broadsideblog

'It's worse than AIDS': Interview with 'Superbug' author Maryn McKenna

In Health, Media, Medicine on March 23, 2010 at 8:25 am
Rob looks like a doctor...

Make sure he's washed his hands!Image by juhansonin via Flickr

It’s extremely rare that I start a book, certainly non-fiction, never about science, and can’t put it down because it reads like a thriller. Maryn’s book, “Superbug”, published today, is an astonishing read — I gulped it down in one sitting.

It’s not an easy read but it’s essential: terrifying, sad, powerful, persuasive.

She’ll be interviewed today by Terry Gross on her NPR program, “Fresh Air”, every writer’s dream. I spoke to Maryn, a friend and colleague and fellow member of the American Society of Journalists and Authors, about it:

Tell us a little about yourself. Why journalism? Why science and/or medical journalism?

I was born in Brooklyn, NY; raised in England where my father was working on an engineering project; high school in Texas, college in Washington, DC. At Georgetown I took an English honors degree in 16th-c theatre and 20th-c poetry, which meant I was very well educated and completely unfit for the job market.

I looked around for a graduate program that would be quick but give me a credential to make me marketable, and went to Northwestern to study journalism. After I got my degree I started the painstaking climb up the ladder of newspaper circulation. My first job was in finance journalism, but after the market crash of 1987 I was a bit burned out, and my paper offered me an open job covering science and medicine and the environment, and it was a good fit.

A bit of career history: where you worked and why you chose those places.

I had internships at the American Banker and as Washington correspondent for the Oak Ridger of Oak Ridge (TN), home of the Manhattan Project. Full-time jobs at the Rockford (IL) Register-Star (3 years), Cincinnati Enquirer (2 years), Boston Herald (5 years) and Atlanta Journal-Constitution (10 years). For the first half of my newspaper years, I was mostly an investigative reporter focusing on public health, and for the second half, I was the only U.S. reporter assigned to full-time coverage of the CDC (the Centers for Disease Control and Prevention.)

I left my last newspaper job in mid-2006 when it became clear opportunities were contracting — I kept hearing, “We don’t see you doing any projects for us” — and went freelance.

When and where did this idea for a book come to you?

About a month before I left my last job, I had the incredible good fortune to meet Sara Austin, news and health features director of Self magazine, at a conference. My first story for her, published in Feb 2007, was the genesis for “Superbug”. I’ve since done two other major features for her and am lined up to do several more. I’ve also written for Health, More, Heart-Healthy Living, and am a regular contributor to the Annals of Emergency Medicine. My first stories as a freelancer were for Susan Percy at Georgia Trend, for which I will always be grateful.

That first story for Self was on the unappreciated threat that community-strain MRSA posed to women and children — because, even in 2007, people were still talking about MRSA in the context of prisoners and athletes, groups that were mostly male. The story was published; it was picked up by the TODAY show and by Montel, which suggested it had broad demographic appeal; and my in-box exploded with notes from dozens of women and some men wanting to tell me how MRSA had changed their lives. It was clear there was a larger story there.

Where and how did you find your agent?

I’ve heard other authors describe how difficult it can be to find an agent, and every time it makes me realize how fortunate I’ve been. In the summer of 1998, I was taking a year off from my newspaper job to do a year-long fellowship at the University of Michigan, in the Knight-Wallace program (which is amazing and refreshing; I can’t recommend it enough).

A colleague, Gary Pomerantz, had been to the same program shortly before, and had come out with a book. I wanted to do a book too, and he introduced me to his agent, David Black of the David Black Literary Agency, who pointed me toward Susan Raihofer there. The book I had in mind didn’t come together, and so for the first three years of our acquaintance I didn’t have anything for her to agent.

But during the 2001 anthrax-letter attacks, I embedded with a CDC investigative team working on Capitol Hill, and that gave me the idea for my first book, BEATING BACK THE DEVIL, a narrative and history of the CDC’s “disease detectives,” the Epidemic Intelligence Service. We sold that in 2002 and it came out in 2004.

Describe selling the book.

