wendell Willkie, disassemble
Voters tolerate wrong decisions but they together and motivates the commitment
a Joe McCarthy, or sabotage an Edward
do not accept indecision. Presidents of lives and fortunes to a Presidential
Muskie. In an era of narrowcasting,
who tell the voters that events are be- hopeful. In the development of these
stories may capture the public imagina-
yond their control are doomed . By blam- intimate, unmediated relationships, the
tion, but no single storyteller can set
ing Congress and the global recession, media, by definition, cart play no part.
the national agenda.
George Bush only highlighted his fail- Indeed, media attention during pre-
ure to keep his ritual bargain with the primary maneuvering is more a curse
voters. When the public demands ac- Institutions than a blessing. Name recognition and
tion, no half-measures or cosmetic sur- The context determines the fundamen- a national reputation often create ex-
gery will do. Voters hope for success, tal expectations that voters bring to the pectations that cannot be met, foster
accept failure , but need to feel that election process. These expectations illusions that cloud candidate judgment,
someone is in charge. When times are may evolve over the entire course of the and attract support that will not last.
good , their leaders need do little. When election season, but rarely change pre- Visibility in Washington and schmoozing
times are bad, voters look to their lead- cipitously. with the Beltway media has little to do
ers for direction. However, the formal rules and ritual with Presidential campaigning. If it did,
The fundamental perception of po- institutions of American politics also Bob Dole would be President by accla-
litical control rarely hinges on any single matter. Despite quadrennial rewrites mation. As Richard Nixon demonstrated
event or story. The climate of public and a changing cast of characters, the from 1962 to 1968, obscurity has its
opinion moves at a glacial pace that plot remains basically the same. Ameri- advantages.
overwhelms discordant events and can Presidential campaigns are melo- Hence, media focus on the pre-pri-

Nieman Reports I Wimer 1993 59

mary courtship between candidates and tween the candidates and the boys on voters, media pundits and invisible
backers poses serious risks to the candi- the bus is never more intimate and money men. When this oblique method
dates. The superstars, like Ted Kennedy problematic than during the frenzied of candidate attrition is combined with
or Mario Cuomo, are inevitably revealed days and nights on the primary trail. the frontloading of the primary season,
to have clay feet and doomed to disap- Stakes are high, time is short, story the resulting process appears as arbi-
point. Whether manhandled or coddled, cycles are rapid, and the impact of nega- trary and senseless as a drive-by shoot-
they invariably lose stature. tive stories is incalculable. Campaign ing. Hence, the Beauty Pageant phase
However, media coverage is also a reporters and commentators are in nir- of the primary season ends quickly.
mixed blessing for the rookies. Report- vana-they are wooed by the candi- Within two weeks of the 1992 New
ers assigned to Presidential spring train- dates and heeded by the public at large. Hampshire primary only Clinton and
ing are bound to look for local color or The action is furious and the exhilara- Tsongas were still judged viable by the
eccentricity. Candidates deemed minor tion of exhaustion sets in. This is when media and financial handicappers. As
league material can only survive as curi- the performance takes hold and the usual, the Beauty Pageant was over be-
osities or tokens for key constituencies. bigger picture inevitably disappears fore most of the contenders had time to
Tsongas caught media attention in 1991 from view. Understanding may be easy strut their stuff.
precisely because of the futility of his
quest and the oddities of his public
performances. Pierre Du Pont, in con-
trast, was merely obscure and not inter- The national agenda is increasingly impervious to
esting enough to get his fifteen minutes both the moral crusades and the scandal-mongering
in the spotlight. Just like fame, notori-
ety is a double-edged sword. During
of the media. The days of Lincoln Steffens, Henry
the pre-primary season it almost always Luce, and William Randolph Hearst are past.
cuts Presidential hopefuls the wrong
way.
During the prologue to the cam- in retrospect, but it is in short supply The Florida primary marked the be-
paign season, media reporting under- during the Presidential primaries. ginning of the second set piece-the
mines the famous, marginalizes the Journalists already know the basic Duel to the Death. In a duel, the whole
curious, and leaves the merely bland story line of the quadrennial primary logic of the contest changes, and so too
unscathed. During the 1992 pre-pri- ritual. They often write about it but must the contestants . The object is sur-
mary season Cuomo was made to look rarely heed their own words. Like most vival, not excellence. Looking bad mat-
ridiculous, Tsongas was cast as Don dramatic genres, primaries naturally ters little as long as your adversary looks
Quixote, and a pre-Gennifer Clinton divide into a beginning, a middle, and worse. In 1992 the winner of the New
was dismissed as just another smiling an ending. Since 1972 these three phases Hampshire beauty contest was ill-pre-
face in the crowd. Fortunately for the have gradually crystallized into the pared to make the transition to street
Arkansas Governor, The Star saved him Beauty Pageant, the Duel to the Death, fighter . Thus, the position papers and
from overdosing on policy papers and and the Final Ordeal. apocalyptic vision that made Tsongas
propelled him on his way to the Presi- In the beginning, every primary with an early favorite proved fatal in the
dency. three or more genuine candidates is a arenas of Florida, Michigan and Illinois.
Beauty Pageant. In beauty contests the Pandering may be the name of the game
object is to get noticed, to stand out in the primary season, but primary du-
Act 2: The Primary Season
from the crowd. Since voters at this els demand pander bears with brass
It is during the primary season that the
stage are expressing their desires and knuckles.
media plays its most important role.
not their fears, positive vibes are a must When Tsongas's campaign contribu-
The candidates use the media to sell
and trashing one's opponents rarely tors threw in the towel, the 1992 pri-
their wares to a discriminating voting
works. Candidates must sell themselves mary melodrama suddenly lurched into
public. Candidates have a spiel to give
when voters have many to choose from. its third and final phase-the Final Or-
and the media provides both the forum
Making Miss Massachusetts look bad deal. The American presidential pri-
and the amplification. Primaries are like
pays few dividends to Miss Arkansas. As mary season is rigged to leave most
Middle Eastern bazaars. The customers
long as several candidates are still in the party activists and voters feeling power-
are there to buy, the only issue is from
running, the incentives for civility and less. By frontloading the campaign sea-
whom. Hence, the shameless pander-
decorum remain strong. son, the Democratic Party has disen-
ing that characterizes primary contests.
Unfortunately, scoring for the presi- franchised the millions of Democratic
Successful primary candidates are ven-
dential primary beauty contests is not Party faithful voting during the latter
dors, not leaders. Primaries are retail
as scientific as that for the Miss Universe half of the primary calendar. By mid-
politics in the fullest sense of the word.
Pageant. Primary contestants are win- March, the duel was over and Clinton
Therefore, the unholy alliance be-
nowed out in ad hoc fashion by finicky was the only viable candidate remain-

60 Nieman Reports /Winter 1993

ing on his feet even though two-thirds spread. Losers who consistently defy for good government. Fortunately, the
of the primary season was still to come. the odds receive more media attention public at large is wise to this game and
The bazaar had been shut down long and more campaign dollars than win- prepared to exact its revenge . For the
before most shoppers had their chance ners who fail to cover their points. time being there is only H. Ross Perot,
to buy. Clinton lost the New Hampshire pri- but 1994 is already on the horizon.
The result of this tinkering with the mary to Tsongas but won the game of
primary schedule is the ad hoc, voter- expectations. In retrospect, the votes
Act 3: The Rest of the Story
scripted ritual of the Final Ordeal. In counted less than the odds and the
Once the primary bazaar is over, the
1992, as in 1988, the Democratic Party voters were less important than the
media's role in the electoral process
faithful rebelled. Primary voters simply oddsmakers. In the game of primary
inexorably wanes. The party activists
refused to cooperate with their own
disenfranchisement. Beginning with
Connecticut, many just stayed at home
in protest. The remainder, however, Visibility in Washington and schmoozing with the
collectively decided to subject the pre- Beltway media has little to do with Presidential
sumptive nominee to a final trial by fire,
with the voters of New York gleefully campaigning. If it did, Bob Dole would be President
agreeing to serve as judge and jury. by acclamation.
Clinton rallied under fire, and the
minute the pollsters and the media took
Jerry Brown seriously, the Democratic politics, the voters' preferences are
and news junkies have had their day.
faithful returned to the voting booth to merely part of the action. As Tsongas
The nominees' attention turns to the
endorse-however reluctantly-a chas- complained repeatedly, the media and
partisans of Oprah, Arsenio, Regis and
tened Democratic nominee. Part melo- financial handicappers had the final say.
Kathie Lee. Character is the issue and
drama, part slapstick, and wholly The primary campaign took on the ap-
position papers turn into unwanted
scripted, the New York Democratic pearance of a roller coaster driven by a
baggage. The object is to gloss over
Presidential Primary was an ordeal im- predatory media, speculative contribu-
details, to equivocate on commitments
posed on Clinton by voters denied a tors and a Democratic Party leadership
and to appeal to as broad an audience
genuine choice. Using talk shows, me- anxious to get it all over with quickly. It
as possible. Facts, issues and even can-
dia pundits and professional pollsters took the Democratic voters ofN ew York
didate behavior must be pasteurized
as sounding boards for their discon- to reassert their control and bring this
and homogenized. The point is to merge
tent, the New York voters created their roller-coaster ride to a safe stop.
the identity of the nominee with the
own ritual of democracy and rite of The real problem with media handi-
hopes and fears of the nation.
passage for the Democratic nominee. capping of primary elections is that
From the media's point of view, the
Once again, the public manipulated the both reporters and commentators have
end of the primary season means a
media to send a message to the politi- come to view primary campaign cover-
reduction in uncertainty, a decline in
cians. age as the paradigm for political jour-
public readership, and a loss of power.
What is the role of the media in this nalism as a whole. Media distortion of
With its passion for minutiae, its con-
three-stage primary spectacle? From Presidential primary contests is bad
cern for issues and its appetite for ec-
the voters' perspective, there is little enough, but primaries are-after all-
centricity and error, the media are now
difference between campaign corre- contests with contestants capable of
the candidate's enemy.
spondents and campaign financiers. learning from the past and outsmarting
Media discontent with general elec-
Both behave like bookies. Both make the media the next time around. Wit-
tions and general election coverage is
odds on the outcome of the elections ness Nixon in 1968andClintonin 1992.
both inevitable and irremediable. To
and both seem to care more about the Treating the work of Congress and
the extent that candidates succeed in
horse race than the horses. However, the Presidency as an endless series of
getting their image across, journalists
horses don't respond to the daily line, daily or weekly contests may improve
believe they fail in their duty to inform.
candidates do. Like traders in a futures the Nielsens and raise circulation, but it
Election coverage becomes the dogged
market, commentators and contribu- only contributes to gridlock. The deni-
pursuit of gaffes and inconsistencies, of
tors set expectations that the candi- zens of Crossfire and the McLaughlin
failures to live up to the public image.
dates strive to meet. From the viewers' Group have more in common with the
Media complaints about the uniformity
vantage point, the media is just another setting of "Guys and Dolls" than with
and slickness of the Clinton campaign
special interest group with which can- the commentaries of Eric Severeid and
during its final weeks were indisput-
didates must curry favor. David Broder. They are candidates for
able evidence of the cohesiveness, effi-
Moreover, commentators and con- Gamblers Anonymous, not Pulitzers.
ciency and simplicity of the candidate's
tributors share a common interest in Politicians who tune in or play along
performance . And media focus on the
predicting winners and beating the cannot help but mistake good ratings

Nieman Reports I Wimer 1993 61

shifting stratagems and stumbles of the Accident, genius or serendipity had little The deeper issue is how all this atten-
Bush campaign was proof positive of its to do with it. Good analysis did . tion serves-or disserves-the candi-
failures. Media peace of mind is just one Persona, however, is another matter dates, the public, and indeed the media
of the casualties of a well-run Presiden- entirely. In a novel, the genre is obvious itself. Looking back on the 1992 cam-
tial campaign. from the beginning and the mechanics paign season, media attacks on the can-
Finally, if necessity is the mother of of plot development are understood, didates generally backfired. The politi-
invention, then irrelevance is the godfa- but the character of the principals is cal climate had changed and the public
ther of ethics. During the latter part of where uncertainty intrudes. When the had learned the lessons of 1988. Both
the election season the media grows six-pack of unknown Democratic Presi- Clinton and Perot turned the establish-
increasingly irritable at being ignored dential hopefuls first squared offbefore ment media into the villain and made
by both candidates and voters and is a television camera in]anuary 1992, the personal foibles and flawed biographies
unlikely to be seduced by last minute into familiar personas. The "draft dodg-
dirty tricks. Media reluctance to hype ing, womanizing, pot-smoking, gay-lov-
"The Man from Moscow" story during ing" candidate became Commander-in-
the final weeks of the 1992 campaign journalists already Chief while the media's influence and
was entirely predictable. Journalists reputation plummeted. What has hap-
upset with the disappearance of issues
know the basic story pened to the descendants of William
and the cultivation of images are un- line of the quadrennial Allen White and Edward R. Murrow?
likely to collaborate in last-minute per- Persona is a composite of personal-
primary ritual. They ity, biography and challenge. It com-
sonal attacks. It is easy for the media to
behave responsibly when no one is re- often write about it but bines the raw material of individual
ally listening and the candidates are rarely heed their own temperament with the formative expe-
surrounded by walls of handlers and riences of the past and the demands of
Secret Service types. The Colsons and words. the moment. In theory, the three di-
Sassos of politics do their best work mensions of persona are inextricably
during the primary season and Willie linked. Character should be "caused"
Hortons cannot be pulled out of a hat at plot was preordained; only the identity or explained by history and illuminated
the last minute. By Labor Day or soon and ultimate fate of the survivor was in by challenge. In practice, however, the
thereafter, the media is alienated and question. Which one had the right stuff connections between behavior, biogra-
savvy. Desperate candidates must turn to make it to New York and would he phy and calling are looser. Heroes,
to the State Department for dirt. really have the legs to make it to 1600 method actors and great leaders may
Pennsylvania Avenue? Even-or espe- require a detailed psychohistory, but
cially-Carville and Co. could not know most performers and ordinary politi-
Persona
the answers to these questions at that cians can muddle through without good
The context establishes the framework
time. reasons or certain motives. In reality,
for the American Presidential campaign
In most novels and all modernAmeri- Presidential aspirants resemble Willy
season and institutions determine the
can Presidential elections, character is Loman more than King Lear. Not every
structure and sequencing of the events
the main issue. Elsewhere plot is su- behavioral trait or action need be ex-
that lead up to the November election.
preme, but only in the United States can plained or motivated.
If Presidential elections were a work of
an Abraham Lincoln, a Harry Truman or
fiction, then the context would define
a saxophone-tooting governor from
the genre-mystery, tragedy, melo- Personality
Little Rock ascend to the highest office
drama or romance-and the institu- The Who of American Presidents and
in the nation.
tions would characterize the plots and Presidential hopefuls is as diverse as the
The media does not create and can-
subplots that carry the story through nation they represent. While Italian
not change the plot, but it does coau-
from beginning to end. Both context Prime Ministers and German Presidents
thor the candidate's persona. It records
and institutions evolve relatively slowly all appear to be cut from the same cloth,
candidates huffing and puffing down
and bring stable expectations to read- the portrait gallery of American Presi-
Main Street in jogging shorts and talks
ers, viewers and voters. Despite all the dents is filled with an amazingly color-
to high school sweethearts and white-
hoopla about H. Ross Perot and new ful cast of characters. Personal eccen-
haired elementary school teachers. It
media venues, the 1992 Presidential tricities are actually expected and
interviews aging chanteuses in Little
campaign season followed the standard cultivated, because the American pub-
Rock nightclubs and turns Checkers,
script pretty closely. That's how Clinton lic-just like the American media-sees
Millie and Socks into celebrities. Per-
got to be President. Carville and Co. personality as the driving force of his-
sona is the name of the game in Presi-
understood the context, mastered the tory. Presidents make history, they do
dential campaigns and the media pur-
institutions and persevered through not obey it. Hence, the idiosyncrasies of
sues the contenders with a zeal
November to capture the White House. the occupant of the Oval Office are
unknown outside of Hollywood.

