Burning Things: Inside A Story Form 50 States

Every time I read an article about wildfires sweeping the western United States, it's always accompanied by an acute sense of loss. I feel for every family forced to evacuate, never knowing what they might come home to or if there will even be a home to go back to when they can return.

Last year, more than 17,000 structures were burned or damaged, many of them houses. More than 550 homes were lost to California's Dixie fire just this year. That's just one fire. And wildfires are not the only culprit. Every year, more than 14 million people go homeless after natural disasters around the world. Events like Katrina in 2005, for example, added 12,000 new homeless in the New Orleans area alone.

Reading about it sometimes makes me wonder what I might do if I was forced to evacuate. We make a mental inventory of what things might be worth saving. Or, in some cases, we wonder what things would be sacrificed. My home, for instance, displays a dozen or so paintings my father painted before his death. He was only 19 when he died, but his talent was phenomenal. The paintings connect me to him. But I don't see how we could save them in an emergency.

What is it about the rest of it?

Aside from family photos and other heirlooms, what about the rest of it? Most of the items in our homes will one day be reduced to an estate sale or hauled away for the trash. And yet, for most people, these possessions become as much a part of them as their memories. 

Early last year, my home was broken into by one of our neighbor's kids. Every item they took was an individual violation, with the worst of them being two cars we left in the garage. One of which, my vintage Infiniti, was nearly totaled (technically totaled). So, I get it. 

And yet, there is always this tiny holdover from when I was 10 years old and forced to give up everything I owned — except for three choice playthings — when I was dubiously moved from one household to another. Things are just things, you tell yourself. Let them go.

Inside 'Where There's Smoke.'  

I wove several themes into the short story 'Where's There Smoke' inside 50 States. But most people who read it see what's on the surface first. One of the last families to evacuate a wildfire that will almost certainly consume their home sees presumed looters racing up to the house as they leave it behind. 

I write about them and what they would do. But if it was you, what would you do?

On the one hand, the fire will likely consume the entirety of everything left behind. On the other, strangers will invade your home, taking those things you painfully surrendered.

There is a grayness here where no one answer is the right one. It's a life-defining moment, regardless what decision is made. If you continue down the hill to safety as your home is ransacked, it says something about you. If you decide to head back to the home to scare them off, that says something about you too. And so do all those supporting decisions in between.

By the way, if you are wondering what to do about wildfire, the American Red Cross has a wildfire relief fund. You can read about wildfires and the volunteers who help evacuees receive the support they need.

Reacting Badly: Crisis Communication Is No Carnival

There comes a point in every crisis when a company must decide whether remediation will cost more early or later. Early is almost always better, but the crisis has to end before anything can be remediated.

Carnival Cruise Lines learned this lesson the hard way. Rather than end the crisis aboard the disabled cruise liner Triumph early, someone made the decision that it would be safer (and cheaper) to tow Triumph to port. And, following what some might call standard crisis communication protocols, Carnival immediately took responsibility and offered full refunds to the inconvenienced passengers.

There was one problem. The crisis wasn't over.

For approximately 3,100 passengers and 1,000 crew members, the crisis wouldn't end for almost a week. And for every day they remained trapped on board, the unsanitary and unsafe conditions were increasingly compounded along with the crisis.

As various services failed onboard the crippled cruise liner, passengers took to sleeping outside or in the hallways to avoid hot, stinky rooms; were forced to wait as long as three hours to use a handful of bathrooms (or use bags, which led to more unsanitary conditions); and resorted to survival-like tactics as food became scarce, power outlets scarcer, and showers mostly impossible.

Sure, some passengers will insist that the Carnival hell cruise wasn't so hellish. A few passengers will be thrilled with the mediation offered: a refund, cruise credit, and $500 in compensation. (One of them, according to the Washington Times story, even laughed when their rescue bus broke down too.)

But unfortunately for Carnival, crisis case studies aren't defined by lighthearted souls. They are ultimately defined by the ones who suffered the worst, especially because the Carnival crisis made the 2007 JetBlue ordeal look like a day at Disneyland. That one didn't end until Neeleman was pushed out.

Carnival might have greater consequences. It faces a class action suit that will draw out its negative publicity well beyond the crisis. Expect that the ugly is only getting started. Not only did the company made the wrong call in allowing the drama to unfold over nearly a week, it's their third cruise line disaster since October 2012.

Crisis communication is 10 percent action and 90 precent reaction. 

There is some truth to the notion that public relations professionals have little business in risk management, remediation, and crisis response. Not all public relations pros are trained in crisis management as well as crisis communication (and too many rely on tired tenets). However, this is once case where the crisis communication team could have stated the obvious. End the crisis first.

Because Carnival did not end the crisis quickly, bad luck stretched what ought to have been a half-day rescue into almost a week. And as the crisis progressed, Carnival was forced to make additional concessions as part of its remediation package. Partial refunds became full refunds. Full refunds became future discounts. Future discounts became cash offers. And ultimately, although almost unbelievable, Carnival told passengers they could keep their soiled bathrobes.

