Lester, thank you for being

Lester Davis isn’t shy about telling the story of his 20-year addiction to crack cocaine, nor is he reluctant to give thanks to the people who helped him find love and redemption and a deeper, truer sense of connection with God. He spends much of his time these days working with men who struggle to conquer their addictions.

Journal reporter Annette Fuller wrote a terrific profile of Lester, tracing the tale of his long fall and slow, steady rise.

I was lucky enough to meet Lester for a little while at his mother’s former home on Rich Avenue. The house he and his brother turned into a drug haven, the house from which his sister eventually had him evicted. He was in a hurry; he’d gone right from his chef duties at the Marriott to a mentoring session at the Samaritan Ministries, and he’d promised to pick up his son from work. But he took time to show us bullet holes in the siding, indelible marks of a life lived on constant edge, and to exclaim over his mother’s rosebush, still thriving at the foot of the front steps.

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I Made That!

Cookie’s doghouse is now famously enshrined within the awesome goodness that is radio show “Destination DIY”, produced by Julie Sabatier in Portland, Ore., along with the stories of a stay-at-home dad/home brewer, a woman who knitted a farm, and the DIY butchers at the Portland Meat Collective. I am crazy about this show.

Here’s the story: [audio:http://shawneestreetmedia.com/wp-content/uploads/2010/10/doghouse_finalmix0212.mp3]

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You Should Be Dancing

This little slideshow is like a happy pill. Whenever I’m feeling hopeless or out of sorts — and that’s too often than I want to admit, in these difficult times — I watch this. My friend and Journal colleague Jennifer Rotenizer took these marvelous photographs of the Mwangaza Children’s Choir of Uganda when they performed at a private school in Winston-Salem a while back.

“Mwangaza” is the Swahili word for “shining light.” And these children do shine brightly.

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In the Doghouse

One thing really does lead to another. Last fall, John Steinberger was sitting in his back yard, idly thinking about his neighbor, Lisa. She’d just put her house on the market, and she’d just gotten a new dog. He didn’t want her to leave. Maybe, just maybe, he thought, he could do something to convince her to stay.

He zeroed in on the prefab house she’d bought for her rescued Jack Russell, Cookie. Now John is a cat man, not a dog man, but he recognized a convergence of interests, and he went for it. Maybe an over-the-top, custom-built doghouse would be just the thing to show Lisa what a great neighborhood she lived in.

So John set about building a solar-heated doghouse for Cookie. And as he got started, well, let’s just say he encountered mission creep. He told Lisa it would be finished in a couple of weeks, but . . .

[audio:http://www.shawneestreetmedia.com/wp-content/uploads/2010/10/john_webclip.mp3]

The whole story will be available soon on “Destination DIY,” an awesome radio show produced by Julie Sabatier.

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Story of My Life

Photobucket

I love working with photographer Christine Rucker for lots of reasons. First, she has a way of putting people at ease with her gentle, unassuming style and easy laugh. They get it right away that she sees them. I believe she possesses extra senses that ordinary people like me just don’t have.

Christine also gives me a gift every time she turns over a batch of photos for an audio slideshow project, because I get something beautiful to look at, deeply, as I’m editing.

This project, commissioned by Group Homes of Forsyth, Inc., an organization that runs group homes and programs for developmentally challenged adults, was no exception. FGH wanted to feature a few of its residents. Christine interviewed and photographed them, but the audio editing may have been my most challenging project to date. Christine was firm that she wanted them to speak for themselves, not through the voices of their assistants. The recording environments were tough — Christine wasn’t able to gather a lot of ambient sound — and some of the residents were more able than others to express themselves. But the group homes folks were happy, and I felt privileged to have spent time listening to the interviews and listening for the heart of their stories.

Christine assembled the audio slideshow.

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A River of the People

About a year ago, writer Phoebe Zerwick and photojournalist Christine Rucker set out on an audacious project to tell the story of the Yadkin River. The river is right now the focus of an intense fight between Alcoa and the state of North Carolina over who should control a series of hydroelectric dams on the Yadkin. Alcoa once used the power to run a smelter on Badin Lake, but it shut down in 2007. The company still generates about $50 million annually from its hydroelectric operations and wants the federal government to issue another 50-year operating permit. The state, other government entities and citizens oppose the relicensing. 

