To sell some papers in November, the Star resorts to scare tactics.


To sell some papers in November, the Star resorts to scare tactics.

The Strip is so happy that November has gone away. This prime cut loves sweeps, but after a month of the local television stations trying to scare the bejesus out of us, we're ready for TV news to go back to being mediocre.

For a few weeks, however, it's entertaining as hell to see the local helmet-hair contingent chasing auto mechanics and garbage collectors with hidden cameras to expose one major scandal after another. Meanwhile, we're told that our lives are being endangered at every turn, and we better watch at 10 p.m. to find out how our cell phone or that extra-large helping of french fries or the things we keep under the sink could be killing us.

Scaring viewers is just how local TV news works. They do it because it makes them money.

But what's The Kansas City Star's excuse?

The daily spent the month of November trying to terrify readers as if it, too, were competing in a sweeps period.

Of course, this is a pretty scary time for the liberal newspaper.

University of Missouri-Columbia professor Clyde Bentley says that on October 23, Star publisher Art Brisbane gave a talk at the school and reported that the poor economy was causing dire losses in the Star's ad revenue. Brisbane denied it when the Strip got him on the phone, and he refused to comment when the Strip asked what he had said. (Believe this cutlet, the current economy has been no picnic for the rest of the industry, including the rag you're holding in your hands.)

But on November 3, the Star got another fright: After slow but steady gains in circulation over the past three years, the latest six-month figures showed a sudden drop in readers. According to the Audit Bureau of Circulations, the Star's weekday circulation was down more than 6,000 readers to 267,273, a drop of 2.3 percent from the previous half-year. Sunday readership was down a similar amount.

Daily newspapers have been hemorrhaging readers for decades -- ten years ago, the Star's weekday circulation was about 25,000 subscribers higher in a town with 300,000 fewer people. But the Star, like others, had been rallying since September 11, 2001, when terrorism and then the war in Iraq boosted people's interest in current events.

But what do you do when even Osama bin Laden and Saddam Hussein become yesterday's news?

If you're the Star, you go tabloid!

Your Prescription Could Kill You!

The Star began its November terror campaign with an investigative package supplied by its parent company, Knight-Ridder, that promised to scare the crap out of anyone taking prescription medication. In the case of the Star's aging audience, that's just about everybody.

The series claimed that irresponsible doctors around the country were endangering the lives of patients by prescribing drugs for uses that hadn't been approved by the Food and Drug Administration. Knight-Ridder had found 800 cases in which patients were seriously harmed last year by such "off-label" prescriptions; the series estimated that the actual number of such cases was closer to 8,000.

The paper ran several horror stories, including one about a pregnant woman who nearly needed a heart transplant after her quack doctor prescribed an asthma medicine to keep her from going into labor too early.

Makes you want to run for the medicine cabinet with a hose.

But wait a minute. Those 8,000 adverse reactions were out of 115 million off-label prescriptions last year. After the stories ran, an angry Huntington's disease researcher pointed out on his Web site what the Knight-Ridder reporters had conveniently left out: a 1 in 14,000 chance of disaster gets us into struck-by-lightning territory. In fact, patients taking off-label prescriptions were more likely to be killed in auto accidents last year than they were to be seriously harmed by their medication. And they were certainly luckier than the 100,000 people who had to be hospitalized -- and the 16,500 who ultimately died -- from complications arising from taking aspirin and other anti-inflammatory painkillers.

After the series ran, Star Managing Editor Steve Shirk got an earful from local physician Jeffrey Kaplan. The neurologist was upset that the alarmist series painted such a misleading picture of off-label prescribing, which turns out to be quite common and, like all medical procedures and medicines, is subject to some risk.

"We often use medicines that are not approved," Kaplan tells the Strip. "We have medicines that work very well and are very safe, and we're going to use them for off-label indications. Thank God the FDA doesn't practice medicine."

A classic example, Kaplan adds, is the situation with his patients who have painful neuropathy, the chronic pain experienced by people with diabetes and other ailments. "There's no FDA-approved medicine for it. One, we tell our patients to suffer, or two, we give them an anti-seizure medicine which is very effective but not FDA-approved [for painful neuropathy]. And the drug company has no incentive to approve it for this use, since it would cost about a billion dollars for FDA approval -- and I'm not exaggerating."

Local cardiologist Mike Farrar gives another example. He prescribes an off-label medicine to postoperative bypass patients not only because it's more effective than the FDA-approved drug but also because Farrar doesn't like the side effect the FDA drug sometimes produces -- sudden death.

