1

The first thing Dr. Amy Goldberg told me is that this article would be pointless. She said this on a phone call last summer, well before the election, before a tangible sensation that facts were futile became a broader American phenomenon. I was interested in Goldberg because she has spent 30 years as a trauma surgeon, almost all of that at the same hospital, Temple University Hospital in North Philadelphia, which treats more gunshot victims than any other in the state and is located in what was, according to one analysis, the deadliest of the 10 largest cities in the country until last year, with a homicide rate of 17.8 murders per 100,000 residents in 2015.

Over my years of reporting here, I had heard stories about Temple’s trauma team. A city prosecutor who handled shooting investigations once told me that the surgeons were able to piece people back together after the most horrific acts of violence. People went into the hospital damaged beyond belief and came walking out.

That stuck with me. I wondered what surgeons know about gun violence that the rest of us don’t. We are inundated with news about shootings. Fourteen dead in San Bernardino, six in Michigan, 11 over one weekend in Chicago. We get names, places, anguished Facebook posts, wonky articles full of statistics on crime rates and risk, Twitter arguments about the Second Amendment—everything except the blood, the pictures of bodies torn by bullets. That part is concealed, sanitized. More than 30,000 people die of gunshot wounds each year in America, around 75,000 more are injured, and we have no visceral sense of what physically happens inside a person when he’s shot. Goldberg does.

Even though Amy Goldberg has been treating gun patients for 30 years, the sense of horror has never completely gone away. On the cover: A bullet she keeps in her office. She pulled it out of a patient's heart during her residency.

She is the chair of Temple’s Department of Surgery, one of only 16 women in America to hold that position at a hospital. In my initial conversation with her, which took place shortly after the mass shooting in Orlando, where 49 people were killed and 53 injured by a man who walked into a gay nightclub with a semi-automatic rifle and a Glock handgun, she was joined by Scott Charles, the hospital’s trauma outreach coordinator and Goldberg’s longtime friend. Goldberg has a southeastern Pennsylvania accent that at low volume makes her sound like a sweet South Philly grandmother and at higher volume becomes a razor. I asked her what changes in gun violence she had seen in her 30 years. She said not many. When she first arrived at Temple in 1987 to start her residency, “It was so obvious to me then that there was something so wrong.” Since then, the types of firearms have evolved. The surgeons used to see .22-caliber bullets from little handguns, Saturday night specials, whereas now they see .40-caliber and 9 mm bullets. Charles said they get the occasional victim of a long gun, such as an AR-15 or an AK-47, “but what’s remarkable is how common handguns are.”

Goldberg jumped in. “As a country,” Goldberg said, “we lost our teachable moment.” She started talking about the 2012 murder of 20 schoolchildren and six adults at Sandy Hook Elementary School. Goldberg said that if people had been shown the autopsy photos of the kids, the gun debate would have been transformed. “The fact that not a single one of those kids was able to be transported to a hospital, tells me that they were not just dead, but really really really really dead. Ten-year-old kids, riddled with bullets, dead as doornails.” Her voice rose. She said people have to confront the physical reality of gun violence without the polite filters. “The country won’t be ready for it, but that’s what needs to happen. That’s the only chance at all for this to ever be reversed.”

She dropped back into a softer register. “Nobody gives two shits about the black people in North Philadelphia if nobody gives two craps about the white kids in Sandy Hook. … I thought white little kids getting shot would make people care. Nope. They didn’t care. Anderson Cooper was up there. They set up shop. And then the public outrage fades.”

Goldberg apologized and said she wasn’t trying to stop me from writing a story. She just didn’t expect it to change anything.

2

The hospital’s main building is a nine-story tower on North Broad, the street that traces a north-south line through Philadelphia. If you think of Broad as the city’s spinal column, the hospital is about level with the heart. Stand on the sidewalk outside the hospital and look south on a clear day and you can see the pale marble and granite of City Hall, about 4 miles away, near Philly’s pelvis.

You can go to Temple for high-end elective surgery, like getting a knee replacement or a heart transplant, same as at any other major teaching hospital in the country. As Jeremy Walter, Temple Hospital’s amiable director of media relations, reminded me more than once, “Temple isn’t just a hospital that treats drug addicts and gun victims.” Still, it was founded 125 years ago by a Samaritan to provide free care, and that public-service mission persists. Some of the most violent blocks in the city are within a 4-mile radius of the hospital, and crime victims funnel in.

I first met Goldberg one weekday last summer, in the hospital lobby. I had arranged to stay and observe for 24 hours, accompanied every moment by Walter, who carried a trauma pager and a yellow folder of consent forms. The rule was that I could observe a surgery if the patient or a family member consented, and if I wanted to do an interview, the patient had to sign a form. Goldberg is 5 feet 2 inches tall, with a runner’s build. She wore a gray mock-turtleneck sweater with no sleeves. Her hair is short and there was a little gel in it that made it spiky. She explained that there are two main categories of trauma: blunt and penetrating. Blunt trauma is like a beating, a fall. Penetrating is a gun or stab wound. “Unfortunately we get a lot of penetrating traumas,” she said. Temple sees 2,500 to 3,000 traumas per year, around 450 of which were gunshot wounds in 2016.

The trauma pager buzzed shortly after noon. LEVEL 1 PED, it said—a pedestrian struck by a car. I followed Goldberg to the ER, and she disappeared behind a windowless set of double doors, into the trauma resuscitation area. A few moments later she emerged and waved me inside.

The trauma unit at Temple University Hospital, in a rare moment of calm.

The trauma area is a rectangular room with three bays, each of which can accommodate two patients side by side when it’s busy. It’s an organized place—there are small trays on wheels for different surgical procedures, each tray holding a particular complement of instruments—but the tubes and cables snaking from poles and machines make it feel a bit chaotic to the untrained eye. The goal of a trauma surgeon is to limit the amount of time that a patient spends in a trauma bay, to stabilize the patient until he can be transferred for a CT scan or to the OR for surgery. The temperature in the room feels about five degrees hotter than in the rest of the hospital. The air doesn’t seem to move.

The pedestrian was awake but silent. This concerned Goldberg because by all rights he should have been screaming in pain. He looked to be in his late 20s. He had black hair and his shirt had been removed. He spoke Spanish. There was a laceration above his right eye and a small amount of blood on the sheets near his head. Goldberg and about 20 other doctors and nurses in blue scrubs clustered around him, checking vital signs, asking questions. Goldberg wore purple latex gloves. She tapped lightly on the patient’s left forearm with one hand. The arm was broken.

“No dolor?” she asked in Spanish. No pain? He shook his head. “Really?” she said. “No?”

Goldberg walked over to another doctor and said, “So are you troubled by the fact that he’s not screaming? He has an arm that’s so freaking broken and he’s not screaming.” She frowned. “I’m troubled by that.”

The patient’s vital signs appeared stable but Goldberg was worried about internal bleeding. A lack of pain could indicate a hidden injury. He needed a CT scan.

Staff wheeled the patient out of the trauma unit and into a nearby procedure room for the scan. Goldberg took off her latex gloves and threw them in a biohazard trash can. Two police officers had been observing from a distance with pens in hand and notepads open. One of the cops, a large man with a buzzcut, got Goldberg’s attention by saying, “Doc.”

“I’m Goldberg.”

The officer asked what the police should put down in their report for the patient’s condition. She said critical. This has been Goldberg’s policy for years, she explained to me as she exited the trauma bay and walked down a hallway toward the CT scanner. “I always make the patients critical until I know they’re fine. It’s a jinx thing.”

Goldberg is superstitious. On days when she’s on call, she shaves her legs. She can’t say why, she just started doing it years ago and now she will not deviate. She’s been wearing the same style of tan Timberlands for 15 years; her current pair, given to her by a colleague when she became chair of surgery, has the Temple logo inked on the heels. She parks her gray BMW in the same spot every time. “It’s so hard to take care of patients without making mistakes that you need every edge.” She recently hired a sports psychologist to talk to the residents about strategies for peak performance. Visualization. Positive self-talk. Breathing. For most of her career, she has stopped at the same Dunkin’ Donuts to order a large coffee with cream and two Sweet‘N Lows. A few years ago, the store stopped carrying Sweet‘N Low so she bought a box and left it there; they keep it under the counter for her. “It’s pink,” she told me once. “Sweet‘N Low is pink, Equal is blue, Splenda is yellow. And that is how you have to build a good system, believe it or not. So nobody makes a mistake.”

Goldberg, a superstitious sort, has been wearing Timberlands on the job for 15 years.

In the hallway next to the ER, she opened a door and I followed her into a small darkened room where six young doctors sat at computers. A window looked into the bay next door that held the CT scanner. “Billie Jean” played at low volume from a tinny speaker. Goldberg watched through the window as staff moved the patient from his gurney onto the bed of the machine. He cried out. Goldberg said, “That seems more appropriate.” Now they gave him some pain medicine. She looked at me and winced. “He has a broken humerus. I mean, you can feel it.” She streaked the thumb of her right hand against her fingers. “It’s one of my least favorite injuries. You can feel the bones rubbing together.” The CT scan showed some clotted blood in the patient’s head, appearing on the screen as patches of white. Goldberg ordered some additional scans.

When a shooting comes across the trauma pager, the code is GSW. There were no GSWs that night, only assaults. One patient was an older man who had been beaten up and complained of stomach pain. Another had been stabbed in the abdomen during a fight. His assailant was brought in too, in handcuffs, a white-haired man in a red T-shirt, his left eye bloodied and swollen shut.

The injuries weren’t life-threatening. Goldberg attended to the patients in the trauma unit. When she wasn’t there, she went on rounds, taking the elevator up to the eighth and ninth floors to check in with patients recovering from earlier traumas. She walked fast from one place to the other and I would lose her sometimes behind corners and doors and she’d have to double back for me. These are busy shifts even when there aren’t a lot of fresh traumas coming in. During a down moment Goldberg mentioned that she was thinking about scaling back her call schedule now that she’s chair of surgery, with large administrative and educational responsibilities. “I’ve been doing this 30 years,” she said. “Do I need to be on call? Do I need to do Saturdays?”

The pager stayed quiet overnight and through late morning, when Goldberg’s call shift ended. I arranged to return and shadow her again on her next shift, in two days. I left the hospital before lunch. The following morning the trauma pager blew up. LEVEL 1 GSW TO CHEST. LEVEL 1 MULTIPLE GSW TRANSFER FROM EPISC (Episcopal Hospital). LEVEL 1 SECOND GSW MALE.

3

Goldberg didn’t know much about guns or gun violence until she got to Temple. She grew up in the quiet Philadelphia suburb of Broomall. Her father owned a dairy business in the city, her mother was a schoolteacher. She was an intense kid who really believed the religious ideas she was learning at Jewish summer camp “in a big, bad way.” When she was 11, she woke up to see a light through her window and feel a tremor underfoot, and she wondered if it was God’s doing.

She went on to study psychology at the University of Pennsylvania and medicine at Mount Sinai in New York. She particularly loved anatomy. “It’s a miracle,” she told me. “The creation of a person, you know. It’s the heart beating and the lungs bringing air. It is so miraculous.” Surgery, for Goldberg, was a way of honoring the miracle. And trauma surgery was the ultimate form of appreciation, because a surgeon in trauma experienced so much variety. She might be operating on the carotid artery in the neck, or the heart in the chest, or the large bowel or small bowel in the abdomen, or the femoral artery in the thigh, at any given moment, on any given night.

In her first or second year of residency at Temple, when she was in her mid-20s, she helped treat a young boy who had been shot in the chest by his sibling who picked up a loaded gun that was lying around. The doctors couldn’t save him. The senselessness made her so angry. Goldberg listened as a senior resident informed the boy’s mother. “I’m sorry,” the resident said, “he has passed.” The mother didn’t react; she didn’t seem to understand what she had just heard. Goldberg spoke up. “He died. We’re so sorry. He died.” It was a lesson: Be direct. “You have to find a very compassionate way of being honest,” she said.

“You think you know what happens here? Because I thought I knew. But there’s nothing that can prepare you.”

She finished her residency in 1992 and decided to stay at Temple, and the feeling of wrongness only intensified. There was a teenage boy in August 1992 who was shot in the heart. His heart stopped beating. Goldberg revived it. He lived. But some weeks later he came in again, with a shooting injury to his brachial artery, in the upper arm. He almost bled out, almost died again, but the surgeons got him back, again. “And then of course the third time he came in, he was shot through the head, and he was dead,” Goldberg said.

She started thinking that Temple should find a way to intervene—to try to talk to patients while they’re in the hospital so they would never need to come back. But she didn’t have the authority yet. She was just a trauma surgeon, a good one, and getting better. She had good hands and good judgment and a methodical approach to the craft. And as five years stretched into 10, and 10 into 20, Goldberg built up a deep well of experience in doing the things that are necessary to save the lives of gun victims, the things that are never shown on TV or in movies, the things that stay hidden behind hospital walls and allow Americans to imagine whatever they like about the effects of bullets or not to imagine anything at all. “You think you know what happens here?” Scott Charles asked me. “Because I thought I knew. But there’s nothing that can prepare you for what bullets do to human bodies. And that’s true for pro-gun people also.”

The main thing people get wrong when they imagine being shot is that they think the bullet itself is the problem. The lump of metal lodged in the body. The action-movie hero is shot in the stomach; he limps to a safe house; he takes off his shirt, removes the bullet with a tweezer, and now he is better. This is not trauma surgery. Trauma surgery is about fixing the damage the bullet causes as it rips through muscle and vessel and organ and bone. The bullet can stay in the body just fine. But the bleeding has to be contained, even if the patient is awake and screaming because a tube has just been pushed into his chest cavity through a deep incision without the aid of general anesthesia (no time; the patient gets an injection of lidocaine). And if the heart has stopped, it must be restarted before the brain dies from a lack of oxygen.

It is not a gentle process. Some of the surgeon’s tools look like things you’d buy at Home Depot. In especially serious cases, 70 times at Temple last year, the surgeons will crack a chest right there in the trauma area. The technical name is a thoracotomy. A patient comes in unconscious, maybe in cardiac arrest, and Goldberg has to get into the cavity to see what is going on. With a scalpel, she makes an incision below the nipple and cuts 6 to 10 inches down the torso, through skin, through the layer of fatty tissue, through the muscles. Into the opening she inserts a rib-spreader, a large metal instrument with a hand crank. It pulls open the ribs and locks them into place so the surgeons can reach the inner organs. Every so often, she may also have to break the patient’s sternum—a bilateral thoracotomy. This is done with a tool called a Lebsche knife. It’s a metal rod with a sharp blade on one end that hooks under the breastbone. Goldberg takes a silver hammer. It looks like—a hammer. She hits the top of the Lebsche knife with the hammer until it cuts through the sternum. “You never forget that sound,” one of the Temple nurses told me. “It’s like a tink, tink, tink. And it sounds like metal, but you know it’s bone. You know like when you see on television, when people are working on the railroad, hammering the ties?”

“It’s just the worst,” Charles told me. “They’re breaking bone. And everybody—every body—has its own kind of quality. And sometimes there’s a big guy you’ll hear, and it’s the echo—the sound that comes out of the room. There’s some times when it doesn’t affect me, and there are some times when it makes my knees shake, when I know what’s going on in there.”

Some of the simple tools surgeons employ in the trauma bay, including the Lebsche knife and silver hammer used to break the sternum while opening chest cavities.

Now the chest is open, and Goldberg can work. If the heart has stopped, she can try to get it beating again. This may involve open cardiac massage—literally holding the heart in her hands and massaging it to get blood flowing up to the brain again. If there’s bleeding in the cavity, she can control it by putting a metal clamp on the heart or on the lung. She can also clamp the aorta, the largest artery in the body, so that instead of the blood going down into the bowels, where it’s needed less, the blood goes up to the brain.

“These crossing bullets are just so challenging,” she said. “Where is the injury? Is it in the chest? Is it in the abdomen? You’re down there, looking, and sometimes you find it, and sometimes you don’t. And sometimes it just really hurts as you work your way through.” She meant that it hurts when patients suffer. Hurts them and hurts her.

There are some gun victims who die quickly, right there in the trauma bay, or soon after being transferred up to the OR. Others develop cascades of life-threatening complications in the following days that surgeons race to manage.

Goldberg said she saw a movie a few years ago that captures what it’s like to operate under these conditions. It was a documentary about the 33 Chilean miners who were trapped underground for months in 2010. “They interviewed them all. And the miner that had the hardest time down there was the youngest guy. Not the oldest guy. It was the youngest guy. And they said, why? Why did you have such a hard time? And he said, God and the Devil were with me.” Goldberg thought that was perfect. “That’s what I had been searching for, for years, in how you feel in the operating room. God and the Devil are with you. You start a case. A young person. Shot. They come in talking. You go upstairs. They have this devastating injury. The Devil. You suck. You’re gonna kill this guy. You call yourself a good trauma surgeon. You’re the worst. And you just plow ahead and plow ahead and plow ahead. You find what’s injured. You control it. God. Oh, you are the best. You’ve done a great job. Then you’re working. You find another injury you didn’t expect. You suck, you suck, you suck.”

During trauma surgery, tissue in the lower extremities can die, causing gangrene, in which case surgeons might have to amputate the leg at higher and higher points, first at the shin, then at the knee, then at the thigh.

It’s possible for a surgeon to get distracted by the wrong wound. The most dangerous wounds don’t always look the worst. People can get shot in the head and they’re leaking bits of brain from a hole in the skull and that’s not the fatal wound; the fatal wound is from another bullet that ripped through the chest. One patient a few years ago was shot in the face with a shotgun at close range over some money owed. He pulled his coat up over his mangled face and walked to the ER of one of Temple’s sister hospitals, approaching a nurse. She looked at him. He lowered the coat. The nurse thought to herself what you might expect a person to think in such a situation: “Daaaaaamn.” He was stabilized, then transferred to Temple. He lived.

The price of survival is often lasting disability. Some patients, often young guys, wind up carrying around colostomy bags for the rest of their lives because they can’t poop normally anymore. They poop through a “stoma,” a hole in the abdomen. “They’re so angry,” Goldberg said. “They should be angry.” Some are paralyzed by bullets that sever the spinal column. Some lose limbs entirely. During trauma surgery, when the blood flow is redirected to the brain and heart by an aortic clamp, blood goes away from other areas, and tissue in the lower extremities can die, causing gangrene, in which case surgeons must amputate the leg at higher and higher points, first at the shin, then at the knee, then at the thigh, to stay ahead of the necrotic tissue as it spreads. The femur bone may have to be disarticulated—removed entirely from the socket, and discarded. There was a woman several years ago whose boyfriend shot her in the leg. The bullet clipped the femoral artery and she bled. Goldberg was on call that day. She had to amputate the woman’s legs to save her life. “I’m so haunted by that,” she said.

Eighty percent of people who are shot in Philadelphia survive their injuries. This statistic surprises people when they hear it. They tend to think that when people get shot in the belly or the chest or the face, they die. But the reality is that people get shot and then they are going to survive, because trauma surgeons are going to save them, and that’s when the real suffering begins.

4

Rafi Colon was shot once in the abdomen with a 9 mm handgun during a home invasion in September 2005. The bullet tore through his intestines. Trauma surgeons at Temple had to open his abdomen to repair the injuries, but fistulas developed, holes that wouldn’t heal, and until they healed, the incision couldn’t be closed. He spent the next 11 months in the hospital, immobilized in bed, with an open wound down the front of him that had the circumference of a basketball. It got to the point where it was a normal thing for him to look down and think, oh, those are my intestines, there they are.

“It became second nature,” he told me recently over lunch at a Panera Bread in the Philly suburbs. “It wasn’t like a gruesome thing.” The holes in his intestines leaked stomach acid and burned away the surrounding tissues and skin, leaving less skin available to eventually stretch over the wound and close it. Colon learned to sop up the excess acid from his exposed intestines with gauze pads and later with a machine that sucked the acid through a tube. When his friends came to visit, they had a hard time looking at him. He messed with them once by asking a buddy to get him a Rita’s water ice, Philadelphia’s version of a snow cone. He knew what would happen when he ate it. The water ice was red, the Swedish Fish flavor from that summer, and 30 seconds after he swallowed it, the red water ice came oozing out of the hole in his intestine. His friends bolted.

Over the course of his long recovery, from the fall of 2005 into the spring and summer of 2006, Colon got a feel for the rhythms of the Trauma Service. Lying there in the bed, he occupied himself by counting the number of times each day that trauma codes were announced over the PA system. It seemed like the busiest times were Thursday, Friday and Saturday nights. He’d ask the doctors, how many yesterday, was it 17? “They’d say, ‘No, 18.’” He could tell when the residents were stressed out by how many Diet Cokes they drank. There were days when the doctors were so busy with fresh traumas that they didn’t make rounds until 7 or 8 at night. “They would say, ‘Yeah, it was a busy day.’ I’d be like, ‘Yeah, I heard.’”

Rafi Colon in his stairwell at home. Though his neck and stomach scars are still visible years after being shot, he can't terrify friends with his water ice trick anymore.

It ultimately took 14 surgeries to repair the damage done by one bullet. Temple’s surgeons stretched his abdominal wall closed with the help of some muscle from another part of his body and an artificial mesh. If you see Colon today, the only way you can tell he was wounded is that he walks with a minor tilt; he calls it “my Keyser Söze limp.”

Goldberg was part of the team of doctors who cared for him. They talked about muscle cars and sports. (She liked the Eagles; his team was the Giants.) He remembers that she was the doctor who would notice when he was feeling despair and let him eat a little something that the nurses wouldn’t necessarily allow, like a small chip of ice, or sometimes a piece of candy. He couldn’t eat normally—he was being fed intravenously—but “the fact that I could get a piece of ice, it was like heaven.”

She has gotten more sensitive over the years, she said. When you’re a young trauma surgeon, you’re developing skills, like how to put a bowel back together. Her medical training was all about learning to operate, to recognize the kinds of patterns that she now teaches to students and young doctors. I once saw her give a lecture to 11 medical students who had just completed their surgical rotation. Goldberg diagrammed anatomy and formulae on a whiteboard and asked questions about how the students would diagnose various hypothetical patients. But she also asked the students to share their experiences with patients and their feelings about those cases. One student spoke about stitching together the chest of a young shooting victim who had died after surgeons attempted to resuscitate him in the trauma area; the student’s first thought was that he was excited to practice stitching a chest, then he felt guilty for being excited. Another student recalled being surprised when a patient asked for his business card even though he was just a lowly medical student. “Yeah,” Goldberg said. “He trusted you.”

Often when Goldberg meets a shooting victim, it turns out she once treated a sibling, parent, cousin or friend. “I’m a family doctor, a little bit, because I’ve been here so long,” she said. One day at the hospital, I saw her go on rounds, meeting with patients in the Surgical Intensive Care Unit (SICU) on the ninth floor. A sign on a bulletin board said WELCOME TO SICU! YOUR HEALING STARTS HERE! The letters were surrounded by gold stars.

Talking to patients seemed to energize Goldberg. She was alternately lighthearted and serious. The patients were uniformly docile and tired. They were on pain medication that slowed their speech. The first patient, shot in the neck, was a young man accompanied by his girlfriend, who sat next to him on the bed with an expression of concern. “When I was shot, I fell on my face,” he said. The second patient was older. A tube to drain fluids was snaking out of his chest. He held out a trembling left hand and smiled. “A little bit of the shakes,” he said. Goldberg told the man he was scheduled to be released the following Monday. He had been caught in some kind of crossfire. “We will miss you,” Goldberg said, “but there comes a day.”

“Cut the umbilical cord, huh?” he said, and laughed softly.

Goldberg descended to the eighth floor to meet with another gun victim. She knocked on his door and said hello in her friendly voice. There were two large men inside the room in T-shirts and shorts. She assumed they were his family, but when she entered, the men rushed over to her and said that the patient was a suspected shooter himself. They were plainclothes cops, guarding him.

“I don’t want to know,” she said. “It’s better if I don’t know.”

She went over to the side of the patient’s bed as the cops watched and said she was Dr. Goldberg and she wanted to explain what was happening and help him if he needed anything.

He looked young. He seemed afraid. There was an open wound in his chest, a vertical incision from below his nipples to his belly button, rising and falling with his breath. Surgeons had needed to remove one of his kidneys, his spleen and part of his stomach to repair the damage of the bullet and save his life. After the surgery the tissue swelled, which happens sometimes, and they couldn’t immediately stitch the incision closed, so they had to leave it open. The edges of the wound were pink and raw.

Goldberg reached out and held his left hand in her hand while telling him what organs he’d lost.

“You don’t need your spleen. You do need your kidney,” she said. “But luckily, God gave us two.”

He nodded slightly. She asked how he was feeling. All he said was, “Pain.”

Goldberg said they would try to help with that and rubbed her fingers across his hand in a gesture of tenderness.

Gunshot victim Lamont Randell, shot twice during a robbery, begins his long recovery process.

5

The key distinction for Goldberg isn’t innocent or guilty, it’s rational or irrational. Gun violence is irrational, there’s no pattern to it. Police statistics show that shootings decrease in the cold winter months and pick up when the weather warms, but any given trauma shift in the winter can be busy and any shift in the summer perfectly quiet.

Goldberg has always found the senselessness of violence frustrating, and when she was promoted to chief of trauma 15 years ago, she started thinking about how to engineer some control, to help patients “above and beyond just being a trauma surgeon.” She imagined a comprehensive approach to prevent shootings and keep patients from showing up in a trauma bay in the first place. She knew this would involve talking to people in the community, but she also knew she was a flawed messenger. “Who’s going to listen to this white Jewish girl say that guns in the inner city aren’t good for you? Nobody’s going to listen to me say that. I wouldn’t listen to me.” She went looking for help, and found Scott Charles.

A big, energetic guy with glasses and a master’s degree in applied positive psychology from the University of Pennsylvania, Charles has been working to reduce youth violence since 1988. When he was growing up in Sacramento, two of his older brothers were shot and his sister committed suicide with a gun, and at 19 one of his best friends was shot and killed. He moved to Philadelphia when his sociologist wife got hired by Penn, and two years later, he joined a nonprofit that designed service-learning projects in public schools. Some of his students from North Philly started collecting the stories of families who had lost children to gun violence, which is how Charles made the connection to Goldberg—Temple had treated one of the victims, Lamont Adams, a 16-year-old from North Philly who was shot and killed in 2004 after a false rumor was allegedly spread about him.

Goldberg hosted a tour for Charles and his students, inviting them into the trauma unit and explaining what gun patients experience there. She was immediately impressed by the way he dealt with the kids. She told him she’d create a new outreach position for him at Temple, that she’d get up “in people’s faces” until she made sure it happened.

“She said, ‘Don’t go anywhere else,’” Charles recalled. “‘I’m going to write you a check for one year of your salary. If I don’t get this position for you, you can cash the check, it’s yours, and take another job.’ And I was like—this white lady’s crazy. My wife was like, who’s this lady who keeps calling you at 11 o’clock at night? ‘It’s this crazy doctor.’”

Charles accepted, joining Temple in August 2005, and since then he and Goldberg have developed a suite of ambitious programs in collaboration with other Temple doctors and staff. “The thing that allows us to do so much of this is she carries a big stick,” Charles said. “Who was going to get in her way?”

There are three programs aimed at preventing violence before it happens. Cradle to Grave is an expansion of that first tour Charles took at Temple. He brings groups of kids and adults into the trauma area and shows them how surgeons save gun patients. He has his own copies of the various surgical instruments for demonstration purposes, removing them from a travel bag: chest tube, rib-spreader, hammer, Lebsche knife. He introduces the visitors to Goldberg if she’s available. He tells the story of Lamont Adams, asking a volunteer to pretend to be Lamont and then placing a circular red sticker on the location of each of Lamont’s 24 bullet wounds (entry and exit). On his chest. His abdomen. His thigh and arms. And most disturbing of all, the two bullet wounds on his hand, a sign that Lamont was trying to shield his face from the bullets at close range.

Charles also runs the Fighting Chance program, a series of training sessions for community members, where doctors show people in neighborhoods how to give first aid to gunshot victims, to apply tourniquets and stop blood loss in the seconds immediately following a shooting, before the EMTs or police arrive. Recently, Charles has also become a sort of Johnny Appleseed of gun locks, handing them out to parents who want to keep their children from getting hurt in accidents. He keeps boxes of them at the hospital and distributes the locks with no questions asked. Sometimes he lugs them to subway stations and offers them to commuters.

When Goldberg first saw Scott Charles talk to a group of children, she knew she needed him on her team.

That’s prevention. Temple has also created an intervention component, called Turning Point, where shooting victims get extra counseling while they’re still in the hospital. “They come in, they’re very scared,” Goldberg said. “‘Am I gonna die? Where’s my Mom?’ Then, as soon as they would recover, they would not be so scared anymore, which maybe wasn’t good.” So if a victim is between 18 and 30 years old, he’s offered a series of supports in addition to the usual visits with Charles and a social worker. Temple asks the patients if they want to talk to a trauma survivor. And they are given an opportunity to view a video of their own trauma-bay resuscitation. (The surgeries in the trauma area are videotaped for quality control.) About half say yes. Charles shows them the video. They get psychological counseling for any PTSD symptoms, as well as case management services to help them get high-school diplomas or jobs.

Turning Point was initially controversial within the hospital. Some doctors thought it was cruel to show patients videos of their own surgeries, especially patients who had done nothing wrong. But Goldberg argued that she wasn’t judging anyone’s past or even asking about it. “The only way I know how to deal with a problem is, let’s break it down. Let’s try to educate,” she said.

Breaking it down has involved doing science. Goldberg and her team have needed to gather data about questions that have never been rigorously answered, a common situation when it comes to gun violence. For instance, when a paramedic first finds a gun or stabbing victim, nobody knows if it’s better to administer IV fluids and put a tube down the victim’s throat on the spot, or if the medic should simply race the victim to the hospital. Trauma surgeons have long suspected that the latter option is preferable—most shooting victims actually arrive at Temple in the back of police cruisers, a practice the cops call “scoop and run”—but there has never been a long-term randomized study.

So Temple launched one. It’s called the Philadelphia Immediate Transport in Penetrating Trauma Trial (PIPT), an elaborate undertaking that has involved close coordination with emergency personnel and also dozens of community meetings where doctors explained how the study works (over the next five years, some victims of penetrating trauma will receive immediate transport and some won’t) and how people can opt out of the study (by wearing a special wristband). In that same spirit, Goldberg has been gathering data on the Turning Point program. For years, patients have been randomized into a control group and an experimental group. One group gets typical care and the other gets Turning Point, and then patients in both groups answer a questionnaire that quantifies attitudes toward violence.

In November the hospital published its first scientific results from Turning Point, based on 80 patients. According to Temple’s data, the Turning Point patients showed “a 50% reduction in aggressive response to shame, a 29% reduction in comfort with aggression, and a 19% reduction in overall proclivity toward violence.” Goldberg told me she was proud of the study, not only because it suggested that the program was effective, but also because it represented a rare victory over the status quo. Turning Point grew out of her experience with that one patient in 1992, the three-time shooting victim who died the third time. It took her that long to get the authority, to gather the data, to get it published, to shift the system a little bit.

Twenty-four years.

6

Each time I went to the hospital, I asked Goldberg what else was going on with her aside from work. She usually talked about running. She likes to run along the Schuylkill River while listening to music and thinking about nothing at all. She competes in a few half-marathons a year.

I never learned much about Goldberg’s personal life. She lives alone in an apartment in Center City. She has a rowing machine there and access to a treadmill in the building’s gym. Her religious faith is still strong—it’s not that she goes around talking about it, she told me, it’s just that she has worked for 30 years in trauma and seen a lot of death, and it’s hard to do that and not feel something about God. I noticed one day she was wearing a white Lokai bracelet, a ring of plastic capsules said to contain mud from the Dead Sea and water from Mount Everest. “The highs and the lows, to stay even-keeled,” she said. “I probably need 10 of them, five on each hand.”

The major non-running events in her life tend to be awards ceremonies. She has reached the point in her medical career where people gather and say nice things about her, and there are plates of olives and prosciutto. Her med-school alma mater, Mount Sinai in New York, recently invited her to give a special lecture at Grand Rounds, a hallowed medical tradition. On March 16 Temple threw a party for her “investiture,” a ceremony where she passed from being merely the chair of surgery to being the George S. Peters MD and Louise C. Peters Chair in Surgery. Endowed chairs at universities are a big deal. Past colleagues from all over the country came to speak about her qualities. One compared her to Teddy Roosevelt’s famous Man in the Arena, “whose face is marred by dust and sweat and blood … who spends himself or herself in a worthy cause.” (“Herself” is not actually a part of Roosevelt’s quote, but the guy modernized it for Goldberg.) She gave a brief acceptance speech focusing on the importance of teamwork to medical excellence. She said she used to dream about being a sports coach, and now she’s coaching the next generation of surgeons. As she once put it to me, “One of us can’t give perfect care. But together, maybe, we can give perfect care.”

In a perverse way, the more efficiently Goldberg does her job inside the hospital, the more invisible gun violence becomes everywhere else.

One of the speakers at the investiture called Goldberg a “realistic idealist,” and when I saw her later, she said she’d been thinking about the phrase. At first it surprised her that people saw her that way, but she realized it captured something true. “When I get angry, and hurt,” she told me, “it’s because I can still be a little naïve.” Even after all this time, the sense of horror she first experienced as a resident treating gun patients has never completely gone away.

One evening when I was at the hospital, I saw what she meant. Two shooting victims came in, a man and a woman, about two hours apart, and were quickly patched up. The man was shot twice, in a wrist and a thigh—four holes, not life-threatening. The woman was shot once in the thigh with a small entry wound but no exit wound—a stray bullet that struck her while she was walking down the street. In the trauma bay, the surgeons taped a paper clip over the entry wound so they could identify that spot on the X-ray. Goldberg wheeled the monitor over to show me the X-ray image: paper clip and bullet. “Very small,” she said, pointing to the slug, “like a .22.” As so many other patients do, the patient asked the trauma surgeons if they were going to take the bullet out, and the surgeons explained that they fix what the bullet injures, they don’t fix the bullet.

They left the wound open to prevent infection and put a dressing on it. “We’ll probably send her home tonight,” Goldberg said. “Isn’t that awful?”

She meant it as a strictly human thing. There’s no medical reason for a patient to be in a hospital longer than necessary. The point was the ridiculousness of the situation. A woman gets shot through no fault of her own, she comes to the hospital scared, and if she’s OK, Goldberg says, “It’s like, here, take a little Band-Aid.” The woman goes home, and for everyone else in the city, it’s as though the shooting never happened. It changes no policy. It motivates no law. In a perverse way, the more efficiently Goldberg does her job inside the hospital, the more invisible gun violence becomes everywhere else.

Which is why she pours so much of herself into the outreach programs, the scientific studies and any other method she has of finding control and making the problem visible. Then, as always with Goldberg, there’s call. “We care,” she told me once. “We’re gonna be here. We’re gonna be here. We’re gonna be here, and then you know what, we’re still gonna be here. And then we’re still here. That kind of thing.”

The last time I saw Goldberg, I was eating breakfast in the hospital’s basement cafeteria, one corridor away from the morgue where bodies are kept, pending transport. It was at the end of a relatively quiet overnight call shift in late March. She walked in with a coffee, looking calm and fresh. The forecast showed rising temperatures. The crust of snow on the sidewalks would soon melt, the days would lengthen, people would leave their houses to enjoy the weather. Spring was coming, and the shootings would pick back up.

I grew up on the border between the United States and Mexico, near the boundary line that starts at the Pacific Ocean and weaves east toward the Gulf of Mexico. My parents, who are both from Tijuana, met in that city in the late 1970s while my father was home from California’s Central Valley, where he was a field worker. They decided to build a family across the border in San Diego, and that’s where I was born.

It was a time when such a relocation was less an international move and more a matter of switching neighborhoods. The border was one place. More than 100,000 of us crossed in either direction every day. My life was shaped by these comings and goings: During the week, we’d go to school and work in San Diego; on weekends and holidays we’d head south for a birthday or a wedding, or to have dinner with my grandmother Esperanza. She was a retired nurse who lived on the steep hillsides of Colonia Libertad, right alongside the boundary. From the front doorstep of my childhood home on Z Street, we had a view of San Diego Bay and its naval ships. We could also see Tijuana in the distance, its lights like multicolored stars at night.

Crossing the border was made possible by my privilege. On my family’s returns into San Diego, all we had to do was smile and declare “U.S.!” when a border agent asked our citizenship. We were brown-skinned Americans, and no other proof was needed. This was the 1980s, and others crossed just as easily with the shopping and tourist visas that were readily handed to Mexicans born in the region. Back then, there was nothing to fear on the border if there was nothing to hide.

But in 1994, just before I turned 14, this began to change. That October, the Clinton administration reinforced the border near San Diego with more fencing and more agents; the number of immigrants from Mexico was increasing due in part to the passage of the North American Free Trade Agreement. Then came September 11, 2001, and the resulting frenzy over border security and deporting criminal foreigners. I was in college by that time, and I resisted the notion of a tightening line, going back and forth as I always had. I’d picked up bar-hopping, and because there was nothing remotely as purifying as a long boozy night in downtown Tijuana, I ventured with friends or cousins to Plaza del Zapato, a city block full of techno and alternative clubs. We’d drink beer after beer while dancing to Depeche Mode and Maldita Vecindad. Sometimes I’d bump into Tijuana-side cousins doing the same, and our parties would merge.

