By Michael Miner

Fallout From the AMA’s Bombshell

An indignant medical librarian sits at his computer in Alabama and denounces the AMA. Posted on-line, the screed bobs on tides of protest to the AMA home page. There it merges with the angry swells that have crashed down on the association since it fired Dr. George Lundberg, editor of the Journal of the American Medical Association. Soon the librarian receives a response from the AMA’s CEO, Dr. E. Ratcliffe Anderson Jr.

“My decision to remove Dr. Lundberg…was difficult, but it was necessary,” Anderson insists. “Here’s why.” The explanation is mostly boilerplate, his original announcement slightly retooled to placate the roiling masses. He says Lundberg “inappropriately and inexcusably interjected the journal into a major political debate that has nothing to do with science or medicine” by publishing a study of college students’ views on oral sex. “It is important to me that all AMA members, and the public in general, understand just how strongly I believe that it is not the AMA’s business, nor is it JAMA’s business, to interject itself into political controversy of this kind.” Lundberg had lost Anderson’s trust, and “trust and integrity are at the very heart of the work we do together every day here at the AMA. Nothing is more important. If we don’t get this right, we don’t get anything else right.”

These are ringing words, even if they don’t persuade the librarian, whose reply begins, “Your ‘argument’ is specious at best.” And it’s a familiar ring, the ring of the military mind. Trust and integrity are core military values, and politics is outside the perimeter. The military calls its jobs “missions,” and fidelity to a mission is expected from every hand. That would include the editor of a base newspaper, who might have to die for the First Amendment but shouldn’t expect to exercise it.

Anderson was a career military man, a fighter pilot who rose to surgeon general of the air force. In 1996 he retired to civilian life, and that November went back to work in Kansas City, as dean of the medical school at the University of Missouri-Kansas City and as director of the Truman Medical Center. Truman is the medical school’s teaching hospital, and the two institutions shared several top administrators.

Marvin Querry, executive dean at UMKC, had championed Anderson for the medical-school post. But in March of ’97 he wrote himself a memo listing “troublesome issues regarding Andy’s performance as dean.” These included Anderson’s “failure to understand university protocol…increasing tendency to not heed guidance, counsel, and direction from the executive dean [that is, from Querry himself]…tendency to not respond to verbal requests.”

One criticism not leveled at Anderson was an inability to act. However heedlessly, he waded into the problems that confronted him. And that fall he must have thought he was solving a big one: he peremptorily fired the chair of the medical school’s department of medicine.

Querry wrote Anderson a frantic letter: “Andy, what have you done? In the words of Laurel and Hardy, what mess have you gotten yourself into now? Whatever possessed you to take the recent unauthorized, unilateral action against Stephen Hamburger, M.D., Chairperson of the Department of Medicine in the School of Medicine, and Chairperson of the Department of Medicine in Truman Medical Center?…Dr. Hamburger faithfully has served the Truman Medical Center (TMC), the School of Medicine, and the citizens of Kansas City and Jackson County for 21 years. He has given medical care for the poor and indigent people of this community, and he has taught our medical students. Now, seemingly out of the wild blue yonder, you have struck out against him. Why?”

Querry reminded Anderson that he’d never said one critical word to him about Hamburger before lowering the boom. So what was it that suddenly made Anderson decide that–here Querry quoted Anderson’s own words back to him–Hamburger’s “apparent resistance to change generally…make it impossible for [you and him] to work together as administrators with trust and confidence”? And did Anderson not realize that he’d violated the chain of command? “Removal of a department chairperson is a serious act,” an act that must be approved by the chancellor and executive dean.

Nine days later the chancellor removed Anderson as dean. But he continued to run Truman and soon was attempting to oust Hamburger and two other doctors from their positions as clinical department heads at the hospital. Claiming Anderson acted out of spite because they’d supported removing him as dean, the three doctors went to court to protect their jobs. Some of that litigation is still unsettled, but last summer Anderson put it all behind him by leaving town to take over the AMA.

