Tightrope: Americans Reaching for Hope

Tightrope tells the tale of an America that is still in the process of losing well-paying jobs, where people work two or more jobs just to make ends meet, where one illness can turn into a bankruptcy for those who are uninsured or underinsured and where opioids and other drugs lead to incarceration, early death and family destruction

              “You wrote about my life,” I say when Nicholas Kristoff and his wife Sheryl WuDunn call me from their hotel room on a stop of their multi-city tour promoting their new book Tightrope: Americans Reaching for Hope.

              I tell them about growing up in East Chicago. Sure, it was always a blue collar town but when I was young both East Chicago and, across the Columbus Avenue bridge, Indiana Harbor where I grew up, had a vital economy, two separate but thriving downtowns and work for all those graduating from the two high schools, Roosevelt and Washington.

              My mother worked at the East Chicago Public Library for 50 years and in the 1960s bought clothes at Broadway Dress Shoppe with its sleek curved window exterior. Albert’s Jewelers had a store on Main Street, and I remember my dad saying they held on as long as they could as Indiana Harbor continued to lose population and other stores closed as the manufacturing slowed down before moving. My friends and I perused the racks at the Mademoiselle Shop on Main Street, wondering if we could talk our parents into buying the latest Bobby Brooks sweater and skirt set. We bought Nancy Drew books, dress patterns and sodas at one of the two dime stores just down the street.

For children’s clothes there was Jack and Jill’s owned by my friend’s family. After he retired, my father would walk from our home by St. Catherine’s Hospital to the Olympia, the ultimate busy Greek diner or as a family we’d eat at the Trolley Diner.  I’d buy freshly made bread on my way home from school at the bakery; my Romanian grandmother would get freshly butchered chicken at a meat story further south on Main always asking that the head remain on so she could make sure it really was fresh. Both the A&P and Kroger’s in Indiana Harbor gave out stamps that you’d paste in books and exchange, when you had enough for items in a catalogue.

Both downtowns were vital and busy, there were no empty store fronts. I told Kristoff and WuDunn, the only husband and wife journalist team to win a Pulitzer Prize. about how kids would graduate from high school and go straight into the mills, even those who in other cities would have gone to college. The starting pay was at least four times more than minimum wage at the time. It was hard work, sometimes dirty and dangerous but my friends whose parents worked in the mills had good solid middle class lives with the added values of health insurance and pensions and saved money because they wanted their kids to go to college. When there was a strike—particularly one that lasted for weeks and weeks—there was a feeling of unease and sadness and even fear. The annual fair held at the Katherine House where I went to day care was canceled. My friends’ families couldn’t afford to get candy and comic books after school like we used to. But then the strike was settled, and the world righted itself until it finally didn’t.

              I wasn’t the first person to tell Kristoff and WuDunn about such a loss—because seeing your hometown hollowed out, losing population and good paying manufacturing jobs, echoes through you–it’s a sadness because I loved growing up there.

“Sheryl and I are so struck with stories like yours,” Kristoff tells me, noting that he’s familiar with what happened to the steel mill cities of Northwest Indiana and even their current commitments to rebuild/reimagine their identities. “wherever we are, whenever we talk about the book, people come up to us and say I grew up in a tiny town in Tennessee, Ohio or West Virginia, anywhere and say this happened to me.”

Tightrope tells the tale of an America that is still in the process of losing well-paying jobs, where people work two or more jobs just to make ends meet, where one illness can turn into a bankruptcy for those who are uninsured or underinsured and where opioids and other drugs lead to incarceration, early death and family destruction.

Like me, like most of us, Kristoff has seen it firsthand as well and he propels the book from that point of view. He grew up in Yamhill, Oregon on a sheep and cherry farm and traces what happened to the kids who rode with him on the Number 6 bus to Yamhill Grade School and then Yamhill Carlton High School. Kristoff went on to graduate from Harvard and as a Rhodes Scholar, studied law Magdalen College, Oxford. He’s a New York Times columnist, won two Pulitzer Prizes, is a frequent CNN contributor and is the author of several books.

Life wasn’t as good for many of his bus mates. About one-fourth are dead from drug overdoses, suicide from depression and despair, alcohol, obesity, reckless accidents and from what WuDunn and Kristoff call “pathologies.”  Of the five Knapp children who lived next door to the Kristoff family and rode Number 6, four are dead and the fifth most likely survived because he spent 13 years in the Oregon State Penitentiary.

“We wrote this book to help change the narrative and to put human faces on issues,” says Kristoff. “Our hope is by using the narrative of the old school bus we can help generate a conversation that would lead to change. It’s deeply painful to see this happen to a community which Sheryl and I loved, where those I grew up with were opportunistic about the future when we were young. Now people are dying unnecessary.”

Each time Kristoff returned home he’d hear more horror stories. He was, he realized, watching the lives of his classmates implode and along with them, the lives of their children.  

“We have so many young children now growing up in toxic environment,” he says.

              “That’s why the situation is so critical,” says  WuDunn, who also worked at the New York Times and is now a senior banker specializing  in growth companies in technology, new media and the emerging markets. “It’s like compound interest rates on steroids –kids getting taken away by the state, trying to place them in stable foster homes, their progeny going through the same cycle.”

