In moments, trauma unit turns into "war zone"

     I clearly remember the moment, my hand on the old brass doorknob of my apartment at Logan and Mozart, the telephone ringing through the dark wooden door. 

    "Don't answer it," I told myself. 

    It was Friday, my day off, since I worked Sundays, and I was heading to the gym. 

   "Just leave," I thought.

     But being a reporter is a calling, like a priest. I sighed, went back inside, answered the phone. The City Desk, of course. The Tribune, they said, was running some big piece on trauma centers, starting Monday. Trauma centers were expensive to run, and closing down. I was to go to Christ Hospital, soon to be the only Level 1 trauma unit on the South Side, and spend 24 hours in their emergency room, then write a piece. 
    For Monday. 

    Okay, I said. Being a newspaper reporter is a calling, like a...

    I got Christ's PR person on the phone. 

    "I'm going to have to talk to the board," she said. 

    "That's fine," I said. "But do it quickly. I'm heading to the hospital right now, meeting a photographer there. You can either let us in or have us arrested."

    They let us in. A different era. The problem I faced was that very little happened for the first 20 hours I was there. I caught a few winks on a stainless steel table in an examining room, worried as I drifted off that I'd wake up being operated on. 

    To show how long this has been an issue, this article is more than 25 years old. Holy Cross, at 68th and California, which gets bypassed by the ambulances in my story, announced last week it is spending $40 million to upgrade to a Level 1 trauma center. 

     

     Everything changed at 1:35 p.m.
     After hours of coffee, pizza, chat and routine treatment of cut noses and sore throats, the call came into the Christ Hospital emergency room Saturday afternoon: Two men with serious gunshot wounds were on their way.
     An operating room at Christ, soon to be the only hospital serving the South Side with an advanced trauma unit, was readied for surgery. Specialists whom another hospital might take hours to find were immediately contacted and put on alert at Christ. Doctors, interns and nurses gathered to map out plans.
    "Why don't we make the chest wound the 99?" said Dr. Joe Mueller, giving priority to a 33-year-old man who police told them by phone had been shot just above the heart.
     Other patients were wheeled away. Supplies were laid out: intubation tubes, packs of syringes, gauze and gallons of medical fluids.
     Paramedics soon rushed in with the first victim. In agony, he tried to jump off the gurney. A dozen doctors and nurses held him down. Nurses slit off his pants while doctors began the "90-second-survey," rolling him on his side to check for other wounds.
    The big man, with homemade tattoos, cursed the doctors, then cried out in pain.
    "Hold my hand, hold my hand," he said, and a nurse gripped his fingers.
     Paramedics who had wheeled in a very old man stood waiting for attention. They were brushed aside by another group of paramedics with the second gunshot victim, a 19-year-old.
     The shooting victims had wounded each other on West 69th Street over a dice game. Twenty-dollar bills still lay on a gurney.
     The ambulances carrying the men had bypassed two other hospitals — Holy Cross and St. Bernard — because they are not part of Chicago's shrinking trauma network. Instead they came to Christ Hospital, at 4440 W. 95th St. in Oak Lawn.
     Even as the trauma team divided itself between the two gunshot victims Saturday, nurse Cheri Aardema put down a phone and announced: "We've got another one coming in. IV drug user with multiple stab wounds. Used heroin two hours ago. Here in 10 minutes."
    By 3 p.m., one resident described the emergency room as a "war zone." A technician, arriving to make a scan of the victims' hearts, took one look and left the room to pass out.
     The key to understanding the difference between a trauma center and a standard emergency room is one word: readiness.
     Any hospital could have inserted tubes to drain the gunshot victims' chests, taken X-rays or cut into their ankles in search of the saphenous veins to hook up lines to pump liquid into their shocked bodies.
     But as a trauma hospital, Christ had to be prepared for whatever happened. If an aneurysm suddenly burst in a brain, neurosurgeons were ready. Cardiac surgeons were standing by in case bullets had damaged a heart.
     It follows that since trauma hospitals must be ready for almost anything, usually their capacities are not needed to their fullest. In fact, for three solid hours earlier that day, from 3 to 6 a.m., no patients were treated in the unit.
     Other "Code 99" trauma calls Saturday were false starts. A "gunshot wound to the left chest" arrived at 12:40 a.m. The trauma team assembled. The operating staff readied.
     But the bullet had been deflected by a rib; the only time the patient was in real danger was when he lit a cigarette while an oxygen tube was taped under his nose. The trauma team bandaged him up, replaced lost fluids and told him to put out the cigarette.
     One hundred six people came into the emergency room Friday, the day before. They were a varied group: an 18-month-old boy who drank bleach, a 93-year-old woman with a fever of 105, a man with a sore throat, a drunk with a blood alcohol level of 0.436, several victims of minor car accidents, a hurt wrestler, a fireman who inhaled smoke, four people who breathed hydrochloric acid fumes at a factory, and dozens more, none in danger of dying, none a trauma patient.
     Despite the high cost of trauma care, Christ joined the trauma network in 1986 "first, (because of) what it does for our educational program," said Dr. Gary Merlotti, head of emergency services. "You cannot run a surgical residency without trauma.
     "It's important for prestige. If you want to become a community hospital, that's well and good, but if you want to be more than that, you need to provide trauma services. Also, the concept is consistent with our philosophy and vision."
     The network started out with 10 hospitals but will soon be down to six when Michael Reese ends its participation next month. As hospitals drop out of the network, the time it takes to get patients to the remaining trauma centers grows longer, cutting into the "Golden Hour," or crucial period after an injury occurs when trauma care is most effective.
     "With all the trauma centers closing down," paramedics have to struggle to keep people alive longer until they can receive trauma care, said paramedic Jim Gleeson, who brought in one of the wounded men from the dice game.
     Merlotti said there are enough trauma centers in the network, as long as they are evenly distributed. But since trauma centers cannot be moved, he said, redistricting is needed, or new centers should be opened. Whatever happens, Christ Hospital will stay in the network, he said.
     "If we leave the trauma system, it will collapse," he said.
     As a trauma surgeon, Merlotti was called in when the two gunshot victims arrived at Christ. After they were stabilized, he checked their heart scans.
     Suddenly, at 3:40 p.m. the room was quiet again. Merlotti gazed at the pile of bloody material left by the gunshot victims, who had been moved upstairs.
     Musing on the huge financial losses that have forced hospitals to drop out of the trauma network, he estimated that the bill for the gunshot treatment could be $2,000 for each patient, though he doubted that the hospital would ever get the money.
     Many trauma patients are uninsured and cannot pay for the expensive care, adding to the financial burden carried by a trauma center.
     "We could charge them $20 and have difficulty collecting," Merlotti said.