Now that he’s collected Lundberg’s head, eminent medical journalists want Anderson’s. Richard Horton, editor of the British medical journal the Lancet, posted on the Lancet home page an editorial calling on Anderson to resign for having “needlessly…foolishly…brutally…brought the AMA to what most observers thought was impossible: a new and sinking low in its history.”

Horton explained, “JAMA is no longer part of a free press….Its decisions are governed by the partisan politics of US health care. The AMA is a deeply politicised organisation….AMA executives have been desperate to shore up their political capital after a year of embarrassing press criticism. And with Clinton on the impeachment rack, to publish a paper that might lend support to the president and jeopardise Republican efforts to unseat him was impossible to tolerate. The only way to pacify their allies in Washington was to lose Lundberg.”

Horton’s interpretation in the Lancet might be absolutely on the money, but it has a ring of its own–of conventional wisdom. The Sun-Times reported Monday that the World Association of Medical Editors and the executive editor of the New England Journal of Medicine had condemned Lundberg’s dismissal, and that it also was assailed by medical journals in Australia, Canada, Malaysia, the Netherlands, Norway, Russia, South Africa, and Sweden.

Anderson isn’t giving interviews, but he did talk to Horton, who allows that “he was steadfast in his view that he had made the right decision.” Anderson might be less political than he is politically tone deaf, and there’s no reason to think 32 years in the air force gave him the hang of press freedom.

Marvin Querry told me he read about Lundberg’s firing in the Kansas City Star. “And there, to my surprise, was E. Ratcliffe Anderson’s name. I thought, ‘Oh yeah, I know that guy.’ It seemed to be another shoot-from-the-hip thing like we’d seen here….I would still like to have dinner with Andy Anderson. I liked the man. My job was to make him successful, and I spent more time trying to assure his success than I did all the other deans and academics hired in this institution.”

An Aggressive Prosecution

The Tribune series on prosecutorial misconduct neglected a virtue often spurned by investigative journalism: context. Understandably, state’s attorney Richard Devine got his back up over the series, which made the problem sound not only horrendous but common. So Devine’s spokesman Bob Benjamin, an old friend of mine, passed along some statistics. In 1998, he said, Devine’s office processed some 67,000 felony cases (and about 300,000 misdemeanors). Of those 67,000 cases, about 2,000 led to guilty convictions that were appealed, and of those 2,000, “eight were kicked back on the basis of purported prosecutorial misconduct.”

Benjamin went on, “Where they were talking about Cook County, their tease was that a prosecutorial-misconduct case comes back on the average of once a month over the past 20 years. The fact is, in 1997 it was six cases. In ’98 it was eight cases. One is too many. You strive for perfection. But the reality in this game is you’re never going to reach perfection, because the law is always changing, different judges have different tolerances, and people do make mistakes–even prosecutors.

“That brings me to my major point. ‘Prosecutorial misconduct’ implies deliberate wrongdoing. The series mentions deliberate wrongdoing that has occurred. But prosecutorial misconduct also covers honest mistakes, honest differences of opinion. So of those eight that I mentioned were kicked back last year, we submit that they were virtually all honest mistakes, differences of opinion, nothing like the heinous kinds of misconduct that the series alludes to.”

Reporters Ken Armstrong and Maurice Possley did more than allude. They got right down to it. Benjamin noticed that the first sentence of their five-part series, “Trial & Error,” began with the words “With impunity.” Said Benjamin, “Right there you know the tone.” In Devine’s office, he insisted, “anyone who’d deliberately engage in this stuff would be bounced on his or her ear in a minute.”

Here’s what Armstrong and Possley wrote. “With impunity, prosecutors across the country have violated their oaths and the law, committing the worst kinds of deception in the most serious of cases.” They also wrote that since 1963 “at least 381 defendants nationally have had a homicide conviction thrown out because prosecutors concealed evidence suggesting innocence or presented evidence they knew to be false. Of all the ways that prosecutors can cheat, those two are considered the worst by the courts. And that number represents only a fraction of how often such cheating occurs.”