But that’s not what Yadkin River Story is about. Phoebe and Christine had long wanted to tell a more intimate story about the people who live along the river, how it runs through their lives, how it connects them. They focused on a stretch of the river in the Yadkin Valley, in northwest North Carolina, far upstream from the contentious dams.

Along the way, they collected audio and made countless beautiful and moving images. They invited me to transform that audio (sometimes deeply flawed audio!) and those photographs into audio slideshows. 

The project evolved into a stunning collaboration with M Creative, a design firm in Winston-Salem. Amanda King contributed her graphic design and information architecture talents, without which this project would never have reached its potential.

The result has exceeded my wildest expectations, and I believe that it will touch many lives. In addition to the website, Yadkin River Story is also a photographic exhibit, which will be on display at the Yadkin Arts and Cultural Center through the end of October 2010. We hope that the exhibit will travel to other North Carolina venues, and have plans to provide the multimedia pieces in DVD format to schools and other interested organizations.

You can go meet the neighbors by following this link.

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Remember This Name

Once in a while I get lucky. Not too long ago, my old colleague Chris English called and asked me for help. He’s the photo editor for university publications at UNC Greensboro, and he’d just come back from a photo shoot with a UNCG alum in Nashville, where he’d taken oodles of photographs, shot video and collected audio.

“You gotta hear this!” he said. He was on a tight deadline, and he needed my help knocking together an audio slideshow.

I can’t resist the combination of still images, sound (and under the right circumstances, video). So I said yes.

I’m so glad I did.

Remember the name Karla Davis, OK, because I expect that you’ll be hearing it again. She’s a former UNCG soccer star — a scholarship player who until just a couple of years ago hadn’t really spent any time playing a guitar and wouldn’t sing in public.

Then she won the Colgate Country Showdown contest (the same contest that launched the likes of Brad Paisley and Leann Rimes), took the $100,000 in prize money and set out for Nashville, where she’s finishing the work on her first recording, which is going to be titled Here I Am.”

Indeed. Here she is.

See the story in this summer’s UNCG Alumni Magazine.

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The Murders at Grassy Creek

Winston-Salem Journal graphic by Richard Boyd

When three people were murdered on a Grayson County, Va., Christmas tree farm, suspicion soon focused on Freddie Hammer, a man who earned his living chopping firewood and doing odd jobs in neighboring Ashe County, N.C.

In 2008, reporter Monte Mitchell of the Winston-Salem Journal spent several months unraveling Hammer’s complicated past, including his conviction on murder charges for killing a Philadelphia police officer in 1978.

Hammer confessed to the tree farm killings, and he is now serving a life sentence in a Virginia prison. He has also confessed to killing his nephew, Jimmy Blevins, whose body had been missing for more than two years before it was found in Ashe County on Aug. 4, 2009.

I served as multimedia editor on this series, working with a web designer, Mitchell and his editor.

Read the series, as well as letters between Mitchell and Freddie Hammer, and see photographs and video in this award-winning multimedia presentation.

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A Warmer, Happier Place


A couple of years ago, a group of students at Warren Wilson College in Swannanoa, North Carolina, joined forces with a Buncombe County program to weatherize the homes of low-income homeowners as a way to save money — and energy.
The program, Insulate!, is becoming a national model for student service on energy conservation and social action.
This story about the project aired on the World Vision Report in December 2008.

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The Need to Read

Locked gate at Henredon Furniture, Spruce Pine, N.C. Photo by Billy Barnes 

About four years ago, I was among a group of radio producers who worked on a documentary project that focused on two main questions: What is poverty? And how has poverty changed since the 1960s, when it was a subject of considerable public discourse?

The series, “North Carolina Voices: Understanding Poverty,” aired in 2005 on N.C. Public Radio, WUNC, in Chapel Hill, N.C. Series executive editor Emily Hanford wrote in the April 2006 edition of the Nieman Reports that the series “captured listeners’ attention, and we hope it got them talking and thinking and reflecting on poverty in their place and time …”

[audio:http://www.shawneestreetmedia.com/wp-content/uploads/2010/10/needtoread.mp3]
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Confronting the Achievement Gap

Mount Tabor High School, Winston-Salem, NC

Mount Tabor High School, in Winston-Salem, N.C., tried to close the ‘achievement gap’ by pushing more students into rigorous course work. The approach fixed some problems, but created others — more non-white students were taking advanced placement or honors courses — but their need for individual help sometimes felt overwhelming to teachers. This story aired as part of “N.C. Voices: Studying High School” on N.C. Public Radio, WUNC.