                        —Originally published in the Sun-Times, Jan. 15, 1990

And when he goes away, it'll get greater

     September is half over, but Donald Trump is still here.
     Turning away our gaze and jamming our fingers in our ears isn't working.
     We have to look at him again, in advance of Wednesday's debate.
     The general media assumption since Trump burst into the GOP presidential spotlight in June has been that he'd eventually go off the rails and say something so staggeringly crude that even Republicans would be disgusted, would wake from their slumber, realize exactly who they are in bed with and hastily collect their panties for the walk of shame.
     But it's mid-September. Trump is still here, and the GOP is still in bed with him.
     Believe me, I'd prefer to leave the whole Donald Trump Phenomenon to historians and psychologists. I try to squint and think well of my country, try not to imagine that a major and once-respected party is romancing the erratic demagogue who would drag us into chaotic decline.
     So let's look at him.
     My gaze keeps falling on Trump's baseball cap: "Make America Great Again."
     You can buy it for $25 on his website.
     Make. American. Great. Again.
     It's his campaign slogan. I've already discussed it as a racist code.
     It's another way of saying "America Isn't Great Anymore." They wouldn't rally around that, even though that's exactly what they believe. America was great, before the Fall, back in the Garden, at some happy time, when white people ruled and minorities were either back in their home countries where they belong, making stuff for us, or stepping off the sidewalk with a mumbled "Howdy suh."
     "Make America Great Again."
     That's soooo familiar. Where did we hear that before? Step into the Way Back Machine, and set the dial to 1980.
     Ronald Reagan.
     Of course. The patron saint of Republicanism, the smiling presence who first taught them to hate their own government. So much cleaner than hating the people government helps, directly.
     "For those who have abandoned hope, we’ll restore hope," Reagan told the Republican National Convention in 1980. "And we’ll welcome them into a great national crusade to make America great again!"
     There's a lot going on in that sentence. Some Dante: "abandon hope ye who enter." A little FDR: "This is a great national crusade to destroy enforced idleness." Reagan liked to echo Roosevelt. He also threw out a lot of rendezvouses with destiny.
     "Let's Make America Great Again" was plastered on Reagan's campaign buttons, on posters. 