And yet, crossing back, I couldn’t escape how the border was being militarized right under our noses. A few years later, we watched as a triple-layer fence went up around parts of San Diego; in 2006 we’d hear on the news about George W. Bush’s plan to extend the fence all the way through Texas. Agents now dressed in heavy vests, with earpieces and gloves. Tall floodlights shone into Mexico along the Tijuana River, sometimes illuminating groups of men huddling in concrete channels. IDs became mandatory for re-entry. The vehicle lines at the San Ysidro port grew exponentially, snaking into Tijuana’s side streets—sometimes into Colonia Libertad, in fact.

There were deeper costs. The fence influenced our daily plans. Cousins of mine in Tijuana trained themselves to wake up at 4 a.m. to accommodate the lengthening wait times at the border and arrive for the morning bell at their schools in San Ysidro or Chula Vista. It also imposed quiet but prolonged divisions in my family. Relatives who had made their lives in San Diego, raising American children, could not travel to Tijuana because they had not become U.S. citizens and might not be allowed re-entry. Others lost their U.S. visas—for, say, a run-in with the law as teenagers—and moved to Tijuana, unable to secure the paperwork to return to San Diego. The border became a knife, slicing through the region, changing how we related, how we thought about the future. We adapted by creating parallel events on each side—dual baby showers, dual birthdays, dual weddings—sometimes even on the same day. For the most part, this worked well. But for someone like me, who had been born in the U.S. and whose parents had become U.S. citizens, the wall remained an almost comical idea. How could any sort of fence cut through who we were?

For many of us, there was one place where these wounds could be salved. Friendship Park, located west of the San Ysidro entry port, is a plaza that surrounds Monument 258, the white obelisk that marks the western end of the boundary between the U.S. and Mexico. Also known as Friendship Circle, the park was inaugurated by first lady Pat Nixon in August 1971, back when the border was barely defined by a barbed-wire fence, and it was intended to serve as a symbol of binational fraternity. “May there never be a wall between these two great nations, only friendship,” Nixon declared at the park’s dedication. Even after the barbed wire was replaced by gigantic steel bars, the area remained a place of connection. For years, those who had loved ones stuck “on the other side,” north or south, could meet at the plaza, touch through the bars, and gossip or laugh or share news.

I did not visit Friendship Park myself until 2011, when I attended a 40th anniversary celebration of the plaza with my mother. The Department of Homeland Security, citing a need to make the fence even more secure, had closed the space in 2009, reopening it only for this one-day event. The park is where Southern California meets Baja California, so of course it is a beautiful place—the breeze sweeps onshore over the rocks, waves crash up against the fence that stretches into the sea. But perhaps I should have expected that Friendship Park would have lost its hospitable sheen by then. To reach the plaza, visitors had to ride in a shuttle for about a mile over a largely submerged mud lane. Once there, the triple fencing created a sort of no man’s land; at the boundary with Mexico, an imposing metal mesh—preventing all physical contact except for the skin of a fingertip—had been installed on the bars.

The U.S. Border Patrol had designated a sort of corralled-in space for us to see into Tijuana, and my mother and I stood there, with a handful of other families and some border activists. We listened to U.S. officials make a speech or two. The space was small and uncomfortable, and I felt as if we were cattle left out to bake in the heat. On the other side of the mesh, an entirely different scene was playing out. In Tijuana’s half of the park—an open, unmonitored stretch of beach—we could hear roaming musicians playing trombones and tamboras, smell shrimp being grilled in stalls along the boardwalk, and see people dancing—actually dancing—in the sun. Mexican officials had set up a tent and a podium, and a few city council members from Tijuana waved hello. My mother and I shared a glance.

And then we decided to make use of our privilege.

We got back in the car and headed south on Interstate 5 so we could join the party on the other side. After a quick curvy right over the Tijuana River, and then a drive along the fence in Mexico, we arrived at the Tijuana beach in about 25 minutes. We parked near the old bullring overlooking the shore, and approached the fence. On this side, the boundary was painted with bright murals, and marked with crosses bearing the names of people who had died trying to cross. We peered through the fence again. We could hear a few speakers but not much. The mesh made it hard to see. A couple of people on the U.S. side recognized us from minutes earlier and waved with half-hearted smiles. They looked trapped.

Later I would think about how easy it was for me to exercise both sides of my identity like this—and how my mother, who received citizenship in the Reagan administration amnesty of 1986, was able to return home that same night, to watch the Tijuana evening news from the comfort of her living room in San Diego. There are so many families for which this isn’t true. Maybe certain loved ones have crossed illegally or overstayed a visa, and now are forced to remain in place as they await citizenship papers. Maybe relatives in Mexico cannot visit because they have been denied a tourist visa or do not have the means to travel. Or maybe a family member has been deported, with no way to re-enter. These deportations have increased over the past decade, leading to the removal of about 3 million people. The number of parents who were deported between 2003 and 2013 but have children who are U.S. citizens falls somewhere between 740,000 and 925,000, according to a report from the Urban Institute and the Migration Policy Institute. That’s a lot of separated families—roughly the population of Austin or San Francisco. And the one place where any of them have a hope of seeing each other again is Friendship Park.

The documentary “Monument/Monumento,” by filmmaker Laura Gabbert, shows one such reunion, between members of the Ascencio family. Friendship Park reopened to the public in 2012, but access on the U.S. side remains restricted to a few hours on the weekends. The family’s patriarch, who sits in a wheelchair, has traveled some 1,500 miles from Mexico City to be there; his children and grandchildren have driven seven hours from the Central Valley. They have not seen each other in person for two decades.

To enter this impersonal and fortified space, under the watchful gaze of border sentries and cameras, is to willingly lay yourself bare: your love, your longing, your pain. And yet that vulnerability only gets you so close. The intimacies you crave—to smell your daughter’s hair, to squeeze your father’s hand—are impossible. All the questions you have, accumulated over years, are unanswerable in a mere few minutes. And those minutes are precious, so instead you search for your loved one’s eyes through the tiny gaps in that mesh. You smile wide so he or she can see. Here you are at last, face to face, but not together.

Inside The NFL's Tobacco-Style Strategy To Hook Your Kids

They were supposed to die in prison. But thanks to an ingenious discovery, they were given a second chance.

And since then, at least 811 people have lost their lives in jail.

One of the greatest enigmas of 2016, explained.

# 1. Back in the comparatively innocent days of 2015, before Donald Trump completed his hostile takeover of the Republican Party, before the Bernie Sanders juggernaut really got going, Hillary Clinton’s campaign thought it could get ahead through well-crafted policy proposals. On August 10, Clinton was set to unveil a grand plan to help families pay for college tuition, and for months leading up to her speech, the preparation soaked up hundreds of man-hours in conference calls, meetings and email exchanges. The level of seriousness, according to one participant, rivaled that of a White House staff gearing up for a State of the Union address. At the outset, Clinton sat down at her kitchen table with Ann O’Leary, the senior policy adviser who was leading the effort, and made it clear she wanted something ambitious. The motivation was obvious enough, with Americans carrying something like $1.3 trillion in outstanding college debt, and even relatively affluent families struggling to cover tuition bills. “The request was that we think big, bring up ideas regardless of whether they were fully fleshed out or might be controversial,” says Robert Shireman, a former Obama and Clinton administration official who was one of several experts who worked on the plan. Reining in tuition costs is a trickier proposition than you might expect, and not one that money alone can solve. If it became easier for families to pay for college, it would become easier for colleges to hike prices; if Washington put up more funds, states would try to put up less. Plus, Clinton had essentially ruled out increasing deficits or middle-class taxes, limiting the revenue available for any new endeavors. The wonks would have to get freaky. Ultimately, Clinton settled on a scheme the campaign named the “New College Compact.” The goal, making public college debt-free, was simple. The mechanics were not. Families would pay “realistic” fees based on income, with poorer families paying nothing at all. Students would contribute directly through work-study programs. Washington would provide most of the money, but states would have to kick in some funds and hold the line on tuition increases. The feds would also crack down on for-profit colleges where too many students were getting substandard degrees and defaulting on their loans. All in all, the proposal would require some $350 billion in new spending over 10 years, which Clinton planned to pay for by raising taxes on the rich. James Kvaal, a former Obama administration adviser who consulted on the initiative, described it in an email as “a once-in-a-century change in the relationship between the federal government and colleges, on par with the Morrill Act (which created land grant colleges in the 19th Century) and the G.I. Bill.” A few days before Clinton’s speech, O’Leary convened a final conference call to discuss media strategy. Anticipating a lot of attention, she instructed the team to be ready by the phones. Clinton delivered her address at a high school in Exeter, New Hampshire, and afterward, held a press conference in the gym. She got just one query about the plan. Earlier that week, Trump had described Fox News anchor Megyn Kelly as having “blood coming out of her eyes, blood coming out of her wherever” during a debate, and so Clinton was grilled on whether Trump should apologize to Kelly, whether he had a problem with women, and what Clinton thought of the fact that Trump had retweeted someone who called Kelly a bimbo.

Over the next 24 hours, the tuition plan received only perfunctory coverage. “The calls just never came,” recalls Gene Sperling, another one of Clinton’s advisers. “It was all Kelly-Trump, 24/7.” Even many professional policy types didn’t grasp the full scope of her proposal; I didn’t realize it myself until I began researching this article. As primary season wore on, her scheme was overshadowed by a bolder, shinier promise from Senator Bernie Sanders: free public college for everyone. The episode was typical of how this election has unfolded. Clinton’s policy operation has churned out more than 60 papers outlining plans for everything from housing for people with serious mental illness to adjusting the cap on loans from the Small Business Administration. The agenda includes extremely big items, like a promise to ensure no family pays more than 10 percent of income on child care, and extremely small ones, like investing in smartphone applications that would make it easier for military families living in remote locations to receive services available only on bases. Some of these ideas are more fleshed-out than others. The childcare plan, for example, is missing crucial details, like a price tag. And because the multitude of initiatives doesn’t cohere under a galvanizing theme, the whole of the agenda can seem like less than the sum of its many, many parts. Even so, Clinton’s plans are as unambiguously progressive as any from a Democratic nominee in modern history—and almost nobody seems to have noticed. The peculiar political dynamics of this election are largely to blame. In Sanders, Clinton drew an opponent whose ideas were even more grandiose than hers. Pretty much anything that Clinton wanted to do, Sanders also wanted to do, but on a bigger scale. Then, after Clinton clinched the nomination, policy dropped out of the conversation almost completely.^[1] “She's got people that sit in cubicles writing policy all day,” Trump told a reporter. “It's just a waste of paper.” In early September, the Washington Post reported that Trump’s policy advisers had quit en masse because not only had the campaign failed to pay them, but he had also made it clear he wouldn’t be requiring their services to prepare for the presidential debates. ^{1. A rare exception was the childcare policy Trump released in September, which was almost comically geared to benefit the rich. He has also issued three completely different versions of his tax plan.} This summer, I stopped by Clinton’s Brooklyn headquarters, where the policy team occupies prime real estate. The three senior advisors—Jake Sullivan, Maya Harris and Jacob Leibenluft—share an office steps away from those of campaign manager Robby Mook and chairman John Podesta. (O’Leary is now leading the official transition operation in Washington.) About a dozen more policy aides occupy nearby cubicles, below a sign that says “Nerds” and “Wonks for the Win.” This team manages more than 30 outside working groups that include academic heavyweights^[2] think tank experts and trusted advisers like Sperling and Neera Tanden, president of the Center for American Progress. It’s an impressive crew, but perhaps over-qualified when it comes to some of the matters that have convulsed this particular election, like the size of Trump’s hands or the semiotics of Pepe the Frog. “It’s not exactly clear what to do with all of that horsepower,” says a person familiar with the process. “There is just this mismatch between capabilities they have and what’s actually required in this campaign.” ^{2. Many of her academic advisers were first reported in a series by Jim Tankersley of the Washington Post. They include economists Joseph Stiglitz, Christina Romer, Simon Johnson, Laura Tyson, Betsey Stevenson, Roland Fryer, Alan Krueger, and Aaron Chatterji; and political scientists Jacob Hacker and Robert Putnam.} People on the campaign assured me that the policy staffers work “the same insane hours as everyone else.” It's just that they’re focusing on November 9, and what Clinton would do if she manages to make it to the White House—where she would face an even less habitable political environment than Obama did. Unlike him, she’ll be entering office without a huge reserve of personal popularity to draw on. She’ll be hemmed in by Republicans on one side and a newly emboldened progressive wing of the Democratic Party on the other. With almost no room to maneuver, Clinton has to find a way to do something good for America. It almost makes the election look like the easy part.

# 2. What She Wants One of Jake Sullivan’s favorite stories about Clinton comes from August 2011, when she was still at the State Department. The recession was over but employment was sluggish, and Obama had asked his Cabinet secretaries to pass along ideas they might have for boosting job creation. Most sent short notes. Clinton submitted a 12-page single-spaced memo,^[3] complete with references. (“Classic Hillary,” was one reaction from within the White House.) ^{3. Among the ideas Clinton suggested were an infrastructure bank, speeding up the retrofit of buildings to make them energy efficient, and taking more aggressive steps to curb currency manipulation by China.} To map out her 2016 agenda, Clinton created a process akin to a college seminar, complete with required reading. She hauled around issue binders and cross-examined the experts who rotated through Brooklyn to brief her. These included Raj Chetty, a Stanford professor and MacArthur “Genius” fellow who is one of the world’s most influential economists. At a lunch session that lasted several hours, Chetty presented his research about the effects of inequality on children. He spoke about an old federal program that had proved more successful than researchers initially realized, and Clinton “got really excited,” Chetty recalls. She told him she had followed the debate over the program since her time as first lady.^{[4] 4. Chetty’s work is based partly on “Moving to Opportunity,” a 1990s initiative in which the government gave families the chance to win lottery vouchers that allowed them to move to more affluent areas. At the time, it was deemed a failure. Using new data, Chetty and his colleagues showed that the young children in families who moved were more likely to attend college and had higher earnings as adults, and were less likely to end up as single parents.} When it came to formulating her own ideas, Clinton wasn’t starting from scratch, obviously. But since her last run for the White House, the Democratic Party had undergone a minor metamorphosis—and in ways that didn’t seem like a natural fit for Clinton, at least as she was perceived by most voters. The progressive wing was clearly ascendant, with groups like Occupy Wall Street and Fight For 15 harnessing populist anger at the financial system, and Black Lives Matter turning an unrelenting spotlight on racial injustice. Minority voters had come to represent a larger proportion of both the party and the population, giving Democrats an electoral-college advantage whose influence was still unclear when Obama ran for office. And there was another trend at work—one that was less obvious, but no less important: In just a few years, the Democratic elite had quietly gone through a once-in-a-generation shift on economic thinking. For most of the past quarter-century, a fight over economic policy has divided the party. It’s helpful to think of it as an argument between two ideological camps that shared basic values, but differed substantially over how to uphold them. On one side, you had liberals, who were convinced that without major government action, people would fall through the cracks of even a healthy economy. They pushed for tougher regulations on business and efforts to reduce inequality, and in some cases demanded stronger protections for workers in trade agreements. On the other side you had centrists, who also supported a strong safety net. But they were more likely to worry that regulations would hamstring businesses. They wanted to liberalize trade and cut government spending to encourage growth, which they thought would ultimately benefit Americans more than big new government programs.

During Bill Clinton’s presidency, the centrists mostly got their way—not least because his more progressive initiatives quickly withered in Congress. By the time Clinton left office, he had recast the Democratic Party as one that saw a role for markets as well as government in solving social problems. The centrists continued to shape policymaking well into Obama’s first term—their influence clearly visible when, in 2010, Obama turned from job creation to what Paul Krugman described as an “obsessive concern” with deficits. Economist Jared Bernstein, whom Vice President Joe Biden enlisted to hold up the liberal end of policy discussions inside the Oval Office, remembers it as a lonely time. “On numerous occasions when I was in the White House,” he told me, “I would make an argument and there would be typically five to seven people on the other side.” Outside Washington, though, the assumptions underpinning the centrists’ theories were crumbling. The Great Recession did a lot of work by utterly discrediting the notion that Wall Street functioned best when left to its own devices. In addition, some of the biggest names in academia were demonstrating that it wasn’t enough to assume that if the economy was ticking along nicely, everyone would be more or less OK. French economists Emmanuel Saez and Thomas Piketty showed that inequality had deepened in the U.S. even as the economy grew. David Autor from MIT showed that trade with China had benefited the American economy overall—but that the long-term damage to manufacturing communities was worse than previously assumed. The arguments that liberal economists had been making for years—that active steps must be taken to prevent inequality, that it affects the economy in structurally corrosive ways—were finally gaining broad currency. This “new liberal economics,” as it has been termed by the policy writer Mike Konczal, has now emerged as the orthodoxy within the Democratic Party. And so, in an unexpected turn of events, Hillary Clinton’s economic agenda now stands as a correction of sorts to her husband’s. In speeches, Clinton often says that it’s time to “rewrite the rules” of capitalism—language injected into the debate by the Roosevelt Institute. She talks about the need for the Fed to encourage full employment, not just hold down inflation. “I’m having conversations with people who are on the campaign, with her policy staff, and finding myself on the same page where that wasn’t always the case,” says Bernstein, who has been advising Clinton. That’s partly because there are more liberals in key positions than in Democratic campaigns past—and partly because the centrists sound more like liberals these days. “We’ll see if it sticks,” Bernstein says, “but this is a little inspirational to me.” This new thinking underpins Clinton’s entire domestic platform, which can be roughly divided into three areas. On the economy, her initiatives would pour $275 billion dollars into public works, more than the Recovery Act did. She has endorsed various measures to help unions recover at least some of their lost bargaining power. She has also called for changes to regulations governing both corporations and banks, on the theory that there are too many incentives throughout the system that encourage short-term thinking and risky behavior. The second area may be the most innovative. Clinton has developed a slate of policies to address the fact that as women have moved into the workforce, society has failed to keep pace with the resulting changes in family life. These include guaranteed paid leave, so that workers can take time off to care for a new child or sick relative. She’s also offered measures to improve the quality of childcare and make it a lot more affordable.^{[5] 5. Clinton hasn’t specified exactly how this would work, but has indicated it would be through the tax code, It’s widely assumed that she means something like a scheme suggested by the Center for American Progress in which families would be eligible for tax credits that vary based on income. Unlike the tax deductions proposed by Trump, this scheme would be worth more to people on lower incomes and would not exclude those who have no tax burden.} The third area focuses on the protection of marginalized groups, from African-Americans and Latinos to the LGBT community. Clinton plans to make a major push for comprehensive immigration reform, in a plan that essentially picks up where Obama left off. On criminal justice, she wants to cut mandatory minimum sentences in half, and limit the types of offenses that trigger them. Again, this reflects the party’s shift away from its ‘90s-era incarnation, bolstered by conclusive data that showed that that mandatory minimums put huge numbers of African-American men in jail, undermined families and imposed crippling financial strain on government—without actually reducing crime. “There has been a sea change in the conversation, a change long in the making,” says Harris, the senior policy adviser. The price tag for all of this comes to some $1.6 to $1.7 trillion in new spending over the next decade, according to an independent assessment by the Committee for a Responsible Federal Budget. Clinton intends to pay for this by increasing taxes on the wealthy (the assessment found her accounting convincing.) Her plan is less expansive than the one offered by Sanders,^[6] and there are some places where Clinton didn’t go as far as she could have. Instead of a sweeping tax on financial transactions, for instance, she called for a narrow one, relinquishing a potentially huge source of revenue. Still, Lawrence Mishel, president of the Economic Policy Institute and a longtime dissenter from the centrist consensus, told me he was struck by its direction: “Her agenda would have to be seen as more complete, more focused on generating wage growth and jobs than I’ve seen from other candidates [since the 1980s]—and therefore I think it’s more progressive.” And yet this realization hasn’t traveled very far beyond the small world of policy experts and activists. Alan Blinder, a Princeton economist who served in Bill Clinton’s White House and is now advising Hillary, told me: “I don't fully think people are wrapping their heads around the ambition of what she is proposing,” ^{6. Sanders wanted the government to take over health insurance by effectively creating a version of Medicare for everybody, while Clinton has proposed tweaks to the Affordable Care Act that would make its insurance offerings moderately more affordable. Another example is drug pricing. Sanders wanted the government to directly negotiate prices with drug-makers. Clinton has offered a series of mechanisms that would reduce prices but without the same blunt impact. Clinton's plan would cost hundreds of billions of dollars; Sanders' would be well into the trillions.} One explanation for this is Hillary Clinton’s reputation as a serial compromiser, or worse, a sellout—the politician who echoed warnings about “super predators” in the 1990s, voted for a bank-friendly bankruptcy bill as a senator and has raked in millions of dollars giving secret speeches to Wall Street. Among her detractors, there are those who acknowledge that her agenda is a squarely progressive one, but they say she is simply bending to the power of the Elizabeth Warren-Bernie Sanders wing out of political necessity, and could reverse course when in office.

Clinton’s defenders argue—with no little frustration—that she has always been more progressive than people realize. They cite her lifelong advocacy for children and poor families and recall the ugly attacks on her openly professed feminism. “When [Clinton] was first lady back in the 1990s, progressives went to her on issue after issue to advocate for progressive causes inside the White House,” Neera Tanden says, “from saving Social Security to health care to minimum wage to children's issues.” More than one person pointed out that her policy views are often incorrectly assumed to be identical to her husband’s. “Hillary is not Bill,” Bernstein says. “I don’t think she has ever been where he is on trade.” He adds: “I remember talking to her in the 1990s. She recognized that these trade agreements are often just handshakes between investors. I don’t think her husband would have said that.” One longtime Clinton aide told me, “The idea that she's some kind of conservative and not progressive is ridiculous.” Of course, it’s possible for both of these things to be correct. A close reading of her record over the years supports the argument that her instincts in certain areas of domestic policy are genuinely left-leaning. But it’s equally true that she is inclined by nature to work within the bounds of what is politically doable, and that she spends large amounts of her time in the company of the corporate elite. What’s different about 2016 is that, for the first time in her political career, she is facing more concentrated pressure from the left than the center. Her advisers were eager to point out to me that, even though it would have been easy for her to court Republicans by signaling that she would dilute her agenda, she still hasn’t “pivoted.” “What she was for in the primary is what she stands for today,” one aide told me. “There is no change in tone or content.” ## The Seven Pillars Of Hillary Clinton's first term. ### ECONOMY - $500 billion for public works, half to be funded by private investors through an “infrastructure bank.” - Raise federal minimum wage to $12. - Change rules for capital-gains taxes to reward long-term investing, not short-term gains. - Appoint officials who will aggressively enforce labor and consumer regulations. ### WORK AND FAMILY - Up to 12 weeks of paid leave to care for a baby or relative, or to recover from illness. - Tax credits and subsidies to ensure no family spends more than 10 percent of income on childcare. - Matching funds for states that create preschool programs. - Seed money for states to invest in programs that raise salaries for childcare providers. ### EDUCATION - A federal-state program that would allow anybody to study at a four-year public college debt-free. - Free community college. - Debt relief for entrepreneurs and people who pursue public service. - A three-month student-loan repayment moratorium for federal borrowers—via executive action—so debtors can explore options for relief. ### CRIMINAL JUSTICE - Cut mandatory sentence periods in half for nonviolent drug offenses. - Change the definition of offenses that require mandatory sentences so they apply to fewer cases. - Help every police department to purchase body cameras, via matching funds. - $10 billion over 10 years for addiction treatment and recovery. ### HEALTH CARE - Fix Obamacare’s “family glitch,” which makes coverage on the exchanges prohibitively expensive for some low-income families. - More financial assistance for people with private insurance who face high premiums or out-of-pocket costs. - Demand drug companies give Medicare the same discounts that they give Medicaid. - Allow imports of high-cost drugs (or their generic equivalents) from countries where they are cheaper. ### FINANCIAL REFORM - Increase capital requirements for the largest banks and place new rules on the activities of “shadow banks” that engage in the riskiest behavior. - Plug loopholes in the “Volcker Rule” to limit high-risk activity by big banks. - Apply a “risk fee” to the largest financial institutions. - Impose a tax on certain transactions to discourage high-speed traders. ### IMMIGRATION - Comprehensive reform that would allow undocumented immigrants to work legally if they pay taxes and pass a background check. Includes beefed-up border security and a path to citizenship. - Close all private detention facilities - Relief from deportation for more groups—like parents of DREAMers—through executive action if necessary. - Better legal representation for children in deportation proceedings - Allow women and children seeking asylum to stay with relatives. # 3. Why She Might Not Get It Clinton and her team are not delusional—they know that passing her agenda would get very messy, very fast. Even if she manages to pull off a decisive victory, Democrats almost certainly won’t take the House. They may not even regain the Senate. Still, Clinton has identified two top priorities that she believes could plausibly become law early in a first term. The first is a jobs bill that includes some version of her infrastructure proposal. This passes for an “easy” option, since it polls well even with Republicans and is favored by business and labor. The second priority, immigration reform, is the opposite of easy. The political logic is that after Mitt Romney lost in 2012, the Senate was able to pass a bipartisan immigration bill because the GOP wanted to improve its standing with Hispanics. A Trump loss, the theory goes, might motivate the House to do the same. One Clinton confidant described the broader calculation like this: “Do they decide their strategy is, OK, our problem was just this guy and now we’ve rid ourselves of him, so all we have to do is crush Hillary for four years and then we will win the presidency? Or do they decide we have to fundamentally reconstitute things … [that] we can’t just be the party of no, let’s figure out some things we can get done. It will be a huge difference whether they choose door number two or door number one.” > On cooperating with Clinton, a senior House GOP aide said: “I just don’t see where any optimism comes from.” Clinton’s team believes she has several advantages when it comes to Congress. “Part of the optimistic view for me is that Hillary Clinton has a history of actually working across the aisle to get big things done,” says Harris. “She jokes that [Republicans] really like her when she is not running for office.” Harris told me she “strongly believes it is possible to move forward” on key issues like immigration and criminal justice, pointing out that that as First Lady, Clinton teamed up with Senator Orrin Hatch to pass an expansion of children’s health care, and with House majority whip Tom DeLay to pass a bill improving foster care for children. John Podesta observed: “Just being willing to sit in the same room with [DeLay] ought to earn you a merit badge. But she actually got something done.“ (Both Hatch and DeLay have since said that Clinton overstates the extent of their cooperation.) Clinton's inner circle is also placing high hopes on the man who could end up becoming her chief antagonist: Paul Ryan. Last year, the Republican House speaker worked with the White House and Democratic leaders to pass an omnibus spending bill that gave both parties something to smile about in the tax policy department. To one Clinton ally, this signaled that “Ryan and the Republicans, even in the context of an election campaign, are prepared to do business on not-insignificant matters.” This person went on: “The optimistic storyline … is that it’s a precursor to future cooperation and, after an election when you have some kind of wind at your back as a new president, it’d be very difficult for them not to work with you on some of these kinds of things.” Obama, too, once imagined a similar scenario. His 2008 pitch leaned heavily on his willingness to bridge partisan divides. In the run-up to the 2012 election, he mused that an emphatic win might finally cure Republicans of their “fever” for shooting all Democratic initiatives down on sight. The fever never broke. Take Obama’s own attempts to pass an infrastructure bill. Throughout his second term, he pushed for legislation very similar to Clinton’s plan. All he got was some highway and surface funding which Congress was due to reauthorize anyway. The big public works package went nowhere.

People familiar with both leaders insist that Clinton could still succeed where Obama hasn’t. They describe Clinton as both more realistic about the prospects for cooperation with Republicans than Obama was, but also better-equipped to work with her opponents. She’s more willing to sit through arguments she thinks are nonsense, and less likely to assume her adversaries are arguing out of bad faith. She is particularly good at finding common cause even with people who have demonized her. “Her natural style is much more inclined to persistent, relentless engagement with the Hill, trying to lift up the thing they care about, and fold them into a large initiative,” one Clinton ally says. It’s a great theory, until you talk to actual Republicans. If they are more amenable to working with Clinton, they aren’t sharing it, not even in whispers. “I just don’t see where any optimism comes from,” says one senior House Republican aide. “She essentially wants to continue working on the unfinished items on Obama's list, and I don’t see why anybody thinks she’ll have more success in the next four years than he did in the last six.” On infrastructure, the senior aide noted that last year’s transportation bill funds roads until 2022. “We just did a six-year, big-ass highway bill,” the aide says. “I don’t see a whole lot of urgency to do another infrastructure bill.” The aide was even blunter when it came to immigration reform: “I can’t fathom how that would come together.” Pretty much all of the major items on Clinton’s list require new spending, which she plans to fund by boosting taxes on the wealthy. For the GOP, that’s essentially a non-starter. As for the possibility that Democrats could attack Republicans for obstructionism, the senior aide basically shrugged. “That’s baked into our brand already,” the aide said. “What are they going to say about us that they haven’t already said?” It’s not only Republicans who will be giving Clinton headaches—she’ll get plenty of those from Democrats, too. To pass anything at all, she needs to be able to compromise with the GOP without alienating progressives. Inside the Capitol, the consensus is that the only way to get an infrastructure bill is to package the new spending with corporate tax cuts that Republicans covet—for instance, lowering taxes on U.S. companies with operations abroad. Such a move will meet intense skepticism from Sanders or Warren, who basically see it as an invitation for U.S. companies to shift jobs off-shore. (“That is nuts,” Warren wrote in a New York Times op-ed in September.) “I think the politics are now going to be harder from the left,” says one person who has been privy to recent tax reform negotiations in Congress. “I am worried that anything that is attractive enough to Paul Ryan on the corporate side is going to be really hard for the Warren-Sanders side.”

Warren in particular is keenly aware that she has a great deal of leverage in this situation, and so far has proven shrewd at using it. She and her allies find a lot to like in Clinton’s agenda. “They have taken seriously the need to keep the reform-oriented wing of the party happy enough,” one Warren ally says, “and for now they seem to have succeeded.” But it would be a stretch to say that they trust Clinton. In order to ensure that she follows through on her promises, they intend to keep up the pressure.^{[7] 7. Top priorities include making sure Clinton opposes the Trans-Pacific Partnership and pushes for a higher minimum wage.} Progressives are also laser-focused on executive branch appointments and staffing. As Warren put it to a gathering at the Center for American Progress in mid-September, “personnel is policy.” If Clinton's legislative agenda stalls, the administration’s best hope of realizing its goals will be through the rules that federal agencies issue and how they choose to enforce them. According to Politico, progressive activists are already circulating a list of appointees they would fight, such as Morgan Stanley vice chairman and former State Department official Tom Nides. “He’s the whisperer to Wall Street, and goes around saying she’s not a crazy person, you don't have to worry about her,” says one operative. (Associates of Nides bristle at this description, arguing that some of Washington’s toughest regulators once worked on Wall Street.) Progressives were heartened to see Heather Boushey, a liberal economist who has championed generous work-family policies, join the transition team. And they want more appointees like Labor Secretary Tom Perez, who made use of a decades-old statute that could be used to change overtime rules and make several million more workers eligible for extra pay. People around Clinton are optimistic that they can bring Warren and Sanders into the fold early. “I think she’s going to have to have a lot of conversations with Warren about what’s doable,” one ally says. The idea is to make them feel invested not just in Clinton’s policy agenda, but in the success of her presidency. “Look, Bernie Sanders won 10 million votes. From my personal perspective, that entitles you … to a voice in what the party is trying to accomplish,” one adviser says. “I think that’s an exercise we began in the platform process, through the convention and will continue as we go through the transition if we win.” # 4. Is That All There Is? The Democratic convention in Philadelphia in July was unlike any of the five others that I’ve attended. Over and over, I was struck by the fact that Democrats were proudly showcasing aspects of their agenda or members of their coalition that in previous years they would have sought to downplay. Even in 2008, I couldn’t envision the DNC featuring an undocumented immigrant in primetime, or members of Black Lives Matter, if it had existed then. On the last night, when Clinton took the stage to give her acceptance speech, I perched in the stairwell of a section reserved for some of her special guests. Gabby Giffords was there; and so was Richard Trumka, the head of the AFL-CIO; and Marian Wright Edelman, the founder of the Children’s Defense Fund, where Clinton began her career in public policy four decades ago. At one point I felt some scratchy fabric brushing against my hand: It was the sequined dress of Katy Perry, who was slipping past me to reach her seat. The person I was there to watch was policy adviser Ann O’Leary, who has worked with Clinton for many years. The speech, she told me, had been undergoing revisions until 4 a.m. and then final tweaks during the day. O’Leary teared up a bit during the introductory biographical movie, and cheered when Clinton mentioned mental health, an issue O'Leary had worked hard on. When Clinton got to the line, “I sweat the details of policy,” O’Leary reached over to tug at my sleeve. “That’s my favorite part,” she said. As somebody who obsesses over policy, I appreciated it, too. But during this election, and especially as Clinton’s position in the polls has started to slide, I’ve found myself experiencing the wonk’s version of a midlife crisis. Exactly how important is it for a presidential candidate to show off a deep knowledge of policy, to grapple with the complications and trade-offs and come up with something that could work in the real world? Do all those binders matter? The political benefit of an extensive agenda is that it convinces voters the candidate is serious about governing. And Clinton has surely done that. But her platform is so hyper-detailed, so painstakingly constructed to be financially and politically practical that it can obscure something more important: what she stands for. Her agenda lacks the kind of bigger vision or narrative that voters need to be convinced that a candidate is on their side. It’s one reason she finds herself struggling against a candidate who is so unashamedly ignorant and whose agenda would be disastrous for the people he champions. This September, a poll showed nearly half of millennial voters thought Trump would be no different or better than Clinton on student loan policy—despite the fact that Clinton mentions her tuition plan constantly and Trump has barely said a word on the subject.

What all this comes down to, in the end, is the best way to govern in an intractable political moment. In my conversations with Democrats who have worked with both Clinton and Obama, that subject came up a lot. People often remarked that for both politicians, their greatest strength was also their main vulnerability. Obama, people told me, was more likely to set an overarching goal and stick to it no matter what. This turned out to be invaluable in the fight for health care reform and many of his second-term successes, but it limited his overall effectiveness at doing deals with Congress. Clinton, they said, is better at the grind of coalition-building. But at times she can become so immersed in this messy process that she loses sight of her larger aims. If she’d been in Obama’s place when healthcare reform hit the rocks, it’s an open question whether she would have shown the same perseverance. If the worst-case scenario comes to pass, and Clinton can’t enact any big pieces of legislation, that’s when her more incremental style could prove the most useful. Like Obama, Clinton would look to advance her agenda through rules and regulations—in fact, she has a list of executive actions at the ready.^[8] She would also look for opportunities for small legislative wins—tacking an amendment onto a must-pass bill, for instance. Given her greater tolerance for this kind of horse trading, it’s conceivable that she could get further with this approach than Obama did. ^{8. These include the moratorium on student loan repayment and closing all private immigration detention facilities.} The danger here for Clinton is also the danger for liberalism itself—that a lack of major progress on the nation’s core economic challenges will leave voters even more convinced that government cannot, or will not, solve their problems. In 2012, Obama could at least run on the legislation he passed while he still held a congressional majority: health care reform, Dodd-Frank, the auto bailout and the Recovery Act. Come the fall of 2020, Clinton is unlikely to have such a resume. The people in Clinton’s close orbit understand all this. They know that their boss has been preparing herself for this job for much of her adult life. They are confident that she will achieve progress in the White House by drawing on the qualities they admire about her the most: her belief in the potential of public policy to change lives, her tenacity. And they believe that advancing her agenda piece by hard-fought piece, laying the foundation for bigger legislation at some future point when the politics permit it, is a deeply meaningful accomplishment. And yet even her most dedicated allies don't talk about the next four years in terms of a transformative presidency. “Realistically what the secretary has to try to do if she is elected is to generate some momentum—to do enough so people don’t believe Washington is just completely broken and nothing is ever going to happen,” one confidant told me. “Give enough relief to families and communities so they think, ‘OK, it’s not all great but it’s headed in the right direction.’ I think that is achievable.”

