Disease Proof

Chattin' with Tara Parker-Pope

Like I said Friday, I convinced—and by “convinced” I mean begged and groveled—New York Times journalist and blogger Tara Parker-Pope for an interview, and, she said yes! So, without any further ado, here’s the blow-by-blow. Take a look:

About being a health blogger...
Me: Okay Tara, as a blog-nerd, I got to ask. How did Well come to be? I know it’s a very young blog.

Tara: The Times has created a great new health vertical, which offers readers extensive health reference information, special reports and a way to research their health questions. The overall effort to increase the amount of consumer health information the paper provides readers includes Well, a new consumer health blog, which we launched in late September.

Me: Very cool. How did you land the lead-blogger job?

Tara: I was the Wall Street Journal health columnist for the past 8 years. I was looking for way to expand my job beyond print and onto the Web. I had been discussing various ways to do that at the WSJ. Then I got a call from the Times and learned of this opportunity. The Times website is the best news website out there, in my opinion. To have the chance to develop a new health blog, plus write for Science Times—it was my dream job. I loved working for the WSJ, but The Times is just a much better platform for the kind of consumer health journalism I want to pursue.

Me: I agree with you about The Times being the best, hence me swooning over you to get this interview. So, how do you like being a fulltime blogger?

Tara: Well, it's quite busy. In addition to blogging, I also write a weekly column for the paper and am developing other stories as well. But what I love about blogging is that it creates an entirely new relationship with the reader. Readers are smart; they take your story to a place you might never have imagined it would go. I see blog-posts as conversation starters and I'm always amazed and impressed by how much readers have to contribute to the discussion.

Me: So, I bet you find yourself obsessively checking comments all day...and night?

Tara: I do moderate comments at all hours but that's because it's a big job. If I let it go too long, they build up and it's tougher to moderate them. Some days are busier than others, but it's not uncommon to check in and find 30 or 50 comments waiting for me. And readers like to see their comments posted quickly. I try to make that happen as often as possible.

Me: Totally. Keeping up with comments is huge, if you don't people get annoyed. So how do you decide what to blog about it? Spend a lot of time reading newswires and RSS feeds?

Tara: Actually I don't do the newswire or RSS feed route. I get ideas just as I always would for reporting news stories. I read medical journals, talk to doctors, talk to people, read magazines, live my life, etc. It's amazing how many ideas come to you just from talking to people. And of course, the medical journals offer a steady supply of ideas. The challenge is finding things everybody else hasn't already written about.

Health news, health issues—they are everywhere. Dr. Phil blabbing about Britney got me thinking about privacy rules and HIPAA, so I did a post on it. Another example, a woman I know had a stroke which resulted in a post called When Doctors Steal Hope.

That got tons of reader comments and I think resonated with readers because it was about real life. A great blog post is one that is about an issue that people can relate to, something that affects every day life.

I love to read stories about life on the frontiers of medicine, but I don't write them, and that's not what the Well blog is about. It's about the everyday decisions we make that affect our health. I do look for a variety of topics—nutrition, weight, aging, kids. And I look for things that are quirky or interesting. I just did a post called The Midlife Crisis Goes Global.

It's just interesting and oddly reassuring that being bummed out in midlife isn't a uniquely American experience. Everywhere, people in middle age are miserable, apparently.

I do write about medical things—breast cancer, prostate cancer surgery, MRSA—but again, issues that people can relate to on some level.

Me: Wow. Great examples! You just answered my question of what makes good blog-fodder for Well. Okay, next question. What surprises you the most about being a health blogger? What have you encountered that maybe you didn't expect?

Tara: I have been surprised and pleased by the amazing reader interest in health. I had no idea my blog posts would end up generating so many comments. That's very gratifying. I've always believed readers were smart, but I have been impressed by some of the really thoughtful comments the blog has generated.

I think a good blog post with lots of comments can actually be more informative and comprehensive than a traditionally-reported news story. I hadn't expected that. One good example is a post I did on sex after prostate surgery. The reader comments were amazing; the stories readers had to share were so poignant and heartfelt. I never could have provided that kind of information in a straight news story.