     Trump acknowledges its origin with Reagan, though that hasn't kept him from trying to trademark it.
     "This is a great country, but it's not being run like a great country," Reagan said in a 1980 TV commercial that ended with the tag line. "Let's Make America Great Again."
     Trump dropped the "Let's," since that suggests communal effort. Americans, led by Ronald Reagan, would join together to regain its lost greatness. With Trump, the implication is we don't have to do anything beyond elect him. He'll do the rest, starting with kicking out the Mexicans who are standing between us and greatness.
     Trump is aping Reagan's rhetoric. It got him elected, but did he follow through? Reagan was president for eight years; did he make America "great again?"
     A complex question, but I was there, and America was plagued by events that were not exactly proof positive of greatness. An economy mired in "Reagan Recession," with 10 percent unemployment and the worst stock market drop in history. Both the Marine barracks in Beirut and the space shuttle Challenger blowing up. Iran-Contra. Nancy and her astrologer. Not exactly our country's finest hour.
     I don't want to be too hard on Reagan. He had his successes too.
     And compared to Trump, Ronald Reagan is Aristotle. He said something — to a Veterans of Foreign Wars convention in Chicago in August 1980 — that bears remembering. Thanking them for their endorsement, he noted the four previous VFW commanders had been Democrats.
     "When it comes to keeping America strong, when it comes to keeping America great, when it comes to keeping America at peace, then none of us can afford to be simply a Democrat or a Republican," Reagan said. "We must all stand united as Americans."
     "Keeping America great." Three words you'll never hear strung together by Donald Trump, because they imply that our nation is great still, and Trump believes the ship has sailed on American greatness. I don't believe he is correct; then again, he hasn't yet been elected president either.

Donald Trump: Godsend for Latinos

     The two words I most associate with the Republican platform are "immoral" and "unpatriotic." 
     An example of immorality is their stance on gay marriage—the denial of basic civil rights to people for no other reason than religious prejudice. They drape it in a smokescreen of an antique sort of religion, as an attempt to obscure its immorality. But fewer and fewer people are fooled.
     And the best example of their lack of patriotism is their stand on immigration. 
     Immigrants, particularly Hispanic immigrants, add to the strength, vitality and economy of the United States. Countries that severely curtail immigration, like Japan, are utterly fucked, demographically, with whole towns emptying out and a dwindling workforce that can't support its burgeoning population of retirees. 
     The United States has accepted, and been changed by, wave after wave of immigration: from Ireland, from Italy, from Eastern Europe. The Hispanic immigration has already happened, has already changed this country, for the better, unless you consider finding a bottle of salsa on a restaurant table an earthquake, or a whisper of Spanish a personal affront. Overblown concern for legality is a fig leaf, the same as religion and gay marriage, an attempt to hide something objectionable. Anyone who cared about America would recognize that we need to both fix our immigration system so that workers can come to this country safely and legally, and put a path to citizenship for those who came to this country and contributed to it despite our broken immigration policy.
     The Republicans, who let their bigotry trump—pun intended—their concern for the United States, would endanger our future strength in order to indulge their current fears.  They use Hispanics as so many bogeymen to whip up their base, and it's always been a mystery to my why the actual Latinos don't push back harder, and exert their political power. It's not a question of if, it's a question of when. 
     Maybe that moment is finally arriving. 
     Like most responsible Americans, I view the advent of Donald Trump as a symptom of Republican pathology and dysfunction. But there was an engaging column in Monday's New York Times today by Ernesto Londono explaining why Trump, counterintuitively, might be just the motivation needed to wake the sleeping political might of our country's Hispanic population. 
     It's a question I've long pondered, and I've never seen the potential laid out in such a lucent way before. So while regular readers of my blog know this is not my habit — in fact, I have never done it before — I'm going to break tradition, and present the first few paragraph's of Londono's excellent article, with a link to the rest. I think what he has to say is that important, and hope you take the time to read it.

