Our Times: An Error of Omission

Margaret Renkl, 61, is a New York Times opinion columnist who describes her beat as “flora, fauna, politics and culture in the American South.” She lives in Nashville where she was a high school teacher for 10 years and raised three sons. She has been with the Times since 2015. My wife, who is unforgiving when writers get their facts wrong about nature, says, “She like plants, so I like her.”

Last week Renkl wrote an essay called “Dear Liberals, Come on Down.” This is how she made her case: 

“Red-state legislators have perfected the art of voter suppression, which you probably know. They have also gerrymandered the South’s blue cities into political irrelevance, which you may not. These cities serve as their states’ economic engines.

“The counties Joe Biden won in 2020 account for 71 percent of U.S. gross domestic product. A bunch of those counties are in red states, and they are growing. Come help us grow. The new gerrymandered district lines are based on current data. With your help, we can outwit craven G.O.P. calculations about where residents reliably vote Republican. Once you’re here, you can help us register voters in disenfranchised communities, too, and drive them to the polls on Election Day.”

Renkl went on to extol Southern cooking, music, hospitality, etc. Two days later the Times ran six letters commenting favorably on her tactical suggestion. I expected at least one to mention Charles M. Blow, but it was as if he didn’t exist. Nor did the Times run a “correction” noting Renkl’s failure to acknowledge Blow. 

Ms Renkl, meet Mr. Blow. He’s your colleague, a New York Times columnist who lives in Atlanta. He’s 52, been with the paper since 2008. And like you, he’s an involved parent. You’d almost certainly like each other.

Last year Harper published Blow’s manifesto, “The Devil You Know,” in which he proposed the very tactic that Margaret Renkl proposed last week in her column. It’s true that she was implicitly addressing white liberals whereas Blow was explicitly calling on Black people across class lines to reverse the Great Migration that swept millions of their grandparents north in the decades after World War I... But she should have acknowledged him for proposing the tactic and analyzing what it would take demographically to turn the electoral tide. 

Too bad none of the editors who oversee the Opinion section caught the omission. I’m sure Charles Blow has suffered worse slights. 

Pseudo Self-criticism

“I Was Wrong” was the stated theme of the 12-page Opinion section last Sunday. The front page was wasted on a giant photo of a pink rubber eraser. The second page was given over to giant type explaining that in the following essays, writers were revisiting subjects about which they had changed their points of view. For example, Michelle Goldberg now thinks she was wrong when she demanded Al Franker’s immediate resignation from the Senate. She wishes there had been a Senate Committee had held a hearing before he got offed! 

The mealy-mouthed mea culpas were properly dissed in a letter from Aaron Schurg of Traverse City, Michigan who wrote: “I got through about three of the ‘I Was Wrong’ columns before realizing that the theme was ‘I was wrong, but let me equivocate.’ I always thought that wrong was wrong; I guess I was wrong (but I can explain). These read like a homework assignment no one wanted to do.”

Apparently the Opinion editors couldn’t find enough pundits willing to acknowledge ever having flubbed the dub, so half the section consisted of conventional op-eds. 

Straight Outta Chester Himes

“Brooklyn Clergyman Is Robbed While Delivering Sunday Sermon,” was the hed on Christine Chung’s feel-good story in the Times July 25. Excerpts follow:

“A showy pastor who was in the middle of delivering his sermon and his wife were robbed at gunpoint of more than $1 million worth of jewelry at a Brooklyn church on Sunday, the police said. The heist was caught on a livestream video of the service.

“Lamor M. Whitehead, 44, a bishop at the Leaders of Tomorrow International Ministries in the southeastern Brooklyn neighborhood of Canarsie, spoke about the armed robbery in an Instagram post, calling it an example of ‘how the devil moves.’

Chung described Whitehead as “an ally of Mayor Eric Adams who has appeared publicly with him on occasion.”

The bishop hit the floor immediately when Satan’s three agents entered his church. At gunpoint he was “stripped of belongings, including his watch, multiple chains, wedding band and bishop’s cross. He said the assailants wrenched off his clergy collar to reach his necklaces.

“Jewelry was also taken from Mr. Whitehead’s 38-year-old wife, the police said, adding that neither of the victims was injured…

“Mr. Whitehead responded to criticism calling him ‘flashy’ for his accessories and his Rolls-Royce. ‘It’s about me purchasing what I want to purchase,’ Mr. Whitehead said. ‘It’s my prerogative to purchase what I want to purchase if I worked hard for it’.”

The robbers have a similar taste for the finer things. They got away in a white Mercedes.

US DOJ Sues Poultry Processors

This story by Linda Qiu belonged on the front page July 25 but was buried at the bottom of B-4. ”The Justice Department filed a lawsuit on Monday against three large poultry processors along with a proposed deal meant to end what it described as a decades-long scheme to deceive workers and suppress wages.

