Duck and cover
After Ricky Gervais and now the bikini and sensational headlines, may I please request a coverless subscription? Seriously, unless your pop culture cover experiment is over, please send the next issue without the hideous cover.
Helen GallagherGlenview, IL
Thanks, David H. Freedman. I enjoyed your article (“Survival of the Wrongest,” CJR, January/February). You write, “Look at the preponderance of evidence, and apply common sense liberally.” I would add that science/health writers should be research-literate, able to understand what is and is not a well-designed study.
The issue of blending personal experience with science and reporting on the combination, which he raised at the beginning of the article, is one I think is worthy of further conversation. Reporters, like bloggers, are sometimes trying to make sense of their own experience in light of “what science says.” Being very careful about examining and explaining one’s dual motives to “tell what’s true for you” and “report what’s true” seem essential to writing fairly about health and science.
Jess WilliamsPittsburgh, PA
Measurement errors and confounders usually cannot be avoided in population-based research, but they can be minimized. The scientists and students I know apply a lot of effort toward minimizing errors and implementing controls to track confounders in their studies. Freedman seems to overlook those efforts and creates an impression that medical scientists conduct research however way they want. Like any human endeavors, science is limited by methods currently available. The key is to stay critical when interpreting research findings and keep the limitations of their methodologies in mind. Journalists probably do not have time to go through this critical process, and discussion about the limitations of health studies may not be interesting to the general public, either. Maybe increasing the public’s awareness of science and scientific methodologies can prevent readers from being misled.
Qing PengAnn Arbor, MI
Reading Freedman’s table-setting article and the four pieces that followed it was a positively Orwellian experience, beginning with his statement that fully two-thirds of published scientific research findings are wrong. So the intrepid cjr team encounters a man at the border of a country who warns, “All the people in my country are wrong two-thirds of the time.” Then it roams around that country with notebook and camera without ever again addressing that warning and its obvious implications.
The lively science journalist for HuffPo is profiled but we never learn how—or whether—she successfully navigates the minefield of predominantly inaccurate scientific research. Media coverage of tainted food is condemned despite an acknowledgement of the lack of reliable scientific findings linking pathogens and food sources—two-thirds of which would, apparently, be wrong anyway. A photographer’s project on hydrofracking is presented without a mention of the disputed research findings in that battlefield of science. The final step into the Twilight Zone came in Freedman’s bio box, in which he admits that “he has been guilty of all the failures of health journalism he describes in this article.” Really? REALLY? And was the article I just read a scene of his crimes? On that front, he helpfully advises: “Of course, I quote studies throughout this article to support my own assertions, including studies on the wrongness of other studies. Should these studies be trusted? Good luck in sorting that out! My advice: Look at the preponderance of evidence, and apply common sense liberally.” And where would we, his readers, find the “evidence” by which we can sort out whether his “evidence” should be trusted? How will we know which one-third of it is correct? If common sense is so helpful, why bother with unreliable scientific research at all? But didn’t people once argue that common sense proved the world was flat because we don’t all fall off the planet? How is “common sense” different from the “conventional wisdom” we all know we should question because it is, demonstrably, so frequently wrong?
After reading all five articles, I was swept away by the frustration and futility of reading, much less writing, about scientific research at all. If that was the intended result, bravo! Mission accomplished.
Diana B. HenriquesHoboken, NJ
Freedman’s piece used a lot of words to say, in essence, “Don’t believe anything you read when it comes to your health. But read as much as you can. That’s the best hope you have.” It’s awkward common sense, but in offering it, Freedman is tarring with too broad a stroke. His passing mention of Gary Taubes, whose books I publish, alludes to his New York Times Magazine piece, which argued that perhaps fats aren’t as bad for us as commonly assumed. But in two of Gary’s books, Good Calories, Bad Calories (which contains more than 100 pages of source notes and bibliography combined) and Why We Get Fat, he simply follows the science, explaining why some studies seem more solid than others. Importantly, he also makes an explicit plea that the theory he favors be tested—properly and rigorously. As Freedman sees it, that might not bring us any more wisdom than all the other studies, be they double-blind or any other form. But to me, it sets Gary apart from many of those he is lumped in with in the article. Follow the science. That’s the best we can do, and should be encouraged to do so.
