Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
In Reply: Although I appreciated Dr Swenson's
teaching and clinical insights, his criticisms of the story bear little relation
to the larger issues of cultural sensitivity and end-of-life care that the
Swenson complains that the story is written as a first-person account;
no such event took place during our week in the Arctic. However, this does
not mean that such events do not occur in the village I was writing about.
Several residents and patients in Nome related similar stories throughout
my 5-week stay. As I wrote the story, I was aware of the need to condense
events to present a formalized and palatable essay—one that would raise
the pertinent issues of medicine and cultural context in a readable format.
This was necessary to protect patient confidentiality and falls well within
the limits of artistic license. Swenson himself acknowledges both these needs,
stating he understands the need to alter events ". . . to make it a better
story." Thus, the ultimate purpose of the story was hopefully served, and
the medical community can concentrate more on end-of-life issues and less
on stylized writing.
Shah SI. A Story About Suicide in the Arctic—Reply. JAMA. 2001;286(8):919. doi:10.1001/jama.286.8.915