Question/Answer

Medical Sleuth New York Times health writer Denise Grady '78G tells us what we need—and want—to know By Rebecca Rule '76, '79G

Denise Grady '78G (Photo by Beatrice De Gea)

Denise Grady has worked as a freelancer, staff writer, and editor for many magazines including Discover, Time, and the New England Journal of Medicine. She has written more than 700 articles about medicine and biology for the New York Times. Her reporting has taken her to Angola, Sri Lanka, and Tanzania, but she also writes on close-to-home subjects: a mysterious neurological disorder among workers at a meat-packing plant, a 43-hour surgery to remove a man's tumor tangled among several organs, asthma in her family and on the rise in her children's generation, and her own sore foot. In 2009 she won the Victor Cohn Prize for Excellence in Medical Science Reporting. Judges cited the grace and vividness of her writing as well as "acutely revealing details" that bring "uncommon resonance and humanity." Early in her career, she taught writing in the English Department.

Q: You traveled to Angola to investigate an outbreak of a deadly virus. How dangerous was it?

A: If you really thought about what the risks might be, you decided it was something you could do in a reasonable way. People thought going to Angola seemed a little risky because of this outbreak of hemorrhagic fever. But it's spread by bodily fluids. It's not in the air. So if you keep your wits about you, don't put yourself into situations where you have a high chance of being exposed, you can do that kind of reporting in a safe way.

Luckily, one of the first people I interviewed was a doctor from the World Health Organization. He said when they tracked down cases, they did not go inside houses, they got people to come out to talk, and stayed a couple of feet away. Common sense. He also said, "We don't stay here too long." After a couple of weeks, you get tired and you might get careless and start making mistakes.

Q: How long were you there?

A: Two or three weeks.

Q: Was there one story that really shifted your world view?

A: About a year ago I went to Tanzania to report on maternal health, and why death rates in labor and childbirth are so high in developing countries, even in a place with a stable government. (Read "Where Life's Start Is a Deadly Risk" and "Fragile Tanzanian Orphans Get Help After Mothers Die") They're very poor, but why was their maternal death rate more than a hundred times what it was in developed countries?

A photographer and I spent a number of nights in the delivery ward and operating room of a hospital out in the countryside. Transportation was hard. It was hard for women to get there. They would come in on the back of a bicycle or a motorcycle in labor from far away. We were watching cesareans performed in the middle of the night. Very little water. They didn't have electric wires—just a generator. No washing machines, though they did have an autoclave to sterilize things.

They saved the gauze from surgery. Nothing was thrown away. Everything went to the next room and where hospital workers, women, washed stuff in basins filled with soapy water on the floor. They would go from one basin to the next and the next. The last one was pretty clear water. Then they would hang it on the line to dry. Surgical drapes, everything from the operating table. After that it went into the autoclave.

Actually it wasn't a bad system. But I had never thought about having to reuse gauze. Operations here—I can't even tell you how many gigantic red plastic bags of medical waste get taken out of operating room. That was an eye-opener. I keep thinking about the gauze.

The patient's anesthesia mask was held on with a piece of string. They were putting a patient under for a caesarian and I smelled ether. It was like being in another time. I know my mother had ether for an appendectomy and that was in the 1920s. We haven't used ether in this country for years.

It's not a terrible thing to use ether. It's relatively safe and very cheap. It does make people sick though. There are better things than ether.

Q: Speaking of olden times, like when you and I were students together in the writing program here, what lessons have stayed with you?

A: I think it made all the difference for me. I was at UNH at a time when I really wasn't sure what I would be doing. I moved here with my husband. We weren't married yet, but he was going to graduate school. I was working at a day care center, opening the center in the morning. In the afternoon I took classes as a special student—one with professor Tom Carnicelli on rhetoric and one with Hugh Potter in American Studies. Hugh Potter pulled together history, politics and literature in a way I had never encountered. We were reading poetry and looking at surrealists, talking about the art and Freud at the same time. He had this broad and deep understanding of what was going on in any given era.

With Carnicelli we were studying rhetoric and doing lots of writing. One day after class, he recommended that I consider the graduate writing program. He said I ought to talk to Don Murray. I was yessing him to death, but I really thought no graduate program in English would take me because I had a biology degree. I left. Professor Don Murray '48 chased me down. He'd stopped by Tom's office and Tom sent him out after me. He said, "You really should apply." He was so encouraging. You look back and realize there are these pivotal moments in your life. That was one of them. I would never dared apply if he hadn't encouraged me.