     I am rooting for Donald Trump.     Not because I want to see him attempt to build an impenetrable wall along the border with Mexico nor because I’ve been following his grotesque campaign with the kind of guilty gusto that got me hooked on the reality show “Here Comes Honey Boo Boo.” I’m rooting for Donald Trump because he could unlock the potential of America’s Latino electorate. Hispanics, among the fastest-growing of all segments of eligible voters, played a crucial role in President Obama’s two elections. Yet, over the past couple of decades, pollsters and political operatives have regarded the Latino vote as a sleeping giant waiting for the right jolt....

To continue reading, click here.

A year is a long time.

     A year is a long time. Sucking my front teeth, trying to think of something to say about the Jewish New Year, I called up last year's post, and read with fresh interest, as if someone else had both lived and written it.  The War in Gaza had just ended, and Jews were jumpy, nervous at being cast as the International Bad Guys, a familiar role, once forced upon us when our only crimes were holding jobs and occupying space and living in a particular place while claiming to belong where we were born, offenses that grew even more severe when it was our own homeland we were trying to hold onto, against the claims of whoever else decided they wanted it instead.
     Now the spectrum of international horrors eclipse the woes of the Palestinians. It's kind of hard to paint Israel as the Source of All Evil when ISIS is raping and beheading people and blowing up archeological treasures, while the Syrian chaos is sending millions fleeing around the world.  Must be frustrating for them.
     Not the highest standard to hold Israel to—better than ISIS—but also a reminder that, on the scale of Actual Horrors, the plight of Gaza and the West Bank are way down there, and millions of Syrians would no doubt be happy to swap places with them.
      When I contemplated the upcoming year — 5776, for those keeping track — my first thought was a dismissive, "What's so happy about it? What's there to look forward to?" Nationwide, a farce campaign trail trod by a parade of idiots. A world gone mad — or, to be more accurate, continuing to manifest its inherent madness in fresh and alarming ways. On the home front: boys gone, leaving an echoing void that I never anticipated until I found myself in it and started running my disbelieving fingers over its dark, cold, damp confines. The newspaper hurtling forward through dense fog toward its rendezvous with an uncertain future that some days looks very much like a mountainside. The whole growing old thing, which you're not even allowed to complain about, because bitching about growing old is one of its worst qualities.
     Good to bear in mind: few woes get any better by grousing about them. Complaint is not a success strategy, though it can take an act of will to shake it off, peer into the murk and ascertain something positive to look forward to, in this new year they're forcing on us, again, like a large and marginal appliance that you can't take back and have to make room for. 
     Well, what then?
     There's got to be something ... we have a week's vacation in October, a bar mitzvah in Boston and a wedding in Philadelphia, with new towns to explore and parks to hike in between. That could be fun. The following month is Thanksgiving, with stuffing to make and family to welcome and news to share. Then in February, Pomona for Parents Weekend. The frequent pleasures of writing stuff, which may bite and become dreary at certain times, like right fucking now, but usually is pleasurable. The book creeping toward publication. By April we'll have galleys, with hard copies in July and it'll be published in the fall—the tail end of 5776, the same year that began last night. And while as my eighth book, I can't scrape together much sincere conviction this'll be the one that shakes the earth, I do harbor irrational hopes of success, and will rouse in my stall as I always do when the firebell rings, and go charging out into the night, snorting smoke in the cold air, chasing after the will-o-the-wisp, as I always do. 
     Quite a lot really. Or enough. Or it'll have to be enough, and who knows what else might develop. A reminder not to gloss over all the good just because a few challenges crowd the stage at the moment, doing their dance macabre. You have to be patient. Even a day is a long time, and if you only had one -- and you never know which one is your last, so it could be today — you could pack a lot into it, and nobody would hand back the most troublesome day in favor of the icy dark void that awaits.
    A day is a long time, and when you realize the weeks and months and, if you're lucky, and we tend to be, years you have on top of that, well, it is a considerable bounty, a treasure trove.
     Sure, not all is enjoyable. A lot of routine, of work. Stuff to clean, to fix, in this 110-year-old tottering ruin we call home. Plus I seem to have boxed myself into a life where I have to write continuously—all together now: "Every goddamn day!" — and while that is, in the main, enjoyable, as the great James Thurber said, "Even the most pleasurable of imaginable occupations, that of batting baseballs through the windows of the R.C.A. Building, would pall a little as the days ran on." 
    The key, I believe, is to realize that the weariness will pass, and energy and hope will flare to life again. Just keep blowing on the embers because, really, what choice is there? There will be room for all sorts of good, and little bad to make you appreciate the good more. A year is a long time, but still, we only get so many of them, and you don't want to waste one, or even part of one, not even a day, not if you can avoid it. Happy New Year, where applicable.

