TheJoan Shorenstein Barone Center

PRESS. POLITICS

. PUBLICPOLICY.

HarvardUniversity JohnF. KennedySchool ofGovernment IrurnonucrroN

Analysisor criticism of professionalpractice, short of existing journalistic norms. This form regardlessof the professionat issue,tends to of critique is valuable, especiallywhen it comes take one of two forms. In the more common from those both inside of and representingthe form, the standardsof the professionare used as finest traditions of the press,and indeed it is a the benchmark againstwhich the practicesof common criticism of the institutional pressthat professionals-physicians, journalists, lawyers, there is so little of it. Without this kind of scholars,engineers, or whatever-are analyzed criticism the idea that there are journalistrc and evaluated.The goal here is to identify norms/ and that there can as a result be good variancebetween professionalpractice and those reportersand bad reporters/good reporting and professionalstandards. At times the variance bad reporting/ seemsto lack substance. identified may be individual, as when the behav- Other instancesof analysisand criticism of ior of a particular lawyer or a particular piece of the press,however, often and perhapsnecessarily legal analysis is criticized for failure to measure from outside the press,are of the secondvariety, up to professionalstandards. And at times the examining the effect of presspractices and evaluation or critique may focus on the profes- standardseven when the norms that help to sion as a whole, as when researchersidentify the define the professionare followed and not "good frequency with which physicians commit violated. Does the definition of a story" on malpractice or with which accountantsfail to occasion(or often) relegateto oblivion events adhereto the Generally Accepted Accounting that ideally ought to be described?Do press Principles. definitions of what is important and what is not Analysis and critique of this variety is com- themselvesincorporate standardsthat mon and valuable, for no set of standardswould marginalize that which ought not to be have much force unless divergencefrom it was a marginalized?Do the contingent constraints sourceof criticism. Still, this form of critique is imposed by the existing nature of daily newspa- only part of the story, and apart that is likely to pers and daily news shows tend systematically to be necessarilyconservative (in the non-political ignore those aspectsof life that do not fit within senseof that terml, becauseit takes the stan- the boxesthat newspaper,radio, and television dardsthemselves as the appropriateform of practicesthemselves define? evaluation. Implicit in such a critique, therefore, It is just this latter type of criticism of press is that things would be as they should be if the practicesthat is explicitly described,and so well applicablestandards were faithfully and univer- embodied,in this analysisof AIDS coverage sally followed. preparedby Timothy Cook, AssociateProfessor But it is not always so. Professionalstandards of Political Scienceat Williams College and in are themselvesvalue-laden, making choices 1989-90a ResearchFellow of the foan about what forms of behavior are appropriateand ShorensteinBarone Center on the Press,Politics what are inappropriate.These choices,however, and Public Policy and Visiting AssociateProfes- are themselvessubject to analysis and critique, sor in the Lombard Chair at the fohn F. Kennedy for it is often the casethat professionalstandards School of Government. In this first of two of incorporate the values and existing practicesof Tim's papersto be published by the Center, he the professionitself, values and practicesthat draws the distinction describedabove far better may, from alarger perspective,work better at than I have here, and then goeson to evaluate some times and for some subjectsthan for presscoverage of AIDS by arguing that a large others. Thus it is often the casethat the deepest number of existing presspractices and standards, and most powerful critiques and analysesrefuse even when followed faithfully, have the ten- to take professionalstandards as a given, instead dency to produceunfortunate presscoverage of attempting to determine whether the standards events like AIDS that may disproportionately themselves,even if universally followed, might place at risk only a small portion of the popula- neverthelessproduce unfortunate consequences. tion, that may not be easily capturedin daily- Analysis and critique of presspractices fits breaking events/that may present an extraordi- well within this dichotomy. Some of it, often narily high possibility of inflammatory interpre- from the pressitself or from institutions affili- tation, and that may involve areasof scientific ated with the organizedpress, is of the former knowledge not easily understoodor conveyedby variety, criticizing journalistic efforts that fall those without the requisite scientific knowledge. Tim's provocative critique of AIDS coverage would be important even if its lessonwere restricted to the enormously pressingissue of AIDS itself. But as a casestudy in how journalis- tic norms and practicesmay systematically misreport social phenomenaof a certain kind, it has an even broadermessage/ one that should be consideredby all seriousstudents of the press and its performance.

Frederick Schauer Frank Stanton Professorof the First Amendment foan ShorensteinBarone Center on the Press,Politics and Public Policy fohn F. Kennedy School of Government Harvard Universitv

I NOTES FOR THE NEXT EPIDEMIC, part One: Lessonsfrom the News Coverageof AIDS

In of 1981, fuly Richard Neustadt and Harvey opportunistic infections that are among the Finebergfinished their revisions of their now- major causesof death for personsliving with famous analysis of the federalgovernment,s 19T6 AIDS. But other policy responseshave been slow decision to undertake a massivevaccination and confused,and the federalgovernment,s campaignfor a swine flu epidemic that never responseand advanceplanning can still be came. Neustadt and Fineberggenerally con- characterized not only as poorly coordinated but cluded that the policy was poorly decidedin as too little, too late. haste on the basis of sketchy data and never re- In particular, without a fully effective treat- evaluated,partially becausethe decision-makers ment/ education and prevention become key, but anticipated pressure from a news media that the federalgovernment,s efforts have been would demand quick a responseagainst the scattershotand incomplete. perhapsmore worst-case scenarioof a repeatof the devastating troubling yet, the health caredelivery system l9l8 flu epidemic. Lessknown is the caveatthai lacks resourcesto treat effectively the mounting Neustadt and Fineberg addedto close their new number of cases,and there are few proposalsto introduction: "The opposite danger,of course,is deal with them adequately.Even the welcome that the lessons of the crash program are learned action in Congressin 1990 to treat cities and too well-too literally-producing stalematein stateshard hit by AIDS as virtual disasterareas the face of the next out-of-routine threat from and to appropriatefunds to those entities set influenza. Somedaythere will be one.,,r forth broad aims with neither specific indica- As it turned out, these authors were tions of what to do nor adequateappropriations. partially prescient. ,,out-of- There would be an For the first decadeof the epidemic, AIDS routine threat," albeit not from influenza. In producedthe policy stalematethat Neustadt and 1981, |une the month before they penned those Fineberghad foreseen.Valuable time (not to words, a curious combination of opportunistic mention lives) was lost from the first recognition diseasesstriking otherwise healthy gay men had of a new and deadly diseasein l98l until April l, been noted in the Morbidity and Mortality 1987when PresidentReagan delivered his first WeekLyReport.In the ten years since then, the speechon the epidemic and definitively legiti- epidemic known as acquired immune deficiency mated its place as a permanent item on the syndrome (AIDSI has becomeperhaps the most political agenda.Decision-makers have been pressing public health crisis in the United States playing catch-up ball ever since. and the world. With the number of deathsin the What accountedfor this sluggishgovernmen- United Statesalone having edgedinto six figures tal response?Why did AIDS not rise more and the spreadof immune disordersgrowing quickly on the political agenda?One possible populations within heretoforeless affected,with key is provided by a central actor in policy- costly and not always readily availabletreat- making on nev/ health threats in the 1970sand ments that can only prolong the lives of those early 1980s,whether swine flu, Legionnaire,s peopleliving with AIDS, and with no cure or disease,toxic shock syndrome,high cholesterol vaccine on the horizon, there is no medical or Tylenols laced with poison: the press.Al- quick fix in sight. As Fineberghimself said in though the news media do not set the political December 1989,we may come to the mid-1990s agendasingle-handedly, they help to determine and look back on the late 1980sas the good old which private matters {such as diseaselbecome days.2 defined as public events (such as epidemics|. How has the United Statesresponded to this After all, none of us live in the macro-society health emergency? The public policy picture is depictedby the news but in micro-societieswith not reassuring.3 True, money galore is now being which we interact on a daily basis.Since we spent on AIDS, about as much as on either heart cannot fully judge the reach, scope and gravity of disease or cancer,but most of it has been de- public problems in our immediate environmenrs, voted to the high-consensusdomain of medical the media construct the public realities distinct research.a Bureaucracieswere mobilized to from the private worlds that we otherwise suggest a viral cause, isolate a virus and develop inhabit and thereby provide ,,resourcesfor treatments against the virus and against the discoursein public matters.,,5