One evening in the late summer of 2015, Lisa Schwartz was watching television at her Vermont home when an ad for a sleeping pill called Belsomra appeared on the screen. Schwartz, a longtime professor at Dartmouth Medical College, usually muted commercials, but she watched this one closely: a 90-second spot featuring a young woman and two slightly cute, slightly creepy fuzzy animals in the shape of the words “sleep” and “wake.” Schwartz had a reason to be curious about this particular ad. Two years earlier, she had been a member of the advisory panel that reviewed Belsomra for the U.S. Food and Drug Administration—and the process had not gone well for the manufacturer, Merck. The company saw its new drug as a major innovation, emphasizing that the medication acted on an entirely different mechanism within the brain than the previous generation of insomnia medicines like Ambien and Lunesta. During the drug’s development, Merck had suggested that it could treat insomnia more effectively and produce fewer side effects than existing medications. In 2012, one Merck scientist described the science underlying Belsomra as a “sea change.” But when Schwartz and her colleagues scrutinized data from the company’s own large-scale clinical trials, what they found was a lot less impressive. People taking Belsomra fell asleep, on average, only six minutes sooner than people taking a placebo and stayed asleep for a mere 16 minutes longer. Some test subjects experienced worrying side effects, like next-day drowsiness and temporary paralysis upon waking. For a number of people, these effects were so severe that the researchers halted their driving tests, fearing someone would get into an accident. Because of these safety concerns, the FDA ended up approving the drug at a lower starting dosage than the company had requested—a dosage so low that a Merck scientist admitted it was “ineffective.” So when Schwartz saw the Belsomra ad, she was struck by how smoothly it sidestepped the drug’s limitations. A soothing voiceover hypes the science, giving a sophisticated explanation of how Belsomra targets a neurotransmitter called orexin to turn down the brain’s “wake messages.” “Only Belsomra works this way,” the voice continues. The ad ends with the young woman curling up with the “sleep” animal and falling into a peaceful slumber. “You have no idea watching that ad that we’re talking about falling asleep 6 minutes faster and staying that way an extra 16 minutes—and that’s at higher doses,” Schwartz said. “We really don't have a great idea of how well it works at the lower dose FDA actually recommends for people starting the medication.” In the United States, commercials like these are simply part of the cultural wallpaper. But just because drug ads are ubiquitous here doesn’t mean they’re a normal way of informing consumers about their medical options. In fact, the U.S. is one of only two developed countries in the world that allow drug companies to advertise their products on television. (The other is New Zealand, which has a population of some 4.5 million people.) One study, from the Journal of General Internal Medicine, found that 57 percent of claims in drug ads were potentially misleading and another 10 percent were outright false. For a variety of reasons, drug companies are now increasingly relying on direct marketing to American consumers. Last year, the pharmaceutical industry spent $5.2 billion on ads promoting specific drugs—an increase of 16 percent over the previous year. At a time when most other industries are spending less on television advertising, drug companies are spending more. They are also devising new forms of so-called direct-to-consumer outreach, like smartphone apps that consumers may not even realize are a form of marketing and that the FDA is still figuring out how to regulate. (The FDA recently asked Kim Kardashian to delete Twitter and Instagram posts touting a morning sickness pill she was taking, because she hadn’t explained its side effects.) Concerns about direct advertisements of pharmaceutical products have become so acute that last November the American Medical Association called for an outright ban, saying that the practice was “fueling escalating drug prices.” Spending on prescription drugs already accounts for about one in every six dollars that go into medical care. Between 2013 and 2018, the government anticipates that the average annual increase in this spending will be about 7.3 percent—higher than the overall rate of health care inflation. One of the reasons for the increase is the massive sum that manufacturers pour into advertising. Last year, for instance, [Merck spent $96 million promoting Belsomra](https://www.statnews.com/2016/03/09/drug-industry-advertising/). The investment proved to be worth it. Analysts expect the drug to generate more than $300 million in sales this year and to overtake both Ambien and Lunesta as the top-selling insomnia medication sometime within the next decade.  Up until the early 20th century, newspapers were full of ads making outlandish claims about potions and elixirs that were sometimes toxic and nearly always useless, such as Doctor Quenaudon’s Spring Cure, an “extract of green herbs for purifying the blood and the cure of all diseases arising from its impurity, also of all other chronic diseases.” Over time, a series of federal laws, starting with the Pure Food and Drug Act of 1906, took these concoctions off the shelves and put their producers out of business, giving rise to the pharmaceutical industry as we know it. In 1938, the Federal Food, Drug and Cosmetic Act mandated that the most powerful drugs could only be purchased with a doctor’s prescription. After that, manufacturers focused their promotional efforts exclusively on physicians, running ads in professional journals, dispatching representatives to doctors’ offices, and wooing them with fancy dinners and junkets. But the FDA, which eventually gained authority over both the manufacturing and marketing of drugs, had never actually prohibited mass advertising. In 1981, Merck broke new ground by running a text-heavy, black-and-white advertisement for a pneumococcal vaccine in Reader’s Digest. The following year, Arthur Hull Hayes Jr., the head of the agency, hinted in a speech that the FDA would be OK with such ads. Seizing the moment, Boots Pharmaceuticals created the first-ever television commercial to promote its version of prescription ibuprofen. That’s when the FDA got jittery. It asked the industry to observe a moratorium while the agency came up with some ground rules. Under guidelines released in 1985, the FDA allowed drug companies to run ads that simply raise awareness of a disease without much restriction. But if a company wanted to describe what a drug was supposed to do, it was required to explain the risks. The ads that followed fell heavily into the first category, because companies saw no way to cram sufficient information about side effects into 30-second spots. The companies began pushing for fewer restrictions, and in 1995, they gained a powerful ally in new House Speaker Newt Gingrich, who started beating up on the FDA as a “job killer.” Under pressure from lobbyists and Capitol Hill, the FDA in 1997 produced new guidelines declaring that companies’ ads just had to devote roughly equal time to the risks and benefits of a drug. One year later, spending on television drug ads had more than doubled, from $310 million to $664 million. A major early beneficiary was a new generation of antihistamines that did not make people drowsy. Thanks to the advertising push, first Claritin, then Zyrtec and Allegra became some of the most frequently prescribed medications in America. These antihistamines represented a meaningful improvement for allergy suffers. The same could not be said for other drugs that manufacturers began promoting with multimillion-dollar campaigns. Take the case of Nexium, which is now infamous in the world of health care policy. Until the 1980s, doctors had treated acid reflux with over-the-counter pills, like Tums, that counteracted the effects of stomach acid. Then, in 1990, a drug went on the market that reduced the production of acid itself. Prilosec would become a moneymaking monster, with sales reaching $6 billion a year. But AstraZeneca, the company that ended up marketing it, knew these profits would last only as long as the drug’s patent, which was set to expire in 2001. So it launched a desperate bid to find a replacement—an effort named “Project Shark Fin” because the graph of Prilosec’s expected revenues rose and fell like an inverted V. Eventually, researchers produced Nexium, which AstraZeneca promoted as a new, improved acid inhibitor. Chemically speaking, however, Nexium was extremely similar to Prilosec. There was little evidence that it was better than Prilosec or new generic alternatives. In fact, public health experts argued that many people taking acid inhibitors didn’t need medications at all—they needed to change their diets. But the advertising blitz worked: Within two years of its release, Nexium had surpassed Prilosec in sales; by 2010, it had surpassed Lipitor, the anti-cholesterol drug, as the highest selling drug of all. > The best thing I heard experts say about Belsomra was that it was no worse than any of the other drugs out there. The first marketing efforts for Belsomra appeared not long after the FDA had approved the medication, in the summer of 2015. Anyone who saw them might not have realized what was being sold, since many didn’t mention Belsomra—or any sleep drug—at all. There was a website, WhySoAwake.com, which focused on sleep science, and a related Twitter feed, which now has more than 60,000 followers. Merck also worked with the nonprofit National Sleep Foundation to develop [BeyondTired.org](https://beyondtired.org/), a site where people with insomnia talk about their experiences. And there was an iPhone app called SleepGuru, which allowed users to monitor their sleep activity. For pharmaceutical companies, the great advantage of such “unbranded” advertising is that, since the ads don’t make claims about specific drugs, they aren’t legally required to talk about side effects, either. Like the fuzzy animal commercial, the unbranded campaign for Belsomra told a compelling story about new developments in the field of sleep research. Older insomnia drugs try to induce sleep by making the brain more receptive to chemical signals that make people drowsy. Over the last two decades, scientists have developed an understanding of a separate set of chemical signals that make people alert. The WhySoAwake site gives a cartoonish version of this story, and a link on one page takes visitors to the Belsomra site, which explains that it is the only drug that acts to quiet the wake signals. In Merck’s last quarterly earnings call for 2015, Adam Schechter, the president for global human health, linked the drug’s sales success directly to these marketing efforts. “With regard to Belsomra, I think we started off with a really good launch and we had nice growth,” he said. “It then flattened a little bit. We ran direct-to-consumer advertising and we saw an increase again in … volume.” When drug companies defend their use of advertising, they often argue that it performs a valuable public service. A much-aired commercial might prompt patients to discuss conditions they never knew they had, the logic goes, or reduce the stigma around certain diseases. If you see ads for depression or irritable bowel syndrome every night while eating dinner, you might feel less embarrassed asking your doctor about it. Critics of direct-to-consumer advertising acknowledge these benefits. But when the people raising awareness about a condition are the same people selling a drug to treat it, some rather obvious problems arise. Ads rarely provide the kind of context consumers need to make good decisions about their health—about how often a drug actually works or whether an alternative treatment might be better. I asked Dominick Frosch, a senior scientist at the Palo Alto Medical Foundation Research Institute who has published widely on how patients make decisions, to review the Belsomra television spot with the fuzzy animals. “The ad promotes a very clear story as to what causes insomnia … that somehow insomnia is a problem of your neurotransmitters,” Frosch said. “They are giving you a very one-sided explanation of what causes insomnia, and of course into that cause fits this particular drug.” > Policymakers in Europe and Australia have decisively rejected proposals that allow American-style drug advertising. There’s a well-established body of research showing that advertising plays a critical role in a drug’s popularity. In one of the most famous studies of direct-to-consumer advertising, a team of researchers from Canada and the U.S. studied consumer behavior in two demographically similar cities: Sacramento and Vancouver. The U.S. consumers, deluged with ads for prescription drugs, were more than twice as likely to ask for a drug they’d heard about as the consumers in Canada, which doesn’t allow such ads. In another study, researchers trained actors to seek medical help for symptoms that resembled depression at different levels of severity. The good news was that most people with symptoms warranting medication received drugs. The bad news was that most people without symptoms warranting medication also received drugs. Just over half of that latter group came away from their physician’s office with a prescription for a drug they’d asked about after seeing an ad on TV. Companies like Merck point out that their ads always instruct patients to consult a physician. And it’s true that doctors aren’t supposed to prescribe medication unless they think it makes sense clinically. But as multiple studies have shown, doctors often give patients the particular brand-name drugs they ask for, even when a cheaper generic version is available. Pharmaceutical companies are eager to exploit this fact, because promoting drugs to doctors has become harder than it used to be. In 2002, the federal government prohibited pharmaceutical companies from providing financial incentives or other “tangible benefits” to physicians who prescribe their drugs. In the last few years, it has begun prosecuting apparent violations through anti-kickback statutes. “In the old days, pharmaceutical representatives were always taking docs out to dinners, bringing them Cuban cigars, taking them to Yankee games in the box seats,” said Stephen Hoelper, a veteran drug marketing executive and vice president for sales and marketing at MediSolutions. The Centers for Medicare & Medicaid Services “doesn’t like that and says that if you induce a physician to prescribe a product, then you are potentially making health care more expensive.” Meanwhile, the employers and insurers who pay most of America’s medical bills have been looking for ways to discourage excessive prescribing in an attempt to rein in costs. Most private insurance plans have formularies, or lists of approved drugs, managed by special companies called “pharmaceutical benefit managers.” These firms negotiate with drugmakers over prices and divide medications into tiers, forcing patients to pay more out of their own pockets for certain expensive drugs. Brand-name sleeping pills frequently end up in the tiers requiring higher co-pays, which means the pharmaceutical companies must work even harder to convince consumers that the drugs are worthwhile. Finally, during the past decade, drug companies have simply had fewer genuine game-changing drugs coming onto the market. With the exception of occasional breakthroughs for diseases like hepatitis C, it is becoming harder and harder to find drugs that offer clear-cut clinical advantages over existing treatments. Between 2003 and 2011, the success rate for clinical trials fell, the time from trial to approval rose, and the ratio of approved drugs to trial drugs declined. These are all signs that the drug pipeline is drying up. Innovation could pick up again, but in the meantime, drug companies have been spending much of their time pushing drugs of questionable clinical advantage, or persuading viewers to seek medication for “a disease that may be hard to distinguish from normal behavior in most cases,” according to Aaron Kesselheim, an associate professor at Harvard Medical School who focuses on the drug industry. In his field, the tactic is known as “disease mongering.” And to critics of consumer drug advertising, Belsomra is a perfect example of these practices at work.  The insights about separate sleep and wake mechanisms represent real scientific advances, as Ian Parker documented in a [2013 account](http://www.newyorker.com/magazine/2013/12/09/the-big-sleep-2) of Belsomra’s development for The New Yorker. Someday, the discovery might even lead to major advances in treatment. But those advances have not yet been made. All of the sleep medicine experts I interviewed emphasized that therapy and behavioral changes remain the best treatments for insomnia. Like most other sleep drugs, Belsomra provides only mild relief. “Clinically meaningless” is the way one sleep expert, Gregg Jacobs from the University of Massachusetts Medical School, [described](http://www.huffingtonpost.com/entry/sleeping-pills-belsomra-side-effects_us_55ef38eee4b093be51bc7b0f) Belsomra’s effects. “Almost none of the patients I see are taking Belsomra because it does not work,” Jacobs said. The best thing I heard experts say about Belsomra was that it was no worse than any of the other drugs out there. In response, a Merck spokesperson pointed out that in one of its trials, Belsomra patients slept half an hour longer than people taking the placebo. However, the sample for that trial was just 62 people. Larger, more predictive trials found that Belsomra had much weaker effects. In a January 2016 report, the nonprofit Institute for Safe Medication Practices [analyzed](https://www.ismp.org/quarterwatch/pdfs/2015Q2.pdf) more than 1,000 consumer complaints that the FDA had received about Belsomra between February and July 2015—a number the institute described as “substantial.” A large number came from patients who complained that the drug was ineffective. Others reported that they had experienced side effects including sleep paralysis and next-day drowsiness. There were also reports of suicidal thoughts and attempts, two of which were successful. Merck correctly points out that the side effects correspond to the ones the company included on the warning label. There is also no way to definitively prove a link between these particular complaints and the drug, particularly when it comes to the suicides. Still, in its report the institute noted that the trials of Belsomra had not tested the drug’s effect on people taking antipsychotics or antidepressants, even though insomnia is a “key symptom” of depression and anxiety. It concluded, “The preapproval trials of [Belsomra] had so many limitations that it was challenging to draw any valid conclusions about what might happen when a new kind of hypnotic is marketed to a patient population measured in tens of millions."  “We all want consumers … to be highly engaged in their health care, and certain advertisements can do that. But it can also lead to a lot of overtreatment,” said David Grande, an assistant professor of medicine at the University of Pennsylvania who has written extensively on drug advertising, “It’s not as if we live in an imaginary world where messages in advertising are being driven by what’s important, rather than what makes more money.” On multiple occasions, policymakers in Europe and Australia have considered and decisively rejected proposals to allow companies to advertise specific drugs there. In 2002, the European Parliament voted down legislation that would have allowed the direct advertising of medications to treat HIV/AIDS, asthma and diabetes. "If we open the door to direct advertising it is a slippery slope down the American road where pink pills on television advertisements offer a miracle solution to everything from baldness to chronic fatigue,” Catherine Stihler, a Labour Party representative from Scotland, said at the time. “Medicines are like no other product. The aim must not be to maximise sales but to ensure that the product is used appropriately." In the U.S., a similar ban on ads for specific drugs would face a slew of First Amendment challenges in the courts. But there are plenty of other remedies available. Democrats in Congress have [proposed](http://delauro.house.gov/index.php?option=com_content&view=article&id=2211:delauro-introduces-the-responsibility-in-drug-advertising-act&catid=2&Itemid=21) prohibiting advertising until a drug has been on the market for a few years, giving health care professionals more time to see how the drug worked in the wider population. Another possibility, which Hillary Clinton has endorsed, would be to make advertising less attractive to drugmakers by barring them from writing off the associated costs on their tax returns. The FDA could seek to review all ads before they air and reject those that make false or misleading claims. It could also require ads to include more information about how often a drug is effective or whom it actually helps. Lisa Schwartz has been working with the FDA and consumer advocates to develop a better model for presenting this kind of information. Along with her husband and fellow researcher, Steven Woloshin, she started a company that is creating “drug facts boxes” for different medications. The idea is to translate the gobbledygook that appears in prescription package inserts or those fine-print full-page magazine ads into language that average consumers can understand. After Belsomra hit the market, Consumer Reports asked Schwartz to create a label for it. Her version [presents](http://static2.consumerreportscdn.org//content/dam/cro/news_articles/health/PDFs/CR-DrugFactsBox-Belsomra.pdf) the data on the drug in an even-handed way, noting that its ability to aid sleep is “modest” at the highest approved doses. “Short track record means that new, unexpected side effects are possible,” it explains. “Since this drug has a different way of acting than other insomnia drugs, the experience with it is particularly limited.” The label gives brief details on alternative remedies for insomnia, like cutting down on caffeine. Finally, it lists Belsomra’s known side effects. Not included on the list but probably warranted: skepticism.

On an early Friday morning in late June 2006, Cheyenne Szydlo, a 33-year-old Arizona wildlife biologist with fiery red hair, drove to the Grand Canyon’s South Rim to meet the river guide who would be taking her along the 280 miles of the Colorado River that coursed a mile below. She was excited. Everyone in her field wanted to work at the Grand Canyon, and after several years of unsuccessful applications, Szydlo had recently been offered a seasonal position in one of the National Park Service’s science divisions. She’d quit another job in order to accept, certain her chance wouldn’t come again. The Grand Canyon is a mecca of biological diversity, home to species that grow nowhere else on earth. But after a dam was built upstream 60 years ago, changes in the Colorado’s flow have enabled the rise of invasive species and displaced numerous forms of wildlife. Szydlo’s task was to hunt for the Southwestern willow flycatcher, a tiny endangered songbird that historically had nested on the river but hadn’t been seen in three years. Her supervisor believed the bird was locally extinct, but Szydlo was determined to find it. The June expedition—a nine-day journey through the canyon on a 20-foot motorboat operated by a boatman named Dave Loeffler—would be her last chance that summer. When Szydlo asked a coworker what Loeffler was like, the reply was cryptic: “You’ll see.” Szydlo, who’d studied marine biology in Australia and coral reefs in French Polynesia, was drawn to the adventurous nature of the work. “From my earliest memories,” she told me, “there was never any place that felt safer or happier to me than the outdoors.” On the morning of the trip, she arrived at the boat shop early. She assumed they’d leave at once, to make the most of the day. Instead, she said, Loeffler took her to a coworker’s house, and for an hour and a half, she sat uncomfortably as Loeffler told his friend about the battery-powered blender he’d packed to make “the best margaritas on the river.” They set out from Lees Ferry in Marble Canyon, the otherworldly antechamber to “the Grand.” From there, the river winds through towering, striated red cliffs and balancing rock formations, under the Navajo Bridge, and, at around mile 60, into the Grand Canyon itself. The views are stupefying, the waters turquoise, and the disconnection almost total—a moonscape beyond cell phone reception. For many people, it’s a spiritual experience. It’s also an intimate one. Travelers eat and sleep together, and, due to the lack of cover, must often bathe and go to the bathroom in full view, using portable metal ammo cans outfitted with toilet seats. Commercial river guides often say that no one can claim their privacy on the river, so fellow passengers should offer it instead. In Szydlo’s recounting of the trip, Loeffler didn’t adhere to this code. When she bent to move provisions or tie up the boat, he commented on a logo on the back of her utility skirt. He asked frank questions about her sex life and referred to Szydlo as “hot sexy biologist.” That June, the temperatures at the bottom of the canyon reached 109 degrees, and when Szydlo scorched her skin on a metal storage box, Loeffler said she had a hot ass. He adjusted her bra strap when it slipped and, one chilly night, invited her to sleep in the boat with him if she was cold. When they stopped to take a picture at a particularly scenic spot, he suggested that she pose naked. He told her that another female Park Services staffer would be hiking in to meet them at the halfway point, and that he hoped they would have “a three-way.” Szydlo told me she laughed uncomfortably and spoke often of her boyfriend and their plans to get married. By the third day of the trip, it seemed to Szydlo that Loeffler was getting increasingly frustrated. They stopped at a confluence where the Colorado meets a tributary and forms a short tumble of rapids gentle enough for boaters to swim through with a life jacket. Szydlo pulled on her preserver, but Loeffler insisted she didn’t need one. When she entered the river without it, the water sucked her under. She somersaulted through the rapids “like I was in a washing machine,” she recalled. She thought she was going to drown. Then the rapids spat her out into a calm, shallow pool. She came up gasping and choking to the sound of Loeffler’s laughter, and thought to herself, “I’m in deep shit.” We’re used to hearing stories of sexual harassment in the Army, the Navy, or within the police force; 25 years after the Tailhook scandal, when scores of Marine and Naval officers allegedly sexually assaulted some 83 women and seven men at a military convention, there’s a general cultural understanding of what women face in traditionally male-dominated public institutions. The agencies that protect America’s natural heritage enjoy a reputation for a certain benign progressivism—but some of them have their own troubling history of hostility toward women. In 2012 in Texas, members of the Parks and Wildlife Department complained about a “legacy” of racial and gender intolerance; only 8 percent of the state's 500 game wardens were women. In 2014, in California, female employees of the U.S. Forest Service filed a class-action lawsuit—the fourth in 35 years—over what they described as an egregious, long-standing culture of sexual harassment, disparity in hiring and promotion, and retaliation against those who complained. (That lawsuit is still pending.) And this January, the Department of the Interior’s Office of Inspector General announced that it had “found evidence of a long-term pattern of sexual harassment and hostile work environment” in the Grand Canyon’s River District, a part of the Park Service. Ever since the U.S. created institutions to protect its wilderness, those agencies have been bound up with a particular image of masculinity. The first park rangers in the U.S. were former cavalrymen, assigned to protect preserves like Yellowstone and Yosemite from poachers and fire. The public quickly became enamored by these rugged, solitary figures. In the early 1900s, as the Park Service was created, a new breed emerged: naturalists who endeavored to teach the public the principles of conservation. As the historian Polly Welts Kaufman has written, the earlier generation of rangers resented the intrusion of “pansy-pickers” and “butterfly chasers.” Also controversial was the presence of a small number of women at the agency. Male naturalists worried that their job would be seen as effeminate, instead of, as one put it, “the embodiment of Kit Carson, Daniel Boone, the Texas Rangers, and General Pershing.” In the 1930s and ‘40s the ranks were mostly filled by returning veterans attracted by the ranger corps’ quasi-military culture. Until 1978, female rangers weren’t permitted to wear the same uniform or even the same badge as the men, but instead wore skirts modeled on stewardesses’ uniforms.  Park ranger or Pan Am stewardess? (National Park Service)  Enid Michael, a park ranger in the 1920s, overdressed for her dance with a bear. (National Park Service.) The other major institution tasked with preserving and managing the American wilderness, the Forest Service, developed on a similar trajectory. Although the Forest Service comes under the direction of the Department of Agriculture (while the Park Service falls under the DOI), its employees perform similar work and its culture is also modeled along military lines. By the 1970s, women held only 2 percent of full-time professional roles in the service nationwide. In California—whose lands are the crown jewel of the national forest system— female employees filed a class-action lawsuit known as _Bernardi v. Madigan_. The case was settled in 1981 with a court-enforced “consent decree” that required the Forest Service’s California region to employ as many women as the civilian workforce—at least 43 percent in every pay grade. The decision ultimately saw hundreds of “Bernardi women” enter the service, to the disgruntlement of many male employees. Lesa Donnelly is a former Forest Service administrator who worked for the agency from 1978 to 2002. In 1994, she filed a complaint charging that three of her male colleagues were harassing her. After word spread (incorrectly) that she planned to file a class-action lawsuit, she received dozens of calls. She heard from women who claimed they were being threatened with physical and sexual assault, and women who said they’d been punished for making complaints. One said the men on her crew joked about raping her in her sleep and had tied her blood-stained underwear to the antenna of their fire truck. Two women told her that a notice in their office about the Bernardi consent decree had been defaced with a scrawled reference to the “cuntsent decree.” She realized her own complaint was “nothing compared to what I found out was happening.” Eventually, Donnelly compiled claims from 50 women, and in 1995 she filed a class-action suit against the Forest Service, including declarations from many of the woman who had reached out to her. The agency negotiated a settlement that allowed for continued court oversight of California’s Forest Service. But when the monitoring period ended in 2006, the old problems soon resurfaced, as Donnelly would describe in testimony to Congress two years later. One dispatcher reported that she’d been sexually assaulted and stalked by a manager. He was made to resign, but after six months the Forest Service tried to work with him again. In 2008, a male supervisor at the same forest said that he hated a black female employee and wanted to shoot subordinates he hated. When the employee reported the comment, the district ranger told her to ignore him. This year, I met Donnelly, who is 58, in El Dorado Hills, outside Sacramento. Now the vice president of the USDA Coalition of Minority Employees, a civil rights group, she has the demeanor of a friendly bulldog. She told me that nearly every year for the last 15 years, she has traveled to Washington, D.C., to lobby the USDA, Congress, and the White House to protect women in the service. She managed to enlist the help of representatives Jackie Speier of California, Peter DeFazio of Oregon and Raúl Grijalva of Arizona, who in 2014 petitioned the USDA to investigate, without success. Each time Donnelly comes to D.C., she added, she brings details of 20 to 25 new allegations. But while her fight against the Forest Service has persisted for more than two decades, in the Grand Canyon, similar questions about the treatment of women have only started to surface. “On the river, the boatman is god,” Cheyenne Szydlo told me. In the Grand Canyon, river guides enjoy an almost exalted status, revered for their ability to “read water.” Boatmen have almost total responsibility for their passengers—they keep the food and determine when and where to sleep, explore, or go to the bathroom. They also control the satellite phone, the only means of contact with the outside world. But within the Park Service, boatmen were more important still. Men like Dave Loeffler guided visiting officials or VIPs on adventures within the canyon, undertook rescue missions, and were featured in travel stories in newspapers and magazines. They “made it seem [to park management] like the river was the surface of Mars,” one boatman for a private company recalled. The administration saw them as irreplaceable. In the early 2000s, three men turned the boat shop into a small fiefdom. There were the “two Daves”—Loeffler and his supervisor, Dave Desrosiers—and Bryan Edwards, the boat shop manager. In addition to this small core of permanent staffers, the park periodically hired intermittent boatmen. One, Dan Hall, worked in the canyon during this period and was friendly with the trio. Hall is garrulous and not remotely prudish. “I have offended people I’ve worked with,” he told me. “I do my best to apologize and not let it happen again …. But with the Daves, it had this very dark side to it.” He remembered the three talking about who could sleep with the most women on the river. “They were always on the make,” he said. In a written response sent via Facebook, Edwards said that “no competition ever existed.” Rafting on the Colorado has always had a bit of a party vibe, and that attitude held for Park Service trips, too. Boats sometimes carried a large quantity of alcohol. Participants sometimes hooked up. But during the early 2000s, Hall told me, it seemed short-lived river affairs were almost expected of female employees. According to one former employee, veteran female staffers warned new hires to make sure they set up tents with a friend rather than sleeping on the boats, as the boatmen usually did. Sometimes, Hall said, boatmen would lobby supervisors to send women from completely unrelated park divisions—an attractive new hire at the entry booth, for instance—on trips. Often, though, the targets were from science divisions that required river access, such as vegetation and wildlife. The field leader of the vegetation program from 2002 to 2005, Kate Watters, said that she complained to her supervisor about the boatmen’s behavior. In October 2005, an expedition was planned to see if the two groups could overcome their difficulties. The trip was led by Bryan Edwards. Participants included Watters, who was married to Dan Hall at the time, and her new intern, a biologist I’ll call Anne. > “I did flash a camera below her skirt as she stood next to me,” Edwards said. “It was intended for shock value only.” The expedition coincided with Halloween week, and one night most of the participants put on costumes. Many were drinking. Anne—dressed as a butterfly, in wings and a dress—was in the camp’s kitchen area, when Edwards—dressed as a pirate—came up behind her. He grabbed the camera she’d left on the table. “The next thing I knew, his hand was between my legs,” she said. Then Edwards shot a picture up her skirt. Watters observed aloud that Edwards’ behavior was unacceptable. Loeffler, who was attired as “a hillbilly axe murderer” and carrying a real axe, demanded that Watters talk it out with Edwards instead of filing a report. She recalled that he bellowed at her, axe in hand, “Fuck you, Kate Watters. You can’t have control over people’s jobs.” Loeffler told me that he was unable to answer questions since he is still a park employee. Edwards wrote in his response, “I did flash a camera below her skirt as she stood next to me. It was intended for shock value only” as Anne had been drinking, he explained. Watters said that in a meeting after her return with Edwards and Desrosiers’ boss, Edwards glared at her and cleaned his nails with a 6-inch buck knife. (Edwards called this description “entirely false.”) In 2006, he received a 30-day suspension over the incident, after which he resigned. Edwards confirmed this to me, but wrote in another message, “I suspect nearly everything you have been told is at least either ‘misrepresentation’ or outright lie.” He felt that he had done “a lot of good in my 12 yrs in Grand Canyon,” he went on. “Because of my abilities, I did things people dreamed about doing but simply could not on that River and dealt with their envy and accusations constantly.” Edwards added, “But as the joke goes: ‘ ... ach, you fuck one sheep!’” Following Edwards’ resignation, relations between the boat shop and vegetation devolved into a cold war. On trips, according to multiple sources, some of the boatmen withheld food or avoided taking volunteers to work sites. Watters complained to the director of the science division and to regional Park Service authorities. After getting nowhere, she quit in frustration and Anne eventually assumed her place. According to Anne and Hall, Loeffler later showed up at a campsite where Anne was working to harangue her about Edwards. He and Desrosiers made it so difficult for her to schedule trips that sometimes she had to use a helicopter, at great expense. These acts of sabotage “became an art form for the two Daves,” recalled Hall. The pair even erected a memorial to Edwards in the boat shop, said two former employees: a crude bust of Jesus wearing a crown of thorns with Edwards’ name written on the base in Sharpie. The implication was clear: Edwards had been martyred. It was around the time of Edwards’ departure that Szydlo took her boat trip with Loeffler. After the scare in the rapids, she said, the uneasy balance between them shifted. Szydlo stopped laughing at his come-ons. Loeffler would sleep in late and then tell her they didn’t have time to visit her next work site. “This person was in complete control of everything I needed to survive,” she said. “I was terrified.” She began to formulate a plan to get out of the canyon if she needed to. “Even if there were trails to take, which in most places there were not, they'd land me in the middle of nowhere, in the desert, up on the rim,” she said. “I didn't have enough food or water to attempt that.” She could try to hike out on the Bright Angel Trail when they reached the halfway point at Phantom Ranch. But doing so would mean missing the nesting sites on the lower half of the river—and, she feared, abandoning any hope of being hired back next season. The day before they reached Phantom Ranch, Szydlo said she felt as if some kind of assault was inevitable. Loeffler slowed the motorboat to a crawl, stopping at nearly every beach. Finally, in the middle of a channel, she heard the motor go quiet. Loeffler came up behind her, grabbed her shoulders and asked her to describe her sexual fantasies so he could act them out. “I broke down crying,” Szydlo said. “Saying, ‘Get off me, stop harassing me.’ As soon as I used the word ‘harassment,’ he was like, ‘Whoa, stop. I don’t know what you’re talking about.’” He revved the engine and sped to Phantom Ranch. For the last five days, she said, they barely spoke, and at meals, Loeffler gave her minuscule portions. After she returned, she emailed her then-boyfriend and told him what had happened. Szydlo worried for months about whether she should file a report. When she finally contacted an HR representative almost six months later, she said, she received a brief response informing her she’d need dates, times and witnesses in order to pursue a complaint. She let it drop, not wanting to start a “huge, ugly fight.” Much as she suspected, other women in similar situations have discovered that taking formal action can bring on its own host of problems. The Eldorado National Forest is a mountainous expanse of nearly 1,000 square miles that stretches from east of Sacramento to the crest of the Sierra Nevada. Denice Rice has worked here for 15 years as a firefighter—on engines and fire crews and as a prevention officer. These days, she likes to operate by herself, driving a truck with a small reserve of water through the hundreds of miles of back roads that cut into the Eldorado. She is often the first on the scene at a fire, helping direct in crews of “hot shots,” the firefighting elite who clear the tree line. On slower days, she might serve as “Smokey’s wrangler,” accompanying the unlucky staffer who has to don the sweaty mascot costume and make safety presentations to kids. Many women in the Forest Service told me that “fire is a small world,” and that they repeatedly had to fight the perception that they were only there to meet men. Rice, who exudes a no-bullshit air of competence, prided herself on her toughness. When I visited her at her home in January, she drove to meet me on a four-wheeler, flanked by two bulldogs. “When you work in fire, you have to have a really thick skin,” she said. Around 2008, Rice was a captain being groomed for promotion when she was befriended by her boss’ boss, a division chief named Mike Beckett. After about a year, their interactions took on a different tone. By Rice’s account, Beckett would describe sexual dreams he’d had about her and comment on her body. When they texted about work, he responded with crass double entendres. He cornered her in the office, followed her into the bathroom, and tried to touch her or lift her shirt. She said he groped or touched her inappropriately at least 20 times. Even when she was out in the field, Rice felt as if there was no escape. Sometimes Beckett would wait late for her to return to the office. He took to radioing in to ask her location and seemed to monitor the line for word of her whereabouts: He’d appear, unannounced, when she was in some remote location—say, a tower lookout high in the Sierras. “He was paying a lot of attention to an employee three to four pay grades below him, which is uncommon,” recalled Rice’s former direct supervisor, who still works at the Forest Service. “He was constantly going around me.” It became so uncomfortable that Rice stopped calling in her location—a significant safety risk. Eventually, Beckett arranged for her to be moved out of the office she shared with a colleague and into a room on her own. It was more of a storage area, recalled the former supervisor, tucked in the back of the building. During this time, her oversight duties were stripped from her one by one, Rice later said in a signed affidavit, and the former supervisor confirmed in an interview. (Beckett declined to answer any questions, and the Forest Service said it couldn’t comment on specific allegations.) Still, Rice was reluctant to take formal action. She didn’t want to be “one of those women,” she explained. “You don’t cry in front of the guys, you don’t show weakness in front of them. And you don’t file. You just don’t file. You suck up and deal.” But one day in 2011, she said, after three years of harassment, Beckett came into her office and, with a letter opener, poked her repeatedly on her chest, drawing a circle around her nipple. She filed. Randy Meyer, the Eldorado union steward, said he got a phone call from Rice “that scared me to death. She was highly emotional and beside herself.” He told a senior forest manager that he was prepared to alert the police—and “then everybody and his brother got involved in this mess.” In the ensuing investigation, some 30 of Rice’s and Beckett’s colleagues were interviewed about humiliating details that Rice hadn’t even confided to her husband. “Everybody knew that he took me in the bathroom, tried to take my clothes off, things that he would say to me: ‘I want to watch you pee.’ They all knew,” she said. “And I still work with these people.” Rice said she got sick from the stress. The supervisor added that once, after he went to check on Rice, Beckett threatened him with disciplinary action. In 2012, at the district ranger’s request, Rice’s supervisor called an all-hands meeting. Rice was certain that Beckett would be on the agenda. She begged not to have to attend, but said she was required to show up. (Rice’s former supervisor couldn’t verify this, but said the meeting was handled insensitively: “Nobody took into consideration that maybe she was still feeling like the target in the case.”) The situation with Beckett was discussed in front of at least 50 colleagues; Rice walked out in tears. “I think that was the worst thing that ever happened to me,” she said. When we spoke, Rice was jumpy and broke down several times. “I can’t go anywhere without wondering, ‘Do people know who I am?’” she said. One male firefighter who has worked with Rice for five years told me, “It changed her whole life. People know Denice’s story on the forest, so she has this cloud around her. I’ve seen it for four years. I see Denice ‘trigger’ all the time: in classroom settings, out in the woods.” Ultimately, the ranger in charge of the investigation recommended that Beckett should be fired. But Beckett retired before any action could be taken. Meanwhile, Rice’s career has effectively stalled. The firefighter who worked with Rice requested anonymity, explaining, “If the powers that be tie me to her in any way, I’ll never promote here again.” Rice’s ordeal wasn’t unique. Lesa Donnelly said that in her capacity as an advocate, she has been contacted by scores of women in the service in California who allege they’ve been punished for pursuing sexual harassment complaints. One 22-year-old forestry technician filed a claim, and, several days afterwards, was visited by officials who searched only her side of the barracks with a drug dog. According to a subsequent complaint she lodged with the Forest Service, her roommate told her that one official had remarked, “You guys must have pissed someone off.” The woman left the service soon afterwards. Elisa Lopez-Crowder, a 34-year-old Navy veteran, was hired as a firefighter in 2010. She ran 45-pound sections of hose into the forest and cleared live trees to create fuel breaks. In her first months on the Eldorado, she said, an assistant captain asked her whether she’d been a “bitch” or a “slut” in the Navy, and whether her skin was really that color or just dirty. One day while she was clearing brush, she claimed, he hoisted her by her line gear and threw her to the ground; according to a male coworker’s account, he held her down with his foot. The coworker intervened, and later joined her to report the matter to their captain. The assistant captain was briefly placed on administrative leave. (In a court declaration he said Lopez-Crowder had “tripped” and that “before I helped her up, I jokingly placed my foot on her pack.”) While an investigation was still underway, he was assigned to the same work sites as Lopez-Crowder. About a year later, she traveled with Donnelly and other Forest Service women to bring their concerns to USDA Secretary Tom Vilsack in Washington, D.C. Lopez-Crowder said Vilsack apologized and assured her that the assistant captain had been removed from his position; it fell to Lopez-Crowder to tell the secretary that he was still on the Forest Service payroll. A short time later, the assistant captain left the force. Lopez-Crowder transferred out of the firefighting division anyway, fearing that she had become a target. “In the years I served in the military,” she said, “I never encountered such discrimination and harassment as I have working for the U.S. Forest Service.” Alicia Dabney, a mother of three who lives on the Tule River Indian reservation, became a firefighter, like her father and uncles before her, at the age of 26 in the Sequoia National Forest. According to Equal Employment Opportunity complaints she filed in 2011 and 2012, Dabney claimed that coworkers made disparaging remarks about her Latina and Comanche heritage and joked about sexually assaulting women. She said a male supervisor instructed her and another female firefighter to tell him when they began menstruating. At a training academy, other participants left lewd sexual propositions on her [voicemail](http://www.marshacoleman-adebayo.com/women-whistle.html). One day she arrived at work to find the floor of the engine house strewn with printouts that read “Alicia Dabney The Whore.” (She provided a photo of the printouts.) Some of the harassment was physical. Once, a male coworker jumped on her neck, “riding me like a big horse,” she recalled. On an assignment in Texas, she said, a supervisor put her in a chokehold and threw her on his hotel bed. A USDA investigation substantiated the first of those incidents but denied that there had been a “pattern of harassment.” In 2012, Dabney was informed that the Forest Service was initiating her termination, claiming she had omitted part of her criminal record—a misdemeanor vandalism charge—and failed to disclose federal debt on her application. (Dabney maintains that she disclosed both.) In 2013, Dabney left and signed a settlement agreement with the Forest Service. In 2011, the USDA put the Forest Service into temporary receivership for its failure to adequately respond to sexual harassment claims. For the next year, all EEO complaints were handled by the secretary’s office in Washington. Tom Tidwell, the chief of the Forest Service, explained in an email to staff that the change would allow the agency “to better process a series of EEO complaints within the Forest Service that, frankly, we have not handled well.” In the Canyon’s River District, the problems had continued unabated since Cheyenne Szydlo’s 2006 trip. Certain boatmen were repeatedly accused of harassing or assaulting women in strikingly similar scenarios. One young boatman covered his Park Service boat hatch with pictures of topless women and boasted to coworkers, including Dan Hall, about a side gig recruiting college women for Girls Gone Wild-style videos. Hall said that half a dozen intermittent boatmen who, like him, objected to the boat shop’s culture, found themselves blacklisted from river assignments. And even in the rare cases when management did take swift action, the targets weren’t always the people you’d expect. In 2011, Mike Harris, a contract hire then in his late 50s, was training a 40-year-old river ranger named Chelly Kearney to operate a new boat. She said that he directed her to pull to the shore, away from their group, and announced that he was going to take a bath. Then, she said, he removed all of his clothes and invited Kearney to join him in the water. When Kearney asked if they could leave, he put on his life jacket and climbed back on the boat naked. He “stood there with his penis completely exposed,” Kearney later wrote in a detailed letter to park leadership. “I stated to Harris, 'Do not get on this boat until you put your clothes on.' He stated to me that he needed to dry his clothes out. I said, 'No, do not get on this boat without your clothes.' He finally put on a pair of long underwear pants." Harris confirmed to me that he climbed onto the front of the boat naked: “I just wanted to sit in the sun and dry out,” he said. However, he said he thought he had permission from Kearney to bathe and didn’t ask her to join him. Upon Kearney’s return, she said she told a supervisor about the incident. The supervisor, she alleged, joked that they “used to not call it sexual harassment until the guy whipped out his penis and slapped you across the face with it.” Kearney didn’t take the matter further. The next year, on another trip, a biologist I’ll call Lynn said Harris repeatedly asked her to sleep in his tent when hers started leaking during a rainstorm. After she refused, he set up his tent directly next to hers. Harris told me that he only asked Lynn to join him in his tent once, and hadn’t meant the invitation as a come-on. “It wasn’t to have sex,” Harris said. “I think I said something like ‘We could snuggle and that’s all.’” Lynn said she emailed her supervisor about the episode. After a third female employee filed an EEO complaint about his behavior in 2013, Harris resigned. Lynn’s complaint was supposed to be confidential, but she noticed that boatmen she’d been friendly with began to act coldly toward her. And matters only escalated from there. > The supervisor, Kearney alleged, joked that they “used to not call it sexual harassment until the guy whipped out his penis and slapped you across the face with it.” In February 2014, Dave Loeffler led a joint Park Service-private sector trip. Both Anne and Lynn were apprehensive about being on the river with him. At one point, Lynn said, a passenger inquired about a boatman who’d been let go and Loeffler ranted about “complainers” who had ruined boatmen’s lives. The following day, as the group approached a campsite, Lynn was standing in the bow of her boat when Loeffler pulled her out roughly by her life jacket—a shocking breach of river norms. Anne came up to Lynn on the beach to find her concealing tears behind her sunglasses. Lynn wanted to leave, but at that point there was no way for her to hike out. On the last night, the party celebrated with dinner and drinks. A woman who worked for a private boat company produced a novelty penis-shaped straw she’d received at a bachelorette party and dropped it in a colleague’s drink. People laughed and passed the straw around. At one point, Lynn was holding it when Loeffler tried to take her picture. Then, someone put on music. It was an eclectic playlist, and people danced accordingly: interpretive dance, head-banging, two-stepping. A hip-hop song came on, and the group started talking about twerking. Lynn gave a comically awkward demonstration in her heavy canvas Carhartt pants, puffy down jacket and rubber boots. Two days later, Anne and Lynn were called into the offices of upper management and informed that they’d been accused of sexual misconduct. In written statements, Loeffler and two of his friends claimed that Anne and Lynn had shoved the penis straw in Loeffler’s face, danced provocatively in short skirts, and, as one complainant put it, behaved “coquettishly” throughout the trip. "I felt I needed to remove myself from this increasingly hostile work environment," Loeffler wrote in his statement. “They were being so rude and inappropriate to myself and others.” According to notes from the manager assigned to look into the situation, Loeffler said he wanted Anne and Lynn to be “treated similarly” to other employees accused of harassment—that is, with the Park Service deciding not to renew their contracts. Both women protested to the managers that they were being retaliated against for their previous reports of sexual harassment. Nonetheless, the park launched an investigation, although both Superintendent David Uberuaga and Deputy Superintendent Diane Chalfant would later acknowledge in an official report that it may not have been thorough enough. In particular, the investigators weren’t made aware of the history between Anne, Lynn and the boatmen. In a meeting, Lynn said Chalfant told her that Loeffler’s charges couldn’t be retaliatory, since Lynn’s previous sexual harassment complaint was confidential. Both Lynn and Anne were informed that their contracts would not be renewed. In Lynn’s termination letter, Chalfant wrote, “We cannot afford to have team members in our employment who are not on board with management’s expectations and requirements.” “What happened to [Lynn] was the most horrifying thing I’d ever seen,” said Chelly Kearney, who had made her own efforts to draw attention to the treatment of women on the river. About a year after she resigned in 2012, she wrote a 29-page letter to Grand Canyon Chief Ranger Bill Wright documenting multiple instances of harassment, assault and retaliation and describing a culture that protected male harassers while allowing victims to be targeted for retaliation. The Park Service requested a formal EEO investigation, but the final report was never distributed beyond the uppermost level of park management and no disciplinary actions were taken. Following Lynn and Anne’s dismissals, Kearney tried again. She forwarded her letter to Uberuaga, writing that she had witnessed a “disturbing and pervasive level of hatred” toward Anne and her boss and that Anne should be protected by federal whistle-blower laws. She received a brief response from Uberuaga thanking her for her concern.  Denice Rice  Cheyenne Szydlo  Alicia Dabney Some former park employees now ruefully refer to the fateful party as “The Night on Cock-Straw Beach,” and the incident became an unlikely rallying point. Hall sent around an email asking a core group of former park employees and colleagues in private rafting companies to gather names of other women who’d been harassed or run out of the River District. With Donnelly’s help, 12 women and Hall wrote to Secretary of the Interior Sally Jewell, requesting a formal investigation into the “pervasive culture of discrimination, retaliation, and a sexually hostile work environment” in the River District. Where Donnelly had tried for decades to get federal authorities to intervene more decisively in the Forest Service, the DOI responded quickly. In October, its Office of Inspector General launched an investigation that grew from the 13 initial complainants to include multiple interviews with more than 80 people. Their final report would identify 22 additional victims or witnesses. It included accounts of Cheyenne Szydlo’s 2006 trip with Loeffler, the Halloween party where Edwards took the photo up Anne’s skirt, the twerking incident that led to the complaint against Anne and Lynn, and several allegations involving a boatman that a former employee identified as Mike Harris. The women’s complaints, the investigators said, were “extremely credible.” The investigators also determined that Chalfant, the deputy superintendent, had allowed the complaint letter signed by the 12 women and Hall to make its way to some of the accused boatmen, in violation of policy. In an interview, the lead investigator, Greg Gransback, criticized the park’s handling of the accusations against Anne and Lynn. “If you compare what had happened to these two in the past and what they were accused of, I mean there’s just no comparison. It’s apples and oranges,” he said. “The park got it wrong where they went overboard.” In a February response to the investigation, the Park Service’s Intermountain Region didn’t contest any of the details in the report, and admitted that, in many instances, appropriate action hadn’t been taken. In the OIG report two boatmen whose actions are clearly consistent with those of Loeffler and Desrosiers deny all allegations made against them. (I was unable to reach Desrosiers directly despite contacting the Park Service, former colleagues, and two family members.) Boatman 3—whom a former employee identified as Loeffler—told the OIG that he “acknowledged making sexual remarks to women, but said that he did so only when he sensed a ‘mutual attraction.’” James Doyle, the communications chief for the Intermountain Region, said he couldn’t discuss individual allegations against employees and added, “We maintain a zero tolerance for sexual harassment and hostile workplace environment.” During the year and a half that the investigation was underway, the park made some changes. After Bill Wright transferred out of the district, his role was filled by a woman. The policy for staff boat trips was revised. There would be no alcohol permitted and an outside supervisor would be required on all expeditions. Dave Desrosiers retired in May 2015. According to its response to the OIG, the Park is introducing a detailed plan to improve its sexual harassment policies, and considering disciplinary action against managers who mishandled complaints. All employees are now required to wear “standard uniforms” on river trips. The OIG team was more than familiar with sexual harassment cases: Gransback had worked on the inquiry that resulted from the 1996 Aberdeen Proving Ground scandal, when 12 Army officers were charged with assaulting female trainees. Still, Gransback told me that even he and his seasoned colleagues teared up when they heard Grand Canyon women describe the fine line they had to walk to do their jobs, “between not being hated and not being desired.” In the Tailhook case, he noted, the accused military members had developed a “Top Gun” mentality, believing they were too important to be taken down. He observed the same dynamic at work among the boatmen. “They became almost untouchable,” he said. But the military, Gransback pointed out, has made “drastic changes,” including evidence-based sexual harassment and assault prevention programs. So far, neither the Park or Forest Service has proposed anything so extensive. (Since June 2015, the Forest Service’s California region has strengthened its protocols for sexual harassment training and reporting, a spokesperson said.) In my conversations with the women, they expressed great pride in their strength. For years, they had performed dangerous, physically demanding jobs. Many of them had faced life-threatening situations. All of them had operated within environments in which women had very little room for error. The harassment they described had not only brought about personal humiliation or the loss of a job or even a career. It had shaken their entire perception of themselves—as tough and resilient, able to handle anything that man or nature could throw at them. They lost other things, too. After her boat trip with Loeffler, Cheyenne Syzdlo found herself avoiding the river. “When I’d hear people talk about how much they loved river trips, I’d be like, ‘Oh God, I hated them, I hated them,’” she told me. Then, in the course of our conversations, she came across an email she’d written to a friend after her second time in the Grand Canyon, before she’d ever met Dave Loeffler. In her message, Syzdlo described the thrill of riding huge rapids in the bow of an inflatable boat. She remembered how even the most experienced guides would pause and become tense, studying the water before steering them in. She recalled the night her group camped on a sliver of beach when a thunderstorm suddenly erupted, sending loose boulders tumbling down the sheer cliff face. She and her colleagues had huddled in their tents and contemplated the possibility that they might die, and then, when the morning dawned damp and bright, laughed as they fished their supplies out of the river. “I’d never thought about that second trip again because the third trip did change everything. It was magical,” she told me. “It’s so primitive and you feel so free. You never experience that in life.” She’d forgotten about it for nearly a decade, but that morning on the river, she hadn’t wanted to leave.

