Fighting the stigma of mental illness

Patrick Kennedy and Peter O'Brien

     Four hours before Republican presidential candidates faced off for the second GOP debate in California last Wednesday, a Democrat, former U.S. Rep. Patrick Kennedy, stood before a small gathering at the Chicago Community Trust headquarters and talked about something people don't like to talk about: mental illness.
     He was introduced by Peter O'Brien, owner of O'Brien's Restaurant on Wells, who began by remembering his son, Peter Jr., who struggled for years before dying at age 32.
     "Peter just couldn't accept that he had a mental illness because of the stigma and shame of mental illness," O'Brien said, explaining why he had started Kennedy Forum Illinois, the local branch of Kennedy's national organization that is trying to reduce the disgrace associated with mental illness and addiction.
     "A lot of Americans run away from it because they don't want to deal with the pain," said Kennedy, who has been public about his own battles with bipolar disorder, alcoholism and drug addiction, though brushing aside O'Brien's suggestion he had done so out of courage. "I got in a car accident that put me on the front page of every newspaper in American in 2006, and at that point I had no choice but finally acknowledge that I had a problem."
     Kennedy went from being an addict in denial to becoming the sponsor of the Mental Health Parity and Addiction Equity Act, which requires insurance companies cover the treatment of mental illnesses to the same degree as physical ones and not impose different, inevitably lesser standards of care. He thought he would be one of hundreds of co-sponsors, but found his colleagues reluctant to attach their names to the law.
     "They worried people would say, 'You're sponsoring this bill,'" Kennedy said, extending an accusing finger, "Do you have a mental illness?"
     Treatment for mental illness or addiction still can be difficult to find or pay for, and most addicts never get help.
     "That's the law of the land but unfortunately no one knows about it, and the insurance industry is counting on you not knowing about it," he said.
     I sure didn't. Though, being a recovering alcoholic myself, I am keenly aware of the stigma, sadly familiar that there is a swath of people convinced that the whole thing is a sham cooked up to cover bad behavior, which I only wish were true. But it isn't. Addiction is a kind of mental illness, an obsessive-compulsive disorder that can be managed but never cured. Treatment can be life-saving.
     Kennedy's talk came back to me later that day, during the third hour of the Republican debate. New Jersey Gov. Chris Christie, trying to project a tough guy image to counter his Squiggy hairdo, promised that as president he would go charging into Colorado and use federal law to bust the pot industry. Rand Paul, who seems to have embraced rational thought as his latest campaign strategy, pointed out Christie's hypocrisy: the GOP is all for state's rights when it comes to putting dinosaurs alongside humans in Alabama biology textbooks, but when whiffing pot from the Rocky Mountain State, Christie grabs the big stick of federal power.
     At which point former Hewlett-Packard boss Carly Fiorina invoked her experience.
     “My husband, Frank, and I buried a child to drug addiction," she said of her 35-year-old step-daughter who died in 2009. "We must invest more in the treatment of drugs. ... Drug addiction is an epidemic, and it is taking too many of our young people."
     When Patrick Kennedy, the youngest son of Ted Kennedy, and Carly Fiorina start saying the same thing, that's significant. Betty Ford revealing her alcoholism was an earthquake because first ladies didn't suffer from that kind of thing or, at least didn't admit it. That Fiorina's comment was almost lost in the cacophony is progress of a sort. The stigma is lessening.
     Not that it will crumble on its own. Kennedy quoted Frederick Douglass:
     "Power concedes nothing without a demand. It never did and it never will."
     "We're citizens as well, in a country facing a growing epidemic of addiction," Kennedy said, calling on people to lobby their officials and put pressure on providers, and get involved. Chicago has a Recovery Walk in Garfield Park Sept. 26, and a national The Day the Silence Ends march in Washington, D.C., on Oct. 4.
     "We have no political power. Stigma eviscerates our political power," Kennedy said. "Twenty-three million Americans are in long-term recovery, but we're not organized; we're anonymous people, meeting in church basements. This is 2015, and we must talk about the most important issue for public health in our country."

Ben Carson excuses himself from consideration for the presidency

      Yes, I know we've sailed off the ends of the earth. 
      Yes, we've found ourselves in some political wonderland where the old values not only no longer apply, but are inverted. 
      Yes, Donald Trump's xenophobia, bigotry and idiocy has projected him to the top of the field of Republican boobs vying for the presidency.
       And maybe Ben Carson, jealous of that, thought he'd get in the game. 
       But no matter how low our expectations, no matter how up has become down and black is sold as white, there is some point where the joke is no longer funny, and we have to get serious, and say: Not in my country, asshole.
      That point came Sunday. 
      Carson, leading several polls, was asked by Chuck Todd on NBC's Meet the Press if a president's religion should matter.
     "I guess it depends on what that faith is," Carson replied, without hesitation. "If it's inconsistent with the values and principles of America, then of course it should matter. If it fits and is consistent with the Constitution, no problem."
    "So do you believe Islam is consistent with the Constitution?" Todd asked. 
     "No, I do not," said Carson. "I would not advocate that we would put a Muslim in charge of this nation. I absolutely would not agree with that. "
     Todd then asked if he would support a Muslim for Congress, and Carson backpedaled a little, allowing that perhaps, if he were a good person despite being a Muslim, that would be okay, apparently too stupid to understand that he had also undercut his initial reaction to the question.
      No matter.
      Any American, particularly any person from a group that has experienced prejudice, any Jew, any black, any woman, has the moral obligation to howl in protest at that. We have become so used to haters, to clowns, that we have been nudged by inches to accept the unacceptable. 
       Yes, Carson is only stating plainly what Trump, with the cowardice of bigots, implies. But it is such a clear, unambiguous statement that it cannot be allowed to stand. Islam is as consistent with democracy as Christianity or Judaism or any other religion, put to all sorts of uses by all sorts of people. To say otherwise is to single Islam out unfairly and hypocritically. It is hatred, pure and simple. For Carson to remain a serious candidate is to pull down the American flag and shit on it.

