The venerable Journal of the American Medical Association (JAMA) inadvertently published a phony essay last fall describing a revered Inuit elder who committed suicide by walking out onto the arctic ice. In a letter published this week, the physician who supervised the young author says that the suicide never happened and that the essay paints a grossly distorted picture of native Alaskan culture.
In the 18 October 2000 issue of JAMA, Shetel Shah of Durham, North Carolina, recounted a poignant story he encountered during a rotation as a medical student in a village on a remote island in the Bering Sea. One day, a 97-year-old Yupik elder "with a distinguished air" told the author that he was once a great whaler and a carver, but now he was useless and wanted to die. After the man's family paid their final respects, Shah and his supervisor watched him walk out onto the ice, where he "slowly vanished into the early-morning fog."
This week, Shah's former supervisor, Michael Swenson of the Norton Sound Health Corporation in Nome, Alaska, says in a letter to JAMA that "the events described in his story never happened." Swenson adds that the article perpetuates a false stereotype about the Yupiks and other Inuits, who in fact esteem their elders, rather than being a culture "where a man is only as valuable as the wisdom he imparts," as Shah claimed.
The JAMA column where the essay appeared, called "A Piece of My Mind," offers patients, doctors, and nurses an opportunity to "bare their souls to the readership," and authenticity is critical, says Catherine DeAngelis, JAMA's editor-in-chief. When Shah submitted the piece, he maintained that the story was true, she adds. The "intellectual dishonesty and the lack of integrity," DeAngelis says, "impugns our reputation."
Shah maintains in a letter he had heard stories about similar acts that actually happened. He only fictionalized the essay to protect patient confidentiality, he writes, arguing the essay was "well within the limits of artistic license."
Shah has a defender in George Lundberg, a former editor-in-chief of JAMA who now holds that title at Medscape. Although Lundberg prefers essays like these to be factual, there's room for literary license, he says: "In my view, the tempest is outsized for the teapot." Anthropologist Stephen Loring of the Smithsonian Institution's Arctic Studies Center in Washington, D.C., who studies Yupik culture, disagrees. The Yupik people in the village where Shah worked are Christians who do not condone suicide. They "would be insulted" by the story, says Loring, who calls it "totally bogus."