5-Star Friday: Beyond charlatans, placebos, and schlock

5-Star Friday: Beyond charlatans, placebos, and schlock

5-star friday

5-star fridayMedicine as science. Medicine as theater.

The former connotes certitude and rigor. The latter more nuance and drama.

For those of us who practice medicine, or turn to it for help, or write about it, we realize it’s all these things. This spectrum is what makes it both delightfully compelling and frustratingly complex.

This week features health care writing at several points along this continuum. There is some dogged reporting and clever writing here. Enjoy!

Gary Schwitzer

Gary Schwitzer | Publisher

I’ll use the publisher’s prerogative and nominate several.

U.S. Senator John McCain’s diagnosis with glioblastoma has put that terrible brain cancer in the headlines. But stories by or about journalists who are facing glioblastoma diagnoses and treatment have also drawn attention recently.

Columbia Journalism Review published “‘Thank God the brain cancer waited for the Pulitzer’” about Philadelphia Daily News editor Gar Joseph.
Journalist Jeffrey Weiss has been telling his story in the Dallas Morning News – the latest: “Fighting brain cancer, a journalist searches for the ‘so what?’ in stories — and in life.” I love his comparison with Johnny Appleseed.
And if you’ve never listened to our podcast about a glioblastoma patient who was mislead by hype in the news, now – or this weekend – is the time.
I hope that journalists resist the urge to discuss what could be done for Senator McCain and the temptation to interview people who have no direct knowledge of his case. But some of that has already begun.
One other story this week that must be mentioned: A shocking story, told soberly with solid reporting by a team from the Los Angeles Times: “An overdose, a young companion, drug-fueled parties: The secret life of USC med school dean.”

Trudy Lieberman | Contributor
How the Cleveland Clinic grows healthier while its neighbors stay sick • by Dan Diamond • Politico

Trudy Lieberman

Finally, a journalist has pulled back the curtain on the Cleveland Clinic, that star of the nation’s hospital system, which knows as much about marketing its brand as it does making patients well. Its promotional prowess has, up to now, kept the media from taking a hard look at its relationship to its Cleveland neighbors who live in one of the poorest neighborhoods around. The neighborhood is so poor that that even the Clinic’s own community assessment published last year ranked the neighborhood as having the “highest need” possible in terms of access.

Dan Diamond’s reporting tour de force this week deserves a wide readership especially as hospitals’ role in the healthcare mess is coming into sharper view. The details Diamond dug up using public records and good old shoe-leather reporting in the nearby Hough and Fairfax communities that have little love for their famous neighbor offer an unflattering picture of the Clinic. Despite its location in a neighborhood of almost nightly violence, the Clinic is not a Level 1 trauma center. One black councilman remarked, “You can come from the Mideast to get a heart, but you can’t run down there” for an emergency. There’s something fundamentally wrong with that.”

In a companion piece Diamond explores something called “community benefit,” a 50-year-old IRS regulation that grants hospitals freedom from paying taxes in return for giving back to the communities where they operate–no matter what those taxes are worth. Whether they do that is controversial. Examining self-reported data from the Clinic and other peer hospitals like Massachusetts General and Johns Hopkins, Diamond concludes, “these hospitals clearly could be doing more.”

Reporters have shied away from taking on their local hospitals and digging into their community benefit. It’s hard work, and hospitals are community icons. Diamond’s work is a model that shows it can and should be done.

Michael Joyce | Multimedia Producer
Unapproved stem-cell treatments touted on federal database ClinicalTrials.gov, study says • by Laurie McGinley • The Washington Post

Michael Joyce

As a health writer, when you find a great study about something no one else has investigated, and the findings clarify a poignant issue that is grossly neglected, you’re at one end of a rainbow.

The other end of the rainbow is when you’re the lucky reader and the writer has you so engaged — maybe enraged — that you want to go out and immediately do something about it. That’s the other end of the rainbow.

Health reporter Laurie McGinley delivers both pots of gold in this provocative article about a study published this week documenting how some unapproved stem cell clinics are using a trusted database “as a marketing ploy to give a veneer of scientific legitimacy” to take advantage of unsuspecting and vulnerable patients.

Joy Victory | Deputy Managing Editor
Surgery Is One Hell of a Placebo • by Christie Aschwanden • FiveThirtyEight

Joy Victory

Among those of us who read a lot of medical research, it’s not particularly surprising to hear that sham surgeries are often as effective as real surgery. But this reality isn’t well-known among the general public, but boy, it should be–which is why it’s so important the news media cover these kind of stories that upend the status quo.

Imagine what healthcare would be like if this was required reading for anyone facing an elective surgery–particularly arthroscopic knee surgery and spinal vertebroplasty. And even more so, if surgeons were required to read it and disclose the study findings to all of their patients, too.

Jill U. Adams | Associate Editor
The Non-Simplicity of Mental Illness • by Laura Dattaro • The Last Word on Nothing

Jill U. Adams

Psychiatric disorders are exceedingly difficult to write about, so any piece that breaks through the usual schlock is worthy of recognition. This essay, full of insightful musings, certainly fits the bill.

Dattaro says she began treatment “searching for the single thing at the bottom of it all: the one memory, the one trauma, the one blemish on my makeup that could explain everything, that could be wiped away to make me a happy person.” Of course, neither happiness nor mental illness is that simple. Dattaro goes on to say: “… as various symptoms have risen and subsided, so too has the diagnosis with which I most identify.”

Psychiatry’s diagnostic manual, the DSM, is credited with legitimizing the medical specialty yet blamed for pathologizing normal human behavior and emotions. Dattaro encourages readers to move past an all-or-nothing view —“ill or not”— and consider mental health as more of a spectrum, adding that “anyone is deserving of the insights of a professional.”

We also had 4 news stories over the past few weeks earn 5-star ratings from our review staff. Here they are:

US News takes careful look at emailed help for smoking cessation

Could tailored emails help smokers quit? Solid reporting on the quality of evidence and the alternatives.

Buzzfeed offers refreshing candor in explainer piece on female condom

The straightforward approach in explaining this rarely used form of contraception really helps.

Washington post deftly examines lack of evidence for a fuzzy area of psychiatry: animal therapy

It’s not easy to write about a timely topic when the evidence is far from conclusive. This article does well, but we would have liked to hear more about costs.

Preeclampsia & aspirin: HealthDay does solid job covering new study findings

Nice job clearly communicating the benefits, harms, and quality of evidence.

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