Timothv E. Cook 1 continues to favor only certain political slants on Although the news media do the AIDS epidemic. We cannot just say that journalists have to be more careful in practicing not set the political agenda their professionbecause, at least in this case, single-handedly, they help to applying the very definitions of good journalism determine which private matters has contributed to the inadequatedepiction of the AIDS epidemic in the news. (such as disease)become The lessonsthat we can take from the first defined as public events decadeof AIDS coveragein the eighties are not (such as epidemics). only apt for how journalists and officials should approachreporting the ongoing epidemic. In some ways, some of the concernsthat I express The media's identification and definition of here may no longer be applicablefor a disease public problems affect not just mass audiences. about which a great amount is now known and Politicians, too/ are highly attentive to news the future courseof which may not-by now-be coverage,which often divergesfrom the specific easily controlled. But if AIDS has taught us any choicesor emphasesthey would prefer. Policy- one thing, it is that we are not in a world freed makers are more likely to respondto issuesas from new epidemics.Following Neustadt and their prominence in the media increases,even Fineberg,these ideasthen should be taken as those that provoke considerableconflict, but notes not only for the current epidemic but for largely in the context of the initial frame that the next one. the media have provided.6The media's construc- To appreciatethe neglect of AIDS in the early tion of AIDS thus has influenced not merely how years/all that one need do is compareit to earlier we as individuals will react, but also how we as a unexpectedoutbreaks oI a fiataland seemingly polity will respond. new disorder.In 1976, severalmiddle-aged, In this first part of a two-part series,I will middle-classwhite male members of the Ameri- examine the coverage,both from my own can Legion sickenedand died after attending a impressionsfrom newspaperand television convention at the Bellevue Stratford Hotel in accounts as well as the more systematic evi- Philadelphia.The new and mysterious disease denceof news content. In the researchpaper that was promptly dubbedLegionnaire's Disease. will make up the secondpart,I will examine, by David Shaw of the los Angeles Times has noted means of participant-observationand content the contrast: analysis,the Sixth International AIDS Confer- Legionnaire'sdisease, which left 29 people ence in SanFrancisco in 1990,to sketch the role deadand 182 ill, receivedfar more press played by journalism and journalists in the coveragein a few weeks in 1976than did ongoing political contestsover the news about AIDS in the three yearsfrom mid-1981to AIDS between government officials, scientists, mid- 1984-during which time several patientsand AIDS activists. thousand people died of AIDS. The New Each part will suggestthe irony of the limits York Times, for example,published 62 of "responsiblejournalism" in adequately stories on Legionnaire'sdisease in August covering a medical disaster.To be sure/ some and September,1975, 11 of them on page journalists, notably those directly affectedby the one. But the New York Times published epidemic, pushed the story, just as others, only sevenstories about AIDS in the first restricted by homophobia or prudery, blocked it.7 19 months of the AIDS epidemic, and AIDS But the defectsof AIDS coveragewere and are didn't make PageI of the New York Times not largely due to individual failures of indi- for the I lth time until the epidemic was vidual Instead,the tried-and-true fournalists. more than four years old-by which time responsiblemethods of journalism as an institu- there were more than 12,000AIDS cases tion-the reliance on authoritative sourcesto and more than 5,000 deaths.s suggestnews, the downplaying o{ subjectsthat do not seem to affect the hypothetical mass The New York Times may have been unusu- audience,the use of venerablestorylines to ally slow on the AIDS story, but no news outlet quickly graspnew occurrences,the concerns was quick to pick it up, and when the media did about being inflammatory, and the rapidity with at last begin reporting it, their interest was which topics become old news-contributed to intermittent. By contrast with the geometric rise downplay the epidemic in its first four years and in both the number of identified casesof AIDS

2 Notes for the Next Epidemic and in the medical interest in the epidemic, connection is best shown by the only newspaper attention to AIDS was astonishingly sporadicin to have increasedits coverageof AIDS in 1984 any medium: newspapers/newsmagazines or over 1983as numbers of casesinexorably network television.e climbed was the San Francisco Chronicle-the Figure I indicates the rise in newly reported only newspaperto have, as of 1984,established AIDS casesacross most of the decade. By the gay community as a newsbeatand thus as a contrast, Figure 2 shows the number of seconds subject of recurring newsworthiness.r2Second, devotedto stories on AIDS in the nightly net- AIDS, mixing as it doesreferences to blood, work news broadcastsof ABC, CBS,and NBC semen/sex, sexuality and death, defied tradi- "taste." from the discovery of a new malady in |une 1981 tional notions of Although these consid- to the International AIDS Conferencein erations are strongestwith television journalists Montreal in fune 1989. Apart from three anticipating the dinner hour of the nightly news, peaks-in |une I983, after speculation in the all reportersfor a mass medium tend to take lournal of the American Medical Association their audienceinto account by seekingout that pediatric AIDS might portend infection by subjectsthat will affect the largestpart of their casualcontact; in August and September1985, audience,viewed as a collection of middle-class following the disclosureof the illness of actor nuclear families, and that will not be offensive to Rock Hudson; and in the spring of 1987, after the such viewers and readers.13Those stories that do potential of heterosexualtransmission of the not seem to affect the stereotypicalmass audi- human immunodeficiency virus (HIV) had ence tend to be either avoided,euphemized or becomeclear-AIDS was simply not reportedas quickly dropped. a continuing story of concern to the audience, Third, AIDS was a slow-moving disasterthat even as the severity and reach of the epidemic did not easily meet the standardconventions for dramaticallv worsened. breaking news. The news media are better equippedto report dramatic, suddendisasters such as floods or earthquakes,as opposedto By contrastwith the geomeuic droughts and famines/ even though the latter rise might be regardedas more important in terms of in both the number of its effect on the world economy or the eventual identified casesof AIDS and loss of life. With no seemingbeginning or end, in the medicalinterest in the and little new changefrom day to day, iournal- ists may simply not be alerted to a slow-moving epidemic,attention to disasteror considerit new enough until officials AIDS was astonishingly sporadic call it to their attention or impressive (usually in any medium: newspapers, visual) evidenceis discovered.ra newsmagazines Finally and perhapsmost important, the or media were in the unenviable position of seeking network television. to raise public awarenesswithout creating public panic. In introducing an early story on ABC, anchor Max Robinson said, "As researchers This pattern is curious, if one scholar is attempt to conquer this diseasecalled AIDS, conect that "the epidemic known as acquired public officials attempt to conquer the epidemic immune deficiency syndrome seemedtailor- of fear," while in the report, Ken Kashiwahara made to the who, what, where, and when ideol- added,"It is a delicate balancing act, raising the ogy that often accountsfor the content of stories level of concern for the diseaseon the one hand, which appearas the'news."'r0Instead, I would while reducing the level of panic on the other." arguethat AIDS presentednumerous problems (6120183l,Reporterstake seriously their role to for journalism as a whole-opportunities for educate and alert, but they sensethat they must sensational,dramatic or moralizing news not- also avoid being inflammatory or alarmist.rsThe withstanding. reesonsare simple. Public serviceincludes First, the earliest identified group at highest protecting the public from information that risk comprisedgay men. The media would have might cause them harm. But in addition, insofar to deal with individuals who had not atteined as journalists visualize themselves as reflecting, journalistic standardsfor newsworthinessprior not meddling in politics, any indication that to 1981,in part becauseof concernsto maintain they have either provoked or aggravateda individual privacy.rrThe importance of this problem can touch off criticism that can affect