It went very quickly. I did a 20-page proposal in about a week, and then reworked it with Susan’s guidance over a very long weekend. She sent it out to a selected group. There were some expressions of interest and then couple of bids, but the high bidder was Free Press, [an imprint of Simon and Schuster] who had published my first book. From start to sale, it was very quick, probably less than a month.

How long did it take you, start to finish?

It depends on when you start counting! Three years from the time the contract was signed; 3.5 from when I started work on that Self story, a tiny portion of which appears in the book. But I first got interested in MRSA during research for my first book in 2003, when I shadowed CDC disease detectives in Los Angeles through an investigation of MRSA infections monitoring gay men who visited sex clubs.

So it may have been gestating for twice as long as I thought.

You name so many people in your acknowledgments — tell us about building so wide a set of sources and why that mattered to you — and to other ambitious writers tackling complicated topics.

The horror of doing a book like this is that, to make the problem real to an average reader, you have to find victims who are like average readers themselves. The benefit of doing a project like this now is that, thanks to social media, you can tap networks much more reliably and reach further than I think you ever could before. I was offered a lot of contacts thanks to that Self story, and to one I did for Health magazine a year later — but still, I worked my networks relentlessly. For every victim in the book, I probably have 10 others whose stories were moving, but not exactly what I wanted.

Overall, between victims and scientists, I did about 200 interviews.

Tell us about the Dart and Kaiser fellowships and how they helped you.

I’m a big believer in fellowships, which I think are the best way — maybe the only way, in the current environment — for journalists to study up on any particular topic. I got a Henry J. Kaiser Family Foundation fellowship for “bridge funding” when I left newspapers; the idea was to spend a year of overnight shifts in ERs to see what the overcrowding was like. I thought I would do a book on ERs but saw so much MRSA that it fueled “Superbug” instead.

Then in 2009, I went after a fellowship with the Dart Center for Journalism and Trauma, at Columbia, because I had collected so many stories of awful things happening to people as a result of MRSA that I realized I needed some help in processing them. I wanted to find a way to tell them that preserved the victim’s dignity and autonomy and wasn’t just disease-porn.

The Dart fellowships are a week-long immersion in both learning about the effects of trauma, and being helped through whatever processing you need to do for any traumatic events you have witnessed as a journalist. After 20 years as Scary Disease Girl, I had seen a lot of trauma, and the fellowship helped me get some distance on those events.

What did you enjoy most about writing the book?

I think people whose work has been newspaper or long-form magazine stories, but who haven’t written a book, tend to think, “Ooooh, a book, that will give me all the space I ever wanted to tell a story.” Well, no. You are still, always, making decisions about what to leave out. This book is about 85,000 words, but it could have been twice as long, and deciding what to cut was very painful — because I’m extremely detail-oriented and like to describe the smallest granular aspects of events. At the same time, I loved having that length in which to tell a braided, complex narrative.

The thing that was most challenging, though, was how time-consuming it was. I worked, without exaggeration, 12 hours most days, 6 days most weeks, for 3 years. I felt that this was a story that needed to be out soon, and that I couldn’t take the time to explore it over 5 years or more — someone else would beat me to some part of it. And to tell it with credibility, I needed to be immersed in the subject. But I made a lot of personal sacrifices to do it.

Are you now scared of doctors or hospitals? How — seriously — do you think most of us will ever challenge a doctor (if we are scared of MRSA) when we are scared or in pain or facing surgery? How scared should we be?

It is not my intention to make people paranoid, really. I don’t want to frighten people away from hospitals. But I do hold hospitals responsible for not doing better, and because they do not, I do think we have to defend ourselves.

What that means is doing due diligence before going into the hospital — if you are in a state where there is a mandatory-reporting law for hospital infections or MRSA, look up the institution’s metrics. And when you are in the hospital, try to find the courage to ask health care workers if they have washed their hands. It’s an easy thing to recommend, a very difficult thing to do, because it challenges the power differential in the relationship between health care worker and patient. But I think it’s necessary.

Next book? current projects?

One of my favorite parts of the book is tracing the detective story of the “third epidemic” of MRSA in food animals, It got me thinking about how complex and multi-national our food system is now. So I think my next project will turn in that direction, probably toward the difficulty of making food safe.

  1. [...] It's Worse Than AIDS – And Everywhere — MRSA: Interview With … [...]

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