Pam Weintraub responds to "How Neutral Should Journalists Be" by Andrew Sullivan, posted on the Daily Dish

January 1, 2011

You have taken my words far beyond my meaning. In doing so, you have attributed to me global beliefs that I do not hold while misconstruing my specific points. The quote you plucked was part of a fast-moving debate occurring over perhaps a dozen web venues for more than a week, creating a backdrop of chaos --and preventing the discussion itself from being completely clear or transparent from any one entry point. In light of this, I would appreciate the chance to clarify what I think, what I don't think, and what I meant, as transparently as I can, and all in one place.

I do not believe that only journalists can critique journalism. To the contrary, I feel that experts are usually best able to see the complexities and spot strengths and flaws in a story about their field.That, after all, is why we fact check with a source. Beyond that, I believe strongly that everyone should participate in the discussion, lending context and depth to a journalistic work long after it has appeared. In the age of the Internet, this is one of our greatest freedoms and rights. I value --and indeed, depend upon-- the input of scientists in the production of science journalism. I have high regard for and always solicit the opinions of many others --journalists and non-journalists, experts and non-experts-- to get divergent views on my work. Moreover, I agree that I should not have used the term "classically-trained journalist" in my bulletin board post, since journalists come from many walks of life and work in many ways. In science journalism, scientists are often premier producers of journalistic works, able to explain their experience deeply and profoundly --and with a level of detail and insight that only they can have. Likewise, when patients write about their experience, that too can lend grit and immediacy an outside reporter never could. There are many entry points to journalism across the media today and thousands of journalistic forms. Instead, I should have said this: I wish the Chicago Tribune story on Lyme disease had laid out the debate in science clearly, and that it had supported its conclusions with evidence included in the body of the story itself. No matter who a journalist is or what his or her background, if a story is put forward as an investigation instead of an editorial, it will be strongest and most convincing if it makes its case by laying out the proof.

Stepping back, my opinion of the Tribune piece was informed not by an abstract idea of journalism --but by eight years spent researching and writing Cure Unknown: Inside the Lyme Epidemic, a memoir and investigative report published by St. Martin's Press in 2008 and first place winner of the American Medical Writers Association book award in 2009. In particular, in the years I've reported the Lyme story, I've found it to be continually oversimplified by the press, and I felt the Tribune reporters fell into this trap. The typical formula goes like this: Journalists focus on the most polarizing aspects of the vicious fight over "chronic Lyme," the condition resulting after patients fail treatment for acute disease, reason unknown. At the extremes, the pitched battle concerns the issue of persistent infection --does it survive treatment or does it not? Yet the coverage rarely tells the deeper story of most such patients, who fail treatment because of late diagnosis, or the academic scientists whose work offers the most insight into the cause.

Following suit, the Tribune writers present two polarized sides of the raging Lyme fight. To support one side, they quote some mainstream academic researchers, but mostly make assertions a priori, with evidence for the statements nowhere in the piece. To portray the other side, they quote activists who sound, quite frankly, disturbed, and present a criminal: A man known for bogus cancer cures, who has developed a fake microscope for Lyme diagnosis and delivered dangerous, deadly chemicals to those he fraudulently diagnosed. The juxtaposition makes it appear as if no academic scientist has ever considered these patients legitimate or addressed the authenticity of their pain.

Yet if reputable academic researchers have been studying this patient group and can comment on the complexity of their illness, shouldn't that be in the piece? If not, why not? If the authors decide to leave this out in what they put forth as a work of investigative journalism, then shouldn't they explain the rationale? It is easy to build a case against straw man arguments, but how can readers know what is going on, or what you are arguing against, if you don't lay it out? Laying things out transparently is not "false balance." False balance is giving equal weight to crackpots and scientists. In any debate over science, I agree that only legitimate scientific views should be considered; crackpots need not apply. However, I believe that researchers invited to present at the October 2010 Institute of Medicine Conference, Lyme Disease and Other Tick-Borne Diseases: The State of Science, meet the bar for legitimate science, and many of them could have added the kind of nuance to which I refer. [Disclosure: I presented at the meeting, giving a talk entitled "The Human Face of Tickborne disease," on October 11. It is linked here and widely archived on the web. As my statement explains, I was a patient with late-diagnosed Lyme disease, though I was treated and have been well for many years now. I have never applied the term "chronic Lyme" to myself. My case was made more difficult by a co-infection, babesiosis, one of the complicating factors the scientists at the IOM meeting discussed. I also wrote about my Lyme/babesia for Discover in 2007. You can see the story here.] You might also consider how a current National Institutes of Health study frames even the most polarized aspect of the fight, right on the NIH website: "While most patients improve after taking antibiotics, some patients continue to have symptoms. It is currently unknown why some patients continue to have symptoms. One possibility is that the antibiotics have not successfully gotten rid of all of the bacteria. Current tests for Lyme disease cannot tell whether the bacteria have been successfully eliminated from the body." If scientists investigating these chronic patients are considered legitimate by the IOM, and if NIH itself posts this language on its website, then I'd say we have a debate in science that can be addressed respectfully in a journalistic work.

"To avoid the 'false balance' trap, I've been calling what we do journalistic fairness --that is, fairly representing the views of all parties, while noting, when true, that the consensus leans heavily one way or the other, or that some speak with more authority and have more evidence on which to base their conclusions than others," adds Paul Raeburn, health and medicine reviewer for the Knight Science Journalism Tracker, a website sponsored by MIT for science journalism peer review.

The big question is this: Who determines whether scientists with alternate or minority perspectives deserve the chance to contextualize their views in a piece of objective science journalism? Probably not the combatants, probably not those known for their vocal and public stance in the vitriolic fight. That, specifically, is what I meant in the quote excised on the Daily Dish.

The comment was not aimed at the Tribune journalists, but at bloggers known for taking a previous, vocal stance in this broad, dumbed-down, almost-meaningless fight over the ill-defined entity, chronic Lyme --despite the fact that they, themselves, are not experts on this patient group. (To science journalists, an expert is someone who publishes original research on a topic in peer-review literature, not someone who serves up opinions on a blog, even if the blogger happens to have an M.D.) On the other hand, there are many academic scientists now studying this group of late-diagnosed, co-infected, and very sick patients; their commentary, which is generally nuanced, thoughtful, measured, and detailed, would have added immeasurably to public understanding and to the Tribune piece.

Beyond all this, there are absolutely standards of balance, transparency, and attribution widely accepted in science journalism feature writing, at least in the national magazine world. Investigative science journalists who write for magazines like Discover do not have to be neutral in their conclusions, but whatever they conclude, they must show us the proof in the story itself. Science journalism students from NYU, Boston University and Columbia come to us as interns acutely aware of these standards, presumably because that is what their professors teach. In this sort of journalism, the bar corresponds to what I describe in the current response. --Pamela Weintraub