9 Reasons The Pretty Bird Hates This Recent “Most Popular” Yahoo News Story

5 Jul

Americans are treated, and overtreated, to death

By MARILYNN MARCHIONE, AP Medical Writer Mon Jun 28, 11:33 am ET

1. The headline is misleading. This story is not about Americans. It’s about terminally ill people, usually cancer patients.

2. The headline is misleading. It implies that the treatment/overtreatment is causing the death, which is just false. These people were going to die anyway. The article doesn’t even claim that treatment is hastening their deaths.

3. It’s not a news story. It’s a piece of hospice advocacy. Hospice care is good stuff, for the right people. But that doesn’t mean that hospice advocacy should masquerade as health news, particularly as health news that borrows its headline’s form from stories about new developments in medical care.

4. It reiterates its deception in its seventh paragraph:

“Americans increasingly are treated to death, spending more time in hospitals in their final days, trying last-ditch treatments that often buy only weeks of time, and racking up bills that have made medical care a leading cause of bankruptcies.”

What’s implied here, again, in the introductory clause, is that the treatment itself is causing the death. The notion is directly undermined within the sentence, when it reports that the treatment choices “often buy only weeks of time,” implying that those weeks have no worth. Further, it tries to position itself within the healthcare cost debate by pointing to the bills racked up by those final treatments. But the real bitch of it is that last bit, where these last-ditch treatments are conflated with the larger socioeconomic phenomenon of medical bankruptcy. Sure, that last course of chemo was the straw that broke the camel’s bank account. Because all the shit that came before was free? This works to deliberately confuse readers. It’s the opposite of news.

5. The human interest hook, Rosaria Vandenberg, sure makes a good heartbreaker, what with that baby crawling on the bed. But how, pray tell, is a 32 year old a typical example of end of life care?

6. Again with Ms. Vandenberg: The argument here is that patients aren’t appropriately informed of other options besides continuing to fight. Good, I’m with you: Let’s have the damn “death panels” so that we can all talk to our doctors about what we’d like to endure before we die. Fine. But Vandenberg was a health care professional, and was quite likely well informed about the treatments she was undergoing and their side effects and risks. In fact, as a pharmacist, she may have well had a better understanding of the effects of something like chemo than some of her caregivers. Her sister-in-law might think that she shouldn’t have been “tortured” in her last days by more treatment. Her sister-in-law? When, exactly, was she made power of attorney over Vandenberg’s treatment decisions? Who the fuck is she to say? That the writer here has to pull such a tangential family member to get a quote is telling of the stretch she’s making to include Vandenberg as a meaningful example at all.

7. The bulleted list of statistics, most of which connect only tenuously to the story anyway. This is the Yahoo! News telltale sign that they’re trying to make a “news” story out of something that should be presented as column, opinion, punditry, etc.

8. The entire article’s purpose is undermined in this sentence: “Ultimately, how patients and their families make the journey is a matter of personal choice—and there are resources to help them, Stovall said.” Conveniently, it’s buried three graphs from the end.

9. It’s none of Yahoo’s business, nor of the legion of idiots who read these stories and take them as gospel, whether I decide to continue or discontinue treatment of a disease that’s basically guaranteed to kill me very soon. The point of the article–that better-informed people would choose to die at home with their families with less care (a point that the fucking headline and drop-down summary disguise)–is completely specious and unfounded, supported only by a few conflicting interviews with a tiny handful of people.

But there’s something else going on here: The idea that we won’t “fight to the end” contradicts a couple of core American ideas: First, that we are fighters, that the American spirit means we can beat anything, etc. And second, that people who die from cancer didn’t fight hard enough, or try hard enough.

This last bit, the rhetoric about cancer as a “fight,” is dishonest and dishonors all those whose lives have been lost to terminal illness. King of the Dickheads Lance Armstrong stands up and flexes his muscles and stands in for all those big bad tough guys who “beat” cancer. Never mind that, according to the American Cancer Society:

“Testicular cancer is one of the most curable forms of cancer. According to the National Cancer Institute, the 5-year relative survival rate for all men with this cancer is 95%. If the cancer hasn’t spread outside the testicle, the 5-year relative survival rate is 99%. Even if the cancer has spread to nearby lymph nodes, the 5-year relative survival rate is 96%. If the cancer has spread beyond the lymph nodes, the 5-year survival rate is around 71%. More than 170,000 men in the United States have survived testicular cancer.”