It was like, if you think I can do it, maybe I can.

Q: Don Murray was a great help to me, too.

A: One thing has always stayed with me. Don said people need to be told what they're good at. They don't always recognize their own strengths. You can spend a lot of time with your red pencil picking out mistakes and fixing flaws, but in the long run you may accomplish more as a teacher or an editor by helping people recognize their strengths.

The other thing that stuck with me was him saying about himself, "I may not be the smartest or most talented person, but I can come in early and stay late."

Q: Working for a daily paper, that must be a way of life for you.

A: Often it is.

Q: You like the pressure of a daily paper?

A: I do. I'm a person who needs deadlines. I work better with deadlines. You would think that if you had a month to polish up something that it would be better, and for more thoughtful and analytical magazine pieces that may be true. But for an awful lot of things it's amazing how good things can turn out, and how not-that-much-better they are if you have more time.

For a perfectionist and a procrastinator, the best thing in the world is to have to get it done.

Q: You've been working a science beat from the beginning. Do you ever think about changing focus?

A: Sometimes I think I should do something totally different. But it's been really fascinating. Medicine has characters and plot—life, death, drama, sometimes mystery. The science and technology renews itself all the time.

Q: Are you a crusader?

A: In terms of drawing attention to things that ought to get attention, maybe yes. Things like maternal mortality. It's not rocket science to fix some of these problems. There is no good excuse for so many dying in childbirth. Or for so many women dying from illegal abortions.

Another eye opener was walking into a women's ward in Tanzania. Twenty women and maybe half were recovering from illegal abortions. This was a hospital with so few resources, they had to save the gauze. And they're having to put their time, energy, and resources into patching people up from these horrible botched procedures.

You read about it in reports from the World Health Organization, but you don't really get it until you go there and look around the ward and see it, until you stand in the operating room and see what it takes to fix something like that afterwards, which was pretty awful.

Q: You wrote a book for young readers, Deadly Invaders.

A: Kind of a bizarre subject for kids. The Times wanted to do a book for students about viruses. They came to me with this idea when, by coincidence, I had just gotten back from Angola with notebooks full of stuff that I hadn't used. That's how that one came about.

Each chapter is a medical mystery in a way—outbreaks that were not understood immediately and took a lot of detective work to figure out what was going on.

Q: Grady, detective.

A: Or the chronicler.

Q: Watson to a medical Sherlock Holmes. Was it fun to write?

A: It was. I do like stories about weird germs. How did you happen to be at this particular place and time and meet up with this germ? There's a weird sort of randomness that's appealing.

Q: Last year you won the Victor Cohn Prize from the Council for the Advancement of Science Writing. That's quite an honor.

A: To be picked by other people in your field who know the territory, I was very flattered and honored.

Q: At this stage of your career, external affirmation must be nice, but you know when you're doing a good job.

A: You do know yourself when something came out well. But I don't think anybody's immune to response from the outside. It's hard to resist the allure of the most-e-mailed list. The Times home page lists the 25 most popular stories. I don't believe there's any writer at the paper who doesn't look at that list to see how high they are and how long they stay.

It's ridiculous in some ways. Sometimes the thing that stays for a week is a recipe.

I get the most pleasure out of knowing I've written about something complicated in a way ordinary people can understand. I like the idea of taking complicated subjects and ideas—things that matter—and expressing them so people who aren't experts can understand.

I'm the only person in my family who went to college. My parents were very smart and read alot. But they didn't have the opportunities. My father went to high school. My mother only went to eighth grade. Somewhere in the back of my mind, I guess I'm still thinking of them as the model of the intelligent lay person. Recently I did a story about a man who was on the operating table for 43 hours.

He waited a while to read the article because the operation had been such an ordeal. But he said, "You know, you really wrote that for the common man." I was thrilled. ~

Rebecca Rule '76, '79G, is a storyteller, story gatherer and humorist and the author of Live Free and Eat Pie: A Storyteller's Guide to New Hampshire, The Best Revenge and Could Have Been Worse: True Stories, Embellishments and Outright Lies.