I had no idea, after spending 20 years in journalism, how fun, interesting and invigorating this new relationship with readers would be.
Hormone therapy...
Me: Indeed! You tend to get good comments if you provide good blog posts. Okay, that’s all the nerdy blog stuff I had, time to talk health. I see you’ve written a couple of books. So I’m assuming smoking and hormone therapy is an interest of yours. Let’s start with hormones and your book The Hormone Decision. What would you tell a menopausal woman facing the hormone decision?

Tara: I have spent the past five years really taking a close look at the available data on hormones, and that is what my book, The Hormone Decision is about. The bottom line is that there is no single answer for a woman coping with menopause. Hormones are not good. They are not bad. They are just a medical option for women at midlife. And for a woman experiencing extreme symptoms that are hurting her quality of life, I believe the data show that the benefits of hormones in that situation outweigh the risks.

Me: Gotcha. And how has your book and work on this topic been received by the medical community at large?

Tara: Very well actually. My goal has never been to take a position one way or the other but to make sure women were getting accurate information. I've had many doctors and people from women's health groups tell me they appreciate my effort to remove the hype and hysteria from the debate and just give women the facts.

In the end, that's why my whole career as a health journalist has been about—trying to give people accurate information so they can make informed decisions about their health.
Me: I think that is very important. Women need a clear and concise voice of compassion and reason on this issue. Alright, we are half way done. Switching gears a little, your other book, Cigarettes: Anatomy of an Industry from Seed to Smoke, is about smoking. What would you say to a young child when they ask or get curious about smoking?

Tara: I wrote about smoking as a business reporter—I was fascinated by the image of “Big Tobacco” on the ropes with all the state attorneys general suing, plaintiff's lawyers, etc. It wasn't true. Meanwhile, I was looking at earnings reports showing that these companies were pretty much just printing money. So that was the focus of my book—not really health, although the health issues certainly did have an impact on the industry as a whole.

I recently wrote a blog post about kids and smoking. I was watching America's Next Top Model with my daughter and the contestants had done a photo shoot showing the ravages of smoking (In a story for the WSJ, I once railed on America's Next Top Model for showing the models smoking when the show is widely viewed by young girls. They banned smoking among the contestants the next season).

But the photo shoot had a huge impact on my daughter. She had heard me say many times that smoking can kill you, but she was kind of amazed at how ugly it made the girls. There is research to support the notion that you have to target health messages to kids a different way.

Me: For sure, kids aren't just mini-adults.

Kids don't care too much about disease and death, but they care about things they understand—friends, the way they look, the way they smell. I think the best thing parents can do to keep kids from smoking is not smoke themselves. That is huge.

And I think they need to emphasize just what a disgusting habit it is, that it can give you wrinkles, ruin your sports performance on the field, etc.
Being a mom...
Me: Smoking is a hot button issue for me too. Now, since you touched on it, how did becoming a mom change the way you go about your work?

Tara: I think being a parent has changed the way I view health. I think before kids I just thought of it in terms of the basics—weight, getting a physical, etc. Now I view almost every decision I make as one that impacts the health of my family. The foods I eat and whether I exercise is a powerful influence on my child's behavior. Do I sign her up for gymnastics, where there is a lot of standing around, or opt for dance classes, where they move constantly. When I bought a car, I looked for a model with a zillion airbags. A healthy life for me and a healthy life for my child are influenced by 100 different small decisions I make every day.

And the fact that I have a school-aged child does influence the topics I choose to write about. I have a category on my blog called Family Matters--I do a lot of stories on kids, teens and health.

Me: Dr. Fuhrman would applaud you. That’s fantastic! You and the little one should try Yoga.

Tara: You know we haven't done Yoga for a while, but I did organize a yoga class for her preschool. I brought in a yoga teacher for six sessions or so to teach the kids the fun Yoga moves.

Me: Awesome! We should practice together someday.

Tara: Well, I should add that just because I write about health and believe in the power of small decisions, that doesn't mean I'm perfect. I struggle just like everyone else. The hardest thing for me is finding time to exercise. So of course, I blogged about my decision to buy a new elliptical machine.
A problem with health journalism...
Me: Totally, ellipticals are great. In fact, if I had been smart and used one. I wouldn't have a knee brace and heating pad on my knee for the second day straight. Relax folks, I’m all better now. Alright, back to business. What health issue is sticking in your craw lately?