With each new event and concession during the crisis, Carnival opened up the opinion that remediation might not be enough. Every time something went wrong, Carnival opened up a round of possible negligence as passengers were put at risk of physical injury for days — particularly the way it handled human sewage issues. It had all the makings of a public health disaster.

It gets worse for Carnival. While the company has already issued a statement about compensation, it really hasn't made a display of empathy. The early remediation feels more like hush money, especially because Carnival's public relations spokespeople were forced to refute onboard passenger claims, continually reinforcing that the conditions were not as bad as some passengers said.

To be clear, the more Carnival attempts to defend its position (even in court), the harder it will be for the company to shake off a long-term stigma. Specifically, doing so will only reinforce that the crisis was not a harrowing experience for the company and its customers, but an "us" vs. "them" scenario with ample photographic evidence and potential investigative evidence that the company not only was responsible for the initial disaster, but also for every reactive measure afterwards — even decisions that were made after the passengers arrived in Mobile, Alabama.

Currently, the company has decided to remain mostly silent pending litigation. The last statement made was Feb. 15. The only other communication is marketing. You can save up to 20 percent on a cruise. The advertisement is probably most conspicuous at the top of the Google news search feed.

Overreaching With PR: Communicators Aren't Commanders

Bob Conrad touched on a great topic last week, even if some of the devices didn't fit together neatly. Oversimplified, he asks if public relations practitioners are prone to overstep in analysis and their own ability.

The answer is probably, but not all of them. It really depends on the individual practitioner. In using the UC Davis spray analysis for evidence as he did, however, he was absolutely right. Most public relations practitioners failed at an analysis because they did not understand the event.

What many public relations professionals who wrote about the UC Davis crisis did was enter in the aftermath and liberally apply standard crisis communication steps, ticking them off like a scorecard. Some of them even thought it was an Occupy protest. It really wasn't. It was about tuition increases.

Regardless, what public relations professionals who wanted the opportunity to include that now infamous picture on their blogs needed to do is take a different approach to presenting the real problem. To be a real case study of the UC Davis crisis, they would have to frame it properly, like this:

The Real Crisis Communication Case Study Question For UC Davis.

You're sitting in your plush communication office balancing your checkbook against your recent cost of living and merit raise because of the extra time you have, now that you are satisfied with next season's class schedule catalog that has finally been sent to print. (You're especially fond of the photo you picked for page 2). When, suddenly, your phone rings. It's the chancellor. 

"We have a crisis," she screams. "The kids are protesting about our insane tuition increase ... you know, the one that has driven up tuition 250 percent in the last ten years. It's turning into an Occupy protest down there and could turn violent. It's not even safe to walk into the campus, assuming those thugs let you by. They want to shut us down! What should I do? Or more importantly, what will you do?"

A. Walk out and express empathy with the mob in your new designer suit.
B. Recognize that they are only kids and give them treats and call their moms.
C. Flog yourself for not planning ahead and having the police already dressed in riot gear.
D. All of the above.
E. Mention the photo you picked for page 2 and go to lunch.

With the exception of "E," I framed these multiple choice questions based on the analysis that Conrad was right to criticize. The reality of this situation is that no cookie cutter crisis communication steps were going to help a public relations practitioner who needs disaster response experience.

The Reality Of The UC Davis Disaster.

The UC Davis crisis was largely unavoidable. The California university system is struggling to keep up with increasing employment costs that it cannot control and less funding as their budgets are cut. (Some of it could be fiscal mismanagement. Hard to say.) Sooner or later, these students were going to protest ten years of successive and excessive tuition increases. Call is predestination.

Given the atmosphere of Occupy rallies around the United States, it is even more likely that such protests (because there is no solution) will turn violent. It's just the mood of the moment, even among students who can afford a $24,000 to $54,000 per year for education. (Yeah, for UC Davis. Go figure.)

Students have rallies and protests all the time, at least when I went to school. Generally, unless they are disruptive or likely to turn violent, staff can reason with students to disperse as needed. Most of the time, you let them do their thing. (I worked as a resident assistant for two years.) If they do not disperse, you call the police (some schools have campus police; some private). Once the police arrive, it's their call — even if someone is advising them.

Of course, something else has changed since I went to school. Police protocols have been radically changed since 9-11, with most department training significantly more elective and aggressive than it was in years prior. In short, officers assess whether the protestors need to be subdued prior to removal (as opposed to simply picking up and arresting those passively resisting).

Personally, I think the officer in charge overshot. But the real point here is that the call to shoot pepper spray into the faces of those students was not one to be made by public relations. There were no PR advisors there, and the outcome might have been the same even if PR advisors were there.

So contrary to all the assessment write-ups, all public relations pros can do in this kind of a disaster is help mitigate it. Sometimes that means playing out a losing hand. And if you worked in communication for UC Davis on that day, you had a losing hand. What else can be said? No wonder I skipped it.

Do Communicators Make The Best Commanders?

