I've commented several times here on the surprising run of psychology and health stories in The New York Times Magazine, which has clearly made these a regular feature of the magazine now. But the Times topped that yesterday, with a special issue on health, featuring stories on breast cancer awareness, bipolar disorder, and a case of fraudulent psychological research.
Interestingly, this has not been matched by a rise in science stories. We're not seeing a similar increase in stories on exoplanets, the Higgs boson, climate change, software, or habitat loss. The Times is observing what has long been the rift between what we would call medical stories (including psychology) and science stories. We might take this opportunity to alert the magazine's editors to the gripping stories they could find if they opened their pages to science stories as well as medical pieces. It would be nice to see an asteroid or computer chip on the cover, along with pink ribbons.
Even so, it's nice to see the Times magazine paying attention to health and psychology stories, dealing with subjects that dominate our economy and have a huge effect on our lives.
So what is the Times featuring in its health issue? I started with the cover story on breast cancer. This is one of the better pieces I've read on the controversies over the use of mammography to screen for breast cancer. Yes, anybody who has been paying attention knows there is a strong lobby for the wider use of mammography, even in younger women, contrary to the latest recommendations. And we know that one consequence can be needless, harrowing treatment for women wrongly thought to have breast cancer following screening.
But Peggy Orenstein, a breast cancer survivor herself, makes the story fresh by describing her own experience, looking at the history of screening, and carefully laying out the arguments for and against screening. When she was discovered to have breast cancer 16 years ago, she writes, she considered herself "a loud and proud example of the benefits of early detection." Now, she says, she is not so sure. "As study after study revealed the limits of screening — and the dangers of overtreatment — a thought niggled at my consciousness. How much had my mammogram really mattered? Would the outcome have been the same had I bumped into the cancer on my own years later?" I'm sure the story will generate a lot of shouting on both sides of this issue, but I found it to be a balanced and helpful story.
It does, however, bury one fact that I found astonishing. Deep in the story, we find this about the Susan G. Komen foundation:
Despite the fact that Komen trademarked the phrase “for the cure,” only 16 percent of the $472 million raised in 2011, the most recent year for which financial reports are available, went toward research. At $75 million, that’s still enough to give credence to the claim that Komen has been involved in every major breast-cancer breakthrough for the past 29 years. Still, the sum is dwarfed by the $231 million the foundation spent on education and screening.
Is that where the millions of people who donate money or "run for the cure" think their efforts are going? To more "awareness," rather than research? I think I would have placed this higher in the story. And I might have asked other groups what percentage of their breast-cancer donations go to research, by way of comparison.
Elsewhere, Yudhijit Bhattacharjee, in a story entitled "The Mind of a Con Man," writes about Diederik Stapel, a social psychologist who "perpetrated an audacious academic fraud by making up studies that told the world what it wanted to hear about human nature." One concluded that a trash-filled environment brought out racist tendencies in individuals. Another found that eating meat made people more selfish and less social, Bhattacharjee reports.
The subject matter is not new; we've heard many stories like this before. But Bhattacharjee captures Stapel describing in matter-of-fact terms how he perpetrated his fraud. When one experiment did not produce the result that Stapel was sure was correct, he said, "You know what? I am going to create the data set." And:
Sitting at his kitchen table in Groningen, he began typing numbers into his laptop that would give him the outcome he wanted. He knew that the effect he was looking for had to be small in order to be believable; even the most successful psychology experiments rarely yield significant results. The math had to be done in reverse order: the individual attractiveness scores that subjects gave themselves on a 0-7 scale needed to be such that Stapel would get a small but significant difference in the average scores for each of the two conditions he was comparing. He made up individual scores like 4, 5, 3, 3 for subjects who were shown the attractive face. “I tried to make it random, which of course was very hard to do,” Stapel told me.
Getting a scientific apostate to talk like this is also very hard to do. But Bhattacharjee did it.
The third feature is a personal account of living with bipolar disorder, by Linda Logan. It's a mediation on the self, and what a mental illness does to the self. She describes a heartbreaking journey on the way to discovering that she has several "selves," each of which has a claim on her. Early in the story, she seems to pick up a theme that is a favorite of journalists, namely that overmedication might cause more problems than it solves. But she doesn't go there. When we've finished the story, we understand that medicine helped her.
One of the front-of-the-book pieces was a medical detective story by a regular columnist, Lisa Sanders, a doctor, about an infant who seems to be dying before our eyes in the intensive-care unit. It's interesting, but Sanders skips the critical details. After walking us through the possible diagnoses and introducing us to the doctors trying to decide upon one, she describes the doctor who makes the diagnosis this way: "Even without seeing the baby, and having only encountered the disease once before, he recognized a classic presentation of infant botulism."
But how? That's was the solution of the mystery, and she doesn't tell us how he did it.
I planned to skip a Q&A called "The Fitness Oracle," but I found some interesting things there, too. (The online version is different from what appears in the magazine, and it appears in the Well blog rather than the magazine. I can't explain why.)
This is the first time I've read the magazine cover-to-cover in a long time. It's a nice piece of work.
-Paul Raeburn
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