Save spin for a trip to the laundromat

"Thank goodness, you're here!"

"Susan, I came as soon as I got your message. What is the emergency?"

"Dr. Weng was doing a BE on a woman, and she coded. The family rushed in the room while he was trying to resuscitate her but couldn't. They freaked out and called the police, their lawyer, and a TV station. Then Dr. Weng ran off. We called 911, but it was too late. But the worse thing is. . . . Uh-oh! Look what's coming."

"Miss! Miss! You can't just barge in with that camera."

"Live on Fox Eye Spy News, this is Miranda Gonzalez with this exclusive onsite interview with the doctor who just assaulted and killed an 86-year-old nun. Why did you do it?"

"I didn't do anything."

"You heard it live on Fox Eye Spy News. He denies everything even in the face of overwhelming evidence."

"I wasn't even here."

"More denials! Do you also deny assaulting this woman with your deviant inflatable latex toys?"

"Missy, you are way out of line. I want you out of here."

"Is that the same threatening tone you used with the family?"

"It was Dr. Weng, and he did not kill anyone. He was just doing a barium enema. It requires an inflatable balloon, which is standard. Unfortunately, the patient had a heart attack and died. These things happen. You better watch what you say, or you're going to have a libel suit on your hands."

"So, you can assure our viewers that Dr. Weng did not have his deviant way with this saintly woman?"

"Absolutely."

"And that he wasn't wearing a red lace teddy?"

"You people are the lowest of the low. You make me sick. A red lace teddy! Of course not. Get the hell out of here."

"Bob, play the tape."

"What tape?"

"The family videotaped everything with their phone."

"Oh . . . my . . . god! He does have a teddy on. And is that an inflatable doll? Susan, what's going on?"

"I'm sorry to interrupt, doctor, but the rest of the TV stations just showed up with their satellite trucks. And a Bentley with the license plate 'SUE EM' just pulled in."

"Bob! He's making a run for it! Quick! The camera. Don't lose him. This is Emmy material."

Even innocent people can panic in a crisis. If there is a police car behind me, I start to panic even if I'm not speeding. Imagine how you might respond to a crush of reporters shoving cameras and microphones in your face. Few of us could rise to the occasion without preparation. Having watched authority figures respond to the Hurricane Katrina crisis, I would like to offer advice culled from experts in public relations on how not to respond in a crisis.

- Don't use a lawyer as your spokesperson. Of course, hire a lawyer. But when have you ever actually believed a lawyer on TV? "My client is totally innocent. He has no idea how those bodies came to be in his freezer, refrigerator, bedroom, basement, storage shed, or car trunk. Once the facts come out at trial, he will be found innocent." You read later how the attorney for the Cincinnati Cannibal says he is confident his client's conviction for eating 39.5 people will be overturned on appeal. People do not trust lawyers, who rate in polls below used car salesmen. So why use them to defend your practice?

- Don't talk about things you don't know. If you don't have the facts, don't make them up. If you don't know, say so. The spokesperson for Tenet Healthcare, owner of Memorial Medical Center in New Orleans, said all 45 dead patients found in the center had died prior to the hurricane but later had to admit that only eight had. Yes, everyone had been evacuated. Well, then again, maybe not. Simple errors can quickly be perceived as attempts to deceive.

- Don't resort to spin. "In war, truth is the first casualty"-Aeschylus, 525-456 BC. The lawyer speaking for the owners of the St. Rita's Nursing Home (their first mistake) argued vehemently that his clients had not let 34 people die but were in fact heroes who saved the lives of 52 people. This, of course, conveniently ignored the fact that they did not evacuate as required, inaction that led to those deaths. Worse, only five of those saved were actual patients and the rest were the owners, staff, friends, and family. You'll only look worse when the truth finally comes out.

- Don't blame others. As the post-Katrina crisis unfolded, an orgy of finger-pointing ensued, with people blaming everyone but themselves. This involved everyone from the mayor of New Orleans to the White House. As more facts came out, however, it became apparent that everyone had made mistakes and all shared in the blame. Though blaming someone else may be comforting, it rarely solves problems. In fact, it can make things worse by creating hostilities and undermining attempts to facilitate difficult problem solving later. Stick to facts.

- Don't drag your feet. Ignoring requests for information or interviews is viewed as stonewalling. The court of public opinion can be swift and harsh for companies or individuals who don't acknowledge a problem. Foot-dragging is viewed as either evasiveness or incompetence. As the White House learned, the longer you delay, the harder it is to make a recovery.

- Don't let everyone talk. While one spokesperson was saying New Orleans was okay, others were saying completely different things. You want to get out one uniform message. Who delivers that message for your group is critical. Choose a spokesperson who is calm, confident, and unflappable but also sympathetic. Under withering cross-examination, it is hard for most people not to become defensive, but that reaction can end up being played endlessly on TV just as easily as "Brownie, you're doing a heck of a job!"

- Don't try winging it. Practice answering the difficult questions with your advisors. Long-winded answers rarely get conveyed in their entirety. Craft concise, clear sound bites if you want to get your message out. Respond to the media. If you can't talk right at that moment, say so, ask for their deadline, and then get back to them. Remember at the beginning of a crisis, most reporting is gossip-aim to overcome that.

No group is prepared to see its practice on the front page accused of Medicare fraud. No one wants to see a partner being taken away in handcuffs for drug abuse/assault/whatever. A crowd of camerapersons filming a body being removed from your office does not inspire a warm fuzzy feeling (unless it is a lawyer). Those things may not be under your control, but you can control how you respond, and you can turn a crisis around with the right attitude. Follow the above rules and remember to emphasize the positive.

"I realize that this all looks really bad, but you have to admit for a man of his age and build, Dr. Weng looks remarkably good in that teddy."

Dr. Trefelner is a radiologist and cofounder of NightShift Radiology. He invites comments by e-mail at ericxray@pacbell.net or fax at 650/728-5099. He also answers questions posed by readers in the "Ask Eric" column on diagnosticimaging.com.