The real question looming in relation to Conrad's post touches on a bigger question, spurred on by the Public Relations Society of America (PRSA). Lately, the society has been attempting to make the case that public relations people make great CEOs.

I mostly agree with Conrad, but for a different reason. A profession, in general, does not indicate whether or not someone would make a great CEO. However, PRSA is presumptive in its answer.

They ask: Who who else besides the CEO or chairman has their finger on the pulse of the company like a public relations person? While it varies from organization to organization, I might say "everyone."

It certainly would on a plane. You see, while a public relations professional might have an understanding of the pilot, co-pilot, navigator, flight crew, passenger service agents, ground crew, mechanics, and even passengers, I think most of us would think twice before letting him or her fly the plane. Unless, of course, he or she happened to be a great pilot.

Planning For Disaster: Communicators And PR Must Step Up

While my grandparents were poor by most definitions, my grandfather would go to great lengths to protect one of the last remnants of his family's possessions in the north woods town of Minocqua, Wisconsin. It was a summer cottage, for which he mortgaged his city home in Milwaukee every year in order to keep and maintain it until he retired. My uncle also owned a nearby home.

As one of the few four-season families in the area, my uncle was a natural leader. In addition to being to a small business owner, he served as a volunteer fire chief, mayor, and led teams to mark snowmobile trails across the partially frozen lake every winter. My grandfather, who was a former engineer and seasonal painter, was much the same.

Both men had experience in disaster planning. Coming from a small somewhat isolated community, it was a skill set that could not be left to other people. I even remember my grandfather putting his skills to good use when tornadoes interrupted a Boy Scout paper drive in the heart of Milwaukee. People immediately turned to him to lead.

Nowadays, there are fewer men like my uncle and grandfather, especially in urban areas. Disaster response tends to be left to professionals. But in considering the Gulf Coast catastrophe, it seems we need more citizens to understand response.

In fact, looking back on my recent guest host conversation on The El Show with Geoff Livingston, I think we might have invested some time on disaster planning beyond discussing how communicators can address unethical behavior. Communicators, even public relations professionals, need to establish a role within any disaster planning. It's vital that they do.

The Four Basic Tenets Of Disaster Planning.

1. Mitigation. Mitigation focuses on long-term measures to reduce or eliminate risk. These might include technologies or policies, set in place by companies or government.

2. Preparedness. Planning, organizing, training, evaluating, and improving activities that will ensure the proper coordination of efforts during a disaster.

3. Response. Response includes the mobilization of all necessary emergency services and first responders in the disaster area. Organized response requires a structure (leadership) and agility (creativeness).

4. Recovery. Recovery aims to restore the affected area to its previous state before the disaster. This almost always occurs after a disaster; it is the opportunity to assess where mitigation, preparedness, and response broke down.

Where Disaster Planning Broke Down With The Spill.

1. Mitigation. It seems obvious that neither the government nor BP (and subcontractors) had properly mitigated the potential for such a disaster. While policies were in place, it seems clear the regulatory agency did not have the technical expertise to oversee the procedural breakdown that led to increased risk at Deepwater Horizon.

2. Preparedness. To date, it seems obvious that the preparedness is almost non-existent. While the initial response saved most of the crew aboard the rig, neither BP nor the federal government has a plan for a large-scale coastal disaster. While this incident seems to have been caused by negligence, it strikes me as appalling that the government is largely unprepared for such a disaster.

3. Response. Given the failure of emergency response in the wake of Katrina, which was largely due to a complete breakdown in communications technology (I know because I've worked with the National Emergency Number Association, among other emergency response associations), it is perplexing that a new administration consisting of people who were hypercritical of and capitalized on Katrina would have done nothing to improve their ability to respond to a crisis. There is no communications technology breakdown this time. But there is a complete breakdown in appropriate federal leadership and agility over the response.

4. Recovery. Recovery is not simply litigation as our government has recently demonstrated as the answer for every problem ranging from the border issues in Arizona to the Gulf Coast oil spill. There is an apparent need to understand where the government's disaster planning continues to break down, not only with this administration but also prior administrations. The fundamental responsibility of any government is to protect its people — not from themselves — but from threats beyond the control of citizens. This time around it seems negligence played a role in the breakdown, but what about next time?

Where Any Communicator Can Effectively Play A Role.

Communicators, along with public relations professionals, have a real opportunity here to place a greater emphasis on tangible skills over manipulating public procedures. But to do it, they move beyond push marketing and puffery and embrace the much harder work that used to fall to people like my grandfather and uncle.

In many cases, they won't learn these skills from a textbook or building social media communities. It requires an ability to move from behind the desk, meet with and appreciate the men and women on the front lines, collect their input and consolidate it into a workable plan that anyone can follow.

More importantly, through their investigative work, communicators need to provide the oversight within their companies to point out where mitigation, response, and recovery is especially weak. Nothing needs to be smoothed over. If anything, people tasked with this work need to be as hard as nails, providing proper assessments to the executive team.

