When Pulitzer Prize-winning journalist Usha Lee McFarling started writing for STAT five years ago, it meant leaving something behind. Long a reporter who covered topics like space, climate change, and earthquakes, she switched gears and began covering biomedical advances. She wrote about 3-D imaging for the operating room, the big business of concussion testing, experimental surgeries for spina bifida, and other medical breakthroughs.
Then the pandemic hit.
As Covid-19 started spreading through McFarling’s hometown of Los Angeles, it became clear to her that the virus was affecting some groups more than others in the city. The pandemic had thrust into sharp relief the massive inequities in the nation’s health care system. McFarling pivoted again, this time to writing about health care disparities and the disproportionate effects of the virus on marginalized populations.
In the months since, McFarling says, she has come to see more clearly the underlying ways race and medicine interact in this country to produce deep inequities. A new beat blossomed for her. She went from writing about one epidemic plaguing the country, Covid-19, to another: racism in health care.
In a recent interview, McFarling spoke with me about the challenges of finding her footing on a beat where medicine, race, and other factors collide — and where sources’ trust and readers’ attention isn’t always easily earned. (The following interview has been edited for length and clarity.)
Anna Blaustein: Prior to the pandemic, you were covering biotechnology for STAT. How did you change gears to cover Covid?
Usha Lee McFarling: [When the pandemic hit], it was all hands on deck for science writing. I really wanted to jump in. I called around to community clinics, sources I have, and doctors and [asked], “What are you seeing?” They were like, “It’s our poor patients, it’s our Hispanic patients, it’s our working-class patients.” Medically underserved groups were getting hit hardest. That was apparent from the first weeks of the infections here in Los Angeles.
From then on, my radar was out to look for that. I was looking for stories everywhere, and I noticed in obituaries, I was seeing Filipino names when they were talking about the healthcare workers that were being lost. That turned into a major story for us — that Filipino nurses were very much on the frontlines and dying at high rates compared to others. These stories, unfortunately, were everywhere.
This was a pivot for me but I really saw a need. I was first on a lot of these stories, and I was very surprised because they seem so obvious and so important but still under covered.
AB: You mentioned calling clinics, doctors, and other sources when you were starting to cover the pandemic. Where else do you find your stories?
ULM: A lot of times it’ll start [with] a fact I’ll see or a small study. I was talking to a Black reproductive endocrinologist, and she just mentioned how sad she is that she gets women that are almost 50 years old coming to her. She said that their gynecologists have told them, Black women don’t have infertility. Don’t worry, you’ll get pregnant. These White doctors were super misinformed. That just kind of stuck with me as a nugget, so then you have to find people that are willing to tell their stories.
I work really hard to get people to want to read these pieces and stay and finish them. I don’t want to contribute to noise. I don’t want to just tell people what they already know.
AB: What has your recent work revealed or clarified for you?
ULM: It’s so clear to me that there’s systemic racism. I don’t know that anyone can argue about it. This pandemic just tore the blinders off. It’s so clear in anything I look at now, whether it’s Black women not getting infertility treatment or rates of kidney disease, people have been talking about this to some extent for decades. So this is nothing new at all, the pandemic just made it really clear, made it kind of an emergency.
Once you see that the systemic racism is out there, you just don’t get surprised by it. In this recent story I wrote about the lack of interest in papers on racism in JAMA, people were saying, The Black physicians aren’t surprised, it’s White physicians that are surprised. I think once your eyes are open to this, you’re not surprised at all.
What I’m seeing is there’s so much overlap: Politics, economics, medicine, criminal justice, it’s all interwoven. I think solutions are going to have to tackle these really big issues.
AB: You’ve been reporting stories on a range of marginalized groups since last year. How do you think about and approach covering underserved communities of which you aren’t a part?
ULM: I just think we haven’t valued these populations as a society, or as news organizations. I feel really honored that I was able to write about the Cherokee Nation. I’m not Native American, and tribal communities are very hard to get into because they’ve been mistreated and poorly described by many news outlets. A lot of them don’t want to engage, so it’s very difficult to tell those stories. We need more reporters from those communities to write, and we need larger news organizations to value that coverage.
A number of stories, people did not call me back, did not want to participate. So you just have to not take that personally. I just try to reach out with a lot of empathy, and I try to describe what I want to do and why I think it’s important, that I understand it’s hard.
I also find once I make one connection in a community, they can talk to other people and say that they trust me. Sometimes you need the fixer on the ground to help you connect with people. I use that a lot to try to get in, and then I feel like I’m able now to show people the work I’ve done, and say, This is the kind of thing I want to do in your community. That helps open doors too.
AB: A lot of your previous writing covered widely acknowledged environmental issues. As you said, racism and inequities in the healthcare system are nothing new. How do you approach writing stories on familiar topics?
ULM: With medical racism, I think most people acknowledge that it exists. It’s such a different topic from the series on ocean pollution I worked on, but it calls for very similar skills and tactics to draw in an audience. I would get it if people were like, I can’t read another one of your articles right now. It’s hard and painful, and we’re all exhausted. I work really hard to get people to want to read these pieces and stay and finish them. I don’t want to contribute to noise. I don’t want to just tell people what they already know. I want to tell stories.
I think there’s a message here for young journalists: Don’t go with the pack. Keep digging and looking. Is there a different angle, or is there someone that hasn’t been talked to about this? Maybe you talk to the first-year medical student instead of the dean of the medical school. Look for the stories other people aren’t telling or ways of storytelling that other people aren’t using.
AB: What’s next for you?
ULM: Last year I focused on the pandemic and marginalized communities, and now I’m writing about the intersection of race and medicine. I really like to be working on stuff that other people are ignoring, and hopefully other people are not ignoring this anymore, even if that makes my job harder. But that’s kind of why I started on it, and I want to keep looking for those under-covered areas.
Anna Blaustein is a research associate with the Knight Science Journalism Program and a student in the MIT Graduate Program in Science Writing. You can read more of her work at annablaustein.com and find her on Twitter @annablaustein.