Hot Zone (Tyee)

OP-ed (The Tyee)

Mediacheck
Today: Wednesday, February 18, 2009
A Combat Doctor's True Duty

Dr. Kevin Patterson was judged unethical for publishing a dying Canadian soldier's identity. Did he not serve a greater good?
By Claude Adams Published: February 18, 2009

TheTyee.ca
Cpl. Kevin Megeney, a 25-year-old reservist from Stellarton, Nova Scotia, died two years ago, of a gunshot wound in the chest, in a medical tent at Kandahar Airport, in Afghanistan. More than 60 other Canadian servicemen have died in combat since then, but we still don't know the full circumstances of Cpl. Megeney's death.
We don't know why he died. But we know how, in a description of graphic, hair-raising, heart-stopping detail that evokes the fiction of Dalton Trumbo, or medical reports from U.S. Civil War battlefields. We know that his lungs bulged out of the chest incision, "inflating and deflating," and we know that litres of blood poured out of his chest wound in a "gelatinous heap." We know that Megeney had red hair and blue eyes and that he looked "cheerful even in death."
The Canadian surgeon who tried to save him called the Megeney shooting "another blue-on-blue" -- military jargon for "friendly fire," which is itself a distasteful jargon for the aberration of one soldier killing a comrade-in-arms, reasons unknown. (A court-martial is scheduled for this June.)
These observations into Cpl. Megeney's death appeared near the end of a 2007 article in the San Francisco-based magazine Mother Jones, an article written by Dr. Kevin Patterson of Saltspring Island, entitled "Talk to Me Like My Father: Frontline Medicine in Afghanistan."
The Canadian Forces make no apology for the fact that, two years after the corporal's death, we still don't know what prompted the shooting. Investigations into "friendly fire" incidents, it seems, unfold in extreme slow-motion, at a pace that seems designed to flatten adverse publicity. By comparison, the military inquiry into Dr. Patterson's act of non-fiction was nearly instantaneous.
'I will never reveal'
Before the end of October 2007, a so-called Summary Investigation found that Patterson had committed a "breach of patient confidentiality." A copy went to the BC College of Physicians and Surgeons, Patterson's professional regulating body.

