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Personal story helps illustrate physiological effects of stress Date: 01/14/14

Dan Gorenstein

The idea that chronic stress can change how your body and brain work fascinated Dan Gorenstein, a radio reporter at Marketplace, and it sparked the idea for an affecting, memorable piece about poverty and health.

The report pivots on the story of a woman with a troubled past and a painful confession. How did Gorenstein find her, and persuade her to go public? How did he balance her interests with his potentially conflicting interest in pursuing a good story?

The piece also distills a lot of complicated research about chronic stress, decision making and health. But it remains a tight, fast-moving narrative. Here’s how Gorenstein did it. 

By Joe Rojas-Burke

Q: Where did you get the idea for this piece in the first place, and how did you start the reporting?

A: This story came about through a confluence of events. This past summer my editors and I decided to follow Camden, N.J., as the Affordable Care Act unfolds – how does the new law affect doctors, hospitals, patients, local businesses and insurers. As I was making the rounds, introducing myself to people in the city and doing some recognizance work, a few people kept talking to me about toxic fear. I had never heard the term, but it reminded me of a beautiful piece written by Moises Velasquez-Manoff that had recently run in The New York Times. I put two and two together and started working the story.

To begin the reporting, I informally interviewed a few of the people who had introduced Camden to the idea that chronic stress can take a biological toll on people that has both short- and long-term impacts on people's health. My next step was to get in touch with Velasquez-Manoff. He was generous enough to supply me with a short list of leading researchers in this area. As I finally got a grasp of the story, I began a series of on-the-record interviews.

Q: Your report opens with the story of a woman who reveals terrible secrets. She endured sexual abuse as a child, and years later abused drugs while pregnant. Her narrative is crucial to the effectiveness of the piece. How did you find her and persuade her to open her life to public scrutiny?

A: The Camden Coalition of Healthcare Providers – a nonprofit in Camden working to reform health care – introduced me to Elizabeth Philkill. I've been a reporter since 2001 and these sorts of introductions often are helpful. First, organizations on the ground have relationships with people and often are sensitive to who is willing (and able) to talk with reporters. Beyond that – and this gets at the question of why Ms. Philkill decided to speak about her life publicly – is that Ms. Philkill doesn't know or trust me. But she does know and trust the people who work at the Coalition. So getting their endorsement opened the door for me to make my pitch.

When it comes to asking someone to share intimate and painful experiences the first thing I do is explain my story, where I think it's headed, what I'm hoping to accomplish. This is all off-the-record. To my way of thinking, people deserve to know what they are getting into. The more they understand the point of the interview, the more they can make an informed decision about their participation. The other thing I've learned over the years is that it can be helpful to have other people in the room. Ms. Philkill had an old friend and two people from the Coalition sit in on our interview.

Ms. Philkill agreed to the interview because she hoped by sharing her experiences, others could benefit. Quick aside – as a reporter I am completely blown away by this act of generosity and compassion. Over the years, many people have granted potentially difficult or emotionally painful interviews because they want to help someone else. Reporters get to see that humanity up close and it's one of the privileges of my job.

Q: How do you respect the interests of such subjects when disclosing sensitive personal events in a story?

A: Being so transparent about my story is how I try to respect the interest of my subjects. That way, when Ms. Philkill or another source agrees to talk, I have some confidence they are comfortable with our discussion and understand what may be said will be included in the final piece. Also when I wrote about Ms. Philkill's experiences, it was in a simple, matter-of-fact way. I'm very careful to avoid little flourishes of language. Depending on the nature of the story, I will fact check for tone as well as for facts.

Q: Did you interview others and narrow it down to the one who appears?

A: I did do two other interviews – but given the length of my story and the strength of Ms. Philkill's interview, I decided the story would be sharper if we focused on Ms. Philkill.

Q: You cover a lot of ground in a very short amount of time. How did you organize your material to make it fit into a tight, fast-moving narrative?

A: Two things. Elizabeth Philkill was fearless in sharing her story, which allowed me to open the piece with a strong clear anecdote that I believe grabs the listener/reader's attention. Second, my editor Betsy Streisand. She is great. Seriously. There were multiple revisions and we kept working them down. My first draft was at least twice as long. The best advice my editor gave me for this story was to slow down and focus on one point at a time. So I tried to break up the story into its individual parts and then put it back together again. I know how easy that makes it sound, but it's very hard to do, especially when you are so close to the material.

Essentially the idea was to give the idea of toxic stress a human face by meeting Elizabeth Philkill, describe the science behind the phenomenon, how toxic stress impacts people in daily life, what clinicians are trying to address the problem and loop back to Philkill to close out.

Q: Several experts appear in the piece, each of them contributing solid quotes and revealing perspectives. How did you choose the experts, and did you interview others and eliminate all but the best?

A: Perhaps to the irritation of my editor, I talked to a lot of people. There are one or two other experts I still wish I could have included in the story. While I've done very little print reporting, print can carry the weight of lots of experts. In radio, I think the best pieces are more of a blend of experts and "real people." If you end up with too many talking heads and not enough 'story' the piece often bogs down.

Dan Gorenstein is the senior health care reporter for the public radio business show Marketplace, covering the business of healthcare. Prior to Marketplace, Gorenstein spent more than 11 years at New Hampshire Public Radio. He got his start in journalism at the Chicago Reporter; an investigative journal that examines race and class disparities in Chicago. He’s won numerous national and local awards, including the Society of Professional Journalist Sigma Delta Chi investigative reporting award.