For a long time, the way philanthropy worked was simple: Rich people gave their money to museums and churches and opera houses and Harvard. Their names went up on buildings, charities gave them made-up awards, their grandkids went to rehab, the Earth went around the sun. But philanthropy is changing. Today's billionaires are less interested in legacy institutions, less obsessed with prestige and perpetuity. Part of this is a function of their age: In 2012, 4 percent of America’s biggest charitable donations were made by people under 50 years old. In 2014, a quarter of them were. The other factor driving the new philanthropists is how they earned their money in the first place. Last year, six of the 10 largest charitable donations in the United States came from the tech sector, solidifying Silicon Valley’s place as the epicenter of the newer, bigger, disrupty-er philanthropy. There, tech billionaires form “giving circles” to share leads on promising charities, and they hire the same consultants to vet them. They use terms like “hacker philanthropy” and “effective altruism.” These guys—they are mostly guys—believe that they became successful businessmen by upending existing institutions, by scaling simple ideas, by "breaking shit." And, with few exceptions, that is how they plan to become successful philanthropists, too. All of this became much more relevant in December, when Mark Zuckerberg and his wife, Priscilla Chan, announced that they were giving 99 percent of their wealth to charity. The total amount they pledged, around $45 billion in Facebook shares at current valuation, exceeds the endowments of the Rockefeller, Ford and Carnegie foundations combined. If Zuckerberg gives away the upper limit of what he announced in December, $1 billion per year for the next three years, he will likely become the world’s second-largest charitable donor after Bill Gates. He is 31 years old. Zuckerberg’s ability to remake the world in his own image, in his own lifetime, is unprecedented. Andrew Carnegie opened his first library when he was 68, and only managed to get around $5 billion in today’s dollars out the door before he died. John D. Rockefeller, generally considered the most generous industrialist in history, launched his foundation when he was 76, and only gave away around half his fortune. If he wanted to, Zuckerberg could eradicate polio, or de-neglect half a dozen tropical diseases, or fix all the water pipes in Flint, or give $9,000 to every single one of the world's refugees. But $45 billion, as a former Bill & Melinda Gates Foundation grantee put it, is "a 1,000-pound gorilla." You don't give away that much money without changing the places and institutions and people you give it to, sometimes for the worse. Zuckerberg should already know this. In 2010, he donated $100 million to the Newark Public Schools on a promise from Cory Booker that he could, according to Dale Russakoff's _The Prize_, "flip a whole city." Zuckerberg rode into Newark with the suddenness of a software update. He was determined to end the stalemate between the teachers’ union and the district, establish dozens of new charter schools and close down failing public ones. Oh, and establish a model that could be replicated in urban school districts all over the country. All in just five years. Needless to say, it didn't happen. Up to $20 million of the donation went to consultants, scrappy little MBAs charging $1,000 a day to develop, among other things, an algorithm that assigned thousands of children to new schools. And nobody bothered to ask parents or teachers whether they wanted to be flipped, causing a ton of resentment that ultimately slowed everything down. By 2015, Zuckerberg was touting Newark's charter schools, with 14,000 students, as a success. Meanwhile, its public schools, with 35,000 students, were announcing a budget deficit of $65 million and layoffs of up to 30 percent of their staff. As Antony Bugg-Levine, the CEO of the Nonprofit Finance Fund, told me, the hard part about social change “is that it doesn’t scale like a social network.” I’ve spent the last few months talking to more than 40 researchers, development practitioners, foundation employees and other Silicon Valley philanthropists, asking them about the difficult business of giving money away. They told me about their own Newarks: Promising ideas scaled into oblivion, donations that disappeared into corrupt governments, groupthink disguised as insight. But they also told me about projects that worked, that scaled, that matched the ambitions of the new philanthropy while avoiding its blind spots. And it turns out that some of the best ideas are the ones Zuckerberg is the least likely to hear in Silicon Valley. # Don’t Be Seduced By Technology Since December I've been studying Zuckerberg’s Facebook posts like a Talmudic scholar, looking for hints of what he's interested in, trying to figure out the investments and bets and mistakes he's going to make. So far he’s light on specifics, mostly speaking in gushy bromides about "connecting people" and "building strong communities." But if there is one clear, undeniable, overriding theme that emerges, it is this: Zuckerberg believes in the power of technology to transform the world. "We must build technology to make change," he wrote last fall. "Many institutions invest money in these challenges, but most progress comes from productivity gains through innovation." He's not wrong. Nearly every social advance in history has technology somewhere near the center of it—the aqueduct, the steam train, the birth control pill. And whenever you start asking people about the life-altering potential of Mark Elliot Zuckerberg and the tech-based philanthropy he represents, the first words you're likely to hear are “The Green Revolution.” In 1975, nearly three out of five people in Asia lived on less than $1 a day. Rains at the wrong time of year meant the difference between starvation and survival. Then, researchers funded by the Ford and Rockefeller foundations created new crops—varieties that grew taller, needed less water and could be planted year-round. Over the next 30 years, this innovation radically improved the lives of hundreds of millions of people. Rice yields spiked by 1,000 percent. Wheat got cheaper, healthier and more abundant. Norman Borlaug, the scientist who developed the new wheat varieties, won the Nobel Prize. It's understandable to be seduced by this story. America spent more than 100 years going from a poor agrarian society to a rich urban one. Technology, the development agencies and the foundations tell you, has the potential to "leapfrog" this process for the next batch of countries, to boost poor communities into the middle class without all the messy slave labor and cholera we went through on the way. But as Kentaro Toyama, a former Gates Foundation consultant and the author of _Geek Heresy: Rescuing Social Change from the Cult of Technology_, points out, it’s not the _development_ of technology that leads to social change, but the _application_ of it. The Green Revolution, he says, wasn't just a case of "new crops, big changes." At the same time the farmers were planting the higher-yield crops, governments were dramatically reforming their agricultural policies. Between 1972 and 1990, Asian countries nearly tripled their investments in agriculture. They provided subsidized loans for farmers to buy fertilizer, trained them in how to plant the new crops and built roads and canals to get their produce to markets. In 1970, only 12 percent of the agricultural land in Bangladesh was irrigated. By 1995, 38 percent of it was. "Technology," Toyama says, "is the easiest part of any solution." The hard part is everything that comes afterward. Take car crashes, which kill more people every year than tuberculosis or pulmonary disease. The technology to prevent these deaths—seat belts, motorcycle helmets—is not rocket science. It's just that no one has figured out how to make it appeal to the people who need it, especially in the developing world, where 90 percent of these deaths occur. Sometimes technological solutions aren't up against indifference, but outright resistance. In the ’80s, a global health NGO called PATH got a grant to develop Uniject, a pre-filled, single-use syringe designed for midwives or birth attendants to inject patients in their homes. The syringe was ready in the mid-1990s, but more than 15 years later, it had only been rolled out in one developing country. The others had laws that prohibited anyone but doctors from giving injections. "Lots of new technologies require policy changes to be effective," says Michael Free, the former director of product development for PATH. "Getting buy-in for that takes a lot longer." All these snags, though, are too complicated for the clean "leapfrogging" narrative you hear from the techno-utopians—and from Zuckerberg himself. "A few months ago I learned about a farmer in Maharashtra called Ganesh," Zuckerberg wrote in an op-ed in the Times of India in December. "Last year Ganesh started using Free Basics [Facebook's no-cost Internet service for developing countries]. He found weather information to prepare for monsoon season. He looked up commodity prices to get better deals. Now Ganesh is investing in new crops and livestock." This, too, is tempting to swallow whole. If farmers knew the prices they'd get for their produce, they could choose the market offering the highest price, or plant more profitable crops in the first place. Entire communities could be changed by the simple injection of information. The only published evidence of this effect in the real world, though, is a 2007 study that showed fishermen in Kerala, India, checking prices for their fish before deciding which port to sell them to. These fishermen sell a perishable good. They have to sell it to someone, they have to sell it today and it's the same distance back to the shore regardless of which port they pick. But the typical African or Indian farmer does not live perfectly equidistant from several produce markets. One might take an hour to get to, the other 10. And when farmers in developing countries buy seeds, they are not comparison-shopping between dozens of stores. They have just a few options, and often have to go through village middlemen or loan sharks. "Even when you have the information," Toyama says, "you're not in a situation where you can get any benefit from it." Also, when “leapfrogging” happens, it can be less of a jump and more of a step. The Kerala study, which sounds so transformative, only boosted incomes for fishermen by around 8 percent, and reduced the price of fish for consumers by 4 percent. It didn’t turn poor fishermen into white-collar workers, and it didn’t give a broad swath of the population access to more nutritious food. And guess what? That's fine! If there's one piece of advice that emerges from the last 50 years of the tech-for-the-poor hope and disappointment cycle, it is this: _Chase the 8 percents_. Zuckerberg has interest and expertise in technology, and there's nothing inherently wrong with making bets on gadgets or innovations that have the potential to help the poor. But as he does so, he should acknowledge that the silver-bullet promise of technology only works at changing the world when it's combined with political will and popular demand. Until he finds a way to engineer those (please don't), he should focus on the small ways, at the margins, where technology can improve people's lives, 8 percent at a time. # $45 Billion Isn't That Much Money In 2001, the Gates Foundation gave PATH and the World Health Organization $70 million, 10 years and a simple objective: Develop a vaccine for meningitis A and make it affordable for every single person who needs it. At the time, meningitis A was concentrated in one part of the world, a stripe across the middle of sub-Saharan Africa known as the "meningitis belt." The disease mostly affected children, causing them to die or become paralyzed in minutes. The yearly outbreaks were predictable. Where they would happen, and how severely, were not. Eventually, PATH developed a vaccine that gave patients 15 years of immunity. At a cost of around 50 cents a dose, public health departments in every country in the meningitis belt could afford to procure it at scale. By 2013, less than a decade after an outbreak killed 25,000 people, the meningitis belt had just four reported cases. Marc LaForce headed the team in charge of bringing the vaccine to market. He says it wasn't just the scale of the Gates donation that mattered, but its duration. In those days, most grants were capped at two or three years, with check-ins every six months. Years of work could be wiped away if a donor decided progress was moving too slowly and pulled out. "If you want to do something major," LaForce says, "you need the ability to go two steps forward, then one step back." Plus, the Gates team left LaForce alone. Back then, the foundation only employed about a dozen people who worked out of a small office in a residential neighborhood of Seattle. Staffers spent their time making lists of diseases, ranking them by annual fatalities, then calling around to find out which ones were closest to being cured. “We didn’t need to be specialists,” says Gordon Perkin, the foundation’s first director of global health. “We just needed to know which organizations had the judgment and the infrastructure, and we gave them money.” This story doesn't just illustrate the potential of philanthropy. It also demonstrates that how Zuckerberg gives away his money will be just as important as what he gives it to. Because one way to look at his $45 billion is that it's a lot of money. Another way to look at it is that it's about what the United States spends on prisons every six months. Or education every four weeks. Or health care every five days. Even at a scale that large, efficiency matters. It’s shocking just how unusual that early Gates grant was. Most legacy foundations pay consultants millions of dollars to study and re-study problems before they give grants toward solving them. The Ford Foundation spends nearly $1 for every $4 it gives away. In 2013, the Rockefeller Foundation’s largest grant recipient (other than its offshoot, Rockefeller Philanthropy Advisors), was Dalberg Global Development Advisors, a consulting firm. “All the work was to provide advice on internal decision-making,” a former Rockefeller employee told me. “To make it seem charitable we'd ask them to write a blog on our website, and that would frequently be the only public or charitable thing to come out of these multimillion-dollar so-called grants.” (In a statement, the Rockefeller Foundation defended its approach, saying that it “has developed a rigorous model on how to determine the problems we support, and ultimately the solutions that we believe will create the most impact.”) The Gates Foundation, as it's expanded to more than 1,300 employees, has become prone to the same bloat, the same "expert-itis," as a former grantee calls it. "They hired Ph.D.s in biotech and all they wanted to do was the science that the grantees were doing." As the staff proliferated, so did the conditions on the donations. The foundation started requiring grantees to keep track of baggage fees and told them they couldn't buy laptops or let their overhead go above 15 percent. "Grant approval processes went from 48 hours to 48 months," the former grantee told me. (The Gates Foundation responded, too: “While each grant agreement is unique, we have policies in place to help ensure that our funds are spent as effectively as possible.") It’s hard to overstate just how un-Silicon Valley all of this is. "Money is sitting there to make the world a better place, and to dole it out cautiously is antithetical to why it’s there," says Freada Kapor Klein, a partner at the Kapor Center for Social Impact, a foundation set up by Mitch Kapor, an early investor in Uber and other unicorns. I heard similar arguments from almost all the tech people I talked to: Zuckerberg shouldn't be afraid to fail; he should approach philanthropy like a venture capitalist, testing out ideas to scale up later on. Bypassing legacy institutions is what Silicon Valley CEOs are good at, right? All those consultants must strike them as the charity equivalent of taxi medallions. Still, running a charity does require fully understanding problems before you try to solve them. "Move fast and break things" is a fine mentality for Facebook, where the consequences of a few bad lines of code are mostly limited to a drop in revenue or an exodus of users to Snapchat. Applying the same philosophy to health or education or criminal justice has consequences that can't be shrugged away. In the 1990s, Western donors' emphasis on HIV/AIDS in Africa resulted in chronic under-funding of less-visible conditions like pneumonia, anemia and diarrhea. Zuckerberg's donation in Newark resulted in public schools being closed and some kids having to walk through rough neighborhoods to charter schools far from their homes. And it’s this neglected zone, somewhere between bloat and "break things," where Zuckerberg has the opportunity to do something quietly, unsexily awesome. The U.S. has more than 85,000 foundations and 1.5 million charities. Most major charitable causes, things like curing cancer, regularizing immigration and providing early education, are already covered by dozens of capable—and overlapping—organizations. In its annual survey of philanthropists, Grantmakers for Effective Organizations reported that 80 percent of donors wanted to see more collaboration between their grantees. But only 13 percent were willing to consistently pay for it. The need for coordination is obvious when you look at the scale of the problems that philanthropists want to solve. Again, studying Gates’ early years is instructive. When he decided he wanted to vaccinate hundreds of millions of African kids, he didn't set up an organization that would replace WHO or UNICEF or all the other agencies already handing out vaccines. Instead, he founded something called Gavi, the Vaccine Alliance—a funding pipeline designed to help those agencies work more effectively. Gavi pays pharmaceutical companies to research tropical diseases, it issues "vaccine bonds" so poor countries can buy millions of treatments on layaway, it orders medications in such bulk that the cost comes down to pennies. In short, it connects a network of actors who have similar interests—something Zuckerberg knows a thing or two about. So if he really wants to leverage the limited funding he has, Zuckerberg shouldn't think of himself as a venture capitalist. He should think of himself as a mutual fund manager. Find promising organizations, perform due diligence, link them to a portfolio of other agencies doing good work—then give them money and _get out of their way_. Or, as Patricia Stonesifer, the current CEO of Martha's Table and the former CEO of the Gates Foundation, puts it, “Don’t expect to be the only solution out there.” # Capitalism: The Cause of, and Solution to, All of Life’s Problems What Zuckerberg actually announced last December wasn't a big fat donation to charity. All he did was establish a limited liability company (LLC) and issue a promise that he would use it for good. Much of the reaction at the time was suspicious, speculating that an LLC was a scheme for Zuckerberg to avoid taxes (which isn't true) or that it would allow him to spend mountains of money without disclosing how he was doing so (which is). But the corporate approach actually makes a lot of sense. Under the standard philanthropic model, billionaires set up a foundation and give it a huge endowment. Every year, the foundation has to give away at least 5 percent of its total value. Meanwhile, the other 95 percent gets invested in blue chip stocks, hedge funds, foreign currencies, whatever will keep the total endowment the same size. That's how foundations like Rockefeller and Ford exist in perpetuity: Do-gooders work on one side of the building finding things to donate to, while bankers work on the other side, making sure there's more to donate next year. Recently, though, donors have started to reject this model. Giving away a trickle of money each year is unlikely to live up to the verbs—_transform, reimagine, revolutionize_—the new philanthropists use to describe their goals. Besides, why should 95 percent of your money just sit there in hedge funds and Halliburton stock, especially if you think you can do just as much good with the money you invest as the money you give away? "This idea that philanthropy is only about nonprofits is an outdated model," says Paula Goldman, a vice president at the Omidyar Network. Pierre Omidyar, the founder of eBay, was one of the most prominent tech billionaires to merge his investing and grant-making. The foundation still gives donations, but the LLC provides loans and seed capital and invests in things like solar-powered lighting startups, Brazilian test-prep companies and funds that discover Indian entrepreneurs. Zuckerberg is going even further, giving up on a foundation entirely and putting all of his charity money in a corporate form with no limits on how to spend it. He’s not interested in making his money back. He just wants the flexibility to fund charities or companies or both. Which explains why one of Zuckerberg’s most recent donations wasn’t a donation at all. It was $10 million in seed capital for an education startup called Bridge International Academies, a chain of private elementary schools that wants to deliver education to the world's poorest students. Bridge’s model, which has only been rolled out in Kenya so far, is based on standardization and accountability. Teachers get a centralized curriculum from Bridge experts, then deliver it to kids from an e-reader. Students—and teachers—are tracked in real time, principals notified of everything from attendance rates to busted pipes. The latest class of Bridge students just took their exams. Sixty percent passed, compared to the national average of 49 percent. > It's tempting to say capitalism perverts philanthropy, full stop, and advise Zuckerberg to go back and form a foundation. But that's not right either. The primary appeal of Bridge, especially to investors like Zuckerberg, is the $6 per month it says it charges its students. Operating as a business rather than a charity gives each school an incentive to deliver a decent education and ensures that it’s not going to wither away when development agencies or donors move on to the next idea. But the problem with dispatching private companies to supply basic services is that they replace the public systems already tasked with providing them. Last year, 116 African NGOs signed an open letter to Bridge International Academies and the World Bank, pointing out that $6 per month is in fact a lot of money for a lot of Kenyans. Bridge schools charge extra for uniforms and lunch. Its teachers earn around $90 per month, teaching classes as large as 70 students. Those pass rates 11 percent higher than the national average are great, but the letter also noted that Bridge, with 400 schools, has attracted more than $100 million in international investment. Meanwhile, Kenya's public system, with almost 20,000 schools, has gotten just $88 million. Lucy Bradlow, Bridge's global director of public relations, counters that the majority of Kenyan kids already attend private schools, many of which cost even more than Bridge and provide even less. In public schools, teacher absentee rates are so high that the average kid only gets two hours of instruction per day. She’s right: Bridge is a little bit better than what's already there. But the troubling part about the company isn't the service it provides now, but the one it wants to provide later. Bridge sees itself as a “model,” one that its backers believe can be spread across the entire developing world. It plans to be profitable once it serves 500,000 students. Eventually, it hopes to reach 10 million. Bridge's own marketing materials describe it as “a scalable Academy-in-a-Box solution.” But the history of philanthropy is littered with projects that helped the poor at a small scale, then made them worse off at a larger one. Microfinance started out small, too. The early trials were non-profit, and revenues were invested back into services that would help borrowers pay back their loans. Then, in the late 2000s, responding to donor pressure to be “sustainable,” microlending went private. Citibank, Barclays and Deutsche Bank established microfinance divisions. In 2007, one of the largest microlending banks, Mexico’s Compartamos Banco, even had an IPO, its executives earning millions loaning out money to women and poor farmers and charging interest rates as high as 195 percent. Since most loans were capped at a few hundred dollars, borrowers could only get enough money to set up informal businesses, stuff like selling fruit on the side of the road or giving rides on a scooter. As microloans flooded the market, small-scale services flooded entire economies. In Bangladesh, nearly 25 percent of the population took out a microloan. In Mexico, Compartamos’ customers were taking out new microloans to pay back the ones they already had. By scaling up too fast, microfinance ended up trapping people in the exact cycle—informal work, bottomless debt, low productivity—from which it was designed to free them. ## How Microfinance Traps the Poor ### *As illustrated by someone we’ll call Joey  It's tempting to stop there, to say capitalism perverts philanthropy, full stop, and advise Zuckerberg to just go back and form a foundation. But that's not right either. One of the most successful private-sector development projects of the last 10 years is M-PESA, the mobile-money system that allows people in Kenya to transfer money via their cell phones. Before the system launched, Kenyans sent money to each other by mail, or by giving envelopes full of cash to bus drivers. Replacing an inefficient, expensive system with a regularized one made everybody better off. That's not as easy to argue, in the long run, about education. So, when Zuckerberg hears pitches from companies seeking to solve the world's problems, he shouldn't ask them if they have a plan to grow, or an ambition to exist in perpetuity. He should ask himself whether he really wants them to replace the systems that already exist, or simply make them better. Because successful companies don't just disrupt other companies—they disrupt economies, governments and the people who depend on them. That's not something that Zuckerberg ever had to worry about, but he has to start. # Go Beyond Giving Directly In 2009, four grad students came up with an audacious idea: Instead of giving poor people the things we think they need—bags of food, stacks of clothing, a pair of goats—what if we gave them enough money to decide for themselves? They called their charity GiveDirectly, and in 2011 they started doing exactly that. They went to villages in Kenya, found the poorest people living there and transferred $1,000 straight to their cell phones. Later, they came back to ask the villagers what they did with the money. Mostly, it turns out, the villagers spent it on better roofs, better food, paying off debts, starting up businesses. All the stuff the development system used to buy for them—but without any overhead. At first, no one wanted to fund an idea this outlandish. But then, GiveDirectly went to Silicon Valley. Google got in early, awarding the charity its Global Impact Award and dispatching the head of Google.org to sit on GiveDirectly’s board. Since then, GiveDirectly has grown like a Y Combinator startup, its budget ballooning from $700,000 in 2012 to $17.4 million in 2014. In 2013, Chris Hughes, Zuckerberg’s Harvard roommate and Facebook co-founder, hosted a coming-out party for the charity with the heads of Dropbox and General Catalyst Partners. Dustin Moskovitz, Zuckerberg's other Harvard roommate and Facebook co-founder, just handed GiveDirectly $25 million. At five years old, GiveDirectly is the most buzzed-about charity in Silicon Valley. What all this hype ignores, though, is that GiveDirectly's audacious idea has been around for decades. Post-disaster charities have been experimenting with cash transfers since the 1990s. In 2010, when floods deluged one-third of Pakistan, aid workers handed out 1.7 million debit cards pre-loaded with $230. As early as the 1980s, Latin American countries were handing out "conditional" cash grants, paying parents to send their kids to school or feed them balanced meals. Even the World Bank, not exactly a laboratory of revolutionary thinking, has poured more than $25 billion into "social safety nets"—unemployment and pension benefits, basically—in developing countries. "Welfare" sounds a lot less “break shit” than transferring money to people via their cell phones, but it is, sorry everybody, the same thing. And that's exactly why Zuckerberg should be excited about giving money directly to poor people: Not because it is a new and revolutionary idea, but because it is an old and effective one—that’s only fulfilling a fraction of its potential. The challenge with direct cash payments, says Owen Barder, the director of Europe for the Center for Global Development, is getting them to all of the people who need them. The places where this strategy has worked well already had functioning banking sectors and national identification systems in place before a disaster struck. In Pakistan, humanitarian agencies used government data to identify the areas with the worst damage, then checked IDs to make sure the debit cards got to the people living there. Most poor countries, though, don't have these pipes laid down. Kenya's Hunger Safety Nets program, which gives cash to people at risk of starvation, took months to establish because payouts were distributed through local agents, whom people didn't trust, or ATMs, which people had never used before. Barder describes a scenario where, 10 minutes after an earthquake hits Nepal, all the people within five miles of the epicenter get $500 on their cell phones. That's a great idea. But it is, he says, a lot harder than it sounds. After the 2005 tsunami, low-caste populations in India were almost entirely excluded from cash transfers because they weren't registered in the national welfare system. In Indonesia, cash transfers were distributed through community leaders who had to come to a central planning center, then travel back to their constituencies with an envelope full of cash. In at least one case, bandits were waiting for them on the bus. The need for modernizing these systems is obvious. In 2009, India launched an ambitious—and largely unheralded—project to issue a 12-digit identification number to all 1.3 billion of its citizens. So far, it has spent around $880 million and registered 970 million people. The numbers are already being used to distribute unemployment checks and disaster relief. But as this effort moves to more remote populations, registering them gets harder. Some farmers have hands so worn the scanners can’t read their fingerprints. Laying down the pipes to get cash transfers to the first 75 percent of a population, the people who have birth certificates and cell phones, is relatively easy. Getting to the last 25 percent, the people one charity could never reach, is technical, slow, expensive and absolutely critical—a perfect project for Zuckerberg. These aren't, of course, the only ideas I heard for how Zuckerberg should give away his money. Charles Kenny of the Center for Global Development says Zuckerberg should invest in global public goods, things no single government wants to pay for but the world needs nonetheless—like a vaccine for malaria, or making renewables cheaper than fossil fuels. Hauke Hillebrandt of the Centre For Effective Altruism says Zuckerberg should prevent "global public bads" like international pandemics or aggressive artificial intelligence—Skynet, basically. In the end, though, Zuckerberg’s greatest impact might be in the model he sets for other philanthropists. The Giving Pledge, which encourages billionaires to donate the majority of their wealth to charity, has attracted more than 142 commitments totaling more than $400 billion. The Founders Pledge has convinced 151 startup executives—most of them [look about 19](http://thefounderspledge.org/members/)—to devote a portion of their exits to philanthropy. Charitable giving in the United States has nearly quintupled since 1994, and shows no signs of reverting back to opera houses and Harvard. Zuckerberg’s money alone is not enough to change the world, but his influence on this generation of givers might be enough to change philanthropy. If he’s successful, he’ll show them the value of going slowly. He'll hire people who come from the places he is trying to save and who have been affected by the problems he's trying to solve. He will ignore NGOs that promise to "flip" anything, and he will distrust anyone whose Twitter bio includes the words “thought leader.” If Zuckerberg really wants to get ambitious, he should challenge the Silicon Valley notion that giving money away is an activity unrelated to how it is earned. Last year, Travis Kalanick, the CEO of Uber, started allowing users to add a $5 donation to their ride for No Kid Hungry. In the UK, the company urged riders to donate old clothes to Save the Children. Kalanick would have a better impact on the planet if he stopped asking us for our clothes and, instead, started allowing his workers to unionize. Similarly, one of Zuckerberg's values for his philanthropy is “empowering communities.” He does the opposite when Facebook turns its data over to dictators. Now that the Giving Pledge is off and running, why not establish a Stop Routing Your Profits Through Tax Havens Pledge? I know, I know, he's running a public company. Shareholder pressure, quarterly returns, impact on innovation, blah blah blah. But perhaps Zuckerberg should ask himself why it is impossible, as a CEO, to apply the same values he aims to embody as a philanthropist. If he really wants to change the world, Zuckerberg can start by changing his own.

