Tuesday, May 8, 2012

"A Moment In The Sun"

The L.A. Times accepted my letter for their “Letters To The Editor” column.

To be honest, it is not exactly a letter.  It’s only one sentence long.  Which makes it more like a “tweet.”  Not even a full-length tweet.  It contains only 92 letters, plus a comma, a dash, fourteen spaces and a period.  Call it a “tweet-ette.”

But, as Dodger announcer Vin Scully says, when describing a dribbler down the third base line that is legged out for a single, “‘Tis a little thing, but thine own.”

I wrote a tweet-ette, and they accepted it.   People would be leafing through their Sunday paper, the biggest paper of the week,

And my sentence would be in it!

(Forgive the italics, but other than the “self” variety, I have not been published for quite some time.)

What happened was that on Wednesday, May the 2nd, there was an article printed in the L.A. Times’ op-ed section, written by H. Gilbert Welch, who is credited as being “a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice.”  I’m not sure he’s a doctor, but the man definitely talks to doctors!

The subject of Welch’s op-ed commentary was the previously under-examined issue of over-testing when diagnosing and treating patients, especially patients who are presenting no symptoms, or whose previously observed symptoms have not changed. 

Welch reported that medical specialty boards and societies, representing cardiologists, radiologists, gastroenterologists and other doctors, recently proposed forty-five specific situations in which tests and treatments be reined in, or entirely curtailed.  This was a case of doctors, whose interests may be otherwise saying, “We want to do less.”  When that happens, it behooves one to listen. 

Why were doctors testing too much?  The “usual suspects” immediately pop to mind.  When they do more, they get paid more.  Also, when they do more, they are defensively indemnifying themselves against the possibility of being sued.  Then, there’s the totally benign – meaning not self-serving – explanation for over-testing:

“Better safe than sorry.”

(My Toronto dentist used to walk in holding my x-rays, saying, “You have nine cavities.”  “Are they all serious?” I would inquire.  “Three cavities are serious, and six cavities are small.”  “Why don’t you fill the three serious ones, and leave the other six for later”, I would propose.  To which my dentist would inevitably reply, “Well… they’re your teeth.”  I would always wind up getting nine fillings.”)

The other side of the argument – an unquestionably persuasive one – is anecdotal:

“Doctors tested my (PLACE RELATIONSHIP TO THE “MY” PERSON HERE) got tested for (PLACE NAME OF SERIOUS, POSSIBLY TERMINAL DISEASE HERE), they caught it early, and they saved (HIS OR HER) life.”

I told you it was persuasive.

“To test, or not to test.”  The line is clearly a tricky one to determine.  Professor Welch’s commentary made a much-needed argument for at least taking a breath before prescribing possibly unnecessary tests.  I have always wondered about this generally unchallenged diagnostic approach, and was reassured that Professor Welch and those medical societies were looking into it, sounding the alarm against what may be prematurely pulling the trigger.

I did, however, find something missing in his analysis.  So I sat down that May 2nd morning, and I composed my tweet-ette.  

My response to H. Gilbert Welch’s commentary the paper captioned “The Testing Glut” which I submitted to the L.A. Times “Letters To the Editor” department was the following. 

Though helpful and illuminating, Welch omitted an important objection to over-testing:  It scares the patients.”

Did I think they would print it?  Probably not.  Why should they?  Though I believed I was making a meaningful contribution to the debate, I am burdened with the misfortune having, what is called in the “attention getting” business, no “platform.”  

“No platform” means that nobody’s heard of you.  As a result, when you say
something – even something worthwhile – it’s like a four year-old saying, “There’s a boogie-man under my bed.”  You are very likely to be thoroughly ignored.

So, imagine my excitement when I check my e-mail on Friday, May the 4th and find an e-mail from Paul.Thornton@latimes.com, informing me that

“Your letter to the editor is scheduled for publication in Sunday’s Los Angeles Times.  This decision is not final until the paper is published.”

Which, means if they can do better, they will.  If Henry Kissinger or Ryan Seacrest wrote in, I was summarily out the window.  But still.

They were publishing my letter. 


Sunday morning, I run downstairs.  I bring in the paper, and pull off the protective cellophane wrapper, jettisoning sections of advertising, till I get to the Front Section, where I immediately turn to the “Sunday Opinion” at the back. 

I can feel my heart pounding, like I was heading towards a “make-or-break” review of a TV series I’d created.  Well, not that much, but it was undeniably along those lines. 

And there it was. 

Under two responses sent in by actual doctors.  

They had printed it exactly as I had written it.  The “acceptance” e-mail had included the warning, “…cuts may have been made for space.”  For me, that was not a consideration.  How much space does one sentence take?”

Below my letter, was, my name and where I lived:

Santa Monica

I was extremely proud.

For about thirty seconds.

Then I thought of three ways I could have made my sentence better.


Mike Tennant said...

And here's the proof:


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