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A matter of life and death

Investigating the ongoing protests for an adult level-one trauma center on the South Side.

Photo: Darren Leow/The Chicago Maroon
Activists have been calling on the UCMC to open an adult level-1 trauma center since 2010.

Early on the morning of August 15, 2010, Earlenese Morris was walking to the bus stop near the corner of East 61st Street and South Cottage Grove Avenue when he heard seven shots ring out nearby. It wasn’t until Morris got home and checked his Facebook page that he realized that the shots he heard had hit his close friend Damian Turner. After calling Turner’s mother, Morris learned that his friend had died at Northwestern Memorial Hospital.

Around 12:45 that morning, Turner, 18, was shot on the corner of East 61st Street and South Cottage Grove Avenue by two men who his friends say mistook him for someone else. After the shooting, Morris learned that Turner was not taken to the University of Chicago Medical Center (UCMC), just three blocks away from where he was shot, because the hospital did not have an adult level-one trauma center to treat his injury. In fact, Morris learned, the South Side had no adult level-one trauma centers, which are staffed around the clock by doctors trained to treat victims of gunshot and stab wounds, car accidents, and other violent injuries. Northwestern, which is approximately 10 miles north of the intersection where Turner was shot, was one of the closest hospitals capable of providing the care Turner needed.

Shortly after Turner’s death, Morris joined Fearless Leading by the Youth (FLY), a youth activist group cofounded by Turner in 2007. While FLY has worked on campaigns to improve the city’s juvenile detention centers and preserve affordable housing in Woodlawn, since Turner’s death, the group has made getting a trauma center at the UCMC one of its top priorities.

That campaign has evolved into a larger back-and-forth between activists and UCMC officials on how the hospital should serve the community surrounding it. Recently, that dialogue has come to a stalemate shaped by a community emotionally charged by Turner’s death refusing to back down in its demands for a trauma center, and a hospital that says that is a costly and infeasible solution for the South Side’s broken health care system.

The UCMC opened its level-one adult trauma center in 1986 and closed it in 1988, saying that it drained hospital resources and took away from other vital health care services. While the UCMC’s Comer Children’s Hospital continues to operate a pediatric trauma center for children under 16, hospital officials still say that the resources required to sustain a trauma center would jeopardize its burn unit, neonatal intensive care unit, and emergency helicopter response service—care which almost no other hospital in Chicago provides.

“Prior to 1988, when our adult trauma center closed, the leaders here had to choose how to spend on care. You can’t choose to do everything, particularly when it comes to programs that are heavily subsidized,” said Lorna Wong, the UCMC’s Assistant Director for Media and Social Media. “If we lose enough money, this whole hospital would close down. A closed hospital serves no one.”

When the UCMC closed its trauma center, Michael Reese Hospital and Christ Hospital and Medical Center in Oak Lawn, south of the city, remained open as close options that could provide South Side residents with trauma care. FLY member Veronica Morris-Moore, 19, said that the UCMC’s decision to close its adult level-one trauma center set off a “domino effect” that caused Reese to pull out of the city’s trauma network the next year. In 1989, Reese administrators told the Chicago Tribune that the UCMC’s decision to opt out of the trauma network put a significant financial strain on the hospital, and projected a $2 million loss over the next fiscal year if it kept its trauma center open.

While Christ Hospital continues to treat trauma victims, there are only four hospitals in city limits that can provide level-one adult trauma care: Northwestern and Advocate Illinois Masonic Hospital on the North Side, and Mount Sinai Hospital Medical Center and John H. Stroger Hospital of Cook County on the West Side. Activists say that leaves the South Side underserved by the city’s trauma network.

Third-year Olivia Woollam, a member of the group Students for Health Equity (SHE), which has partnered with FLY in the trauma center campaign, said that the UCMC already has many of the resources required for a trauma center in place, and that the hospital has not been transparent about the feasibility of hosting a trauma center.

“The thing that kills me about this is that nobody knows what’s actually going on. Nobody knows if the UCMC can finance a trauma center or not because they haven’t released the data,” Woollam said. “Give us the data. That’s why we’ve been asking for a feasibility study.”

FLY staged its first protest on September 28, 2010, the day that would have been Turner’s 19th birthday. Since then, the group has staged several provocative protests to put pressure on the UCMC, including “die-ins” on the main quad where participants mimicked getting shot, and a mock- funeral during a 2011 event commemorating Martin Luther King, Jr. Day.

The campaign reached a critical point this fall when UCMC administrators agreed to publicly meet face-to-face with activists at an open forum hosted by Student Government. Stephen Weber, the hospital’s Chief Medical Officer, and Donald Liu, Surgeon-in-Chief and director of the pediatric trauma center at Comer Children’s Hospital, did not promise to support a request for a feasibility study on the trauma center, but said they would be willing to continue a dialogue with activists.

But in the six months since the open forum, FLY has been unable to schedule a single meeting with the UCMC, Morris-Moore said.

Darrius Lightfoot, 20, a FLY cofounder, said that the lack of communication between FLY and UCMC officials has left him feeling “brushed off.”

“We’ve been asking and asking and asking, and they say, ‘Sure, we can meet,’ but they never give an exact specific date,” he said. “I would like to see them put some effort into getting this trauma center. We can at least meet and figure out alternatives if they don’t want to host a level-one trauma center there.”

While Morris-Moore said the first public meeting marked an important step in the campaign, she understands why hospital administrators might be hesitant to meet with activists.

“They have to take time out of what they’re already busy doing and planning to do to address this community and these people that we’ve mobilized, that we’ve organized, and are fired up about this issue,” she said.