As I mentioned last week, bad PR is only a symptom of bad planning, I hope this helps move the conversation away from understanding and toward proactive responsibility. Communicators need not only be internal reporters, they can cut themselves from the same cloth as my grandfather and uncle.

Where Any Citizen Can Effectively Play A Role.

I might offer up the same advice to anyone. It seems apparent that while many local governments and some state governments have disaster response plans that we can count on, these plans are not scalable in the face of a disaster such as Gulf Coast oil spill, the aftermath of Katrina, the border breakdown in Arizona, or even the flooding in Tennessee.

Once they become too big for local and state agencies, the federal government is ill-equipped to respond beyond providing oversight. That means there is a greater need for citizens, each and every one of us, to have enough skills — like my grandfather and uncle did — to protect ourselves and our families in the wake of a disaster.

After all, if I was writing a family disaster plan today, the most obvious conclusion I would have to draw upon from the recovery efforts so far is that there are organizations doing all sorts of things that increase the risks to our health and happiness. And when their own mitigation breaks down, they do not have a plan to save you. We are on our own.

Helping Haiti: How To Respond Effectively

As the sheer scale of the destruction in Haiti caused by last week's 7.0 magnitude earthquake continues to reach people all over the world, the response has been overwhelming. So overwhelming that logistical logjams and the lack of an adequate supply chain may leave a majority of in-kind donations waiting for weeks before they can reach people in need.

"During these times of natural disaster, our first response is to donate food, clothing, and blankets to the disaster zone," said U.S. Congressman Kendrick B. Meek. "But this goodwill often causes delays in the supply chain providing recovery to those in danger."

In some cases, supplies are dropped and left on pallets for days before disaster relief organizations can move them to the most impacted areas. When supplies do arrive, some distribution points are disorganized enough that people in critical need are not the first to receive them. This is where communication becomes critical to any relief operation.

Timothy Ogden, writing for the Harvard Business Review, outlined four components that companies need to consider before making a pledge for support. They are important considerations in that Ogden recognizes that donations tend to spike in the immediate aftermath but fall short during reconstruction.

• Don't earmark donations for the short term.
• Research and choose experienced organizations.
• Consider monetary donations over in-kind contributions.
• Look ahead for potential long-term commitments that count.

For individuals, lending support can seem even more daunting. Every day, Haiti tops the conversations on social networks, but the call for support tends to be undirected. Bloggers Unite, which is a not-for-profit social network that helps direct bloggers to raise awareness and funds for causes in need, is attempting to direct some of the communication toward nonprofit organizations that meet the criteria.

The Bloggers Unite for Haiti home page includes three international organizations — Doctors Without Borders, Unicef, and Care — with direct donation information.

In addition to directing people toward those international organizations, all of which have experience in the area, the American Red Cross has developed a response page that helps individuals learn how to invest their donations, ranging from International Response and Haitian Relief and Development funds to broaden efforts such as service to the armed forces or wherever the need is the greatest.

For companies, specifically, choosing a broader approach to disaster relief might not amount to a timely news release, but will help organizations that are temporarily diverting funds to meet the immediate relief efforts. Without long-term or broad support, these organizations often find their ongoing programs challenged after an immediate crisis has abated and the media has moved on to cover the next story.

The takeaway is simple. Individuals and organizations do the most good when they respond to a crisis or disaster as opposed to reacting to it. You can help Haitian people the most by making direct donations to organizations like the American Red Cross or those listed at the Bloggers Unite page and by directing others who want to help to do the same.

Playing The Numbers: Endoscopy Center Forgets People

Since the beginning, the Endoscopy Center of Southern Nevada, which is responsible for the largest hepatitis C scare in the history of the country, has communicated a message much like it ran its practice — by the numbers.

Its message is clear. The risk is minimal to 40,000 patients who must be tested for hepatitis C as well as hepatitis B and HIV. Only six patients have been proven to be diagnosed with acute hepatitis C. Except… Except…

We’re not really talking about numbers. We’re talking about people.

Numbers don’t tell stories; people do.

My longtime friend and colleague Keith Sheldon, for example, is not a number. He’s a person. He’s also one of the many who never learned he needed to be tested because of a letter. He learned, like thousands of other patients, through the media.

“I was sitting in bed with my wife reading the Saturday paper,” Sheldon said. “At first, I didn’t think the crisis applied to me.”

It wasn’t until his wife started crying that his initial reaction, things like this happen to other people, didn’t apply. Sheldon was not only at risk, but had unknowingly put his wife at risk. And learning the center was notifying patients by letter and setting up a foundation was little consolation.

“As soon as I learned my health was at risk, I immediately made an appointment with my doctor,” he said. “He saw me the same morning … when it comes to your health, you don’t wait for red tape.”

It didn’t matter to Sheldon that he had to pay out of pocket for the test, despite promises that the center had already made arrangements with various health insurance providers. He needed answers … answers that still haven’t arrived. Because of the number of people being tested, most results will not be made readily available for seven to 10 days, which is next Monday or Tuesday at best.

