In Kentucky, the Louisville Courier Journal once forced action on strip-mining, pollution in the Ohio River, and the dumping of sewage sludge and radioactive waste. Now that no reporter there (or anywhere in the state) has an environmental beat, these practices go unchecked. No one will cover continuing threats such as overlogging, mountain-topping, or the hazards of abandoned mines. Future dangers will emerge, go unreported, and kill people.
The coronavirus was used by the Trump administration as an excuse to legalize pollution, even though pollution makes it more likely that people will die from the coronavirus. We lack the reporters to cover the consequences.
A second example of how news deserts kill is the opioid crisis, which coincided with the collapse of local news. Americans in places like eastern Kentucky, western Pennsylvania, West Virginia, and southern Ohio knew, long before opioids made headlines, that something ominous had people in its grip. Years before major media covered it, opioid abuse was like cancer: a subject one didn’t bring up at dinner because it probably concerned someone at the table. With too few local reporters writing about overdose, it took a decade for a national picture of the disaster to emerge.
The belated steps taken to address the opioid problem are now endangered by the spread of the novel coronavirus, which makes research and treatment much more difficult. By inviting a new epidemic we have extended a previous one.
In 2020, the lack of local reporters had the same consequence for the coronavirus as it had for pollution and opioids. We were missing the people whose work would have clarified a national disaster. We still do not know which communities were hit first. Months into the pandemic, millions of Americans were still reacting to hints and winks from Washington, because they had no local reporters to tell them that the illness was already infecting their neighbors. Conspiracy theories spread because social media had taken the place of local newspapers. Propaganda from Russia or China had easier access to dinner table conversation than realities down the block.
It was local reporters who provided the portraits of those who died. It was they who wrote about the mass dying in nursing homes. Local reporters found some of the places where bodies had been abandoned, and recorded some of the names of nurses and doctors who died. They revealed some of the occasions when states suppressed data about death. We can be sure, sadly, that most such stories were missed, simply because there were not enough journalists to cover them.
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Adam Mickiewicz, a great Romantic poet, began a famous poem with the lines:
Lithuania! My fatherland! You are like health.
Only he who has lost you can know your true worth.
Health is indeed like that; you appreciate it when it goes away. Truth is like health: we miss it when it fades. We can see the importance of medical knowledge and local knowledge now that they are dissipating.
If you lose your health completely, if you die, even the longing for health is gone. Something similar holds for truth. As we lose the people who produce facts, we are in danger of losing the very idea of truth. The death of truth brings the death of people, since health depends upon knowledge. The death of truth also brings the death of democracy, since the people can rule only when they have the facts they need to defend themselves from power. More than a hundred and fifty thousand of us died needlessly because all Americans were denied the truth. We now need the truth about what has happened, so that such things will not happen again.
We cannot be free without health, and we cannot be healthy without knowledge. We cannot generate this knowledge by ourselves as individuals: we need a general belief in the value of truth, professionals whose job is to produce facts, and robust institutions that support them. This is an example of the paradox of liberty: we cannot be ourselves without help; we cannot thrive in solitude without the solidarity of others. We can only balance solitude with solidarity when we share a factual world that enables us to see the larger meaning of our actions. During a pandemic we can choose solitude because we have solidarity with others whom we wish to see live and thrive. Local reporters warn us about dangers, help us to see challenges, and shield us from the divisive abstractions of ideology and the addictive emotions of technology.
As I write, we still need much, much more testing for the coronavirus. For the future, we need a sustained policy of supporting independent local reporting. A restoration of truth, and the application of truth to health, can begin as a reaction to a pandemic. We should have bailed out local newspapers in 2009; we should have bailed them out in 2020. They can be renewed now by a tax on the social media that exploited their labor and destroyed their livelihood, leaving the country poorer in spirit and weaker in health.
Yet the commitment to truth must go beyond the reflex to ward off mass death. We also need to remind ourselves what we know about leading a healthy life. Our present system of commercial medicine is poor at teaching us the basics. The centralization of traditional media in our country eventually imploded into the black hole of social media, which consumes factuality without producing it. Similarly, the centralization of commercial medicine weakens the voices of doctors, slowly turning them into mouthpieces for companies that own hospitals or sell drugs. What doctors know becomes harder and harder to hear, until at last it is crowded out by what makes money.
Doctors have their own methods of reaching truth: by scientific tests, but also through dialogue with patients. They can help us to restore the factual world, but only if we treat them with the respect they deserve.
LESSON 4.
Doctors should be in charge.
Now that I am a parent, and my parents are grandparents, I think more about what I learned from them during childhood, during what my mother calls the “blur” of the 1970s. The time that she and my father spent with my two brothers and me during our early years still matters, every day, decades on. I try to appreciate this, and to recall some specific episode with them on their birthdays. I missed my mother’s most recent birthday, though, because I was in a hospital in Florida.
During the two days and a night I spent there, from my mother’s birthday into Christmas Eve, I was too anxious to sleep. My hands and feet were tingling and hot. I had been run through numerous tests during the day, but no doctors were around to talk about the results. So I looked out the window. I watched the moon appear in the sky, and stared at it through the night. The drawings of it in my diary look like a child’s. As the sun rose behind the hospital, I kept my eyes on the moon, trying to fix it in my vision until it disappeared. It wavered, vanished, and reappeared three times before it was gone for good.
As the day broke, my view was of an enormous complex of hospital buildings, each painted in what was meant to be a cheerful pastel. The bright walls came to an abrupt end at flat black asphalt roofs, which were covered with trash. I could tell that the wind was blowing, because plastic bags filled with air floated to and fro over the rooftops all day long. I focused on the plastic bags, wondering whence they had come, what they had held, and in what part of the Gulf of Mexico they would strangle which wildlife. Turning my eyes downward I noticed people, coming and going, also in bright colors. I must have been above a staff entrance, since almost everyone who entered or exited beneath me was wearing scrubs.