Selected Skirmishes: Hope Springs Paternal

What medical reporters think inquiring minds don't need to know

On May 3, 1998, readers of The New York Times were treated to an amazing front-page story by science writer Gina Kolata, "Hope in the Lab: A Cautious Awe Greets Drugs that Eradicate Tumors in Mice." It began, "Within a year, if all goes well, the first cancer patient will be injected with two new drugs that can eradicate any type of cancer, with no obvious side effects and no drug resistance--in mice.

"Some cancer researchers say the drugs are the most exciting treatment that they have ever seen. But then they temper their enthusiasm with caution, noting that the history of cancer treatments is full of high expectations followed by dashed hopes when drugs with remarkable effects in animals are tested in people."

The story ignited the vaunted media frenzy. But was this flame of interest sparked by the tremendous scientific breakthrough? A celebration for the sick? The need to speed such promising developments to market? No. Just about every enlightened quarter of the press offered its own analysis of Kolata's story--and trashed it. Not for its presentation of the medical facts, but for its audacity in putting such good news on the front page. This, the conventional wisdom held, cruelly subjected cancer victims to spasms of "false hope."

Take it from the new conscience of American media, Brill's Content: "Kolata did get the science right….And Kolata made it clear that the drugs had been successful thus far only in rodents. But that caveat was lost amid the article's optimism and its placement." Scientific progress is fine when given an indecipherable blurb back on page D-74, or tucked away in obscure professional journals. But putting that stuff on the newsstand for all to see?

The esteemed Bernard Kalb, host of CNN's Reliable Sources, feared that Kolata had put out the news too quickly. "Did the Times and the pursuing media get ahead of the science," he fretted, "provoking false hope for cancer patients and their families?" This was the concern of CNN's medical correspondent Steve Salvatore, who suggested the real problem is "the mentality and the mindset of the cancer patient. …Put [that research] in the hands of a person who is desperate, who's been told that they have cancer spread throughout their body, they have six months to live. None of the latest treatments are going to help them. Their family's upset, they're upset, and they're grasping at straws. You put this article in front of them, they're going to be hopeful."

How mean-spirited can one reporter be? Better to hide this stuff in a safe place so those pesky terminal cancer patients won't be getting all excited, calling their doctors and asking obnoxious questions. Otherwise, these folks are apt to be stricken with "False Hope Syndrome," a condition which leads people to act as if they have a chance of surviving when any responsible person would just lie down, take his chemotherapy, pull out his hair, puke up his innards, and fade off into the statistically bleak horizon.

Indeed, some think the dread disease of unwarranted optimism is a killer. Take ABC's medical editor, Dr. Tim Johnson, who agonizes over how much information the little people can handle. "There is a large part of me which says my most important responsibility is to keep things off the air," he said.

Keep that in mind during the next ABC medical update. You'll be enjoying the luxury of knowing that your reporter is delivering all the news he thinks you can handle. Most important, he'll be filtering out any potentially dangerous germs which could touch off a bout of the dreaded "false hope."

But who will protect you from that vastly underreported--and infinitely more lethal--syndrome, "false despair"? I do not know if the gatekeepers of scientific knowledge have bothered to quantify the costs and benefits of hope, but I'd be interested to see the balance sheet. By its very nature, hope implies a statistical chance; one cannot claim to be "hopeful" and yet fail to understand that failure is a potential outcome. To remain hopeful in the face of such grim possibilities is to claim at least a moral victory over death and defeatism.

Cancer patients are often said to be "terminal," but some bright thinkers have asked: Who among us is not? In electing to be hopeful, and taking all reasonable measures to get well, those ailing bodies who resolutely search for the best medicine do nothing but make life better. Maybe optimism is itself a partial cure; great healers like Yale's heroically hopeful Dr. Bernie Siegel think so. In any case, what is the downside? Too many phone calls to the receptionist at the oncology clinic? Too many requests for Science reprints at the public library? Too upbeat an attitude when fighting the good fight?

Great advances are being made in many disparate branches of cancer research, and much of the progress rests with cheerful souls who smile when they read what Kolata writes, eagerly volunteering for the clinical trials that will decide the issue. More interest should accompany their brave efforts--more funding for research, more investment in the pharmaceutical firms that sponsor trials, more publicity for signs of life in the battle against the most brutal murderer of our friends and loved ones. That accurate reporting on the marvels of science should become a cause for elitists pushing self-censorship is itself a stunning reminder of the life-giving benefits of the public's right to know.

Contributing Editor Thomas W. Hazlett ([e-mail]) teaches economics and public policy at the University of California at Davis.