“I hold the clinic’s management responsible for this disaster,” Sheldon said. “Specifically those individuals who had the day-to-day responsibility and oversight for how business was conducted.”

Recently, one doctor, who was employed at the center and asked the Las Vegas Review-Journal for anonymity because he fears "retaliation" from Dr. Desai (majority owner of the Endoscopy Center of Southern Nevada), said he left the clinic in 2000 — which places the start of the unsafe practices back to more than a decade — because he "was so depressed." He was reprimanded several times, the article says, because he was allegedly pressured to perform unnecessary biopsies, coupled with fabricated lengthy patient examinations, that could add more than $300 to a bill.

"It was so unethical," he said. "I couldn't live with myself."

As more stories surface, it seems to be that the entire practice was built on the concept of placing profits before people. By the account, it was always about playing the numbers: Reusing a single dose vial or the same syringe here and an extra biopsy there, well, it could help the clinic pay the bills.

Sheldon, who also teaches public relations and assists companies in crisis communication situations, is also mortified by the lack of empathy or apology by the center. From a business, ethical, and public relations perspective, the clinic is doing a dismal job of handling this crisis, he said.

“Rather than waste thousands of dollars on a poorly written, ill-conceived and
disingenuous full-page ad in the Review-Journal, the Endoscopy Center should have offered to pay for people to have their blood tested immediately,” he said. “ You just cannot put profit over people.”

When asked how the clinic might have responded, Sheldon offered…

“We demonstrated dismal judgment. We lost track of our mission of taking care of our patients to the best of our ability. We put profits over patients. For these transgressions, we are sorry. We pledge to make full restitution to the degree determined by the courts.”

I wholeheartedly agree. Anytime a company has surrendered all measure of professional efforts, there is nothing left to be done other than offer full disclosure, pledge full restitution, and permanently resign from the medical profession. These are not numbers; they are people — 40,000 people who are slowly learning through the media that they and their families — wives, husbands, sons, daughters — are at risk, one person at a time.

And, worse, it seems more and more clear every day that the numbers like six people infected and 40,000 at minimal risk, are designed to diminish the impact of real people, are growing every day. Dr. Desai ran six number-crunching clinics in southern Nevada. And, it has already become clear that the first clinic only offered a truncated list with 40,000 patients. Many more patients need testing.

For all of them, restitution seems obvious.

• Direct and full compensation for all testing without any fees being passed on to insurance companies.
• Free counseling for patients who are having challenges coping with the situation.
• Compensation for the pain, suffering, and anguish caused to the thousands of people put in harm’s way.
• The maximum amount paid out in medical malpractice to anyone who has to endure a shortened lifespan and risk of infecting loved ones as well as compensation to their families.
• The pledge that none of the management team will ever work in the medical profession again.

These are the only numbers we’re interested in reading about. As for the rest, it’s all about people. People you know and people who may never know if they are infected.

When handling a crisis, always put people first.

Sheldon offers up some hard but true advice for companies that abuse public or employee trust: “Would you have treated members of your family like this?”

The answer, more than likely, would be no. But we can only assume that. Other than the one-page advertisement that claimed patients should still have trust in the clinic, Dr. Desai isn’t talking.

Repeating Milgram: Endoscopy Staff Behavior

In 1963, Stanley Milgram gave the world a glimpse into obedience by publishing the results of his experiment in the Journal of Abnormal and Social Psychology. I learned about the study in college.

The experiment, conducted at Yale University, tested how much pain one participant would inflict on another, provided the participant inflicting the pain would relinquish responsibility to the person they perceived as an authority.

Although the experiment was staged (the person enduring the pain was a actor) and no one was injured, Milgram found that 65 percent of participants would administer an electric shock of what they believed to be 450 volts. Even more surprising, not one participant refused to administer shocks before the 300-volt level, despite several switches clearly marked “danger: severe shock” and the actor complaining of chest pain, banging on the wall, or dropping silent.

With light to moderate prodding, an authority figure in the experiment was able to convince the participant to deliver electric shocks. Some would protest, but continue to “shock” the actor nevertheless.

Understanding Obedient Staff Behavior.

Understanding Milgram’s experiment was followed by strip search prank call several years ago. It was not an experiment. It involved a caller claiming to be the police and instructing fast food managers to strip search employees. In more than 70 reported cases, managers surrendered personal responsibility to an authority figure, becoming like a puppet, and demanded employees remove their clothes.

By comparison, the notion that staff at the Endoscopy Center of Southern Nevada would blindly follow the instruction of administrators to reuse vials of single-dose medicine would likely take less surrendering of responsibility to a higher authority, especially one who had served on the board of the Nevada Board of Medical Examiners.

Why? Proximity to the authority figure. Perceived level of authority. Assurances of a minimal risk. Other nurses already practicing the procedure. And on. And on.

It the only answer for people still wonder why they didn’t stop the practice at the Endoscopy Center of Southern Nevada. Objectivity was sacrificed in favor of perceived acceptance. As one CDC officer reported it: the center’s practices to be so obviously dangerous that it was like “driving the wrong way down the freeway.”