(;?. Nit>m:Jn Re:norts /Winter 1991

celebrated and nurtured as symbols of polls. The Gennifer Flowers affair trans- Washington's cherry tree, Truman's
American identity and motivations for formed the candidate and the campaign. haberdashery, and Nixon's farewell
national policy. The identity of the na- The aura of scandal invigorated his cam- press conference, the flaws made
tion becomes embodied in the charac- paign by suspending a Sword of Clinton a true representation of the
ter of the President. Damocles over every appearance. On national mythology. Whatever their in-
This public expectation places a heavy the other hand, Clinton's dogged per- tent, campaign journalists became ac-
burden on Presidential hopefuls. A sistence in fending off reporters' que- tive collaborators in this creative pro-
weighty resume and demonstrated com- ries and continuing the campaign dis- cess.
petency count for little. Experience and played the determination and boldness
success in government are neither suf- of a genuine leader. When Hillary and
Challenge
ficient nor necessary qualifications for Bill Clinton rolled the dice on 60 Min-
The pursuit of the Presidency is the
the Presidency. The President must have, utes they displayed an audacity unseen
ultimate challenge in American mythol-
since the heyday of Richard Nixon.
ogy. To be considered Presidential ma-
Clinton's performance in the two
terial is the ultimate accolade in Ameri-
months following The Star's revelations
From the voters' began the metamorphosis that would
can politics. Some, like Mario Cuomo,
seek nothing more than the label
perspective, there is transform the Governor ofArkansas into
"oughtabe" President.
the forty-second President of the United
little difference States.
Campaigning for the Presidency,
however, is another matter entirely. The
between campaign campaign season is a prolonged ordeal
correspondents and Biography with endurance and versatility as the
campaign itnanciers. Biography also matters, but primarily as primary requisites for success. Each of
a backdrop to personality. With the the three acts of the campaign season
Both behave like exception of victorious generals like requires the candidate to play a differ-
bookies. Both make Dwight Eisenhower, candidates who ent role before the omnipresent eye of
attempt to run on their past are doomed. the television camera. The challenge is
odds on the outcome Richard Nixon succeeded in his obses- to play each part well, to make costume
of the elections and sive pursuit of the Oval Office precisely changes quickly and invisibly, to im-
by down playing his past and by playing prove one's performances over time,
both seem to care the born again Nixon on Laugh-In and and finally to establish a core identity
more about the horse The Tonight Show. that makes one instantly familiar to an
However, biography becomes criti- ever-growing audience.
race than the horses. cal when personality is insufficient to Success in Presidential politics rarely
carry the symbolic burden of national goes to those who excel in any single
identity. When public image is form- setting or environment. Candidates have
or seem to have, a persona distinctive
less, biography can pick up some of the to schmooze with campaign contribu-
enough to be immediately recogniz-
slack. Hence the origins of the "Man tors, pose with fidgety children, expose
able and capacious enough to reflect
from Hope" legend on the eve of the themselves to Barbara Walters, hold
the diversity and contradictions of the
1992 Democratic convention. Clinton hands with adoring spouses and look
nation as a whole. Presidential wannabes
needed a saga and a collection of anec- good without a tie. Nobody can do it all
must be seen as capable of filling these
dotes to explain his motivation and well. The point is not to look too bad
very large shoes.
justify his behavior. Clinton's handlers, too often and to look better at the end
In 1988 George Bush was perceived
in collaboration with the media, of- than at the beginning.
as the wimp with a resume until he
fered his troubled childhood as the Bill Clinton is President because he
duked it out with Dan Rather live and
reason for his compulsion to please and met the challenge of endurance, versa-
trashed Bob Dole in New Hampshire.
the unerring self-control of his cam- tility and growth. While Mario Cuomo
The genius of Roger Ailes and Lee
paign appearances. When Clinton's could spellbind with the legends of the
Atwater was to cast the consummate
opponents dredged up the draft issue past and turn George Will and Sam
Yankee civil servant as Dirty Harry on
and his adventures in Oxford and Mos- Donaldson into lapdogs on Sunday
the campaign trail.
cow, they were actually adding to the mornings, Clinton was without peer in
In 1992 Bill Clinton faced a similar
stereotypical saga of the overachieving relating to real people on sound stages
problem. Before The Star printed alle-
baby-boomer from Arkansas. In the end, and street corners. The film clips of an
gations of marital infidelity made by
both the voluntary and involuntary rev- overweight Clinton loping down
Gennifer Flowers, Clinton was doing
elations about Clinton's past served to Mainstreet U.S.A. and the forays into
an excellent job of molding himself into
enhance his reputation while demean- McDonald's instantly turned the Yale-
the faceless, unnamed Democrat who
ing that of his detractors. Like educated policy wonk into the viewer's
consistently beat George Bush in the

Nieman Reports I Winter 1993 63

next -door neighbor. In primary debates tation and meaning of Presidential per- expectations of coherence between
Clinton stayed cool and let the other sona in American society. The 1992 behavior and biography become less
contenders throw the spears. On the campaign revolutionized both the How and less relevant to voter decisions.
talk show circuit, he preferred inter- and What of Presidential persona.The Television, with its dawn-to-dusk cov-
views before live audiences that could continuing debates over Clinton's per- erage of public and private lives and its
be enlisted against intrusive questions formance and Perot's intrusive acrobat- illusion of immediacy, encourages view-
and hostile questioners. He preferred ics are legacies of this subtle sea change ers to regard candidates as they would
Donahue to Larry King and David Frost in American politics. their next-door neighbor. Inconsisten-
to David Brinkley. On the stump, Clinton In the first place, the media's role in cies, eccentricities, insecurities, and
was long-winded, always earnest, mani- character flaws are tolerated and even
festly sincere and never histrionic. He expected. Smoothness breeds suspicion
knew that real people don't mind being and proficiency is labeled as "slickness."
bored, but never forgive being manipu- Throughout, Clinton Integrity is no longer the main issue.
lated. All in all, Clinton was a sent the same message, The President may remain a symbolic
McLuhanesque populist for the cool leader but what he symbolizes are the
medium of television. He was Johnny both verbally and contradictions of the nation.
Carson minus the naughtiness. nonverbally, to the Reporters dig for those character-
Moreover, during the darkest days of forming incidents or episodes that ex-
the primary campaign Clinton never viewing audience: "The plain a Presidential candidate's behav-
lost sight of who his real audience was. voters are my judge ior. Commentators, in contrast, look
When accosted by reporters, Clinton for core beliefs and consistency over
simply marched forward until even the
and jury, not the time. Both quests are elusive. Revela-
media got tired of asking the same old reporters." He tions are swiftly buried under a multi-
questions. Throughout, Clinton sent media avalanche of competing stories
understood then, as he
the same message, both verbally and while the querulous pursuit of petty
nonverbally, to the viewing audience: does now, that media inconsistencies alienates the public. The
"The voters are my judge and jury, not should not get in the reporter's contribution is diminished
the reporters. " He understood then, as while the commentator's pontification
he does now, that media should not get way of his message. seems irrelevant. The resulting frustra-
in thewayofhis message . Clinton made tion inevitably leads to the horse-race
the transition from Little Rock to 1600 mentality. Disenchanted by a public
Pennsylvania Avenue because he sur- creating a Presidential persona is slowly, that discounts their stories, suspects
mounted all the challenges that voters but inexorably, diminishing. Print and their motives and celebrates the very
and media put before him. It was not a broadcast exposes are diluted by the contradictions they abhor, the descen-
pretty sight and there were many prat- number and diversity of media chan- dants of William Allen White and Ed-
falls along the way, but the fast-talking nels. The press may be coauthors of the ward R. Murrow now make book on the
Governor of Arkansas actually looked candidate's persona, but they must now
more presidential than George Bush by share credit with Larry, Phil, town meet-
the first week in November. Both his ing moderators, and radio talk show
persona and his waistline had grown hosts all across the country. Roger Mudd Disenchanted by a
since New Hampshire . may have crippled Ted Kennedy's cam-
paign on the launching pad, but that era
public that discounts
Persona and the Media is past. Today it is an appearance on the their stories, suspects
Arsenio show that gets front-page play.
The media's role as coauthorofClinton's their motives and
As Clinton proved, you can circumvent
Presidential persona is the subject of celebrates the very
the Fourth Estate and still become Presi-
much retrospective soul-searching. Was
dent. contradictions they
the press unfair in February, too enthu-
More importantly, television is not
siastic in July, and too forgiving in Octo- abhor, the descendants
only changing the way we view Presi-
ber? Did they take Gennifer Flowers
dential candidates, it is transforming of William Allen White
too seriously, hype "The Comeback Kid"
our expectations of what a President is
too naively and downplay "The Oxford and Edward R. Murrow
or should be. "Character"-or the con-
Peacenik" merely to compensate for the
sistency and unity of action over a life- now make book on the
desperation of the Bush campaign? All
time-is becoming increasingly irrel-
of these issues are interesting from the
evant both in our personal lives and in candidate's-and the
perspective of the participants, but they
overlook the changing mode of presen-
the public arena. As impressions oflead- President' s-fate.
ers become more and more fragmented ,

64 Nieman Reports /Winter 1993

candidate's-and the President's-fate. virtues to the public at large are seen as and junk mail, media are becoming
After all, the public still wants to know vices by the establishment media. They personalized. Every family will have a
the score. have lost touch with their audience and camcorder, every child will become a
lost influence with the politicians. performer and every household will
The problem is that for the first time, become a media outlet. Political perfor-
Media
the contingent universe of the reporter mances will be mediated but the media
The 1992 campaign changed both the
is seemingly within reach. Video tech- will become transparent. Everyone will
How and What of American presiden-
nology encourages the illusion that ev- become his own Paul Harvey or Andy
tial elections. Narrowcasting and the
erything can be seen and nothing Rooney. Print and broadcast journalists
proliferation of presentation formats
missed. Every comment, every action, will no longer be needed to explain the
have diminished the role of the Fourth
politicians to the public. In this medi-
Estate and altered the ways in which
ated universe of demythologized politi-
candidates communicate with their au-
cians and media-savvy voters, the politi-
diences. Clinton and Perot used-and
continue to use-the Establishment
What are virtues to the cians will be the last true innocents.
They will be the last believers in doing
Press as a foil in a televised dialogue public at large are seen good and not just looking good. They
with the American public. The well pub-
licized discontents of the White House
as vices by the will be the "last action heroes." Never-
theless, these heroes will still need
press corps are but a by-product of the establishment media.
media commentators to decipher the
diminished clout of the traditional me- They have lost touch moods and motives of a discriminating
dia.
with their audience and manipulative public.
More important but less obvious,
The future is now. The mere mortals
however, are the changing expectations and lost influence with in Washington are grappling with the
which American voters bring to Presi-
the politicians. destiny of the nation in full view of a
dential campaigns and candidates .
suspicious but hopeful public and a
Around-the-clock, televised coverage
cynical press. Both the politicians and
makes Presidential candidates seem as
the press would prefer to be on a bus
familiar- warts and all-as any per-
indeed every misstep can now be ac- campaigning, but the former, at least,
sonal acquaintance. Polished presenta-
counted for. Nothing can escape the are condemned to try to get things
tions with Armani suits, $200 haircuts
reporter's gaze. What the public ac- done .
and studied grammar evoke distrust,
cepts as brute reality, the media sees as For now, the bookmaking continues
not admiration. The people are looking
grist for its mills. and the line on 1996 changes weekly,
for authenticity, not perfection.
Where does this mismatch between but the bookies are losing both credibil-
In contrast, journalists comfortable
the media and the public lead? ity and audiences. Neither the politi-
with the tightly scripted, wholesale poli-
Politics is the art of reconciling the cians nor the public is being well served.
tics of the Reagan era look askance at
unreconcilable. Good politicians are Maybe the Fourth Estate should learn
the seeming chaos of the new retail
like magicians-their best work is per- from the tabloid media and not just
politics. They view contradiction as the
formed with sleight of hand. All-out condemn it. Maybe the stars of the
product of duplicity and inconsistency
coverage ofPresidential elections, when Establishment Media would be more
as the result of incompetence. What are
combined with the oddsmaker's men- credible if they spent less time sparring
tality, transforms the media into voy- with each other and with colluding
eurs, campaigns into caricatures and politicians on nightly television. Maybe
All-out coverage of government into gridlock. Exposing the they should relearn the lesson of Jo-
magician's craft benefits neither the seph Pulitzer and Maury Pavich and just
Presidential elections,
candidate nor the audience in the long tell interesting stories about quasi-fic-
when combined with run. The ultimate victim of this compul- tional people and leave the rest up to
the oddsmaker's sive and microscopic handicapping of the audience. •
events is the political process itself.
mentality, transforms Eventually this mentality will disap-
the media into pear. The law of supply and demand
will prevail. The era of media barons
voyeurs, campaigns and staged network extravaganzas is
into caricatures and over. The networks are reluctant to
broadcast Presidential press confer-
government into ences yet photos of the President frol-
gridlock. icking in the surf make the front page of
The New York Times. Like computers

Nieman Reports I Wimer 1993 65

 WINTER READING

Which Way the New World?

The Roar of the Crowd:
How Television and People Power are Changing the World
Michael]. O'Neill
Times Books. 228 pages. $21.

BY SAM HURST

ichael O'Neill's new book, against Mikhail Gorbachev, and eventu-

M "The Roar of the Crowd," races

across the landscape of con-
temporary events like a freight train,
allyrose to power himself. It's a scene of
new-styled Russian journalists working
fax machines, hidden computer e-mail
moving gracefully from Boris Yeltsin's networks and pirate radio transmitters
rise to power to television coverage of late into the night. It's a portrait of new-
the Persian GulfWar, from]apan 's trade styled politicians playing to television
policies to India's emerging television moments like the famous video snap-
market, all in an effort to weave the rise shot ofYeltsin standing on a tank in Red
of democratic movements and the glo- Square rallying the forces of democratic
bal communications revolution together resistance, broadcast around the world
into a description of modern life and a LIVE, shaping global diplomacy with increasingly doubtful about their ability
foreshadowing of the future . It's a daunt- the flip of a video switch. And it's a to use military force ."
ing effort, which is utterly confusing- portrait of old-style Communist politi- He gives television (and the high-
not because it is poorly written or poorly cians, like the nervous, fumbling tech communications revolution that it
thought out, but because the swirl of Gennedy Yanayev, unable to make the embraces) too much credit. And he
events and trends is itself so stunningly transition to the new electronic age underestimates the power oflong-term
confusing. where leaders live or die by their ability trends. The collapse of the Soviet Union
I staggered along myself until I was to appear cool and self-confident in the erupted from a steady process of de-
relieved to read O'Neill's own admis- heat of a television close-up. cline that anyone who worked or vis-
sion in the closing pages that " ... the O'Neill's conclusion, and the under- ited in Russia throughout the 70's and
beginning of wisdom is to recognize lying theme of the book: "The role of 80's could see for themselves. The root
that for many problems there are no the media was critical because, like the of the collapse was economic stagna-
solutions .. .In the case ofthe electronic tree falling in an empty forest, Yeltsin's tion, the repression of human rights,
age, complexity challenges understand- resistance did not exist until it was and a belief among reform members of
ing and deep contradictory forces chal- seen and heard [My emphasis]. It be- the Communist Party that the world
lenge solutions. One is more awed by came real only when it became news was technologically remaking itself and
limitation than by possibility." and when millions of people were con- leaving Russia out. Resistance to the
Those words are the great truth of nected to the White House (Russian) by coup leaders, and old guard Commu-
this book. O'Neill tries nobly, but I the shared knowledge of move and nist doctrine was real, shown not just in
think in vain to pull widely disparate countermove in an epochal encoun- the courage of activists, but in the apa-
and powerful trends together. The book ter." In a similar vein 0 'Neill argues that thy of the man on the street. It was not
opens with a review of the democratic " ... extensive reporting about young sol- a figment of television imagination. It
impulse in Russia on whose shoulders diers and officers being unwilling to was finally grasped by television, but it
Boris Yeltsin resisted the 1991 coup attack civilians made the coup leaders
continued on page 73

66 Nieman Reports /Winter 1993

 I w I N T E R R E A D I N G r-[- ---------------
skelter example set by his idol 30 years
The Days When Kennedy Charmed the Press ago.
"We do have a problem of manage-
ment; centrally, it is a problem of your
President Kennedy: use of time," McGeorge Bundy, his na-
Profile of Power tional security advisor, wrote Kennedy
Richard Reeves in May 1961. "We can't get you to sit
Simon & Schuster. 798 pages. $30. still. .. "
In most ways, however, the Clinton
presidency is not like Kennedy's. JFK
devoted much of his time to the interna-
BY MuRRAY SEEGER tional crises of the day-the missile
standoff and security of Berlin; the col-
lapse of Laos and expanding, fateful,
ure, I remember where I was when Instead, incident and event are lined