[audio:http://www.shawneestreetmedia.com/wp-content/uploads/2010/10/achievementgap.mp3]
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Jousting with the Dictionary

The story of spelling whiz Josiah Wright, a home-schooler from Fleetwood, N.C., in Ashe County, was one of my very early video pieces, and despite its vast imperfections it is still one of my favorites. Josiah represented Northwest N.C. at the Scripps National Spelling bee in 2007. He made it to the finals, but was knocked out by the word “ptilopod.”

Here’s the story that appeared in the Winston-Salem Journal in May 2007

FLEETWOOD, N.C. When Josiah Wright takes the stage today for the first round of the Scripps National Spelling Bee in Washington, he will try not to think of the other 285 spellers as his competitors.

His true opponent?

Webster’s Third New International Dictionary Unabridged.

“You’re not fighting against the speller on your left and the speller on your right,” Josiah said. “You’re fighting against the dictionary.

“You can almost think of it like a jousting tournament, with all these kids lined up and a dictionary on a horse back. And you’re trying to stay on your horse. That’s the way I think of it.”

Josiah, 12, won the Winston-Salem Journal Regional Spelling Bee in March when he correctly spelled the word “philately,” which means the collection and study of postage stamps.

One of his current favorite words is hummuhumunukunukuapuaa, a type of triggerfish popular in Hawaii. It’s the longest word in Webster’s Unabridged Dictionary, the official source of words for the national spelling bee. Any of its 450,000 entries are fair game.

Josiah’s copy of the hefty, maroon-bound dictionary resides on a shelf in his parents’ bedroom, but he doesn’t often crack it open. Instead, he practices using eSpindle, a computer program that simulates a spelling contest and pulls words from several different word lists based on the probability that they will appear in the bee.

Josiah learned to read at age 3 and was doing second-grade work by the time that he was 5, said his mother, Anne Margaret Wright. She is also his teacher — Josiah has always been home schooled. The family moved to Fleetwood, in Ashe County, five years ago.

“He always loved to play with words,” she said. “We’ve done every other subject, but I never taught him spelling because he learned on his own.”

When Josiah is not spelling the kinds of polysyllabic words that would make most of us run for the dictionary, he reads or writes (He’s working on a science-fiction novel) or practices tae kwon do (He has earned a purple belt).

Josiah Wright plays in his backyard with brother Zechariah, May 2007.
He also helps care for his four siblings — Benjamin, 7; Gabriel, 4, Abigail, 3, and Zechariah, 2. His three middle siblings are adopted, and all have Down syndrome.

Their special needs help Josiah keep his own gifts in perspective. “I know it must be really hard,” he said. “I just try to be sensitive and loving and help them work through it. All three of the middle guys will probably be more compassionate and caring and considerate than I’ll ever be. I can predict that already.”

He also thinks ahead to a time when he will have a family of his own.

“I’m going to give my kids hard words from the day they’re born,” he said with a laugh. “And I’d also like to marry someone who is as interested in spelling as I am. When I’m older,” he said. “I mean, way older.”

He wants to go to college and eventually earn a doctoral degree. But even daydreaming about those goals will have to wait a bit — he has a spelling bee to win.

To prepare for the bee, Josiah sat alone in front of his parents’ computer for two or three hours a day, listening to an electronic voice pronounce words and then typing his responses.

“My parents actually told me that I’m not allowed to do more than three hours a day,” he said. “And as you can imagine, it didn’t take as much persuading as some things.” He spells 1,000 words a day, in groups of 100. Even though he limits his studying to only a few hours each day, he admitted that he occasionally tires of the regimen.

Oh, my word, yes. There are some days I’d like to wring the neck of the computer — if it had a neck,” he said. “There are some days I’d just like to slug it. But I just have to keep on going and remember that with each word I spell, I’m evening out my odds.”

Josiah’s mother said that she and her husband, Ronny, wanted Josiah to have a balance between studying hard and preparing well, so that “Josiah could do his best but not become a spelling machine.”

Josiah competes at the regional spelling bee in March 2007.
Though he has participated in the regional spelling bee for four years, this is his first trip to the national competition and his only chance to win. [Link to video.]