“The moves are part of the department’s broader investigation into the poultry industry’s anticompetitive practices. The filings come just weeks after the department lost a criminal price-fixing lawsuit against chicken company executives.

“For at least 20 years, the processors Cargill, Sanderson Farms and Wayne Farms and a data company called Webber, Meng, Sahl unlawfully shared information about employee compensation to suppress wages and stifle competition, according to the civil antitrust lawsuit, which was filed in Federal District Court for the District of Maryland. The data shared was so detailed that processors assembled a nationwide map showing company budgets and wages at individual plants

“The three processors, along with 18 others listed in the lawsuit as unnamed co-conspirators, employ more than 90 percent of poultry processing workers in the country, according to the lawsuit.”

Let’s hope DOJ doesn’t blow this one. 

Metastatic Screening

The worst thing a headline can do is distort the meaning of the article it’s supposed to summarize. That’s what an editor of the Times Science Section did to Paula Span’s July 19 article about cancer centers urging patients to undergo costly, unwarranted screenings. According to the hed, “Cancer Centers Push Testing, Even to a Fault.” Testing is not the same as screening, which was the focus of Span’s article. And ”even to a fault” implies that the clinic owners had good intentions but were overly conscientious in urging patients to undergo various procedures.

For the 50 percent who will read her piece beyond the headline, Span defines her terms: “Screening refers to tests for patients with no symptoms or evidence of disease, including prostate-specific antigen tests, mammograms, colonoscopies and CT scans.”

JAMA Internal Medicine has recently published three studies documenting the extent to which cancer centers’ websites ignore recommendations by medical societies and the US Preventive Services Task Force about who should be screened for lung, prostate and breast cancers, and how frequently. “Some sites discussed the benefits of screening but said little about the harms and risks,” Span reported. “Some offered recommendations about the age at which to start screening but glossed over when to stop —an important piece of information for older adults.

“The researchers analyzed more than 600 cancer center websites that provided recommendations for prostate screening, and found that more than one-quarter recommended that all men be screened. More than three-quarters did not specify an age at which to stop routine testing. Yet guidelines from both the Preventive Services Task Force and the American Urological Association state that men over 70 should not be routinely screened, because… ‘the potential benefits do not outweigh the expected harms.’

“The study reported, 62 percent of cancer center websites did not include information on the potential harms of screening. Because prostate cancer grows slowly, it often causes no problems. But detection and treatment can lead to complications from surgery or radiation, including lower quality of life from incontinence and sexual dysfunction…

“In a study of over 600 breast cancer centers, more than 80 percent of those recommending a starting age and intervals for screening mammograms were at odds with guidelines.” The harms associated with mammography include “false positives, leading to repeat mammograms or biopsies, the psychological consequences of which can continue for months... And while most breast cancers diagnosed in women over 70 are very low risk and might never progress... nearly all are treated with surgery... and sometimes thereafter with radiation and endocrine drugs, all of which can have negative side effects.

“As for benefits, the data showed that 1,000 women aged 50 to 74 would have to undergo mammography for nearly 11 years to prevent one death from breast cancer.”

It’s no mystery why the cancer centers’ websites are so often misleading. Dr. Alexander Smith, a palliative medicine specialist and geriatrics researcher at UCSF, explains bluntly: “‘In the US health care system, the more procedures you do, the more you get paid.” He notes that radiology, which is used to conduct lung and breast screenings, “is one of the biggest moneymakers for health systems.” 

Another doctor tries to put it diplomatically: “Some websites may have been developed by marketers with little input from health professionals.” Span herself says it straight: “Talking about risks could discourage patients from clicking the ‘Make an Appointment’ button.”

Paul Ellwood, ‘Father of the HMO’

The designer of the “managed care” system by which more than 70 million US Americans pay for medical treatment, Dr. Paul Ellwood, died in June at the age of 95. He coined the term “Health Maintenance Organization” in 1970. The Nixon Administration embraced the approach.

According to his obit in the Times by Robert McFadden, Ellwood “envisioned large nonprofit organizations that would compete for patients by providing the best care at the lowest price and that would contain costs by keeping patients healthy to begin with, through an emphasis on preventive medicine, like regular physical exams, well-baby checkups, mammograms and immunizations.”

In due course, however, Ellwood “worried about the effects of cost controls on quality of care, especially after federal and state policy changes encouraged the growth of for-profit HMOs. As HMOs grew, merged and became enormously profitable, he repeatedly voiced disappointment with the way his original ideas had worked out in practice…

“In later years he championed what he called ‘outcomes management’ — a national database to show how the treatment of patients actually works out. Without such measures, he argued, health care providers and policymakers had no way of knowing whether care was being compromised to cut costs, and no way to evaluate proposals for reforms.”

In a 2010 interview Ellwood said, ”We have to create an agency to collect health outcomes data, isolate it from the rest of the government and the rest of the health system, and then use its findings to determine what it is that’s worth spending public or private money on for health care.”