Timothy E. Cook 3 before the their legitim acy.ln either case,journalists would SecretaryLouis Sullivan appeared government's end up shying away from topics that present the news media to announcethe the possibility of raising alarm or to report them so finding that the drug AZT worked to slow as to reassurerather than to worry. reproduction of HIV among infected to Consequently,journalists spent little time asymptomatic individuals; according news not been so investigating AIDS as a topic. Instead,they Sullivan's spokesman,had the not have ap- awaited particular authoritative sourcesto upbeat, his bosswould likely been no provide events that could becomenews stories. peared.16Scientists and physicians have Receiving So despitethe growing severity o{ AIDS and more disinterestedthan officials. for one to increaiing attention in medical and scientific credit for one's work is necessary enablesresources circles, reportersplayed up the epidemic, even continue to do science;credit can be re-invested after its mass-mediateddiscovery in mid-1983, (e.g.,grants, promotionsI that publicity is now a device less than they minimized its effect and threat. in further research.rTIf playing down dead Only during the three peak periods was the to build a career,it is only by media processenterprising and topic-driven, with ends and stressingadvances that the news journalists seekingout new anglesand aspectsof will cover. the epidemic. To be sure, the quality of the news was not always enhancedduring such saturation coverage.Especially in 1983 and 1987,coverage In science,news confercnces flipped from a reassuringportrait of the contain- rarcly called to announce a to an arc ment of AIDS to establishedrisk-groups and the alarmist depiction that suggested,equally failed expefiment, erroneously,that everybodywas now at risk of better the news, the more likelY contracting HIV. On television, there was it is that prominent will "epidemic teat"- PeoPIe frequent attention to the oI it. frightened responsesto AIDS which, in their announce vividness and inaccuracy,only servedto fuel quell fear. Little wonder that rather than the With the government and the scientists journalists preferred,with seeminghaste, often dominating the coveragefrom mid-1983 to mid- move onto other matters. to drop the story and 1985,reporting on AIDS went back from alarm- has been more routine than Whin the news ing to soothing, suggestingthat government, has unwittingly peddledunwar- enterprising,it -"di"in" and sciencewere slowly but inevitably prior to the ranted reassurance,especially progressingtoward managing the epidemic' This Hudson's illness in the revelation of Rock approachwas interrupted only by the revelation when authoritative summer of 1985. Only of Rock Hudson's illness in late |uly 1985,and, governmental officials and sources-most often though journalists retumed to routine event- a news event that establishedscientists-created driven coverageof AIDS after Hudson's death in peg for reporterswould the epidemic servedas a October 1985,this post-Hudsoncoverage was Of course,such a depen- becomenewsworthy. less reassuring. On the nightly network news, sourcesintroduces bias denceon authoritative for instance, the stories declined in number from limits the diversity of perspec- only if doing so the 1985level but were more prominently governmental and scien- tives represented.But presented,and the complete oversight of AIDS an interest in projecting an tific sourcesshared ihat oc"rtted as recently as the month before and medicine coolly and image of government Hudson flew to Paris would never be repeated. progressagainst the epidemic gradually making With Hudson's illness certifying AIDS's calling journalists' attention to and who avoided newsworthiness,more approacheswere brought results. By contrast, inaction and disappointing to bear-not only medical and sciencecorrespon- criticize the government's those more likely to dents, but also law reporters,political reporters of their own, and all responsehad no newsbeat (both foreign and domestic)and regional string- piggybackonto stories at they could do was ers who brought new angles and spoke to new such as congressional establishednewsbeats, sources.There was thus less consensusabout meetings. hearingsor medical how to cover the epidemic. The variety of ate rarely called In science, news conferences storylines reinvigoratedattention to the epi- and the better to announcea failed experiment, demic on numerous dimensions' Additional likely it is that prominent the news, the more sourcesgained attention/ and they were now in peoplewill announce it. Thus, in 1989,HHS

4 Notes for the Next EPidemic disagreement,unlike the pre-Hudsonera when the awarenessof the American peopleas to what medical and political sourcesconverged on a AIDS is and how HIV can and cannot be trans- storyline that reassuringlynoted scienceand mitted. Yet though AIDS had crossedthe thresh- government doggedlyat work. old of public awarenessby mid-1983,the media Thus, from the fall of 1985to the spring of did not push the urgency of the problem. The 1987,the story of AIDS gradually built. With the first public opinion polls on AIDS in 1983 internationalization of AIDS news, the media's showed relatively little concern that it would discovery of roughly equal numbers of cases reach epidemic proportions; the issue had been among men and women in Africa and the Carib- seemingly contained,being defined as distant "epidemic bean,and the resurfacingof of iear" and not immediately threatening. Only after the stories,news coverageof AIDS built up to its summer of 1985did the public at leastbegin to highestpoint to datein 1987. Only when conceiveof the diseaseas likely to affect their PresidentReagan gave his first speechon the world-and only then would there be much epidemic on April l, 1987, and when Vice- pressureon the government to do something PresidentBush, on behalf of the administration, about the epidemic.2oThere are many culprits in presentedpolicy recommendationsto the Inter- the continuing slow, confusedresponse to the national AIDS Conferencein Washington did the onset of AIDS, certainly, the media are not upward spiral finally stop, and only then did alone.2l Yet some improvements can be worked AIDS become a permanently recurring part of into the fabric of American fournalism in prepa- the political agenda. ration for the next epidemic, as well as the As with prior periods following the peaks, current one, without making undue demands reportingsince mid-1987 has slackenedoff.t8 upon the resources of news organrzations and Once again,it is routine and event-driven, journalists or upon the attention and interest of focusing aboveall on prescheduledoccasions audiences. All of these suggestionscomprehend like the annual International AIDS Conferences that journalists are performing a well nigh that have taken placeeach fune since l985.te In impossible task of getting all the news, and that the 1990s,the coverageof the HIV epidemic, audiencescannot be expectedto devote massive though avoiding the extraordinary focusesof amounts of time to seekingout and consuming |une 1983,September 1985 and the springof large quantities of news. The challengeof AIDS 1987,should continue to be a relatively constant coverageis to provide a representativeunder- news item. There are some drawbacksto routine standing of the diseaseand its possibleimplica- coverage,insofar as saturation of the airwaves tions for medicine, science,education, politics may be necessaryto keep individuals vigilant and society to an audience(both among elites about proper prevention. But it avoids the on- and in the public) that has many other compet- agarn,off-again cycle of alarm and reassurance ing activities besidesattending to news but that that proved so debilitating in the first decadeof must be involved in the crucial political deci- the epidemic. sions about AIDS that face us.