S John F. Kennedy was murdered

30 years ago. And I know where I
was the night he made Nikita
up in factual order leading to more than
100 pages of footnotes, bibliography,
acknowledgments and a background
U.S. participation in Vietnam; Cuba and
the aftermath of the disaster at the Bay
of Pigs.
Clinton has been pushed into for-
Khrushchev blink and take back the essay by Peter J. Keating, Reeves' chief
eign affairs after dedicating his early
missiles Moscow was sending to Cuba. researcher, who is given deserved, gen-
energies to domestic business. Substi-
But, for a reporter working in Ohio, erous praise.
tute Bosnia for Laos, Somalia for Cuba
many other details of the 1,000-day For those still blinded by the Kennedy
and Haiti for Vietnam and you get a
Kennedy Presidency are jumbled in the charm, there are the scenes of Jack
crude parallel.
memory bank. "Ich bin ein Berliner," Kennedy the tough guy and cheap
On the home front, the Kennedys
Laos, Vietnam, Bay of Pigs; Ross Barnett, lothario. The Bobby Kennedy fans may
were very cautious in responding to the
George in-the-doorway Wallace, the be disturbed to see their hero as the
demands of the civil rights movement,
March on Washington; they all pile to- immature, nasty character with whom
avoiding association with Martin Luther
gether. some other members of the Administra-
King, Jr. , as a serious risk to re-election
After the early supportive memoirs tion refused to deal.
in 1964. They preferred dealing with
ofArthur Schlesinger,Jr., and Theodore The Bill Clinton crowd will take heart
Roy Wilkins and A. Philip Randolph, the
Sorensen, recollections of President because the early weeks of confusion in
doyens of the movement about whom].
Kennedy have been dominated by the his White House suggest that the Presi-
Edgar Hoover could supply no dirty
often ridiculous debates over the assas- dent was simply following the helter-
tape recordings.
sination and the Warren Commission
Kennedy won credit for an historic
Report, compulsive promiscuity, mob
change in economic policy by deliberat-
connections and other peripheral ques-
ing an increase in the federal deficit to
tions.
It is certainly timely, therefore, to PRESIDENT stimulate a weak economy, but he re-
sisted until early 1963 that advice given
have this new book by the veteran po-
litical writer Richard Reeves that fo-
cuses strictlyonJFK's days in office. In
KENNEDY by Walter Heller and the other Keynesian
economists around him.
"Kennedy was more comfortable
diary form, Reeves examines Jack
with the politics of the tax cuts than the
Kennedy at work and play from] anuary
economics," the author observes.
19, 1961, in Washington, until Novem-
The economic numbers reported
ber 22, 1963, in Dallas.
here suggest how much the U.S. has
Since Reeves starts with the day be-
changed in the 30 years since Kennedy
fore inauguration, he offers little about
was taken from us. The budget deficits
the dramatic 1960 election that saw
he faced were $9 to 11 billion. The trade
Kennedy elected by a whisker after eight
deficit with Japan was 500 million dol-
years of the Eisenhower-Nixon Admin-
lars.
istration.
Reeves describes in deadpan style a
The book ends abruptly with the
briefest possible note about the assassi-
PROFILE OF POWER collaborative journalistic-political cul-
ture that has disappeared from Wash-
nation that changed forever the direc-
tion ofU.S. history. There is little analy-
sis or soul-searching, and no wild
RICHARD ington. Kennedy charmed much of the
press, as he did people around the
speculation in this book. REEVES continued on page 71

Nieman Reports I Winter 1993 67

- - -----------------jl w r N T E R R. E A D r N c I
is that the federal subsidy for local sta-
Who Should Fund Public Broadcasting? tion operations should be eliminated.
Local broadcasters should be supported
by their local communities, they say.
Quality Time? They are right, of course. The present
The Report of the Twentieth Century Fund Task Force fragmented system was set up out of a
on Public Television with background paper romantic and thoroughly mistaken idea
by Richard Somerset-Ward that there should be a weak central
The Twentieth Century Fund Press governing authority for public televi-
188 Pages. $9.95 pb. sion while the real power resided with
the stations. Localism, it was called, and
it justified the Nixon administration's
successful effort to emasculate an early
BY EDWARD M. FouHY attempt at a public television news pro-
duction center.
Beyond the vulnerability of a system

T
he Twentieth Century Fund has to trouble the majority of the Task Force built on localism, the idea that creativity
done us all a great favor . It has members. In fact, they would like to see would flourish at hundreds of local
reduced to a slim, paperbound more of the government's money going stations went against the laws of broad-
volume one of the enduring public de- into national programming instead of casting, and particularly it went against
bates that has confounded policy mak- into the operation of the several hun- the laws of news broadcasting.
ers who dwell in an important corner of dred public stations around the coun- As the Task Force report points out,
the public policy community for 25 try that carry PBS programs. More on there must be a central programming
years. How do we, as a nation, finance that later. organization with the funds and the
our public television system, guarantee The dissenters, primarily Lloyd N. staff to commission programs, develop
that it is available to all, encourage it to Morrisett of the Markle Foundation and them (a more difficult task than might
be innovative, probing, serious and sub- David W. Burke, former president of be imagined), fund the worthy ones
stantive and still maintain its indepen- CBS News, find the basic system flawed. and ruthlessly kill off the weak ones, all
dence? How does a nation whose jour- Morrisett argues that either Congress the while imposing rigorous editorial
nalistic touchstone is the First should pay for all of PBS 's program- standards on the ones that do reach the
Amendment, keep meddling politicians' ming and be held accountable by the public.
hands off the public television network? public for their choices, or public tele- The report says under the present
It's a question you may be too an- vision should declare its financial inde- system local stations get the major share
noyed to ponder as you look up from a pendence from Washington, "marshal of federal largesse and spend it on
quiet hour with the cast of the "MacNeil/ its own resources and achieve opera- overhead-station staffs, cameras, stu-
Lehrer NewsHour" to find someone in tional efficiencies. " In return, he says, it dios and the like. Just three public sta-
a Big Bird costume asking you for money would get the editorial freedom it now tions-WGBHBoston, WNETNewYork
to run your local station. There hasn't lacks. The implication is that if public and WETA Washington-produce the
been a satisfactory answer to the ques- television earns respect, support from bulk of PBS's national programs; 300
tion since the Carnegie Commission the public would flow in sufficient vol- stations produce no programs at all for
wrote the rules that put the federal ume to pay the "Washington Week" national distribution, yet federal dol-
government in the television business regulars and keep "Barney and Friends," lars continue to pour in to these sta-
back in 1967. the hugely popular children's program, tions whose main local production may
You need not look for the answer and all the other PBS shows, on the air. be their fund-raising weeks. The aver-
from this high-powered Task Force re- Burke, a veteran both ofWashington age public station produces just 2 per-
port, only for a continuation of the policy battles and network news execu- cent of its own programs.
argument with each side presenting its tive suites, has seen the corrosive effect The central programming authority,
case in civilized tones befitting PBS. of self-censorship. He correqly argues PBS, is underfunded, poorly staffed and
In shorthand, the debate comes down that it is impossible to know the extent lacking either the will or the ability to
to this: Even though it provides only 16 to which editorial freedom has been enforce its editorial standards, even
percent of public television's total bud- sacrificed in exchange for Congress's though a recent reform created a Chief
get, Congress, through its appropria- largesse and that "federal funds by their Program Executive in whose hands re-
tion power, exerts enormous influence very nature carry a silent but perverse sponsibility for programming has been
over the programs millions see on the form of censorship." concentrated.
air. "Nova," "Frontline," "Sesame Street," The central recommendation the "MacNeil/Lehrer" exists in a world
get at least some of their funding from Task Force, chaired by Brown Univer- apart. Its standards are high , its edito-
the government. That system seems not sity president Vartan Gregorian, makes
continued on page 71

68 Nieman Reports /Winter 1993

-------------------11 W I N T E R R E A D I N G 11----------------- -
there is something missing." What is
Looking at Prozac Journalistically missing is their humanity, an awareness
of themselves as vulnerable beings who
must suffer, grow and die. Kramer does
Listening to Prozac
raise the issue of "cosmetic
Peter D. Kramer
psychoharmacology," musing, for ex-
Viking. 409 pages. $23. ample, about the ethical dilemmas of a
day when normal, but shy and inhibited
people, may feel compelled to take
Prozac to have the peppy, aggressive
personality necessary for success in late-
BY MARIA KARAGIANIS stage capitalism.
Yet, despite his moral qualms, he is
clearly a convert who disapproves of
' ' Newsweek," psychiatrist Peter the media hysteria when Geraldo,
Kramer points out, "made Prozac a
Donahue, Larry King, "Eye on America",
star." The green-and-white capsule,
"Prime Time Live" and Time magazine,
first introduced in 1987, had, within
"eager," as he writes, "to see bad where
three years, appeared on the covers of
Newsweek had seen good" started pub-
both Newsweek and New York Maga-
licizing reports of depressed patients
zine, as well as been featured in an
becoming suicidal on Prozac. And then
article in the prestigious New England
Newsweek, "not contrite," came back
Journal of Medicine. Although pharma-
"just reporting the trends" with a cover
ceutical companies had been making
on violence in America which included,
antidepressants for 40 years, it was only
in that issue, a story called "Backlash
Prozac that became an icon. And, in that
Against Prozac." And then Time jumped
familiar journalistic syndrome of celeb-
in, with "a backlash to the backlash"
rity creation, then destruction, Prozac 's
with a cover expose of the Scientologists,
renown was followed by "rumors, noto-
"who were shown to be fomenting much
riety, scandal and lawsuits."
of the anti-Prozac hysteria. "
The media built up the god, Prozac,
So it goes. As his own contribution to
then proceeded to tear it down-in a
truth, Kramer has written fluently an
process not dissimilar to reportage dur-
interesting 300-page defense of Prozac
ing national political campaigns. In a sive hair-pulling. Powerful in ameliorat- and of the psychiatric profession, rel-
secular age still hungry for miracles, ing a wide array of symptoms, Prozac- egating any discussion of side effects,
Prozac-"a sleek, designed, high-tech and this is the author's main theme and possible long-term consequences of
drug "-promised not only transforma- fascination-not only has the power to taking Prozac and the above-mentioned
tion, but transcendence. Prozac was on heal. It possesses an even more impres- charges that the drug may induce sui-
"Nightline" and on "The Today Show." sive power-the ability to alter human cidal or homicidal impulses in some
It promised salvation, out there in mass personality. disturbed patients, to a 12-page appen-
media-land, on television when anx- Kramer expresses faint moral queasi- dix at the back of the book.
ious Americans went to bed and when ness about playing God by tinkering Although he raises the specter of
they woke up. with the human psyche as, for example, America becoming a nation of blissed-
According to Kramer, Prozac enjoyed when he reluctantly prescribes mood out zombies, he draws on case histories
the fastest acceptance of any brighteners for people whom he can't from his own psychiatric practice, ani-
psychotherapeutic medicine ever- diagnose as sick. In fact, moral ques- mal studies, the history of antidepres-
650,000 prescriptions per month by the tions seem to have motivated him, in sants in general and Prozac in particu-
time the Newsweek cover appeared, part, to write this book. He writes, for lar, and clinical reports to ascertain that
just over two years after Prozac was example, of"The Thanatos Syndrome," biology need not be destiny, and that,
introduced. By the time Kramer was the novel by Walker Percy, the Southern as he writes in the last chapter, bad or
writing his paean to Prozac, 8 million writer and doctor who converted to good, Prozac is here to stay. •
people-including four million Ameri- Catholicism, and whose dark vision was
cans-had taken this particular mood- of a world in which plotters had intro-
altering drug for such diverse symp- duced an insidious drug into the water Maria Karagianis earned a master's degree
toms as social inhibition , eating supply, which makes the shy bold. This this past june at the Harvard Divinity
disorders, poor self-image, depression, is a nightmare world where people are School. She is a former staff writer for The
anxiety, panic attacks and, even, obses- "not hurting, theyarenotworrying ... but Boston Globe Magazine.

Nieman Reports I Winter 1993 69

-----------------11 w I N T E R R E A D I N G If---------------~-

issue-when blacks entered the major

What Do You Do When Your Father Is a Racist? leagues, an event that upset Paul, Sr.
But it is Hemphill's observations of
the Birmingham he left, but kept going
Leaving Birmingham: back to, that is important. White native
Notes of a Native Son sons do not usually lay open their lives
Paul Hemphill the way he does-it's the kind of stuff a
Viking. 351 Pages. $23.50. man usually tells his shrink rather than
his publisher. Neither his family nor the
city comes out looking too good, then
or now.
BY PAUL DELANEY
Hemphill's is an insider's view, a
ringside seat to the mind, action and
en my appointment as Chair- My family was part of the great exo- reaction of a typical Birmingham white

W: man of the University of

Alabama'sJournalism Depart-
ment was announced last year, I was
dus ofblacks who abandoned the South
in the 1950's. The letter writers were
also sad that I was barred from studying
racist, his father, who was part of the
city's worst elements and who sup-
ported like-minded officials to run the
struck not only by the volume of the journalism at the school where I would town. Hemphill's training, albeit as a
reaction, but also by the type and tone. become chairman in 1992. But more sports writer on some real rags until he
Telephone calls of congratulations poignantly, they felt very guilty about got to The Atlanta Journal, provided
jammed my voice mail, many of them their own abandonment of decency and him with the basics that would enhance
from people I had not heard from in fairness in the saga of Birmingham. his development and success as a col-
decades. Others were from strangers, Paul Hemphill essentially did the umnist and writer of several books and
some of them Alabama graduates from same thing. While blacks, in effect, were eventually as a Nieman Fellow.
as far back as the forties . pushed out, the Paul Hemphills left of Appropriately and, perhaps, predict-
Then the letters began arriving, their own accord. But his family stayed, ably, the year at Nieman, Harvard, Cam-
mostly from whites who had lived in maintaining their staunch racism that bridge and Boston was his debutante
Birmingham or who had moved away. became Birmingham's legacy. ball, his coming out party. Fellows in-
In almost every instance, they expressed In his book, Hemphill explains how cluded Tony Lukas, Jonathan Yardley
regrets that they had turned their backs and why he left. It was for more per- and Henry Bradsher, and among the
and not done more during the city's sonal reasons-terrible relations with people he met was Jerry Rubin, unoffi-
turbulent years, the 1960's, a period his father, Paul, Sr., the dad the son cially and secretly brought in by Lukas.
that to this day defines Birmingham to loved dearly. Paul, Jr. evolved into a Hemphill would be exposed to the East-
the rest of the world. man who became alienated from what ern Intellectual Establishment.
his father, neighbors and fellow whites The place, the people, the experi-
stood for. ence impressed Hemphill immensely.
Hemphill also went on to pursue his He grew as a journalist and writer. He
career in journalism. He elected to leave had the blessings of Ralph McGill, his
Birmingham because he did not want hero, and Dan Wakefield, who suggested
to waste away in the sports department Hemphill try for the Nieman. But the
of the local papers. Paul Hemphill, Jr., approval he did not receive was that of
did not fare too badly, and in that, his his parents.
story and his life are in stark contrast to "Maybe now, I thought, my parents
those blacks left to suffer. The moral is will be impressed," he writes. "That
simple : leave or stay, the Hemphills of seemed odd, that a 32-year-old man
Birmingham will end up okay. \\;Ould need some sort of affirmation
The book is an excellent account of from his parents; but it had been a rocky
Hemphill's personal and professional road."
dilemmas. He was not destined to be- He later lamented:
come the baseball great he dreamed of, "Not once in their lives would my
despite all the summer camps, training parents ever ask me what it was like to
and trips to baseball parks. His success spend a year at Harvard-leading me to
as a writer was undermined, in his mind, assume that they were not pleased, they
by the fact that his father did not con- were embarrassed."
sider that much of a career at all. Base- All the analyses and digs at Birming-
ball did provide a strong bond between ham were underscored by this feeling
father and son, marred again by the race of rejection. But it does not skew his