I feel the same way about the center's crisis communication plan. It's like watching a horror show of a horror show, where you watch the next victim stumble up stairs with a flashlight.

The latest update: The Las Vegas Metropolitan Police Department and county prosecutors opened a preliminary criminal investigation. These investigations join inquiries by the FBI and the Nevada attorney general’s office.

Add to all this news an endless stream of sources being tapped by the media, including a very telling and almost incoherent interview with the center’s recently hired third-party crisis expert. Somebody forgot to tell her she wasn't a spokesperson.

Employees Need To Learn To Say No.

Comedian George Carlin includes it in his bit. He says people are too fat and happy to question authority. He's right. It happens all the time.

Even on social networks, it's obvious people blindly follow perceived authority figures, sometimes even participating in a “pile ons” just to be accepted. There is no concern for facts. Most online diatribe can be traced back to obedience and acceptance. It happens everywhere in places all over the world, places just like the Endoscopy Center.

There is only one lesson, and more employees could learn it:

• Th nurses could have complained to the administration that the practices were unsafe, refused to perform them, and demanded correction.
• Upon administrative insistence, the nurses could have told the center to correct its practices or report the incident to county health officials.
• Upon insistence or further inaction, the nurses could have resigned and immediately reported the infractions to county health officials.

Three simple steps could have protected thousands of people from being at risk of hepatitis B, hepatitis C, and HIV. Unfortunately, no one was up to the task. In all the world, only a mere 10-25 percent of people would have been willing to step up to the plate, depending on the country where they were raised.

Skirting Apologies: Endoscopy Center Not So Sorry

On Friday, the Las Vegas Review-Journal reported that the city of Las Vegas shut down the Endoscopy Center of Southern Nevada. After waiting until six patients had completed treatment, all employees were asked to leave the building and the doors were locked.

As mentioned last week, the Endoscopy Center of Southern Nevada was using single dose vials of medication, some of which had become infected with hepatitis C, a potentially fatal blood-borne virus, more than once. Hepatitis C is not the only potential infection that could have been spread; some fear hepatitis B and HIV could have also infected patients, some as far back as 2004 or earlier.

In what appears to be an effort to "control communication," the Endoscopy Center of Southern Nevada, which has declined to comment to any media outlet, did not seem short on words this Sunday. They ran a full-page advertisement in the Las Vegas Review-Journal.

The advertisement, designed to mimic an "open letter to the public" with the headline “Open Letter to Our Patients and the People of Southern Nevada,” smacks as a near-exact carbon copy of an ill-advised communication disaster attempted by Jack in the Box several years ago. Somebody must have missed that case study. It did not work then. It will not work today.

Dr. Dipak Desai offers sympathy but no apology.

“Recent events at the Endoscopy Center of Nevada of Southern Nevada are causing great concern to our patients and the community at large.”

This opening line says it all. It is so obviously written to mask where the responsibility might reside. This was not an accident. The responsibility lands squarely on the medical director and presumed "letter writer" of the advertisement.

In fact, according to the Las Vegas Review-Journal story referenced above, clinic staff has already told health investigators that they knew this technique fell well below accepted medical practices and was dangerous. However, they say they were ordered by administrators to engage in the practice anyway. So they did. The ad continues…

”First, I want to express my deepest sympathy to all our patients and their families for the fear and uncertainly that naturally arises from this situation. The trust we have spent for years building in this community has been challenged by the discovery that some of our patients may have been exposed to blood-borne diseases at our facility. In cooperation with the Southern Nevada Health District and other health agencies and officials, we have carefully reviewed our procedures and implemented the changes they recommended.”

Despite the near admission in the third sentence, there is no direct admission (despite mounting testimony) or any apology whatsoever. Clearly, the aim is an ill-advised attempt to position the crisis as an accident while once again attempting to leverage "trust" that patients placed in the clinic while they were "unknowingly" placed at risk by what seems to be a very "knowing" staff. The ad continues…

“We are also working with third party payers to be sure all our patients who need to be tested are, and that the costs are completely covered.

For those who are uninsured, a foundation is being set up to cover the cost associated with their tests. You will learn more about this in the days to come.”

It amazes me that any company or organization would attempt to promote the argument of denial, despite the fact that the clinic is already proven responsible for the infection of several patients. In addition, the attempt to portray itself as a good public citizen by setting up a foundation reminds me of post-crisis measures employed by Jack In The Box, which they only implemented after sustaining a loss of $20 to $30 million.

The ad continues with another paragraph, first thanking the health district for bringing the problem to the Endoscopy Center of Southern Nevada’s attention and continued clarification that the clinic did not spread the disease to patients one way as has been reported, but another erroneous way all together. As if that matters. The ad closes…

"At the same time and without making excuses, I think it’s important for the public to know that the chances of contracting an infection at our center from 2004 though June 2007 were extremely low. Of the six cases reported, it appears one exposure took place in July 2007 and five on Sept. 21, 2007. Regardless, if you were a patient at our facility, I encourage you to get tested.