The Tribune also quantified the problem by counting criminal convictions reversed in Illinois since 1977 for any kind of misconduct. As John Callaway observed during a Chicago Tonight panel discussion of the series, the newspaper mixed apples and oranges–local numbers for misconduct broadly defined and national numbers for misconduct narrowly defined. An overaggressive summation in a burglary trial doesn’t compare with evidence concocted to send an innocent man to the electric chair. And there was another context the Tribune failed to provide, though this one the paper acknowledged. There’s no reason to think those 381 defendants were the only ones wrongly convicted. Sixty-seven of them had sat on death row. How many wrongly convicted defendants sit on death row today? How many wrongly convicted defendants have already been executed? Of course, the Tribune has no idea.

It’s the power of these questions that justifies the series. Armstrong and Possley’s most compelling finding was that prosecutors–though things might be different today in Cook County–get away with misconduct, even after they’re reversed. The kind that convicted the 381 was declared by the U.S. Supreme Court “to be so reprehensible that it warrants criminal charges and disbarment. But not one of those prosecutors was convicted of a crime. Not one was barred from practicing law. Instead, many saw their careers advance, becoming judges or district attorneys. One became a congressman.”

In other words, society enables corrupt prosecutors by condoning their excesses and rewarding them. One example of this tolerance is the Tribune itself. As I’ve pointed out before, the Tribune talks the talk, asserting in 1995 that “none of those involved in the [Rolando] Cruz prosecution deserves ever again to enjoy a position of public honor or trust.” But when the chips are down it stops being categorical. The same editorial had placed attorney general Jim Ryan, who’d been state’s attorney in Du Page County for two of Cruz’s three prosecutions, at the top of a list of “those who did wrong or were derelict [and] must be held to account.” Yet last fall the Tribune endorsed him for reelection. Robert Kilander, now a circuit judge, is actually under indictment for his role in the prosecution of Cruz. Stunningly blase, the Tribune endorsed him last year for retention, on grounds that “he is entitled to the presumption of innocence” and, what the hell, would have to leave the bench anyway “should he be convicted.”

Ultimately, the important context the Tribune brought to its investigation was the Tribune. Just as William Kunkle placed misconduct in a new frame of reference by bringing indictments against the Du Page prosecutors, the Tribune defined it as a social problem a conservative newspaper can comfortably decry. Heretofore, despite high-profile scandals such as Cruz and the Ford Heights Four, despite the press’s cherished Call Northside 777 tradition of championing the falsely accused, no dots had been connected, no pattern named.

No doubt Benjamin is right that prosecutorial misconduct is less rampant than the Tribune made it seem. But it’s the press’s forgivable penchant to overstate society’s ills once it decides not to ignore them.

The next round of journalism should dig into why some prosecutors behave that way. Here are some reasons that might be worth looking into: Because most defendants are lying scum, pure and simple, and as soon as you meet them you’re itching to get them off the streets. Because what you know is always a little larger than what you can prove. Because most juries want so badly to convict that empathy and reassurance will do instead of evidence. Because to the desperate families of the maimed and dead you are the only hope of justice, and their idea of justice is revenge.

Because the dignity of the state is an immense burden that leaves little room for second thoughts. In a Sun-Times interview before he left the governor’s mansion in 1991, Jim Thompson was asked what he thought about Gary Dotson. Dotson was the convicted rapist who’d spent six years in prison when, in 1985, his supposed victim repudiated her accusation. Thompson, once the biggest prosecutor in town, grilled the recanting victim on national TV, declared he was more certain than ever that Dotson was guilty, but commuted his sentence to time served. In 1989 DNA tests showed the semen on the woman’s underpants couldn’t have been Dotson’s but might have been her boyfriend’s, and a judge threw out the rape conviction. Thompson told the Sun-Times, “I still feel he did it.”

Art accompanying story in printed newspaper (not available in this archive): E. Ratcliffe Anderson Jr. uncredited photo.