Seven Days on the Trail with Kevin Baker and Jack Hitt.

When Donald Trump launched his bid for the White House, one of his earliest initiatives was a promise to help Americans who had gone to war for their country. Or, as his campaign put it, to take care of “all Veteran complaints very quickly and efficiently like a world-class business man can do, but a politician has no clue.” Last summer, about a month after declaring his candidacy, Trump unveiled a hotline for veterans to share ideas about how to overhaul the bureaucracy that served them. A campaign aide said that Trump himself would personally respond to some of the messages. “I love all veterans and will help them finally lead the kind of lives that they should be leading,” Trump declared at the time. Many of the veterans who called the hotline—855-VETS-352—say they were sent to an automated voicemail message telling them to email the campaign. Those who reached a live human were similarly instructed to send an email, or to mail their medical records to campaign headquarters at Trump Tower. It soon became evident that Trump had no actual plan in place to help anyone who contacted him through the hotline. Calling it a “publicity stunt,” one veteran wrote on PopularMilitary.com, “We are not sure what the estimated wait time is, but it is probably safe to say you should hold on to your [Veterans Affairs] card for now.” This perfunctory effort was perhaps to be expected, since Trump has a long and colorful history of showing disrespect toward men and women in uniform. He did not serve himself, avoiding the Vietnam War via four education deferments, followed by a medical deferment for bone spurs in his feet. (His campaign notes that Trump received a high number in the draft lottery and was unlikely to ever be called up.) But on numerous occasions, he has dismissed the experiences of those who did. In the 2015 biography _Never Enough: Donald Trump and the Pursuit of Success_, Trump is quoted as saying, “I always thought I was in the military” because of his time at the New York Military Academy, an expensive boarding school 60 miles north of New York City where Trump brought [women onto campus](https://www.washingtonpost.com/politics/decades-later-disagreement-over-young-trumps-military-academy-post/2016/01/09/907a67b2-b3e0-11e5-a842-0feb51d1d124_story.html) so often that his yearbook nickname was “Ladies’ Man.” The author, Michael D’Antonio, writes that Trump believed the academy “provided him with more military training than most actual soldiers.”  "I'm really good at war," Trump recently claimed. Here he is as a student at the New York Military Academy. (Getty Images, © Seth Poppel/Yearbook Library.) In the 1990s, Trump made headlines for lobbying the New York State legislature to ban disabled veterans from working as street vendors around Trump Tower. “Do we allow Fifth Avenue, one of the world’s finest and most luxurious shopping districts, to be turned into an outdoor flea market, clogging and seriously downgrading the area?” he wrote to a state assemblyman. Thirteen years later, he appealed again to then-Mayor Michael Bloomberg. “Whether they are veterans or not,” he wrote, “[the vendors] should not be allowed to sell on this most important and prestigious shopping street.” At times, his remarks on veterans and military service have veered into outright mockery. In a 1997 interview with Howard Stern, Trump likened his determination to avoid sexually transmitted infections to serving in combat. His sex life in the 1980s was “my personal Vietnam,” he said. “I feel like a great and very brave soldier.” Last summer, he declared that Senator John McCain—a former Navy pilot who was held prisoner for five and a half years and tortured by the North Vietnamese—was “not a war hero.” His reasoning: “I like people that weren’t captured.” Meanwhile, when Trump has weighed in on national security questions, his remarks often reveal either ignorance or disdain for military expertise and the codes of conduct that govern the armed forces. “I know more about ISIS than the generals do. Believe me,” he boasted in one speech, adding, "I’ve had a lot of wars of my own. I’m really good at war." His foreign policy prescriptions include proposals to “bomb the shit out of ISIS,” to “take out” the families of ISIS members and to torture terrorism suspects. (“Would I approve waterboarding? You bet your ass I would,” he told one crowd. “And you know what? If it doesn't work, they deserve it anyway, for what they're doing.”) When it was pointed out that soldiers couldn’t legally carry out those last two actions, Trump was unconcerned. "They're not going to refuse me. Believe me.” (He walked back that last statement the next day.) The Geneva Conventions, he recently observed, have made American soldiers “afraid to fight.” Trump’s pronouncements on foreign policy, combined with his years of broadsides, have set off a very real fear within military circles about what might happen were he to become president. In the last two months, I spoke with dozens of people in the national security realm—current and retired officers, veterans of the wars in Iraq and Afghanistan, and former White House, State Department, Pentagon and CIA officials. The words they used to describe their mood: Terrified. Shocked. Appalled. Never before, they say, has a candidate gotten so close to the White House with such little respect for the military. > One former Marine infantry officer described Trump as a “fake-bake-ing chicken hawk.” “He completely misunderstands the military profession that he would head if he were the president,” said Robert Killebrew, a retired colonel who served in the Army for more than 30 years. Others were less polite. In a pair of ads produced by the American Future Fund, a retired Special Forces commander named Michael Waltz calls Trump a draft-dodger who “hasn’t served this country a day in his life,” and a Vietnam veteran, Tom Hanton, says that Trump’s quip about POWs was “the most infuriating comment I think I’ve heard from a politician in my entire life.” One former Marine infantry officer described Trump to me as a “fake-bake-ing chicken hawk” whose “knowledge of the Middle East could be trumped (sorry) by your average Georgetown sophomore.” Trump’s chosen foreign policy advisers—which include a 2009 college graduate who touted his experience in the Model U.N. on his online résumé and another who used Kanye West lyrics to make arguments on his foreign policy blog—have only stoked these anxieties. “Weirdo nobodies,” was how one military historian characterized them to me. “They’re probably the least qualified group of foreign policy and national security advisers I’ve ever seen or even heard of,” said Richard Kohn, an expert in civil-military relations and retired professor at the University of North Carolina. A source with firsthand knowledge told me that Trump’s campaign pursued retired General David Petraeus, Middle East scholar Daniel Pipes and former U.N. Ambassador John Bolton, but all three men declined. In a TV appearance not long afterward, Trump said he wouldn’t hesitate to replace the members of his military team if they didn’t agree with him. (Trump’s campaign didn’t respond to multiple requests for comment.) For even the savviest of presidents, the relationship between a commander in chief and his military is famously fraught, an intricate dance of egos and agendas, worldviews and bureaucracies. A President Trump, however, could usher in a clash of historic proportions. “If you take the man at his word,” said Michael Breen, the president of the Truman National Security Project and a decorated former Army officer, “we have a presidential candidate who seems to have committed himself to triggering what would probably be the greatest crisis in civil-military relations since the American Civil War.” One of the first tasks of a new president is finding the right people to surround himself with. His cabinet members are there to enact his agenda, and if they fail to do so, he can pressure them to resign or fire them. The president’s relationship with his military leaders is fundamentally different. While he gets to appoint both the secretary of defense as well as the chairman of the Joint Chiefs of Staff, the latter is an apolitical figure, not a partisan official. The incoming White House typically inherits the previous administration's chair of the Joint Chiefs (the leaders of the Army, Navy, Air Force, National Guard and Marines) and combatant commanders. The president cannot control what his generals say to Congress. And while he technically has the power to remove three- and four-star generals from service, it’s far riskier to dismiss a general than a cabinet member gone rogue. “If a military official resigns, it’s a crisis in civil-military relations,” said Peter Mansoor, a retired Army colonel and former executive officer under Petraeus. “If a cabinet position does that, it’s just politics.” Probably the most famous example of such a crisis was when President Harry Truman canned Douglas MacArthur—and that didn’t end well for Truman. MacArthur was revered for his leadership in WWII. (One of his aides praised him as “the greatest man since Christ.”) But after Truman named the 70-year-old general the supreme commander of Allied forces in the Pacific during the Korean War, MacArthur started ignoring orders, withholding information about his operations, and publicly questioning Truman’s policy. So Truman removed him from his post, effectively ending his military career. It was a deeply unpopular decision. Letters poured into the administration demanding Truman’s impeachment and calling him “a Judas” and “the pig in the White House.” Meanwhile, when MacArthur returned to the United States he was greeted with parades and endless praise. The Senate held hearings on MacArthur’s dismissal, during which the general blasted his president’s foreign policy. Truman, who privately said MacArthur’s testimony was “a bunch of damn bullshit,” never recovered, and in March 1952, he announced he would not run for re-election. The military leadership’s independent nature gives it considerable power to fight back against a president it doesn’t like. As chairman of the Joint Chiefs of Staff in the 1990s, for instance, Colin Powell nearly derailed President Bill Clinton’s administration in its first year. The military brass was skeptical of Clinton long before he arrived at the White House. He was the first antiwar president, having avoided the Vietnam War and once writing of “loathing” the military. During the 1992 campaign, he’d pledged to rewrite the military’s laws to allow gays and lesbians to serve openly. Powell had no intention of letting this happen. The four-star general viewed the new president and his team as “children,” as diplomat Richard Holbrooke later recalled. Powell was a charming operator with an inspiring life story who had spent most of his nearly 35-year career in Washington and knew how to work the levers of power. (“You show me a general in Washington who ain’t political and I’ll show you a guy who ain’t going to get promoted again, and probably should not be a general in the first place,” he once said.) Shortly before Clinton’s inauguration, he told a class of Naval Academy midshipmen that if they found Clinton’s policy “completely unacceptable and it strikes to the heart of your moral beliefs, then I think you have to resign.” Five days after Clinton’s inauguration, Clinton met with Powell and the rest of the Joint Chiefs in the Roosevelt Room. “[Homosexuality] is a problem for us,” Powell informed the new president, according to a notetaker. One by one, the rest of the generals flatly opposed the president’s plan. Furthermore, as former White House aide George Stephanopoulos wrote in his memoir, the Joint Chiefs had already lined up congressional support for their position: “Their message was clear: Keeping this promise will cost you the military. Fight us, and you’ll lose—and it won’t be pretty.” And that’s essentially what happened. Powell did little to quash rumors that the entire Joint Chiefs would resign if Clinton went through with the policy. During the next nine months, the battle over the issue cost Clinton dearly. Eventually, he agreed to Powell’s proposed compromise, which we now know as “Don’t Ask, Don’t Tell.” “The new president had been rolled,” wrote historian Matthew Moten in his book _Presidents and Their Generals._ The Bush administration, meanwhile, provided a disturbing preview of the damage that can be done when a civilian leadership pushes the armed services to adopt policies of dubious legality. Donald Rumsfeld, Bush’s defense secretary, was regarded as uninterested in the military’s advice and dismissive of the Joint Chiefs. After September 11, 2001, Rumsfeld authorized the use of “enhanced interrogation techniques”—practices that exposed the U.S. to charges of violating the Geneva Conventions and the War Crimes Act. The decision set off years of turmoil within the armed services. Retired Colonel Lawrence Wilkerson, the former chief of staff to Colin Powell, who was by then secretary of state, said that there were numerous instances of individuals in the chain of command sitting on the order to introduce abusive—and, some thought, illegal—interrogation methods in December 2002. “There was never a collective agreement to do the things that Rumsfeld told people to do in that memo,” Wilkerson recently told me. “There were certain leaders that passed on and gave orders based on those documents, but there are lots and lots of people who walked away from it and refused to do it.” > Former CIA general counsel John Rizzo predicted an employee “exodus” if Trump became president and followed through on his proposals. Alberto Mora, the Navy's general counsel, memorably fought to ban any use of enhanced interrogation techniques, which he believed were torture. Mark Fallon, the deputy commander of the Pentagon's Criminal Investigation Task Force, similarly argued that allowing his agents to witness the acts described in Rumsfeld's order, let alone implement them, would be disastrous. "Either they'll watch the law being broken, or, as sworn law enforcement officers, seeing laws being broken, they may try to arrest the military interrogators,” he told his boss, CITF Commander Colonel Brittain Mallow, as recounted in ex-FBI agent Ali Soufan’s book, _The Black Banners_. “Nothing good can come of this." Retired military officers told me that the effect of this kind of internal dissension can be crippling. "You have usually an enormous decrease in morale because you sense that there's nothing you can do about it," Wilkerson told me. "Your values are being disrupted; you feel powerless." Andrew Bacevich, a retired Army colonel and military historian, said that "any policy that is inconsistently applied creates confusion and consternation in a hierarchical organization." On some occasions, the military has been able to use the tools at its disposal—the press, Congress, calculated leaks, endless bureaucratic maneuvering—to reshape a president’s entire policy. President Barack Obama, for instance, arrived in office determined to end the wars in Iraq and Afghanistan. But he encountered two formidable opponents in Petraeus, the head of the U.S. Central Command, which coordinates military activities across the Middle East and Central Asia, and Lieutenant General Stanley McChrystal, who the new president had named the top commander in Afghanistan. McChrystal’s effort began with a 66-page classified review of the war effort that reached the opposite conclusion to the one favored by Obama. In McChrystal’s assessment, he argued that he needed at least 40,000 more troops in order to succeed in Afghanistan. Petraeus, the respected architect of the surge who was being talked about as a future presidential candidate, stumped for additional troops in the media. Admiral Mike Mullen, the chairman of the Joint Chiefs, tacitly endorsed McChrystal’s plan in testimony before the Senate Armed Services Committee. Then the classified McChrystal report was leaked to Washington Post reporter Bob Woodward. On September 21, 2009, the Post ran Woodward’s story on the front page: “McChrystal: More Forces or ‘Mission Failure.’” The impact of this leak is hard to overstate. It essentially forced Obama to take ownership of the Afghan War—a move he and his aides had resisted. If he stuck with his preferred option, he would be contradicting a respected general in the field who was predicting near-apocalyptic consequences unless additional troops were dispatched. At a speech at the International Institute for Strategic Studies in London, McChrystal was asked if a more modest approach could work. “A strategy that does not leave Afghanistan in a stable position is probably a shortsighted strategy,” he said. Obama was furious, according to Woodward’s book _Obama’s Wars_, telling his aides: “We’ve got to stop this.” In the end, he couldn’t. In a December 1 speech at West Point, Obama ordered 30,000 new troops into Afghanistan. McChrystal could—and did—find another 10,000 soldiers from the ranks of the coalition forces, which meant he got his 40,000. The generals had won. In the many books by and about Trump, and in interviews given by his employees past and present, a clear picture emerges of his leadership style. Trump prides himself on his unpredictability—“My moves are totally uncalculated,” he boasted to one biographer. He’s known as a micromanager who insisted on personally signing company checks and calling people his employees had already contacted to check their work. By his own admission, he gets “bored too easily” and relishes shaking up a company or an industry. “My attention span is short and probably my least favorite thing to do is maintain the status quo,” he has written. “Instead of being content when everything is going fine, I start getting impatient and irritable.” The culture at Trump’s company has been described as Darwinian. “He really believed that having people fighting and in conflict for approval made them work harder,” Trump’s former executive secretary, Rhona Graff, once recounted.  American heroes (plus Trump and Piers Morgan.) (Getty Images.) The military leaders that Trump would inherit are, by all indications, less forceful personalities than Powell, Petraeus or McChrystal, but it’s hard to imagine them responding well to this kind of behavior. The current Joint Chiefs chairman, Marine Corps General Joseph Dunford, is known as an especially skillful operator able to bridge the diplomatic and military worlds, with a low-key demeanor that helped to win over Obama. And in recent months, Dunford has found subtle ways to signal disapproval of Trump’s statements. When he was asked during a Senate Armed Services Committee hearing about Trump’s support for torture and attacking the families of suspected terrorists, Dunford didn’t mention Trump by name, but observed that such orders would have an “adverse effect” on “the morale of the force” and “aren’t legal for them to do anyway.” He also pushed back against Trump’s assertion that NATO was “very obsolete” by telling reporters, “In my mind, the relevance of NATO is not at all in question.” In an indication of how much Trump’s statements on national security have triggered intense debate within the military, Defense Secretary Ash Carter has made it clear he doesn’t want officials weighing in on campaign politics. The nation’s intelligence agencies have also been gripped by similar anxieties about the prospect of a Trump presidency. CIA Director John Brennan recently told NBC News that he would refuse to execute orders from a future president to use waterboarding. John Rizzo, the former CIA general counsel who worked at the agency for 35 years, told me that the employees he still spoke with were “terrified” at the prospect of reopening the debates over the use of waterboarding and other harsh interrogation techniques. “Deep concern is a mild way of putting the prospect of their commander in chief basically ordering them to go down this road again given all the trauma,” he said. If Trump won and followed through on his proposals, Rizzo predicted an employee “exodus.” “At a minimum,” he went on, “people would refuse to participate in anything resembling the former interrogation program and insist on a transfer to another part of the agency where they wouldn’t be involved in these things.” Meanwhile, with Trump still in a strong position to clinch the Republican nomination, some current members of the military bureaucracy are starting to game out exactly what they would do if he were elected. There are some who think Trump’s brash persona might actually be an asset. Wilkerson, the retired Army colonel, told me he’d recently spoken to an active-duty colonel who thought Trump might force through welcome changes to the military establishment. “If Trump comes in and shakes up these graybeard idiots,” Wilkerson said the colonel told him, “I’m all for it.” But such sentiments seem very much the minority view. Earlier this year, Bryan McGrath, a defense consultant and former Navy officer of 21 years, watched in shock as Trump climbed to the top of the Republican field. He dusted off an anti-Trump manifesto he’d written the previous fall and sent it to Eliot Cohen, a former State Department adviser and professor at Johns Hopkins University. McGrath and Cohen polished up the letter, sent it to their contacts in the foreign policy community, and on March 2 published it on the website War on the Rocks with nearly 100 signatories. The letter charged that Trump would “make America less safe” and was “utterly unfitted to the office.”  Trump avoided the draft, but called his sex life in the 1980s “my personal Vietnam.” Citing his fear of sexually transmitted diseases, he said, "I feel like a great and very brave soldier.” (Getty Images.) After the letter was published, McGrath said, he heard from numerous active-duty officers voicing disgust for Trump. One junior officer said he would be duty-bound to resign his commission if Trump were elected. A more senior officer wrote to say, in McGrath’s words, that “if [Trump] thinks that I am going to carry out an unlawful order, he has another thing coming.” Max Boot, a senior fellow at the Council on Foreign Relations, told me in an email that he had also heard from an officer who said “he’d retire sooner than serve under President Trump.” I recently spoke to a 32-year-old Army reservist named John Ford, a captain in the Judge Advocate General’s Corps. Ford told me that he hadn’t taken Trump seriously as a candidate at the start of the year. But then Trump’s victories in New Hampshire and South Carolina solidified his first-place slot in polls for the GOP primary, and Ford started thinking in some detail about the unthinkable. “I would probably not resign right away” if Trump were elected, he told me. “I would see to what extent Congress can keep him in check.” Ford believed many other servicemen and servicewomen were grappling with this question: “They’re basically thinking to themselves, ‘How do I finesse this? What are the odds I personally would actually be asked to do something illegal or unconscionable?’” The choice, as Ford saw it, would come down to two options: Quit before you’re asked to do something illegal, or remain in the service and fight back against unlawful orders. Neither option was particularly appealing. The problem with quitting, Ford pointed out, wasn’t only that it meant giving up his career and letting down his fellow officers. It would mean a U.S. military dominated by the type of people who would go along with an off-the-rails Trump administration. “If everybody who disagrees shows up on January 21 and says we all resign, well, who’s left?” he asked. “It’s the people who are not going to provide any pushback and who aren’t going to sit on actions that are illegal.”

These three campaign gurus for Jeb Bush, Ted Cruz and Marco Rubio have had some time to reflect on this nightmare of a campaign. And do they ever have stories to tell.

