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Today at the East County Community Health Services clinic in El Cajon, Supervisor Dianne Jacob is holding a “newser,” an announcement directed at the media. Because Scripps East Hospital in El Cajon has recently closed, Jacob wants people to know Grossmont is the nearest hospital for emergencies. But she also wants people to use an emergency room only when it’s necessary. On this issue the public needs educating, a job some feel is not the bailiwick of elected officials. But not to worry. For Jacob and Jacob’s media-relations officer, the solution is a no-brainer: Stage a media event. Facing the cameras will be a lineup of doctors, patients, and emergency medical technicians, standing behind Jacob and supporting her speech at the portable amplified podium with a seal whose motto reads, “The noblest motive is the public good.” Jacob hopes her newser will spread the word about not using the emergency room for nonemergency problems. Six hundred thousand uninsured people live in the county, about 20 percent of the population. Of those who use the emergency room, 60 percent don’t require urgent care. It’s not their fault. People without health insurance or a primary-care physician tend to seek immediate relief for influenza or a bloody nose. How better for Jacob to get this message out than to call on television.

And so, in the form of two-person news crews, the local stations oblige: kgtv/Channel 10; kusi/Channel 51; kfmb/Channel 8; knsd/Channel 39; xetv/Channel 6; kswb/Channel 69; and kbnt/Channel 19 (Spanish-language Univision). These seven stations broadcast 113 hours of news every week in San Diego, the 25th largest media market in America. I’m riding to the newser with kgtv photographer Richard Klein and weekend anchor/reporter Lee Ann Kim. Having been assigned this story at the morning editorial meeting, Kim and Klein began calling emergency rooms to interview the staff but were told, in so many words, to stay away. They learned that doctor-patient confidentiality forbids shooting people’s faces in an emergency room and that doctors are too busy on Mondays (this is a Monday) to talk to reporters about the “overuse” of their facility. So the pair decided to find a new angle or, better, to make something out of the newser. What’s more, their boss, news director Mike Stutz, expects them to use their storytelling talents. Driving to the press conference, Kim reminds me that most “media events” are spelled B-O-R-I-N-G! Sure, there’s a valid medical message to cover, but administrators are the snooziest talking heads of all. “The message,” Klein says, “gets lost when you show a crowd of people. The viewer will just change the channel.” The shorts-wearing, gangly photographer, looking not unlike a high school tennis coach, wants to craft the piece differently, so it doesn’t end up as a 30-second voice-over — an anchor reading over the videotape — the standard mind-lolling, flash-obvious method of daily TV news presentation.

Kim, a Korean-American woman whose black hair sculpts her face in feathery flips, tells me she’s learned to be wary of county and city bigwigs who call for cameras. They stage such events to get the media to publicize not something informative or definitive but a plan, a task force, a commitment to study the problem further because the assembled are so very concerned. The reporter has seen it before, especially with Susan Golding’s office. When we arrive, the six other channels are erecting cameras on tripods; reporters are writing on hand-cupped notepads. Sure enough, it’s just as Kim feared: Jacob says she’ll be announcing a “joint effort” to “establish guidelines” for emergency rooms, so today we will introduce to you the media — and thus you at home — the people who will work together (at a later date) to establish those guidelines. Kim whispers in my ear, “It’s bullshit.”

In the clinic’s waiting room, Kim says she’ll start talking with people and then “pop in the question, ‘By the way, have you ever gone to an emergency room in a nonemergency situation?’ ” Kim starts mingling; Klein shoots a row of waiting patients. Just then Margaret Radford, a recognized anchor/reporter from Channel 8, comes in. Says a seated woman, “Margaret, we’ve watched you for a thousand years,” laughter, laughter; “It’s almost like we know you,” a stiff-legged man rises to greet her. Klein tells me later that the more well-known the anchor/reporter is, the worse it often is to get honest, unstaged coverage. “They start acting like they’re on TV, more careful with their words, intentionally angle themselves to the camera,” he says. People are in awe of anchors, so much so that they’ll often say what they think the anchor would like them to say.

Kim has found a diabetic man who’s periodically used emergency rooms for problems related to diabetes that are not life-threatening. He can’t afford insurance. There’s a festering boil on his arm that he calls “cancer,” which he says he can’t afford to get checked. (His best, albeit unused, sound bite is, “It’s a shame that it costs so much to be sick.”) Though Kim interviews him at length and Klein tapes them, he’s had scant use of the emergency room. Up pops a girl named Amy. The 16-year-old has lost one entire fingernail (the other nine are a Gothic purple) and says she was told to come here by people at the emergency room. “It’s all pussy and feels really, really bad.” This is it! Kim and Klein ask if they can go in-depth with Amy and her mother. They say yes. The mother admits on camera that the emergency room wanted $300 just to look at the fingernail; she also complains of another emergency-room bill totaling more than $900. That one she’s paying $50 a month because “what else can I do?” Klein hustles outside to “spray” the newser; that is, get footage of the line-up without sound. Back inside he follows Amy down the corridor with nurse Betty, shoots her consultation, plus the all-important Band-Aid on the wound, and the final bill-paying moment, a 20 and a 10, $30. Throughout, Klein keeps the camera on so he can “be in the story as much as possible. It gives an immediacy that for TV is really good.” A 20-year 10 News veteran, Klein loves filming the real. But it’s hard to capture. Covering people, he says, “You never, never, never want to touch someone” because that may evoke a manufactured feeling — your niceness may make them act differently. About news gathering, he says, there’s “always a line — you have to draw it and never cross it.” That line is between capturing the expressive emotions of people and currying just enough of the subject’s favor to insure a hoped-for intimacy you know viewers want to see. (How well we know the ploys of Barbara Walters as she gets her subjects to weep.)

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