The competition is limited to students younger than 16 and those who have not passed beyond the eighth grade. Josiah is in eighth grade now.

The speller to beat, he said, is Samir Sudhir Patel, 13, a Texas speller who at age 9 finished third in the national bee.

Josiah at least wants to make it to Thursday’s rounds, which will be televised. He also wants to show people that it’s possible for a self-taught speller to do well in the national bee without the help of tutors, foreign-language training and other coaching that many other spellers get.

“One big goal for me is that I’d like to prove all those people wrong and show that you don’t need to have expensive study and three years of experience to be able to do really well.”

This story originally appeared in the Winston-Salem (N.C.) Journal on May 30, 2007.

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Alzheimer’s Disease Changes a Beloved Husband

Living with Alzheimer’s disease has changed everything for George Griswold, but nothing more than his marriage to his wife, Nan. Laura Giovanelli wrote a compelling portrait of the Griswolds in the Sunday, Aug. 16 edition of the Winston-Salem Journal.

See photographs and hear them talk about their marriage.

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Suicide on Campus

Two long months have passed and the door to the room where Paul Wilfong lived at the N.C. School of the Arts remains locked, the shades closed.

On Thanksgiving night, Wilfong, 22, a fourth-year student in modern dance, turned down dinner invitations from friends, cleaned his room, made one last try at calling his mother on her cellular phone, and, in the silence of the deserted campus, hanged himself in his room.

On the small NCSA campus, the painful, ultimately unanswerable, question persists: Why didn’t we see?

No one, it seems, recognized the extent of the turmoil that Wilfong apparently kept locked inside his mind. Classmates and teachers knew him as a handsome dancer who relentlessly pursued the perfection of his form. Intensely private, he kept even his friends at arm’s length.

Now, in the aftermath of his death, they have been left to second-guess their own relationships with him, to read new meaning into the offhand comment he made here or the isolated incident there – and finally, to try to make peace with his death.

“We spent countless hours together, and that’s what makes it all the more confusing,” said Trish Casey, one of Wilfong’s dance instructors. “How could we not have seen? That’s the biggest question, and the one that’s hardest to hold in our minds.”

Though the school offers counseling services, Wilfong never attempted to take advantage of them, officials say. Nothing known about his life signaled him as someone at risk for suicide.

“We never got a chance to help him,” said Chris Burris, the director of counseling at NCSA.

Suicide is the second-leading cause of death among traditional-age college students, behind auto accidents. The estimated number, 1,100 a year nationwide, is relatively low. But in an era when more people with identified psychological problems go to college – and more parents with grievances go to court – schools are paying increased attention to the issue.

They are committing additional resources to psychological services, but in doing so confront the question of how much responsibility they can, or should, take for their students’ lives. Moreover, there’s the hard reality that even well-designed programs or highly trained staff don’t always stop a suicide.

“One of the things that has yet to be well-defined is what kinds of initiatives are going to be effective for the prevention of suicide,” said Allan J. Schwartz, an associate professor at the University of Rochester who researches college suicide.

“We’ve got to do something – or at least we’ve got to find out if we can do something about it. Let’s not sit here and say, ‘Oh well, it’s always been that way,'” he said.

Rate is below general population
The suicide rate among college students is about half that of the general population, according to several long-term studies. It has been stable since the late 1970s, when it peaked.

“No data indicates that rates are getting any better, either … and that’s reason enough we should do something about it,” Schwartz said. The rate is lower among students than in the general population, he said, because guns are banned on most college campuses.

Campus counseling centers have, nonetheless, seen an upturn in the number of students wanting services, said Michelle Pruett-Nostheide, a spokeswoman for the National Mental Health Association.

“It’s a huge problem before you even get to the (serious) mental-health disorders,” she said. “We’re definitely seeing more people having trouble.”

About 80 percent of college counselors responding to a national survey in 2000 reported seeing more students with severe psychological problems. A new study at Kansas State University found a doubling of the number of students seen for depression and a tripling of students expressing suicidal thoughts between 1989 and 2001.

The availability of anti-depressants and other psychiatric treatment has enabled more students diagnosed with mental illnesses to attend college. The Americans with Disabilities Act requires that schools admit them if they meet admissions standards and give them “reasonable accommodation” to make academic progress.

Some say that suicide prevention requires no less than a cultural shift on campus, starting with top administrators.

