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A Reporter on the Heart Beat; Return to the Tribune


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A Reporter on the Heart Beat

Back in '72, when Fischer was challenging Spassky and the Sun-Times city room went chess crazy, we sat down with Thomas J. Moore one night and licked him four games straight. So Moore bought some chess books and boned up on the openings. Over the next six months, during which we played him almost every day after deadline in the Sun-Times cafeteria, we were lucky to cop one game a week.

"I don't think he's smarter than I am," we pouted, "but he sure works harder."

He might have been smarter too. A year later, he and Ed Pound brought down the second most powerful man in Chicago government. And now Moore's the author of Heart Failure, the autumn's most controversial book.

Would it be correct to say you put Tom Keane in prison? we asked Moore the other day, catching up with him at the airport in Houston (he's on a national book tour). We knew Moore, a stickler for exactitude, would not want us overstating the role he and Pound had played in destroying the political career of Mayor Daley's City Council floor leader.

On the other hand, Moore does not shy from credit when it's due.

"It would be very correct," he told us. "He was charged and convicted on evidence we developed. It was a conflict of interest in a delinquent-property scheme we uncovered and revealed."

Moore and Pound were never box office. The shenanigans they unraveled were always so dry and complex that it took a U.S. attorney to comprehend exactly what their exposes were exposing. But they made a brilliant team.

"Ed was the best interviewer I ever saw," Moore remembered. "I guess I was the theorist, and tried to figure out what happened and how did it happen and if it happened how could we prove it."

Pound's now at the Wall Street Journal. Moore stayed at the Sun-Times for a while, doing some interesting investigative work based on interpreting government computer readouts--"I think I do blaze new trails," he told us--then joined Knight-Ridder in Washington.

Heart Failure began when Moore found a government computer tape "in which some work had already been done in analyzing mortality rates at hospitals across the country. It had figures on everything from prostate removal to open-heart surgery."

Moore worked the numbers until they gave him death rates from heart bypass surgery on a hospital-by-hospital basis. "The thing that was really interesting, and about here my love affair with medicine and the human heart began, it appeared such comparisons between hospitals--not only had no journalist ever made them before but nobody had made them before. There were enormous differences, and nobody even knew what a good mortality rate was!"

Moore spent seven months doing a series for Knight-Ridder, then worked up a book proposal. Seymour Hersh introduced him to Robert Loomis, Hersh's editor at Random House (Loomis edited A Bright Shining Lie and Paris Trout, both 1988 National Book Award winners). Loomis wanted the book. Moore put in another year and wrote it.

"I actually reconstruct what happens when people start to die in open-heart surgery," Moore told us proudly. "These are three case studies of actual hospitals, naming names, quoting the patients themselves verbatim . . . this is a no-holds-barred, no-names-spared look inside . . . these are real people in a flawed system that is not working."

Powerful stuff. Yet it has nothing to do with what's made Heart Failure so controversial. The book is just now reaching stores, but a lengthy adaptation of a different section of Heart Failure was the cover story of the September Atlantic under the title "The Cholesterol Myth."

In 1985, Moore writes, the federal government launched a massive campaign to lower the nation's cholesterol levels even though the drugs to accomplish this were hazardous, there was no firm correlation between reduced cholesterol and extended life, and among women of most ages and the elderly of both sexes high cholesterol levels and heart attacks had never even been linked statistically.

A recent New York Times article about a new cholesterol study that will finally be made of women and the elderly referred to "a backdrop of rising debate" over the 1985 cholesterol campaign. That's Moore. The same issue ran two letters reacting (in opposite ways) to a Times editorial of a few days earlier--"Doubts About the Cholesterol Crusade"--prompted by Moore's "vigorously iconoclastic article."

Moore's churned the waters. But we'd a already read the Atlantic article, so we didn't want to talk to Moore about cholesterol. We asked him what's gone wrong with bypass surgery.