And the college itself took more than a year before ruling that Patterson had indeed broken the doctor's code by naming the dead soldier. He was reprimanded, fined, and told to brush up on medical ethics. As part of the deal, Patterson apologized to the Megeney family, and confessed to having made a "bad decision."
Patterson was also put on a kind of creative probation: In any future writing, journalism or otherwise, he would not include the names of patients, or use information that could identify patients. (Interestingly, the deal says nothing about Patterson's freedom to divulge names, or details, with a patient's approval.)
Patterson gets little sympathy from fellow doctors, or from the arbiters of professional ethics. They all fall back on Hippocrates, the father of medicine, who said, "All that may come to my knowledge in the exercise of my profession... I will keep secret and will never reveal." I talked to several doctors and ethicists, and they all agreed that Patterson should not have used Megeney's name, or details that could have revealed his identity. Dr. Gabor Mate, a well-known commentator on social issues, said flatly that without doctor-patient confidentiality "there is no basis for a healing relationship." And bio-ethicist Dr. Margaret Somerville of McGill University had no time for the argument that the horrors of war need greater exposure. "The problem is, that's the argument that should have been put to the Megeney family (to get their permission) before the article was printed," Dr. Somerville said. "It's a valid argument but it definitely doesn't take precedence here."
What's the 'greater good'?
Stephen Ward, a professor of journalism ethics at the University of Wisconsin, in Madison, is not so sure. He said that telling the story of the death of Cpl. Megeney, in all its gore, may serve a "greater good" -- giving citizens needed insight into the "nitty-gritty" of the soldier's experience in wartime. "If the writing has anything to do with the pressures placed on the soldier," Ward said, "then it's good to know. We are too often accused of sanitizing war."
The "we" in Ward's quote, of course, are journalists, and Kevin Patterson is not a journalist. He is a civilian doctor who, in effect, keeps a journal, and shares this journal with his readers. (He is also an accomplished author of fiction and non-fiction.) Should he not, then, get a special dispensation from Hippocrates' inflexible rule of "Never tell?"
Patterson put forward this argument himself shortly after his article was published in 2007, as the controversy began to build. "It is necessary," he wrote, "to face with open eyes the grotesque nature of war trauma. The recent disengagement and fatigue of the public with these matters is itself grotesque." Who better to chronicle the "grotesque trauma" than the nurses and doctors who have to treat the wounded, often under extreme conditions? The military, sensitive to any news that may hurt recruiting, certainly won't tell these stories. And embedded journalists with the Canadian soldiers in Afghanistan are well aware of the price of breaking military rules about disclosure: you're on the next flight home."
Name of the deceased
Leaving Cpl. Megeney's name out of the Mother Jones article, of course, would not have protected his anonymity since Canadian newspaper readers already knew the soldier's name, and knew that he died from friendly fire. All that Patterson added to the story were the medical details of his final minutes of life.
Tom Maddix, an ethicist with Providence Health, said using Megeney's name was unnecessary. "Stories have great power," he said. "and the exact name of the person is not the issue." Professor Ward disagreed. He said using the name gave the story credibility and authority.
It's instructive that it was the Canadian Forces, and not Megeney's family, that provoked the investigation into Patterson's conduct. Mother Jones magazine contacted the soldier's family in Nova Scotia before the magazine hit the streets, to alert them to what was coming.
A military victory
Clara Jeffery, the Mother Jones editor, says she spoke with Karen Megeney, the soldier's mother, by phone. As she wrote in the magazine's blog, "She assured me that the family would like to see the article, and that she was a nurse and would read it before any other members of her family; she said it would help to have closure to know more about what happened. We heard from other members of the family who also wanted to read it, and some whom after they did expressed the desire to write to Dr. Patterson 'to express my appreciation to him for exhausting every effort to save [him]'."
It was only later, after the Canadian Forces completed their investigation, and the College of Physicians weighed in, that the Megeneys went public with their displeasure.
The Canadian military took an uncompromising zero-tolerance approach to Dr. Patterson, even though he was a civilian volunteer in a war zone. "The issue here is entirely about medical ethics, not military law or discipline," a Canadian Forces spokesman told me. Did the Megeney family bring an official complaint to the military about the Mother Jones article? "The family was not happy," is all the CF spokesman would say.
All arguments about the need for patient confidentiality aside, should the Canadian Forces be the sole judge of what information can and should be released about how soldiers live and die in foreign lands? Is there not a case to be made for the claim that the stories of the war dead belong to all of us since we have a moral, physical and spiritual investment in their sacrifice? Is it not arguable that, in some cases, their names and their violent stories should transcend our norms of "privacy?"
Is a policy of official silence not at least as grotesque as the stories of how soldiers die?

Postscript: To see a public discussion of this story, please go here.
Postscript 2: I was very unhappy to see that in a published anthology of Canadian essays from Afghanistan, Patterson’s story is included, but it is stripped of any mention of Sgt. Megeney’s death . . . Another war casualty falls out of history! (April 14, 2009)

Blood on the Lens
Take cover from online interactive war reporting.
By Claude Adams Published: January 3, 2007 
TheTyee.ca
A segment on Kevin Sites's Hot Zone website begins with a man in Afghan dress peering through binoculars at a desert horizon. We hear a sharp "pop." Then a whooshing sound, followed by an explosion. The camera seems to fall to its side. A voice says: "That was close!" Another voice says: "I'm hit. Yeah."

The victim is a producer for National Geographic magazine, Gary Scurka, who is clutching his lower right leg. He is wounded -- shrapnel from a shell fired by a Taliban tank. "Shoot this, I'm bleeding," he tells cameraman Sites, who takes a few seconds of video, then barks: "We got it. Now let's move to the other side of the tank, the other side! They've zeroed in on this position."

Then Sites turns the camera back on the wounded Scurka. "We'll wrap you up first. Give me the fuckin' scarf...(This is for) posterity." Then from off-camera, he asks Scurka: "You've just been hit by a tank shell. How do you feel?" Scurka calmly allows himself to be interviewed while the blood flows from his leg. After a few moments, they call in a Medivac helicopter and Scurka is flown to safety.

