playing god in the newsroom

After doctors discovered that twenty-seven-year-old Caroline Tomasulo had leukemia and would need a bone marrow transplant to survive, her mother, Caroline Russo, began working feverishly to raise the $100,000 necessary for the treatment and aftercare that was not covered by insurance. To bring the public's attention to her daughter's desperate plight, Russo has spent more than a year trying to get the attention of the media.

But the Toms River, New Jersey, resident has had little success. No television or radio stations have provided coverage and only a handful of local newspapers have done stories. As a result, Russo has been forced to raise all the money through raffles and store- front canisters, and she remains some $50,000 short. "To be honest, I've been shocked that the media have not paid very much attention to my daughter's situation," Russo says. "It would seem to be the perfect story for them."

Her frustration comes as no surprise to David Cain, founder of the Children's Organ Transplant Association (COTA), who travels across the U.S. helping patients, including Caroline Russo, raise money for transplants and other life-saving medical procedures. Media coverage can be the difference between life and death, says Cain, but who gets that coverage and who doesn't is kind of a crap shoot. Editors, reporters, and columnists around the country say that making such choices is an inexact science involving news judgment, timing, and luck, as well as the persistence of patients and their friends and relatives.

A few media outlets, such as the Star Tribune in Minneapolis, have informal policies against covering individual need cases, preferring not to have to choose between similarly desperate patients, according to science editor Gordon Slovut. At the other end of the spectrum, COTA's David Cain agrees that the press should not have to choose, but argues instead that patients in need of money for life-saving surgery should always get coverage.

Most news organizations end up in between, making the hard choices. "You could start a cable channel with just the people in desperate need we're asked to cover," says Al Macias, assignment manager at KNXV-TV in Phoenix. "There is no comfort level for me on this question. If your solution is to do none of them, I'm not so comfortable; if it's to do all of them, I'm not so comfortable; and if it's just to do some of them like we do here, I'm not so comfortable with that either. But I think it's the best policy."

"I'd like to do a hundred stories on every one of these people," says Steve Gasque, a reporter with Atlanta's WSB-TV, "but then I would be neglecting the other stories that are important to the news fabric of this community."

Nationally syndicated Chicago Tribune columnist Bob Greene, who receives dozens of these requests every year, says, "There is no correct answer to these requests other than 'yes, I'll write about it.' But the reality is that you can't do very many of them. It is a terrible lottery for media coverage that people are forced to enter."

Arizona Republic columnist E.J. Montini notes that every time he writes about one case, he receives many more pleas. "I can tell you it's just horrible to have to explain to a mom or a dad that you can't write about their dying kid," he says, "because you just wrote about another kid with the same disease."

Most editors say they make the call based on the story's newsworthiness, like any other editorial decision. The Atlanta Journal and Constitution is typical. "We'll cover the story if we can find a special medical angle or a deeply human element," says metro editor Mike King, who has been covering such stories since the early 1980s when he was a science and medicine writer. If the case involves a new medical procedure, a broader health trend, or an important ethical, legal, or political issue, it is more likely to be deemed newsworthy.

Occasionally, he admits, cases not meeting those criteria find their way into the paper, and the "deeply human element" standard can evolve depending on the timing (has one of these stories run recently? how busy is the news day?), the patient profile (is it a cute young child?), the promotional skills of the patient's supporters (enlisting a celebrity, developing a unique fundraising stunt) or even the tenacity of those pitching the stories. King feels comfortable deciding each instance individually since "it is an editor's job to determine what's news for the paper's readers."

King makes an appeal of his own, for editorial context. He believes the press has a responsibility to explain why these dramatic fundraising appeals are necessary, that society has yet to come to grips with the cost and access issues surrounding life-saving medicine.

Deni Elliott, professor of ethics at the University of Montana, who has produced two documentaries on this topic, adds that it is important to mention that even if money is raised for one patient, many others in the community are not helped, and are dying. "The media's coverage often leads the public to believe that these desperate pleas are unique, but unfortunately they are very common," she says.

The Arizona Republic's Bill Hart summed up the feelings of many journalists on this difficult topic in a June 6, 1993, column that began: "Should I be the one to choose whether you live or die?" Hart described the different options available to the media in dealing with these requests -- including the possibility of just picking them by lottery -- before eventually concluding that maybe "this is one of those instances where simple humanity dictates that we continue to fumble along as best we can."

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