Peer review, for one, he said. "It practically means that the only ones looking at how the heart surgeons at a hospital are doing are the heart surgeons at a hospital." His computer studies identified the hospital that "had among Medicare patients the worst mortality rate in the country for bypass surgery for hospitals performing 30 or more operations a year. In fact, 23 percent had died! My punch line was that literally for years, the surgeons didn't notice anything! There was no baseline data. When things go wrong in medicine the tendency is to blame the patients, to think they had unusually sick patients."

Heart surgery, Moore said, "is one of the most demanding activities done in our society today; it takes only the smallest of mistakes and patients can die. It can be the smallest technical detail."

Such as?

"Not keeping the heart quite cold enough during the operation. The slightest damage to the little graft they're putting in might cause no blood to flow through it. If they take a stitch a millimeter too deep it could kill a patient easily."

Sounds tricky, we cracked, but remember, we're not talking about brain surgery here.

Moore gravely considered the matter. "I think brain surgery may be more demanding in terms of manual delicacy," he pondered, "but on the other hand you have a relatively rigid body and all the time in the world rather than this soft, almost flabby mass of tissue. I think in brain surgery we're talking in tolerances of tens of thousands of inches and it's done through microscopes. Don't quote me on brain surgery. Quote me on heart surgery."

Not a modest request. "You grind away, studying these mysterious books," said Moore (who approached the heart as he approached chess), "until one day you can talk to a heart surgeon about his business. Crystalloid cardioplegia. Distal anastomosis . . ."

We asked Moore if he wouldn't mind spelling that, and then asked him what he intends to do next. "The next book is going to be on longevity," he replied. "I'm going to explore why we have made such excellent progress in expanding human longevity. I think the answer is surprising. It's certainly not medical care."

Return to the Tribune

Jim Squires is happy. A wayward sheep is back with the flock.

"John Twohey coming back as sports editor is not nearly as important as Twohey coming back," Squires told us. "Sports editor is the only job I had that was important enough to put Twohey back in the tent. He's a big-timer, Twohey is. He had something to do, to get out of his system, but I always figured he'd come back. I guess he did, too."

Says John Twohey, "This is another example of God writing a lot of unpredictable screenplays."

Three years ago, Twohey decided that he'd rather work for himself than Jim Squires. He'd edited the Tribune's Sunday magazine and then Squires had made him something called design director, with responsibility over art, graphics--everything that goes into the look of the paper. And it hadn't worked out. "So he and I had a parting of the ways," Squires recalled. "I shoved him out of the tent, I guess."

Twohey became a consultant. But now he's back. And by this point in the saga, you have probably leaped to two wrong conclusions. No, Twohey has no newspaper background in sports. And no, he won't be running the sports department. He reports to Richard Leslie, associate managing editor for sports.

"I think Jim has got a track record for unorthodox casting," says Twohey, putting it mildly. Jon Margolis, a national political writer, was handed a sports column; Steve Daley, a sports columnist, became a media critic; now Joe Tybor, a legal affairs writer, is covering Notre Dame football.

We asked Tybor how that happened. "I don't really know. This is kind of a crazy place," he said. "I'm an attorney trained to do what I was doing. The Tribune asked if there was something else I wanted to do. I said, not really. They said, what about Notre Dame football? I said, you've got to be kidding!"

"It's part of Squires's philosophy," Twohey observes, "that a good reporter can function just as well in almost any neighborhood."

Another aspect of Squires's philosophy is a sort of double helix management at the Tribune, an administrative bureaucracy and a parallel operational bureaucracy.

"The way our structure is set up from top to bottom," Squires said, "is we try to put administrative types in administrative jobs and have somewhere within the system jobs where really creative newsmen can spend their time dealing with news."

Leslie's the sports administrator. Twohey's the creative newsman. In a year or two, because Squires likes to play musical chairs with his staff, both could be doing something totally different.

"The national champions!" said Joe Tybor. "Don't tell them, but I'm having an absolute ball!"

"You have institutional discontinuity wherever you look," mused a reporter in another department, not meaning it as a compliment.

Art accompanying story in printed newspaper (not available in this archive): photo/S. Dale.

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