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Persistence and community champions open doors for series on COVID-era amputations

Persistence and community champions open doors for series on COVID-era amputations

Picture of Eli Cahan
Vascular surgeon Sammy Siada prepares for an amputation procedure.
Vascular surgeon Sammy Siada prepares for an amputation procedure.
(Photo via Eli Cahan)

One Tuesday in July, I received the invitation I’d been hoping for. 

After months of calls and meetings and emails and texts — not to mention nudge after nudge — Dr. Sammy Siada, a vascular surgeon at UCSF Fresno, had a procedure that fit all the discussions we’d shared. Clear things with PR, Siada said, and I’d love to have you there.

The offer was an absolute godsend. Because while from the second I’d pitched the story for the fellowship I knew exactly what it should look like — getting the story was a whole other ballgame. 

One of the most important elements I wanted to include in the story was an amputation itself. The word “amputation” — though meaningful and jolting — is abstract for most. Yet as any amputee will tell you, the process of having a dusky, rotting, gangrenous limb cut off to avoid the damn-near inevitability of sepsis and death is anything but abstract. 

So if I wanted to tell a story about those who lost a piece of themselves due to a toxic brew of illness and circumstance — about what they’d faced before and after — I’d have to show them losing that piece of themselves, too.

But as I would quickly learn, a combination of stigma, privacy, and timing made attending an amputation in person a real challenge — something I implicitly understood, but not something I practically considered until the challenge stared me down in the course of reporting. For example, many amputations — even for those known to be at high risk — take place in emergency settings, where finding consenting patients for participation in a story is either impossible, unethical, or both. 

Of course, hospital visitor restrictions during COVID-19 didn’t make things any easier. How would any institution stand to gain by allowing a potentially infectious journalist into an operating room to witness and document a procedure that represents, in some ways, the shortcomings of this country’s health system — particularly, as it relates to communities of color?

To put it another way: Sheri Fink is one thing. But a cub reporter from New York?

In hindsight, my answers to those questions of why an institution should grant access could have only gone so far. And that’s why community champions like Siada — who had both the trust of their networks and institutions, as well as the vision to see the value in getting the word out on what amputees were enduring during the pandemic, were so crucial. Without them, transforming public health statistics into human narrative — at least, where amputations are concerned — might have been an insurmountable challenge.

Part of the challenge, then, was finding the right champions.

From the outset, I covered the basics, emailing major patient advocacy organizations like the Amputee Coalition and treatment providers like Hanger Clinic. Of course I’d heard about the mythical “churches and diners” form of shoe-leather reporting, but perhaps out of laziness — using pandemic precautions as an excuse — I’d put it out of the question. “I’ll be fine just emailing the experts,” I’d told myself. But, for various reasons, the “info@” emails didn’t get me very far. 

So, a couple months into the reporting, I simply hadn’t made much progress. That’s where persistence — and creativity — came in.

I had to widen my sourcing aperture and personalize my methods: The Google-able organizations — and their inquiry boxes — just weren’t cutting it. So, I shifted my strategy from groups to individuals, and expanded my “search engines” to include the academic literature as well as social media. (Not to mention, I took the advice of a grizzled mentor and started calling, rather than emailing.)

I spent early mornings, late nights, and weekends combing through PubMed, where I discovered perspective pieces that helped me identify the experts whose vision matched what I was curious to explore, cohort studies that asked questions I was asking, and case reports that featured patient narratives I was keen to learn more about. 

Providers from California to Illinois to New Jersey wrote me back (even if it took a few emails), eager to share what they’d been noodling on. We spent hours on calls and Zooms, after which a few were gracious enough to write patients to ask if they’d participate. Such gestures took me on road trips to Fresno and Long Island and were critical in leading me to folks like Leafer Miller and Anthony Sambo. Some also acted as liaisons between me and their institution’s data team — allowing us to quantify their intuitions and include quotable statistics (as well as data visualizations) in the story.

I also spent what seemed like all waking hours interacting in patient social media groups, which provided another massive groundswell of support for the investigation. 

After group leaders were considerate enough to allow me in, I reached out to those who posted their struggles and triumphs, pictures and pep talks. Americans from all walks of life and all corners of the country — New Hampshire to Texas, Ohio to Oklahoma — understood that their stories could make a difference and were happy to share. 

Plus, many had three friends and a grassroots leader I should talk to. Many were generous enough to share those connections. Sean Harrison, the charismatic and relentless voice of AmpLife talk radio, as well as Shelly Baxter-Wetmore, the charming and indefatigable matron of an amputee support group, were invaluable hubs within extended networks. They were wellsprings of passion and companionship throughout the investigation as well.

Above all else, I felt extremely fortunate to develop the sources I did. While my persistence potentially got my nose in the tent with the right people, it was their fire, fury, and grace that allowed us to take this story out of speculation and abstraction into specificity and lived experience. Rather than hand-waving and buzz-wording about health disparities, social determinants, and social injustice, — their dedication and passion got me into an operating room at an ungodly hour of the morning 3000 miles across the country to show how a young man’s life had been forever changed. 

Even as this investigation is finished for the time being, these are lessons I’ll carry with me in all the future reporting I do.

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