"How I Got That Story"

Interview by Sarah Fenske of the LA Weekly

SARAH FENSKE: This was such an interesting story – and it was fascinating how far out in the boondocks it took place. How did you first get interested in it?

SAUL ELBEIN: So, this is funny: I actually first learned about it in the New York Times. After the nurses sent in their complaint about the doctor and got arrested, they hired a lawyer who was really media-savvy. The lawyer was connected to a former editor at the New York Times – this really tenuous connection, but, one of the things he realized was that this thing was going to disappear unless there was some national scrutiny. So the New York Times did, I think, one story, and I came across it and almost dropped the paper. How could this be? I was figuring that somebody was going to do a long feature on it, but no one did. There were a couple of short updates, but I started playing phone tag with the lawyer and thinking about the possibility of a story. Almost a year later, I managed to set up an interview. It was one of those places where other people had covered it, but nobody had done it as a long story. It took almost a year to get the interview then – at what point in the story were you able to finally dive in? The trial happened in February, and I called the lawyer then – but I don’t think I talked to him until December. So they had already been acquitted. You were a freelancer at the time. In light of the fact that this was far from the big city, and it had already been covered in a few outlets at that point, was it hard to sell the Observer on the piece? No, not at all. And the truth is, this is one of the stories that was so relevant, so immediately appealing – everybody seemed to like it. I did a version for This American Life, too, and that was the same thing. I pitched This American Life and had a response from them within 12 hours. The Observer didn’t really care that somebody else had broken the story first. To them, that only made it stronger. I mentioned to them that I was doing the This American Life piece, and they said, “Well, do you want to do a piece for us, too?” I ended up doing the Observer piece first, because at This American Life it takes forever to get anything done.

One of my favorite things about this story was the portrait of Kermit, Texas. I thought your opening section was great – it gave such a sense of place, of this interesting town in the middle of nowhere. How much time did you have to spend out there to achieve that level of understanding?

I spent a week in Kermit, which I would not recommend. I spent a long time out there – there was really nothing to do, so at night I would just drive for an hour in some direction. I heard there was a giant crater or sinkhole or something – I drove around trying to find it. I finally got to the chain link fence around this giant pit, which I couldn’t see into because it was dark in the West Texas desert. When people would ask me why I was in town, I’d say I was there to see the giant crater, which obviously wasn’t true, but saved me from having to get into, “Oh, I’m here to look into the most embarrassing thing that’s ever happened in your town.”

Do you think being there a little bit undercover, then, helped you get a clearer picture than if you’d charged in and said, “Hey, I’m here with the big-city paper?”

The truth is, I wasn’t undercover. Kermit is so far off the main roads, you don’t go to Kermit unless you mean to be in Kermit. You don’t get there by accident – it really is impossible. That’s an interesting question, actually. I think it actually did help to be able to sit around and watch what was going on. But that was mostly setting. There wasn’t any aspect of the actual story that I was undercover about, or that I got by being a fly on the wall. I felt like I spent all this time hanging out in Kermit, just being bored, that later became useful when I was trying to create that sense of place and that opening section. The two nurses who were the main characters in this story: Was it hard to get them to open up? I got them to agree by rendezvousing with their lawyer for months. But I think what you’re really asking – when I was sitting down with them, I was trying to get them to tell me a story. And they’re not writers. They didn’t think of things the same way that I did. I was asking them these questions about what happened, and they wanted to tell me, “This was the procedure in the hospital, here’s how he violated procedure, and we were interested in procedure.”

Not really a compelling narrative.

Exactly. And my mom’s a nurse, so I know this way of thinking about things. But getting them to open up about what they thought were the issues wasn’t the same as getting them to open up about what I thought the issue was. To them, the reason they disagreed with the doctor wasn’t this epic story – it’s that he was doing these procedural things that they thought were wrong. There was sort of a disconnect the first couple of times we talked.

And were you ever able to bridge that?

No, I don’t think I ever did bridge that. I wrote, and rewrote that piece, numerous times. And one of the things that they kept wanting in there – there was some shady stuff at that hospital. Borderline fraud; maybe actual fraud. It took having a good editor to say, “No, that’s not what this story’s about.”

So they wanted you to do more of an investigative piece about what was going on with this hospital, and less the human-interest piece you ended up writing.

Yeah.

Were they ultimately happy with the story, or disappointed that you weren’t able to get into all the fraud and the other things that consumed them?

Their feelings were mixed. They were happy there was coverage. But there were some things I got wrong – not big things, but messing up the chronology of certain things, and getting a couple procedural things wrong, and that bothered them. But in the end, they liked the piece.

As you said, they were nurses – they care about procedure.

To sum it up, the things that made them good nurses made them difficult subjects.

The story was fascinating in that the nurses were prosecuted, and there’s a verdict in their favor – but then there’s this crazy twist at the end where the sheriff, and the doctor, and the county attorney, and the hospital administrator all end up being charged criminally by the state attorney general for their role in going after the nurses. I was stunned by that.

