February Editors’ Roundtable: The Milwaukee Journal Sentinel on patients’ rights

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Our February Roundtable looks at “Law creates barriers to getting care for mentally ill,” by Meg Kissinger. In her narrative, Kissinger touches on violence, mental health and 40 years of debates over patients’ rights. The story of Martha Wilson, who feared the violence her son might commit, is paired with that of Alberta Lessard, whose struggle to maintain her own rights went all the way to the U.S. Supreme Court. Part of a multimedia project from the Milwaukee Journal Sentinel, Kissinger’s story was assigned by George Stanley, the paper’s managing editor, and edited by Greg Borowski.

Jacqui Banaszynski
Knight Chair professor, Missouri School of Journalism


On stories that teach and reach:

A cornerstone of effective narrative is to invite empathy through the capture of universal emotion and authentic drama. Meg Kissinger does that here, and with one of the toughest of subjects. Mental illness isn’t something that is easy to relate to for those who don’t suffer from it or aren’t intimately connected to it.

But the real genius of Kissinger’s piece lies in how she uses the narrative not just to evoke emotion, but to teach. Her deep reporting and deft weave of story and context takes readers through an important tour of the history, law, politics, policy and economics of society’s attempts to deal with the mentally ill. It’s a classic example of “teachable moment” journalism – Kissinger uses a compelling storyline to crack open understanding of shared systems. She lays out that aspect of her package with the simplicity that only comes from bulletproof reporting.

I was lured into Kissinger’s piece with the heartbreaking introduction to the Wilson family and the quick reminders of the horrors that played out at Virginia Tech and a Tucson shopping center. Spare use of the right numbers highlighted the enormity of this issue. Then the grabber – a tight but sophisticated “nut” section where Kissinger lays out the contrast between our reactions to physical and mental illness, and delivers a quick litany of “whys” – sets up that perfect hook:
The answer begins 40 years ago on the second-story window sill of Alberta Lessard’s West Allis apartment.

From there I am not just being taken into the tragic story of one family, I’m on a quest – almost an archeological dig through courtrooms and records and memories. Kissinger doesn’t leave us with the frustration of where we are, but helps us understand how we got here. Along the way, she reveals how the best of social intentions that drove the civil liberties movements of the 1960s and ’70s set the table for unintended consequences today. This is the stuff of elite, book-length journalism. Bless her heart, Kissinger gives it to us in the daily fishwrap.

That approach reminded me of two other remarkable works that used intimate stories to teach bigger social truths:

  • In “And the Band Played On: Politics, People, and the AIDS Epidemic,” published in 1987, Randy Shilts went on a hunt for “Patient Zero.” He reported around the world to try to track down the origin of HIV’s sudden spread. (Shilts died of HIV/AIDS in 1994. His book is a movie of the same name.) Alberta Lessard is the “patient zero” in Kissinger’s story, and helps us track the origins of decisions that determine how we deal with the mentally ill.



  • In 1996, The Oregonian’s Tom Hallman Jr. wrote “Children of a Lesser Hope,” a groundbreaking piece on children being raised by developmentally disabled parents. Hallman found a small program for normal-intelligence children who, often by the age of 5, had surpassed their parents’ ability to read, make change and navigate society. This was a subset of children born after society banned the forced sterilization of those deemed incompetent, including those long called mentally retarded. As with Kissinger’s piece, it was a glimpse at the unforeseen consequences of a good social intention.


I could cite other examples. For my lights, this is the best use of narrative journalism. It doesn’t just engage – it educates and enlightens. In terms of service and relevance, it runs parallel to the best of investigative journalism. No matter the story, certain elements are always present:

  • Deep, layered reporting. The sourcing box to Kissinger’s story shows how far she went to get it right.

  • A clear, tight focus. Kissinger doesn’t try to tell it all. Instead, she layers information in support of a primary question.

  • A view of history. Kissinger doesn’t just look at the moment in front of her, but wonders what led up to that moment, and where it might go next.

  • The right, relatable characters. The reader has to feel some genuine connection to the people who shine light on the bigger issue. Kissinger found that in the Wilson family.

  • A disciplined story structure and writing. Kissinger didn’t rely on tricks and flourishes; her elegance is in her simplicity. Not easy to do, but so easy to read.


Tom Huang
Sunday and enterprise editor, The Dallas Morning News


I’m a big admirer of Meg Kissinger’s story on mental illness and the law. It’s a complex and controversial topic, one that can provoke a highly charged debate, especially in the aftermath of the Virginia Tech and Tucson, Ariz., shootings.

Meg tackles the subject with authority, sensitivity and balance. She is an ambitious storyteller, using what I call a “braiding” technique – weaving several storylines together, shifting time frames and moving from one perspective to another.

In my view, this braided approach is not entirely successful, so let me dive into the issues of structure and sequence a bit more.

In “Sequencing: Text as Line,” an essay in “Telling True Stories: A Nonfiction Writers’ Guide,” Tom French urges writers to report and write along a clear, simple line.

“The act of narrative writing is arranging the elements of each sentence, each paragraph, each section, along a line,” French writes. “The skillful writer arranges a line that the reader can follow easily.”

French is not arguing that writers should restrict themselves only to chronological storytelling. But he says that every time a writer diverges from the simple line, there’s the potential for confusing the reader – a new character is introduced, the scene and time frame are different. French asks the writer to think hard before he or she chooses to break the narrative line.

There are often good reasons to break that line, especially in explanatory stories like Meg’s. In “Writing Tools: 50 Essential Strategies For Every Writer,” Roy Peter Clark explains: “The writer tells us a story, then stops the story to tell us about the story, but then returns to the story… Wonderful insights and explanations are hung like pearls on a strong narrative string.”

