09:15 PM CST on Tuesday, March 29, 2005

Moderator: Jodi Leese:  Sherry Jacobson took questions about Jadon White and the conditions at Parkland, Dallas County's public hospital system, on Wednesday, March 23, 2005.

O_M:  What has the reaction been like to this story?

Sherry Jacobson:  Since my story on Sunday about Jadon White, a cancer patient at Parkland, I've received several dozen e-mail messages and phone calls. The reactions have been all over the map. Most people are very sympathetic to Jadon's plight, although some people have criticized the way he was trying to use the Parkland system. For example, people are wondering why the hospital didn't respond faster to Jadon's symptoms. Others have been critical of Jadon for not doing more to research his disease once his carcinoid tumor was diagnosed.

O_M:  How did you get to know and choose Jadon for this story?

Sherry Jacobson:  I am the Dallas Morning News reporter who regularly covers Parkland. Last winter, I was doing a story about overcrowding at the public hospital, and I happened to talk to Jadon and his father. Jadon happened to catch my eye while he and his dad were waiting to pick up medication at Parkland's pharmacy. He was wearing this huge black leather coat, which I noticed, and so I interviewed him and his dad for that story. About 10 months later, his dad called me at my desk at the Morning News and sounded very upset about the fact that Jadon was having trouble getting into the cancer clinic. I then talked to Jadon and he sounded very ill. Over the next few days, I talked to my editor about possibly following his case as an example of how things work at Parkland, and this story came out of that decision to do it.

Yvette:  I feel like my mom has fallen through the cracks. Are you planning another story on the treatment at Parkland, and do you have a subject picked out?

Sherry Jacobson:  Well, as the paper's main reporter on Parkland, I am always looking for good stories and new ways of explaining to people in Dallas how the hospital works. I doubt that I would be looking to do a story similar to Jadon's any time soon, but if you'd like to send me an e-mail, I'd be happy to consider it. sjacobson@dallasnews.com

alesia:  My Father went through a similar experience. He was insured but was treated at a "Teaching hospital" What are you wanting the outcome of your stories to be?

Sherry Jacobson:  The main reason I do stories is to inform people, not to seek desired outcomes. But you do hope they are taken seriously by the people or institutions you are writing about. In this case, I would hope that Parkland doctors and hospital administrators are considering Jadon's plight -- which involved a recurrence of his cancer that apparently went undiagnosed for weeks -- as an indicator of possible flaws in the system.

SandiB:  In the course of your reporting, did you come across any Internet sites or support groups that might help Jadon?

Sherry Jacobson:  Yes, I did. The main site for this is the Carcinoid Cancer Foundation, which has the URL of www.carcinoid.org. There's also a local group in the Dallas area that supports carcinoid patients. I don't have those details at hand, but please contact me at sjacobson@dallasnews.com, and I will send them to you.

Mark:  I'd like to send something to Jadon. How could I get in touch with him?

Sherry Jacobson:  Get in touch with me and I will be happy to forward your message to Jadon. I don't feel at liberty to make Jadon's contact information public.

Mark:  You hear about "miracle drugs" for chronic pain (Suboxone, etc.). Is there a wide variety of opinion among doctors on how to treat pain? Or is there a general consensus that ANY pain is too much pain?

Sherry Jacobson:  I'm not a doctor, or an expert on pain management. But it's a controversial topic. Doctors don't always agree on how much pain a patient should be able to tolerate. In Jadon's case, it never seemed that he was satisfied with the medications that he was receiving. Or they never seemed to alleviate the pain to the extent that Jadon wanted. There are some doctors who think that pain is never beneficial to the healing process. But it also seemed clear that some of Jadon's doctors thought that he ought to be able to withstand some of the pain and discomfort he was experiencing. There seemed to be an underlying concern, though, that Jadon might be abusing his pain killers. However, when I saw him taking some very powerful narcotics it seemed very clear that he was in tremendous pain.

Cat Cheng:  Are our tax dollars being handled wisely by those bureaucrats who run Parkland? Do we need more money or is the system inefficient?

Sherry Jacobson:  I attend all the meetings of the Parkland Board of Managers. And every session is mainly given over to analyzing how dollars are being spent, how money can be saved and how to get more out of the healthcare buck. Parkland has been losing federal dollars in recent years and the Dallas County commissioners have been unwilling to raise the hospital's tax rate. Meanwhile, the patient demands on Parkland are growing. At some point, something's gotta give.

ArcLight35:  What has Parkland's response been to your story about Jadon?

Sherry Jacobson:  Officially, there's been no response. At a meeting yesterday of Parkland's board, two board members complimented the story. But there was no public discussion about the problems the story highlighted. Several Parkland doctors also have written me, expressing a range of opinions on the story, from agreeing that there are problems to criticizing the story for being unfair to Parkland.

Suzanne G.:  Was Jadon the victim of stereotypes or generalizations in diagnoses? I have heard doctors assume young people are "too young" for cancer.

Sherry Jacobson:  Actually, they diagnosed him fairly quickly when he first showed up at Parkland's emergency room 18 months ago. But that was for a tumor in his lung that was clearly visible on an X-ray. The problem really started when Jadon developed mysterious leg pain last fall and couldn't get anyone to connect it to his previous cancer. I don't know if there was an age problem so much as the ER doctors just not recognizing what they were seeing.

Alan:  OK, I know this is a little off-subject but WHY is the wait in emergency rooms always so long? Unless you're bleeding to death, it seems a minimum of 2 hours is ALWAYS the case (based on my experiences and other anecdotal evidence)!!

Sherry Jacobson:  Actually, it's not off-subject at all. That's a big part of the story I was trying to tell. The average wait at Parkland's ER, from start to finish, is about eight hours! There are just so many people (many of them uninsured) who are seeking care at emergency rooms, whether or not they actually are in a medical crisis.

Alan:  Also, one more: What's Jadon's status at the moment? And what his and his family's reaction to your story?

Sherry Jacobson:  Jadon is considering whether or not to have surgery to relieve the pain in his lower back, which is preventing him from sleeping. The doctors seem to think there is a tumor that could be removed to alleviate his suffering. Jadon and his family seem to like the story.