. .. some improvements can be l. Realize that even the "general audience" can worked into the use-and be interested in-news that is neither fabfic of about them nor reportedfrom or toward their American ioumalism in supposedperspective. pteparution for the next As we have seen,AIDS reporting was ham- epidemic, as well as the cufient peredby the presumption that, unlike Legionnaire'sdisease, swine flu, Alar sprayedon one, without making undue applesor laced Tylenol capsules,the diseasewas demands upon the resourcesof unlikely to affect any and all of us in the general news otganizations and public. Yet as soon as sciencebegan to point toward a viral agent,the epidemiologicalempha- iournalists or upon the attention sis upon high-risk groups was displacedby the and interest of audiences. virological concern with high-risk behaviors that could help to spreadHIV. These behaviorswere and are not restricted to members of those We should not overlook the many benefits of groups/but the concentration in marginalized the news coverage,including gradually raising segmentsof the population made it easierto

Timothy E. Cook 5 "outbreak" American necessarilydepends think of AIDS as an isolated rather iournalism sourcesto heip provide them with informa- than an epidemic that could eventually reach all upon or createevents that can becomerrewS; sectorsof societY. tion such cooperation,newsgathering could AIDS, as do many other stories,reveals the without be economically viable' The more presumptions about the mass audiencethat no longer problem is how sourcesare used and makes ieporting about minorities (whether i-potilttt sourcesare called uPon' racial,ethnic or sexual)difficult' We have seen which has always had difficulty.covering this responseamong journalists seekingto fournalism media have been frequently criti- the media overkill on the story-later ,"i"t"". The fustify for oversimplifying, sensationalizingand reveaiedto be a hoax engineeredby her hus- cized sciencenews'23 Yet scientific band-that yuppie lawyer Carol Stuart was dramatizing becomemore technical and abstruse, murdered by a black robber in Boston' Ed Siegel, inquiries becomeincreasingly dependenton television critic for the Boston Globe, wrote/ ooii"i", technology,and audiencesneed "The media fell into public pandering"'The questions of that can be readily understoodin general,i.e., white, public wanted saturation information own terms. Here, as elsewhere,reporters Iorr"r"g" of the murder of a white couple and their to accessibleindividuals who can encapsu- they got it. The generalpublic does-not.want turn late information, but scientific sourcesoften saturation coverageof the murder of a black in areasfar from the purviews where person/unless it's a child, and they don't get comment they can best provide reliable evidence'2aThus, it."22 conclusions about the possiblespread But doesthe generalpublic get iust the news -itt""ai"g HrV thr:oughcasual contact were legitimized it wants? Not necessariiy.First of all, this of immunologist Dr. William-Haseltine presumption may not be basedin fact' fournal- by Harvard in the mid-1980s,sexologists William Masters ists haue less constant contact with their mass and Virginia and, mote recently, by Dr' audiencesthan with their peers,superiors and fohnson, Lorraine Day, the head of orthopedic surgeryat sourceswhom they meet on a more systematic FranciscoGeneral Hospital' All were basis and who reinforce each other's ideasabout San epidemiologicalor virological matters what is and isn't news. Reporterstend to disdain discussing which theY were not expert' audienceresearch, since it would compromise on and scientists also have different what little autonomy they have left and compli- fournalists of evidence. For the former, lone cate their alreadyimpossible task of managing understandings serveaJundeniable evidenceof afact their workload. Whether or not parts of the cases is thereby shown to be true, whereasthe audiencewould respondfavorably to stories that which latter, aware of anomaliesand the over- are not about them is an open question as long as of any single case,generally they are not given the chanceto do so' determination largebatches of systematically gathered Seco.td,the presumption ignoresthe-uses that require Evenlhen, any single study must be the public could obtain from reporting trom a daia. as tentative until it is ioined by many variety of perspectives,given the multiplicity of regarded The preferencefor clear-cut communities to which individuals belong' otl.rr. iournalistic runs smack into the nuanced conclusions of Instead of the lowest-common-denominator {act and odd moments result when the approachthat homogenizesthe-news and makes science, consensusis turned upside-down'In the ii apply to everybodyand nobody, the media media's of AIDS, recall the shift in news coverage snouja start recognizingthe diversity of its case a portrait of an epidemic well away from audienceand the variety of its interests with an from "general population" to a situation where, in appropdateplethora of topics, storylines, sources the "Now words of Life magazine'scover/ No a^ni"ott"lnsiont. And since different individu- the Is SafeFrom AIDS." The nuancesof risk als attend to the news for different reasons,it One obliterated at either stage' would seem to make not only iournalistic sense were covering scienceare often misled but economic senseto do so. fournalists ,toi orrly by lone studies-recall the reporting of cold fusion and of oat bran in 1989-but by lone good a story to passup' On o[ the story means that casesthat enabletoo 2. Getting all sides a have October 29,Ig85, Torn ,lrokaw of NBC led off reportinglannot stop with experts. Experts "There as follows, may be a dramatic no lock on the truth, and one should not treat story in the treatment of AIDS tonight' scientific and medical sources as Delphic breakthrough Everybody is anxious for some encourag- oracles. Maybe.

6 Notesfor the Next EPidemic ing news." fim Bittermann's story on very contingent, theory-driven and altogethermessy. preliminary results from Paris on the experimen- The popular vision of sciencelooks at the tal treatment Cyclosporin-A was, for the most generationof indisputable facts that become part, cautious about the results, yet the network bricks of the temple of knowledge.Yet starting presentedwhat it knew was, at best, premature with Thomas Kuhn's famous analysis of scien- and, at worst/ wrong. Brokaw noted, "Their tific revolutions, a clearerunderstanding of the researchand testing have been very limited so scientific method shows its dependenceupon the skepticism as well as hope is running high questionsthat are asked,a processfurther tonight." Yet Bittermann's report concluded narrowed by an institutional structure that with unwarranted reassurance:"Still there is in favors only particular questionsand methods.26 this hospital tonight an AIDS victim up and These tendenciestowards scienceas a social walking around who the doctors say less than a processare even more pronouncedwhen we turn week ago was only hours from death." This story from the laboratory to what has been termed was followed by one by sciencereporter Robert "public science," where scientists set forth Bazell showing doubt among personsliving with "rhetoric, argument and polemic to persuadethe AIDS and health care workers about the treat- public or influential sectorsthereof that science ment. But it too concluded on a positive note. ...is worthy of receivingpublic attention, en- "There is no question that the results from Paris couragementand financing."zt News becomesa will persuademany American researchersto try way to decide "who will speakfor science," to this new approach." In less than two weeks set researchagendas, to establishcareers and to NBC had to report that two of the patients receiveaccolades, prizes and grants.In short, receiving the drug had died, one even beforethe scientists, like other sources,have axesto grind. initial story was reported. Although television, Far from being outside of political and social with its emphasisupon individual actors,is processes,they are part of it. more prone to such errors,newspapers commit Yet journalists do not generally approach the samemistake. WitnessGina Kolata's1989 scientific sourceswith much skepticism. In- New York Times front pagestory that pointed to stead,reporters tend to be uncritical of the a lone case(that died, apparently for unrelated scientific facts with which they are provided. causes)where HIV disappearedfrom a man's A reliance upon sourcesmay be inevitable, but body after a bone marrow transplant. Only later news cannot abandonthe searchfor diversity in did it become clear that other attempts at this any realm in order to ensurean adequateunder- highly risky treatment had been unpublicized standing of what is going on. The early coverage flops: "There are lots of us who haven't pub- of AIDS suggestslimits on what experts, lished our results becausethev've been so whether politicians or scientists, will provide, dismal."25 even though data suggestingthat the epidemic was far from under control was readily available. Likewise, different kinds of expertiseshould lournalists covefing science ate be brought to bear. For example,while journal- ists have covered,often respectfully, the de- often misled not only by lone mands of demonstratorsin ACT UP (the AIDS studies-recalL the reporting of Coalition to Unleash Power)at the International cold fusion and of oat bran in AIDS Conferences,they have tended to cast these occasionsas "science vs. politics," under- 1989-but by lone casesthat estimating the degreeof politics that infuses the enable too good a story to passup. scientific discussionas well as the degreeof scientific knowledge among the demonstrators. The experience of the persons living with AIDS prescribe journalists Some would that science has only occasionallybeen tapped;they are should painstakingly follow rules of sciencein allowed more to discusstheir emotional state or has sourcebeen desig- deciding credibility: the their symptoms but rarely to offer commentary nated by discipline as in a position to their as informed experts about the epidemic though provide reliable information, and can the lone nowadaysthey surely are that.28Reporters on or lone casebe backedup by other inde- study any epidemic must cast their nets widely to pendent studies or cases? rules are neces- Such ensurethat they have not prematurely closedoff not sufficient. must recog- sary but Reporters public debate and to allow different kinds of nize that even the best scienceis intuitive, expertiseto inform that discussion.

