CHICAGO - The distinguished Journal of the American Medical Association says it got duped into publishing a medical student's phony account of an elderly Alaska villager walking onto the frozen Arctic Ocean to commit suicide.
Journal of the American Medical Association
Shetal I. Shah had presented his bleak essay, published Oct. 18, as factual. But in a letter in the current JAMA, Shah's former supervisor said there was no such suicide victim and the story perpetuates a myth about a tradition that does not exist.
Shah's account was published as one of JAMA's "A Piece of My Mind" columns, in which doctors detail the emotional side of medicine.
Shah described a proud, toothless 97-year-old patient at a remote Alaska medical clinic where Shah worked briefly. The man, a member of a Siberian Yupik village, came to say goodbye before vanishing "into the early morning fog," Shah wrote.
In a letter in the current journal, Shah defended the essay, saying it was based on stories he had been told by residents during his stay. He said he created the tale to highlight pertinent "end-of-life issues."
In some arctic cultures, elders sometimes voluntarily froze to death on the ice in times of village hardship, said Ernest Burch, an anthropologist affiliated with the Smithsonian Institution. But that was a 19th-century custom that no longer exists, Burch said.
Shah's former supervisor, Dr. Michael Swenson, a physician with Norton Sound Health Corp. in Nome, said the story presents a hurtful stereotype about current Yupik society, where despair among the elderly is far less common than among urban cultures.
Swenson said he understands Shah "wanting to 'tweak' his description of the events a little to make it a better story. But Shah's story goes beyond such editorial adjustments: The events described in his story never happened."
The journal's editors said that Shah presented the essay as fact and that the editors thought it "represented his actual experience."
"I am so upset," said Dr. Catherine DeAngelis, JAMA editor. "It breaks my heart when this kind of thing happens, and there's no reason for it."
She said JAMA editors question essay authors when their stories sound suspicious, but the process isn't foolproof. "What could we do short of giving them lie detector tests?" she said.
Dr. Jeffrey Drazen, editor of the New England Journal of Medicine, said he has assumed that JAMA's "A Piece of My Mind" columns are factual. But he said he would not find it troubling if some were fabricated.