Table Cover

That said, you are right — the whole story at this point is what Pou is doing now. Also, as your follow the money comment points out, now I’m dying to know: Who is backing Pou? Why? Is this backlash against the threat of devastating malpractice lawsuits? What does her fancy PR firm see in her?

If the piece had been a really punchy summary of what is being changed and why with a grabby headline then not only would more have been achieved in the way of public attention and policy change, but it would have cost a few thousand dollars at most.

And no, I am not missing the point here. This work is appropriate for a BOOK, where the details can be chewed more thoroughly.

Want to investigate the moral dilemmas of emergency care? Audit all the major ER center records. Visit ten of them and observe and document. Interview ten lead ER doctors. Do it anonymously if you have to. And take the trouble to look at the money trail. Who pays what and who keeps what. That would have twenty times the impact for less cost (although as spelled out this would be an expensive article as well).

Then do it again for non emergency care. This time really all you would have to do is follow the money, look at the flows and see who really gets what.

Those two (series of) articles would have the potential to inform and impact the full national healthcare reform debate.

Assuming that all the reporting and lawyering has a somewhat fixed cost (and it sounds like the lawyers must have done pretty well on this piece), they still could have done far more with this piece, especially when judged by the standards of changing policy, perception, and discourse, which is also a quirk of the piece itself.

It seems to me that the article ends right where, in a way, it should be beginning. You have a doctor who gave instruction and provided information on how to end the patients’ lives. You have a doctor who helped carry that out. You have a hellish situation in which they were working. But the final piece of this story, which is mentioned at the beginning and the end but never fleshed out, is that Pou is now advocating for immunity and broad discretion to be allowed to medical professionals in crisis situations. Pou has used her situation to frame the discourse and advance a particular argument about transparency and accountability of medical personnel during crisis situations. I believe, though I have no way of knowing, that Pou acted in good faith and in what she considered the best interest of the patients stranded at the hospital. But without a paper trail or proper documentation of what she ad her staff did do, we cannot assess either the criminality or the nobility of their actions.

Which makes me wonder: Where is more of the source material? Why was’t ProPublica publishing more over the entire span of the investigation. Surely they could have worked with the lawyers to write some stories, and instead of licensing a piece that spends almost its whole length on the material evidence, spent the past couple of years publishing stories establishing and complicating the material evidence, culminating in a piece that provides more analysis and insight into the broader issues, something with more of a chance to reframe the discourse and to argue for, or at least raise and define a debate, around what kinds of standards of transparency, documentation, and prioritization apply to doctors in these kinds of crisis situations.

I have no doubt that the fixed cost of this project may have been in the hundreds of thousands by necessity, but the additional cost of publishing that information online is very, very low, and the possibilities for a searching analysis, better discussion, and the potential for changing, reframing, and improving the public discourse would be much greater.

Perhaps the prior problem here is is that the culmination of the project would be an NYT mag story, instead of a public investigation that builds an audience of people with influence over the situation, or others like it. How the hell does a single piece in the NYT mag and a few graphics that most people will forget in a few weeks really help to reframe the discussion? Did anyone ask the about project’s relationship to the power structure, and how best, strategically, to address those issues?

It’s an amazing piece (one that made be seriously reanalyze this event, which I watched unfold closely), and a worthy experiment, but I think in terms of what is necessary and what is possible, the initial indication is that this piece fails, pretty hard, to provide a create, smart, and sustainable model for investigative journalism in the coming decades, and, depending on the outcome, may also fail as a piece of investigative journalism.

Una investigación de 13.000 palabras abre el especial de fin de semana del New York Times: es la de la actuación del hospital de Nueva Orleans cuando enfrentó el desastre provocado por el huracán Katrina. Una historia para impactar al público esta…