Timothv E. Cook 7 "both was Geraldo Rivera's two-parter on 3. Do not assumethat telling sides" of the sion news in May, 1983. Similarly, risk-taking story is responsibleiournalism, particularly if 20120 as Randy Shilts of the San one side is vivid and the other is not. iournalists'Francisco such and Charles Ortleb of the As journalists become increasingly aware that Chronicle attained complete and early objectivity may be unattainable, recent journal- New York Native the epidemic but also tripped into ism has begun to stressbalanced accounts' Yet reporting of Newsweek, Ior instance,was the absolutebalance may be as difficult to achieveas big mistakes.'o to do a cover story on AIDS absolute objectivity, unless one is willing to first newsm agazine tf tggg, well before the first front- assumethat there are two sidesto any given in the spring in the New York Times or the first story. Even if there are two sides,iournalists page st;ry network flewS;but that same ,r""d to be more cautious about whether both lead story in also pushed them to excerpt the sidesdeserve equal time. commitment of Masters and in 1988' As we have seen,AIDS reporting often fell flawed alarmism fohnson the unknown may have to prey to what a study of California earthquake Perhaps,errors about " operational costs of aggressive Lorretag"has termed an alarm-and-reassurance be seenas the pattet\."2s Storiesled with dramatic worst-case iournalism. scenariosthat shadedthe differencebetween "could" and "would," then turned to more reassuringindications of the low likelihood of .. . an alarm-and-reassur ance calamity. At the very least, an alarm-and- p attern invites selectiv e interpreta- reassurancepattern invites selective or confusion that tion or confusion that restricts the potential to intirpretation learn from the news' rcsfticts the Potential to learn More centrally, in such supposedlybalanced from the news. stories,the vividness of alarm can easily pre- dominate over the relatively bland reassurance/ whether on television where upset individuals The dilemma for iournalists is the difficulty acted out or voiced fearsthat spreadmisinforma- with independently verifying the validity of the tion or in newspaperswhere the nuanced judg- statemenis that sourcesproffer. If GeorgeBush ments of risk would not appearuntil several saysX, and X turns out to be untrue, reporters paragraphsinto the story, often after the iump can retrospectivelydefend their pursuit of i.o- th" front page. Thus, during the heavily factuality by saying that it was a fact that Bush coveredsaga o{ Ryan White, a hemophiliac indeed said X, regardlessof whether X turned out teenagerwith AIDS who sued to regain full to be true. Trying to check up on every fact in a ,"".tt to public school in Kokomo, Indiana, breaking story is certainly impossible. journal- stories routinely quoted worried parents pulling But in a long-range/continuing story, their children out of school and noting their ists can make iudgments more easily; airing concern of casualtransmission in ways that statements that are known beforehandto be sciencehad virtually ruled out, such as by misleading, and especiallythose that the reporter sneezing. Visual imagesof specialprotective specifically wants to debunk, is simply irrespon- outfits for prison guardsor police officers who sible. A recent example occurredin Boston, deal with p"ttott. living with AIDS inaccurately where local television news and the tabloid suggestedthat such reactionswere legitimate' BostonHerald gaveprominent coverageto the Although the stories also quoted expertsto fearsof the patients of a gynecologist,Dr' Earl correct those misimpressions,the vividness of Gelman, who had been arrestedfor soliciting a the allegationsmeant that stories,far trom prostitute who claimed to be HlV-positive' The educating the pubiic about the ways in which Heruld story could defenditself againstcharges HIV could and could not be transmitted, often of journalistic irresponsibility by pointing to simply reinforced and authenticated viewers' their quoting expertsthat noted the infinitesimal doubts. possibility, particularly in these circumstances, -of "Police But caution in reporting the facts is not a good atty transmission of HIV: yesterday in itself. In the caseof AIDS, such caution has said they had no confirmation of the womafl's contributed to the underreporting of AIDS and claim, but some prostitutes have been known to the misleadingly reassuringportrait of the tell police they have AIDS to prevent closebody "Medical epidemic. Nor is drama necessarilyto be searches"and experts said it is ex- avoided;perhaps the best early report on televi-

8 Notes for the Next EPidemic {

tremely unlikely Gelman, if infected with the tion for economic and political information that AIDS virus, could have passedthe diseasealong holds today. "Soft news," by contrast, became to patients." But conveniently,these comments important parts of the newspaperas it aimed at a came after the jump; the headline,by contrast, mass audiencein the |acksonian period. The was "Doc's sex arrestignites AIDS fears,"3rand tension between information-basedand story- by highlighting the clinic's offer of HIV tests, basedjournalism has continued since then, suggestedthis to be a reasonableresponse. whether between or within news organizations.3a Although journalists often like to think other- wise, the split between hard and soft news does 4. Resist the human interest temptation unless not inhere in the content of what is being and until the political angleshave been ad- covered;they are no better at drawing a tangible equately covered. border between hard news and soft news than |ournalists have often respondedto the AIDS they can demarcatenews from non-news.3sNot epidemic, whether in print, radio or television, merely the same subject matter but the same by looking for the facesbehind the statistics. event could be fodder for hard news or soft news. One might think that the statistics are sobering enough,but the immediacy of the lives {and, usually, the deaths)of personsliving with AIDS ...therearc dovvnsidesto the are judgedas providing a fuller and deepersense of the extent of the epidemic. And indeed, hum an inter est pr eoccupation. distinguished journalism has emergedon the First, by focusing on individuals, struggleof individual personsliving with AIDS, the story may not provide a particularly as their stories cast light on larger problems-the availability of treatments, dis- representative sample of percons crimination, support from lovers, families and living with AIDS or the friends.32 population at risk. Yet there are downsidesto the human interest preoccupation. First, by focusing on individuals, the story may not provide a representative SociologistRobert Park wrote fifty years ago sample of personsliving with AIDS or the in his introduction to Helen MacGill Hughes's population at risk. A story can be more vivid classicanalysis, human interest "...givesthe without being typical, and the conclusions news the characterof a story that will be read for drawn from one isolated casecannot be consid- its own sake,even when the readeris not at all ered as anything more than suggestive.Yet such concernedwith it as news...Itis the ability to coveragedoes not come acrossas tentative. For discoverand interpret the human interest in the example,the Fall 1989 AIDS Quarterly program news that gives the reporter the character of a on PBSdevoted a segmentto the larger problem literary artist and the news story the characterof of the growing numbers of women with AIDS. literature."36 As Hughes then said, the purpose But most of the segmentwas devotedto a of news thereby shifts from the instrumental woman who contractedHIV from her bisexual emphasisof the front pageto becomeexpressive husband {himself interviewed with his back to and contemplative. Audiences can certainly the camera).The report left the sensethat learn from such literary accounts. By freeing bisexual men were/ in the phraseof the New them from the necessityof having to get some- York Times, an "AIDS specterfor women,"33 thing done in the here-and-now,literature even though women are far more likely to provides the opportunity to contemplate other contract HIV from a sexual partner who is an experiencesand derive conclusions and lessons. intravenous drug user. But human interest stories downplay the role A secondand subtler problem occurs as of intervention. Even more than breaking news, human interest stories displacethe attention they make the audienceinto spectatorsrather from pageone or the lead story. Featurestories than participants, to recall the dichotomy occupy a different place for journalists and for popular among mass communication scholars, the public. "Hard news" depicts ongoing events, they favor gratifications over uses. This ten- allowing individuals to intercedein the continu- dency is exacerbatedby the current preference ing process. The first newspapersin the United for stories,particularly in television, where Statesaimed at merchants, they provided news individuals outside government are shown as that could facilitate wise investments-a func- generallyhelpless to alter the outcome.3TThus,

