The list of recipients may be a who's who of history. And who could criticize the choice of a Mother Teresa, or Nelson Mandela, or Martin Luther King.
But Henry Kissinger's award for negotiating the end of the Vietnam War was questioned by those who blamed him for waging it.
And Le Duc Tho, his Vietnamese counterpart, refused to accept his joint award because of the destruction of his country the war had caused.
Sometimes the award was spectacularly premature. Yitzhak Rabin, Shimon Peres and Yasser Arafat received the 1994 prize for agreeing to a peace that has yet to happen.
The science awards can be uneven as well. Albert Einstein may have won in 1921 for inventing modern nuclear physics.
But this year's award is to the people who perfected the little disk that runs an iPod ... a lesser scientific achievement perhaps.
How does that happen? It's a secret. The Swedish Academy, which invites nominations and bestows the awards, won't say how they do it or even who they're considering.
"Albert Fair and Peter Grunberg won the physics prize, but we don't know who else was in the running," said Adam Smith, the Web site manager of the Nobel Committee. "We just know that they won. And it will be 50 years before we are able to look back into the archive and find out who actually was nominated for this year's prize."
Saving Babies -- Exposing Sudden Infant DeathThe Scripps Howard News Service is publishing
the results of an investigation into the medical chaos that surrounds how cases of infant death are reviewed and diagnosed. Scripps Howard reports that one in every five Americans knows a family that has been touched by Sudden Infant Death Syndrome (SIDS).
Already,
SIDS support groups are recommending this project to their supporters.
The project, done by Tom Hargrove and Lee Bowman and called "Saving Babies: Exposing Sudden Infant Death in America," explains how some states and counties routinely label almost all unexplained infant mortality as the result of SIDS. Others virtually never make this diagnosis. Lack of standards and investigative protocols allow medical authorities wide latitude in how they examine the mysterious and unexpected deaths of more than 4,000 infants every year.
The project opens this way:
Every day in America at least 10 babies die suddenly and mysteriously.
Yet some of the more than 4,000 victims of sudden infant death each year could be saved if there was a simple national standard for infant death investigations, a seven-month review by Scripps Howard News Service has found.
In fact, we are getting further away from solving the mystery of Sudden Infant Death Syndrome because of sloppy procedures, manipulation of statistics, misguided efforts to protect the feelings of grieving parents, and deliberate attempts to make SIDS go away, at least on paper.
The Scripps review of 40,000 infant deaths going back to 1992 revealed that the quality of infant death investigations, the level of training for coroners, and the amount of oversight and review vary enormously across the country. In many cases, professional bias -- both for and against a diagnosis of SIDS -- trumps medical evidence.
As a result, the odds that an infant's death will be correctly diagnosed are often determined by geography rather than science. In other words, the same death might be called SIDS in one county and called something else just down the road.
The project includes
an interactive database showing that more than 20,000 deceased children were reported to the Center for Disease Control (CDC) from 2000 to 2004. Readers can also see how their county or state handles such cases and make comparisons to other counties and states. The chaos quickly becomes obvious. Pain and frustration follow the chaos.
Look at this passage:
For thousands of parents of healthy babies who die suddenly and unexpectedly each year, lingering doubt and confusion over how their child died exacerbate the pain of losing an infant.
Uncertainty fuels the nagging worry that they might have done something -- or not done something -- that could have changed what happened.
Most of the time, in most parts of the country, the official explanation for the sudden death of a baby up to 1 year old is SIDS -- Sudden Infant Death Syndrome -- a diagnosis reported to the federal Centers for Disease Control and Prevention for more than 2,200 baby deaths in 2004, the most recent year for which complete data is available.
See a state-by-state summary and frequently asked questions about this project.
I interviewed reporter Tom Hargrove about the project. (Note to educators: This interview would make great teaching material. It is an outstanding example of a journalist who sees beyond the story in front of him to the deeper and more meaningful story.)
Q. How did you find this story?
I originally wanted to test the effectiveness of the Consumer Product Safety Commission's "Dangers of the Adult Bed" campaign a few years ago. They, with the support of the American Academy of Pediatrics, urged parents not to co-sleep with their infant children because of the dangers of accidental death by smothering.
It turns out that in most places, infant death by asphyxiation actually increased after the campaign.
