Sunday, April 19, 2009

Tooting From Seattle: Conclusion

Six AM, Sunday Morning: Surprisingly, I’m awake. I wound up in the hotel bar last night with some fellow health journalists. I was the quiet one in the crowd. What is wrong with this picture? (That was a trick question, by the way.) Anyway, more “toots” from the Association of Health Care Journalists conference:

Early Sat Morning: A session on autism. The reason this illness is on the agenda has to do with the considerable media coverage over the years regarding whether vaccinations cause autism in kids. The expert panel informs us this is not the case. The jury is in, the panel informs us, in the form of at least six studies. No causation has been found. Paul Offit MD of the University of Pennsylvania, vaccine expert and author of “Autism’s False Prophets,” reminds us that with scientists in virtual unanimity, the issue can hardly be written up as a “controversy.”

I experience a flashback to the less-than-stellar reporting in the NY Times two years ago in a series of articles similarly describing early-onset bipolar as “controversial” (as if it could be argued that these kids’ behavior were normal, that they were the victims of bad parenting, and that certain researchers in cahoots with Pharma were disease-mongering). Don’t get me started ...

Ignore that last sentence. At lunch, the AHCJ awards Mary Carmichael of Newsweek first prize in the large magazines category for her terrific story, “Growing Up Bipolar.” Had she been in attendance I would have given her a hug. But I’m getting ahead, and I’ll save this for another blog piece. Back to autism ...

Parent advocate Alison Singer informs us that the media has been pitting parents against science, which is “not so.” The studies have been done, she lets us know. “The questions have been asked and answered.” Scarce research money, she concludes, needs to be applied to searching for the underlying mechanism of action for autism and its treatment, not in yet more vaccine investigations.

Late morning: I wander into a sparsely-attended session on “healthy environment,” expecting something along the lines of clean air and clean water. But what the panel means by environment is exactly what the brain science researchers mean by environment - namely, anything out there that impacts health.

Stephen Bezrucha MD of the University of Washington lets us know that mortality rates in the general population actually go down during economic hard times. One reason, he said, may have to do with people having more time to connect with their friends and families.

Naturally, this raises the whole stress-mental illness issue, together with whether work is “tonic or toxic.” Well, actually, I’m the one who raises the issue at question time.

Brief sidebar: In two sessions from Friday, at question time, I mention in passing my diagnosis (as it happened to be germane to the discussion). So for two days fellow journalists are coming up to me and congratulating me on my courage in disclosing.

I feel a bit awkward about this. I’ve been “out there” for 10 years. It’s not like I had been agonizing over the last few days on whether or not to come out. But the conversation serves as a forceful reality check. Our population has good reasons for not disclosing. The stigma out there is fierce. I’ve created a comfortable world for myself as a bipolar “expert patient” journalist. But the world that my fellow patients deal with tends to be a lot harsher. I’m supposed to know that, but how easy it is to forget.

Back to “tonic vs toxic.” Michael Hayes PhD of Simon Fraser University reminds us of the famous “Whitehall Study” that investigated British civil servants, which found that those high up the managerial food chain - in “high control/low demand” - positions fared a lot better on just about all health measures than the worker bees in “low control/high demand" positions.

Lunch: Oxymoron time. I’m rolling in the aisles listening to a “funny economist.” Uwe Reinhardt PhD of Princeton flashes a slide of a confused Alan Greenspan juxtaposed with “Atlas Shrugged,” and I’m experiencing a Seinfeld moment (think Kramer’s famous one-liner in “The Contest”).

As a financial journalist, I used to write that economists were full of crap (but was never smart enough to prove it), so it’s reassuring to hear one of the world’s leading economists enthusiastically own up to the fact that “my profession has been a complete and total failure,” that “what we say adds up to zilch,” and that economists “build models that only make sense on the planet Vulcan.”

A very sizable percentage of my fellow health journalists have either been business/finance journalists or currently are, so the aisles are clogged with rolling brethren. Health care is as much a business and economics story as it is a medical and health story. Virtually all of us are straddling two fields.

As if to reinforce the point, one of the afternoon sessions involves statistics.

Late afternoon: A panel of AHCJ award winners share with us how they researched and wrote their prize-winning stories. Their presentations amount to mini-masters classes in rooting out hidden information and activity and exposing it to broad daylight. These are extremely hard times for the journalism profession. Even in the best of times, you have to be crazy to enter the field. But listening to the presentations, I am experiencing an outbreak of “rational.”

Yes, I reflect. Now I recall why I became a journalist. I’ll leave out the preaching. You fill in the blanks.

Sunday Morning: Plane to catch. I’m outta here ...

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