              But WuDunn and Kristoff aren’t just about detailing the destruction and despair, they’re all about solutions as well.

“Remarkably, even during the Great Depression life expectancy didn’t fall the way it is now,” says WuDunn.  “For the last three years in a row, life expectancy has decreased in the U.S. unlike other first world countries. That’s because during the depression they had a process and plans for getting back on track.”

It’s not only about the outsourcing of jobs to other countries where labor is cheaper and environmental rules lax, it’s about how America’s politicians react—or don’t– to it.

“Globalization is global, and it affects all countries, particularly our peer countries in Europe but they’re not exhibiting the same challenges that we are, to the degree that we are experiencing them,” says WuDunn. “We’re absolutely capable of changing. There’s evidence based research showing the solution of these issues. Great Britain decided to do something about children living in poverty and were able to reduce it by 50%. Portugal is the best example of dealing with drug use, they don’t jail drug users, they place them in rehab.”

Indeed, statistics indicate that a dollar invested in addiction treatment saves about $12 in reduced crime, court costs and health care savings.

“We’ve been paralyzed by this idea that nothing works,” says Kristoff. “The narrative is we waged the war on poverty and poverty won, this obsession with personal responsibility and that poverty is a choice, these false narratives are powering what’s going on in this country.”   

America is crippling itself by not taking care of its own, by spending more money on incarceration that rehabilitation, by short funding schools and by a tax system that benefits the rich and takes away from the poor.

WuDunn worries about how we can maintain our primacy in the world when so many of our families are failing.

“Change will only work if everyone says we need to advocate for this,” she says. “One man came up to me and said it’s really important to invest in human capital. We need to do that if we want to be able to compete against China and India. Taking care of Americans is an investment in all of America.”

Kristoff sums it up succinctly.

“There’s real desperation out there,” he says.

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Dopesick: Dealers, Doctors and the Drug Company that Addicted America

          “How do you meet a mother at her son’s grave near the football field where he had once made the crowds roar and not want to help her figure out what happened to her kid?” asks Beth Macy, author of the New York bestseller  Dopesick: Dealers, Doctors and the Drug Company that Addicted America (Back Bay Books).

Beth Macy

To answer her question, Macy, an investigative journalist, takes readers into board rooms and pharmaceutical laboratories, dying rural communities and the seemingly perfect lives of those living in suburban McMansions. She visits a prison for a follow-up interview with a convicted drug dealer and meets with parents who have lost their children. She talked to doctors, read trial transcriptions in case of big pharmaceutical companies accused of hiding information about the addictiveness of their drugs and conferred with law enforcement. As she was doing all this research, she had a nagging thought—would it all be out of date by the time her book was published?

“I thought by then there would be a good chance we would have solved the opioid crisis,” says Macy.

 But we hadn’t and still haven’t. Between 1999 and 2017, 702,000 people died from opioid overdoses. According to data from the National Center for Health Statistics, Centers for Disease Control and Prevention, provisional data for 2018, adjusted for delays in reporting, showed a slight decrease. Unfortunately the decline was so light that it’s questionable whether it’s even the beginning of a trend or just a blip. After all this time the data proves just one thing, opioid death rates are still extremely high.  

“It was all happening fast,” says Macy, noting at times she was typing up her interviews with sources only to learn that they had overdosed and died. “I listened to the stories of how people became addicted–sadly so many stories were typical. People were injured or in pain from surgery, were over-prescribed opioids and became addicted.”

          Indeed, Macy talked to one woman who had lost her job in the coal fields.

“She had gall bladder surgery and became addicted because she was over-prescribed and in the end no doctor would write her a prescription,” says Macy. “Her neighbor had surgery and had also lost her job and needed money to pay for her high blood pressure medicine and her rent, so she sold her medicine to her.”

Over-prescribing often started a downward spiral—lost jobs, broken marriages, families finally worn out from helping addicts over and over again, homelessness and finally death. Mothers told her of daughters who used sex to get meds. Stress communities, those where the addiction and death rates are high, are everywhere though Macy notes that in upper income areas people are “still cloaked in this sense of stigma and shame.”

It’s a crisis that impacts us now but will continue to do so in the future.

“We’ve lost generations in some of these stress communities—there’s a county in Tennessee where I’m told that 90% of the children are being raised by someone else,” she says.

What can be done? Macy says law enforcement officials tell her that educating people is an important part of the solution. And so that has become her goal.

“I want to get the stories out,” she says, “in order to help.”

Dopesick is the winner of the following awards:

The 2019 Library of Virginia People’s Choice Award in Nonfiction

LA Times Book Prize for Science & Technology Winner
American Society of Addiction Medicine Annual Media Award Winner
2018 Kirkus Prize Finalist
2019 Library of Virginia People’s Choice Award for Nonfiction finalist
2019 Ohioana Book Award in nonfiction finalist
Andrew Carnegie Medal shortlist
800-CEO-READ 2018 Business Book Awards Longlist

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