70 Nieman Reports /Winter 1993

---------------------------------------------------------------------------------------------------
--------------------11 W I N T E R R E A D I N G r--1----- ------- ---
observations.
Like most whites in Birmingham,
Hemphill, Sr. was no bomb thrower.
Kennedy Who Should Fund?
continued ftom page 67 continued ftom page 68
But, his attitude about "the niggers"
was an obsession, and his support of world, and he had several very influen- rial integrity unquestioned, but the
Bull Conner and hardline racists was tial personal friends within the press documentary and news specials that
total and unyielding. This was an incen- corps. His complaints about stories he appear on PBS vary widely in quality.
diary combination that gave comfort to did not like and leaks he could not Many are excellent, like this season's
the bomb throwers and allowed the control could have come from Lyndon compelling series on the Great Depres-
Conners to thrive, thereby denying the Johnson or Richard Nixon. But the sion produced by Henry Hampton. Oth-
city the kind of progress found in other press in the 1960's had a different view ers are flawed, like last season's "Ameri-
Southern cities, such as New Orleans, of its role than it does in the 1990's. can Experience" documentary that
Charlotte and, in particular, Atlanta, Not only did reporters cover up the asserted a unit ofblackAmerican troops
Birmingham's arch-rival. President's misbehavior, but some acted liberated Dachau and Buchenwald when
Hemphill saw the light long before as intermediaries between Soviet intel- the historical record showed clearly they
he departed Birmingham. The boy who ligence agents and the Administration. did not. Or consider the case of the 90-
rode with his truck-driving daddy grew These days statesmen send international minute attack on General Motors that
weary of the racist harangues of his messages via CNN; in 1961, Moscow led off the "Frontline" season this fall . It
increasingly bitter father, a racism un- used agents disguised as journalists and was editorially demolished by The Wash-
derstood only by history: whites tradi- U.S. reporters played along. ington Post for flawed and dishonest
tionally hated blacks. He saw the differ- Oddly in a book written by a journal- reporting. The present system of edito-
ent treatment of blacks, beginning with ist, these associations are minimized. rial quality control is too weak to head
Louvenia, the maid. They were explored more fully in "The off such embarrassments.
Those differences are highlighted in Crisis Years" by Michael R. Beschloss, As troubling as the questioning of
kind of asides, other voices, interviews the most detailed published account of funding is, the Task Force report also
with the Rev. John Porter, pastor of the missile crisis. ponders an even more basic question,
Birmingham's biggest black congrega- For all of the praise of his research- whether there is a need for a public
tion, and Mimi Tynes, a white socialite ers, Reeves has permitted some nig- broadcasting system at all now that cable
from "over the mountain" suburban gling errors to escape final editing. has filled the niches public TV once
enclaves. This inclusion provides point- Khrushchev is referred to as "premier" reserved to itself. If there is a cable
counterpoint confirmation of of the Soviet Union, which means prime channel called "Discovery," for example,
Hemphill's account as well as verbal minister, a title not used in Moscow. As that broadcasts documentaries every
evidence of the huge gap between black Beschloss recorded, the proper title for evening and another called "Bravo" that
and white perception and reality in Mr. K was Chairman (of the Council of specializes in quality drama, who needs
Birmingham. Ministers). PBS? The answer is children, who have
The author was off-but not far off- In one chapter Reeves refers to the never been well served by commercial
in his conclusion that the city has not "Chicago Daily Tribune" and in the next, television. Schools and colleges need
changed much. Racism is still rampant properly, "The Chicago Tribune." There the educational programming only PBS
and pretty obvious, but there has been is also the "Walter Reed Naval Hospital provides and the viewers in the 40 per-
significant change from the old days. in Bethesda, MD," a combination of the cent ofAmerica's TV homes who cannot
But his is a journalist's account, a Reed Army Hospital in the District of or do not subscribe to cable need it. In
columnist's view of his upbringing, re- Columbia and the Bethesda Naval Hos- short the nation needs it.
lations with his family, his hometown, pital. • Nothing has been analyzed and dis-
friends, acquaintances. The warts are sected more than public television. It's
Murray Seeger covered economics in Wash-
there, so are the positives. The writing been tinkered with, reorganized, criti-
ington, Europe and Asia. A 1962 Nieman
could have been better, so could the cized and debated. But if war is too
Fellow, he is special advisor on external
editing. But in true journalism fashion, important to be left to the generals,
relations for the International Monetary
it is a good read on Birmingham, until then television is certainly too impor-
Fund.
something better comes along. • tant to be left to television people . The
Twentieth Century Report is useful for
Before becoming Chairman ofthe journalism
reminding us of that basic truth once
Department at the University ofAlabama
again. •
Paul Delaney was a National Reporter,
Foreign Correspondent, Deputy National Edward M. Fouhy is president ofthe Pew
Editor and senior editor at The New York Center for Civic journalism in Washington.
Times. He was a reporter, producer and news execu-
tive during a 23-year career that included
stints at all three television network news
divisions.

Nieman Reports I Winter 1993 71

 W I N T E R R E A D I N G 1-1--------- ----- --
How an Editor Found a Profound Secret ,~Ply fishing Tht:eu~.
9

In a Cher Movie t/Je;Midlife Crisis ·

Fly Fishing Through the Midlife Crisis
Howell Raines
William Morrow
343 Pages. $22.

BY jiM THARPE

bout halfway through Howell twinges of dread, disappointment and

A Raines 's meandering tale of

friendship, loss, midlife crisis and
reawakening, fly fishing guru Dick
restlessness can overwhelm a man and
cause him to buy expensive sports cars,
land in Montana or gifts for women he
Blalock-overweight heart patient, calo- barely knows .
rie-flaunting cook and possible CIA Raines was in The New York Times
operative-sums things up in a single Washington Bureau when the "black
sentence. "Ifyou're going to keep score, dog" began to chase him in earnest. " I
you might as well be on a golf course," assigned stories to reporters and edited
scowls the pontificating Blalock. what they had written, and at the end of
What Blalock is talking about, of the day, I had produced nothing that
course, is fishing, and according to would last," he writes. " I also knew that
"Blalock's Way, " fishing in general, and like millions of American men my age, I
With guidance from the affable Dick
fly fishing in particular, has nothing to was a hamster who would not be al-
Blalock, Raines sets out to resolve that
do with how many fish you catch; in lowed to step off the wheel. Too many
deficiency by becoming an expert fly
fact, it might not have much to do with mortgages, bank notes and college tu-
fisherman-to move from the "Redneck
fish at all. Blalock spends the better itions for sums not yet imaginable de-
Way" to "Blalock's Way. "
portion of this book convincing Raines pended on my diligently bartering my
Along that rocky road , Raines throws
that his life-long obsession with rod and days for dollars ."
in some observations about being a son
reel should be a contemplative pursuit When not engaged in that grim trans-
and a father, takes a few shots at any
approaching religion, not a competi- action, Raines spends most of his time
Republican whose path he crosses and
tive sport barnacled with fish counters, either reminiscing about fishing, plan-
offers a few more details than the aver-
weigh-ins and the other modern flot- ning fishing trips or rising before dawn
age reader can digest about the intrica-
sam associated with the sport. and throwing open his wallet to make
cies of fly fishing . Raines also finds it
Raines 's book is a thought-provok- those daydreams a reality.
necessary at several points in the book
ing jaunt across The New York Times Raines 's love of the sport began with
to throw in fish-related recipes, a tech-
Editorial Page Editor's 50 years of rivers his childhood in North Alabama sur-
nique that worked well in John Hersey's
and streams, bayous and bays, a tale rounded by the earthy men and women
book, "Blues," but seems out of place
told by a man entering the choppy, who would whet his lifelong appetite
here.
uncertain waters of midlife with the for angling. These early trips were his
Raines is at his best in this book when
wise but unsaintly Blalock as his fishing introduction into what he calls the
writing about his relationships, espe-
and spiritual guide. "Redneck Way," expeditions with his
cially when delving into his hereditary
"He was the sort of fellow who would colorful hillbilly kin that weren't con-
soup with his carefully drawn portraits
use Sweet'n Low and then plan his sidered successful unless they ended in
of Uncle Erskine and Uncle Erskine's
itinerary so that it would take him by the large numbers of dead fish.
son, David Ralph, whom the family
place that had particularly good coco- On his 40th birthday, Raines's wife
called Daveydraf. Daveydraf, Raines
nut cream pies, " Raines writes of his presents him with a chronological photo
writes, was the only boy he ever knew to
rotund friend. album of his life as a fisherman. "As you
be expelled from Ensley High School,
As the book's title suggests, Raines flipped through the pages, the fish grew
which was quite a feat since some of its
spends a good deal of time discussing larger and I grew older," he writes. He
students went from high school straight
his descent into and climb out of his adds: "I had spent countless hours at
to prison. When Raines writes of his
own midlife crisis-that time between fishing of all kinds, but was truly expert
family's Alabama fishing expeditions,
40 and 50 when, as Raines notes , mild at none."

72 Nieman Reports /Winter 1993

 W I N T E R R E A D I N Gl 1 - - - - - - - - - - - - - - - --

you can almost hear the old tin washtub Raines's book seems like a quick read, 10 or 12 billion in just 50 years. That's
filled with cracked ice and bottled Coca- even though it's 300-plus pages. He a trend which will put enormous, per-
Colas jangling in back of the car bloated accomplishes this deceptive brevity by haps unmanageable pressure on global
with fishing gear as it dashes down breaking his tale into 38 chapters with resources and traditional economic and
some dusty backwoods Southern road. titles like "Fathers and Sons, Nerds, political institutions whether television
Readers searching for a personal DweebsandWonks", "AmareoPescare: reports it or not. For much of his book
glimpse into the private life of the man An Essay", and "Spies, Flies and the O 'Neill seems to think that cellular
who occupies one of the most powerful Mystery of the Blalocks." phones and satellite television hooked
seats of American journalism will be One of the things that Raines fre- up to computer data banks in every
disappointed by the book. At the end of quently wrestles with in the book is the Bangladeshi village will herald a new
one chapter, Raines writes sparingly of reason people like himself spend a lot age of grass roots democracy, what he
his divorce from his wife, Susan, whom of time and large sums of money pursu- calls "people's power." But so far that
he met, courted and married in Ala- ing fish. Early in the book, he writes: "In vision of a new world order links only
bama. "The winding down of any long my view, the people who fish do so the wealthy, the educated and the tech-
marriage is a complicated story and a because it seems like magic to them, nologically literate in different coun-
sad one, too, if the marriage has been a and it is hard to find things in life that tries. Ninety percent of the 95 million
good one for a very long time. I am not seem magical." people born into the world each year
going to tell the entire history of that It's hard to find books that fall into are poor. And the cruel irony of the
marriage, because the story does not that category as well, but when Raines is electronic revolution is that while the
belong to me alone." Two paragraphs at his best in this book it's a word that flow of information and technology cre-
later the marriage is ended, leaving the comes to mind. • ates enormous wealth it does not create
reader grasping for what went wrong. A jobs. In fact, it eliminates jobs and
A lifelong bait and lure fisherman, jim
few chapters later Raines talks about streamlines labor. By the end of the
Tharpe, Nieman 1989, on occasion has
being on vacation with a "voluptuous book O'Neill acknowledges that it is
flirted with fly fishing. Tharpe, who will turn
young woman," who remains unnamed, just as possible, perhaps more likely,
40 in February, spends his days as Managing
and yes, even on this trip he is dreaming that the new world order will leave out
Editor of The Montgomery Advertiser when
of fish. the poor, creating a standard of living
not fishing or planning his approaching mid-
Raines writes lovingly of his two sons, gap not from one nation to another, but
life crisis.
of watching them grow from clumsy from class to class within and between
youths to accomplished young men who nations.
can turn a long cast from a limber fly rod Bringing one view to the table in the
into ballet. One of the charms of this beginning of the book and another,
tale is Raines's ability to blend the pro- apparently contradictory view in the
found with the, well, not so profound.
He quotes from William Faulkner with
Which Way? next chapter is not the result of fuzzy
headedness on O'Neill's part. He has
the same ease as he remembers that his continued.from page 66 made a valuable contribution by trying
negotiation of the final stage of his mid- was not created by television. Likewise, to wrap his arms around the powerful
life crisis began in a London theater it wasn't the report of soldiers refusing themes that are re-shaping the world so
while he was watching the movie "Moon- to attack civilians that made coup lead- quickly we can barely grasp them as
struck." In the film, Olympia Dukakis ers take notice, but the actual fact of they flash by. The difficult reality of the
asks a bewildered Danny Aiello why their refusal. This is an age-old debate next decade is that there are many forces
men-especially married ones like her about technology and communications. at work, all powerful, all poorly under-
movie husband-chase other women. Television does magnify events, tele- stood, and often contradictory. We may
Maybe, Aiello observes, it's because they scope time, create instantaneous celeb- not understand the future until it is
fear death. rity. But it is dangerous to underesti- history, and a new future is bearing
"Goofy male behavior is often seen mate the importance of real world down on us. •
as a case of a 'middle-aged crazy' trying economic and political events that are
Sam Hurst, a 1993 Nieman Fellow, is a
to prolong youth," Raines writes. "But often the result ofdeep historical trends.
freelance television producer in Rapid City,
another, darker way of describing that If O'Neill exaggerates on the details,
SD.
same behavior is that men act wild be- he is certainly not wrong on the big
cause they are trying to run away from picture. Television, computers, fiber
death." After making that discovery, optics, satellites are all contributing to a
Raines admits: " I remember feeling new world order whose outlines we
sheepish about finding a pearl of wis- can only barely see today. But there are
dom in a movie that was being pro- several other equally powerful trends.
moted as an opportunity to regard Cher The global population explosion threat-
as a serious actress. " ens to catapult today's 5.6 billion into

Nieman Reports I Winter 1993 73

 W I N T E R R E A D I N G r--1---------------
could type and write.
From Tank Crewman Despite its unevenness , "Muddy
Boots and Red Socks" is worthwhile
To Foreign Correspondent reading. Browne was among the earli-
est reporters to settle in Saigon when
the American presence was minimal
Muddy Boots and Red Socks and President Ngo Dinh Diem and his
A Reporter's Life brother and his brother's wife, the no-
Malcolm W. Browne torious "dragon lady" MadamNhu, were
Random House. 352 Pages. $23. at their scheming best. Browne 's ac-
count of those days is fascinating.
His reporting for The Times in South
BY jACK FOISIE America turned out to be a three-year
assignment, which seems to have been
his longest uninterrupted stay in any
ooks by foreign correspondents He was greatly aided by his ability to

B usually consist of "amid shot

and shell" story-telling, a string-
ing together of their best clips, or a lofty
learn languages quickly and well. The
book is salted with his pithy transla-
tions of local names and expressions.
part of the world. It was during the days
of the first democratically elected Marx-
ist government anywhere in the world,
in Chile. With his linguistic ability he
appraisal of historical events they have Who would have thought, for example,
was soon on familiar terms with many
witnessed and headline personages they that the Cambodian capital of Phnom
of the key players. He writes revealing
have known . Mal Browne's memoirs Penh, with its history of pleasure, in-
appraisals of Ernesto "Che" Guevara
(although he is not yet retired from The trigue and violence, simply means "Mrs.
and other Castroite socialists.
New York Times where he now reports Penh," Browne reports .
The nickname "Che" is an Argentine
on science) doesn't exactly fit any of Perhaps in modesty he seldom quotes
slang word meaning something like
those categories. from his own dispatches and this is
"Mack" or "Hey you. " It's another of
He does recount graphically the hor- regrettable. Often an inspired piece of
Browne's droll translations.
ror and heroics of combat which he first reporting/writing on an event at the
Browne is in some respects like the
witnessed as an Associated Press re- time it is happening can years later add
well-regarded New York Timesman be-
porter in Vietnam. But his strength is to a reader's understanding of the situ-
fore him, Herbert Matthews, who re-
political reporting, also initially in Viet- ation.
ported favorably on Castro when he
nam and, after joining The New York For all his talent, Browne's account
was still a revolutionary in the Cuban
Times, on assignments in South America of his journalistic career occasionally
highlands. Browne also developed a
and Eastern Europe and back to Asia reads professorial in tone, his opinions
reputation for reporting liberal causes
again. are laced with smugness and he is down-
more sympathetically than was in vogue
right catty about female correspondents.
generally at the time. As a result his
For example, he writes, a female re-
relations with the American establish-
porter who goes the route of extremely
ment was often flinty.
favorable assessment of world leaders
It was Admiral Harry Felt, com-
"may win riches with a best-selling kiss-
mander-in-chief of U.S. Pacific forces
and-tell book, or perhaps with a bril-
during the Vietnam war who testily re-
liant marriage."
plied to a Browne question: "Why can't
The print media is noted for its indi-
you get on the team?"
vidualists, and Browne lives up to the
In American-style democracy, how-
quixotic tradition. He and his third wife,
ever, an adversarial relationship be-
Le Lieu, and their dog Nif-Naf, are
tween press and officialdom is not nec-
inseparable in their travels, defying red
essarily disturbing, if it doesn ' t
tape, death threats and border guards,
degenerate into feuding.
even during the most difficult assign-
Browne was peripatetic in his later
ments. His dogmatic determination to
overseas years for The Times, returning
wear red socks every day is another
to Saigon twice and being among the
eccentricity.
last reporters to leave when the curtain
Browne happened into journalism
was falling. In his sixties he volunteered
accidentally. A combat-trained tank
to help report the Persian Gulf war. His
crewman in post-war Korea, he wan-
conclusions are hard-boiled and, I think,
dered into an army press relations of-
fice when there was need for a GI who
continued on page 76

74 Nieman Reports /Winter I993

- - --------------______jl W I N T E R R E A D I N G 1-1--- -------------

Laughing Along the Way With Molly

Nothin' but Good Times Ahead
Molly Ivins
Random House. 255 pages. $23.