He was a 72-year-old man with a messed-up back and he knew he shouldn’t be lifting this stuff, but he was here to help a friend move, and so were some other old guys who had their own issues with bad knees and arthritic joints, so Hercules Williams Jr. plucked a small wooden end table from the back of a U-Haul truck and carried it down the sidewalk, slowly. “That’s the Herc I always knew. Lifting that thing like it was nothing,” shouted 64-year-old Larry Owens, who sometimes walks with a cane. “You’re gonna feel that tomorrow.” “I feel it now,” Williams said, setting the table down and placing a hand on his back. “I feel it _now_.” Donald Shakir, the beneficiary of all this labor, saw that Williams was having trouble and grabbed the table from his hands, pulling it up the steps and into the living room. Shakir is a muscular 63-year-old with thick black glasses and a bright-orange beard. He’s legally blind and can’t see at all out of his left eye, even with the glasses. He also suffers from arthritis in his knees, but if the pain was bothering him that afternoon, he didn’t let on. He had been leading the operation, telling the guys where to put a chair or a couch, insisting on lifting the heavier objects, pausing every so often to look around at his new neighborhood. He didn’t want to call attention to himself, but this was a big day for him, a setting down of roots after a period of upheaval and wandering. Three years earlier, he had met a woman named Nzinga Amon and fell in love. They moved in together. At first, they slept on a couch in Shakir’s sister’s basement; they had to spoon each other to keep from falling off. “Hoooooo,” Amon says now. “It was hilarious. But what do they say: love is blind?” After that, they moved to a cramped one-bedroom apartment. This new place, though—a house instead of an apartment, with a Formstone facade, on a quiet block in southwest Baltimore? “It means stability,” Amon told me. After the men unpacked the first load of boxes and furniture, they drove the empty U-Haul back to the old place to load up again, passing fans and flower pots through an open first-floor window. Inside, a TV was tuned to the Orioles’ first game of the season. “The Orioles ain’t won nothing since I’ve been home,” Hercules Williams said, shaking his head. He was dressed in an Orioles raincoat and a white Orioles cap. He told me that he went to his first game at Camden Yards three years ago and couldn’t believe the size of it; he’d only ever seen a game at the far smaller Memorial Stadium, which the team abandoned in 1991. “I thought I was in New York City. The crowds, you know? And the _gaiety_ of it all?” he said. “That was the first big positive crowd I saw since I got out.” Every so often these guys let slip a phrase that reveals how long they spent in prison. Forty-one years and four months for Williams. Nearly 44 years for Owens; 41 and change for Shakir. They were all convicted of murder in the early 1970s. Shakir was 19 when he shot and killed a 77-year-old confectioner during a stickup. He wanted money to buy drugs. Owens had just turned 20 when he gunned down a dry cleaner, also during a robbery to fuel a drug habit. The circumstances around Williams’ conviction are murkier. He maintained his innocence and had a strong alibi, but his alleged accomplice testified against him in exchange for immunity, sticking him with the same sentence Shakir and Owens got: life in prison. Back then, lifers who demonstrated good behavior and personal growth could get paroled after 20 or 25 years. But in the following decades, the state’s prison system became more punitive. Maryland is one of three states where the governor can overturn the parole board’s decision to release a prisoner. In 1995, after a lifer named Rodney Stokes committed a brutal murder while on work release, Governor Parris Glendening, a Democrat, said the parole board shouldn’t bother sending him any more applications from lifers, because “life means life.” Every governor since has followed his lead. So by the time Williams and Shakir and Owens had put in their 25 years, it didn’t matter what they had done with their time. They weren’t getting out. They were going to die in prison, with their loved ones far away. But then a fellow inmate named Merle Unger Jr. discovered an unexpected kind of door.  Merle Unger. Merle Unger escaped from jail for the first time in 1967, when he was an 18-year-old dropout with an interest in petty crime. People in his native Greencastle, Pennsylvania, saw him as a harmless character—a scrawny kid who figured out how to tie his bedsheets together and climb out of the nearby jail at night so he could see his girlfriend and play bingo at the Catholic church before climbing back into his cell in time for roll call. He did this until a sheriff’s deputy went to play bingo, saw Unger sitting there and was like, wait a minute. Whenever jail officials increased security, Unger found another route out. A local radio station started a Merle Unger Fan Club. His public defender made T-shirts that said, “Merle, baby, where are you?” In 1975, after more escapes and arrests, he found himself locked up in Carlisle, Pennsylvania, fixating on a skylight in the lunchroom, 45 feet up. Early one morning he tied a piece of rope to a 5- or 10-pound dumbbell and wrapped the other end of the rope around his neck. He piled up some tables, put a small step ladder on top of the pile, climbed atop a beam, pulled up the ladder, set it up again, reached higher, hurled the dumbbell through the skylight’s glass, and climbed through the broken window into the December cold, wearing a short-sleeved shirt. “I mean, I’m not proud of that,” Unger told me last month. “I just wanted my freedom.” On the run, Unger made it to Hagerstown, Maryland, where he robbed a grocery store at gunpoint. An off-duty cop, Donald Kline, happened to be shopping at the time and shouted, “Halt, police officer!” When Unger ran, Kline chased him into an alley. Unger opened fire. Kline was hit three times and died in the hospital. Later that night, police found Unger hiding in a house, bleeding from one of Kline’s bullets. But before he could be tried, Unger escaped again, using a hacksaw slipped to him during a visit. He cut the bars of his cell and crawled out through an air duct. His public defender opened the mail one day to find a poem from Unger: “Some say I am un-cool or even a fool / because I escaped again. / But tell me true / What would you do / If your life was at an end?” He fled to Florida and got caught in Orlando. Brought to Talbot County, Maryland, in 1976 to stand trial for the Kline murder, he was convicted and sentenced to life plus 40 years. But Unger had a strong preference for staying in Florida, a preference he expressed in 1981 by escaping a maximum-security prison in Maryland at the wheel of a hijacked dump truck. The FBI led a national manhunt after that episode. He was captured a month later while breaking into a gun store in Clearwater, Florida, and convicted of armed burglary, beginning a tug-of-war between Florida and Maryland for the right to incarcerate him.  A Pennsylvania paper splashes the news of Unger\'s capture six months after he killed Donald Kline. In the middle of all this, in the ’80s, Unger happened to meet a woman. A fellow inmate in Florida had put a personal ad in _Mother Earth_ magazine, and he got so many responses that he sold the extras to other prisoners for a dollar apiece. Unger bought a few, sent letters and a woman from Illinois came to visit. They ended up getting married in 1988 and had two children, both conceived in prison. He says his life changed when he held his infant son for the first time: “I didn’t want to commit no crimes anymore.” In Unger’s telling, this is the moment he developed an obsessive interest in the American legal system. Another friend worked in the prison’s law library and told him about a case in which a federal inmate earned his freedom by challenging the constitutionality of the jury instructions in his trial. Unger spent hours studying the case. It was all he could talk about. And the more he read, the more he thought he might have a shot at winning a new trial on the murder charge if he came back to Maryland to fight it. Today in Maryland, juries are told to decide cases solely by evaluating the facts. But this isn’t what they were told before 1980. As the judge in one 1976 murder trial put it to the jury, “It is your responsibility in this case to determine the facts, as you do in every case, but also it is your responsibility to determine for yourselves what the law is.” The practice was a holdover from the 1700s, when colonists, fearing that tyrannical British judges would run roughshod over their rights, gave juries the power to nullify unjust prosecutions. Over the centuries, though, states moved away from these instructions, because they encouraged juries to second-guess fundamental rights of defendants, like the presumption of innocence and the standard of reasonable doubt. “These are all fragile rights,” says Michael Millemann, a law professor at the University of Maryland. “It’s hard enough to get jurors to enforce when you tell them, ‘That’s the law, you have to do it.’ And when you tell them, ‘You have to decide what the law is,’ it just invites gross injustice.” For decades, the state’s higher courts blocked attempts by convicts to obtain new trials; reopening all those cases would have thrown the system into chaos. But by the time Unger returned to Maryland to file his petition, the makeup of the state’s Court of Appeals had changed, and in 2012, the court ruled that Unger’s constitutional rights had been violated. He was entitled to a new trial. And by the logic of the decision, so were the 230 other living prisoners—mostly first-degree murderers, and some rapists—convicted before Maryland changed its jury instructions. > Hercules Williams described his building as “clean, laid-back. A man can chill. Some fresh old ladies.” Then he shook his head and added, “I’m an old man, I’m not trying to get with anyone.” _Unger v. State_ doesn’t say that these prisoners should be freed, only that they can ask to be retried. In practice, though, there’s a strong incentive to settle cases where the defendant has a clean prison record. Re-trying a case that’s 30 or 40 years old can be tricky: the witnesses have moved away, the detectives are dead and the case file is skeletal, or missing, or destroyed. Since the decision came down, 142 of 231 prisoners have negotiated their freedom, almost all of them getting probation. One was acquitted at a new trial. Another eight have died behind bars before they could get a hearing. There are still about 70 prisoners with open cases, which means that even more may yet go free. But Merle Unger Jr. is not one of them. In 2013, Talbot County prosecutors tried him a second time for the murder of Donald Kline, relying on the original 1976 trial transcript in the absence of living witnesses. A jury found Unger guilty once again and sentenced him to life. Now he lives alone in a five- by 10-foot cell, making [fine-art cards](https://www.facebook.com/profile.php?id=100011643750446 "fine-art cards") that feature paintings and colored-pencil drawings of deer, elk and eagles. He sells them for around $10 apiece on Etsy. In a phone call from prison, Unger told me he’s still fighting his case, filing appeals to win his freedom. “When you get old,” he said, “you look back at all the things you did and you regret them. … I want to prove that I can do something good.” When I asked him how it felt to still be in prison after springing so many others, he tried to be gracious. “I’m happy for all them,” he said, “because they all deserved a second chance. That’s something the American prison system got away from: giving people second chances.” For the first time in a generation, American politicians actually agree that we put too many people in prison and that this is a bad thing. (The United States has the highest incarceration rate in the world, with 716 people per 100,000 behind bars; the comparable rate is 475 in Russia and 121 in China.) And yet the most commonly proposed solutions tend to focus on nonviolent federal drug offenders: relaxing sentences, rescheduling drugs, diverting addicts into treatment programs. These steps barely address the larger problem. The vast majority of U.S. prisoners are in state prisons, not federal, and the majority of those have been convicted of violent crimes (54 percent) as opposed to drug crimes (16 percent). To reduce the American prison population in a meaningful way, states will have to liberalize sentences and parole for some violent offenders—a terrifying prospect for politicians. In Maryland, though, the politically impossible has been happening for three years now. Unger v. State is essentially a natural experiment in the controlled release of violent offenders. And because the experiment is so new, nobody knows how it will end up—not the lawyers, the judges, the social workers, the families of the ex-offenders, the families of the victims, the citizens of Maryland or the former prisoners themselves. Thanks to a legal lightning strike, almost 150 people who were supposed to disappear in prison are now living on the outside. Are they ready? Are we?  Nzinga Amon (left) has been trying to help Donald Shakir fit back into the world. “It just sort of developed,” Nzinga Amon told me of her relationship with Donald Shakir. We were sitting on a stoop across from their old place in West Baltimore, watching Shakir and the other guys lug desks and drawers into the U-Haul. She said she met her husband by chance in 2013—just two people waiting for a bus. She wasn’t looking for a relationship at the time. She had a job as a reading tutor at an elementary school and was enjoying her independence. Still, she was drawn to Shakir. She liked his calmness, his seriousness. She liked that he shared the poetry he had written in prison and that he talked to her about his regrets: the son he didn’t raise, the mother who died while he was away. And she liked how he kept finding ways to surprise her. Shakir had this beautiful singing voice, a high, sweet falsetto that seemed unconnected to his big body. “We all change, we all grow up,” she said. “I can appreciate the man he turned out to be.” It wasn’t until they moved in together that Amon realized how hard it is for lifers to re-enter the world. These are not unskilled people; in prison they learned masonry and welding and other trades, and the ones approved for work release regularly earned promotions and even managed crews. But the only job Shakir could land at first was as a minimum-wage dishwasher at Pizza Hut. He felt as though his manager was constantly testing him, giving him all the crappy assignments, like cleaning the drains, to see if he could take it. He ultimately quit because his arthritis made it too painful to spend hours on his feet. At home he seemed scared a lot of the time. He was afraid of the night. The kids on the street and the way they dressed and talked, the vacant blocks where people used to live when he was young—he didn’t feel safe. “I’ve never seen so many drug users in my life,” he told me. “I’ll never get over seeing so many empty houses.” When Amon has meetings after dark, Shakir calls repeatedly to make sure she’s O.K. One time he waited for her on the stoop of their place, in his pajamas. “We lived in a world that had rules,” Shakir told me. “And we came out into a world without rules.” For many of the released, it was unsettling to move through public space, a series of little jolts. They found roads where buildings used to be, buildings where parks used to be. Banks spewed money out of a wall, 24 hours a day; there were no ATMs in the early ’70s. Crazy people walked down the street holding loud conversations with themselves; friends had to explain what Bluetooth was. The city had reconfigured itself while they were away. And in a lot of cases, so had their families, or what was left of them. Shakir’s friend Larry Owens didn’t have a spouse or a sibling or a child to come home to. The last time he saw any of his kin was in 1992. “I look at it like this,” he told me. “They got their life to live.” He ended up moving in with his 62-year-old cousin, Barbara Lotts. She and Owens were never close, but her reason for housing him was simple: “Wasn’t nobody else,” she said. “It is what it is.”  Larry Owens taught himself to paint portraits while incarcerated and got so good at it that he became a mentor for a bunch of other guys in there and now teaches a community art class. He’s still living in a spare bedroom in her house, and they basically get along. She accepts that he’ll moan and talk to himself in the night and that he’ll continue to wake up every day at 6 a.m. “Larry,” she wants to say, “you’re free, you can sleep in.” Owens doesn’t like to be a burden, so he takes out the trash and kicks in a little money when he can. “I love her,” he says, “but I want my own.” Owens and Shakir are lucky in the sense that they have each other. They’ve been close since they were 9 or 10, having grown up in the same housing project in the neighborhood of Fairfield. They fell into drugs at the same time, and for the first year of their incarceration, they shared a cell at the Maryland Penitentiary. They’re basically inseparable now. They get together every weekend and talk on the phone during the week, and they also hang out with other ex-lifers released thanks to Unger v. State, like Hercules Williams, and another friend, Kareem Hasan, who was locked up at 17 after a fatal neighborhood dispute. (His co-defendants testified against him in exchange for shortened sentences.) Now 57, Hasan has achieved a lot in the short time he has been out: a steady job with the city of Baltimore, a car, a marriage to a registered nurse named Annette, a business plan for a youth mentoring nonprofit. He functions as a constant positive presence in the group, a connector and a joker. Just before his release, he called Annette and said, “Mmm-hmm. Mmm-hmmm. I hope your shit is in order. I’m coming home.” She was elated. “I’m at peace of mind with him, you know?” she says. “I never gave up on him.” The men seem to share a bond that’s reflected in language. Often they refer to themselves as part of “the Unger family,” or sometimes just as “Ungers.” More than one of them told me, “I’m an Unger.” They realize they’re a part of something bigger than themselves. And they are. Digging them out of prison took an unprecedented effort by the Maryland Office of the Public Defender, which worked with professors and students at the University of Maryland law school to help prisoners file petitions to reopen their cases. Early on, the attorneys also realized there needed to be a major social-work component: if the Ungers didn’t have help adjusting to life on the outside, they were more likely to fail. So teams were mobilized to snag the Ungers in a safety net. These social workers still travel across the state to prepare prisoners for re-entry. They are there on the day of release to hand the client a personal hygiene kit, a binder of information on government programs, and a $20 bus pass. And in the weeks and months after release, they help Ungers with challenges large and small, everything from obtaining health care and I.D. cards to finding independent living situations. One of the first Ungers to win his release was James Richardson, a stocky 71-year-old with cataracts in both eyes and two bum knees. He lived with his daughter for eight months until UMD social workers helped him get his own apartment in a Baltimore building that caters to seniors and sets the rent as a percentage of income. (UMD asked me not to name the building because there are only a few complexes that accept residents with criminal records and the school doesn’t want to create “negative backlash” for the management company.) Five other Ungers live there, including Hercules Williams. They see each other in the elevators, check in, sit on their balconies and talk. Williams described the building as “clean, laid-back. A man can chill. Some fresh old ladies. We got the run of them.” Then he shook his head and added, “I’m an old man, I’m not trying to get with anyone.” One afternoon Richardson showed me the panoramic view of the city from his upper-floor balcony. Life after prison has been “way more than I really expected,” he said. “I was met with open arms, and people willing to help in any way they could help.”  "Mmm-hmm. Mmm-hmmm": Kareem Hasan with his wife Annette at their home. Maybe the most important strands of the safety net are the two monthly meetings in Baltimore where the men gather as a group—25 to 40 people saying hello, snacking on carrot sticks and pretzels. These aren’t fancy events, but they give the guys a place to see their friends and get help if they need it. The social workers set up a presentation or two: a pitch by a nonprofit leader looking to train black men in computer programming, a class on nutrition and health benefits delivered as a “Jeopardy!”-style game show. (“Let’s try Social Security for $1,000.”) Often a man named Walter Lomax speaks about justice reform. Lomax spent 39 years in prison on a wrongful conviction, and since winning his freedom in 2006, he has been organizing on behalf of older prisoners. Another elder who speaks is a lanky Baltimorean named Karriem Saleem El-Amin, who did 42 years on a murder conviction. El-Amin told me he tries to get people to share their struggles by poking fun at his own. One time, he went to use a public toilet and couldn’t find the flush lever; he started to panic, until the toilet sensed movement and flushed itself. He didn’t know toilets could do that. “Don’t nobody tell you these little _delicate_ things that have changed,” he explained. There is only one woman in the Unger family. Her name is Etta Myers. She went to a few of the meetings, but people kept mistaking her for someone’s spouse, so she stopped. Myers is attractive, with short yellow hair. She smokes cigarettes and sips tea from a mug that says “Woman of God.”As tough as some of the men have had it, she has probably had it worse. The state locked her up in 1977, when she was 22 and struggling with a heroin addiction. Police said that Myers and her ex-boyfriend shot and killed a man during a robbery. The only evidence linking her to the scene was the testimony of three men who thought they saw her walk away and who admitted to being on drugs that day. She swore she was never there. The jury found her guilty of first-degree murder. Myers spent 36 years in a women’s prison. Over the decades she became a leader there, the co-founder of a therapy group and a manager in the sewing shop, a multimillion-dollar business that made flags and uniforms. The Maryland Parole Commission tried to release her twice, but governors blocked the commission both times. When she finally got out in 2013, she was given a bed in a Catholic halfway house for women. She now rents a small place in North Baltimore, which she shares with a white and orange cat named Ya-Ya. When I met her there a few months ago, the TV was tuned to a children’s station showing a cartoon about the Bible. Myers said she watches children’s shows because there are a lot of precocious kids at her church and she wants to understand them better. She’s astonished by her great-niece Chloe, who is 3 years old. “She had a little bump on her head. And I said, ‘How did you bump your head, Chloe?’ And she said, ‘Well, I don’t think we have time for that, that’s really irrelevant right now.’ And I said, ‘Who says irrelevant at 3 years old?’” The last decades of her incarceration were marked by a spreading loneliness, her loved ones dying one after the other—her mother, her brother. “I was like, there’s nothing else, there’s nothing else for me.” And then she came home and realized that for the first time in her life, she was finally in a position to have a healthy relationship. Before prison, her boyfriend beat her. After they were convicted, she didn’t see him again until the day they were both released—36 years later. He used to be a specimen, a beautiful, muscular man, but he rolled into court in a wheelchair. Later she saw him at an event and reached down to hug him. She didn’t want to waste her time being angry. What she wanted was to meet a “nice older man” and feel less alone. But the rules of courtship had changed since 1977. “Guys don’t come after girls,” she says. “That was amazing to me. And I guess it had to do with the fact that I was much older. And then the challenge was, O.K., well, where do you go to meet nice old men at? ... I’ve been to several bingo places, and it’s usually a bunch of old biddies, and I don’t consider myself an old biddie.” Grocery store? Church? “You don’t find a whole lot of single men in church. You see them there, they have a wife right beside them. Then their wives are looking at you trying to make sure you’re not trying to hit on them or something crazy.” After a while, she stopped trying to find a partner. She now spends her time volunteering at her church and with nonprofits that work on criminal justice issues. In March, after the Maryland legislature restored voting rights for ex-offenders, she registered to cast the first [vote](http://www.usatoday.com/story/opinion/2016/03/09/first-time-voter-felon-age-62-maryland-column/81535722/ "vote") of her life, at 62. “I put my trust in the God that I worship, and believe He’ll send me a companion if it’s meant to be,” she said. “And if not, I guess I just won’t have one.”  Forty-five years ago, Thomas Magrogan was shot in the heart by one of the Ungers. In 2013, when 89-year-old Shirley Rubin heard that her husband’s killer was about to be released from prison, she felt physically sick. The couple had owned a small grocery store in southwest Baltimore until one day in 1972, when a teenager walked into their store and shot them both during a robbery attempt. Shirley’s husband died; she survived. She ended up losing the store and struggled to raise the kids on the little money she had left. The gunman “ruined my life,” she told the [_Baltimore Sun_](http://articles.baltimoresun.com/2013-07-10/news/bs-md-murder-releases-20130710_1_new-trials-court-ruling-southwest-baltimore "Baltimore Sun" ). “The only thing that kept me going in these last 41 years was the fact that [he] was in prison.” Antonio Gioia, as the deputy state’s attorney for major crimes in Baltimore, has the unenviable task of calling people like Rubin and telling them that their loved one’s killer may soon be walking around. He’s been doing it for three years, and he still dreads it. “The most prominent emotion is one of disbelief. ‘Why are you calling, Mr. Gioia?’” he told me. “They just cannot accept the fact that this very painful episode that’s left a terrible hole in the lives of the family is being reopened.” In April I went to see Kevin Magrogan, whose only sibling, Thomas Magrogan, was shot in the heart 45 years ago by a teenage drug addict named Bryant Lee Goodman. Magrogan now lives in the farm country west of Baltimore, where he works as a tax preparer. Sitting behind a desk piled with returns, he told me that his brother’s murder made him “the new head of the household, because my father just never recovered.” His father was a fleet superintendent for a linen company in Baltimore. Before the murder, he worked 12 or 14 hours a day, but afterward, he could only muster 4 or 5 hours, and Kevin had to help out after school to make sure the linen trucks got in at night. His father stopped going out in public because people were always talking to him about Tom. He stopped going to Irish dances with Kevin’s mother. “He would just come home and sit,” Magrogan said. Family members of victims have a right to speak at Unger settlement hearings, and when Goodman’s came up, Magrogan opposed his release, arguing that because Goodman had been given a drug infraction in prison, he was still potentially dangerous. “Where’s he going to get the money for drugs when he goes back on them?” Magrogan told me. “He’s going to revert back to crime. And if he gets in a pressure situation again—we know he’s already killed once. Why not kill again? He’s got nothing to lose.” Goodman, who is now in his 60s, also exercised his right to speak during the hearing—one of the few Ungers to do so. He said he was “truly sorry” for what he had done, according to the Sun. He went free. The process left Magrogan feeling as if the state just wanted to save the cost of incarcerating elderly prisoners. “It was all show and tell,” he said. “I’m sure that if I was very rich and powerful, he would have been retried.” This feeling that the system is rigged is common among the families of Unger victims. The sister of a Johns Hopkins medical student killed by a 16-year-old in 1979 told me she thinks the idea of a life sentence has been devalued. “What message are we sending to other possible criminals, that we’re getting kind of soft?” she asked. She said she recently read a story about a former lifer eating a lobster with his family. How did that make her feel? “How would it make anybody feel? You know what I mean? What are you doing eating a lobster?” Generally, the defense attorneys and social workers trying to ease the Ungers’ transition into post-prison life don’t dispute the damage their clients have done. “You can’t ignore the tragedy of homicide,” says UMD’s Michael Millemann. “You can’t escape from that.” But when he receives an anonymous voicemail that says, “I hope one of these guys kills you,” or when an Internet commenter assumes he must be a Communist, he thinks people aren’t getting the full picture. Millemann has been working with prisoners since the late ’60s. A judge once called him “the LeBron James of lawyering for poor people.” In 2013, he put together a team of law students and social workers to analyze the earliest Unger cases, and pretty soon, a familiar pattern emerged: poor black defendants convicted by all-white juries after paltry or nonexistent police investigations. A large number of the petitioners weren’t murderers the way most people think of them. In Maryland, you don’t have to pull the trigger to be charged with felony murder; the non-shooter in a fatal robbery is just as guilty of murder as the shooter. That was the situation with a significant number of the Ungers, including Karriem Saleem El-Amin. They were drunk and armed at 16 or 17 or 18 and robbed someone with a group of friends. They didn’t shoot, but they got life. Meanwhile, in some cases, the actual gunmen cut deals with the state and went free after a few decades—so why was the non-shooter still in prison, still bearing the burden of society’s judgment? > Of the 143 Ungers who have been released, not a single one has been convicted of anything more serious than a minor traffic offense. Even some of the social workers had been skeptical at first. But that changed quickly. Almost to a person, the prisoners spoke with insight about the people they used to be, expressed remorse for their crimes and described the programs they’d completed in prison to better themselves. They were like living remnants of an earlier, rehabilitative era in corrections, when Maryland lifers could go out on work release (ended in 1993) and take college classes through Pell Grants (ended by Congress in 1994). A forensic social work fellow named Elizabeth Smith interviewed dozens of men all over the state. She told me that she “would get pulled up by [corrections officers], and they’d say, ‘Get this man out of here. He should die at home with his grandchildren.’” It seems counterintuitive, but murderers can be good bets for parole. A [study](http://law.stanford.edu/wp-content/uploads/sites/default/files/child-page/164096/doc/slspublic/SCJC_report_Parole_Release_for_Lifers.pdf "study") by the Stanford Criminal Justice Center found that between 1995 and 2010, 48.7 percent of all paroled prisoners in California went on to commit new crimes. But among murderers, the rate was a tiny 0.58 percent, “and none of them recidivated for life-term crimes.” Data from New York shows similarly low recidivism rates for paroled murderers. The likeliest reason for this is age. According to figures from the Bureau of Justice Statistics, people who murder, rape or rob tend to be in their late teens and early 20s. By the time murderers are eligible for release, they are usually way past their criminal primes. The average age of the freed Ungers is 64. I told Millemann that out of all these people, there had to be a few who still posed a threat. “If prosecutors think there are [Ungers] who are too dangerous to be released,” he pointed out, “they’ve got an option: Re-try them and convict them.” (Prosecutors took this route with Merle Unger and a man who killed his wife with a shotgun in 1972. In the case of a notorious petitioner who murdered an 11-year-old girl in 1969, Baltimore city prosecutors fought to keep him in prison, and he died behind bars this past December.) For all these reasons, the people fighting for the prisoners feel they’re doing the right thing. So far, the results have justified their faith. According to the Office of the Public Defender, of the 143 Ungers who have been released, not a single one has been convicted of anything more serious than a traffic offense. There has only been one probation violation, a technical infraction that resulted in a stern talking-to. Zero of the Ungers have violated parole. Zero have been sent back to prison. These numbers didn’t surprise me. After meeting a range of Ungers, and seeing them interact with their families and each other, and talking to them about the horrific things they saw in prison—guys losing it in weak moments and slashing their wrists with razor blades, hanging themselves in their cells, keeling over from sudden aneurysms—it seemed obvious that the last thing anyone wanted to do was go back. Although they didn’t perform their remorse for me, sometimes falling back on cliché (Shakir: “Don’t nobody have a right to take a life, period”), they also didn’t evade questions about their original crimes and the people they used to be. They caused pain to other families and to their own, and now that they can sit on their balconies or go to an Orioles game or eat a meal with their wives, they would rather not blow it up, for themselves and for their friends who are still in prison, the 70 Ungers with pending cases. The experiment is young and tenuous. The state of Maryland is looking to prevent future releases and recently filed the latest in a series of legal challenges to _Unger v. State_ in appellate courts. If a single member of the Unger family fails in a big way—and even advocates recognize there’s a risk of that—everyone could be affected. The guilt would be a lot to bear. “You don’t mess up so you don’t mess up the chances of the guy behind you comin’ out,” Kareem Hasan told me. “That’s one of the things we stress when we get everybody together. That’s why we try to grab them right when they come out the door.”  "It means stability": Donald Shakir (right) outside his new home with Owens and Hasan. Every month or two, a few more Unger petitioners are released. I went to Baltimore in February to see three of these men, all serving sentences for first-degree murder, sign settlement agreements. A crowd of about 30 family members, legal staff and social workers watched with me from the courtroom’s wooden benches. Walter Lomax, wearing a black pinstripe suit and a scarf, sat right where the guys could see him. They’re usually nervous when they walk in, Lomax explained, and he wanted them to recognize a friendly face. “Murphy’s Law,” he said. “Anything that can go wrong, will go wrong.” The prisoners wore blue Department of Corrections jumpsuits and were handcuffed with their arms in front, chains circling their waists. Antonio Gioia stood at the prosecutor’s table and read their names one by one: Tyrone Toliver, Leroy Brunson, Carl Marine. They looked solemn, standing absolutely still, staring forward or at the ground. Eventually, each was asked some questions to ensure that he was competent to sign the deal. Was he currently under the influence of drugs or alcohol? Did he understand that he was forfeiting his right to a new trial under _Unger v. State_, along with all innocence claims, in exchange for a suspended sentence and probation? No victims’ representatives were part of the proceedings; Gioia told the judge that in two of the cases, no surviving family members of the victim could be located, and in the third, the family member did not respond to a letter. After Marine signed his deal, Gioia said, “Your honor, that does conclude our business with the court,” and the men were led downstairs to a holding cell while some final paperwork was processed. The whole thing took 31 minutes. Following the hearing, the 30 supporters went to a Dunkin Donuts across the street to wait for the men to emerge from a side door of the courthouse. The guards always release the Ungers last, after the rest of the day’s defendants are packed into vans and returned to prison. I tried to talk to Carl Marine’s twin sister, but she smiled shyly and put her head down on the table. “I’m too excited,” she said. Kareem Hasan had driven here from his job at the city’s wastewater treatment plant, and Donald Shakir and Larry Owens had arrived together. They all said they remembered going through this process themselves, and how strange it felt to be suddenly deposited on a sidewalk. “All these guys who are being released, we have history,” Shakir told me. “They’re family. They may be closer to us than our own family.” After two hours and many coffees, people got restless and went outside to stand on the sidewalk. The air grew colder. Hasan had to leave for a family function. Shakir started singing a Motown song to himself. It was fully dark outside when two of the three Unger men appeared across the street in civilian clothes—Brunson and Marine. A cry went up from the sidewalk. “_My man_!” Marine’s family rushed over. “Look at you, boy!” A guy mock-punched Marine in the chest and then threw his arms around him and burst into laughter. They grinned and said he was too skinny and needed to fatten up. “Believe me,” he told them, “that won’t be a problem.” He whirled around, overwhelmed, trying to acknowledge all of his people. “Thank you and thank God,” he said. “We gonna make y’all proud. I’m home now. This is my team.” Brunson’s people were more subdued. They waited to the side as he spoke to three female social workers from UMD, who gave him their usual release packet—the binder, the hygiene kit, the bus pass and their business cards. Then the UMD team and the family of the third client, Toliver, went over to the courthouse door to ask a guard why he was being kept inside. The guard said that one of the clerks had gone home for the day before completing Toliver’s paperwork. He would have to spend one more night behind bars. The guard said he was sorry. While all this was happening, Owens and Shakir hung back, not wanting to get in the way. When it seemed as if Brunson was getting ready to leave, Shakir went over to embrace him. “Hey brother, we gotta hook up,” Owens said. He and Shakir gave Brunson their numbers and made sure he knew he could call if he wanted to talk. Brunson nodded and thanked them. Over at the courthouse door, a set of metal gates spread open, and Toliver, still in chains, walked the couple of yards to the last blue van. It drove away, and Owens and Shakir walked off together, into the city.

The price of college is breaking America. At a moment when Hollywood celebrities and private equity titans have allegedly been spending hundreds of thousands in bribes to get their children into elite schools, it seems quaint to recall that higher learning is supposed to be an engine of social mobility. Today, the country’s best colleges are an overpriced gated community whose benefits accrue mostly to the wealthy. At 38 colleges, including Yale, Princeton, Brown and Penn, there are more students from the top 1 percent than the bottom 60 percent.

Tuition prices aren’t the only reason for this, but they’re a major one. Public university tuition has doubled in the last two decades, tripled in the last three. Prestige-hungry universities admit large numbers of students who can pay ever-increasing fees and only a relative handful of low-income students. The U.S. now has more student loan debt than credit card debt—upward of $1.5 trillion. Nearly 40 percent of borrowers who entered college in the 2003 academic year could default on their loans by 2023, the Brookings Institution predicts.

The colleges would have you believe that none of this is their fault. They would point out that public schools took a huge financial hit during the recession when states slashed their education budgets. This is true, but that hardly explains the size and pace of the price hikes or the fact that tuition at private schools has exploded, too.

It also doesn’t explain why colleges have failed to take advantage of the best opportunity to radically drop the price of a good degree that I’ve seen in 15 years of watching and reporting on the industry. This opportunity doesn’t have the daunting price tag of worthy proposals like “free college.” It doesn’t require any action from Congress at all.

The answer is online learning. When online degrees started proliferating 20 years ago, they earned their reputation for being second-rate or just plain scammy. Many were little more than jumped-up correspondence courses offered by for-profit colleges out to make a quick buck, and they were particularly ineffective for low-income students.

But there have been remarkable advances in online learning in the last decade. Nearly every prestigious college and university now offers multiple online degrees taught by skilled professors. And many of the courses are really good—engaging, rigorous, truly interactive. They are also a lot cheaper for universities to run. There are no buildings to maintain, no lawns to mow, no juice bars and lazy rivers to lure new students. While traditional courses are limited by the size of a lecture hall, online courses can accommodate thousands of people at a time.

This is how universities could break the tuition cost curve—by making the price of online degrees proportional to what colleges actually spend to operate the courses. So far, colleges have been more aggressive in launching online graduate programs. But there’s huge potential for undergraduate education, too, including hybrid programs that combine the best of in-person and virtual learning. And yet nearly every academic institution, from the Ivies to state university systems to liberal arts schools, has refused to pass even the tiniest fraction of the savings on to students. They charge online students the same astronomical prices they levy for the on-campus experience.

This is because many colleges don’t actually run online programs themselves. They outsource much of the work to an obscure species of for-profit company that has figured out how to gouge students in new and creative ways. These companies are called online program managers, or OPMs, an acronym that could come right out of “Office Space.” They have goofy, forgettable names like 2U, HotChalk and iDesign. As the founder of 2U puts it, “The more invisible we are, the better.”

But OPMs are transforming both the economics and the practice of higher learning. They help a growing number of America’s most-lauded colleges provide online degrees—including Harvard, Yale, Georgetown, NYU, UC Berkeley, UNC Chapel Hill, Northwestern, Syracuse, Rice and USC, to name just a few. The schools often omit any mention of these companies on their course pages, but OPMs typically take a 60 percent cut of tuition, sometimes more. Trace Urdan, managing director at the investment bank and consulting firm Tyton Partners, estimates that the market for OPMs and related services will be worth nearly $8 billion by 2020.

What this means is that an innovation that should have been used to address inequality is serving to fuel it. Instead of students receiving a reasonably priced, quality online degree, universities are using them as cash cows while corporate middlemen hoover up the greater share of the profits. In a perfect twist, big tech companies are getting the spill-off, in the form of massive sums spent on Facebook and Google ads. It’s a near-perfect encapsulation of the social and structural forces that allow the already-rich to get richer at the expense of everyone else. And it all started with a man named John Katzman, who has come to deeply question what has become of his own creation.

It’s 8:00 a.m. and John Katzman, education entrepreneur, is doing his morning workout while simultaneously explaining how he upended the business of American higher education not once but twice. I had suggested meeting for coffee. But Katzman had just arrived in Washington, D.C., on the red-eye from California and he likes to attack sleeplessness with exercise, which is how I wound up conducting an interview on side-by-side elliptical trainers in the gym at the Ritz-Carlton. Katzman likes to describe himself as “the ghost of unintended consequences”—a man who sees the corruption and inefficiencies at the heart of the education system and leverages them to get very, very rich.

Katzman is now in his late 50s, but you can still see traces of the boyish upstart who founded his first company out of his parents' apartment on Central Park West in 1981. He got the idea as an undergraduate at Princeton University, when he tutored local high schoolers for the SAT to earn extra cash. Pretty soon he was making so much money he nearly dropped out. He didn’t, but shortly after graduating, he founded a test prep company called The Princeton Review.

There were other test prep companies out there, but no one in the business embodied his customers’ aspirations quite like Katzman—old money, Ivy League degree, cool and a little bit brash, always willing to explain to a reporter that the SAT was a “scam” and “moronic” and that its supposed value as a meritocratic sorting instrument was “bullshit.” In attacking the SAT’s flaws, Katzman only created more demand for a service that could exploit them. Princeton Review was ultimately valued at $300 million—and helped spawn an entire industry of companies that would teach kids to game the test, if their parents could afford to pay. Elite universities became even more swollen with the children of the 1 percent.

Yet Katzman was still only tinkering on the margins of the higher education market, which is worth at least $300 billion. The majority of that money comes, in one way or another, from the government: state funding for public universities and community colleges, federally guaranteed student loans, tax credits, grants for low-income students. For most of the past seven decades, private companies could build thriving businesses on the periphery of higher education—broadcasting football games or selling expensive textbooks. But the big pile of government money was largely off-limits. It remained in the control of public and nonprofit colleges that, whatever their shortcomings, weren’t explicitly designed to put profits ahead of students. That is, until the arrival of the internet.

One of the first companies to locate a loophole was Kaplan, Inc., Katzman’s biggest rival in SAT prep. In 2000, Kaplan bought a chain of vocational schools called Quest Education. Most of the schools were modest storefronts serving a few hundred students. The real value was in the Davenport, Iowa, campus, which had “regional accreditation”—the same stamp of approval given to schools in the Ivy League. The genius of this move was that 1) any accredited school can be paid for with federal grants and loans and 2) thanks to a 1998 reform intended to encourage distance learning, the Davenport college's accreditation magically extended to everything Kaplan did online. Instead of charging $500 to prepare students for a college entrance exam, Kaplan could charge $50,000 for college itself, through a new division called Kaplan College. It had found a way into the pile of government money. The University of Phoenix and a dozen other for-profit corporations did the same. At some for-profit schools, almost 90 percent of revenues came from federal funds. The stock market took notice; many investors and executives became very wealthy.

For obvious reasons, Katzman could hardly start selling online degrees from Princeton Review University. Besides, he was no fan of for-profit colleges. “Just about all of them were levels of suck,” he says. “I didn’t want to do that.” So he decided to get Princeton itself, or an equally prestigious institution, to lend its name to online degrees instead. He would focus on graduate schools, where admissions standards are opaque. He would provide all of the upfront capital. He’d do the digital marketing and hire course designers and produce the videos of lectures and the software that allowed students and faculty to interact live online, with worldwide 24/7 support. In return, the colleges had to give him 60 percent of the tuition. This was still a good deal for them, since 40 percent of something was better than 100 percent of the nothing they had before.

In 2008, Katzman left Princeton Review and founded his second startup, eventually named 2U, which was one of the very first OPMs. He likes to joke that the acronym also stands for “other people’s money.” “The key insight was to take the systems from for-profits that were actually good ... married to the goodwill and good quality of the best traditional schools,” he says. “That is virgin snow.”

Selecting a college is one of the most high-stakes financial decisions a person will ever make, right up there with buying a house. And yet every year, millions of people do it on the basis of shockingly little information. College rankings are notoriously unscientific. There’s no form of independent quality control, since every school decides for itself what students need to do in order to pass courses. Accreditors assess the administrative practices of schools, but they are indirectly funded by colleges themselves. And the biggest financier of higher learning, the federal government, can’t force a school to reduce tuition if it believes students are being overcharged. What all of this means is that colleges essentially approve one another to be eligible for government money.

Nor can students expect “the market” to help them figure it out. Universities aren’t like restaurants that rely on repeat customers: pretty much nobody gets two bachelor’s degrees. If you choose the wrong place, as many students do, it’s not easy to signal your dissatisfaction by transferring to a competitor. Besides, every year, colleges are practically guaranteed a fresh supply of high school graduates and adults looking for new skills. The result is a profiteer’s paradise: millions of highly motivated, naive, overwhelmed consumers loaded up with armfuls of government money. Perhaps no one understands the many ways in which this can go horribly wrong better than Bob Shireman.

Shireman, a prototypically earnest D.C. policy wonk, is surprisingly genial for a man who is actively hated by an entire industry of powerful corporations. Over his three-decade career, he’s fought exploitative for-profit education companies more aggressively than anyone in Washington. In February 1990, as a newbie staffer for Illinois Senator Paul Simon, Shireman was dispatched to take notes on a series of hearings being conducted by Senator Sam Nunn, chairman of the Permanent Subcommittee on Investigations. The subject was abuses by for-profit colleges, and what the 28-year-old Shireman heard there was, he recalls, “eye-opening and appalling.”

There was the recruiter who described hunting for students outside welfare offices in poor, mostly black neighborhoods. A prospect was considered qualified if he could “breathe, scribble his name, had a driver’s license, and was over 18 years of age,” the recruiter explained. There was the bricklaying institute in Texas that bused in hundreds of what the Senate termed “homeless street people” from New Orleans. There was the culinary school in Washington, D.C., where training consisted of working—for free—in a water treatment facility cafeteria. There was the college owner who brazenly declared, “I’m a businessman out to make a profit. Truly I don’t care about the well-being of these students.”

These schools had been gorging on government money. During the previous six years, the guaranteed student loan program had almost doubled to $12.4 billion, while defaults had increased by a staggering 338 percent. The bad debt was heavily concentrated in schools that paid salespeople on commission to sign up as many students as possible in order to harvest their grants and loans. Since many of the degrees were essentially worthless, the students had little hope of ever getting out of debt.

It wasn’t the first time Congress had uncovered misconduct on this scale. It was at least the third. After the 1944 G.I. Bill, most vets used their benefits to attend for-profit schools, many of them fly-by-night operations offering substandard training in fields with no jobs. A second feeding frenzy came in the late 1960s and early 1970s, when expanded G.I. Bill benefits for Vietnam War veterans and Lyndon Johnson’s Great Society injected billions of dollars into higher education. “Every time Congress has been led to believe these scandals are a thing of the past, they come roaring back,” Shireman says. “Government action always ends up being too late for hundreds of thousands of students.”

The Nunn investigation was no different. In 1992, Congress banned “incentive compensation”—meaning that if colleges wanted federal financing, they could no longer pay employees or outside recruiters based on the number of students they signed up. More than 1,000 unscrupulous operators unceremoniously closed up shop. Then, in the early-2000s, the George W. Bush administration softened the ban and the industry began to reformulate again.

In November 2008, Shireman joined the Obama transition team and in early 2009, became the deputy undersecretary for higher education policy at the Department of Education. By then, the for-profit industry was dominated by publicly traded corporations, powered by a potent mix of Wall Street money and the internet. Shireman noticed that the new crop of executives were smart-suited graduates of the best business schools, not the small-time grifters of old. From 2000 to 2010, enrollment in the for-profit sector quadrupled. At its peak, the University of Phoenix Online enrolled over 200,000 students. In 2010, Kaplan pulled in nearly $1.5 billion in federal funds. Kaplan’s success was welcome news for its owner, The Washington Post: At a shareholders meeting, the Post’s then-chairman and CEO, Donald Graham, announced, “Going forward we have excellent prospects as a company and the primary reason for that is spelled K-A-P-L-A-N.”

This boom was built on easy access to government money. Very few federal student loans require credit checks, and they can be used at any accredited college. With incomes stagnant, borrowing exorbitant sums became the norm. The warning signs were all there. The nonprofit Shireman founded, the Institute for College Access and Success, had reported a tenfold increase in college graduates with large debt burdens. A fourth wave of scandal was cresting.

This time, it fell to Senator Tom Harkin to issue the damning report with findings that could have appeared verbatim in the previous three. He convened a commission to investigate for-profit colleges, which found that some of the biggest for-profits were among the more notorious offenders. From 2006 to 2008, the loan default rate at online Kaplan University nearly doubled. Undercover Government Accountability Office investigators recorded recruiters at its campus in Pembroke Pines, Florida, misleading prospective students. (Kaplan did not admit wrongdoing, but reached an agreement with the Florida attorney general to improve its practices and donated $350,000 to a scholarship fund.) In December 2009, the University of Phoenix paid a $78.5 million fine to settle allegations of incentive compensation malfeasance brought by whistleblowers working with the Department of Justice.

The schemes were not subtle. Recruiters at a for-profit called Westwood College were trained to promote tuition costs of $4,800 per term without mentioning that Westwood had five semesters instead of the standard two. Westwood also falsely told students their tuition would be completely covered by grants. In reality, the school gave students private loans—they were instructed to call them “student supplemental financing”—at an interest rate of up to 18 percent. (Federal loans currently charge 5 percent.)

Shireman had already decided to fix the incentive compensation rules. He also used a long-dormant clause in the Higher Education Act to create new quality standards for the industry. For-profit colleges fought the changes, hiring lobbyists on both sides of the aisle, including Democrat Tony Podesta and, perhaps inevitably, longtime D.C. fixer Lanny Davis.

The industry managed to tie up new regulations in court for years. But there were just too many horror stories to ignore, too many lawsuits and state investigations. Enrollment in for-profit schools dropped, cratering share prices that had been premised on rapid growth. Both the president and CEO of two Kaplan higher education divisions departed in 2011, not long after the Post published a self-flagellating expose.

Shireman had stepped down the previous year. He was 48 years old with a wife and family, and he wanted to get back to California. In the hour between the announcement of Shireman’s impending resignation and the close of trading on Wall Street, the value of the major for-profit companies jumped by hundreds of millions of dollars.

During the for-profit meltdown, no one paid much attention to 2U, John Katzman’s fledgling company. In 2008, he struck his first deal with USC, for an online master of teaching. At the time, the university was in the middle of a dogged, decadeslong climb to the top tier of the U.S. News & World Report rankings. It lacked the money to compete with deep-pocketed rivals like Stanford or Harvard, so it issued a mandate to the deans who ran schools and colleges like independent fiefdoms: Be creative. Marilyn Flynn, then the dean of the School of Social Work, recalls that online education was a “very high priority” for USC President C.L. Max Nikias. “Our merit reviews would reflect our ability to do this,” she says. She signed up with 2U in 2010. USC’s online master of social work would cost exactly the same as the on-campus version: currently, $107,484.

Katzman’s pitch was hard to resist. Back then, many online programs were extremely lo-fi. 2U, by contrast, offered live video interaction with teachers and other students, arrayed on screen in squares like the opening credits of “The Brady Bunch.” Plus, the company assumed all of the financial risk. College deans could use their cut to lure star research professors by promising them large salaries and small or nonexistent teaching loads, pushing programs up the rankings. The online courses would be staffed by adjuncts, most working far from the campus and much cheaper to employ. “This is a cash cow,” Flynn says bluntly. “Universities are struggling to find a business plan that works. And I was very aware that we would have a dramatic increase in revenue from this.”

Hundreds of students across the country and overseas signed up for the USC degrees. In 2010, 2U began negotiating to launch an online MBA with UNC Chapel Hill and a nursing degree with Georgetown University. The partnership with USC’s education school was especially smart, because there is a huge market for master’s degrees in education. A graduate degree almost always qualifies a teacher to an automatic raise: More than half of America’s 3.8 million public schoolteachers have one. Many earn their degrees while working full time, making the convenience of online learning a major draw.

Master’s degrees are also an entirely different market from undergraduate ones. Colleges are legally required to publicly report undergraduate admissions statistics, including SAT scores and what percentage of their applicants gain admission. This prevents elite schools from simply jacking up the number of students admitted to their most prestigious undergraduate programs to make more money—those programs are sought after precisely because they are exclusive. Ph.D. programs at elite universities tend to be similarly selective.

By contrast, master’s programs are a black box—there is no requirement to publish any admissions data. This means universities can dramatically lower their admissions standards and enroll thousands of highly profitable students without sullying their brand. The University of Pennsylvania, for example, offers a master’s in “Applied Positive Psychology,” which is essentially a $66,000 Ivy League degree in self-affirmation. It has “no specific prerequisite courses” and applications are accepted from anyone with a minimum 3.0 grade point average.

There are also strict limits on how much government money students can borrow for an associate or bachelor’s degree. But as long as a master’s degree is accredited, students can take out federal loans for the entire cost of tuition, fees, books and living expenses, with no limit on what the college can charge. These loans can easily top $100,000.

By 2009, private investors had caught on to the potential of OPMs. 2U raised $100 million in four years to expand its operations. And then the company hit a snag, in the form of the regulations Bob Shireman and his colleagues authored before his departure. The new incentive compensation rules strengthened the existing prohibition of any “commission, bonus, or other incentive” based “directly or indirectly” on enrollments or financial aid. Sharing tuition revenue, however, was how 2U made all its money.

In 2010, 2U’s then-chief operating officer, Chip Paucek, met with Secretary of Education Arne Duncan to lobby for an exception for OPMs. He brought along a dean from the Georgetown nursing program to help argue the case.

According to four former Department of Education employees who were involved with or had knowledge of the issue, career staff had serious misgivings. But they told themselves that the OPMs' university partners wouldn’t risk their reputations by offering shoddy degrees or defrauding students. In March 2011, the department issued a final clarification: It was OK to share tuition with a third-party firm, as long as the recruiting was part of a larger package of “bundled services” that included marketing, support services, the provision of technology and career assistance. 2U’s business model was now enshrined in federal regulation.

If there’s one thing you can count on in these uncertain times, it’s that the cost of college will rise—and then rise some more. Almost every year, whether the economy is in a state of boom or bust, tuition hits a record high. But why? Is it really twice as expensive to provide a degree as it was 20 years ago? Colleges go to absurd and extraordinary lengths to avoid answering this question, reporting their financials in a way that deliberately obscures how much money different units spend and make. They don’t even like to use the word “profits,” preferring euphemisms like “surplus.” If nobody knows how much your degree really costs to run, then nobody can accuse you of charging too much, which is an excellent strategy for charging too much.

One of the very few prestigious colleges that has attempted to create an affordable online degree is the Georgia Institute of Technology. In 2014, its college of computing created an online master’s with the radical objective of charging the lowest tuition possible. Charles Isbell, a Georgia Tech dean, says he saw the effort as part of the university’s mission of public service. Udacity, an online education provider, helped design the program. AT&T chipped in a $4 million gift for startup costs. Georgia Tech sets a price that allows it to break even—currently, $6,600.

To understand just how jaw-droppingly low this figure is, consider that Georgia Tech has the eighth-ranked computer science department in the country, according to U.S. News & World Report. Here are the prices for similar online degrees, along with the department’s ranking:

Georgia Tech is charging around one-tenth the tuition of Columbia University. Even if Georgia Tech wanted to make a 100 percent profit, it would still be charging $47,000 less than what USC demands for a lower-ranked degree.

There are two main reasons most online degrees are so expensive. The first is that middlemen like 2U spend enormous sums on marketing, a cost that is then passed on to the student. In materials it provides to investors, 2U helpfully estimates what happens to every $100 in revenue for a typical program that's not being launched or expanded. Approximately $15 is spent on actual teaching. Developing and administering the courses costs around $23. Marketing and sales eats up $19. And the cost of buying ad words and search terms on Facebook and Google keeps on rising, as OPMs compete with each other and with colleges running their own online programs.

Based on the size of the OPM industry, 2U’s spending patterns, and Facebook and Google’s share of the digital advertising market, nearly $1 billion in online education cost savings may be going straight into the pockets of Mark Zuckerberg, Larry Page, Sergey Brin and their fellow shareholders every year. That doesn’t include billions more paid by colleges that don’t use OPMs. Recently, I tried a Google search for “Georgia tech online masters computer science.” The first result was a paid advertisement for Johns Hopkins’ version of the same degree, which costs $42,500.