Wildcats beat Panthers

     In my four years as a student at Northwestern, I never went to a football game, and attending one Saturday afternoon, I tried to cast my memory back more than three decades and figure out why. 
     The best I can come up with is I had no inclination to go, and nobody asked me.  I can't recall what I did on Saturday afternoons instead; studied, I suppose. 
     It probably helped that the NU football team in the late 1970s and early 1980s was particularly lousy—they only won one game during my undergraduate years there, and students had to satisfy themselves with tearing down the goalposts after they set some kind of collegiate record for losing.  I also vaguely recall that, coming from an Ohio high school with a powerhouse football team, it was something of a relief to not have to think about football.
     The Wildcats certainly did well Saturday, crushing the Eastern Illinois Panthers 41 to 0 by the end of the third quarter, at which point my wife and I decided, after two and a half hours of football, we could go to dinner knowing the game was safely in the bag.
     We were there because our kid was there. All the incoming freshmen were, running onto the field before the game in one of the many ceremonies cooked up since I've left. Clever, in that it gets the new student to at least one game, and puts 1,000 additional spectators in the stands, though the game seemed well-attended. He waved to us as he passed by, which we took as a triumph.
     This weekend is Parents and Family Orientation at Northwestern, crammed with receptions and seminars and events, that my wife and I have been gamely attending. I've found that, in general, I am infected with more school spirit as a parent than I possessed as a student.  I am not, by nature, a joiner, and as a young man, the idea of being part of something as vast and old as a university struck me as a dubious honor, something I should hold at arm's length. I never bought a college ring, or a yearbook, or a piece of purple clothing. I wanted to shine on my own, not reflect glory by association. Besides, they let me in, so really, how exclusive a place could it be?
     Watching the game, we shouted and cheered and, I noticed with a mingling of amusement and horror, I sang faintly along when the band played "Alma Mater."
     "Hail to purple... hail to white ... hail to thee, Northwestern."
     So what changed? Some mellowing with age, I suppose. I've had my life to achieve ... well, not a whole lot, not compared to my classmate Ben Slivka, who donated a dorm. Though I did raise a kid who got into Northwestern, which is certainly something. He picked this school, and the school was kind enough to return his embrace. To feel anything short of at least appreciation, if not affection, would stink of ingratitude.   
     I tried to squint, and see the campus as it might be to someone viewing it with new eyes, and not somebody who has been visiting off and on for the past 37 years, mostly to use the library for the past 33.  A big, beautiful place.
    And the game was fun. The weather was perfect, the predicted rain did not come, a slight autumnal chill in the air. The announcer, perhaps in deference to Northwestern's storied academic rigor, kept inserting a few fancy words into his play-by-play patter.
     "He is met by a plethora of Northwestern tacklers..." he said at one point.
     "Brought down by a deluge of Northwestern tacklers," at another.
      On our way to our car, we stopped at a shop on Sherman and bought a decal that reads "NORTHWESTERN" in big block letters for the back window of the van. I never had one as an alumni, would have been horrified at the thought of displaying that kind of thing. But Saturday it was my idea to buy it. When it was merely my school I couldn't take pride in the place. But now that it's his, satisfaction comes easily, a natural part of the pride I feel for him. 

Racing toward his future.

Saturday fun activity: Where IS this?