Armstrong’s cancer had spread throughout his body, so he didn’t represent the easiest case; even so, though according to the ACS his survival rate should have been around 71%, his doctors gave him a nearly 40% chance of survival. If four out of six people with Lance Armstrong’s exact condition–a condition that was probably exacerbated by his use of performance-enhancing drugs–will survive, shouldn’t the one whose body is a heavily monitored profit machine be among those survivors? I mean, this guy, who had endless money and resources to “fight” his cancer, is our poster-boy? I’m picking on Armstrong a bit here (mostly because he just bugs the fuck out of me). It’s not the poster-boy himself who needs a flogging. It’s the rhetoric of battle that calls for a poster boy that’s at fault. It’s the idea that disease is a fight, that you’re strong if you “beat” it that’s so very wrong. It’s the implication in that statement that those who don’t “win” die because they are weak.

It’s this very implication of weakness that gives the fucking assholes who coined the term “death panels” license, and that creates the need, in the first place, for opinion columns advocating end-of-life care and higher standards of patient information. It’s this goddamn logical fallacy–die and you’re weak–that makes it okay for asshole Republican senator–and physician–Tom Coburn to stand up in town hall meetings and tell a woman whose insurance company has sentenced her to watch her husband die to ask her neighbors for help paying for his feeding tube. But that’s all right, Yahoo. You keep on truckin, with your conflicting stories every other week about dark chocolate and red wine and how and why to die. Anything to make a buck.

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3 Responses to “9 Reasons The Pretty Bird Hates This Recent “Most Popular” Yahoo News Story”

  1. Håvard S. Johansen July 9, 2010 at 7:05 am #

    Interesting points. I think the idea of ”fighting” disease is something of a coined phrase in more places of the world than the U.S. The problem, specifically in terms of diseases like that which you talk about, is that the disease is in some form generated from inside oneself, and this means, of course, that fighting the disease is in some way fighting oneself. From my experience, and from talking to others, is that the key seem to be to take one day at a time. The fighting consists of almost giving up, not really give up, but in a sense stop hoping so much. Especially when something like that can go on for years and years, and if one spends energy every day hoping, attempting to get back into a daily life like before, fear will grow proportionally, and one paradoxically will drain oneself and become less apt to getting well, which probably, for a cancer patient with a serious diagnosis, may not be an option after a while. Conclusively, relaxing, and doing as best one can day by day, and not worry so much about the result, seem to bring about the best result, both mentally and physically. This, of course, assumes that you have a health care facility that takes care of you, which should be a basic right, but most people don´t have in the world. But that´s a different topic, although related.

    I won´t go on about Lance Armstrong, but as far as I know, I don´t think he was tons rich when he became ill, and it was pretty rough on him. He did have the luck of being very young and strong, at least physically. The poster boy isn´t all bad either, it helps against self-stigmatization in terms of overcoming a sense of shame from being sick, which, at least over here, seems to be more common than we like to talk about.

    I think the rhetoric you point to culminates in something very fundamental: that being sick, over a long amount of time, excludes you from a respectable society, even though disease is a natural part of life.

    I wonder, in this modern day and age of human beings becoming all-powerful, is death and disease now becoming the last taboos?

    • Victoria July 9, 2010 at 11:49 am #

      I’m sure everything you say here is vital. I could never pretend to tell anyone how to deal with disease, which is clearly an individual set of choices, but I do think the way we talk about disease is toxic. The point you make about fighting yourself is really interesting to me. (And my focus on the US is simply because I know no other culture, so your perspective is great to hear.)

      Disease gets one step up from poverty on our rhetorical scale. People want to look for blame; when we talk about poverty, at least in the US, here is the big divide: Conservatives tend to blame the poor and liberals tend to look at the culture for causes. It’s the same with disease, except almost no one looks at the sick person for blame, unless we’re talking about AIDS, where a fringe element of assholes still does that.

      What we get out of the language of blame, I think, is a false sense of isolation from the problem. If there’s a cause, I can avoid that cause and it will never happen to me. Our victim-language about cancer is often an inversion of this, too: We talk about how someone was so young, we talk about lifestyle. We stop just short of saying “s/he did nothing to deserve it.” All of those trappings seem toxic to me, and the “fighting” language fits with that package. (My grandmother didn’t survive her colon cancer and live for 20 more years because she “fought” or was so tough or “beat it”; she survived because her doctors were able to cleanly remove the softball-sized tumor (along with part of her colon) and her body responded to treatment positively. Her mental state probably helped her to not fall into the often-accompanying depression.)

      But then, again, I also reject war & battle metaphors for just about everything–relationships, writing, anywhere they pop up. With the exception of potentially terminal disease, they’re always overblown and melodramatic, and they tend, in their use, to trivialize the real horrors of war and battle in the comparisons.

Trackbacks/Pingbacks

  1. For Your Perusal, a Much-Needed Corrective to that Awful Yahoo News Article a Few Weeks Back « The Pretty Bird - August 2, 2010

    […] Aug In the most recent New Yorker, Atul Gawande makes essentially the same argument that shitty Yahoo News article made. Unlike the Yahoo assholes, he makes it with humanity and grace. If, like me, you’re […]

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