BY DICK J. REAVIs

' ' Nothin' butGoodTimesAhead" older, equally thorny problem, that of

is a collection of columns by being a Southerner, and is distinguish-
nationally syndicated Texas po- able from it only by the presence of
litical columnist Molly Ivins. The com- something that Texana specialists call
pilation includes items originally pub- the New York-Texas axis. But all of
lished at the now-defunct Dallas these maladies occur widely in different
Times-Herald, by her present anchor strains elsewhere in America, where
publication, The Fort Worth Star Tele- they are usually passed off under the
gram, and by venerable liberal organs category of "not fitting in".
such as Mother Jones and The Progres- Both Ivins's Texan angst and its ac-
sive. companying liberalism are evident in eral circles is a only a mystery to them.
"Nothin' but" gives us her predict- "Nothin' but" lines like this: "I can only On the other hand , a joke whose
ably liberal take on subjects like Bill hope that this modest oeuvre-as we punchline was "but Mr. Collor, you
Clinton, David Koresh, George Bush, often say in Amarillo-will remind you can't do that and hold inflation to 1250
the Gulf War and gun control. But she that we need to stop and laugh along percent!" might gets roars in the board-
rises to populism when, for example, in the way. " A few pages later, she writes, room.
feinting an apology for having called "The noise is about her oeuvre, as we The Amarillo/Lubbock routine pos-
the White House press corps "a bunch always say in Lubbock". Similarly, "Au its not only a hierarchy of cities, but a
of trained seals sitting around waiting contraire, as we always say in Ama- hierarchy of languages as well. "The
for their four o'clock feeding"-she rillo ... ". noise is about her work, as we always
additionally accuses them of "having Lines like these don't have universal, say in London" would get no laughs,
blown every big story of the eighties." or fill-in-the-blank referents. They de- and the translation of "oeuvre" to Pol-
The book is part serious, part jive, a pend upon something that doesn't fit- ish, with Chicago as a city of reference,
mixture ofliberal punditrywith regional in a particular way. "The noise is about wouldn't win many chuckles, either, in
humor, always with a dash of hyper- her oeuvre as we always say in Sacra- part because readers wouldn't recog-
bole. Its formula is a proven commer- mento" makes no sense, but might be nize the Polish word for work. Iflvins's
cial success; sales of "Molly Ivins Can't funny if Memphis or Moscow were the lines read, "The noise was about her
Say That, Can She?", her previous book, cities it chose, because it relies on the obra, as lots of people say in Lubbock",
achieved best-seller status and "Nothin' reader's belief that there 's a hierarchy or "al contrario, as lot of people say in
but" is already at the top of Texas lists. of cities on a scale of cosmopolitanism. Amarillo", they'd be factual references,
But deciding why Ivins 's humor is And of course, among her liberal read- not quips, just as if Port au Prince were
popular, or what to think of it, is like ership, there is. the setting for her citations from French.
opening one of those gilded wooden Not many conservatives get the joke, The joke turns on a perceived incon-
eggs that tourists bring back from Rus- because among conservatives, cities are gruity in speaking the supposedly high-
sia: inside every egg, there 's another matrices of numbers, not cultural quali- brow language of France, and living in
one. ties. Numbers about production, num- Texas agribusiness towns like Lubbock
A good deal oflvins 's humor is mined bers about markets , numbers about and Amarillo. Conservatives don't find
from the double layers of an angst un- profit margins, those are what distin- humor in this side of the joke because
known in New York or Boston, the guish cities in their books. The values at for them, knowing eight foreign lan-
angst of being an American in Texas, the center of liberal life, and the cultur- guages is a business skill; one either has
and that of being a Texan in America. ally-and politically-sensitive humor the skill, or doesn't. For them, knowing
This malady is a variety of the much that's permitted-or prohibited-in lib- French is not a feather in a bonnet of

Nieman Reports I Winter 1993 75

 W I N T E R R E A D I N G 11---- - --- - - - - - ------
erudition-and it's never a pretension, I am reminded of something that
either.
Like most jokes, the Lubbock/Ama-
happened when I was a little boy. A
driver ran over Michael Tennis Shoes'
From Tank Crew
continued fro m page 74
rillo joke has a winner and a loser, and dog. Michael came running, scooped-
the losers aren't the conservatives who up the dog and began bawling, while in some ways erroneous.
miss the point. The winner is he who the driver stood by, trying to console "The Gulf War was dominated by
recognizes the word oeuvre, thinks that him. The car had merely passed over American technology and our side
French is a distinguished language- the animal, knocking him flat, but caus- won," he writes. "Sophisticated Ameri-
and doesn't live in Lubbock or Ama- ing no injury, the driver pointed out. "I can military technology could, after all,
rillo . Its loser is whoever lives there, didn't really hurt your dog," he told the crush peasant armies, not withstanding
regardless of his place on liberal/con- crowd of us boys. But Michael wasn't our defeat in Vietnam."
servative value scales. buying it. He stared up and blurted, Hardly apt, comparing the highly
A related joke, also typical of Ivins- "Yeah, but you didn't help him one motivated Hanoi-directed forces in Viet-
and also made twice-is "I had always damn bit, either! " nam with the cowed forces of Sad dam
envisioned the literary life, or as we Ivins is the driver, parading through Hussein and his intimidated generals
used to say in East Texas, 'being an the neighborhood at the wheel of a in Iraq.
arthur, as involving a lot of hanging out bestseller book. White Texans are Browne concludes: " .. . honest re-
at Elaine's in New York City." Quoting Michael; the dog is our pride. Some of porting is the last thing most people
Texas politicians, Ivins writes that they us are running to salute Ivins as she want when the subject is war. In the
say things like, "Ah cain't tell yew how goes by, but the rest of us, our dogs eyes of millions of enthusiasts, there
happy yew are to be here," and "We're under leash, are keeping away from the may never have been a bad war. War is
gonna have us some ree-form around street-and hoping that rich man or thundering good theater, in which
here." In Ivins's columns and those of lawyer jokes will come back into vogue . cheering the home team is half the
the similarly syndicated, but really sur-
real Texas movie reviewer,John Bloom,
• fun. " •
Dick J Reavis, Nieman 1990, is currently jack Foisie, a 1947 N ieman Fellow, opened
aka Joe Bob Briggs, Texans speak in
writing a book for Simon & Schuster about the Saigon Bureau of The Los Angeles Times
dialect.
events in Waco last spring. in 1964 and later covered Southeast Asia
Everybody eats watermelon, but only
blacks stereotypically do, and every- from Bangkok. Retired, he occasionally
body speaks in dialect-President muddies his boots in Monmouth, Oregon.
Kennedy invaded "Cubar" not Cuba-
but Texans stereo typically do. The Ivins/
Bloom act is unquestionably based on a 284 Photographs and No Text
regional stereotype.
In Critical Theory, I'm told, their use It is fitting that there is no text in "An Autobiography" by Richard Avedon (Random
of dialect would be tagged as "internal- House. $100) . There needn't be. The 284 photographs speak volumes about the
ized colonial discourse." Or to put it nearly half century that the master photographer documents. In crisp black-and-
more simply, Ivins and Bloom are ac- white prints in this elephant-size folio he captures both the powerful and the
tors in the Texas version of "Amos and powerless. As far as fashion photographers go, Avedon has no peer and the images
Andy." They're funny because they lam- taken from his Harper's Bazaar and Vogue days are the epitome of style. But
poon an us that's somewhat and some- sometimes his studio portraits of the famous fail miserably. His 1976 series on the
how dubiously regarded by the much- power brokers of America, including
vaunted mainstream. Stereotypes do President Gerald Ford, Nelson
get internalized. "Amos and Andy" at- Rockefeller, Henry Kissinger, Edmund
tracted a black as well as a white audi- Muskie, Eugene McCarthy, and Rose
ence; Ivins and Bloom have fans in Mary Woods, are dull and unimagina-
Texas as well as elsewhere. tive . Conversely, his photographs of the
These clowning Texans are fortu- real and surreal people entitled "In the
nate that one great difference separates American West" are hip and honest. His
their ouevres from those of the creators jaunts as a photojournalist are equally
of "Amos and Andy": nothing in the effective and moving. If the book shows
regional heritage of self-stereotyped
Texans compares with the oppression
an imperfect world, so too is this an
imperfect book. Many of the photographs
I
of Africans in America, and indeed, are personal. His father, for example, is
Texanhood, as the stereotype presents
it, is a status open only to whites.
in the book 10 times while conspicu-
ously absent are Avedon's famous pho-
I
tos of the Beatles. •
-Stan Grossfeld I
Richard Avedon self-portrait

76 Nieman Reports /Winter 1993

-------------------11w I N T E R R E A D I N G fI------------------
A Good Read, but Only a Clip Job of Justice Brennan
AJustice for All:
William J. Brennan, Jr., and the Decisions That Transformed America
Kim Isaac Eisler
Simon & Schuster. 303 Pages. $22 .

BY JoEL KAPLAN

ore than 30 years ago, a deci- Sullivan Case and the FirstAmendment." those opinions and so the reader never

M sion that transformed Ameri-

can journalism was handed
down by the U.S. Supreme Court. In
But little has been written about the
man who made it happen: William ].
Brennan Jr. In "AJustice For All," jour-
really gets a sense of the incisiveness of
Brennan's legal thinking.
The result is that the book is simply
New York Times v. Sullivan, Justice nalist Kim Isaac Eisler attempts to paint a clip job of Brennan's life and hence,
William J. Brennan was able to craft an the first definitive portrait of Brennan not a serious piece of biography.
opinion that has protected the media in since his retirement in 1990 after 34 For example, there are no notes of
this country from assault by public offi- years on the bench. any kind, nor any elaboration of the
cials who did not like any criticism of In this biography, Eisler takes the source of many of the author's asser-
the way they did business. By creating reader through Brennan's early years in tions and opinions. All Eisler gives the
an "actual malice" standard, Justice Newark, NJ as the son of a politically reader is a four-page bibliography and a
Brennan allowed journalists to do their powerful union leader, through his days statement that most of the material in
jobs without fear that an innocent or as a successful corporate lawyer and the book came from the papers of seven
even stupid mistake would bankrupt state judge. The bulk of the book fo- former justices.
their news organization. cuses on Brennan's most famous cases, "His fight with Frankfurter had
Brennan's decision gave investiga- from the Roth obscenity decision of the marked Brennan's only failure of per-
tive reporters the right to dig up scan- 1950's to the symbolic speech flag-burn- sonality," the author writes at one point.
dals like Watergate, Iraqgate and the ing case of the late 1980's. He even "He had been close with Frankfurter's
Iran-Contra affair. It gave editorial writ- devotes a half dozen pages to Sullivan. ideological twin, John Marshall Harlan.
ers the right to call for the impeachment But unfortunately, Eisler's attempt He had also maintained close friend-
of a president and the resignation of a to describe and define Brennan is fa- ships with Marshall, Stewart, White and
couple of others. It even ultimately gave tally flawed. It's not so much that nei- Powell. And he won the grudging re-
the tabloids the right to write about an ther Brennan nor his family cooperated spect of the Court's most difficult mem-
alleged affair between a candidate for with the author. The problem is prima- ber, Douglas. Privately, Brennan felt
president and the state employee whose rily that the rendition is superficial and that Douglas could be a 'horse's ass.'
job he procured. unrevealing. As Eisler himself conceded But that wasn't saying much. Around
The brilliance of New York Times v. in the acknowledgments that follow the the Court that was considered more
Sullivan is not so much that it has stood book: "This work does not attempt to fact than opinion."
the test of time-it certainly is still good be a definitive statement on Justice Where does this information come
law today-but that Justice Brennan Brennan's judicial career ... Brennan's from? Another book? Papers of a justice?
was able to secure a unanimous deci- judicial writings are so vast that it would Since the reader has no way of knowing
sion of the nine-member court. That be impossible to deal with the ramifica- where Eisler gets his information, there
was no easy task, given that some mem- tions of all of them in a liftable is no way to judge the credibility of his
bers of the court believed firmly that the volume .... Rather than a final statement, conclusions.
words of the First Amendment prohib- this book stands as an important first William]. Brennan Jr. should be the
ited a public official from ever winning step in a process of consideration that subject of a terrific biography one day,
a libel suit while others believed that will doubtless go on for decades." of interest to journalists, scholars and
libel was the province of state legisla- Nevertheless, the 303-page book is a the general public. Unfortunately, this
tures and wanted the case narrowly good read, well-written and not bogged is not it. •
decided. down by what many writers would do-
joel Kaplan, Nieman Fellow 1985, is an
The intricacies of how that decision simply excerpt highlights of Brennan's
Assistant Professor ofNewspaper at the 5.1.
came down has been told expertly in opinions. If anything, Eisler goes out of
Newhouse School ofPublic Communications
Anthony Lewis's "Make No Law. The his way not to quote too much from
at Syracuse University.

Nieman Reports I Winter 1993 77

 OMBUDSMAN

How Columnists Can Stay Out of Trouble

BY jOANN BYRD

olumnists are troublemakers. trouble if people disagree with a People who call this ombudsman to

C They harp on other people's

flawed thinking and the way
things are going and systems that don 't
columnist's opinion. If the voicemail
gets jammed, or the mailbox, so what?
This is why they put all that space in
complain about a columnist as often as
not identify themselves as part of the
columnist's flock. And they always be-
work. They locate holes in the conven- voicemail and mailboxes. If readers wear gin by recognizing one truth: "A colum-
tional wisdom and challenge our quite out the fax machine to tell a columnist nist is entitled to her opinion."
comfortable assumptions. he's wrong, then columnists don't do What readers say after that has be-
Some columnists specialize in find- monologues, but conversations. gun to collect in consistent patterns I
ing new things for us to worry about, or Forget bigots and partisans who are should tell you about. ("You" being a
even more examples of what already constitutionally unable to entertain any columnist, or someone who wants to
had us feeling pretty bad. Columnists point of view not their own. They favor know just how much the world de-
force us to think when we thought we'd the ad hominem attack, and there's mands of people in exchange for guar-
already done enough of that. nothing anybody can do about it. anteed space and so much license.)
All of that is the kind of trouble the Trouble is when a columnist under- Anyway, the message I bring from
world needs. mines his own credibility or the power the ombudsman's own voicemail and
But what is awful to watch-or expe- of his arguments. Trouble is when a mailbox is this: A columnist can avoid
rience-is a columnist making trouble columnist's readers aren't so sure 93 .7 percent of the trouble she brings
for herself. they're going to keep considering his on herself simply by doing what she
Let me say that it doesn't count as views.

joann Byrd has been ombudsman at The

Washington Post since june 1992. Before
that, she was Executive Editor, Managing
Editor and City Editor of The Herald in
Everett, Washington, and Assistant City
Editor and general assignment reporter at The
Spokane Daily Chronicle. She got her first
news job at age 13. As a 1989 Fellow at the
Freedom Forum Media Studies Center at
Columbia University, she began developing a
procedure for making ethics decisions in
newsrooms. She has an MA. in philosophy,
with an emphasis on ethics.