Timothy E. Cook 9 that the Pregotrial raises-how to protect health network news has tended less to craft morality workert f.orn exposureand infection to HIV plays about personsliving with-AIDS than sadiy care as the caseloadgrows-was obscuredby the io ,rot" that they couldn't help having been in melodrama. the wrong place in the wrong time' Human interest siories about personsliving with AIDS generally lead inevitably to their deaths,over- iooking their frequently noble-and in a few When thesehuman interest "rr", Jo {ar, successful-{ight to survive' These angles aq7eat in breaking news, presumptions are best revealedwhen the story either to Take this front they draw attention defiesriporters' expectations. ot prg" t."i", in the BostonSunday Globe in late -popular cuhutal themes 1989: iidividual storYlines and For the past year, Globe reporter Sally away from analqsesof PolicY Knott have facobs".td photographerfanet ProbLems. tracked the life of a29-year-oldwoman with AIDS. But what was to have been a story of death became,instead, a sto-ryof To cover AIDS adequately,journalists must life. Not even Mildred's doctors fully find a way to enliven and communicate simply understandwhy she is still alive' In the without ieducing their accounts either to barren Boston Globe Magazine.3s fact or to new variations on very old storylines' The human interest approachis worthwhile as Even in breaking news stories on AIDS, the io"g ". it is only one apptoachout of many, and, human interest preoccupationis never far' In the errei there, specialcare should be taken to assure they may pt"t".tt a distorted picture of Drocess, inrt tft" chosenindividuals are representativeof ihe epidemic and of the political responses ifr" htg.t population and o{ the larger political thereio. Sick, lost and/or abandonedchildren- and scientific Problems. which Helen Hughes identified fifty years ago as longtime favorites for human interest tear]erkers-have been prime subiectsof AIDS "innocent 5. Be constantly aware of the education that may coverage,reinforcing the notion that b"r, o...r, through the media' Realizing this victimi" are somehow worthier of attention responsibility mians that we must also rcalize from the media or from government' Thus, that we wiil be in for the long haul' PresidentBush and his wife made the although arewary about embracing the role historic step to meet with gay personsliving |ournalists of education. After all, it compromisestheir with AIDS during a visit to the National Insti- autonomy and integrity, and it addsanother task tutes for Health in late December 1989-a to news organizations already stretched to the meeting that was open to the White House press breaking poittt. SanfordSocolow, former execu- corps and where photographerssnapped ^way- "It's tive proiucer of CBS News, recently said, "itrurtty the only news coverageconsisted of not the news department'sfob to go out and Bush with babieswith AIDS, his next stop on his job promote the awarenessof AIDS' It's their to visit.3e o.t, and look {or stories about AIDS'"42 When these human interest anglesappear in io" Th" news media cling to the protections that breaking news/ they draw attention either to the First Amendment offeredto the vastly popular-cultural themes or individual storylines different (and much more self-consciously "tt^d"*"y from analysesof policy pr-oblems'40 interventionist) pressof the late eighteenth When Di. Veronica Prego,a person living with century. Nowadays,with increasingconcentra- AIDS who claimed to have contractedHIV by tion of ownership and decreasingcompetition, il"irrg a"cidentally stuck with an infected needle' the First Amendment protection oniy makes took"the stand in New York in her suit alleging senseif the news media are performing their negligenceon the part of the hospital where she responsibility to the public' To be sure, there are wo"rk-ed,,r"*, a""o.tnts called attention to her many other institutions, public and private, impending death, alluded to in the courtroom political and otherwise, that need to play key abovethe sobsof her mother and sister' Even parts in the public sphere. It is all too.easyto the august New York Times called attention to tl"-" the news m"dia for many social phenom- her "rJd silk dress,which only heightenedher ".rr, "rp""i"lly when, to recall the image of the pallor."or The central dilemma for public policy

70 Notes for the Next EPidemic media critic of the los Angeles Times, "The on a routine basis. But the hallmark of news has press,contr'ary to common mythology, is rarely always been allowing us to intervene into an if ever a lone gunman. More often, it is society's ongoing processwhose end we cannot know. If accomplice."a3 this is the case,the roller-coasterride of AIDS Nonetheless,the media have a crucial poten- coveragemakes no sensewhen the situation tial to affect the future courseof the AIDS worsensby the day. epidemic. Education on how to avoid infection The problem with AIDS coveragehas been not is imperative. While some individuals at risk, merely the long valleys of unwarranted reassur- such as gay men, can be and have been reached ancebut also the heights, especiallyin 1983and effectively by private educational campaigns, 1987,when the public would havebeen better others are not. Indeed,many populations in the servedby more dispassionatecoverage that did United Statesare reachedonly through the mass not wax hot and cold. Such commitment to the media-such as those audiencesat particular long term gains especialurgency as the epidemic risk (young,minorities, women) that are also shifts away from gay men, who comprise a f.airly heavy consumersof television. For example, well-organizedconstituency, to other children identify television as the chief way in marginalizedbut less easily mobilizable popula- which they found out about AIDS, during the tions-intravenous drug usersand primarily decisivegap between when they have cognitively through them into urban minority communities matured enough to understandwhat AIDS is but and to women. Again, if journalists are to play a before they have engagedin high-risk behavior.ao virtuous part in the fight againstthe HIV epi- demic, they will have to go beyond the elite sourcesupon whom they customarily rely and The problem with AIDS reflect a diversity of voices. Above all, acknowledgingthe long haul means covetagehas beennot merely the not declaringa premature end to AIDS. It is long valleys of unwaftanted difficult to know what the future courseof the teassurancebut also the heights, HIV epidemic will be, but suffice it to say that even if starting today, no new individuals were especiallyin 1,983and 1987, infected, we would still be involved in an enor- when the public would have been mous international public health emergency/as better seruedby more we try to grapplewith the huge numbers of cases that are uninfected and unaware,with a health dispassionatecoverage that did care delivery system that is ill-preparedto not wo.xhot and cold. provide the long-term treatment to those who are HlV-positive as well as those with AIDS- related complex or AIDS and the burgeoning To fulfill this educational function, traditional "pattern two" epidemic in Africa and the Carib- is news must shift. assumptionsabout what old bean with equivalent numbers of infected men peoplegarner so little One of the reasonsthat and women. In effect, the recommendationsI necessary from the news is that reinforcement have made here may be too late to affect fully rise and fall in for learning is lost to the constant the future courseof AIDS. But if they enableus news even as issueswhich disappearfrom the to avoid the mistakes of this epidemic when the new they fail to be solved.asThe searchfor the next epidemic hits, they will have servedtheir prevails over the continuing commitment to purpose. following pressingissues to which they return

