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was now tromping him, he, too, began dipping into tabloid sleaze. “I don’t want to die a hero,” he said, explaining why he cross-dressed as a woman to do a show on transvestites. He later acknowledged that as a white male, he lacked Oprah’s ability to get cozy with a female audience about finding a good man, a foolproof diet, or a bra that fit. While Oprah was besting Donahue at every turn, The Wall Street Journal reported on critics who called her show “Nuts ’n’ Sluts” and “Freak of the Week.” Her executive producer defended the tabloid programs, saying when viewers complained about a show on sex, it was only after they’d watched every minute of it. When she was asked about a show on child murderers, Debra DiMaio asked for clarification: “Are you talking about kids who kill kids, or kids who kill their parents?” Oprah had done shows on both.

She said she would never do another show with white supremacists, but she resented being criticized for doing tabloid television. “It bleeps me off when you guys write as if I do shows about how to dress your parakeet,” Oprah told one critic. “I was uncomfortable doing ‘Women Who Have Obnoxious Husbands,’ but I turned down [televangelists] Jim and Tammy Faye Bakker. Won’t talk to them. And I won’t do ‘Is Elvis Alive?’ ”

During the May sweeps of 1988, she stunned everyone when she chose to air a show on teenage boys who’d died of autoerotic asphyxia, a sexual practice that sometimes involves tying a noose around the neck during masturbation. By then she was not just competing against Phil Donahue, but also contending with the talk shows of Sally Jessy Raphael, Geraldo Rivera, Morton Downey, Jr., and Regis Philbin and Kathie Lee Gifford, with Joan Rivers, Jenny Jones, Jerry Springer, Maury Povich, Ricki Lake, and Montel Williams waiting in the wings. The pressure to top previous sweeps ratings and trounce the competition led Oprah to present a controversial show featuring the parents of two young boys who had accidentally strangled themselves as a result of the extreme sexual practice.

Dr. Harvey Resnik, a clinical psychiatrist, also appeared on the show. As former chief of the National Institute of Mental Health’s Center for Studies of Suicide Prevention, he had published a paper on erotized repetitive sex hangings in which men bind their necks, or cover their heads in a plastic bag pulled tight with a drawstring, and achieve an intense high through masturbation while reducing the supply of oxygen to the brain. “When oxygen is depleted, more carbon dioxide is retained, causing an altered state of consciousness. The result is a light-headed giddiness known as a head rush, something that skin divers and pilots who lose oxygen also report. This altered state can affect the sexual pleasure center of the brain. The risk is that with diminished blood flow, the person passes out, slumps forward, and completely obstructs the airway, which results in death from asphyxiation. The behavior is well known to medical examiners.”

As a consultant to survivors of victims of autoerotic asphyxia, Dr. Resnik understood the shame attached to that particular kind of death. “Just as with other problems we have in mental health, we know that self-help groups and the ability to share grief and to share information is quite helpful,” he said.

The day before the show aired, Oprah’s executive producer, Debra DiMaio, called Dr. Park Dietz, a forensic psychiatrist, criminologist, and professor of biobehavioral sciences at the UCLA School of Medicine. He warned her about broadcasting such a graphic subject. “I had a heated discussion with the producer. I argued that television is not a suitable medium for discussing this subject, because the risk of people imitating it is too high,” he said. “I told her that if the show were aired, it would foreseeably result in one or more deaths.” Dr. Dietz added that if anyone sued Oprah for reckless and negligent conduct, he would testify to a jury that he had warned the producer against airing the show. Oprah later said she had “meditated” on the matter and concluded that