Jonathan B. SegalVice president and senior editorAlfred A. KnopfNew York, NY
What Freedman’s article, most health/medical writing, and most research tends to ignore is the issue of heterogeneity. Practically all studies are based on averages, most often of a select group of patients. The findings may well apply to similar patients. But a significant portion of people are outliers, and the data simply does not apply well to them.
The CATIE trial of psychoactive drugs showed that while one class of drugs works best in one group of patients, that drug often did not work well in another group of patients, who responded better to another class of drugs.
Researchers, physicians, and people who write about medicine need to begin to grapple with these issues of heterogeneity. It is the only way we are going to attain the promise of individualized medicine.
Bob RoehrWashington, DC
Helena Bottemiller’s article (“Safe at the Plate,” CJR, January/February) really resonated with my experience getting food-safety records. I have been struggling mightily with the fda’s Center for Veterinary Medicine (CVM) FOIA office this last year, during which time, countless simple inquiries like “Is my FOIA request still open?” went unanswered. At least a dozen such emails and phone calls to CVM went unanswered in the last year, as I attempted to follow up every month or so.
While this lapse may have been due to the retirement of a sick employee, it doesn’t excuse the CVM from fulfilling the requirements of the foia law. The CVM eventually did replace its FOIA officer, but the disturbing pattern of non-disclosure continues. My seven-month-old FOIA requests grow older by the day, and even simple inquiries into their status go unanswered. Thanks for raising awareness on this issue.
Tim SchwabWashington, DC
I was surprised, in the coverage of the passage of Obamacare, that so little was written about how things are done in other countries and how much leverage government-run healthcare has in reducing its costs. You dismiss this leverage in your editorial (“Obamacare: round two,” CJR, January/February), saying it’s not part of Obamacare, but it is part of Medicare. That basic journalistic question—How much does it really cost?—was never adequately answered for US citizens. Let me give you an example. I remember a news story that ran about 20 years ago in the Globe and Mail, about a Canadian woman who gave birth to a baby in a US hospital and received an itemized bill. Canadians like me were aghast at the outrageous overcharging the hospital did. A single maxi pad cost something like $40. We all knew that was insane, and we wondered why US citizens paid those crazy prices. But when I moved to the US and started getting medical bills, I saw that they were never itemized. American consumers have no idea what they’re being charged, in detail, and I think that’s why they accept the price-gouging that is probably the norm. The only reason we saw itemized bills in Canada was that our government-run insurance required them before it would pay. Shouldn’t US journalists insist on that also? Comparing US costs for standard medical procedures to those in Canada, Britain, France, etc—or what the government agrees to pay for the same services in those countries—would be a great idea.
Carrie BuchananUniversity Heights, OH
Depth of field
In his review of Alan Huffman’s book on Tim Hetherington (“Unfinished business,” CJR, January/February), Michael Meyer writes that “nearly half of Huffman’s book is devoted to reconstructing Hetherington’s final days in Libya.” Seems like another attempt to cast in bronze an image of Tim as a “heroic war photographer” by a member of the fraternity of conflict correspondents. It’s a self-referencing circle. The people making films or writing about Tim after his death only see him through the lens of war reporting, which Tim rejected completely. Tim created amazing images and projects on Creole architecture in Sierra Leone, neon-lit gas stations in the Arab Emirates, and post-2004 tsunami devastation and rebirth in Indonesia (among others). Has no one seen that work because they don’t know Tim well enough, or is it ignored because it does not fit the stereotype of the photographer “with a British accent plucked from a Graham Greene novel”?
As much as I hope Tim’s work is disseminated further and his talents exposed to the world, I fear the coming attention will be focused on a retrograde trajectory from the one Tim was pursuing.
Christopher WiseBangkok, Thailand
We neglected to include the credit for our January/February cover image on our Table of Contents page. Here it is now: Adrianna Williams / Corbis.