The second reason online degrees are so expensive is the generous profit margins sought by both OPMs and the colleges themselves. The beauty of the model is that after a course is taught for a few years, up-front development costs get paid off and profit margins rise. At that point, 2U estimates that out of every $100 in tuition revenue, the profit is almost $43, split evenly with the university at about $21 apiece. On a recent call with Wall Street investors, 2U revealed that for programs operating for at least four years, profit margins are up to 25 percent, 4 percentage points above their projections. I asked a number of schools why the prices for online and on-campus courses were the same. Most declined to explain their reasoning, but former USC dean Marilyn Flynn said there had been a “policy decision” to charge the same amount for both versions of its social work master’s degree “because there is no difference in the quality.”

When the Department of Education officially endorsed the 2U model, it essentially removed any incentives for colleges to create cheaper online degrees. The decision, says David Bergeron, then a senior department official who worked on the regulations, “caused an explosion in the marketplace.” By 2014, 2U’s annual revenue had passed the $100 million mark. It also had an increasing number of competitors. According to Tyton Partners, more than a third of colleges with online programs—525 total—have signed OPM contracts. Paxton Riter, founder of an OPM called iDesign, told InsideHigherEd that proportion could soon reach 50 percent.

The upper ranks of these companies are a who’s who of refugees from controversial for-profit colleges. To name just a few examples, OPM executives include the two high-ranking Kaplan executives who left in 2011, a former University of Phoenix vice president and a president at Career Education Corporation, a scandal-ridden for-profit that has been investigated by the SEC, the DOJ and more than a dozen state attorneys general.“When you have similar incentives and similar actors involved, it's difficult not to worry,” says Spiros Protopsaltis, a senior education official during Obama’s second term.

Also scrambling to get in on the action: textbook publishers. With the internet imperiling their comfortable racket selling $300 textbooks, publishing giants such as Wiley, Pearson and Bertelsmann have snapped up OPMs for hundreds of millions of dollars. One analyst described the current state of the industry as “a scene out of ‘Mad Max,’ a chase through these dystopian hinterlands with obstacles in the way and people attacking each other.”

All of this has created serious doubts from the man who made the OPM market possible in the first place: John Katzman. As 2U’s board began preparing in 2012 to go public, he moved to an executive chairman role, with Chip Paucek running the company day-to-day. What happened next is disputed. Katzman says the two agreed on a vision, but then Paucek made “a series of decisions that I consider to be not in the interests of kids, not in the interests of educators, but in the interest of stockholders.”

Katzman notes that after Paucek took over, UC Berkeley launched a 2U-supported master of information and data science without in-state tuition. All students pay the same for the 20-month program: $66,150, plus fees. Katzman watched in dismay as enrollment declined in USC’s master’s in teaching, even as it surged in its much more lucrative social work program, which costs more than twice as much. (Karen Symms Gallagher, the dean of USC's education school, observed that around the time the teaching master’s was created, post-recession education budget cuts significantly reduced job opportunities.) “There are CEOs who believe they have a fiduciary duty to their stockholders to just market the most expensive programs and encourage schools to jack up tuition,” Katzman says. “I am horrified. That was not the goal.”

2U’s headquarters is next to the last stop on the D.C. Metro’s Orange Line, in suburban Maryland. Walking inside is like teleporting into a neon-and-teak-accented Silicon Valley startup—except, because office space is a lot cheaper here, on a heroic scale. There’s a coffee bar in the lobby, a cafeteria that serves affordable gourmet food and fridges full of lightly flavored carbonated water.

I met with Paucek, now the CEO, who readily acknowledged the key role he played in the Department of Education rule change. “I personally had a lot to do with that,” he said. He made no apologies for the profit margins that have made him a very wealthy man. “Some folks don't think that there should be any profit motive in education whatsoever,” he said. “I've been in for-profit education, in one way or the other, my entire life.” His position on Katzman’s departure is that the two men simply had a difference of opinion over leadership style and the focus of the business. “Every company has founding drama,” Paucek said.

Katzman quit in August 2012, a year and a half before 2U listed on the Nasdaq. By then, OPMs had punctured a hole in the distinction between for-profit and nonprofit education. The breach started out small and manageable. But the exception to the incentive compensation law is now being expanded by multibillion-dollar companies that have realized that the best way to avoid for-profit regulation is to pretend to be something else. “The department opened Pandora's box,” says Protopsaltis. “Closing it will not be easy.”

Kaplan Higher Education never really recovered from the combination of business missteps and the intense public scrutiny of the for-profit industry in the late 2000s. In April 2017, Donald Graham announced that Kaplan University was being sold for $1 to Purdue University, Indiana’s public land grant college. It sounded like Purdue had picked up a distressed asset and turned it into a public concern. But that’s not exactly what happened.

What Purdue really did was create a separate organization, eventually named Purdue University Global. It was granted a highly unusual legal status by the Indiana legislature, in which it is simultaneously considered a nonprofit institution immune from Bob Shireman’s for-profit regulations and a private institution immune to public records requests. Purdue University Global took ownership of Kaplan’s few remaining physical campuses, all of its online programs, and hired its academic personnel.

But Kaplan Higher Education still very much exists as a division of Graham Holdings. It is now being paid 12.5 percent of Purdue University Global’s revenues to provide recruiting services, marketing and other OPM capabilities under a long-term contract. The contract, which Purdue tried to keep secret, penalizes the university if it tries to lower prices, raise admissions standards or otherwise cut into Kaplan’s revenue stream. In other words, Kaplan University became an OPM to itself.

Once again, Kaplan is at the forefront of a trend—this time, for-profit colleges that have discovered a way to secure all of the benefits of a nonprofit institution with none of the obligations. One of the most striking cases is a former for-profit college named Grand Canyon University.

In July 2018, the college's parent company (known as LOPE on the Nasdaq), got final approval to create a nonprofit, also named “Grand Canyon University.” LOPE lent the nonprofit $870 million plus interest. The nonprofit promptly paid the $870 million right back to LOPE to purchase Grand Canyon's physical campus in Phoenix, Arizona, as well as the university’s academic operations. (Most of its roughly 90,000 students are online.)

Meanwhile, LOPE signed a 15-year contract with the nonprofit to provide OPM-style services. In exchange, LOPE gets 60 percent of Grand Canyon University’s tuition and fee revenues, in addition to $52 million in annual interest payments on the loan.

It sounds impossibly convoluted, but it’s actually quite simple. Grand Canyon put all of its academic operations into a nonprofit that serves as a conduit for federal financial aid. (Last year, Grand Canyon received over $760 million from federal student loans, the most of any college or university nationwide.) The nonprofit university is also able to avoid local property taxes and for-profit regulations, not to mention the industry’s toxic reputation. But most of the profits eventually end up in the same place—with LOPE, a $5 billion corporation. Grand Canyon University is “not non-profit in any meaningful legal sense,” wrote Brian Galle, a former attorney in the tax enforcement policy section of the Justice Department, in a letter to the Department of Education. He later added, “[It’s] a trustworthy-looking wrapper around a for-profit business.”

As a general rule, it’s in students’ best interests if university contracts with private companies are arm’s-length transactions between independent firms. But in this case, Brian Mueller, former CEO of the University of Phoenix Online, is the CEO of LOPE and president of the nonprofit Grand Canyon University. In 2017, Grand Canyon’s accreditor, the Higher Learning Commission, issued standards allowing, among other things, the president of a nonprofit university to run the for-profit company that gets most of the nonprofit’s money. Which is great news for Mueller: According to the Chronicle of Higher Education, he has made at least $15 million selling LOPE stock since January 2017, far more than the salary of any other nonprofit college president. This entire structure wouldn’t be possible without the exception that the Department of Education granted to OPMs.

And nonprofit conversion has spread like a virus. The remaining big half-dozen for-profit companies are all, industry insiders say, considering similar moves. Luckily for them, the Trump administration is about to take the rickety structure of regulation protecting college students and burn it to the ground.

The person in charge of higher education at the department is Diane Auer Jones, a onetime official in George W. Bush’s Department of Education who worked for some of the most powerful operators in the previous for-profit scandals. Soon after starting at the department, Jones promptly threw out all of the regulatory work that her predecessors and career staff had been developing and began rushing through new versions that she wrote all on her own, according to a staffer currently working for Jones. “The political staff are writing the regulations in secret and the policy staff are kept in the dark,” the staffer says. (The Department of Education didn’t respond to a request for comment.)

Jones’ proposed rules, released in January, amount to a sweeping deregulation of higher education. They include abolishing a rule that prevents colleges from outsourcing more than half of a program to outside companies—for example, OPMs—and a rule that bans federal aid to programs where students don't interact with an instructor. “We’re talking about basic questions here, like the amount of student learning we should expect and what the faculty role is,” says James Kvaal, an Obama White House official who is now president of the Institute for College Access and Success. “The prospect of removing any federal guardrails at all is really scary.”

The rules, if adopted, would also weaken the power of accreditors, as well as the government’s oversight of whether colleges are eligible for federal money. In a December speech, Secretary of Education Betsy DeVos said that her department’s current oversight role “stymies competition.” (An accreditor is also one of the few outside organizations that can block an OPM contract.) Late in the Obama administration, the department shut down an accreditor that had approved many of the for-profit colleges cited in the Senate's investigative report a decade ago—including several belonging to Career Education Corporation, Jones’ former employer. Soon after taking office, Jones resurrected the accreditor, citing support from nine others. In fact, only one of the accreditors she named endorsed the move. The department blamed an “inadvertent error in the editing process.”

If Jones’ proposed rules are finalized later this year, it will be almost impossible to prevent another armada of private profiteers from rolling in. This time, they will be much harder to detect. By now, the public is largely aware of the dangers of shady for-profit colleges. But OPMs are taking Katzman’s approach of “the more invisible, the better” to extremes. The next wave of for-profits are becoming so entangled with well-known, trusted institutions that it will be impossible to tell where one ends and the other begins.

John Katzman created yet another company in 2015, this one intended to “decimate the OPM industry,” he later told InsideHigherEd. Katzman now talks about OPMs with the same virtuous venom he once aimed at the SAT. “Why are colleges and universities handing over more than half of their tuition to online program managers?” he demanded in one opinion piece. The long-term contracts that universities are signing in order to earn revenue from online education, he wrote, amount to a “payday loan.”

Katzman’s latest venture, Noodle Partners, aims to be more virtuous: by helping universities create online degrees without charging them 60 percent of tuition forever. The company manages the programs and negotiates prices for services and capital, which lowers the long-term cost to the university. (Once the startup costs have been covered by either Noodle or the university, Noodle will charge a fee that, according to Katzman, equals about 34 percent of tuition revenue.)

But if higher education circa 2019 is a contest between the original 2U model and Katzman’s new vision, the 2U model is, for now, still winning. OPMs have migrated from institutional heavyweights like Harvard or Yale that have plenty of leverage to protect their academic integrity, to smaller colleges buffeted by financial challenges. If there’s a fifth wave of for-profit scandal on its way, the most likely candidates are colleges where OPMs threaten to seize control of their hosts, like the fungus that turns carpenter ants into six-legged zombies.

For a preview, take a look at Concordia University in Portland, Oregon, once a small, respected Lutheran teachers college. After creating an online master’s program with a Silicon Valley-based OPM called HotChalk, by 2015 Concordia had become the single biggest provider of education master’s degrees in the nation. (It’s currently the third-biggest provider.) An Oregonian investigation found that in five years, the number of graduate students went from 800 to 6,200, with HotChalk getting as much as 80 percent of tuition revenue.

Then, the program was hit with very some familiar-sounding accusations. In 2013, a whistleblower lawsuit alleged that HotChalk ran a “classic boiler room” in which recruiters employed misleading practices to sign up students, including offering them “phony ‘scholarships.’” Federal prosecutors also investigated whether Concordia had violated the rule prohibiting schools from outsourcing more than 50 percent of academic operations—the same rule Diane Auer Jones is bent on eliminating. According to the government, HotChalk “recruited, hired, employed, supervised and managed all or substantially all” of the online instructors who were ostensibly working for Concordia. Without admitting wrongdoing, the college settled with the government for $1 million—but, as the Oregonian reported, it was HotChalk that paid the bill. Months after the settlement, Bertelsmann invested $230 million in HotChalk, essentially acquiring a controlling stake. HotChalk still runs the master’s program at Concordia.

By now it should be obvious that this isn’t merely a matter of identifying the unscrupulous operators and shutting them down. It’s about something more fundamental. American universities have long been caught in the push and pull between their lofty academic ideals and societal obligations on one side and the temptation to maximize profits as a market actor on the other. When states slash funding and force public universities to find replacement money, they tip those scales toward profit-making. When universities let tuition rise to $70,000 a year and promote degrees in terms of “return on investment,” they hardwire their entire organization with the logic of privatization. I’ve seen a department chair’s eyes light up after an OPM market analysis encouraged him to increase tuition, on the logic that it would signal prestige and stoke demand.

So it’s not entirely a coincidence that 2U’s first and still-biggest partner, USC, is also at the heart of the college admissions scandal. In order to vault the school into the top tier of American colleges, its former president, C.L Max Nikias, and his predecessor, Steven Sample, turned USC into a money-chasing machine. Carmen Puliafito, the medical school dean, claimed to have pulled in $1 billion in donations. At dazzling galas, he mingled with luminaries like Gwyneth Paltrow and Larry Ellison. Apparently, his fundraising prowess was so valued that for years nobody noticed he was spending much of his time in hotel rooms smoking meth.

Marilyn Flynn, the USC dean who signed one of the first 2U deals, abruptly stepped down last summer. Weeks later, the chair of USC's board of trustees sent a letter to the university community about “alleged inappropriate financial transactions and agreements involving Marilyn Flynn.” The U.S. Attorney’s office has launched an investigation into a $100,000 donation made to the school of social work. (Flynn noted that at age 80, her decision to retire was “an appropriate and natural option.”)

And when the college admissions scandal broke in March, USC again managed to stand out. At the other seven university athletic departments named in the charging documents, according to the government, individual coaches took bribes in isolation. At USC, the complaints say, it went deeper. Four people were indicted, including a senior athletic department administrator who allegedly coordinated the flow of bribes and fraudulent admissions.

As our most trusted universities continue to privatize large swaths of their academic programs, their fundamental nature will be changed in ways that are hard to reverse. The race for profits will grow more heated, and the social goal of higher education will seem even more like an abstraction. Even the partnerships that are undertaken with noble intentions never truly put the student first. After Katzman's impassioned pitch about how his new business was helping colleges save money, I asked him if that meant tuition would fall. He paused for a moment. “Can I put into my contract that the university is going to take the surplus generated from this program and give it directly back to the students?” he asked me. “No. That's way over my pay grade.”

CREDITS

Story - Kevin Carey

directs the education policy program at New America.

Creative Direction & Design -

Donica Ida is the former creative director of Highline.

Additional Creative Direction and Design - Una Janicijevic

is a freelance art director in Toronto.

Research - Matt Giles

is a freelance writer and the head of research and fact-checking at Longreads.

Development & Design - Gladeye

is a digital innovations agency in New Zealand and New York.

Now We're Talking

In a just world, Paul Coates would not be famous primarily for the work of his son. As the father of Ta-Nehisi Coates, whose analysis of American history has transformed the public discourse on race, the 72-year-old Coates is immortalized in his son’s writing as an eccentric and quixotic figure.

“My father was haunted,” Ta-Nehisi wrote in his first book, The Beautiful Struggle. “He’d explain to anyone who’d listen” that those in power “infected our minds. They deployed their phrenologists, their backward Darwinists, and forged a false Knowledge to keep us down. But against this demonology, there were those who battled back. Universities scorned them. Compromised professors scoffed at their names. So they published themselves and hawked their Knowledge at street fairs, churches, and bazaars. For their efforts, they were forgotten.”

Paul himself was largely forgotten by the time his son gained prominence, but in my hometown of Baltimore, his legacy and impact on the city have been profound. After leading the local chapter of the Black Panther Party in the late 1960s and early ’70s, he founded a prison literacy program, opened a bookstore devoted to community service and established the publishing company Black Classic Press to disseminate the work of contemporary authors like Walter Mosley and historic writers like W.E.B. Du Bois, John G. Jackson and Carter Woodson.

Although Coates and I have friends in common, we had never met until late last year, when we began a series of conversations about his life and political evolution. The first interview took place on Christmas, a holiday he doesn’t observe. “I resent it because it takes money out of the community,” he said. “It reflects a powerlessness to make decisions about what's in our best interest.” As the discussion, which has been edited and condensed for clarity, stretched into the evening and continued for months to come, we talked about his unlikely path from childhood poverty to the Vietnam War to the Panther Party. At a time when the country, and Baltimore in particular, face existential challenges, few people offer such a clear-eyed perspective on the past and the road ahead.

I was talking to our friend Edwin the other day. Did you know he’s a Trump supporter?

Yup. Voted for Trump and still loves him. You two met in the Panthers, right?
Did anyone else from that circle go MAGA?
He also told me a while back that he’s no longer on the Du Bois side of the debate with Washington.
Seriously?
But Washington was cool with second-class citizenship. He wouldn’t fight for equal rights. He was basically running around telling people to pull their pants up.

Booker T. Washington (second from left on the bottom) with fellow members of the National Negro Business League Executive Committee. LIBRARY OF CONGRESS/CORBIS/VCG VIA GETTY IMAGES

This is one of the strange things about American discourse: We have all these new platforms, but they flatten the conversation. Like you could spend a long time on Black Twitter without seeing anybody defend the pound cake speech—it’s completely discredited. But half the old black guys I know think Cosby was right.
Did you grow up with politics? “My family always treated me as the gifted one. They felt I was different, and they treated me different. Even as a child, I was aware of that. Like I was special.”
How was your relationship with your aunt?

Coates' mother, Edna, on the right. COURTESY OF PAUL COATES

Were they the only adults in that house?
Did you return to school?
How did your parents and teachers see you?
Did you rebel against your parents as you got older?
Ever?
He just ran into them?
What was the neighborhood like?
What made you leave for the Army?
What did you pick for a military occupation?
Did you have much experience with dogs?
Were you nervous about going into a predominantly white space?
Did you identify with John Wayne?
But he didn’t want a black guy with his sister.
Was there a lot of bigotry in the Army?
Baldwin didn’t make the same impression?
Where were you stationed?
What was rural Texas like?
How did you feel about the war?
It’s amazing that you were experiencing racism and discovering black writers at the same time the civil rights movement was accelerating, but your identity as a soldier was strong enough to overshadow your identity as a black man.
How long were you in Vietnam?
Did you go back to Philly when you got out?
Which part of town?
Baltimore is one of the most segregated cities in America.
Subtle.
How did Baltimore compare to Philly?
Did you get involved with political organizations?
Did you understand the differences between those groups and the Panthers?

Coates during his time leading the Baltimore chapter of the Black Panthers. COURTESY OF PAUL COATES

Did the Baltimore chapter of the Panthers monitor police activity?
I’ve always admired how proactive the Panthers were. They didn’t just have meetings. They went out in the community and got shit done.
Do you think the FBI really believed the Panthers were a national security threat?
That’s what I mean—they obviously weren’t a national security threat, but they were a threat in the sense that they were educating people to question authority.
Who was the Defense Captain in Baltimore?
What did you get arrested for?
They took pictures?

How did you get made?
You were going to let New York hash it out?
How did you feel about being in charge?
It seems daunting.
What changes did you make as Defense Captain?
What do you mean?
Did you have a sense that breakdown was coming?

(Left) A “pyramid of Coates children,” says Paul. (Right) Coates with baby Ta-Nehisi. COURTESY OF COATES FAMILY

What did you think your next move would be?
Had you been living in a Panther apartment?
You wanted the book project to replace the Panthers?
Was the FBI still watching you?
Did it feel more stable than the Panthers?

Coates in the basement of Black Classic Press, the publishing house he founded in 1978. COURTESY OF PAUL COATES

It can’t be easy to run a publishing company right now.
Do you want to keep the business in the family?
What do you see as the legacy of the Panthers? “People criticize [Ta-Nehisi] for not having hope. But it’s not that you don’t have hope. It’s just: What would you base the hope on?”
BLM is definitely less centralized, but is that an advantage or a disadvantage?
I guess it is difficult to target a movement without a clear leader.
Of course, BLM is a response to the exact same problem that created the Panthers more than 50 years ago. Should we feel encouraged that the fight against police brutality continues, or discouraged that it still has to?

Coates with Eddie Conway, one of the people who inspired him to start Black Classic Press. COURTESY OF PAUL COATES

What do you make of the fact that two of the most visible black candidates in the 2020 race so far, Kamala Harris and Cory Booker, are among the least progressive?
A lot of people forget this, but even when she made the “superpredator” comment, she was partly catering to the black electorate.
A certain constituency, anyway. The black clergy were all about bringing more police to the community. I was writing for The Baltimore Times back then. Do you know Peter Bramble?
He and Joy were both at the paper when I was there, but Peter left in the ’90s to become rector at St. Mark’s in Brooklyn. It’s one of the biggest black Episcopal churches in the country, but he ended up quitting over gay marriage. Just refused to do it. And I mean, I’ve known Peter forever. I just saw him the other day and I have a lot of love for the guy—but he’s like a lot of black clergy on this. Do you think your generation of leaders should have done more to ally with the gay movement?
I guess it’s easy to forget how much the culture has changed since then—or even since the ’80s, when Ralph Northam was running around in blackface.
A lot of people were surprised that so many black voters continued to support Northam, but I bet half the Virginia legislature has some racist shit in their past. He was just the idiot who got caught.
And plenty of white people don’t. You still hear, “Why can’t my kid be LeBron for Halloween? He loves LeBron!” Without any recognition of the history that connects to, the minstrelsy, mockery, disparagement. Things like that make me wonder how far we’ve actually come.
Right, because a lot of shit is actually worse. The murder rate here is up 50 percent from a few years ago, even though the city is shrinking. We’re sending more and more black men to prison, the school system is a disgrace…

Max Eden didn’t even want to read about Parkland. He saw the news on Valentine’s Day, after a dinner date with his girlfriend at a little French place in Washington, D.C., taking an Uber home. There was the gut-punch—“oh shit, another school shooting”—then the queasy afterthought that none of this hits as hard as it used to. He knew what would follow. For a few angry weeks, Democrats would demand gun control and Republicans would call for arming teachers. He decided he’d sit it out this time, ignore the news as much as possible. And for a few days he did, until a journalist tweeted that the shooter’s school record proved a point that Eden had been making for much of his career.

At 30 years old, Eden has a neat beard, a balding head that he’s resigned himself to buzzing short and a quick, sometimes nervous intelligence. A Yale graduate, he is a senior fellow at the Manhattan Institute, a conservative think tank that focuses on economic and urban policy issues. For years, the institute has produced arguments about how liberal policies intended to help minorities actually hurt them. It underwrote the early welfare reform work of contrarian sociologist Charles Murray, whose book, “The Bell Curve,” infamously argued that there are racial differences in intelligence. Its senior fellow George Kelling helped advance the theory of “broken windows” policing, which posits that crackdowns on petty quality-of-life offenses ultimately reduce major crimes. More recently, fellow Heather Mac Donald has regularly appeared on Fox News to discuss the “Ferguson effect”—her argument that the Black Lives Matter movement has caused police to become less proactive, fueling urban crime.

Eden’s portfolio was lower-profile. His speciality was education, which in conservative policy circles usually meant critiquing liberal reforms for focusing on underprivileged children at the expense of their more fortunate peers. (In 2016, he wrote an article to this effect titled “#AllKidsMatter.”) Eden’s mother had been a public school teacher in Cleveland, and her complaints made the work personal.

Over the previous two years, Eden had focused on school discipline. The Obama administration had embarked on a major effort to address the “school-to-prison pipeline”—the glaring racial disparity in school suspensions and expulsions, which is a major contributor to an even more glaring racial disparity in America’s prisons. Eden believed the reforms had plunged schools like his mother’s into chaos and saw the reformers themselves as members of a “social justice industrial complex.” “As more money flows to ‘woke’ conferences and training programs,” he would write, “school district leaders have increasingly learned that the fastest path to career advancement is to produce fake statistical progress for minority students while passionately decrying privilege and institutional racism.”

Eden tracked the news for violent incidents—like a 2017 high school stabbing in the Bronx—at schools that had adopted the new approach. Still, compared to other education debates that riled up conservatives, such as campus sexual assault or bathroom access for transgender students, discipline reform never really caught on. There was, Eden said, no natural Republican “political constituency” for his issue.

Until a few days after Parkland, when the journalist’s tweet started him thinking. The shooting had occurred at the most elite public school in one of the most affluent suburbs in Broward County, and Eden typically focused on low-income, urban, majority-minority schools. But then he noticed what kids from Marjory Stoneman Douglas High School were saying about Nikolas Cruz, the 19-year-old former MSD student charged with killing 17 students and staff and injuring 17 more. In TV interviews and on social media, the students insisted they’d repeatedly warned local authorities that Cruz was obsessed with guns. A couple of days after the massacre, the FBI acknowledged it had failed to act on two tips. It would emerge that Cruz had repeated interactions with the Broward County Sheriff’s Office as well. Eden wondered, he told me, whether the shooting was connected to Broward’s reputation as “ground zero” for a policy he characterized as “try to arrest as few students as possible.”

In 2013, Broward had launched an arrest- and suspension-diversion program called PROMISE that became a national model for reformers. Many believed it had even helped inspire the Obama administration’s own efforts. And when Eden tangled with reform advocates online, asking them to show him where the new policies were working, they always pointed to Broward.

In the days after the shooting, Parkland students led the country in the most forceful call for gun reform in recent memory, and plenty of conservatives were looking to place the blame on anything other than lax gun laws. The first to land on PROMISE was Jack Cashill, the conspiracy-minded author of a book about “the railroading of George Zimmerman.” Cashill had long argued that Trayvon Martin, the black teenager whom Zimmerman shot and killed in 2012, was in fact a budding criminal whose aptitude for “street fighting, drugs, guns, burglary and mixed martial arts” had been obscured because his Florida school district participated in a program to reduce student arrests. Now, Cashill theorized that Broward had similarly excused Cruz because, although he is white, his name made him “a statistical Hispanic.” The next day, a right-wing blog posted a series of tweets arguing that Cruz had benefited from “the Trayvon Martin standard.” The thread was shared almost 12,000 times, and the theory quickly spread from Infowars to Rush Limbaugh to Breitbart to Fox News, until Ann Coulter was describing PROMISE as “the school to mass murder pipeline.”

But it was Eden, whose work had been cited in the Senate, who made the argument influential. Twelve days after the shooting, Eden wrote an article for the Manhattan Institute’s City Journal, suggesting—in more measured terms than Cashill or Coulter—that Broward’s approach to school discipline might have allowed Cruz to “slip through the cracks.” Within days, Florida state Representative Richard Corcoran announced that he planned to propose legislation revoking Broward’s “no-arrest policy,” and U.S. Senator Marco Rubio wrote to Education Secretary Betsy DeVos and Attorney General Jeff Sessions, calling on them to revise former President Barack Obama’s reforms. In the coming months, Eden would testify before Congress and speak to DeVos. In the conservative and mainstream press, his arguments helped to advance a narrative that he’d later acknowledge happened to be “very politically convenient” for conservatives: that the Parkland shooting “wasn’t guns, it was Obama.”

And then, in April, he traveled to Parkland. Eden hoped to write an article about a failed policy—he wasn’t planning to get personally involved. But there were some in Parkland who found his arguments persuasive. The father of one slain MSD senior sought Eden out and declared that his work would be central to his search for “justice for my daughter’s murder.” It was the start of an unlikely partnership that would entangle a grieving community in one of the ugliest political fights that people in Broward could remember.

Twenty years ago, the Columbine school shooting was the deadliest of its kind in U.S. history. As with the shooting in Parkland, no major gun reforms followed. And yet Columbine did prompt profound change of another, less obvious kind, as schools all over the country overhauled their safety procedures. In 1997, just 10 percent of public schools had campus-based police, known as school resource officers or SROs. By 2014, it was 30 percent. Between 1996 and 2008, the number of school districts that had their own police departments more than doubled.

The purpose of these new practices was to protect students from violence. But what happened instead was the widespread criminalization of bad behavior. Before Columbine, some 79 percent of schools had zero tolerance policies for violence, according to the Department of Education; a federal law mandated a year’s suspension for bringing a gun on campus. After the shooting, schools rushed to expand these policies to lesser forms of misconduct. What was seen as a “weapon” expanded to the point of absurdity. Students were suspended or expelled for bringing butter knives in their lunchboxes, aiming “finger guns” or biting a Pop-Tart into what teachers interpreted as the shape of a gun. Arrest rates skyrocketed for vaguely defined offenses like “disruption.” (These arrests often escalated from behavior as minor as throwing pencils in class or running in halls.) In public schools with SROs, students were five times more likely to be arrested for “disorderly conduct” than at schools without them. Researchers eventually deemed that the new zero tolerance rules didn’t actually increase school safety. Meanwhile, even as juvenile crime rates steadily decreased after their 1994 peak, suspensions kept rising.

The new precautions coincided with a heightened suspicion of teenagers in the mid-’90s, a fear that was often racialized. And it was students of color—especially black students, and especially black boys—who bore the brunt of the post-Columbine emphasis on school security. Black students account for around 15 percent of the public school population but around a third of school-based arrests. Even as preschoolers, black students are more than three times as likely to be suspended as their white peers, and twice as likely to be arrested at school, according to The Sentencing Project. In recent years, security cameras and student cellphones have captured shocking footage of black children on campus being manhandled like dangerous criminals—a teenage girl violently flipped over and thrown across the room by an SRO; a kindergartner handcuffed for a temper tantrum.

Russell Skiba, a professor emeritus at Indiana University and a leading researcher on disparate discipline, noted that over 20 years, all but a handful of studies have found that the reason for the discrepancy isn't that black children are misbehaving at higher rates. Rather, black students are punished more for offenses that rely on subjective assessment, such as “disruptive behavior” or “defiance.” White students, meanwhile, are more often punished for objective offenses that can’t be ignored, like smoking or vandalism. Black students are also 31 percent more likely to receive discretionary suspensions, according to the Justice Center—that is, not for violations that would automatically mandate it.

Many researchers largely attribute the problem to implicit bias: teachers, administrators and SROs judging the same behavior differently depending on the race of the child. One superintendent in Minnesota examined discipline referrals for her district’s kindergartens and found that when white kids misbehaved, teachers described them as high-strung or frustrated—unable to “use his words”—while black classmates were labeled unmanageable or violent.

These experiences can alter the course of a student’s life. According to an authoritative 2011 study in Texas, children who are suspended are twice as likely as similar peers to drop out and 11 times more likely to become involved with the juvenile justice system. Other studies have found those who drop out are three times more likely to end up incarcerated.

Broward was as good an example as any of this phenomenon. In 2011, the county had the most school arrests in Florida. As the nation’s sixth-largest district, this was perhaps not surprising—but 71 percent of those arrests were for misdemeanors like graffiti or possessing marijuana. According to the local NAACP, black students in Broward were two and a half times more likely than white students to be suspended, expelled and arrested. Their achievement gap was also stark. In 2011, only 57 percent of the district’s black male students graduated; several years earlier, the graduation rate for that group had been the third-worst in the country among districts with a large black population.

Robert Runcie became Broward’s first permanent black superintendent in 2011. He wasn’t a career educator. A tall, wiry, driven man with a thin mustache, he’d grown up in a cinder-block house in Jamaica and emigrated with his working-class family to the U.S. when he was 6. He studied economics at Harvard and Northwestern and founded a technology consulting firm. In 2003, his college friend Arne Duncan, then the CEO of Chicago’s public schools, asked him to run the district’s data systems. There, he helped to work on an algorithm project to determine which students were at greatest risk of being harmed by gang violence.

After his arrival in Broward, Runcie was contacted by a small core of leaders, convened by the local NAACP, that had been trying to address the school-to-prison pipeline. Runcie “was a data geek,” said Gordon Weekes, an attorney in Broward’s public defender’s office. “He said, ‘Whatever the data shows, it shows.’” When the data demonstrated that there were indeed significant racial disparities at work, the group assembled a coalition, joined by Runcie and various local agencies, including law enforcement, to review the district’s policies.

The team was particularly intrigued by a model developed in the poorest school district in metro Atlanta. Over a 10-year span, the arrival of police in Clayton County schools had led to a 1,200 percent increase in school-based arrests, overwhelmingly for petty offenses. Black students were 12 times more likely than white ones to be arrested. Graduation rates fell to an all-time low and crime in the county increased. As Clayton Juvenile Judge Steve Teske explained, once children are pulled into the system, they begin to identify as delinquents and are desensitized to the threat of jail. Arrest a student for low-level misbehavior, Teske has said, and “you might as well be sending him to prison one day.”

In 2004, Teske brokered a partnership between school and law enforcement in which arrests would be diverted for four minor offenses—fights, disorderly conduct, disruption and failure to follow police instructions. This led to a 70 percent drop in arrests and rising graduation rates. Georgia’s then-Governor Nathan Deal, a Republican and former juvenile judge, described Teske’s work as “revolutionary.”

In 2013, Broward’s team expanded “the Teske model” into a program they called PROMISE (Preventing Recidivism through Opportunities, Mentoring, Interventions, Support and Education). It covered 13 common types of misbehavior, including alcohol and marijuana possession, vandalism and “minor fighting.” Instead of being arrested for those offenses, students could be sent to one of the district’s alternative schools, Pine Ridge Education Center, for classes, counseling and a wide range of social services to address the underlying causes of misbehavior. Over the next four years, Broward’s school arrests fell 63 percent. An independent assessment by Nova Southeastern University, which offers counseling services in partnership with PROMISE, found that same-year recidivism dropped from 50 percent to 8 percent. The black male graduation rate, meanwhile, increased significantly. Runcie and his Executive Director of Student Support Initiatives, Michaelle “Mickey” Pope, were inundated with calls for advice from educators around the country. Runcie would eventually be invited to a White House panel that recognized Broward as leading the nation in discipline reforms.

In January 2014, all public K-12 schools received a “Dear Colleague” letter from the departments of Justice and Education (the latter then led by Arne Duncan). Under the Civil Rights Act, the letter said, federally funded entities could not penalize students of one race disproportionately. Any “disparate impact” could be evidence of discrimination, even if policies were race-neutral on their face. The letter signaled that the education department’s Office of Civil Rights would investigate potential violations. The American Civil Liberties Union described the move as “groundbreaking”; dozens of states and school districts subsequently instituted reforms.

Conservative critics like Eden objected on multiple fronts. They argued that the guidance was federal overreach and that it changed the standard for discrimination from equal treatment to equal outcomes. Many were deeply skeptical of the restorative justice programs that replaced suspensions for certain offenses, or bristled at the implication that educators might harbor unconscious biases. They often cited a 2014 report that attributed the disparities to previous misbehavior (though Skiba said this study has methodological flaws). Some argued that the research didn’t prove that suspensions actually cause the negative outcomes cited by reformers.

And then there were those who believed that minorities simply misbehave more often, as a result of poverty or single-parent homes. Eden’s Manhattan Institute colleague, Heather Mac Donald—whose books include “The Diversity Delusion: How Race and Gender Pandering Corrupt the University and Undermine Our Culture”—wrote in City Journal, “Given what we know about the breakdown of family socialization in the black community, it is wholly consistent that black students would be more prone to insubordination and classroom disruption.” Somewhat more gently, Eden agreed: “I see dramatic disparities, but I think they’re baked into American society due to the American sin of slavery and generations of policies, whether well- or mal-intended, holding African American students to lower standards.”

But mostly, conservatives complained that the letter forced schools into a dangerous numbers game. Eden characterized it this way: If three black students and one white student were suspended for swearing at a teacher, the school could be violating the guidance by producing a disparate outcome. As a result, he said, schools are compelled to “juke the stats”—borrowing the term from “The Wire,” a show that delivered a devastating indictment of broken windows policing and traditional disciplinary approaches in poor urban schools.

To support his argument, Eden collected school surveys administered by officials or teachers unions. He found more than 10 large districts where teachers said discipline reform wasn’t working. In Oklahoma City, one teacher reported that the principal had said suspensions were no longer mandatory unless there was an incident involving blood. In other districts, some teachers reported feeling so distraught—by both the policy and the implication that they were racist if they objected to it—that they’d considered leaving the profession altogether.

Eden’s most recognized work is a 2017 report claiming that after New York City enacted reforms, at 38 percent of schools an increased share of teachers said order and discipline had grown worse. However, education policy writer RiShawn Biddle took issue with the methodology. Biddle noted the raw survey data showed that, district wide, the proportion of teachers who thought order and discipline had been maintained actually remained steady, at 80 percent. (Eden also found that at 44 percent of schools, more students reported fighting than before.) Beyond that, Biddle said, there are inherent limitations to using survey responses as an objective measure of safety. He pointed to a 2016 study that found white teachers have lower expectations of their black students than do black teachers, as well as a 2015 study showing that black children are suspended less often when taught by black teachers. “Teachers, students, parents all have biases,” Biddle said. “You’re dealing with perception, and for many people, perception is reality.”

After President Donald Trump was elected, Eden and other reform opponents had the ear of Education Secretary Betsy DeVos. Four months into the new administration, Eden wrote an op-ed urging DeVos to rescind the Obama letter. In the fall of 2017, a Federalist Society report accused reformers of transforming schools into “menacing places where gangs of out-of-control teens prowl the halls.” Soon afterward, DeVos hired the study’s co-author. In September, DeVos, who’d already withdrawn one Obama guidance concerning the rights of transgender students, announced she was pulling a second, concerning campus sexual assault. Conservatives clamored for her to keep going, with one think tank cheering, “Two Down, One to Go.”