When I went out there, none of them [the hospital administrators and local law enforcement] had been tried yet, but they’d all been served with various indictments. I met the sheriff and the doctor while I was in Kermit, but none of them would talk to me on the advice of their lawyers. Which was a real shame – if I’d been out there before they were indicted, I think they would have been glad to shoot their mouth off.

Were they willing to talk to you on background, or sit down and shoot the shit off-the-record?

You know, I wasn’t – I’m 24 years old now. I haven’t been doing this long. The learning curve I’ve experienced over the last few years means that, when I was out there two years ago, I don’t know that I knew enough to suggest we do that. I just didn’t know to do that. I did talk to the doctor, a bit, at the hospital. And actually meeting him helped, in the same way that being in Kermit for awhile helped. He didn’t seem as if he had any boundaries. He had to know why I was there – a stranger at a hospital board meeting; it was clear I was with the press. I talked to him for a couple minutes and then there was this moment where I turned away. And he put his hand on my shoulder, and leaned in really close, and told me that my fly was down. It was this really intimate moment that was really creepy. It was almost the way people describe sociopaths – so present and so charismatic, it creeps you out. That never made it into the story, but it definitely colored it. Whether he was a bad doctor was almost beside the point. It was really about the overreach. As a doctor, you have to submit to the medical board. If there’s a complaint, even if it’s spurious, you have to wait for them to investigate it.

You can’t just get the person who filed the complaint arrested.

Right. So that’s part of it. The other part of is that, it came out that he actually had a history of really awful practice in a bunch of different counties. He had this pattern of working his way through these small towns, peddling these questionable remedies, and people got hurt. And then getting in trouble with the medical board, or the city powers that be, and leaving town and moving on to some other place. He also had a history of becoming buddies with the town law enforcement and getting them to help him. You read through this and you think, how did they think they could get away with this? But the truth is, had any of the particulars of the case been a little less appalling, it probably would not have achieved national attention, and they probably would have gotten away with it.

Frankly, it sounds like if the nurses had gotten some local lawyer instead of somebody who was media savvy and had connections, this thing could have just gone away.

They had a really good lawyer. And it’s funny: Before I did this story, I never thought of that as a factor in how these cases get tried.

On that note, you mentioned you were 22 when you wrote this story, and that there were things you didn’t know then – reporter tricks – that you know now. Do you think you would write a different story if you were doing it today, with the extra two years of experience you have now? Or do you think your naivete, your lack of cynicism, was actually a help?

I’m sure I would write a different story. I can’t say it would be a better story – but any story you write at any point in your career, there’s as much you in the story as there is the story itself.

That wasn't meant as an indictment. The fact you did this when you were so innocent, and that you were looking at it so wide-eyed, may be one reason the story turned out so well.

I think there’s some truth to that. You know, as I work on stories that grab me, one of the ways I process the story is I’ll talk to my friends, and I’ll take the most salacious details and I’ll drop it on them, to work through the ledes or the key moments. And here I said, “There are some nurses in West Texas, and they tried to report this bad doctor, and they wound up arrested,” people would be like, “Oh, of course, smalltown Texas.” And I’m like, “No! That’s not the right reaction. We should be appalled, because this is appalling.” I think that was a non-cynical response on my part – that’s an idealistic response. And I think I’m less idealistic now than I was then.

You also did this piece for This American Life. What was the big difference between trying to do a big, complicated, fascinating story like this for radio, versus doing it for print?

In radio, there is no possibility of working around or massaging quotes. For the print piece, I probably interviewed each nurse a half-dozen to a dozen times – some of them quick calls to follow up, and sometimes they’d turn into 30 minute conversations where I really wanted to get off the phone because I didn’t want to talk hospital procedure any more. With This American Life, we had one shot. We were out trying to collect their stories, and it really had to be in their voices. And that’s when it really hit home for me that these people thought about narratives in a different way than I did. We’re sitting there in people’s homes and offices trying to get them to tell the story in a way we could use – which meant we’re asking them to tell the story over and over. I found that the way to make people comfortable with that was almost to turn it into a collaborative procedure: “Now can you tell it and change this detail a little bit? Now can you tell it and maybe play up this bit?” It was a little bit more theatrical – I was going to say a little bit less pure journalism, but I guess I mean that the tricks you use are different. The artifice is in a different place.

Do you think you’ll ever do radio again?

I would work for This American Life again in a heartbeat. Aside from the prestige and the fact they pay well, they’re great people. But there’s also – it’s harder to do, but when you get that quote, when you have somebody explain in their own voice what happened, and it’s the first time they’ve ever told it that way, and they know that, you share this moment that’s not possible in any other medium. It’s one of the things that makes radio so powerful.

One last question for you. You mentioned your mother is a nurse – what was her reaction to the piece? Did she read it, and, if so, what did she think?

This is a funny story, actually: The first comment on the Observer piece is from my mom.

Please tell me it was a positive comment!

Oh, yeah, it was positive. Bless her heart, she doesn’t quite understand quite how the comment system works: That when it asks your name, it’s going to attach your name to your comment. So the first comment on the Observer website is, “On behalf of nurses everywhere, I think Saul did a great job – Rivka Elbein.” Interview by Sarah Fenske, L.A. Weekly