78 Nieman Reports /Winter 1993

 knows she has to do. Every time. homework, I think. on other journalists. A columnist is in-
For convenience, we will call these Anyone who's written a column for viting strangers to see the inner work-
collected lessons from the more than a week could tell you all of ings of her brain. A reporter (whose
ombudsman's phone Caution One , that. And readers with the credibility to thinking may be revealed by what's in
Caution Two, Caution Three and Cau- be heard on this subject intuit the rules . or not in a story) at least has the facts of
tion Four. This trouble happens because the the matter and the traditional formula-
Caution One: Do your reporting. columnist, sitting beneath a ticking clock tions of a news story for fig leaves.
(The way readers say this is something or coming up dry or distracted by prob- But a columnist is exposed like no
like, "So-and-So wouldn't think that if lems at home, just doesn't do it this one else at a newspaper. And a pretty
she knew anything about history (my time. constant target. And expected to be
town, the law, this disease, the intent of It's capital-T Trouble when you have wise and insightful week after week
this, the fine print, et al.) ." Or: "Tell So- to explain that you didn't do what ev- after week.
and-So to get his facts straight next eryone knows to be the ABC's. More trouble you do not need. •
time. That isn't the way this happened." These burdens do not fall so heavily
Even if it's not a reporting column,
readers trust a columnist's perspective
on some topic only when the column Nieman Reports Recycled Computers
matches up to the whole of the story.
For any conclusion based on what might And Writer Win Support Free Press
be called facts, make the trip, do the
interview, read one more report. ASCAPAward Oslobodjenje, the Sarajevo newspaper
Caution Two: Do your reporting that won the Nieman Foundation's Louis
first. (Reader to ombudsman: "So-and- An article in Nieman Reports was one of Lyons Award this year, and other strug-
So made up his mind in his ivory tower the winners of the 26th Annual ASCAP- gling newspapers in Eastern Europe and
down there and then talked only to Deems Taylor Awards for outstanding the former Soviet Union, are using cast-
both of the people who agreed with print and media coverage of music in off computers that have been donated
him.") Most of us have to overcome the 1992, The American Society of Com- by American newspapers and other busi-
brain's ability to overlook or dismiss posers, Authors & Publishers has an- nesses.
what doesn't support what we think. nounced . The computers are recycled by the
But if one contrary fact is going to sink "Popular Music-Political and Social nonprofit East-West Education Devel-
your ship, it's better to know about it Realities Can Be Discovered in Serious opment Foundation of Boston.
before you leave the dock. (T-shirts, Criticism of the Medium," by Anthony For newspapers struggling to pros-
$22 plus shipping and handling.) DeCurtis appeared in the Fall1992 "Crit- per in the new climate of freedom the
Caution Three: Make it a see- ics &The Arts" issue. DeCurtis, a senior computers, although not the latest, can
through case. ("Where is this guy com- features editor of Rolling Stone, was be a definite improvement in technol-
ing from?" Or "His thesis may be fine- also cited for two articles in that maga- ogy. For the donating companies the
though I doubt it. I hear he plays tennis zine. gift is a tax break.
with a lobbyist for the insurance indus- In all, eight writers of journal, maga- The East-West Foundation also ac-
try.") Even if yours is an established zine and newspaper articles and their cepts computer donations from indi-
voice and a reliable perspective, that respective publishers, and the authors viduals .
doesn't tell readers how you got to this and publishers of eight books were A contributor can designate a specific
particular finale . A transparent path to honored at a ceremony on December 7, purpose or country as recipients for its
your (undoubtedly correct) conclusion 1993 at the Society's New York head- computers.
is also the recommended way to bring quarters. ASCAP President Morton Inquiries about the program should
your readers to the same place. Gould was scheduled to present the be addressed to the East-West Educa-
Caution Four: Give an inch to the awards, which included $6,000 to be tional Development Foundation, 49
opposition. ("Here 's why she's wrong distributed in cash prizes to the win- Temple Place, Boston, MA 02111. •
about this. Did she ever consider ... ?") ning authors and writers.
And a little respect. ("Listen: So-And-So The ASCAP-Deems Taylor Broadcast
thinks we don't deserve a place at the Award in television was awarded to derlying and surpnsmg connections
table because we don't agree with him?") NBC's "Saturday Night Live" for "its among musical genres of every kind ... "
Demonstrate that you know yours is singular role in providing cutting-edge And a special citation will be presented
one of the available opinions and art- popular music .. .for 18 years." The to the editor of "Opera News".
fully explain why the other views don't Broadcast Award in radio will be pre- The Awards are given in honor of
cut it for you. Readers want to see that sented to the host and producer of Deems Taylor, who was the composer,
you 've weighed everything. Then they American Public Radio's "Schickele Mix" music critic and editor. He served as
can agree with you without doing more for "an educational and entertaining President of ASCAP from 1942-1948. •
radio program that showcases the un-

Nieman Reports I Winter 1993 79

 RESPONSE
Publisher's Note- Nieman Reports
'Debacle at Waco' Disputed regrets any errors in the article "De-
bacle at Waco" which led readers to tbe
conclusion that the Waco Tribune-Her-
Waco, TX than once that we hold off printing our ald broke commitments made to the
Those of us who know the truth from series and that I agreed each time. It AJF or madephone calls into the Branch
the inside and who have read "Debacle said that we held the series for about a Davidian compound on the morning
at Waco" by Wendell Rawls Jr. in the month at the request of the ATF, then ofthe February 28 raid. Although such
Summer 1993 issue of Nieman Reports "suddenly and inexplicably" decided information contained in the original
shudder to think that his work meets we could wait no longer. article was obtained from local and
the standards of this esteemed quar- I told Mr. Rawls the same thing I federal officials, subsequent investiga-
terly published at Harvard University. publicly stated in an open letter in our tions by state and federal authorities
The article misrepresented our deal- newspapers the day after the failed raid provided no evidence to support their
ings with the Branch Davidians and the and have told numerous other report- allegations.
Bureau of Alcohol, Tobacco and Fire- ers who interviewed me:
arms that sought to suppress our series "We told the agents that we appreci- Editor's Note-Wendell Rawls's ar-
about the now-famous Davidian reli- ated their position but couldn't make a ticle said that The New York Times was
gious compound near Waco. commitment not to publish." one of the newspapers that reported
The piece contained two important When the ATF approached us we that Sharon Wheeler had alerted the
errors: considered its concerns as any respon- press in advance of the raid. While
1. It erroneously and without any sible newspaper would. But we made noting that Wheeler had called various
substantiation stated that five calls from clear that we would not commit to news outlets, Rawls said The Times
Tribune-Herald telephones were placed delaying publication. We heard noth- and others had not asked the editors
to the compound in the hour before the ing from the ATF to persuade us to hold and television news directors what she
ATF raid the morning of Feb. 28, imply- our series. had actually told them. If they would
ing that someone at the newspaper Our series included details of a 1987 have checked, Rawls wrote, they would
alerted the Davidians that the ATF was shoo tout among cult rivals and the pres- have discovered that Wheeler had told
coming. ence of a stockpile of assault weapons them nothing. Rawls based his criti-
There was no attribution and the at the compound. David Koresh 's ad- cism on a version of a New York Times
Tribune-Herald was offered no chance herents were armed, committed in the article that appeared in The Houston
to deny or disprove this allegation. extreme to their beliefs, and had a his- Chronicle. The version of the same ar-
No one on the Tribune-Herald staff tory of weapons use against foes. It was ticle that appeared in The Times said
made any calls into the compound the only prudent that we take steps to pro- that Ms. Wheeler did not provide de-
morning of the raid. We examined with tect our employees, customers and tails of the raid and actually quoted
the help of expert counsel the move- property if we were to risk incurring television news directors describing
ments that weekend of every staffer their wrath. Once we had in place a what she had told them.
connected to our coverage of the raid. program upgrading security the deci-
We gave our cellular phone records to sion to print was made. There was
authorities conducting an investigation nothing "sudden" or "inexplicable" Nashville
of the tragedy. about what we did. As a regular reader of Nieman Reports,
The newspaper's actions have been The article implies that we acted out I commend you for soliciting and pub-
examined by Texas Rangers, investiga- of a desire to maximize the series' expo- lishing Wendell Rawls 's critical piece
tors from the U.S. Treasury Department, sure to win a Pulitzer Prize. Nothing on the journalistic performance during
a task force of the Society of Profes- could be further from the truth. I don 't the Davidian Compound Crisis.
sional Journalists and the American believe in assigning stories or making It reminded me that not since A. J.
press itself. There were no phone calls. decisions for the sake of winning prizes. Liebling's "Wayward Press" pieces in
2. The article attributed to me the I deeply resent any such implications. the old New Yorker have we had the
statement that the ATF requested more Bob Lott, Editor sort of tough-minded news media criti-
Waco Tribune-Herald cisms that are needed to keep a "way-

80 Nieman Reports /Wimer 1993

ward press" from straying-or to ex- tributed because he thought Newsday many reporters felt that with such vast
pose the press when it strays. was "Serb-bashing." Such is the desire media coverage the world would "do
I well remember during my Nieman to disbelieve. something" to end the carnage. How-
year, Liebling's evening with us and his Months later, The New York Times ever, she added , "The coverage of the
candid assertion that "newspapermen reported the Muslim-led government's genocide in Bosnia has ended that illu-
and clergymen who spend their lives claim that 50,000 Muslim women had sion."
exposing the flaws of others have the been raped by Serbs in Bosnia. Sud- Sylvia Poggioli
thinnest skins when their own flaws are denly rape became a major story-but
exposed." That still is true. reported in a propaganda context that
We badly need a regular, caustic, made it easy to doubt.
satirical published critique of a press Well, casting doubt is easy. The hard Two Parties inJapan
that continues to be wayward. part is "finding things out, " in Harrison
I hope that Nieman Reports will con- Salisbury's phrase. That's what Gutman Tokyo
tinue to publish occasional pieces by did , and he was honored for it with T.R. Reid's observation in "Japan'sFeisty
journalists or ex-journalists with Rawls's virtually every award journalism has to Press" (Fall 1993) to the effect that
insight, integrity and courage. offer, including a Pulitzer for interna- Japan's newspapers, magazines and TV
tional reporting. have abandoned their passive role to
John Seigenthaler attack the corrupt "system," is certainly
Chairman, The Freedom Forum Nina Bernstein valid insofar as it goes, but it fails to note
First Amendment Center Nieman Fellow 1984 the underlying political situation in
which the sustained rule by the Liberal-
Democratic Party appeared shifting to-
Bosnia Reporting Prague ward its eventual replacement by a com-
I believe Nina Bernstein may have petition between two rival parties similar
New York missed somewhat the point of my ar- to that in the United States and Britain.
Sylvia Poggioli's critique of reporting in ticle. The Liberal-Democratic predomi-
the Balkans (Scouts Without Compasses, It was not my intention to single out nance in Japanese politics is usually
Fall 1993) failed to acknowledge Roy any one journalist either for blame or referred to as the "1955 system," which
Gutman of Newsday, whose courage, praise. A number of fine journalists was adopted as preferable to a stale-
independence and tenacity in exposing have won awards for coverage of the mate open to the threat of leftist/Com-
"ethnic cleansing" and the concentra- wars in former Yugoslavia, Roy Gutman munist infiltration.
tion camps of Bosnia did, indeed, rep- included. ManyJapanese, including myself, feel
resent one of journalism's finest hours. I attempted, however, to point out that Japan can now afford to return to
In June and July 1992, when the the quagmire of disorder, disinforma- the system of two-party competition.
international press corps was focused tion and danger posed by these wars. It Relative to the term "system" quoted
on the siege of Sarajevo, Gutman did was-and is-an unprecedented situa- by Reid from van Wolferen, the 1955
the first in-depth reporting on "ethnic tion in post-World War II Europe . system is only a subsystem; that's the
cleansing," from deportations by sealed I was stressing the new realities of reason why Japanese media felt free to
cattle car to the murder of the Bosnian the post-Cold War world which are criticize it. T.R. Reid is perfectly right in
Muslim elite. On August 2, in a story posing new challenges not only for jour- saying, in regard to "bad guys ," "there
headlined "Death Camps," he detailed nalists but also for policy-makers, as we was a clear tendency to pile on once a
eyewitness accounts of killings at Brcko also can see now in the crises in Soma- politician was caught in the sights."
and Omarska, camps where only one lia, Haiti and the former Soviet Union. An adequate perspective is needed
out of 10 inmates survived. That piece Moreover, the situation I was de- in reporting on a Japanese regime that
finally broke through public apathy. scribing was one in which not only is somewhat like a medieval Christian
On August 23, 1992, in "Rape by American, but also British, French, Ger- regime or a Sunni Islam regime where a
Order," datelined Tuzla, Gutman docu- man, Italian, Spanish, Canadian, considerable degree of authoritarianism
mented the systematic rape of 40 young Croatian, Serbian, Bosnian, Slovenian serves to protect values consistent with
Muslim women by Serb forces who had and other journalists from around the human dignity. I have limited myself to
captured their town inN orthern Bosnia, world had to operate. Sunni Islam just on account of the very
and the pattern of similar rapes as war Many of us , in that summer of 1992, unfortunate Salman Rushdie affair in
tactic. had "to find things out" to report the which an unidentified assassin or assas-
I happened to be in the Belgrade atrocities of "ethnic cleansing," but I sins killed a Rush die translator inJ a pan.
office of The Associated Press the night believe few of us today can feel our That was not so long ago.
Gutman's articles moved. A local desk pieces "broke through public apathy."
man showed me the copy, topped by an As Susan Sontag wrote in The New York Joe Kazuo Kuroda
FYI memo from an editor saying the Review of Books (October 21 , 1993), Nieman Fellow, 1956-57
story had not been internationally dis-

Nieman Reports I Wimer 1993 81

 N lEMAN NOTES
COMPILED BY LOIS FIORE

Will Nat Nakasa Ever Go Home?

BY LEWIS c. CLAPP
Gordimer, "He felt strongly that he writers and artists from South African
estled among the rolling hills of

N Westchester County between

New York City and Connecti-
cut, Ferncliff Cemetery is known as the
needed a wider intellectual context."
Nakasa pursued his application to
the Nieman Foundation by obtaining
letters of recommendation from two
society irrespective of their color or
origin.
John Thompson, Executive Director
of the Farfield Foundation in New York
who had given financial support to star~
final resting place of many famous
people, including actress Judy Garland, personalities who were well known to
the Harvard community, Helen Suzman, The Classic, agreed to pay Nakasa's
composers Bela Bartok and Jerome
the white member of the South African Harvard expenses. Nakasa's only re-
Kern, writer James Baldwin and black
Parliament (who actively opposed the maining hurdle was to obtain a travel
activist Malcolm X. There, too, but in an
doctrine of apartheid) , and from his visa from the South African government.
unmarked grave, lies Nathaniel Nakasa,
literary mentor, author Nadine On the day before his classes were to
a 1965 Nieman Fellow from South Af-
Gordimer. Suzman was particularly start at Harvard, Nakasa was finally re-
rica.
impressed by Nakasa's spirit of equal- fused a passport to travel to America.
For nearly three decades Nakasa's
ity. "It is rare indeed," she wrote, "to Nakasa, who had believed a state-
body lay forgotten until early this year
find an African who has managed, de- ment by the Minister of Justice that no
when Dana Snyman, a young South
spite all the difficulties, to throw off any action would be taken against people
African journalist, wrote a feature story
racial resentments as has done Mr. who opposed apartheid, was bewil-
about finding the grave for the Afri-
Nakasa. " dered . He said, "I have never been a
kaans daily Beeld. Tim du Plessis,
Gordimer echoed the thought in her member of a political party nor have I
Nieman Fellow, 1993, translated the
letter as she described Nakasa's role in been actively connected with politics."
article into English and sent it to Bill
helping to start the magazine. A group The only path open to Nakasa if he
Kovach, the Nieman curator. After an
of African writers including Nakasa had wished to go to Harvard was to obtain
investigation, Kovach ordered a marker
wanted to start a literary magazine, but an exit permit, which would seal for-
placed on the grave.
they had trouble finding money for the ever any hope of returning to his native
As a poor child in Durbin, Nat worked
project. Eventually a small grant was country. After receiving travel docu-
to help his family. Even though he would
obtained from the Farfield Foundation ments from Tanganyika, he left for the
be up at 4 in the morning to sell news-
in New York, but by that time the origi- United States.
papers, he managed to get enough
nal writers had dispersed and only Nakasa was perplexed by what he
schooling to obtain a junior certificate.
Nakasa was left to continue the effort. saw of New York City, "a great modern
In spite of his meager education, he
He threw himself into the project blindly slum" where "countless blocks of flats
became a reporter and editor of a new
ignoring obstacles, such as how they are without paint on the outside and
literary quarterly called The Classic.
would obtain a white printer for a black- corridors are in a state of perpetual
Painfully aware of his limitations, Nakasa
run magazine. Not knowing how best semi-darkness." He felt better about
established an advisory committee.
to edit or administer a literary maga- Cambridge and Boston where he en-
Nadine Gordimer, a 1991 Nobel Laure-
zine,Nakasaformedamulti-racialBoard joyed the charming neighborhoods with
ate in literature, was his literary con-
of Trustees and editorial advisors to old wooden homes, but he was not at
science. He saw Harvard as the place
oversee the publication. He was deter- ease in the academic surroundings of
where he could acquire knowledge and
mined that the endeavor would be non- Harvard which seemed atypical of the
develop skills he lacked. According to
political, purely literary and open to all American way of life. "I could probably