“You can’t just find needles in a haystack, but if you have a culture of prevention, you have a chance to uncover problems,” said Phil Satow, the president of the Jed Foundation, an organization that he founded after his son, Jed, committed suicide at the University of Arizona in 1998.

Suzanne Williams, the director of counseling at Salem College, has a simple way of expressing her approach to breaking the stigma around mental- health issues on campus.

“Talk, talk, talk, talk, talk to students, in every arena you can,” Williams said. “You can set brochures out and do screenings … but I think the relationship and continuing to talk is the most important thing.”

At the same time, overselling the promise to help troubled students could create the impression that schools are responsible for things that are beyond their control, thereby exposing them to legal action.

Schools around the country are awaiting the outcome of a $27 million wrongful-death lawsuit against the Massachusetts Institute of Technology filed by the parents of Elizabeth Shin, who set herself on fire in her MIT dorm room in 2000. Shin had had contact with the university’s counseling services and was known to have been suicidal. The family alleges that MIT was negligent and failed to follow its own policies.

“A return to in loco parentis is taking root with a pretty substantial litigiousness on the part of parents,” Schwartz said, referring to the philosophy that colleges assume a parent’s place in the student’s life. “If you’re a parent, a child’s well-being is your No. 1 concern. The more the institution agrees that it’s going to take on the parental role, the more untenable it’s going to be.”

But Satow said that previous case law indicates that colleges are liable only if they caused the suicide or were willfully negligent.

“If they have an active program to prevent suicide and use a variety of interventions, case law said they wouldn’t be considered liable,” he said.

Student confidentiality is also an issue, he said. Many students fear that asking for help will jeopardize their academic careers or social standing. Sometimes, they avoid the counseling office for fear that the school will notify their parents. Administrators are sometimes reluctant to tell parents of a suicide attempt, fearing that it may violate a student’s right to privacy under the federal Family Educational Rights and Privacy Act. But in the case of a suicide threat or suicidal behaviors, the law says that confidentiality must go out the window, Williams said.

“You’re walking the line between student privacy and informed family members. It’s a very hard thing to do. But I always have to weigh as a mental- health professional, what can I live with?’ she said.

Strategies to prevent suicide
Just three weeks before Wilfong’s suicide, Bill Donohue, the vice chancellor of student life, sat down with his staff to go through a checklist of strategies for preventing suicide on campus.

The checklist was part of a study published by the Jed Foundation. It advised schools to implement screening programs that catch students whose behavior might indicate depression, and create educational programs for students, faculty and advisers. It also recommended that schools have stress-reduction programs, emergency services and an emergency plan for dealing with the aftermath of a student suicide.

On paper, it seemed that the arts school was doing everything right.

Donohue tries to emphasize that everyone on campus, from the cafeteria workers to the instructors, is responsible for spotting students who might be in trouble. By its very nature, Donohue said, an arts education subjects students to a very stressful schedule and criticism from teachers.

“We hold them close – real close, and there are some things we invade. I’m going to guess that – and I’m only projecting – that we’ll listen more carefully when people tell us things … we’ll respond more personally when we feel disengagement. I’m guessing that any family or community would do that naturally.”

Teachers are often the first ones to notice when a student’s performance is slipping because of emotional problems, and they are supposed to refer them to counseling, said Susan McCullough, the dean of the school of dance.

But, she said, “Paul wouldn’t have been in that category.”

“A” student with self-discipline
Even among his driven peers in the dance program, Wilfong’s self-discipline and persistence stood out. An A student, he was often the last one to leave the studio or the first one to get to the gym in the morning. But he was also often the first to criticize his performance and ability.