Both local docs say off-label prescribing is so common and has proven so effective that it's not really an issue in the medical community.

But, hey, sounds scary, doesn't it?

And the photos were nice and spooky.

Your Liver Could Kill You!

The next bloodcurdling installment in the Star's spooky November was based on a terrific piece of reporting. The paper had discovered that 22 years ago, blood donation centers in the United States had, for chickenshit legal reasons, decided to put off using a somewhat effective test for screening blood for the hepatitis C virus.

Perhaps 300,000 people could have avoided contracting the debilitating disease if the centers had used the test earlier. Since 1987, new-infection rates have gone down dramatically as testing has improved -- but hep C is a slow, insidious killer that may not show symptoms for decades. A million Americans may carry the virus without knowing it, but, the Star found, the U.S. government does little to educate folks.

The Star had done a great service with its reporting and call for government action.

So why'd it have to go and ruin things by throwing in an extra "Boo!"

Brad Freilich, a local hepatitis C specialist, says he was shocked when he read the series and found that the Star had downplayed the effectiveness of treatment for most hep C patients. The series, in fact, made the disease sound like a sure and painful death sentence; for example, it cited one study in which only 11 out of 293 patients were cured by medication.

That surprised Freilich, because he was the doctor who not only had consulted the two reporters and told them a very different story but also had conducted a Q&A column on the Star's own Web site.

Freilich was so angry about how his input on the story had been ignored that he wrote a lengthy rebuttal that appeared in the paper a few days after the initial series.

"The authors misunderstood many facts concerning the treatment of hepatitis C," Freilich wrote.


"It is ironic that I ended up the one being the most critical, when I'm the one who helped them," Freilich tells the Strip. But he says he was astounded that the Star wrote the story as if no one had told the reporters that treatment is more effective than they let on. "I find that hard to believe given the huge amount of material available and the large number of people they talked to. I called up [one of the reporters] and said, 'How could you possibly do this?'"

In reality, Freilich says, hep C treatments are more effective than, say, some treatments for high blood pressure. But saying so would make it less scary. Freilich says the study that the Star cited was flawed -- researchers knew that the patients had a history of avoiding treatment. In fact, Freilich says, about 75 percent to 80 percent of people infected with the virus will never develop cirrhosis of the liver or liver cancer, the two most dire outcomes of the disease. About 70 percent of those infected have a strain of the virus that, 55 percent of the time, can be eradicated with anti-viral medicines. The other 30 percent face even better odds, with a 95 percent chance of eradicating the disease.

There's no doubt that hepatitis C is a serious killer, and treatments can be painful and lengthy. But Freilich says stories like the Star's only encourage patients to avoid treatment and not get the care that they need.

"This is no different than any other illness," Freilich says. Taken out of context and without fair comparisons, you can really paint the picture any way you want. My sense is that's what happened here."

Your Mom's Boyfriend Could Kill You!

The third in the Star's unholy trinity of hair-raising tales was a stunt of chilling proportions -- two pages filled with more than a hundred photographs of nearly every local child killed by abuse or neglect in the past three years.

This was paired with a news story that three times in its first six paragraphs emphasized how hard the reporters had worked obtaining records and poring over them. (Star readers can be forgiven if they thought this was aimed at impressing them. Such self-congratulatory language in a news story is actually included for the benefit of journalism-contest judges.)

The gist of the story: A lot more kids in Missouri end up being killed by their parents than in other places, even more than state authorities realized.

But as it read over the captions accompanying all those photos of dead kids, the Strip couldn't help wondering what, exactly, readers were supposed to conclude about the children strangled, suffocated, shaken, shot and otherwise slain by parents, stepparents and strangers?

At least one thing seemed clear: If your minimum-wage, single mom's taste in men runs to drug abusers and felons, you can count your life expectancy on one hand.

But then this meat patty spotted a remarkable statistic buried deep in the series. The Star had found that 164 kids had died in just three years, whereas the state had previously counted 147 in five years. But the Star also found that the state was actually less culpable for those deaths than even the state itself had assumed. State Auditor Claire McCaskill had found 103 cases in which the families had been previously reported for abuse or neglect. The Star could find only 77 such cases.

In other words, the state had some warning of disaster in fewer than half of the cases.

Those statistics make it difficult to lay too much blame on local governments.

Maybe that's why, in its final installment, the Star was forced to come up with this stunning conclusion: "Ignorance, uncontrollable anger, teenage pregnancy, poverty, and drug and alcohol abuse. Until society tackles those issues, child abuse will continue."

Yeah, and world peace would be nice, too.


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