82 Nieman Reports /Winter 1993

spend a year without knowing the full they took everything away from you , In South Africa some of Nakasa's
meaning of being black in the United everything, and yet that tenant farmer friends pulled together a collection of
States," he lamented. still gets up in the morning, the black Nakasa's writings and along with a eu-
Nakasa attempted to deal with his man in Harlem still rides the subway." logy by Nadine Gordimer published
inner feelings at first by assuming an air When the Nieman year ended, Nakasa "The World of Nat Nakasa." After that
of indifference and detachment about moved to New York, writing occasional Nakasa was largely forgotten until Dana
his situation and events in South Africa. free-lance assignments for The New York Snyman found his unmarked grave.
His associates at the Nieman Founda- Times and Esquire magazine. He took Thompson, who had helped make
tion wondered how anyone growing part in a television program about South the funeral arrangements, said "We just
up under the oppression of apartheid Africa and he began work on a biogra- assumed" the funeral home would take
could maintain such a casual objectiv- phy of his friend Miriam Mkeba, the care of the grave marker.
ity. On one occasion, however, Nakasa's South African folk singer. But his real The Nieman Foundation has now
indifferent facade disintegrated. At a goal was to get back to Africa, possibly done that. The bronze marker installed
seminar where Tom Pettigrew, a young Tanganyika, were he could work on a on his grave reads:
social psychologist, was talking about magazine that might be smuggled into Nathaniel Nakasa
race relations, Nakasa, who had been South Africa. He dreamed that he might May 12, 1937- July 14, 1964
drinking a good deal of beer, began even be allowed to return to his native Journalist, Nieman Fellow,
with a small challenge, but soon lost homeland. South African
total control. As Ray Jenkins, a class- The Farfield Foundation's Thomp-
mate, described the two hours, Nat son, who had supported him so often in
1951
shouted incoherent statements about the past, continued to help. Hearing
drinking blood, about who is to judge that Nat had become despondent, he Elaine (Cass) Sargent, wife of former
civilization and about how the white went to Harlem one day in July, found Nieman curator Dwight Sargent, died in
man can never really understand what Nat and took him back to his home her home in Pelham Manor, NY Septem-
goes on inside a black man. The next overlooking Central Park. Thompson ber 8. Mrs. Sargent was a nurse and an
accomplished singer who was chair of the
day Nakasa made a round of apologies. thought that if Nakasa would stay with
musical committee at Wellesley Hills
There are no reports of further erup- him and his family for a few days he Congregational Church. Sargent, now
tions for the rest of the year; but he did would get over his loneliness and sad retired, was national editorial writer for
drop out of sight for periods of time. feelings. They had dinner and talked the Hearst newspapers and curator of the
When he surfaced he would attend semi- into the night. According to Thompson, Nieman Foundation from 1964 to 1972 .
nars or go to lectures, remaining quiet Nakasa's spirits seemed to be buoyed
for the most part. His conversations up and he talked about his plans. But
1953
with friends were frequently inscrutable Nat also expressed concern about fi-
and he accepted occasional offers to nances and his mother in a South Afri- Kenneth E. Wilson died of cancer on
travel and speak about conditions in can mental hospital. He also talked September 20. He was 71 years old.
South Africa. about his own sadness and wondered Wilson was born in San Francisco and
The New York Times published a aloud if he too was going mad. When grew up in Santa Rosa. He began his
journalism career writing sports articles
piece he wrote about his impressions of Thompson reassured his friend that in
for The Press Democrat in Santa Rosa
Harlem, comparing it to the life and time everything was going to be OK, while he was still in high school. He went
sights of the South Africa. He was fasci- Nakasa seemed to perk up. They said to the University of California, Be rkeley,
nated that such opposites as the Rev. good night and went to bed. In the and joined The Press Democrat as a copy
Martin Luther King Jr. and Malcolm X morning, Thompson found the win- editor after his graduation in 1948 . He
could emerge as leaders. The Times dow open. Nakasa's body was lying on was appointed managing editor of the
asked him to write his impressions of the ground several stories below. He morning edition in 1950.
the South. When he returned he seemed was just 28 years old. After Wilson's Nieman year, he began
disillusioned by what he perceived to About eighty mourners, many ex- working at The San Francisco Chronicle as
assistant news editor and was later pro-
be the real tragedy of the black Ameri- iled South Africans, attended the fu-
moted to news editor. Wilson eventually
can. He told his friend Kathleen Conwell, neral and heard Miriam Mkeba sing a took charge of The Chronicle's transition
"When I was there, there were mo- Zulu chant. There was some thought to computers. When he retired in 1988 his
ments when I wanted to bow to a tenant that the body might be sent to Africa. title was assistant to the publisher for
farmer in Alabama because I under- But it soon became evident that even in systems.
stood the miracle of his survival. They death Nathaniel Nakasa could notre- "Ken was born to work on papers," his
took away his identity and yet he has turn to his native country. The next day Chronicle obituary said. "He once told
survived. In South Africa we have a his body was taken to Ferncliff Cem- Rodney Jones, who knew him for years,
culture that has lasted for generations; etery and buried a few feet from Malcolm that as a kid he'd gotten dummy pads
somewhere and would lay out pages of
we have a language; we are a people; we X's grave, in what some call the "black"
imaginary newspapers. "
are grounded in something solid. But section.

Nieman Reports I Winter 1993 83

 After Wilson was diagnosed with cancer to be no less than "a theater without achieved. It seemed as if he just liked
earlier this year, Chronicle humor colum- actors, plays without playwrights , and bursting our bubble . Behind our back,
nist Arthur Hoppe said that Wilson was a reporting without summary or opinion." he bragged about his three children so
"solid man with an innate dignity, a fine much a co-worker recently said she
mind, a refreshing modesty, a strong was sick of us before she even met us.
sense of justice and self-deprecating sense 1957 But Daddy shielded us from too much
of humor ... I'm proud that he's my best Harold Liston, 72, died on May 29 in parental pride until he deemed us old
friend." his hometown of Normal, IL, after a five- enough to handle it. To us children, it
Ken Wilson leaves his wife of 44 years, month illness following heart surgery and felt as if nothing came easy in our
Verna Lee, sons Matt, also a journalist at a stroke. He retired at the end of 1982 household. A walk home was never just
The Chronicle, and Dan, two sisters and after 15 years as editor of The Pantagraph a way to get to the house. It could be a
two granddaughters. in Bloomington, IL. At the time of his seminar on urban affairs or a lecture on
Memorial contributions may be made to Nieman year he was city editor of that architecture , but it was always more
the John G. Trezevant Fund at the Univer- paper, and over the years became assis- than just a walk home. Pop took us to
sity of California, Berkeley, School of tant to the editor and then editor. see presidents, and he talked with us
Journalism, 121 North Gate Hall, Univer- Liston leaves his wife, Phyllis, three sons, about politics. Then he expected us to
sity of California, Berkeley, 94720. Geoffrey, Jonathan and Christopher, and a be able to join him in a discussion of
granddaughter. why third-party candidacies have yet to
work in this nation .
1955 Other people's parents took them to
Robert Drew has been named by the 1966 the circus for their birthday. My father
International Documentary Association to took me to watch Walter Cronkite tap-
Robert Maynard died on August 17. His ing the CBS Evening News. Then we
receive its 1993 Career Achievement daughter, Dori Maynard, a '93 Nieman
Award in Los Angeles on November 5 in spent some time talking about what
Fellow, wrote for the magazine Outlook was behind the urban unrest reported
honor of a lifetime of award-winning, the following column about her father:
pioneering film achievements. on the Cronkite show. I was 9 years
The day I graduated from college, old. With Daddy, there was always an-
In 1960 Drew's film "Primary," an my father reminded me that far from
account of the Kennedy/Humphrey race in other point, always something more to
over, my education was only begin- do, discuss or think about.
Wisconsin, was the first film shot entirely ning. That was my Dad . He was a father
in sync sound with hand-held cameras Years later, I discovered that my fa-
who felt one of his first duties as a ther was not a man with a mean streak.
moving freely, using portable equipment parent was to protect his children from
that Drew and his colleagues engineered. He was a doting Dad who wanted his
complacency. No matter how great our children to look beyond the borders
A statement announcing the award says conquest, he was quick to note, more
that with this film , "American 'cinema and beneath the surface of life's issues.
was yet to be done. By that time , I had joined him in
verite' was born, creating a whole new Growing up, I did not always find
world of film journalism, in which the journalism and had graduated from
that one of my father's more endearing watching the taping of a news show to
camera became very nearly a human traits. I would come home aglow over
observer, watching as real life stories were helping him prepare for his appear-
some accomplishment, only to have ances on "This Week With David
allowed to unfold naturally. " According to Dad remind me of the goals yet to be
Drew, film and television journalism was Brinkley."
I had also learned that those child-
hood lessons actually came in handy,
now that I was covering the complexi-
ties of a mayoral campaign or urban
affairs. My father was not one for saying
"I told you so." Instead, he would nod
his head slightly and say, "How about
that. Something I taught you turned
out to be useful." Then he would laugh
his big laugh.
I've had several reasons to remem-
ber those lessons in the weeks since his
death. The first time it happened was
downright eerie. I went out to buy the
week's newsmagazines, another habit
ingrained in childhood, and almost fled
without one of them. There on the
cover was a poignant picture of an
Mrican-American child, under the head-
line "A World Without Fathers." It was
not a subject I was ready to think about
that day, the day of my father's memo-
rial service. Then I heard Dad's voice

84 Nieman Reports /Winter 1993

 chiding me for allowing sentimental Navy pilot in the Pacific during World War recently made me the youngest and most
rubbish to override intellectual explo- II. handsome grandfather in South America."
ration. After his Nieman year, he returned to
I bought the magazine. Nestled in- Time Inc. as editorial director. In 1973 he
side was a story celebrating my father's became a visiting professor at Harvard 's 1984
life . "Give Me a Chance to Try," was the Graduate School of Business Administra- Nancy Webb writes to say that she and
headline on that story. tion. her husband, Dick Shafer, have moved to
His life was proof of what properly Banks is survived by his wife, Mary Mill Valley, CA, "a Golden Gate Bridge
prepared people can do with a chance . Campbell Banks, four sons, a daughter, away from San Francisco," where Dick
He parlayed an appointment to edit and eight grandchildren. works. They have two children, Ariel, in
The Oakland Tribune into an opportu- kindergarten, and Cameron, who is
nity to buy the newspaper. "The great Free-lance writer Barlow Herget ran for almost 4 years old. As a local alumnae
pleasure in life is doing what people Mayor of Raleigh, NC this fall and al- Nancy is invited to the annual Nieman
say you cannot do," he would often say. though he ran a strong campaign, the race Orientation Week cocktail party, held
Then he was quick to quo te Disraeli "didn't come out on my side. " Herget has each September in the Fellows' garden at
and add that "the secret of success in been a City Council member since 1989. Lippmann House. This year, Nancy's
life is for a man to be ready for his As a journalist in the 70's he worked for invitation was forwarded to her at her
opportunity when it comes." The Arkansas Democrat, The Detroit Free new address. Too far away now to attend,
His life's work was to make sure Press, and wrote editorials for The News she continues in her letter to say "The
others also had the benefits of prepara- & Observer in Raleigh. white picket fence [around Lippmann
tion and opportunity. He truly believed House] and the utopia it contains, plus
no one could prosper unless we are all familiar aspects of annual receptions-
prosperous. Even when he became bed- J .K.G.'s (John Kenneth Galbraith] tower-
ridden, he always had the energy to 1975
ing presence, Bobbie Norfleet's excite-
help friends and young journalists with Gene Pell, president of Radio Free ment about something new and good,
letters of recommendation or words of Europe/Radio Liberty for eight years, has Tony Oettinger's thoughtful voice, a fresh
advice. resigned. The new president, William batch of Niemans jumping for joy, heels
Many people have written to remind Marsh, previously served as executive vice- sinking into the soft, moist green- I've
me that Dad's work is his living legacy. president of the stations. brought with me all the way to the West
I agree. However, looking at the sol- Coast."
emn boy with the big eyes on the cover
of a national magazine , I hear my 1977
father's voice again'. He is asking me to 1986
assess that child 's and other children's Photojournalist Robert Azzi, who spent
chances for either preparation or op- several years in war-torn Beirut, organized Barry Shlachter returned to reporting
portunity. Then he gently reminds me a project whereby eight teenagers from in August, covering Texas and the South-
that while he accomplished a fair Bosnia-Herzegovina will spend the aca- west for The Fort Worth Star-Telegram,
amount, there is still much more yet to demic year studying in Exeter, NH, living after a year editing specialist writers. Last
be done . with host families. Azzi, in an account in year he spent a month in Nigeria conduct-
The Boston Globe of the mid-November ing reporting seminars on behalf of the
arrival of the students, said "I wanted to Center for Foreign journalists and two
1970 make a contribution rather than take the weeks on a similar chore in Uganda on a
pictures. I wanted to participate." Azzi Fulbright/Hays grant. Barry's wife, Amrita,
Louis Banks, a former managing editor received help from Timberland Co., which completed a year-long study for UNICEF
of Fortune magazine and former editorial provided boots and clothing for the on India's urban children and traveled
director of Time Inc., died of congestive students; Virgin Airlines, which provided through Mrica to do a series on how
heart failure in Naples, FL, on Sunday, air transportation from London; and the Mricans themselves perceive the AIDS
November7. Business Corporation, which provided air crisis.
Banks began at Time in 1945 as a corre- travel from Logan Airport in Boston to
spondent in the Los Angeles bureau . He New Hampshire.
was chief editor of Fortune from 1965-70 1987
and was editorial director from 1970-73,
Marites Vitug's first book, "Power From
the second highest editorial position at 1981
Time Inc. The Forest: The Politics of Logging" was
The account of his death in The New Daniel Samper, in a postcard from published this summer. It describes the
York Times said: "He helped launch a Spain, where he has lived for eight years, evolution of the country's logging indus-
number of new ventures, most notably tells us : ''I'm now the international editor try and the relationships of the loggers to
Money magazine . He retired as a member of 'Cambia 16' and, in spite of it, it is still the politicians and, according to reviewer
of the corporate board in 1987 when he the most prestigious Spanish Philip Bowring in The International
reached the age of70. " newsmagazine ." Daniel's wife , Pilar, is the Herald Tribune, "says volumes about
He was born in Pittsburgh and raised in correspondent in Spain for a TV news money and power in the Philippines and,
Southern California. He graduated in program in Colombia. Daniel's youngest by implication, why its economy has
economics from UCLA and served as a daughter has just married and lives and stagnated while those of its neighbors in
studies in Boston and his oldest "has East Asia have boomed. " He goes on to