“When he got here, he hadn’t had a lot of previous dance training. This place cultivated all that – that the place could shape his body as a dancer,” said Kashanna Brown, a third-year dance student and one of Wilfong’s closest friends at the school.< "You would give him compliments, he would say, 'Thank you.' I don't think he believed it. He was a beautiful mover, a beautiful dancer," Brown said. Four days before his death, Wilfong had finished performing two lead roles in the fall dance recital. He was working on his senior projects and talking of graduate school. On the outside, everything seemed to be going his way. "We saw his potential. He would have seen it eventually. He was at the brink of a major breakthrough - he was there," Brown said. Wilfong was guarded about his personal life and feelings, she said. No one among his group of friends apparently thought he was at risk for suicide. "You just didn't know because the exterior was so beautiful," Brown said. "It's a lot of that not knowing - that's what hurts - of what was really wrong," she said. "If he'd come to any one of us, we would have helped him because he was part of our family. He was our brother." Brown went to Indianapolis, Wilfong's hometown, for the funeral. She keeps a picture of him at her bedside and still wears a loop of red and yellow ribbon that students made for his memorial service. "He's everywhere," she said. "There's not one moment in the day that he doesn't cross my mind. I'll be in dance class and I'll feel his absence." Brown and others who cared about Wilfong are slowly coming to terms with the reality that they may never fully understand what was going on in his mind. On campus, officials say that it is time to heal and to try to move on: They plan to open Wilfong's old room to a new student soon. Wilfong's mother, Kathleen Harman, said that in hindsight, she sees the clues that her son was deeply troubled. When they spoke a few days before Thanksgiving, Wilfong seemed very sad, but Harman attributed it to relationship troubles with his girlfriend, who lives in Taiwan. "He didn't use the word 'depressed,' but I thought he was sad," she said. "If I could have seen his face, I would have known." Harman doesn't think that school officials failed Wilfong. "They had no idea," she said. "The love they gave to my son on that campus - a parent couldn't ask for more. "You pray that they step out and ask for help when they need it instead of hiding it.... The bottom line is that Paul made a choice. It breaks my heart and I don't understand it and I never will." Published February 6, 2003 in the Winston-Salem Journal

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A Strict Protocol

With a blue-chip pedigree, Dr. William Frederick McGuirt Jr. used to be a respected member of the faculty at the Wake Forest University School of Medicine.

Now, he is scheduled to go before the N.C. Medical Board on charges that he falsified research data for an industry-sponsored clinical trial – violating a fundamental tenet of research ethics. If he is found guilty at a hearing in December, he could lose his license for at least two years.

McGuirt resigned from his job as an associate professor of surgical sciences in otolaryngology at Wake Forest in April, and began seeing patients at Piedmont Ear Nose and Throat Associates, a private clinical practice. He declined to comment on his case.

The incident provides a window into the world of industry-sponsored research, where pharmaceutical companies depend on the work of impartial academics, and universities compete to attract billions of dollars of research contracts each year.

Professors of medicine are often expected to earn a part of their salary from research grants. The need to conduct research, in addition to teaching and seeing patients, can amount to a high-pressure honor system.

“We’re creating an environment where it’s very hard,” said Bette-Jane Crigger, an expert on human-subjects research at the Hastings Center, a bioethics study group.
“There are so many pressures to do as much as you can that it can lead to error, or outright fraud.”

For Wake Forest, which through hustle and skill has become a major winner of public and private grants for research, the incident was the spark for re-examining the way that researchers are monitored. It also came at a time when the medical school was reorganizing the administration of clinical trials.

Pharmaceutical grants
McGuirt, 39, graduated from the University of North Carolina School of Medicine in 1989. He completed his residency at Presbyterian University Hospital in 1990 and a fellowship at Montefiore University Hospital, both in Pittsburgh, in 1994.

McGuirt also has family ties to the medical school. His father, Dr. William Frederick McGuirt, is the chairman of the otolaryngology department, where the younger McGuirt served on the faculty.

In 2001, he began working on two grants from Alcon Laboratories, a major pharmaceutical company with U.S. headquarters in Fort Worth, Texas, to study whether putting antibiotics drops into children’s ears after surgery helps prevent infections in the months after surgery. The research protocols specified that McGuirt was to follow up with patients within two to five days after surgery.

But he didn’t do that, according to officials at the medical school.

In February, the school began an internal investigation of McGuirt’s research after two nurse clinicians in the Office of Clinical Trials Research reported evidence of protocol violations to Dr. Sheila Vrana, an assistant dean for research and the research-integrity officer. According to the investigators, McGuirt tried to hide the violations by entering false data in the patients’ charts and signing off on them.

Based on the investigation, the school decided that the second clinical trial should be suspended. It also found problems with McGuirt’s data in the first study, said Mark Wright, a medical-school spokesman.

“We found that the protocol was not followed, but the documents indicated that it had been. In the medical school’s view, this is not the way the medical school conducts clinical trials,” he said.