Thank you for allowing me to share these thoughts with you.”

The six cases mentioned were those that prompted health officials to conduct an investigation, and not the results of 40,000 tested. Worse, this closure attempts to use the number of confirmed infections as a tool toward exoneration, as if six patients who have been confirmed infected are less significant when compared to the 40,000 that have yet to be tested.

What it also neglects to mention is that health officials are also concerned, however, that even more patients could have been infected prior to 2004 when the clinic operated under a different name. Not everyone is taken by these controlled statements. As expected, one local law firm, Craig P. Kenny & Associates, ran a full-page advertisement in the same section. Its advertisement encourages patients to contact the firm to discuss legal action.

While heroes are seldom found during a crisis, there is one clear hero in Las Vegas. Quest Diagnostics, which is completely unaffiliated with the Endoscopy Center, is the first business to offer to test patients for free. The offer from Quest Diagnostics to provide this community service came after the Endoscopy Center was slow to offer the same and after another health care provider, one that sent overflow patients to the Endoscopy Center, shrugged off any responsibility.

As shocking as it seems, the Endoscopy Center of Southern Nevada has not made any mention of how it intends to compensate those patients who have been infected nor has there been any comment that seems to demonstrate remorse or empathy. So far, it seems they are content to play the numbers and control an uncontrollable message.

Causing Crisis: Health Clinic Spreads Virus

Sometimes a crisis communication checklist is not enough. The Endoscopy Center of Southern Nevada is attempting to apply some practices, but the message is failing to resonate. I’m not surprised.

This is the largest hepatitis C scare in the history of the country.

The Endoscopy Center of Southern Nevada was reportedly using single dose vials of medication, which had become infected with hepatitis C, a potentially fatal blood-borne virus, through their initial use and were used again. Hepatitis C is not the only potential infection that could have been spread.

The Southern Nevada Health District is asking some 40,000 patients who had procedures requiring injected anesthesia at the clinic between March 2004 and January 11, 2008, to contact their primary care physicians or health care providers to get tested for hepatitis C as well as hepatitis B and HIV. Given the transient nature of Las Vegas, it is nearly impossible to tell how many of these patients have moved out of the area or have been living with an infection for years.

The reality and gravity of the situation is severe enough that the statement released to the media by the Endoscopy Center of Southern Nevada fails to exhibit even a basic understanding of crisis communication, considering the severity of the issue.

“On behalf of the Endoscopy Center of Southern Nevada, we want to express our deep concern about this incident to the many patients who have put their trust in us over the years. As always, our patients remain our primary responsibility and we have already corrected the situation.”

Obviously not. If patients were the primary responsibility, this would have never happened. How could anyone even think such a statement was appropriate to include as a patient care message during a press conference that addressed wrongdoing of the worst kind — reusing single dose vials is widely known to pass infection.

The statement goes on to say things like “In addition to our corrective actions, we are on a mission to maintain the trust our patients have had in us during our years of service to southern Nevada.” They must be joking. And, unbelievably, they attempted to play the legal counsel card — pending class action suits already being organized and a criminal investigation — to limit their comments and refuse to take reporters’ questions. Unbelievable.

If you break off communication with the media during a severe crisis, they will have no alternative but to seek other sources. Every media outlet covering the story is doing exactly that.

According to the Las Vegas Sun today, several doctors unaffiliated with the Endoscopy Center of Southern Nevada have surmised that the clinic appeared to put profits ahead of patient care, directing staff to cut corners in order to accommodate the high volume of patients. The procedures were performed by certified nurse-anesthetists, with apparently no one at the practice willing to step up and say what they were doing was wrong.

These practices continued until the Southern Nevada Health District identified six cases of hepatitis C, five of which stemmed from the Endoscopy Center of Nevada. While the center continues to stress that the actual risk of anyone being affected by this is extremely low, it seems to be little consolation for the individuals. Elected officials are already calling for the removal of the clinic’s license.

This crisis has already been mishandled to the point of no return.

In such extreme cases, one might ask if the clinic is worth saving. While this could be debated endlessly, I’d rather focus on what they did wrong from a communication standpoint, which made this unrecoverable.

They are attempting to apply a truncated crisis communication formula frequently employed by public relations professionals who have little real world experience. Worse, they are being selective in which ones they are using — the statement doesn’t even include an apology, possibly for fear of admitting criminal negligence.

Look, crisis communication is a process and not a formula. You can come forward, apologize, explain the incident, address corrective measures, seek outside consult, promise it will never happen again, and perhaps demonstrate some measure of empathy (I was told the owner appeared empathetic at the press conference) all you want. But it won’t change gross negligence.

What the crisis communication team needed to consider.

• The clinic needed to come forward sooner and explain precisely what occurred and why it occurred, regardless of potential civil and criminal cases. If the crisis was caused by placing profits before patients as some speculate, an admission is appropriate.