Woollam said that both the UCMC and FLY had become “entities” to one another, and that a face-to- face meeting would help both sides better understand each other.

“You can’t learn anything from sound bites. You can barely learn what someone ostensibly thinks about something, let alone what someone really thinks of something,” she said. “I think the only way to do that is to talk about controversial questions in as non- emotional a way as possible.”

Cheryl Reed, the UCMC’s Director of Strategic Communications, said that most of the conversation around the trauma center had been “emotional,” and that activists needed to come to the table with data to show UCMC administrators that the hospital needed a trauma center. Reed added that the hospital was taking steps to address gun violence on the South Side. In February, the UCMC announced a partnership with CeaseFire Chicago, a nonprofit organization that works with community leaders to reduce violence in at-risk neighborhoods. The hospital will spend $120,000 over the next three years to fund a professionally trained “violence interrupter” to work with community members to prevent disputes from turning into violent incidents. FLY, she said, had not expressed an interest in working with the hospital on its anti-violence campaign.

FLY member Corey Mason said that the group’s trauma center campaign itself has raised awareness about gun violence. Second-year Michael McCown, a SHE member who also worked at FLY last summer through the University Community Service Center’s Summer Links program, said that the UCMC and FLY took different approaches to reducing violence on the South Side.

“The idea is to recognize that violence doesn’t occur in a vacuum but in the context of racial and economic oppression,” McCown wrote in an e-mail. “Rather than address violence qua violence, FLY is addressing it in terms of politics, and qua violence more internally, to understand how it keeps people apart and from working on the real root causes of the system that is producing the violence,” he added, clarifying that he was not speaking as a spokesperson for FLY.

For Morris-Moore, it simply doesn’t make sense that the UCMC cannot treat victims like Turner who are injured just blocks from the hospital.“The forefront of medicine is in our backyard, and there’s nothing that they can do for traumatic injuries,” she said.

A 2011 analysis by radio station WBEZ 91.5 showed that trauma victims in southeast neighborhoods of the city, like Woodlawn and Hyde Park, have to spend 50 percent longer on average in an ambulance than residents in other parts of the city before they receive care. However, UCMC officials say that that statistic is insignificant, citing a 2010 national study published in the Annals of Emergency Medicine, which found that the time a trauma victim spends in an ambulance is unrelated to her chance of survival. That conclusion was confirmed by Lee Friedman, a professor at the University of Illinois at Chicago School of Public Health, who found that differences in transport times for trauma victims in Olympia Fields, a Chicago suburb, did not affect mortality rates.

A forthcoming study by Dr. Marie Crandall, an associate professor of surgery at Northwestern, could challenge those results. The study, which has not yet been published, suggests that patients, like most South Side residents, living more than five miles away from an adult level-one trauma center in Chicago are less likely to survive a gunshot wound. Crandall declined to comment on her research because it has not yet been peer-reviewed.

Lightfoot felt the effects of the South Side’s dysfunctional trauma network firsthand when he was shot twice in the ankle on East 63rd Street and South Cottage Grove Avenue as a 16-year-old. He said that he waited between 10 and 15 minutes before an ambulance came to take him to Provident Hospital near Washington Park. Lightfoot said that he waited at Provident for two hours before he was taken to John H. Stroger Hospital of Cook County where the bullets were removed.

Lightfoot believes that if the UCMC had a trauma center, the hospital would be obligated to take care of those individuals with the most life-threatening injuries, regardless if they could pay for care.

“They don’t want these black, poor, unprivileged folks coming into their hospital, using their Medicaid and Medicare and being uninsured,” said Lightfoot, who has lived in Woodlawn since 2005 and is frequently woken up in the middle of the night by gunshots. “It’s heartbreaking to see that folks really don’t care about you.”

Reed said that the hospital was one of the leading hospitals in the city for patients eligible for Medicaid. The hospital provided $138.4 million in Medicare and Medicaid coverage and spent nearly $237.1 million in community benefits in fiscal year 2011, according to the UCMC’s 2011 Community Benefit Report.

But second-year and SHE member Gabrielle Newell says that it is difficult to determine exactly how the UCMC, which receives tax breaks as a nonprofit institution, allocates funds to the community.

“Given the resources available to us, given our tax breaks, I think we do have a responsibility to serve the people surrounding us, and I don’t think that we’re doing enough,” she said.

In 2008, Senator Chuck Grassley (R-IA) investigated the services that the UCMC provided to the community as part of a national probe into whether nonprofit hospitals were really providing the care to the poor and uninsured required to maintain their tax-exempt status. Grassley concluded that the Internal Revenue Service (IRS) had poorly defined what services qualified for the tax benefits, and included a provision in the 2010 Affordable Care Act requiring the IRS to review charity care provided by hospitals every three years.

But nearly two years after Turner’s death, after a long back-and-forth with UCMC officials, several of his friends say that he continues to inspire their push for a trauma center.

Karenda White, 20, who described Turner as an “older brother” and was with him the day before he died, said that Turner’s personal struggles inspired his activism.

“His experience made him want to help others and see better for his neighborhood,” said White, who is also a FLY member.

Mason said that once Turner set his mind to something, he didn’t back out. Mason said that he saw Turner’s charisma on display one day when the two demonstrated downtown with FLY to protest evictions from Woodlawn’s Grove Parc housing complex. Even though it was cold and police urged them to leave, Turner continued to lead protesters with a megaphone.

“When a guy like that is gone, it really makes you think, ‘Man, what are all the things he could’ve done?’” Mason said. “It makes you reflect on yourself and think, ‘Man, what can I do since I’m still around?’”

 

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