David Carr’s death
New York Times media columnist David Carr, who died suddenly February 13, was a lungnoid according to the NYC medical examiner–and complications from his NET cancer caused his death. The medical examiner also cited heart disease as a contributing factor. The report calls the NET cancer metastatic, which means he could have had tumors in his liver or elsewhere.
Carr was clearly an interesting and complicated man.
Depending on whether or not his tumors were producing serotonin and were in his liver as well as his lungs, that could have had an influence on his heart disease.
Carr’s NET cancer connection
Reports have not said, however, whether or not that heart disease was carcinoid heart disease or not. That Carr earlier used cocaine and other drugs may have contributed to his heart disease–or been entirely responsible for it. Without more detail than is in the published reports, we can’t be entirely sure.
…complications from his NET cancer caused his death.
To its credit, the New York Times article quotes the medical examiner’s report in the third paragraph of its coverage, as do some other media reports. However, the vast majority report only that lung cancer was the cause of death, complicated by heart disease.
Media coverage of Carr’s death
Most reports immediately jump into a discussion of Carr’s smoking habit either stating directly or implying that his lung cancer was caused by that. Not even the Times‘ report discusses neuroendocrine lung cancer, beyond the quote from the medical examiner.
…we can’t be entirely sure.
Carr had beaten Hodgkins’ lymphoma, an experience he talked about in his 2008 memoire, The Night of the Gun. Most reports included his lymphoma, properly named.
Simplifying cancer
One of the problems all cancer advocates face is the public perception that cancer is a single disease. Even among people who understand there is a difference beyond location between breast cancer and lung cancer or lung cancer and prostate cancer, few understand that there are multiple forms of each–all of which have distinct courses, prognoses, and treatments. In fact, even among NET cancer patients there is not always an understanding of how many different forms carcinoid/NETs can take.
Most reports included his lymphoma, properly named.
The media today are in the business of simplifying the complex to a level most people will understand. This has always been the case to a certain extent–and with cancer in particular, it arguably always has been.
Another missed opportunity
Still, Carr’s death represents, as did Steve Jobs’, a missed opportunity for the media to educate the public about NET cancer. As a reporter, I like to think I would have seen “small cell neuroendocrine lung cancer” and asked how that was different from other lung cancers. It was certainly an idea I tried to instill in the young reporters I trained over the years.
The media today are in the business of simplifying…
Carr was clearly an interesting and complicated man. We will miss him as a media critic and as a keen observer of the world around him. I wonder what he would have written about the reporting on his death. That the media missed a major part of the story by failing to confront the unanswered question–what is neuroendocrine lung cancer?–would surely have irked him.
(Thanks to Ellen DeSilva Thompson for pointing David Carr’s story out to me. My focus has been elsewhere the last few weeks.)
Thank you for all of your efforts I am posting this on my website with a link to your site, if you don’t mind.
Tom Clarkson
Founder
CarcinoidCARES.org.
Fine by me. The more we can get the word out, the better. Thank you for your efforts.
The Times was intentionally vague about David Carr’s death. I love Carr. My favorite Times byline. And, yes, he would have said the Times blew it. There may have been confidentiality reasons that the Times could not go deeper into his death. The Times refused to tell other news organizations if they were aware of his cancer. The question has also been raised whether he was aware. But he looked so sick; it would seem he had to be aware. Was he getting treatment? The Times is always scrupulous about reporting details that readers have. And many readers had questions related to his death. The Times did not address them. His family may have requested confidentiality for various reasons. It’s all rather odd that more details weren’t released. We could have all been educated on his cancer and understood more about him and the loss we feel. He will be greatly missed.
The Times story is pretty precise, but only if you already know what neuroendocrine cancer is. It is curious they did not answer the unanswered question about how this is different from other forms of lung cancer. I suspect it is the reporter seeing the words “lung cancer” and just assuming this is the formal name for the particular form–“after all, lung cancer is lung cancer and he was a smoker so what does it matter” may well have been the interpretation. On the other hand, why use the full formal name if that is your thinking? You may be right that they decided to keep things private for the family by not going into the details of what the words actually meant.
The Times story said he had an autopsy because his death was unexpected and untimely, leaving the suggestion to readers that Carr and others did not know he had cancer. Does one die suddenly from cancer and unaware you have it? The story doesn’t address if he knew he had cancer and was getting treatment. A friend of Carr’s in a published account said 2 weeks before Carr died Carr told him he could not make an appointment due to seeing a doctor and a planned procedure. Carr looked sick, rail thin. Another friend of his commented seeing Carr on TV and thinking his cancer must of have returned. The problem with the Times’ story it leaves the impression that Carr and other did not know he had cancer, when it’s likely that he did know. Why not say he knew he had cancer and was getting treatment or not getting treatment? One doctor on twitter speculated that Carr may have known and questioned if Carr had decided against treatment. The Times doesn’t go any further than quoting the medical examiner and leaves the rest of these questions unanswered. I too loved and admired David Carr, and I understand the Times’ wanting to protect his confidentiality. It’s not how the paper would have handled another story on someone who died unexpectedly and it wrote about it extensively. At some point, I would expect we’ll learn in some published account if he knew he had cancer and was getting treatment. My prayers are with his family.