Nieman Reports I Winter 1993 85

say that Marites was threatened and faced I must say it was something close to
Mitsuko Shimomura stopped in
libel suits during her years investigating madness . But what can you do? It is
Cambridge this fall during a two month
the loggers. where the story was. I can't tell you
visit to the United States. She spent 10
Vi tug sits as a member of the board of what I thought, Bill, but I can tell you I
days traveling to various cities on behalf
editors of the Center for Investigative was scared.
of the Japan Society, lecturing on the
Journalism, and also writes for Newsweek
dramatic political and social changes Vladimir Voina is back in Boston, this
from Manila.
going on in Japan. Now Mitzi is doing time as editor-in-chief of The Boston
research for a series she is writing on Courier, a new Russian language weekly
1988 corporate responsibility, interviewing the published for the 35,000 members of
heads of corporations who have a reputa- greater Boston's Russian community.
For a few days this fall, there seemed to tion for being "good corporate citizens"- Vladimir says,
be hope for a measure of peace in Ireland. companies trying to develop a philosophi- At this stage of our existence life is
We asked Emily O'Reilly, political corre- cal and moral standard, rather than just hard: we need ads and financial sup-
spondent with the Irish Press in Dublin trying to make as much money as possible port, good writers and young report-
to put the reports of peace-followed ' regardless of the consequences. ers who can cover city life. Sometimes
quickly by yet more violence-into per- Shimomura is senior staff writer for Asahi I fill a good half of our eight-page
spective: Shimbun. newspaper with my own stuff, signed
The world's media have been revisiting or unsigned, or signed by an invented
Northern Ireland during the worst period name. This is not good, but I am the
of violence in over a decade. In one week only professional among a tiny group
in October alone, 23 people were killed, 1990 of part-timers, all great enthusiasts, who
nine by an IRA bomb, 13 by Loyalist hit work for our newspaper free of charge .
John Harwood and his wife Frankie
squads and one , an IRA terrorist, by his
announce the birth of Leigh Blackbur~ After two journeys in August to Mos-
own bomb . cow and Kiev, and one to Tallinn Esto-
Harwood, born August 21. John and
The killings occurred in the midst of nia, I am full of impressions: in,many
Frankie have another daughter, Mary
frenzied political activity sparked off by a respects it is another country, and I
Jeanne , who was born in Cambridge
joint peace initiative by the two nationalist cover it with enthusiasm, even when it
during John's Nieman year.
leaders-John Hume of the Social Demo- seems morbid . I am still writing my
cratic and Labor Party (SDLP) and Gerry weekly column for Creators Syndicate
Ann Marie Lipinski and Steve Kagan
Adams of Sinn Fein-the political wing of in Los Angeles. My stories are trans-
also announce the birth of a daughter,
the IRA. lated and published in Japan and Ko-
Caroline Ann, November 1. Born in
The two leaders claim to have mapped rea but they need additional subscrib-
Chicago, Caroline is their first child.
out a process which could lead to a ers in this country to keep their author
cessation of all violence, but to date the afloat.
Paolo Valentino, based in Moscow for
British and Irish governments have been Vladimir is now married to Jane Knox-
the Italian daily Carriere della Sera, had
reluctant to take on board anything with Voina, a Russian professor at Bowdoin
an eyewitness account of the events in the
Sinn Fein/IRA origins. College in Brunswick, ME, and a research
Russian White House during the at-
Both Hume and Adams claim that there fellow at the Russian Research Center at
tempted takeover in October. In a phone
has been a major sea change in the think- Harvard University.
call to curator Bill Kovach, Valentino
ing of Irish republicans-those people
described his experience:
who want a United Ireland. They claim
A colleague from La Repubblica and
that Republicans now realize that they 1992
I had worked our way up to within 10
cannot coerce the one million Unionists
meters of the White House during the Deborah Amos, London-based corre-
in the North into accepting a United
shooting. We were hiding with some spondent for National Public Radio for 10
Ireland deal.
other civilians behind a small wall. For years, has joined ABC News as a corre-
The problem for British Prime Minister
a while the shooting stopped except spondent for its newsmagazine-in-devel-
John Major is that his slim Commons
on the upper floors where the para- opment, "Turning Point. " Amos and her
majority is being propped up with the
troopers were still clearing the build- husband, NBC journalist Rick Davis, will
support of Unionist MP's and he is unwill-
ing. A woman came out and asked if be based in New York.
ing to do anything that would jeopardize
there were any correspondents. We
that. Isaac Bantu, still in the Boston area
went with her into the completely dark
writes to say that The Press Union of '
and burned corridors.
Personally, Emily reports that Daniel Liberia (PUL) was "at daggers drawn" with
We got our interviews with Rutskoi.
James O 'Reilly Ryan was born on June 15, the Interim Government of National Unity
We were the last journalists to talk with
joining big sister jessica who is now three (IGNU) . According to the Executive
him before he was arrested . He asked
and a half. Emily's husband, Stephen Committee of PUL, it has ordered its
that we relay the message that they
Ryan, went to Dallas in September to members to disobey directives by the
were asking for guarantees from West-
collect eight design awards at the Society Interim President, Dr. Amos C. Sawyer,
ern ambassadors for their safety and
of Newspaper Design conference. Along who is said to have begun a clamp-down
they would surrender. When we left I
with her work with the Irish Press, Emily on the press for publication of war-related
took the message to the Italian ambas-
last year published her second non-fiction stories. Isaac continues: "At a press
sador who brokered the surrender deal.
book, this time on the pro-life movement conference on behalf of the president in
in Ireland.

R() Nieman Reports /Wimer 1993

Monrovia, the Minister of Information We will need a lot of international Seth Effron ('92) , Tom Regan ('92) ,
said that the press was free to report any support, if not to fight the bill, then at Tom Witosky ('92), and Katherine
other stories including those on corrup- least some of its Draconian provisions. Fulton ('93 ) rounded out the Nieman
tion, political issues or otherwise. " How- contingency. Katherine is enjoying
ever, Bantu says that the PUL, after delib- teaching about the new technology at
eration, issued a statement, saying that it Duke University in a course entitled
viewed with "serious concern and trepida- 1993 "2001 : A Media Odyssey. "
tion" the government's action, which the Nguyen Quang Dy is back in Hanoi, In addition to the scope of topics
PUL sees as aimed at curtailing press and after shopping around for a new job presented, what made the Raleigh con-
freedom as provided for by the Liberian has decided to join World Affairs Review ference unique was the fact that report-
Constitution . .. " as an editor and to become director of a ers had access to over 100 IBM comput-
new Media Development Center. ers for hands-on training. With the help
Charles Onyango-Obbo updates us of dozens of volunteer instructors from
from Kampala, Uganda, about his newspa- Olive Talley was among several fellows around the country, reporters prac-
per, The Monitor : who took part in a computer-assisted ticed using spreadsheets and crunch-
The government ban on its depart- reporting conference sponsored by ing data.
ments and state- owned businesses Investigative Reporters & Editors and The While the last five Pulitzer Prizes in
advertising with private newspapers News & Observer in Raleigh in late Octo- investigative reporting utilized some
was lifted-for all newspapers except ber. She sent us this report: aspect of computer-assisted reporting,
The Monitor. It was the private pro- The conference inspired me about folks at this conference learned that its
government newspapers with low cir- the future of journalism, rekindling uses are not limited to serious take-
culations that were hurting. With our optimism that seemed to vanish as soon outs.
numbers, we don't really need govern- as I returned to the newsroom at the The Miami Herald, for example , ana-
ment adverts to survive . end of my Nieman year. lyzed vehicle registration records to
Only politicians wouldn't know it: Hearing re-entry stories from other profile the 250 Broward County resi-
such repressive actions only help the fellows consoled me. dents who drive Rolls Royces.
credibility of newspapers. Hence circu- But equally rewarding was the inspi- The Raleigh IRE meeting was the
lation has gone up considerably since ration of witnessing the huge amount most ambitious, most comprehensive
the ban. Private business people , see- of learning that took place. Nearly 600 conference on computer-assisted re-
ing this, rushed in to book space. journalists from 42 states, Puerto Rico, porting ever offered. It will not be the
This puts us beyond the point where Guam, Canada and Mexico, came to- last.
the government can pressure us-the gether to share new ways of using com- With the help of a $221,000 grant
very opposite of what they intended. I puter technology to improve report- from the Freedom Forum, IRE plans to
have fears that they will try something ing. offer a similar conference in San Jose
worse . The problem as I see it is not We heard lectures on software, hard- next fall and a series of newsroom
that the government does not want an ware, statistics and math. We learned seminars and training sessions between
independent press as such; what they the difference between a database and now and then.
do not want is one which is economi- a spreadsheet; where to find databases As keynote speaker Frank Daniels III
cally successful enough to function in- and how to negotiate for them; and pointed out, computer-assisted report-
dependently of all political patronage . how to use computers to improve cov- ing is not about computers. It's about
This is what explains why they will erage of beats and politics. We sailed using computers as tools for better
let a hostile newspaper belonging to an the Internet and navigated government reporting and ultimately, for develop-
opposition group (which invariably has bulletin boards. ing a self-sufficient newsroom.
poor circulation and credibility) ben- Speakers included several Niemans. Newspapers' survival, he said, will
efit from government advertising, and Phil Meyer, whose first computer en- depend on their ability to sell news-
not allow an independent, relatively counter was with Harvard's IBM main- not ads. And it's the new technology
viable paper owned by journalists to frame during his 1967 Nieman year, that will enable us to provide more
do so. urged reporters to view Hypertext as a meaningful and relevant news that will
There is a press bill which is coming new way of thinking about and orga- be the salvation of newspapers.
before Parliament. It is worse than any- nizing their stories. (By the way, Francis 'We must use these news tools and
thing that ever came from behind the Pisani uses graphics and a script about skills as a catalyst to reforge the cred-
Iron Curtain. It requires that all jour- the Class of '93 as demonstration mate- ibility of our newsrooms with our read-
nalists be registered by the govern- rial for his Hypertext program.) ers, our community and our publish-
ment. The government committee ap- Melanie Sill, a current fellow, spoke ers,' said Daniels, the executive editor
pointed to do this can refuse to license on using Hypertext for organizing huge of The News & Observer in Raleigh .'
a journalist, without explaining the amounts of interview notes and other The top reporters who already use
reason for the refusal. Even after a material on long-term projects. this stuff on a regular basis get teased a
journalist is registered, the committee I presented "60 Ideas in 60 Minutes," lot about being nerds .
can cancel his license at will. There is a whirlwind slide show of quick hits, At this point, I'd rather be a nerd
no appeal procedure. This committee features, and long-term investigative than a dinosaur. •
will also determine whether one is pieces using computer-assisted report-
qualified to be a journalist. What it ing and a brief explanation of how the
takes to be qualified is not spelled out. stories were done.

Nieman Reports I Winter 1993 87

 Book Reviews
1993 Index A]ustice for All.. .Kim Isaac Eisler ... Wi77
Articles A Sense of Place ... David Lamb ... Fa72
Kovach, Bill .. . Hungarian press . . .Su2
African Media Seminar ... Fa30 American Ground Zero ... Carole
Kovach, Bill . ..Salisbury ... Fa2
Alsop, Joseph ... Defense of... Sp84 Gallagher ... Su79
Kovach, Bill ... Lyons Award ... Wi3
Amundson, Dan ... Children ... Sp7 At The Hinge ofHistory .. .]oseph C.
Kreck, Carol. .. Children ... SplO
Apple, R.W.Jr ... .Morris Lecture ... Su66 Harsch ... Su75
Kurtz, Howard .. . Book Excerpts .. .Su66
Araujo, Rui. .. East Timor . .. Fa20 Autobiography . . .Richard Avedon .. .Wi76
Lazar, Susan G ... . Health ... Wi17
Banks, Adelle ... Religion ... Su36 Even White Boys Get the Blues ... Doug
Lewis, Charles ... Health ... Wi27
Balk, Alfred . . .Economics ... Su72 Marlette ... Sp74
Liley, Betsy ... Health ... Wi36
Bernhard, Nancy. .. Religion ... Su16 Extreme Conditions .. .John
Loftus, Joseph ... PR .. .Su84
Biggs, Selden ... Election ... Wi57 Strohmeyer ... Fa70
Louv Richard . .. Children ... Sp25
Five Myths of Television Power. .. Douglas
Black Columnists Seminar ... Sp38
Lubr~no, Gina ... Gays ... Fa86 Davis ... Su76
Bosnia Reporting . ..... Fa16, Wi81
Ludtke, Melissa .. .Children .. .Sp4
Branch Davidians . .... .Su12 Fly Fishing Through Mid-life
Lyons Award ...... Su84;Wi3
Buresh, Bernice ... Health ... Wi23 Crisis ... Howell Raines ... Wi72
Manning, Robert ... Memoirs ... Sp59
Byrd, Joann . .. Columnists ... Wi78 Hodding Caner ... Ann Waldron ... Fa68
McNulty, Henry .. . Gays ... Fa80
Carroll, James ... Religion ... Su27 Leaving Birmingham ... Paul
Meyers, Bob .. . Health ... Wi8
Casey, Shaun ... Religion ... Su32 Hemphill. .. Wi70
Meyers, Mike ... Health ... Wi34
Children ... Sp4 Lenin's Tomb ... David Remnick. .. Fa65
Mezzacappa, Dale ... Children . . .Sp12
CIA ... Sp46 Listening to Prozac ... Peter D .
Morgan, Gillis ... Editor looks back. ..Sp85
Clapp, Lewis ... Nakasa .. .Wi82 Kramer .. .Wi69
Morris, Joel Alex]r. Lecture ... Su66
Clark, Mike .. .Gays ... Fa85 Lord Beaverbrook ... Anne Chisholm &
Niebuhr, Gustav ... Religion ... Su28
Cohn, Victor ... Health ... Wi3 Michael Davie ... Sp72
Nieman Fellows Selected .. .Su84
Cotter, William R. .. . Hate speech ... Fa23 Mad As Hell .. .]ack W. Germond &Jules
Objectivity ... Wi48
Cox, Harvey .. .Religion ... Su6 Witcover ... Fa63
Poggioli, Sylvia .. . Bosnia ... Fa16;Wi81
Crewdson, John . .. Health .. .Will Media Circus ... Howard Kunz ... Sp68
Priest, Dana ... Health ... Wi32
Daniloff, Nicholas ... Soviet Press ... Wi44 Muddy Boots and Red Socks ... Malcolm W.
Racial Tensions in Press ... Su56
Deaths: Browne ... Wi74
Radelfinger, Martin . .. Religion ... Su4 2
.. . Banks, Louis ... Wi85 Murdoch ... William Shawcross ... Sp71
Rawls, Wendell ... Religion . . .Su12;Wi80
.. .Liston, Harold ... Wi84 Newspapers' Upheaval. . .Stephan Russ-
Regan, Tom .. .Internet .. . Fa26
... Maynard, Robert ... Fa89;Wi84 Mohl...Sp73
Regan, Tom .. .Internet health ... Wi43
. . .Miller, Edward M.... Sp92 Nothin' but Good Times Ahead .. .Molly
Regan, Tom ... Children ... Sp28
.. . Paxton, Edwin ... Su86 Ivins ... Wi75
Reid, T.R. .. .Japan's Press ... Fa14/Wi81
... Torrey, Volta ... Sp92 Paper Soldiers ... Clarence Wyatt . .. Fa71
Religion ... Su3
... Wilson, Kenneth E... .Wi83 Preparing for the 21st Century ... Paul
Rosen, Jay ... Objectivity ... Wi48 Kennedy ... Su 78
Detzel Thomas . . .Health ... Wi35
Salisbury, Harrison ... Memorial. .. Fa3
Deuts~h, Robert . . .Election ... Wi57 Shaw, Russell ... Religion ... Su24
President Kennedy . .. Richard
DiCanio ... Health . .. Wi26 Reeves .. .Wi67
Simon, Jim ... Health ... Wi35
Driscoll, JohnS .... Religion ... Su21 Quality Time ... 20th Century Fund ... Wi68
Steinfels, Peter ... Religion . ..Su3
East Timor ... Fa20 Read All About It .. .]ames D.
Stepp, Laura Sessions ... Children .. .Sp15
Eck, Diana ... Religion . ..Su9 Squires ... Su77
Stolberg, Sheryl. .. Health .. .Wi6
Fiquette, Larry ... Gays .. . Fa84 Roar ofthe Crowd ... Michael].
Stoll, Ira ... Children ... Sp30
Freed, Kenneth .. . Off-Record .. .Sp57 O'Neill ... Wi66
Third World Press ... Sp35
Freehoff, William . .. Religion ... SuS States of Mind .. .Jonathan Yardley ... Su8l
Wasserman, WilliamJr.. .. 3d world Strange Bedfellows ... Tom
Gabbard, Glenn ... Health ... Wi17
press ... Sp35
Gay News .. . Fa80 Rosenstiel. .. Fa63
Wexler, Richard ... Children ... SplS
Gelfand, Louis 1.. .. Gays .. . Fa82 Strom Thurmond ... Nadine
Wino, Billy ... Public Interest Journal-
Glaser, Lynne Enders ... Labels ... Su69/ Cohodas ... Fa69
ism ... Wi54
Fa88 Taming the Storm .. .Jack Bass ... Sp76
Goldberg, Jeffrey ... Religion ... Su30/Fa88 Terror in the Night .. .Jack Nelson ... Sp75
Hanley, Barbara ... Religion . ..Su42 The Fifties ... David Halberstam ... Fa66
Harwood, Richard . .. Liberalism .. .Sp82 Legend The Hard Way .. .Alexander B.
Health ... Wi3 Brook. . .Fa74
Hehir,). Bryan ... Religion ... Su39 The Shadow of Death ... Philip E.
Fa- Fall Ginsburg ... Sp78
Hersh Elizabeth K. ... Health ... Wil7
Hoov~r, Stewart ... Religion ... Su42 Sp- Spring Thinking Out Loud .. .Anna
IRE seminar ......... Sp50;Wi87 Su- Summer Quindlen ... Su80
Johnston, Lloyd D ... .Health ... Wi29 Today Is Not Like Yesterday ... Ted & Nyna
Wi- Winter Brae! Polumbaum ... Sp80
Karabell, Zachary ... CIA ... Sp46
Kemp, Sid ... Health . .. Wi40 Volunteer Slavery .. .]ill Nelson .. . Fa73
Kovach, Bill. .. Children ... Sp3

88 Nieman Reports /Winter 1993