Arts & Entertainment

Reality Will Provide

A colleague of mine who loves the news business more than anybody I know (a business which has not always loved him back, by the way — but that's another story) used to say the same thing whenever we were fretting about having a slow news day or week, worrying that we'd have nothing to keep people interested.

"Reality will provide," he'd say.

The phrase popped into my head because, as we left on Friday, we were debating exactly what we should focus on for today's program. At that point, there were so many things percolating:

1.) U.S. mayors were meeting at a conference in Miami. So many of the issues they were talking about are things we talk about every day — like crime, the foreclosure crisis, poverty and the environment. Sen. Barack Obama and Bill Clinton talked with the group of city leaders over the weekend.

Would anybody want to hear more, we asked?

2.) Floodwaters in the Midwest are receding. Do we need to check in on recovery efforts?

If you don't live there, do you care?

3.) And, we normally check in on Mondays with The Washington Post Magazine. We had our eyes on a riveting story about those who literally keep watch in the interagency watch center that evaluates possible security threats on air travel, clearly a matter of urgency in the wake of Sept. 11.

Could we get the reporter on the line? In the studio?

... And then a bombshell. In Zimbabwe, opposition leader Morgan Tsvangirai, who heads the Movement for Democratic Change — whose party mounted the most serious challenge to Robert Mugabe in his 28 years of presidential rule — announces on SUNDAY that he is withdrawing from the race. As of right now, NPR's Morning Edition is trying to reach him for an interview. They are first show up, as we say (heard earlier in the day than other NPR programs), but we're next.

Clearly a story to which we have devoted much time and energy is a priority.

Who can we get? Who is on the ground? Who knows what's going on?

We were very fortunate to reach reporter Jeffrey Barbee, who is reporting on the ground in Zimbabwe. We also heard from Open Society Institute analyst Akwe Amosu for more analysis.

Still, we did want to hear more about the mayors' meeting in Miami. Michael Nutter of Philadelphia was our guest.

And we also reported on a study (pdf) about the problem of long emergency room waits and how they affect patients needing mental health services.

Finally, Say You're One of Them. It's a book of short stories from a fresh and unexpected new African voice, Uwem Akpan. We hope to bring you a number of conversations about new fiction from Africa over the course of the summer. But here's a start.

Uwem Akpan's exhilarating, heartbreaking collection. The stories so moved singer Angelique Kidjo that she composed a song about it. Agbalagba closes the show.

We did not have time for Laura Blumenfeld's fascinating piece about the Homeland Security watch group. So here it is.

Does it change the way you think about having to take off your shoes at the airport?



Please keep your community civil. All comments must follow the Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

Would we care more about the flooding in Iowa and Missouri if the victims were looting shops, shooting at law enforcement, and crying for media attention?

Would we care more about the Mugabe power grab if Zimbabwe were sitting on untold oil reserves?

Inquiring minds want to know...

Sent by True_Liberal | 8:03 AM | 6-25-2008

I still enjoy listening to your show as often as possible.
I thought you had a very interesting segment today on the long waits in the ER for psychiatric patients. Unfortunately, you missed the main issue involved, because the author failed to highlight it for you, and the mother of the patients was not aware of it. The report itself lists the first "free-form" reason for delays as "Unwilling psychiatrist to evaluate patient between 1 pm and 10 am, despite being on-call." There are other issues, of course, but the lack of a specialist to assume care of the patient will lead to a long delay every time. The survey results noted that "62 percent indicated there are no psychiatric services involved with patient care while patients are being boarded in the emergency department prior to admission or transfer." This means that no psychiatrist or other psychiatric clnician evaluated the patient during that time.

The lack of psychiatric specialty coverage in ER's is an example of a much larger problem of finding specialists to cover ER's all over the US. A pretty good article on this issue in the Washington Post in Dec. 2007 is here:
Pay close attention to the comments after the article, where a number of physicians weigh in.

This is a problem relating to neurologists (like me), neurosurgeons, psychiatrists, and many other specialists. It is a symptom of the lack of alignment of interests of physicians and hospitals in the current medical system. The physician has many disincentives to care for ER patients, including poor reimbursement for providing inconvenient service, malpractice risk, lack of other physicians to help in complex multi-specialty problems, etc. The hospitals have had such problems with some specialties that they have started paying the physicians a fee for coverage, above and beyond any billings, but this only applies to certain critical specialties that bring in lucrative patients to the hospital, such as cardiologists, OB's, etc.

There is much more to tell about this story. It would be interesting for you to interview psychiatrists in the community about this issue to obtain their perspective on why it is so hard to get ER coverage. Your ER doctor guest and his organization are probably being careful not to ruffle the feathers of the specialty community too severely, for fear of aggravating the problem with obtaining specialty support. The ER physicians' organization alludes to the need for more money to somehow improve the situation. You correctly asked for some specifics about how this would help, and the spokesman was unforthcoming. This is because the solution is one that is difficult politically and financially within the hospital. The issue will only get better if hospitals begin to substantially compensate physicians for specialty care in the ER, above and beyond the patient's insurance (or more often, the lack thereof). Unfortunately, the system is now made up of hospitals and physicians who are forced to see themselves as economic actors, who make cold, careful calculations about what they will do, and what risks they will take. This is what modern American medicine has come to.

Sent by Preston C. Calvert, M.D. | 4:43 PM | 6-27-2008

I've been listening to Tell Me More Podcast ever since I saw Michelle on Politically Incorrect with Bill Maher. (I hope she does the show again.) It's one of the most informative shows I listen to. The perspective on the stories is one I don't get to see much of anywhere else. But rather than comment on a story you've done, I'd love for Tell Me More to do a story on an article I read in the LA Times today. . here is the link. .,0,978616.story I think the story speaks for itself. Setting Lift Ev'ry Voice And Sing to the tune of the Star Spangled Banner. I thought it was song beautifully. But there is NO WAY you can tell me white america is ready for that one. In fact, I don't many black people under 30 are even aware of the song in general. I'd love to hear Tell Me More's take on this one.

Sent by David E. Jones | 3:41 PM | 7-4-2008

David--we heard you--our interview with Rene Marie aired Monday July 7--take a listen

Sent by Michel Martin, host TMM | 11:46 PM | 7-7-2008


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