My soft spot: Healthcare journalism

With all the current discussion regarding Dr. Sanjay Gupta, CNN's chief medical correspondent, as the nominee for Surgeon General under President-elect Barack Obama, I thought I'd offer a glimpse into my own history for the perspective I'm coming from regarding healthcare and journalism.

In the fall of 1995, I was a young and idealistic student at Sonoma State University and part of Project Censored. Each week we received a stack of paper news media reports to review and match against selection criteria, then discussed them the following week to see if further research (mostly on the Nexis database in the library which contained records of news stories for journalists, quite different from what LexisNexis is now) would be justified to forward it to the much smaller batch of articles a national panel of journalism experts would review & vote to be one of the top 25 underreported stories of the year. The exact criteria and methodology of review have since changed, although so has the news media and the accessibility of information in ways I don't think we could even comprehend over 13 years ago. I was the last class with founder Carl Jensen & am no longer too familiar with the direction Project Censored (now under the Sociology department instead of Communication Studies) has gone since then.

The often-cited 2000 To Err Is Human: Building a Safer Health System report about medical errors being the 3rd highest killer in the United States? Old news to me by 5 years at that point. Two articles that ended up being combined into one and voted #12 for the spring 1996 book (1995 news stories) were in my article stacks: 180,000 Patients Die Annually From Treatment in Hospitals, based in part on a July 1995 JAMA adverse drug events (ADE) study. I apologize for the typos/funky wording in that HTML copy which may be from an optical character resolution (OCR) scan that wasn't post-edited well. I guarantee I used proper grammar in all text I wrote above my name. Can you see my writing style there? I still can. I used way too many commas in my youth and now I only use slightly too many... right? I remember balking at the emphasis on the names and careers of individuals in Chicago but being overridden by higher ups who wanted the personal touch in there.

Investigative journalism and librarianship are not all that far removed in the ability to research with ruthless efficiency under tight deadlines. Where there is a drastic difference between the fields is the pressure in journalism to not have your corporate owners, board members and advertisers look bad and lose revenue as a result of your research. For medical librarians (or any specialization), think about the amount of time you have personally invested in learning the medical and health care field, the information needs in it, and the specialized tools of the trade to be an effective researcher there. Journalists, even those with an MD or focused on health issues, do not usually have such background training nor much time or comprehensive access to the information sources we librarians do. Industry deregulation and the rate of media mergers that was a concern in the 1990s is eclipsed by the extent of the corporate media empires today.

This is why I can't offer an opinion about Dr. Gupta; I never watch CNN. It is hurting greatly in this economy but we always have and will continue to subscribe to a daily & Sunday print newspaper, The Seattle Times, from the independent and family-owned Seattle Times Company. They did an excellent job of researching methicillin-resistant Staphylococcus aureus (MRSA) in the state of Washington that led to the Department of Health announcing they would track MRSA rates as I mentioned in November. It's no longer common to see investigative journalism stories in corporate media since it takes a substantial amount of time and money to do the research for them... and you must also watch your back. This is why I hope people will continue to understand the value in and support independent media sources. They are truly better for our health!

'Staff infections': Where to turn for online information?

Last week a three part investigative journalism series (1, 2, and 3) was published by the Seattle Times about methicillin-resistant Staphylococcus aureus, or MRSA. This details how they did it when "state and federal governments don't bother to count MRSA cases." The Department of Health in Washington announced that they would begin tracking the incidence of MRSA in hospitals here as a result of the series.

S. aureus is also known as 'staph', so patients can have either a nasty MRSA infection or a regular old 'staph infection.' I always question how much time clinical staff are being able to spend with their patients to make sure they understand a diagnosis when they email family & friends about their 'staff infections'. I've seen this happen with enough frequency to suspect it isn't a fluke, so I decided to do a little research of my own along these lines.

It absolutely kills me as a medical librarian to admit that Google is on the ball with this common mishap, look what happens when you search for 'staff infection' there:



Google 'knows' you mean staph infection and redirects you accordingly in a fairly straightforward way.

Does consumer health gold standard MedlinePlus? Unfortunately, no. The 6th search result makes the connection only as a pronunciation key:

"... infection that is usually caused by staph (pronounced: staff ) bacteria. What Is a Staph Infection? Staph is the shortened name..." All the other search results on the front page talk about medical staff preventative measures.

WebMD? Their advertisers are but not their resources. All three Yahoo ads mention Staph Infections before a Hepatitis B resource, a video where staph infections are mentioned as a possible tattoo side effect (listed twice in a row), then a MRSA-titled resource that doesn't mention staph or staff but does mention infection in the preview.

One .gov that gets the 'staff infection' search right? Healthfinder.gov! Check it out:



Healthfinder is also making the staff and infection connection but at least pulling a Staph Infection article to the top of the resource list. We know that the Health News article to the right about MRSA screening for health workers would be of interest but someone searching for a 'staff infection' may not.

Google Flu Trends is helping to identify search patterns for that particular topic, what do the data look like for 'staff infection' in addition to MRSA & staph infection?



There is additional subregion data that gives some clues about health literacy needs in certain areas.. but is anyone else thinking and monitoring along these lines?

Friday Foolery #5: 3 centuries of ginger, antibiotics & MRSA

These are some of the contents of a medicine chest, circa 1820, housed at the British Columbia Medical Association Medical Museum that I learned about on Wednesday thanks to Morbid Anatomy. If I ever make it to New York in my lifetime, I will visit the Morbid Anatomy Library because a project with a mission to 'survey the interstices of art and medicine, death and culture' sounds like a kindred spirit to me. I can't watch MedlinePlus surgery videos without getting queasy but could study still life artistic depictions of disfiguring diseases, dissections & death and never be bored.

Speaking of queasy, I'm not sure how the ginger was prepared in the 19th century for the medicine chest but a 21st century preparation of it in lollipops (Preggie Pops, which have now evolved to drops) helped me function well enough that I never had morning sickness at work. Laudanum is ethanol with opium (yum!), and the other medicine chest contents are

Goulard's extract [a solution of lead acetate and lead oxide], paregoric elixir [a camphorated tincture of opium], spirits of nitre, oppodeldoc [a mixture of soap in alcohol, to which camphor and sometimes a number of herbal essences, most notably wormwood, were added] and ether.

100 years after this medicine chest there were numerous innovations in the field of medicine such as the discovery of insulin, vitamins and the (re-discovery of) penicillin. Check out the accomplishments of the Nobel Laureates of that era in addition to the (re)discoveries details, then note the following from the Antiseptics page with a header of How Germs Get Used to Antiseptics, 1921

VARY YOUR ANTISEPTICS; otherwise the disease germs will get used to them. The distinguished French physician and bacteriologist, Charles Richet, has recently laid before the French Academy of Sciences a note on researches made by him, together with Henry Cardot, on acquired characteristics and heredity in microbes. He experimented, among other things, on the influence of antiseptics, to determine especially whether bacteria may acquire immunity to toxic substances in the same manner that the higher animals do.

It's 2008, and methicillin-resistant Staphylococcus aureus (MRSA, or mer-sah... one of a handful of acronyms where you don't say each individual letter out loud) is a real threat due to exactly what Dr. Richet was warning the medical community about regarding antibiotic resistance almost a century ago.

According to the Centers for Disease Control (CDC), there are over 12 million doctor visits for skin infections by American patients annually and half of them turn out to be MRSA. Please know the symptoms to watch for & check out the National MRSA Education Initiative for more information.