Remembering Max Beauvoir

Bakery, Haiti, 1987

     Max Beauvoir did something, a small thing perhaps, a gesture, but one that I've never seen a person actually do, before or since.
     But first I should explain how I found myself in his antique and book-lined study, sitting across a desk from the head houngan, or voodou priest, of Haiti, who died last week at age 79.
     My Northwestern roommate, Didier, had taken a job in Haiti with Catholic Relief Services and, hoping to show him some support and, I suppose, have an adventure too, I volunteered to visit for a few weeks. It was 1987, and Baby Doc Duvalier had just fled the country the year before. Democracy was in full swing, supposedly, and it was a rare moment of optimism for that tiny, star-crossed island nation. 
     Unemployed or, if you prefer, a freelancer, I justified making the trip by convincing the Atlantic magazine to consider a story about voodou. Thus I found myself scouring the countryside, looking for the distinctive flags and peristyles indicating that the ancient Africa faith —kind of a funky folk Catholicism -- was practiced there. 

Max Beauvoir

     Of course I had to meet Beauvoir, who was a significant figure in "The Serpent and the Rainbow," Wade Davis' factually-shaky 1985 best-seller on the supposed reality of Haitian zombies. Beauvoir, a chemist trained in New York and Paris who veered into the priesthood in midlife, was portrayed as half shaman, half hustler. 
      That's how he struck me, an oily figure, part menacing, part ridiculous. He subjected me to a tirade, an hour-long rant on the perfidy of the Reagan administration, claiming that the attempt on Reagan's life was his, Max Beauvoir's doing.
     "How did you do that?" I asked.
     "With a red candle," he replied.
      I did manage to score an invitation the next night to the big, showy ceremonies Beauvoir held regularly.
     When it came time for me to leave, he did the thing I hadn't seen before. He held his hands to the side and clapped twice, summoning a servant, a girl of about 12, to take me to the road to catch a tap-tap, the colorful communal taxis that criss-cross Port-au-Prince. On the walk out, I realized I had no small bills, only a $20 in my wallet. A tap-tap back the city cost one gourd, or 20 cents. Figuring I'd have better luck getting change from Beauvoir's servant than from a tap-tap driver, I gave her the $20 and asked her if she could break it. She in turn beckoned over a five-year-old boy, who took the twenty and ran off. I remember standing with her, watching the boy recede, thinking: I am not a savvy traveller.
    To my vast surprise, he returned a few minutes later, with a fistful of gourds, an even 100 of them, well-worn, crumbled brown bills that were soft with use, feeling more like leaves than currency.  I tipped him, and the girl, and climbed aboard a brightly colored taxi.
     The next day's ceremony struck me, at the time, as slightly "spurious"—more tourist show than authentic religious spectacle. But as the drums drove to a frenzied pitch and the mambos wailed, a woman seemed to reach into the fire and fill her mouths with glowing coals, smiling a bright orange crescent in the darkness. I was sure it was a trick, but it was a good trick.  

