‘A very special’ Esquire story

The magazine claims that advocacy and good intentions exempt them from a scientific critique

If you like or follow literary journalism, you’ve probably stumbled upon Esquire’s “Patient Zero,” a new Tom Junod and Mark Warren story. It follows a woman diagnosed with terminal colon cancer through a last-ditch treatment effort from an unlikely source: a study run by Eric Schadt, a mathematician who evangelizes big data as a way of locating the genetic origins of a disease and creating individualistically designed alternative treatment.

It’s slated for publication in the magazine’s December issue, but Esquire has been promoting the heck out of it online, introducing the piece with a trailer calling it “the most extraordinary story we’ve ever published” and inserting “an amazing story by Tom Junod and Mark Warren” into the byline.

But in all the hyperbolic presentation, there’s a serious problem with the piece, according to the Knight Science Journalism Tracker’s Paul Raeburn. “This account of Schadt’s peerless intelligence appears to rest solely on what the reporters were told by Schadt himself,” writes Raeburn, a problem further intensified by the writers’ failure to explain how Schadt’s revolutionary treatment actually works.

Though the story’s subtitle—“There’s a Whole New Way of Killing Cancer: Stephanie Lee is the Test Case”—makes it seem as if the authors are detailing a new form of treatment, in reality the piece seesaws between profiles of Lee and Schadt, offering only vague details of the groundbreaking treatment and how it fits into the broader scope of cancer care. Providing a thin description of a medical procedure might warrant chastising in any medical story, but it’s particularly problematic in this piece, because Schadt’s technique isn’t just different—it aims to uproot the fundamentals of medical treatment:

What data had taught him was that the underlying faith of molecular biology—of all biology, since Watson and Crick had elucidated the structure of the DNA molecule—was false. Untold billions had been spent in the hope that we could understand disease one gene at a time, or one genetic pathway at a time; by targeting the gene or the pathway “for” Alzheimer’s disease, say, we could target Alzheimer’s disease itself. Schadt told Merck that this was a strategy doomed to fail, because disease arose not from single genes or pathways but rather out of vast networks of genes and pathways whose interactions could be understood only by supercomputers guided by abstruse algorithms.

Raeburn is right when he criticizes the writers for letting “swaggering storytelling, their hyperbole, and the constant straining for the edgy metaphor,” get in the way of telling a nuanced and balanced tale of what the magazine hocks as paradigm-shifting treatment. He’s also kind to praise the language of the piece—which, in its overwrought poetry, fails to tell the meatier narrative of how to judge just how revolutionary a new treatment is and of the barriers to making it accessible. (For example, this description of cancer cells—“The eggs of the epithelium had been stepped on, by pitiless boots; the bright colors of the smooth-muscle cells now swirled in toxic pools, the sheen of industrial aftermath,”—tells us little about what cancer cells look like, or how they are invading patient Stephanie Lee’s body, or how they might be stopped by data-driven treatment. But it is pretty, in a hysterical sort of way.)

Raeburn’s criticisms of the story might have died down if Esquire hadn’t decided to tackle his David in a blustering Goliath of a post, titled “A Response To Paul Raeburn’s Dissaproval Of Our Story Patient Zero.” The main problem with Raeburn’s post, Junod and Warren argue, isn’t the criticism itself; it’s his attempts to “turn his disapproval of our storytelling into an attempt to discredit us and our effort to obtain advanced medical care for a woman we care about deeply.” Come again?

A link to a fundraising campaign on the website (They’ve raised $12,728 so far) and ample disclosures of the writers’ personal friendship with Lee are the only signs that the authors are thinking of this as a human interest feature.

Meanwhile Raeburn, whom they repeatedly call “a journalism beat cop,” doesn’t understand “humanity,” they write. (The post, if you can’t tell by now, does a poor job of trying to shake off Raeburn’s accusations of hyperbole.) They take issue with not just Raeburn’s criticism, but his medium: “that most self-congratulatory journalistic genre — the online “takedown” — grotesque.” Moreover, they argue, their relationship to their subject—and their quest to connect her with life-saving treatment—prejudices Raeburn against them: “Our efforts to create a vivid portrayal of Stephanie Lee’s life and Eric Schadt’s science not only render us less than serious in Raeburn’s eyes; they render us suspect.”

Rather than excusing the absence of scientific explanation as a necessity of narrative, the writers claim that as a work of advocacy, their piece is immune to factual criticism. “The story didn’t begin as a story; it began as an unabashed act of advocacy for a human being who needed help,” the post reads. But they fail to flesh out the larger story of the inherent economic inequalities that exist in accessing new treatment, which fails all the other Stephanie Lees that might be out there.

Regardless of the magazine’s intentions in producing the piece, it’s dangerous to tell a story about medical treatment without elucidating the nuances of what makes a treatment revolutionary. (It’s also a narrative flaw: The piece is choppy and difficult to follow without the overarching story of the specifics of this intervention that Lee is trying to receive.)

In the end, Raeburn blames the controversy on divergent intentions: “I read Junod’s and Warren’s story as a cancer story constructed around a patient undergoing treatment—a staple of magazine writing. Junod and Warren wrote what they thought was a story about helping a Mississippi woman get care for her terminal cancer. Aside from the fight over whether the work should be viewed as an advocacy piece or a piece of narrative explanatory medical reporting, it still fails in its larger aims. “The problem with their story is that it creates false hope,” says Raeburn. “The likelihood that Lee will be helped by the treatment is very, very small.” Regardless of how Junod and Warren may have served their subject, they fail their readership.

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Alexis Sobel Fitts is a senior writer at CJR. Follow her on Twitter at @fittsofalexis. Tags: , , , , , ,