I think it's important that we, as journalists, not act as if the latest study is the best study. There is a tendency to do this in my business and I'm sure I've been guilty of it from time to time.

We saw this with the Women's Health initiative and hormones—this tendency to throw out all the data that came before it. That was a mistake. We need to look at new research in the context of whatever came before it.

A bigger issue probably is the issue of absolute risk versus relative risk. It's so easy to talk about a 20% increase in risk without giving the context. We can't do it every time but whenever possible, it's important to tell readers what a number means to them. So when everybody was writing about a big increase in breast cancer risk due to alcohol consumption after a study came out last fall—I thought it was important to say what that really mean to women.

There was a Kaiser study that reported a 30% increase in breast cancer risk associated with three drinks a day. I made the following point: But before you panic, remember these scary percentages translate into very small risks for the individual woman. A typical 50-year-old woman has a five-year breast cancer risk of about 3 percent. If her risk jumps by 30 percent, her individual risk is still only about 4 percent.

I think we need to try to make the distinction between relative and absolute risk as often as we can. I don't do it every time, often because the data aren't easy to come by, but when a finding has the potential to alarm, then I think we really need to work hard to give readers the context and perspective they need to make sense of it and frankly, absolute risk should be standard in every medical journal abstract. It annoys me to no end that the medical journals don't do this every time.
Me: I feel your passion. Hey, what do you think about the reports linking the raise in allergies to insufficient breastfeeding?

Tara: I don't know enough about the data but there are so many things going on environmentally that I find it tough to believe any one thing can be blamed. I think it’s important not to judge women for the choices they make or men for that matter either. Instead the focus should be on providing information about the benefits of breast milk and making it easy for women to continue to nurse "in the real world.''

It was amazing to me when I was in the hospital with my daughter how often some of the nurses tried to stick a bottle in her mouth. The thing is, the health of our kids is the cumulative result of so many decisions we make. If someone didn't breast feed they aren't to blame for their kids' allergies and just because a woman breastfeeds, doesn't mean she gets to stop worrying about nutrition for her children.

My point is, we are bound to get some things right and do a few things wrong the goal is to just get it right most of the time.
Feeding her family...
Me: Sounds like my dating history. Okay, are you ready for a tough one? How do you keep your family eating healthy?

Tara: It is a struggle. I am so busy. Convenience foods are such a temptation and I confess I often use them. I just try to buy organic, look at labels, pay attention to portion size all the things you're supposed to do but mostly, I don't want to obsess too much.

I think Michael Pollan makes a good point when he notes that this culture of nutritionism has taken much of the pleasure out of eating. Now when I put salmon on my plate in the cafeteria I swear I think to myself "mmm, omega 3s..." There's something really wrong with that.
Jessica Seinfeld's book...
Me: No way! You're talking to a guy that makes vegan brownies with spinach—you're totally normal!

Let's talk about that Jessica Seinfeld book, “Deceptively Delicious”, it is one of the single worst things to happen to childhood nutrition ever.

Me: You are so right! Healthy eating is not about tricking kids.

Tara: This idea that we have to hide vegetables from our kids is so wrong. Our job isn't just to inject nutrients into their little bodies. It’s about teaching them about healthful eating. Why are we so puritanical about vegetables, serving them steamed and flavorless? We make our good food taste really good. We should make our good-for-you food taste really good too.

Me: Awesome. Thanks so much for doing this Tara. I really appreciate it.

Tara: By the way, I read your story. Very inspirational, makes me realize I need to get moving.

Me: Thank you so much. It took a lot for me to publish that story. You never think you're going to be a "success story."

Okay, I won't keep you any longer. Thanks again. Please keep in touch, this was really great. I am honored.

Tara: Thanks. Back to blogging. They are probably wondering what happened to me, and, don't be honored, because it's nice that you were interested. Thanks.

Me: Peace.
So there you have it. Thanks again Tara! I know, that officially makes the 100th time I’ve thank you, but thanks—101! Now, to keep up with all the interviews—yes, there’s more to come—just check out DiseaseProof's interview category. Peace.
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