Timothv E. Cook 11 states, 1981-1988 Figure 1. AIDS cases,by quarter of report and casedefinition-United

g,ooo

8,OOO

7,OOO I 1987 Revision OnlY 6,OOO E 1985 Revision a 0) 5,OOO A Pre-1985 Definition a o O 4,ooo 3,OOO

2,OOO

1,OOO

2341234'| 234 1234 341234123412341 1988 1981 19A2 1983 19E4 19E5 1986 1987 Quorter-Yeor of Report

(April 14,19891,p' 230' Source:Morbidity and Mortality Weekly Report, vol. 38, no. 14

12 Notes for the Next EPidemic Figure2. Secondsof nightlynewstime on AIDS--UnitedStates, June 1981-December1989

(h -

U) a

JUN81 JUN82 JUN83 JUN84 JUN85 JUN86 JUN87 JUN88 JUN89

Source: Vanderbilt University TelevisionNews Abstractsand Index (19g1-19g9)

Timothy E. Cook 13 Norns

7. fames Kinsella's overview of various iournalists' This essaywas written while I was a ResearchFellow responsesto the AIDS epidemic provides-numerous at the ShorensteinBarone Center at the fohn F' foan illustrations of eachresponse. See Kinsella, Coveting Kennedy Schoolof Government, Harvard University' the P\ague: AIDS and the Ameilcan Media lNew I am grateful to my colleaguesat the Center {or their Brunswick, Nl: RutgersUniversity Press,1990)' camaiaderieand suggestions,with particular thanks to BrendaLaribee for help in generatingFigure 2, fim "Coverage Ledermanfor a semesterof stimulating schmoozing, 8. David Shaw, of AIDS Story: A Slow and to Ellen Hume, fim McEnteer, Fred Schauerand Start," LosAngeles Times (December20, 1987),pp' dra{ts' David Yepsenfor specificcomments on earlier 39-40.

l. Richard E. Neustadt and Harvey V. Fineberg,The 9. This section is basedon a number of published Epidemic That Never Was: Policy-Making and the studiesof news content. My own interpretation of p' Swine Flu Scare,rev. ed' (New York: Vintage, 19821, television news content can be found in two forth- xxvi. coming studies coauthoredwith David C' Colby: "Epidelmicsand Agendas:The Politics of Nightly Nervs Coverageof AIDS," lournal of Heahh Policy' 2. Hawey Fineberg, remarks in panel, Harvard AIDS "The Politicsand Law (summer 1991),and Mass- Institute, AIDS in the 1990s,Harvard Schoolof Public Mediated Epidemic:AIDS on the Nightly Network Health,December 1989. News" in ElizabethFee and Daniel Fox, eds., AIDS: The Makingsof a Chtonic Disease(Berkeley: Univer- l99l). Another study deals 3. See,among others, SandraPanem, The AIDS sity of Caliiornia Press, television news stories on AIDS: Bureaucracy{Cambridge, MA: Harvard University with the timing of and SoonbumChang, Press,I988i; and Charles Perrow and Mauro Guill6n, Everett Rogers,fames Dearing focusing on print The AIDS Disaster:The Failwe of Oryanizations in [ournalism Monographs. Those "Illness and Deviance: New York and the Nation (New Haven, CT: Yale media include EdwardAlbert, AIDS," and Andrea Universitv Press,1990). The Responseof the Pressto Baker,"The Portrayal of AIDS in the Media: An Analysis oi Articles in the New York Times," both in and 4. William Winkenwerder, Austin R' Kessler ooujlas A. Feldman and Thomas M' fohnson, eds', "Federal for Illness Rhonda M. Stolec, Spending The Socia|Dimension of AIDS: Methods and Theoty Virus," Causedbv the Human Immunodeficiency (New York: Praeger,1986),pp. 163-194,William A' (fune 15, 1989), New England [ournal of Medicine 320 bheck, "Beyond the Political Model of Reporting: pp. 1598-1603. Nonspecific Symptoms in Media Communication abouiAIDS," Reviews of Infectious Disease.s9 ll987|. "News 987-1000;and Panem, AIDS Bureauuacy' cnap' 6' 5. Harvey Molotch and Marilyn Lester, as PurposiveBehavior: On the StrategicUse of Routine Sociologi' "Acquired Events,Accidents and Scandals," American 10. EdwardAlbert, Immune Deficiency a good cal Review39 ll974l:101-l l2 at 103'For Syndrome: The Victim and the Press,"Studies in review of agenda-settingliterature, seeEverett M' 3 (1985):135-158 at136' "Agenda-Setting Communications Rogersand famesW. Dearing, Has It Been,Where Is It Going?" in Research:Where "Uptight Yearbook' Pierson, about Gay News," famesA. Anderson, ed.,Communication 11. Ransdall March/April 1982,pp' vol. l1 (Newbury Park, CA: SagePublications, 1988), Columbia [ournalism Review, individual pp. 555-594. 25-33.These concernsabout maintaining privacy have recently surfaced again with the contro- iersy about "outing," in the news-publicly revealing role in elite 6. For a fuller discussionof the media's the sexual orientation of a famous person' agenda-setting,see Timothy E. Cook, Ma-kingLaws ond tttokingNews; Media Strategiesin the U'S' House "Coverage Story," p' 38' Impres- o'fRept es enta tives (Washington,D'C' : Brookings, 12. Shaw, of AIDS those media outlets 1989),chapter 6. sionistic evidencesuggests that that were most inclined to cover homosexuality were also those that reportedAIDS earliest and most thoroughly-NBC more than CBS and ABC; Newsieek andTime more than U'S' News andWoild Report; the los Angeles Times morc than the New York Times.

14 Notes for the Next EPidemic 13.Herbert |. Gans,DecidingWhat's News (New 21. For the most inclusive (somewould say excessive) York: Vintage, 1979),chap.7. list, seeRandy Shilts, And the Band Played On: People, Politics and the AIDS Epidemic (New York: "Setting St. Martin's Press,1986). 14.A good example is Christopher f. Bosso, the Agenda:Mass Media and the Discovery of Famine in Ethiopia," in Michael Margolis and Gary A. 22. Ed Siegel,"Who Calls the Tune? The Public, Not Mauser, eds.,Manipulating Public Opinion: Essayson the Media," Boston Clobe llanuary lO, 19901,p. 69. Public Opinion as a Dependent Vafiable (Pacific Gtove,CA: Brooks/Cole,1989), pp. 153-174. 23. See,e.g., Dorothy Nelkin, Selling Science:How the PressCovers Science and Technology(San 15. See,for example,David Paletzand Robert Dunn, Francisco:W.H. Freeman,19861, and C. "Press fohn Coverageof Civil Disorders:A CaseStudy of Burnham, How Supetstition Won and ScienceLost: Winston-Salem,1967," Public Opinion Quatterly 33 Popularizing Science and Heahh in the United States 11969l:328-345. {New Brunswick, Nf: RutgersUniversity Press,1987). For a highly useful critique of this position, see Christopher Dornan, "Some Problemsin Conceptual- 16. Robert Schmermund,comments in panel, "NIH izing the Issueof 'Scienceand the Media,"' Critical AnnouncesAZT," at the Harvard School of Public Studiesin Mass CommunicationT ll990l:48-71. Health, April 1990.