And, even weirder, Florida had become the infant strangulation/suffocation capital of the nation. Florida had three times as many such deaths as California, even though California has nearly three times the population.
So I backed up and started looking at all infant deaths, about 40,000 a year. Then I began filtering out deaths that had reasonable causes for which coroners are unlikely to make mistakes ... kids with congenital heart defects or who died in automobile accidents, etc. What I was left with were the sudden, unexpected and outright mysterious deaths. There are about 4,000 to 5,000 of these every year.
It's true, as the Department of Health and Human Services has celebrated, that SIDS deaths have declined by more than 50 percent since 1992. But sudden and unexpected infant death has not fallen by anything like that rate. Instead, death by the medically useless label of "cause or causes unknown" had doubled. And death by asphyxiation had grown, but only in some areas. Death by asphyxiation grew in places known to have state-of-the-art public health systems and strong Child Death Review programs.
It became painfully obvious that I'd stumbled on one hell of a measuring error, one involving the deaths of babies. My editors agreed "The Florida Mystery" (as I called it) was sufficient grounds to set me loose for seven months, generosity that is becoming rare in declining newsrooms these days.
Q. What would we learn from uniform reporting?
First, the diagnoses would change dramatically. Based upon everything we've seen, at least 35 percent or 40 percent of all sudden infant deaths are actually the result of asphyxiation. We know this because states that aggressively investigate and review all child deaths report threat-to-breathing deaths at that rate. These are all avoidable deaths, the result of adults co-sleeping with infants or babies who were given unsafe sleeping environments. Secondly, if states follow the CDC's Sudden Unexplained Infant Death Investigation (SUIDI) protocol, deaths attributed to "unknown causes" would drop from 30 percent of all deaths to more like 5 percent.
Finally, reports of SIDS would stabilize. If a coroner does what he's supposed to do -- an autopsy with a full blood toxicology, a death scene investigation by trained personnel, and a complete review of the child's medical history -- then according to standards set by the World Health Organization and the CDC, the child died of SIDS if no other cause was identified.
Q. Is this an indictment of the coroner/medical examiner system?
Sadly, yes. It's dangerous to paint with broad brushes. But, statistically by the group, medical examiners are significantly more likely to identify threats to breathing than are elected coroners. Medical examiners are also much more likely to be medical doctors or licensed forensic pathologists (or both) than are coroners. Death is a serious business. It shouldn't be overseen by the owner of the local funeral home who graduated high school (we hope) but received little additional education.
Q. Exactly how did you analyze the records?
With the Statistical Package for the Social Sciences (better known as SPSS) and the application of basic statistical tests. For example, after we built a database with 20,000 suddenly deceased infants from the 1990s and 20,000 from 2000 through 2004, we told the computer what kind of review system exists in each state. Some states have no Child Death Review, some have only a statewide review committee, some have only local death review committees and some have both local and statewide death review committees. The rate at which coroners and medical examiners identify cases of asphyxiation is two-and-a-half times greater in states with both local and statewide child death review groups than in states with no review whatsoever. The statistical odds that this pattern is coincidence are very, very close to zero. (If it were a poker game, I'd bet my house.)
Q. What were the goals of online/interactive components?
First, transparency. Anyone could download and repeat Scripps Howard's analysis. More importantly, people may identify important patterns that I missed. Allowing readers to second guess me may actually further our understanding of sudden infant death. Finally, we wanted parents and policy makers to see the truth. It is impossible to look at this information and not realize that infant death investigations are chaotic.
Q. This project deserves a "shout-out." Who helped you?
This project would never have happened without the help of my colleague, Lee Bowman, one of the best science writers in the business. When I first suggested The Florida Mystery to him, he said, "Oh, they're probably just trying to get their SIDS numbers down." I practically ran to the computer to test if there were inverse relationships between death by asphyxia and SIDS. The answer, of course, was yes.
We are always looking for your great ideas. Send Al a few sentences and hot links.
Editor's Note: Al's Morning Meeting is a compendium of ideas, edited story excerpts and other materials from a variety of Web sites, as well as original concepts and analysis. When the information comes directly from another source, it will be attributed and a link will be provided whenever possible. The column is fact-checked, but depends on the accuracy and integrity of the original sources cited. Errors and inaccuracies found will be corrected.
... think before it speaks. The science awards can be...