     Okay, enough already. I've been waaaay to sympathetic when it comes to picking out Saturday fun activity photos. It isn't really that the Hive is so good, it's that I'm just a big old softie. No more! It's time to just stump people, and to do that, I need something really hard, like this single jeering face tile I noticed downtown. It might be difficult to make him out in the photo above, so I'll give you a close-up. 
     There. Take a good look.
     So where is this guy, who seems to be roaring in derision over your inability to place his location? I imagine to have any chance of success, you'd have to not only have noticed him, the way I did, but also remember the location, which seems a near-impossibility. 
    To show my confidence in the difficulty of this week's activity, I should offer something good as a prize? How about a signed, hardback copy of my last book, "You Were Never in Chicago," a $25 value, at least, assuming that it being defaced by the author doesn't reduce its worth. Place your guesses below. And good luck. 

Google in the driver's seat

     A man wants to drive.
     Sexist? Sure. But we live in a sexist society. I didn't invent it, I'm just trying to live in it. Scanning 25 years of marriage, I'd say I drive 95 percent of the time. Maybe more.
     I like to drive. It feels strange to sit in the passenger seat watching the scenery go by. Powerless.
     Which is why I've been following the advent of Google's self-driving cars.
     They're curiosities, now. Only four states allow them even to be road tested—California,

Nevada, Michigan and Florida, though this month the tech giant is scooting vehicles around Austin, Texas, through a special arrangement with the government there. They always have a human driver, in case something goes wrong.
     But that will change. You'll eventually see one, then a few , then they'll be everywhere.
     The artificial intelligence required -- perceiving conditions in real time and reacting to them -- is incredible, and it's amazing that in the 2 million miles driven, there have been a handful of minor accidents, and all of them are the fault of other, human drivers; mostly rear-end collisions when the Google car is stopped at a light.
     But what interests me most is not the hardware or the software, but the wetware: how Americans will accept the the cars when they're introduced. Right now Google is talking about 2020, which is just around the corner. We'll do so grudgingly, I assume, given our worship of freedom, the open road. Born to Run, Jack Kerouac and Neal Cassady in their '49 Hudson. "The road is life." How will we sit passively and let a silicon chip do the driving?
     The same way we gave up galloping horses for sputtering black Model Ts. There will be psychological hurdles. I noticed in the official Google video of the first civilians to ride in the car, the 12 are mostly senior citizens, with one middle-aged woman and one child. There isn't a male between the ages of 12 and 60, with the possible exception of one grey-haired guy who's blind. While that might be coincidence, it also might be because we expect Daniel Craig to be working the gear shift of his Aston Martin Vanquish, not puffing out his cheeks with his hands on his knees and watching the world go by.
     But it will happen, just because the cars are so much safer. Let's say you spend $1500 a year on your car insurance, and the insurance on a self-driving car is $150. Suddenly you can save half the cost of your car over its life expectancy. Most people will do it.
     About 32,000 Americans died on the road last year, in accidents that were caused by excessive speed, drunkenness, stupidity, texting, aggression, lack of care and general obliviousness. Not problems that will be associated with the Google self-driving car, though it will take us a while for us to see that clearly, to recover from what we can call Myth Hangover—the tendency to react to technology based, not on actual reality, but on stories.
     Look at security cameras. For decades, the idea of being recorded in public places was filtered through George Orwell's 1984, where a repressive government uses cameras to spy on citizens. That such cameras are actually used to catch criminals and -- for you fans of irony -- hold excessive and racist police forces to account, has been very slow to register. We're still scared of Big Brother.

     One person run down by a Google car will cause more fuss than 1,000 killed by careless drivers. The tolerance for harm from technology is all out of scale. We're still afraid the machines will get us. The Google self-driving car will play out as the latest installment of the John Henry saga. For those not up on your folk songs, John Henry is a steel driving man, pitted against a steam drill, vowing to "die with a hammer in his hand" before he lets the steam drill beat him down.
     And—spoiler alert!—die he does. The steam drill wins. The steam drill always wins. Paul Bunyan notwithstanding, loggers use chain saws instead of axes. The century when people drove their cars will be a misty romantic memory, like the era when they rode horses and dipped candles. Not that there won't be all sorts of blustery macho pushback from a culture that spawned the Fast & Furious movie franchise The self-driving cars will be portrayed as weak and tepid, like clip on ties and package vacation tours. But we'll accept them, just as no city worker breaking up an old patch of concrete with a jackhammer frets, "You know, it would be so much more spiritually satisfying to use a sledge hammer and a spike to do this." Get used to those Google bean cars, because you'll be seeing a lot of them.