Immersive journalism

Most traditional news-gathering is extractive -- the journalist dips into the stew of human events and extracts a narrative that is "objective," backgrounded, sourced and usually impersonal. But Sites and the Hot Zone are examples of "immersive journalism," where the storyteller is a leading character in his own narrative. Thus, a relatively minor incident on a distant battlefield involving two Americans is deemed worthy of world attention. There's blood on the lens, dramatic actuality, a shaky camera, a blurred desert landscape and, for added drama, we hear the heavy nervous breathing of the correspondent who will, in an hour or so, transmit these images, by satellite phone, to an office in California.
It's all about reflexivity, the narrator experiencing himself, embedded in the story. All the equipment he needs -- his digital cameras, his Thuraya/Hughes 7101 satellite phone, a Hughes R-BGAN satellite modem, and an Apple 12-inch PowerBook -- is safely tucked into a backpack that weighs less that 50 pounds. Technicians in the California office will record the video, re-edit it if necessary, tweak the sound levels and feed the videotape immediately onto the Hot Zone website where it will be available, in theory, to a potential audience of 400 million Yahoo! subscribers around the world, at their computer terminals. They will have a chance to share in a few moments of Kevin Sites's peripatetic life as a conflict correspondent.
But what do the pictures mean? What information do they transmit? How do they advance our knowledge about the war, about Afghanistan and its people, other than the obvious fact that war is dangerous for everybody, including reporters?

The answer is: not much.

We learn as much about Sites and his inner dynamics as the war itself. The reaction among academics and journalists has been mixed. Orville Schell, dean of journalism at the University of California in Berkeley, foresees a flood of "younger people roaming the world feeding news stories to Yahoo." But Ross Howard, a journalism instructor in Vancouver who has written on media and democracy, dismisses it as "interactive entertainment" that skims the surfaces of conflicts without any serious journalistic engagement.

Short on 'sense-making'

Journalism, says scholar James Carey, is "a form of storytelling aimed at imposing coherence on an otherwise chaotic form of events." It's called sense-making, the ability to take disparate sounds, images and pieces of data, and shape them into coherent narratives than enlighten an audience. The key word here is "enlighten." The function of news is, in its simplest terms, to tell us something we don't know, or to remind us of something we need to be reminded of. Kevin Sites, a 42-year-old American videographer not given to modesty, says he is "at the nexus of a new wave of journalism" -- a wave that he and his bosses hope will re-awaken an interest in world news among the 18-to-34 age demographic.

In fact, Sites makes all the familiar mistakes of traditional news-gathering. He stereotypes, oversimplifies, melodramatizes, condescends and even, at times, engages in what journalism professors would call "the language of colonial discourse." After a brief visit to the South Sudan village of Malual Kan, for example, Sites films women building the roof of a hut while the men sit in the shade playing dominoes. In his script, Sites concludes that Sudanese women lead "a life of servitude." He visits an outpost of the "ragtag" rebel army, the South Sudan Liberation Army, where men in civilian dress and plastic sandals stage a parade for his cameras, and concludes, "What they lack in style they make up in resolve."

South Sudan is today at peace, but Sites makes the remarkable observation that "the army won't hesitate to fight anew if peace in South Sudan fails." (In fact, based on my own travels in South Sudan, the SPLA rebels would often go months without engaging the enemy, and there was frequent internecine conflict.) Meanwhile, Sites reports that aid workers for the International Red Cross are content to "sleep in grass huts and take cold showers. They wouldn't have it any other way." (This is patently untrue.)

In Sites's Sudan, then, all women are oppressed, all soldiers heroic, and all aid workers self-sacrificing. He draws these conclusions without a single interview of substance, after what one presumes is a brief visit to the village accompanied by headmen.

