The Worst Example of the Anechoic Effect? - "Erase the Story or Be Erased. Your Family, Too."

We posted earlier this week about how the US Federal Bureau of Investigation (FBI) let four alleged members of the Yakuza, that is, Japanese organized criminal gangs, into the US in the hope that they would talk about their gangs' activities in this country. One attractive aspect of visiting the US for the four was apparently the opportunity to get liver transplants at UCLA Medical Center. That hospital provided the transplants with with some alacrity, for which the four apparently paid full list prices. Later, two of the four also gave UCLA Medical Center substantial contributions. But none of them gave the FBI much useful information.

In the post, I briefly mentioned that a reporter who was on the trail of this story in Japan was warned off by a threatening message from some shadowy strangers. That reporter, Jake Adelstein, left a comment on our original post, and a link to an article he wrote in the Washington Post about his reporting on the Yakuza in Japan:

Three years ago, [alleged Yakuza boss Tadamasa] Goto got word that I was reporting an article about his liver transplant. A few days later, his underlings obliquely threatened me. Then came a formal meeting. The offer was straightforward. 'Erase the story or be erased,' one of them said. 'Your family too.'

I knew enough to take the threat seriously. So I took some advice from a senior Japanese detective, abandoned the scoop and resigned from the Yomiuri Shimbun two months later. But I never forgot the story. I planned to write about it in a book, figuring that, with Goto's poor health, he'd be dead by the time it came out. Otherwise, I planned to clip out the business of his operation at the last minute.

I didn't bargain on the contents leaking out before my book was released, which is what happened last November. Now the FBI and local law enforcement are watching over my family in the States, while the Tokyo police and the NPA look out for me in Japan. I would like to go home, but Goto has a reputation for taking out his target and anyone else in the vicinity.

In early March, in my presence, an FBI agent asked the NPA to provide a list of all the members of Goto's organization so that they could stop them from coming into the country and killing my family. The NPA was reluctant at first, citing 'privacy concerns,' but after much soul-searching handed over about 50 names. But the Tokyo police file lists more than 900 members. I know this because someone posted the file online in the summer of 2007; a Japanese detective was fired because of the leak.

Of course, I'm a little biased. I don't think it's selfish of me to value the safety of my family more than the personal privacy of crooks. And as a crime reporter, I'm baffled that the Japanese don't share intelligence on the yakuza with the United States.

This more detailed version is even more chilling. We have often talked about the anechoic effect, the phenomenon that stories about mismanagement, conflicts of interest, and corruption of the leadership of health care organizations, and resulting threats to physicians' core values get much less attention than they are seemingly worse. One obvious reason for this is that people within health care may fear that discussion of such issues may jeopardize their careers. Ill-informed, conflicted, and even corrupt leaders may not like their errors or misdeeds exposed in public.

However, I don't think we have previously heard of anyone whose life, or whose family's lives were threatened because they publicized a story of questionable health care leadership. So the present case may be the worst example of the anechoic effect yet revealed.

But to return to the health care end of it - maybe the leaders, physician and lay, of UCLA medical center should reflect on their decision to give Mr Goto and his associates special, at least more rapid treatment because they paid cash, and because of the possibility they would contribute future money to the institution, in light of the threats made against Mr Adelstein and his family. Does an institution that is supposed to try to save and prolong lives want to take contributions from people who threaten the lives of people who question those contributions?