McGuirt is widely regarded as a good doctor, Wright said, and no patients were hurt by his actions.

Dr. John Butterworth is the director of the Office of Clinical Trials Research. He wrote a long memo to Dr. William Applegate, the medical school dean, and Dr. James Smith, the associate dean, about the McGuirt incident and the medical school’s response.

“We were generally in the position of scrambling to gather our data-collection forms, drugs, etc., after Dr. McGuirt informed us that he had enrolled a patient and that he would need the drug in 30-60 minutes,” Butterworth wrote. “My colleagues in the OCTR (Office of Clinical Trials Research) and I saw much evidence of Dr. WF McGuirt’s disorganization and the frenetic pace of his clinical activity … I encouraged my staff to tolerate Dr. McGuirt’s disorganization (but to work to eliminate protocol violations) because there was no evidence for knowing and willful misconduct.”

In the June 6, 2002, memo, Butterworth wrote that he believed that McGuirt wanted to do industry-sponsored research to better his chances for promotion and attract more money for his own research.

Undermine validity of trial
Even if no one gets hurt, making up research data is ethically wrong, Crigger said.
“I would say that there is a dignitary wrong done to them,” Crigger said. “They (patients) weren’t partners in research – they’ve just been used.”

Clinical trials are carefully designed to test specific outcomes, she said. Faking data can undermine the validity of a trial, or stop it entirely.

“No sponsor is going to sit for that,” Crigger said. “They’re going to have to go before the FDA and show why the list of applications (for the product) can be extended. They need to be sure that the data is accurate. If the data is faked, potentially the integrity of the whole trial collapses.”

Wake Forest was one of several sites for the testing of a new application for Alcon antibiotics Ciprodex and Ciloxan, as well as a moxifloxacin solution in children and young adults who had had ear surgery, said Mary Dulle, an Alcon spokeswoman.

The clinical trial was suspended at Wake Forest, but not at the other sites, she said.
The legal, ethical and financial consequences of research fraud weigh heavily on officials at the medical school, Wright said. In this case, once the allegations of research violations were made in February, the school notified Alcon Labs, the Office of Human Subjects Research, the Food and Drug Administration and the N.C. Medical Board, Wright said.

No other industry-sponsored trials were stopped as the result of questions about McGuirt’s data, and no federal agency intervened, Wright said.

Large sums of money
A lot of money – as well as credibility – rides on a medical school’s ability to conduct clinical trials properly.

Researchers at Wake Forest bring in about 15,000 patients a year to take part in clinical research. Last year, the university won a record $146 million in research financing – less than 11 percent of it from industry-sponsored research projects such as the one in which McGuirt was participating.

Federal regulators rely on universities to oversee their own research programs, but do step in if discrepancies are found. For example, the federal Office for Protection from Research Risks shut down human-subjects studies at Duke University in 1999 after a random site visit in which investigators found inadequate oversight on the part of the school’s Institutional Review Board.

Last year, the government shut down Johns Hopkins University’s research program after the death of a healthy subject in an asthma-drug trial.

It’s impossible to know how often research fraud occurs, but there have been some recent high-profile cases, including the discovery that a physicist at Lawrence Berkeley National Laboratory used deliberately faked data in his quest to identify a new element.

“We’re hearing about more of it,” Crigger said. “Is it because it’s happening more often, or are we just hearing about it more? I don’t know.”

After the shutdown at Duke, Wake Forest instituted a mandatory ethics exam for faculty who are conducting research with human subjects.

Following the investigation into McGuirt’s data, medical-school administrators reviewed research policies and took steps to tighten research oversight further, Wright said.

A clinical-research investigator/coordinator certificate program began in February, and the school is developing a mentoring program for inexperienced researchers.

The school has also taken steps to hire a research-compliance officer whose only job will be to monitor clinical trials. It has also closed its Office of Clinical Trials Research – which mainly served to recruit industry sponsors – as part of an administrative reorganization that was already under way in February.

“No system will be foolproof,” Wright said. “But we want to make sure that we have learned the most from every situation.”

The N.C. Medical Board is expected to hear testimony in the matter Dec.19.
If McGuirt is found guilty of an ethical violation, the board could revoke, annul or suspend his license for a specified period of time. McGuirt could appeal the decision in Wake County Superior Court.

Published Oct. 20, 2002 in the Winston-Salem Journal

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