• The clinic needed to apologize, at minimum, to the five people likely infected with hepatitis C by its procedures and offer immediate restitution. It further needed to voluntarily pay for a proactive location and testing of all 40,000 patients as well as family members that may have been affected as a result.

• The clinic needed to maintain an open door policy to address all concerns and questions from the media and other stakeholders, regardless of personal jeopardy, as personal and public safety remain at risk.

• The clinic needs to verbalize empathy, sympathy, and embarrassment over its procedural practices without any trite statements revolving around preserving patient trust and promises that it will never happen again. It would seem more logical for the clinic to voluntarily dedicate 100 percent of its resources to the crisis.

• Dipak Desai, medical director and majority shareholder in the practice, needs to step forward as his own spokesperson and promise to step down immediately after overseeing restitution to the victims. Desai also needs to fully cooperate with all investigations and help determine which doctors and nurses were engaged in these procedures or knew about the procedures but neglected to speak up.

All this should have already happened. However, it did not. Given the severity of the crisis and the initial handing, it’s likely this will be unrecoverable. And frankly, despite placing it in the living case study slot, maybe that is for the best if it does not recover.

Mining For Communication: Crandall Canyon Mine

It has been weeks. Six men remain missing, likely dead. Three rescue workers have lost their lives. Several have been seriously injured. Many more have suffered.

Yet, the media continues to report in microscopic detail. Everyone from the man on the street to Utah Gov. Jon M. Huntsman has offered opinion. And mine owner Robert Murray continues to miscommunicate at every turn, including his insistence that a seismic shock was responsible for the collapse despite evidence that suggests otherwise. The mine is unsafe.

"Not all seismic activity is what it looks like," said Jim Pechmann, who has been a seismologist for more than 20 years. "The reported activity was undoubtedly related to the mine collapse."

A few weeks ago, someone had asked that perhaps the Crandall Canyon Mine would make for a case study so public relations students might learn how to better plan for and handle crisis communication; perhaps after our hearts have healed.

With as many communication mistakes as have been made during this tragedy, I’m unconvinced our hearts will ever heal. So, my comment today is with the hope that those involved might handle the conclusion better than they have the last few weeks.

First and foremost, while some principles remain true, crisis communication and disaster response or emergency communication are not the same. Had Murray been advised of this, perhaps some of the communication would have played out differently. You see, in the midst of a disaster, there is no room for speculation, presumption, guesswork, media conference teases, and emotional rally cries that more cause pain and suffering beyond the tragedy.

Without question, an entire book could be written on the many missteps of the Crandall Canyon Mine communication. For us, the best that can offered up are a few tenets in a series of well-spaced apart posts, starting with a few basic principles that were missed during this disaster (and why some communicators will still get it wrong next time).

Situation Analysis. While some public relations practitioners suggest rapid-fire response and up-to-the-minute detail, nothing outweighs accuracy. All too often throughout this crisis, the pressure to educate not only overshadowed proper fact-gathering, but also infused itself into the decision-making process that quite possibly led to increasing the risk to rescue workers. There seems to have been little regard for assessment, which has frequently led to the release of erroneous information and overreaching conclusions.

Identify Crisis Team. Many public relations practitioners conclude that a principal such as Murray should be made spokesman. This is not true. With exception to the biggest news breaks in the story, Murray was not a suitable spokesperson and would have been better served focusing all of his attention on the rescue efforts. A different spokesperson could have kept reporters up to date and stories focused on facts with occasional input from reputable specialists as needed.

Prioritize Publics. In this case, the first people to receive any updates should have always been the families of those affected. Affected families should never have to learn new or conflicting information from the news. The second priority are other team members: rescue workers, and response partners (including medical personnel), ensuring that if they do answer media inquiries, miscommunication is minimized. The third priority is government officials; people to whom the media are likely to turn for additional comment. And then, and only then, can the media receive updates that are centered on major news items and not miniscule detail.

Narrow The Message. In today’s world, communication happens at the speed of light. All publics receive it quickly and react very differently. While all information will eventually be released (it pays to be truthful), a spokesperson must keep the issues manageable and the focus narrow. Wild claims without evidence are fraught with peril: it is always best to remain hopeful for the best outcome, but prepare people for the worst.

Accept Responsibility. Murray’s inconsistent and often emotionally charged communication over the last three weeks has demonstrated one simple truth: all mishandled communication happens from the inside out. Even if Murray was right, that an earthquake caused the collapse, there was never time to angrily defend his company's safety record and its efforts to reach the trapped miners. Doing so only demonstrated a lack of empathy to the families, eroded reputation, and worse, positioned Murray as someone who cared more about his company than the men who lost their lives.

Although most people can understand the pressure Murray must feel, someone needs to tell him that it doesn’t matter who or what is to blame. Sometimes, no matter what the cause, you have to accept responsibility (if not accountability) all the same.

Our hearts and prayers go out to the families. If you would like to lend assistance, read today’s story in The Salt Lake Tribune that includes a variety of funds that have been established. If there is anything good to be found in this story, it is in the generosity and sympathy extended by people from across the country. Well done.