Mud pies and cannibals

During a visit to Haiti last spring, Sites visited a slum and illuminated the desperate poverty by filming a woman baking "mud pies" -- food made from dirt after the stones and twigs are removed. It's a remarkable microcosmic image of life in the hemisphere's poorest country. Life in Haiti is so bizarrely wretched, he tells us, that people "crave dirt." But the real story is a little more complex: the earth is actually mixed with spices and bouillon cubes, and the dirt provides some of the minerals so sorely needed by pregnant women. It's the only way they can get it. Sites doesn't tell us this. Nor does he bother to interview (or film) anyone actually consuming the mud pies, or a nutritionist who could explain the phenomenon. Instead, we are left with the paternalistic one-dimensional tabloid image of a people "craving dirt."

Some would call this kind of journalism "colonial discourse" -- featured by an absence of the details of identification when the reporter is confronted by individuals whose language and culture he or she does not understand. In his book Rhetoric of Empire, David Spurr argues that what we need is a journalism "inspired by the celebration of plurality, the conscious affirmation of the differences seen from my window." Yet, when Sites interviews the widow of a man killed by members of the Lord's Resistance Army in Northern Uganda, we don't even see the widow's face, and only hear her allegations that her husband was then cannibalized. And Sites says in his narration: "This is the most horrible story I've ever heard."

Had this woman lived in the West, she would have been individualized with information about her family, personal details, corroborative testimony from witnesses and details about how the community was dealing with the outrage. None of that appeared in Sites's report -- the woman was a faceless, one-dimensional victim, presented as representative of her gender, her culture and her society. She is part of a larger, bleak narrative: we learn nothing about her individual "human experience."

Obviously, Sites is limited in the scope of his journalism. As Echo Fields notes in his study of content analysis in TV news, a reporter in the field often does not have access to the people who actually generated a particular news event; as a result "the fruit of one's analysis is not the 'truth' of events, only a plausible description of a narrative based upon them."

What's new?

Kevin Sites claims to be at the "nexus" of a new type of journalism. However, the processes of news-gathering and storytelling that he employs are, for the most part, conventional. In his classic 1973 study News from Nowhere: Television and the News, Edward Jay Epstein said that broadcast news narratives are, by necessity, structured to resemble works of fiction that are simple, direct and with "universal appeal." Images selected for broadcast will have "instant meaning" and they will "tell a story to everyone watching the program."

Thus, a naked child with a distended belly will represent poverty, and a woman carrying a bucket of water in the hot sun will be representative of all African women. As a consequence, nuance and subtlety (and precision) are sacrificed in the cause of producing a compelling narrative. It is the formula that NBC correspondents followed in 1973, and it is the formula that Kevin Sites follows today.

For example, one unnarrated story on the Hot Zone site shows a young Palestinian woman who, Sites tells us, was hit by a tear gas grenade during Israeli-Palestinian fighting when she was seven years old. The incident left her completely blind, and today "her imagination has blossomed" to the point where she writes evocative poetry. "Give me my childhood," she recites. "Don't shoot me in the head. I am a child in the age of flowers." The video item has strong emotional (and propagandist) value precisely because we get no contextual information about the incident that left her blind -- the circumstances of the fighting, where it happened, why she was there, etc. Instead, we get the iconic image of a young Arab woman, smiling despite her blindness -- meaning: courage under adversity -- and reading a message that suggests Israeli disregard for innocent children, without exploring that subject matter.

See me, feel me...

While Sites has produced some sensational video and told some compelling human-interest stories, he has added little of substance to our understanding of the nature of conflict, its roots, the motivations of combatants, or any original ideas for conflict resolution. Sites simply did not have the resources (or indeed, the mandate) to explore the stories behind the stories.

In Sites's defence, some communication theorists believe that this kind of journalism has great potential value. Michael Dertouzos argues that "any new channel of communication among the people and organizations of this world is likely to contribute to increased understanding, hence greater peace."

But others argue, more convincingly, I believe, that in a digital universe, more information is by no means a guarantee of greater clarity and understanding. More bits and bytes do not equal insight, and human-interest stories, of the kind produced in Kevin Sites's odyssey, do not equal human understanding.
(This article is drawn from my master's thesis in applied communication at Royal Roads University.)