24. SharonDunwoody and Michael Ryan, "The 17. Seeespecially Bruno Latour and SteveWoolgar, Credible Scientific Source,"lournalism Quarterly 64 Laboratory Life: The Construction of Scientific Facts, ll987l:21-27. 2d ed. (Princeton:Princeton University Press,1985), chap.7. 25. Ronald Mitsuyasu of UCLA quoted in Boston Clobe, December22, 1989,p. 15. Cf. Gina Kolata, 18.A searchof the Nexis data baseshowed that the "Physicians Rid a Man's Body of AIDS Virus in number of newspaperstories were halved from 1987to " Experiment, New Yotk Times, December 19, 1989,p. 1989;Larry Thompson, "Commentary: With No Al. Magic Cure in Sight, Dramatic Epidemic LosesLuster as News Story," Washington Post, fune 13, 1989, health section,p. 7. 26. For a key introduction to recent trends in the sociologyof science,see Karin D. Knorr-Cetina and Michael Mulkay, eds.,Science Observed: Perspectives 19.The downside to the concentration on the Interna- on the Social Study of Science(Beverly Hills: Sage tional AIDS Conferencemay be that as research Publications.19831. progresses/there will be far lessbreaking news to report and, eventually, the news devotedto AIDS will wane. The 1989Montreal conferencewas virtually 27. Frunk M. Turner, "Public Sciencein Britain, 1880- pushed out of the news altogetherby the Tiananmen t919," lsis 7l (1980):589-608. For an excellent Squaremassacre in China and its aftermath, and the extensionof Turner's concept,see Thomas F. Gieryn, only news that network reporterswere able to squeeze CeorgeM. Bevins and StephenC.Zehr, on often referredto news that was not news at all, "Professionalizationof American Scientists:Public such as women being at particular risk or the possibil- Sciencein the Creation/Evolution Trials," American ity of treating AIDS as a chronic condition much as SociologicalReview 50 (1985):392-409. one treats diabetes. The 1990San Franciscoconfer- encereceived considerable attention, but mostly from the "science-vs.-politics"angle. The l99l Florence 28. Recently, there have been some interesting conferencewas far lessvisible than either one- exceptions. Kimberly Bergalis, the first person known though in a comparatively slow news week-with the to have acquired HIV from a dentist, releaseda text of principal angles being repeats of the "no break- a letter condemning state and local policymakers that through" narrative from Montreal and the "science- was widely republished. That exemplar of middle- vs.-politics" story from SanFrancisco. brow Americana, the Sunday magazine supplement Parade, on fuly 7, 1991, published a lengthy interview with a 17-year-oldhemophiliac with AIDS, Henry 20. A useful sample of poll results is Eleanor Singer, Nicols, who noted, "I am consideredan'innocent' "The TheresaF. Rogersand Mary Corcoran, Polls-A victim. Of course,there are no 'guilty'victims." (p. 6). Report: AIDS," Public Opinion Quarterly 5l (1987): And on a Nightline program on April 30, 1991,that 580-s9s. discusseddoctors with AIDS, severalpersons living with AIDS were treated as authoritative sources in the

Timothy E. Cook 15 Helplessnessand the Evening News," lownal opening segment,providing their informed opinions ,of (Autumn 1977ll100- 105, and along with physicians and lawyers. Coimunication "Learned Helplessnessin Local TV News," [ournalism Quarteily 63 (1986):12-18,23' 29. Ralph H. Turner, foanne M. Nigg and Denise Heller Paz,Waiting fot Disaster:EarthquakeWatch in BostonSunday Globe, Oct' 29, 1989,p' Al ' California (Berkeley:University of California Press, 38. 1986),p. 58. 39. From an interview with Dr. Anthony Fauci, "Bush-Meets reportedin Lou Chibbaro,fr., G-ayMen 30. SeeKinsella, Covering the Plague,chaps' 2 and 8' with AIDS During NIH Visit," Washington Blade ()anuary5, 1990), 9. "Doc's P. 31. David Armstrong and Helen Kennedy, Sex Arrest Ignites AIDS Fears," BostonHerald (fune 25, 40. In their ongoingresearch on how the public learns l99l),p. l. from news accountsin different media, Russell out Neuman, Marion |ust and Ann Crigler noted that, 32. Three outstanding examplesfollowing the life of a of five issues,AIDS was the only one where the on television PWA rverefean Blake'sprofile of PWA Paul Cronan audienceslearned significantly less from WBZ-TV in Boston,Patricia Nayman's recurring series news storiesthan from newsmagazinesand newspa- "All were distractedby the on Archie Harrison on National Public Radio's f.tr- Rpp"t.ntly, their subiects "When and Things Considered,"and SteveSternberg, io"nt ,tpot individual human interest stories and AIDiComes Home: The Life and Death of Tom Fox," a*"y f-- the larger issues. SeeNeuman, fust "Knowledge, The Atlanta lournal and Constitution, August 20,1989, Crijler, Opinion and the News: preparedfor SectionE. Cal"culusof Political Learning," paper delivery at the annual meeting of the American Political ScienceAssociation, Washington, D'C', "AIDS Specterfor Women: The 33. fon Nordheimer, September1988. Bisexual Man," New Yotk Times, April 3, 1987,p' At' Even more tellingly, the headline after the iump was " "For Many Womin, Fearof AIDS Lies in the Shadows 41. Marvine Howe, ATeary Doctor Tells of AIDS 1990' of Male BisexualitY." from a Needle,"NewYorkTimes, fanuaryll, p.Bl.

34. Seeespecialiy Michael Schudson,Discovering the September News: A Social History of American Newspapers 42. JSBCenter Brown BagPresentation, (New York: BasicBooks, 1978)' 1989.

"Making Times' 35. SeeGaye Tuchman, News By Doing 43. Thomas Rosenstiel,in the Los Angeles Work: Routinizing the Unexpected,"American calendarsection, November 27, 1988,p' 28' lournal of SociologyTgll973l: ll0-l3l' 44. Myron Belfer, presentation at Harvard AIDS "Introduction," 1989' 36. Robert E. Park, to Helen MacGill Institute, AIDS in ih" 1990t, Boston,December (Chi- Hughes, News and the Human Intercst Story cago:University of Chicago Press,1940), p' xxi' 45. The classicstatement of the volatility of news "The attention is G. Ray Funkhouser, Issuesof the of 37. GraceFerrari Levine showedhelplessness to be a iixties: An Exploratory Study of the Dynamics theme in over seventy percent of the television stories Public Opinion," Public Opinion Quartetly 37 ll973l' have become she analyzed, both nationally and in New York' Such pp.62-7i. If anything, of course,-matters of helplessnesstended to be heaviest in iinslderably more fait-forwarded than the years that portrayals "Learned storles about the general public' Seeher Funkhouser studied.

76 Notes for the Next EPidemic