I don’t think that Meg could have told her story in one simple line. But I do think the story could have been even more powerful by weaving together only the strongest narrative threads. The other material – the other perspectives and anecdotes – could make strong secondary stories or sidebars.

For the purposes of this discussion, I will outline the sequence of Meg’s story here:

  • Introducing Martha Wilson (April 2011)

  • Passage providing context to violence and mental illness, plus details on Virginia Tech and Tucson shootings (April 2007, June 2010)

  • Psychiatrist Jon Lehrmann speaks about tendency for public to look the other way when confronted with mental illness

  • Framing question: Why can’t the public and families do more to make sure the mentally ill get the care that they need and help them and others stay safe?

  • Introducing Alberta Lessard (October 1971)

  • Martha Wilson looks for help for her son Richard (April 2011)

  • Sam Hengel’s story – boy who held teacher and students hostage (November 2010)

  • Alberta Lessard’s court case (Fall 1971)

  • Lessard’s lawyers’ legal strategy and U.S. Supreme Court ruling (1971-1972)

  • Background on anosognosia

  • Aftermath of the Lessard ruling, including Milwaukee County Court Commissioner Rosemary Thornton’s experience

  • The pace of public mental hospitals emptying out accelerates after the Lessard ruling

  • Alberta Lessard’s experience after the court ruling

  • How mental health care is different today, including debate over court-ordered outpatient treatment

  • The experience of several people who survived the Virginia Tech and Tucson shootings, or whose loved ones were killed in the shootings (2011)

  • Pat Spoerl’s story – she has struggled for 35 years to keep her son safe (2011)

  • E. Fuller Torrey’s registry of violent crimes committed against and by people with mental illness

  • Richard Wilson’s violent act (May 2011)

  • Alberta Lessard reacts (May 2011)

  • Lessard’s continuing problems and arrests (Sept. 2011)

  • Martha and Jeff Wilson attend Richard’s court hearing (June 2011)


The strongest narrative threads are the stories of the Wilson family and of Alberta Lessard. (I include Lessard’s court case and the aftermath of the Supreme Court’s ruling as part of Lessard’s narrative thread.)

Each would be a powerful story in its own right. But the two stories also play well off each other – they show how complicated and painful the issues are. And they get to the heart of the central question: Why can’t the public and families do more to make sure the mentally ill get the care that they need and help them and others stay safe?

I would have advocated braiding these two narrative threads together, and interrupting the story, as sparingly as possible, whenever greater context and explanation is necessary.

While there’s value in the passages on Sam Hengel, Pat Spoerl and Rosemary Thornton, I probably would have moved them into sidebars. This would allow the reader to focus on the Wilson and Lessard stories, and move with more velocity toward Richard Wilson’s violent act.

There’s a strong argument for including the voices of the Virginia Tech and Tucson shooting survivors and families of the victims in the main story. Here’s another approach, though: Write a story based on their experience, and then run it prominently alongside the main story.

Some general takeaways for narrative writers, then (in addition to all the things Kissinger pulls off here): Use clean, simple lines whenever possible. Braid fewer narrative threads, not more. Introduce fewer characters and voices, not more. And stop to provide context and explanation, but only when necessary.

 

Maria Carrillo
Managing editor, The Virginian-Pilot


This story could have been written as a straight chronology, beginning in the past, with a woman who thought Richard Nixon was out to get her.

It could have then moved to the present with the story of two mass murderers and why a young man named Richard Wilson didn’t get the help he needed before he turned into a killer.

But the story was infinitely more effective because Meg Kissinger started in the present, bounced back in time, then toggled back and forth.

Normally, I’m hesitant to jump around that much. As Tom points out, readers can get lost, and the writer can, too. He’s right, also, that the story could have been more tightly focused around the two strongest narratives.

But what I most liked here was that story within the story. It actually kept you focused and eager to read on.
Why didn’t people around Cho or Loughner do more to make sure these obviously ill men got care and that others around them were safe? Why couldn’t Martha and Jeff Wilson force their troubled son to take the medicine that might make him well?

The answer begins 40 years ago on the second-story window sill of Alberta Lessard’s West Allis apartment.

Who could stop there?

Kissinger did several things effectively to weave Lessard’s tale into the larger story.

First, she recognized that Lessard’s case was not only pivotal, but inherently compelling and ironic. Readers would want to follow it through. It was the perfect way to illustrate how difficult it is for even the well-meaning to address the issue of mental illness. Lessard is crazy, sure, and also – at times – perfectly rational.

She took her time. This is a difficult subject, for society to address and a reporter to tackle within the constraints of a newspaper article, even a long piece like this one. So Kissinger told a little at a time, giving you the opportunity to get to know Lessard and become invested in her circumstances.

She made Lessard familiar. So often, particularly with the coverage of mass murders, the deranged killers are little understood. This woman didn’t pick up a gun or a knife, but it wasn’t a stretch to imagine that her paranoia could have fueled something deadly.

She didn’t wait to point out why the old story is so relevant today. Notice that Kissinger doesn’t expect you to read to the end to understand the ramifications of Lessard’s battle. She stops to make sure you take in just how important this case was.

For instance:
Her persistence would change mental health care across America.

And then later:
The standard of imminent danger set by Lessard’s case would prove to be a tragically inaccurate measure for who was mentally ill and in need of being kept safe. ... In time, even Lessard would be denied protection she desperately sought. By correcting one outrage, her case had created others.

 

Again, who could stop there?

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For more on this story, check back tomorrow for our Q-and-A with Meg Kissinger. For full bios of the Roundtable editors, see our introductory post.

Is there a story you’d like the Roundtable to tackle? Send a link to us at contact_us@niemanstoryboard.org.