Kabuki Trump

     Journalism is a kabuki. 
     I've been saying it for years.
     What does that mean?
     Kabuki is a highly stylized form, a centuries-old type of Japanese theater, with long-established plot lines worn smooth from time, repeated again and again and again, with the same characters going through the same motions.
     Journalism too has its tropes, its cherished plots that withstand the test of time, and are performed over and over again by the same actors. 
     Look at Donald Trump's supposed gaffe in New Hampshire this past week A supporter prefaced his question by saying that Muslims are a problem in this country, and that Barack Obama is neither a Christian nor a citizen.
     "Muslims..." he said, his voice dripping with contempt. "We know our current president is one." 
     Trump did not correct him, and this led the news media to dab on its face paint, don its kimonos, snap open its fans, and begin to go through the motions of the classic tale, The Would-Be Leader Stumbles. Again and again we heard serious reporters ask gravely: Is this the mistake that would finally bring the high flying Trump down to earth? I almost burst out laughing, listening to the NPR panjandrums ponder the possibilities. 
    What planet are these people living on? Association with that kind of hateful rhetoric won't hurt Trump. Exactly the opposite; it's what put Trump where he is. He's been a birther for years. Heck, his acceptance of the supporter's hallucinogenic bigotry will no doubt make him more popular, as exactly the kind of bold truth teller that right wing GOP wackjobs adore. They'll be rolling at his feet like puppies, while Trump juts out his Mussolini lip and preens like Il Duce. 
     The man is a demagogue—he only has one message: embrace him, accept his Cult of Personality and he will save us from everything. I almost said he's dangerous. But thank God only a third of the nation are stone crazy right wing haters, and that will be our salvation. And I'll be honest. Say what you will about Trump, I'd prefer him in the White House, hands down, to Ted Cruz, a frightening nightmare image, not from kabuki, but out of science fiction. Every time he opens his mouth and lets another falsetto squeal of moral indignation out, I see his face 60 feet high, mouth moving grotesquely, uttering mendacious slogans, something out of Orwell, projected against the sides of public buildings. 
    We count on journalism, or what's left of it, to be intelligent. To describe reality, not to try to jam reality into the molds of our expectation so it takes a form we recognize. Trump isn't George W. Bush saying something stupid by mistake, he's Huey Long saying something stupid that he really believes and his followers really believe. Let's focus on that, not a witless rendition of hackneyed story lines that really don't apply to every circumstance. Trump won't be president, not because he'll blurt out something that reveals him as he actually is, but because only 33 percent of the voters in this country passionately lap up the poisoned gruel he's serving. 

Saturday fun activity: Where IS this?

     A good restaurant blends food, atmosphere and service. A great restaurant will combine them in such a way that is uniquely its own, creating a vibe, a personality that no other place don't has. 
      Of all the thousands of eateries in Chicago, the place pictured above has something going on that no other restaurant has. Homey, yes. Good food, yes. And a staff like no other.
     Where is this? And what makes it so unique? 
     The winner will receive one of my dwindling stock of 2015 blog posters, which are going fast now that I've decided to plaster them up on walls, where they belong. A reader tweeted this photograph of a poster in the West Loop after a few weeks exposed to the elements, and it made me very happy. Get one before they're gone.
    Place your guesses below. Good luck. 

A helping hand from the men in black

Archbishop Blase Cupich

  

     "Masters and wealthy owners," Pope Leo XIII wrote in his encyclical on labor in 1891, "must be mindful of their duty."
     That duty, he wrote in "Rerum Novarum" ("On the Condition of Labor") is not, as the current governor of Illinois seems to believe, to meekly accept whatever crumbs fall from the table of the rich and the powerful, but to form their own organizations to fight for decent wages, reasonable hours, mandated breaks, safety standards and a humane work environment.
     "It is the duty of the state to respect and cherish them, and if need be, to defend them from attack," Pope Leo wrote, during a time of vicious anti-union activities, even more extreme than our own.
     It is heartening to see his approach embraced by Chicago's Archbishop Blase Cupich, who went to bat for Illinois' besieged labor unions this week.
     “History has shown that a society with a healthy, effective and responsible labor movement is a better place than one where other powerful economic interests have their way and the voices and rights of workers are diminished,” Cupich told a gathering at the Chicago Journeyman Plumbers Local 130 on the West Side Thursday. “The church is duty-bound to challenge such efforts, by raising questions based on long-standing principles.”
     Cupich's comments that fit nicely in with the general trend of Catholic clergy embracing the downtrodden, emphasized lately under the inspired leadership of Pope Francis, who arrives for his first visit to the United States this week.
     The question is not, as Gov. Bruce Rauner seems to consider it, whether Illinois would be a more welcoming work environment if laborers were stripped of their rights. It certainly would, just as it's cheaper to manufacture goods using near slaves in China than it is to produce something in Chicago. Nor does supporting unions suggest that they are right in all regards and never have corruption and excesses of their own.
     The question, as Cupich so clearly stated it, is whether it is moral to make people live like that, and whether our government will set itself against the interests of workers as a matter of policy.
     “We have to ask," Cupich said, "do these measures undermine the capacity of unions to organize? Do such laws protect the weak and the vulnerable? Do they promote the dignity of work, the rights of workers? Do they promote a more just society?”
     That is a big "No." Rauner is attempting to hold the budget hostage until he is given the weapons he wants to unleash against unions. I have been in a union for most of my career at the Sun-Times, and have seen first hand how it counterbalances, slightly, the power and control that rests with the owners. Without it, wages drop, security is gone, and workers find themselves at the whim of owners.
     I'm not in the habit of speaking for God, but if the archbishop wants to point out that undermining unions is immoral and contrary to the will of the Divine, a denial of the love that He feels for His creation, I certainly won't contradict him either.
     This is sadly nothing new. Read the following about unions and ask yourself: Blase Cupich in 2015 or Pope Leo in 1891?
     "It is the duty of the state to respect and cherish them, and if need be, to defend them from attack. It is notorious that a very different course has been followed, more especially in our own times. In many places the state authorities have laid violent hands on these communities, and committed manifold injustice against them; it has placed them under control of the civil law, taken away their rights as corporate bodies."
     That would be Pope Leo, 124 years ago. This is an old fight, one that has to be fought anew in every generation, and it's good to see the men in black on the right side once again.

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