On April 10, 2018, at a meeting of the Broward County School Board, a slight, skinny kid walked up to the microphone and confidently announced that he’d completed an investigation into “the conduct of the school board and superintendent prior to the shooting at Stoneman.” Kenneth “Kenny” Preston was a 19-year-old home-schooled student in khaki pants and a dark blazer with a near-pompadour of black hair. He projected the same forceful, hyperarticulate poise that had propelled the MSD student activists into the spotlight nearly two months before, although he was at the meeting to make a very different point.

Preston’s investigation had begun as a report for an online journalism course and it was now more than 3,000 words long. He focused on two charges. First, that Runcie had spent only 5 percent of a $100 million bond dedicated to safety improvements. (The district said far more than 5 percent had been allocated.) Second, that PROMISE and its champions had tied the hands of SROs, obscured the number of campus crimes and allowed more than 1,000 incarcerated students to re-enroll in district schools. Preston quoted an anonymous former SRO who had told him, “we all knew some kind of tragedy like this was going to happen in Broward.” Several board members contested the accuracy of Preston’s findings, and Runcie lamented the spread of “fake news” about the school district. But within hours, Preston’s report was featured by The Hill; the next day he appeared on the radio show of National Rifle Association spokesperson Dana Loesch.

Although conservative media treated the report as the work of an intrepid wunderkind, it wasn’t entirely a solo project. After the shooting at MSD, Preston had been incensed to see Runcie on television calling for “sensible gun control” before the dead had even been buried. After coming across Max Eden’s work online, he messaged him on Facebook to ask for help refining his presentation. “Our goal was to make [Runcie] the focus,” Preston told me—referring to what was already a small band of critics of the school district.

Among them was Andrew Pollack, who had become what the Miami New Times would call “the Parkland massacre’s conservative face.” On February 14, Pollack’s daughter, Meadow, an MSD senior, had been shot nine times. The final five shots came as she attempted to cover the body of a schoolmate, Cara Loughran, who died when the bullets passed through Meadow’s body into her own. On the day of the shooting, Pollack had been on a Valentine’s Day bike ride with his wife in the Everglades. When they heard of the shooting, they sped back to the city and raced from hospital to hospital, looking for Meadow. At one point, they would later discover, they’d been driving behind the ambulance that was transporting Nikolas Cruz. That unspeakable day, Pollack had been photographed in a hospital parking lot, wearing a Trump 2020 T-shirt and holding up his phone to show a picture of Meadow beaming in a black strapless dress.

A week later, Pollack stood up in a televised meeting at the White House, his tan face drawn, his two sons gripping his shoulders. He was “pissed,” he said. He couldn’t get on a plane with bottled water, “but some animal can walk into a school and shoot our children.” Pollack contended that gun control was a pipe dream and the country needed to unite around school safety solutions instead. In short order, he became a Fox News regular.

A 53-year-old transplant from New York, who’d run a scrap metal dealership before getting into real estate, Pollack, with his salt-and-pepper buzz cut, has retained an accent and an attitude friends affectionately described as “Long Island redneck.” His 21-year-old son, Hunter, called him “a real tough guy.” Pollack called himself a business guy or a people guy or just a “real guy”—someone who, he frequently said, “barely graduated high school” but had common sense.

In his first Fox News appearance, four days after the White House meeting, Pollack still looked shellshocked. He'd always seen Meadow, whom he'd named after Meadow Soprano, as the toughest of his three children, the one who seemed most like himself. When the host asked what he thought of the calls for gun control, Pollack accused him of “polarizing this event.” “You didn’t say one thing about fixing it!” he exclaimed. For Pollack, to “fix it”—a phrase he’d make his signature hashtag—meant fortifying schools like courthouses or airports.

In subsequent Fox appearances, Pollack liked to observe that his opponents were driven by an agenda—trying to politicize his daughter’s death—but he was not for any party except the party of your kids coming home after school. Though he said he’d never tied a tie in his life before the shooting, he now wore suits almost daily for interviews or meetings with state legislators, governors, members of Congress, President Trump and Secretary DeVos. His social media following swelled to more than 120,000 people. His dog Sonny became a repeat attraction on the Twitter account “Conservative Pets.”

Sometimes, Pollack marveled at the man he’d become. His daughter’s murder had empowered him. “I could walk through flames right now,” he said in that first interview on Fox. He sometimes referred to himself as “Mr. Pollack,” as in, “Nobody’s even looking at this except Mr. Pollack.” He almost always called his daughter’s killer by his inmate number, 18-1958.

Despite his growing profile, Pollack read every message he received, afraid of missing a vital clue in his mission to expose what had gone wrong. So when Kenny Preston reached out to families of MSD victims about his report, Pollack rallied other parents to sign a letter to the school district, demanding answers. He would later write that he told Preston, “Listen, I don’t give a fuck if it turns out you’re wrong. So what if it blows up in my face? ... I want to know everything, and you’re doing the right thing.”

Back in Washington, Eden was also impressed by Preston’s tenacity. Preston had challenged the school board even after a two-hour meeting with Runcie, three victims’ families and 10 district officials, in what Preston saw as an attempt to “reeducate” him. “He’s my fucking American hero,” Eden told me. He viewed the school district’s reaction as a sign that it had something to hide and decided to go to Parkland himself, to see what he could find out.

There, Eden met with 15-year-old Anthony Borges, who’d been shot five times while holding a classroom door closed to protect other kids. His family had sued the district, charging that PROMISE was part of a lenient “atmosphere of the whole school.” Borges had only recently been released from the hospital when Eden visited him in his bedroom. He had fresh surgical incisions healing on his wiry torso and a colostomy bag sticking out the side of his stomach.

Eden hadn’t planned to talk to Pollack, who was so frequently on television, “pointing every finger at everything that was popping up.” Eden figured if he knew anything about PROMISE, he’d have said so, loudly. Plus, even from a distance, Pollack seemed “really intense.”

But then Pollack invited Eden to his Spanish-tiled ranch house in Coral Springs. Pollack had joined the newly established Marjory Stoneman Douglas High School Public Safety Commission, which was undertaking an exhaustive inquiry into the tragedy, and he wanted advice. Eden suggested he find out about Cruz’s disciplinary record—whether Cruz had committed any crimes he wasn’t arrested for. His contention was that if Cruz had been arrested at school, a criminal record could have prevented him from buying a gun. Pollack said he was told that the commission wasn’t sure whether the district had yet shared all the relevant records. He, too, sensed a cover-up. (The commission would later confirm the district had cooperated fully in sharing information.) Pollack made Eden an offer: If Eden would help him with an “independent investigation,” Pollack would introduce him to everyone he could find, put him up in his house for free, even reimburse his flights.

Between April and September of 2018, Eden came down to Broward every several weeks. The independent investigation turned into a book that he and Pollack would write together. They made an odd pair: Eden’s cool, preppy eloquence and Pollack’s brash swagger. The two men had almost nothing in common—“I can't imagine any circumstances under which we would have struck up a friendship,” Eden said—yet they reached a point where each knew what the other would say about anything they found. They are both Jewish, said Eden, and that seemed significant. Pollack leaned into this idea, telling Eden their collaboration was “like a Moses and Aaron thing.” Pollack believed he was channeling something he couldn’t express, but that was why Eden was there—to help him find the words. He had come to see PROMISE, and everything it stood for, as key to the entire tragedy. As he put it: “The reason [Cruz] murdered my daughter and 16 other people was that the system around him was even sicker than he was.”

At the Broward County School Board building, a high-rise in downtown Fort Lauderdale just steps from the courthouse, district officials couldn’t believe that PROMISE was becoming a scapegoat for the shootings. Chief Academic Officer Daniel Gohl started a spreadsheet to track the spread of the claims. At first, he said, the attacks seemed like “throwing spaghetti against the wall.” But then, they started to stick, maybe because PROMISE tapped into so many cultural divisions at once: debates about child-rearing and which kids are dangerous, suspicions that the Obama administration had favored minorities, and simmering racial and political tensions within Broward itself.

As the strongest Democratic county in the state, where Democrats outnumber Republicans nearly 2-to-1, Broward conservatives bitterly resented what they saw as monolithic liberal power. Runcie’s tenure in Broward had been complicated by some of his efforts to combat inequality: A decision to transfer a star principal from an A-rated suburban school to an F-rated inner-city institution had rankled.

Runcie himself viewed the attacks on PROMISE as part of a Trump-era push to undo anything associated with Obama—even if “what we put here in Broward County had nothing to do with the Obama administration.” He found himself starring in Parkland conspiracy theories, including one that accused him of working with Sheriff Scott Israel (and Obama, and Hillary Clinton) to let Cruz loose in order to facilitate a gun grab. The Borges’ family attorney, Eden later wrote, told him he’d learned about PROMISE from a blog that urges traditionalist Christians to migrate to a “Redoubt” of survivalist communities in Idaho and that blamed PROMISE in part on George Soros. Like a constant drumbeat below these claims was the knowing repetition that Runcie hailed from Chicago. After a while, noted Runcie, who said he spent the first few weeks after the shooting working 15-hour days, seven days a week, “I stopped looking at all the stuff from what I call ‘the crazies.’”

A week after Preston’s school board speech, a community forum was convened at a local high school. Nearly two months after the shooting, it was clear there had been real and systemic failures across multiple agencies. The FBI and Broward County Sheriff’s Office hadn’t followed up on obvious warnings, including a tip about a YouTube video in which Cruz allegedly declared he was “going to be a professional school shooter.” Sheriff's officers had contact with Cruz’s family 43 times since 2008, but he’d never been arrested. There was also the inaction of the SRO posted at Stoneman Douglas on the day of the shooting and the fact that multiple staff hadn’t confronted Cruz or called a “Code Red” lockdown.

But when it came time for parents, students and teachers to voice their anger, PROMISE was a recurring target. A teacher from South Plantation who’d lost a loved one at MSD said the program had “created a safe haven for criminals in our schools.” A father of three Parkland students waved a copy of a disciplinary document, claiming that it allowed “students convicted of rape and murder to sit next to our kids.”

Runcie and other district employees tried to explain that the program was used for only 2 to 3 percent of all student behavioral offenses and that 90 percent of its graduates weren’t repeat offenders. A black teenager, dressed sharply in a dress shirt, suspenders and bow tie, came to the mic to say he’d attended PROMISE after a drug offense, and it had opened his eyes—that “every day someone was talking about life choices.”

But none of that seemed to matter, as dozens of speakers lined up for more than an hour. A mother suggested that when the district hired security contractors, it favored “minority and diversity outreach” vendors over those with safety expertise. Members of the audience shouted: “Where is the money?” One father told Runcie he’d watched him during the Pledge of Allegiance and hadn’t seen his lips move. Runcie clenched his jaw and said nothing.

Kenny Preston took the mic again, more combative than the week before. “I don’t want a runaround,” he admonished Runcie. When Preston called for the district to vote out the existing board and elect new leadership, the applause in the room was deafening.

The city of Parkland is a pristine, almost antiseptic landscape of more than two dozen interlocking gated communities. For years, strict zoning laws prohibited the construction of any stores within its limits. In 2017, it was named the safest city in Florida. Marjory Stoneman Douglas, nestled amid the pink stucco, palm trees and man-made lakes, had long been considered the district’s most desirable school.

Many months after the shooting, messages of support were still draped on the buildings surrounding MSD. Gauzy purple bows hung from the trees lining the school driveway; #MSDStrong T-shirts were everywhere. Bereaved parents who’d been counseled to stay busy created foundations in their children’s names, made rubber bracelets with different colors for the victims, became lay experts on ballistics or metal detectors.

Whenever Eden visited, he stayed in a house that felt haunted. Earlier that spring, the far fence of the Pollacks’ backyard tennis court had been interwoven with pink tape spelling Meadow’s name, for a memorial playground fundraiser. The tape remained there for months, a physical reminder of her absence, alongside subtler reminders, like the part of the fence that was damaged when a tree fell on it but never got repaired.

Every morning, Eden and Pollack walked to Pollack’s favorite cafe in a nearby retail strip for breakfast. Eden spent his days interviewing MSD teachers, administrators, students and parents. He found he could only stay in Parkland for a few nights at a time. Talking with traumatized people and learning more about Cruz left him feeling exhausted and dirty. He watched one source, a teacher who’d been at the school that day, sink into depression. He couldn’t sleep at all in Broward, nor well in Washington—only in his childhood bed at his parents’ home in Cleveland. So that summer he flew in a triangle, from Broward to Cleveland to Washington, then back for another round.

Pollack, meanwhile, could never turn off. “With Andy, it’s the same at 7:30 a.m. as it is at 11 p.m. as it is at 3 p.m.,” Eden said. “I don’t think he can do anything else.”

“This is my life now,” Pollack would tell reporters—so many reporters he couldn’t remember whom he’d spoken to.

That summer, Pollack threw himself into the campaign to oust Runcie. At a backyard barbecue with other MSD families, Preston, Pollack and others brainstormed candidates. They hoped to elect three to four new school board members to form a five-seat majority that could unseat Runcie and shut down PROMISE. Preston and Pollack met with Lori Alhadeff and Ryan Petty, two parents of Parkland victims.

Pollack also approached Richard Mendelson, a former MSD social studies teacher and wrestling coach who teaches in the psychology graduate program at Fort Lauderdale’s Keiser University. Mendelson had been a close friend of Aaron Feis, one of three MSD coaches killed by Cruz. Soon after the shooting, he wrote Pollack to offer his support, and after the idea of running was proposed, he quickly agreed. His opponent would be Laurie Rich Levinson, who had signed the original PROMISE agreement as a representative of the school board. The battle lines couldn’t have been clearer.

The anti-Runcie forces got an early boost in May, when a local NPR station reported that Cruz had been referred to PROMISE, despite Runcie’s repeated assurances otherwise. Runcie’s staff returned to their records—distributed across 17 different data systems, plus paper archives—and eventually found that during the first month of PROMISE’s existence, in November 2013, an eighth-grade Cruz had been referred for breaking a bathroom faucet. They couldn’t confirm whether he’d actually attended.

Later, even some of the most vehement critics, including Eden, would admit that it was probably some kind of records mishap. But to Pollack, it was hard proof that Runcie, “a guy with a Harvard education,” had intentionally misled the people of Parkland. A week later, Petty and Alhadeff jointly announced that they were challenging two school board members as an explicit rebuke to the district.

I met Alhadeff, a teacher turned stay-at-home mother, in the empty banquet room of her gated community’s clubhouse. She recalled how at the shiva for her daughter, “hundreds” of people told her, “we want change, we want change”—but then were unwilling to do anything. “It just became very clear to me that I needed to be able to step up,” she said. Both Alhadeff and Petty called for school security improvements, like bulletproof doors, and vowed to review PROMISE. Petty tweeted that such programs created “perverse incentives” for schools, while Alhadeff told reporters that the district had swung from “over-disciplining kids to not disciplining kids at all.”

Eden said Pollack had sometimes struggled to grasp his systemic arguments about school discipline reform—how the specifics of Cruz’s story connected to Eden’s broader thesis. But Pollack’s quest for “accountability” became all-consuming. In June, Pollack learned that the school guard who’d failed to confront Cruz had almost been fired the year before, over allegations that he’d sexually harassed several students. One was Meadow. The guard, who denied the accusations, had received a three-day suspension. Pollack was enraged to discover that he was still working at MSD. That, Eden recalled, was when the culture of Broward schools became a “cosmic problem” for his friend. Pollack stepped down from the MSD safety commission and took on the management of Mendelson’s campaign.

Mendelson seems to relish the incongruity of his large, boisterous bearing and his fondness for intellectual debate—a bookish jock. We met at a Starbucks, along with Ray Feis, the younger brother of his late friend, Aaron. Ray has the same bald head and glasses as his brother, the same ruddy coloring and red beard. He’d lived next door to Aaron but had sold his house after the shooting. “It just didn't feel right, seeing other people move in and him not being there, you know,” he told me. During our conversation, Mendelson turned to a coffee-stained copy of a Broward policy document to argue that “even capital offenses”—like rape and murder—“are considered school-based discipline issues now.”

The issue of school discipline was finally attracting national attention among conservatives. In mid-July, Pollack and Preston traveled to Washington, D.C., to speak at the high school leadership summit of Turning Point USA. The pro-Trump group had recently named an MSD student as its high school outreach coordinator. At the TPUSA event—which offered scholarships to cover expenses for MSD students—Senator Marco Rubio introduced Pollack in a video. Pollack called on the audience to volunteer for Mendelson’s campaign, calling it “the single most important political race in 2018.”

Pollack had also gained an unlikely ally in Tim Sternberg, a former assistant principal at Pine Ridge, where the PROMISE program is housed. Sternberg believed, he said, in dismantling the school-to-prison pipeline. But he’d come to view PROMISE as disorganized and ineffective. (In addition, he claimed to Eden, he’d been passed over for two promotions that went to black candidates.) When Sternberg resigned in 2017, he sent a flurry of emails to Runcie and others about what he saw as the program’s shortcomings but was unsatisfied with the responses. Even though Sternberg believed the program was ultimately salvageable, he began sharing information with Eden and Pollack. “I started almost joining a bandwagon of ‘PROMISE, PROMISE, PROMISE,’” he said.

The MSD safety commission tried to calm the furor. In mid-July 2018, its chair, Pinellas County Sheriff Bob Gualtieri, emphatically declared to reporters that PROMISE was “completely irrelevant, it's a rabbit hole, it's a red herring, it's immaterial.” But there was too much anger swirling around the school district and its officials, some of it stemming from unrelated grievances. The district had sometimes appeared less than forthcoming with the press or public. Promised security updates had been delayed, and family members of the victims accused the district of doing a poor job of attending to survivors’ needs. One victim’s mother, who was also a Broward elementary principal, initially wasn’t paid when she took bereavement leave. That summer, a Sun Sentinel investigation found that MSD—like many other Florida schools—had underreported campus crime, in order to attract or retain students.

And, in August, the Sun Sentinel discovered that an outside consultant had found serious failures in how the district—as well as other local agencies—had handled Nikolas Cruz. According to Cruz’s mother, he had suffered from autism, attention deficit hyperactivity disorder and obsessive-compulsive disorder. Under federal disability law, Cruz was supposed to have access to the most mainstream educational environment possible. After being sent to Cross Creek, a school for students with intensive behavioral issues, in middle school, he’d done well enough to be transitioned to MSD by 10th grade. However, when he was 18, district staff had incorrectly allowed him to forfeit his disability status in order to stay at MSD, even though he’d displayed disturbing signs of needing help, including bringing dead animals and bullets to school, cutting himself and discussing suicide attempts. In the eyes of the district, he was now a general education student and ultimately had to withdraw after failing classes. Days later, he bought the AR-15 he’d use to kill his classmates. When his mother later tried to re-enroll him in Cross Creek, the district failed to follow through.

Even MSD families who didn’t share Pollack’s politics, or his focus on PROMISE, began to join the calls for Runcie’s ouster. One of the most high-profile was Fred Guttenberg, whose 14-year-old daughter Jaime was Cruz’s second-to-last victim. Guttenberg had become a full-time advocate for gun control after Jaime’s death. He tweeted that Runcie had “lost the faith” of those he was supposed to lead and that the school board needed a “wholesale makeover.”

An already ugly race turned uglier. “Oust Runcie” bumper stickers, in MSD colors, proliferated around Parkland, although some critics referred to the superintendant as “Duncie.” On Twitter, Mendelson wrote that the election was “good versus evil” and would decide whether children “will return home safely each afternoon.” He hinted to me that Broward’s problems were partly caused by its mistaken focus on diversity. “If you were to look at the demographics of people who have been advanced into leadership roles in the past decade, as opposed to the general populace, you would see a vast difference, because they misinterpret what diversity means here,” he said. “I don’t know if I’m comfortable going further than that because I wouldn’t want the implications of that to be put in print with my name next to it.”

When early voting started in mid-August, Mendelson’s and Levinson’s volunteers set up camp across from each other at polling stations. Pollack was a daily fixture at one, often showing up with his dog. Ray Feis manned the table at another location daily with his younger sister. He’d been undone by Aaron’s death, friends said, and had quit his job as a manager at a pool repair company to focus on the campaign. Almost every day, the police were called to polling stations following accusations of harassment from both camps. Levinson said that Mendelson volunteers called her a murderer with blood on her hands. Ray Feis in turn claimed that when he introduced himself to Levinson’s husband, “he started cursing me out.” (Mendelson said, “I cannot speak to every polling site, but where I was located, this simply did not happen.” Levinson said on behalf of her husband, “He did not use any curse words. He wouldn’t shake his hand because of what they were saying about his wife all day.”)

One day, two deputies questioned Mendelson, responding to complaints that supporters had been heard screaming at voters, “You don’t care about my brother.”

In Fort Lauderdale, the officials who’d created PROMISE repeated a sentiment so often it seemed like a mantra: that this was grief, and grief was a process, and that they had to respect that process no matter what form it took. Sometimes, though, respecting the process made it hard to defend themselves.

At public forums where he or PROMISE were frequently attacked, Runcie’s face was a mask of calm: listening and nodding; responding in measured tones; biting his tongue when attacked; making himself available to talk even as critics claimed in viral videos that he was ignoring them. One-on-one, he was considerably more exasperated. “Hell yeah,” there were kindergartners in the PROMISE program who could have otherwise gotten arrest records for having tantrums, he told me. This “law enforcement criminalization mentality,” he said, “man, we know that doesn’t work.”

Runcie argued that the real problem wasn’t excessive leniency, but that Broward’s disciplinary standards were still unevenly applied. Broward’s wealth distribution is often described as following a roughly east-west axis, dividing Fort Lauderdale and other eastern communities that struggle with urban poverty from wealthy western suburbs like Parkland. Multiple educators told me they suspected that, contrary to public perception, it was the wealthy western schools that were most likely to underreport infractions.

“You’ve got a lot of people in the communities that make the most noise about our discipline,” said Runcie. And yet, “they’re the very first ones to come in and say, you know, John or Sally is a great straight-A student; they’re going to be graduating this year and we don’t need some discipline record that will taint their chances.”

Those are the schools, he continued, where parents mediate off-the-record resolutions to fights or bring in lawyers to contest a three-day suspension. “Think about that,” he continued. “What kid in a middle-class or poor community [can] get an attorney to show up with their parent at school and say, ‘I need this taken care of’?” Weekes, the public defender who helped develop PROMISE, argued that administrators need the discretion to say, “‘I know this kid and this kid’s mom just lost her house or got a divorce—they acted up for two days after that.’” But, he went on, “We want that to happen across the board, with all children. And it wasn’t happening so much with children of color.”

There are no hard numbers measuring how many students get these kinds of informal second chances. But in a state where every school gets graded, and real estate prices reflect those grades, said Daniel Gohl, the district’s chief academic officer, “I see how we set up a system that pits schools against each other and doesn’t treat data neutrally.”

Tim Sternberg sometimes worried about what would happen if his new friends in the anti-PROMISE brigade got what they wanted. “Then what?” he asked. “Then we’re back to kids being arrested at 10, 11 years old? The kids in the west will continue getting away with what they get away with, because that’s what they’ve always done, and the administrators in the east will do what they do, so those kids all get arrested?”

Runcie looked increasingly exhausted. His own children had received death threats at their schools or jobs. Over the years, he had taught himself to cope with trauma: As a child, his mother had been shot in the face in a hate crime while he sat beside her on their front porch. In Chicago, 300 to 400 students in his district were shot every year. “You need to find ways to create positive things out of tragedy,” he said, “or you go around creating more tragedy.” The idea of responding to the Parkland shooting by throwing the book at students for offenses that didn’t endanger school safety struck him as morally wrong. “If that’s what we’ve gotta do,” he said, “then I’m just not gonna do this work.”

On August 28, election night, the Mendelson camp gathered at a Coral Springs restaurant to wait for the returns, feeling sure of victory. They’d raised over $40,000, knocked on 50,000 doors. “How could you not vote this man in?” one supporter asked. “He was going to be the savior of this community.” But when the results came in, Levinson had won with 56 percent of the vote. (Lori Alhadeff won her race, while Ryan Petty did not.) MSD students who’d volunteered on Mendelson’s campaign were weeping, as were some of the adults. “I don’t know the last time that I cried before these candidates lost the school board race,” said Eden, who described the campaign as a joint effort, despite his intentions to maintain “journalistic detachment.”

Pollack found himself filled with disgust. In a county that had become synonymous with contested elections, he doubted the veracity of the results. But then, he reasoned, it was par for the course in the “politically correct cesspool” that was Democratic Broward. He put his house up for sale. “I gave it my all,” he told me, “and now it’s just like, let Rome burn, let Broward burn.”

Pine Ridge Education Center, where the PROMISE program is housed, is a bustling, friendly place. When I visited last October, kids and their parents waited for appointments in the front office, which was decorated with gigantic, candy-colored blowups from the Dr. Seuss book “Oh, the Places You’ll Go!” Most of the high school students were there for fighting or marijuana possession. In one class I attended, they worked in clusters to answer questions about substance addiction. In a room across the hall, middle school children plugged missing words into sentences on the blackboard about self-esteem and bullying.

The week before, Mickey Pope, the Broward school official, had taken a local mayor on a tour of the school. She said the mayor had been taken aback to discover elementary school students there—like many others, she'd thought PROMISE was for chronic delinquents, or at least much older kids. When they encountered a 5-year-old attendee, the mayor knelt beside him. “Baby, why are you here?” she asked. “I was bad,” the boy told her. He’d gotten mad and started crying, then kicked his teacher when she tried to take him to the office. (Before PROMISE, Pope said, he could have been arrested for battery of a school board employee.)

The attacks on PROMISE had left its staff demoralized and depressed. Dr. Henry Brown, Pine Ridge’s principal, had come back to work early after having open heart surgery to throw a small party for his staff, in an attempt to cheer them up. He reminded them to stay focused on the students, but it was difficult. There was already a perception that theirs was a bad school, full of bad kids, and now that perception had hardened along racial lines. Black parents, he said, continued to see PROMISE “as an opportunity to help their child from becoming another statistic,” while vehement opponents had little understanding of the program or the students it served. PROMISE students, he said, included kids in foster care, kids facing the possible deportation of a parent, kids shouldering outsize responsibilities while their parents worked multiple jobs. One fourth grader had recently wanted to set up a lemonade stand so her mother could find someplace to live.

Laura Kolo, a coordinator who’d been with PROMISE since its second year, insisted that contrary to the criticisms, the program did have a curriculum and a structure, one that had been vastly transformed since its inception. Students rarely returned more than once, and the majority of those that did were in elementary or middle school—not the dangerous teens depicted in public debate. When “high alert cases” came in—students who required more intensive intervention than PROMISE could provide—the public didn’t see the effort that went into connecting them with social services, therapy and legal help. “We would say, ‘Come visit! Look what we’re doing, the lives that we’re changing,’” said Kolo. “Sometimes the kids are good, sometimes they’re not so good. That’s what we’re dealing with.” But, she said, the critics never came.

The battle over PROMISE had rattled its creators, too. A month after the school board election, the district’s Schoolhouse to Jailhouse Pipeline Committee held its quarterly meeting. Before the shooting, its members used to talk about how to make the program better, poring over data about patterns for various offenses. These days, their work was inevitably derailed by conversations about preventing another shooting—a crucial subject, but not the committee’s responsibility. From a corner of the table, Gordon Weekes interjected wearily: “We’re here to talk about minor school-based misbehavior.” It was important, he felt, not to let the kids who needed PROMISE get lost in the aftermath of the tragedy.

For Weekes, the situation was particularly fraught. He had helped develop PROMISE, but, as a member of the public defender’s office, he was also part of Cruz’s legal team. On the day of the shooting, he’d been one of two staffers sent to address the media and had broken down on national television while noting the number of the victims.

In his role as Cruz’s co-counsel, Weekes had criticized the district for “all the missed opportunities in this matter.” When I spoke to him in September, he couldn’t discuss whether he believed Broward had a culture of leniency, he said, because that might be “a pivotal issue in our case.” In other words, as part of Weekes’ legal duty to explore every avenue of defense in a death penalty case, he might have to attack the operation of a program he believed in, deeply, for everything it had done for Broward’s students of color.

Another committee member, Judge Elijah Williams, observed that it was Columbine that had prompted a larger police presence in schools in the first place. “That’s how we got into this mess,” he said. It had taken 10 years, as thousands of kids were needlessly funnelled into the criminal justice system, for schools to address the harm that was being done. Now, Williams lamented, the post-Parkland clamor for more school guards threatened to land them right back where they’d started.

As the first anniversary of the Parkland shooting drew near, the community planned moments of silence and days of service to honor their dead. At the time, Eden wondered whether Pollack, who’d poured his grief almost entirely into his battles, was having trouble accepting that “there’s only so much that can be fought, and we’ve just about reached the end of it.”

Pollack sold his house and went on the road in his camper. In 2018, he’d promoted an initiative, named for Aaron Feis, to install more armed guards in public schools; one county training included a virtual reality simulation in which potential guards practiced shooting a gunman on campus. Now, Pollack met with police chiefs across Florida to warn them against programs like PROMISE. In an interview on NRATV, he declared he would “take [Runcie] out if it’s the last thing I do on earth.” “Him or the PROMISE program,” he told me. “One of them is going to go.”

In early February, the Sun Sentinel reported that the former MSD security guard who failed to confront Cruz had requested a protective order against Pollack. He said that Pollack came to a youth baseball practice he was coaching, shouting that he wasn’t through with him yet. (“It's not accurate. I showed up at the game because I couldn’t believe that those parents would let their kids be coached by a guy like that,” Pollack said. “I wasn’t heckling him. I just told him that I have my lawsuit and that I’m not through with it and him yet.”)

In late 2018, Eden and Pollack finished their book, “Why Meadow Died.” Due out later this year, the book delivers Eden’s policy arguments in Pollack’s everyman voice. They hadn’t tried to interview Runcie or visit Pine Ridge. But the book’s seventh chapter opens with a surprising line: “The fact that the PROMISE program is a farce is interesting and noteworthy, but it bears little direct relevance to the tragedy.”

In late December, the MSD safety commission had come to the same conclusion. Buried beneath its unexpected recommendation to allow arming teachers, the commission’s report found that even if Cruz had been referred for arrest in 2013 over the broken bathroom faucet, Florida law would have mandated his immediate release to his mother. In addition, any record Cruz might have received for such a minor offense wouldn’t have prevented him from buying a gun. “I’ve been battling this for eight, nine months,” said Sheriff Bob Gualtieri, MSD safety commission chair, at one school board meeting. “People say, well, if he’d been arrested that would have prevented him from being able to purchase the firearms. That is 100 percent false and not true whatsoever.”

After finishing the book, Eden began emphasizing to me a point he hadn’t made before: that in his initial City Journal op-ed, he had never actually mentioned the word “PROMISE.” He told me he had only intended to suggest that its potential role was a question someone should answer. Now, he was worried that his book would be dismissed as the NRA counternarrative, and that, if DeVos withdrew the Obama discipline guidance, newspaper headlines would read: “Unconnected effort to reduce discrimination is a casualty of the Parkland shooting.” He began saying that the criticisms of PROMISE had been caricatured and that to claim the program was the sole cause of the massacre “would be a dumb argument indeed.”

In truth, Eden had come to view the Parkland shooting as more complex than he’d originally understood. Now, he said, he saw it as a story of intersecting institutional failures, less about excessive leniency alone and more about how schools handle students with extreme behavioral disabilities. The policy pressures to place Cruz in the most mainstream classroom setting possible, he contended, combined with the expense of special education, had prevented Cruz from being placed in the alternative school setting he needed. (Runcie said cost is "not part of the conversations" when specialists determine the best educational placement for students.)

It was an argument that raises important questions, but also one less amenable to electric reaction. Balancing the right of students with disabilities to reach their full potential against the rights of other students to learn without disruption is a challenge everywhere, and even more so at schools like MSD. One of Pollack’s and Mendelson’s most outspoken volunteers proudly told me how she’d forced a principal to put her special-needs son in regular classes so that he wouldn’t pick up bad habits from the kids in special ed. As Eden acknowledged, it’s an issue that “doesn’t cut super neatly either way.”

But by the time Eden had reached this conclusion, his hoped-for goal had been achieved. In December, DeVos and acting Attorney General Matthew Whitaker officially withdrew the Obama guidance. As a result, some school districts may repeal their reforms and the Department of Education will likely be less aggressive in investigating alleged discrimination. And on February 13, a day before the anniversary of the shooting, Florida’s new Republican governor, Ron DeSantis, whom Pollack had campaigned for, called for a grand jury investigation into whether the school district bore any responsibility for the shooting. In addition, he ordered a statewide audit of all diversion programs, specifically naming PROMISE.

That month, the movement to fire Runcie also came to its heated conclusion. On February 25, the district held its third town hall meeting on school safety. Kenny Preston was there, and so was Tim Sternberg, who’d recently announced his own candidacy for the board, championing Pollack’s #fixit slogan. It might have been a replay of all the other meetings—but this time, Runcie had defenders: more than 1,000 people attended, many from other parts of Broward, many of them black. Some came on church buses. Some may have been alerted by an email sent by a district employee, who described the rhetoric coming from Parkland as “like nothing that has been seen since desegregation orders were enforced”—a characterization that angered many critics. Runcie’s supporters expressed condolences to the grieving families but said their side of town hadn’t been represented in the debates over the last year.

The vice mayor of West Park condemned “people who are pimping the pain of the victims” for political or personal vendettas. A state senator who represents parts of eastern Broward declared, “Just as strongly as you feel about getting rid of Bob Runcie, we feel just as strong that it ain’t going to happen.” Fred Guttenberg spoke, wearing a shirt bearing Jaime's name and evidently distressed. “The bullet that shot my daughter did not know what color she was,” he said, jabbing his finger in the air. “And I’m frustrated as hell at what’s happening in this room tonight to make this about color and socioeconomic status.”

But for many of the black attendees at the town hall, the attacks on PROMISE had always been about color. After the meeting, online Runcie critics wrote that “the ‘bused’ people” had “taken over” the meeting and left no room for “legitimately concerned parents.” Pollack tweeted that Runcie was “trying to spark racial conflict” in “a demented effort to save his job.” After a school board meeting the next day, Lori Alhadeff called for a vote on whether to fire Runcie for “willful neglect of duty.”

The vote took place on March 5. Hundreds of people spilled into the halls and two overflow rooms. Over more than four hours, five people spoke in favor of Runcie’s termination, including one victim’s father. Eighty spoke in his defense, including local politicians, educators, clergy and two black mothers of MSD survivors. Many emphasized that Parkland was not the only community that had lost, or stood to lose, its children. “We grieved for you in a way that you’ll never understand,” said one man with a soft Caribbean accent. “It ripped our hearts open.” Others spoke of the need to move on. Runcie’s wife, Diana, spoke last. She recalled her husband coming home the night of the shooting, crying, and telling her, “I can’t believe I lost my babies.”

Alhadeff’s motion lost, 6-3. Runcie would stay. He told me that he hoped the district could harness all that passion from the meetings to find a way forward. To him, the fight over PROMISE had raised “a big philosophical question [about] what we mature into as a society, how we raise our kids, how we develop human beings. Do we recognize that all our fates are connected together? That what happens to you ultimately is somehow going to impact me?”

But a year after the shooting, not all shared such an optimistic view. Parents who’d become close in the immediate aftermath of the shooting had become estranged over political differences; the county seemed more polarized than ever before. At that final town hall, Fred Guttenberg took stock of the situation with a muted, weary anger: “My daughter is dead, and this community is coming apart.”

CREDITS

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This article was reported in partnership with Type Investigations.

Story - Kathryn Joyce

is a contributing writer for Highline, a reporter with Type Investigations and the author of “The Child Catchers: Rescue, Trafficking and the New Gospel of Adoption.” Her work has appeared in The New York Times Magazine, The New Republic, Pacific Standard and many others.

Creative Direction and Design - Una Janicijevic

is an art director in Toronto.

Research - Ben Kalin,

formerly of Vanity Fair, is a veteran fact-checker and the founder of Fact-Check Pros, a full-service fact-checking agency.

Development & Design - Gladeye

is a digital innovations agency in New Zealand and New York.

Now We're Talking

Leading the Democratic National Committee is never easy. In a party notorious for circular firing squads, the DNC chair has to dodge crossfire from southern centrists, urban activists and western iconoclasts—without taking a bullet himself. But the job is especially fraught this year. In the first midterm election of the Trump era, Tom Perez is trying to flip seats in blood-red America while also rallying the Resistance.

Perez has been chairman of the DNC since early last year. He took office on the heels of a scandal. In the 2016 primary between Hillary Clinton and Bernie Sanders, the DNC negotiated a secret fund-raising agreement to benefit the Clinton camp. Public exposure of that deal enraged Sanders supporters and led to the first contested election for a DNC chair in more than 30 years. The ensuing campaign, between Perez and Congressman Keith Ellison, only deepened the party’s divisions. Ellison, a stalwart progressive, was among the most ardent supporters of Sanders in Congress. His bid for control of the DNC reflected a movement to dislodge the establishment. Perez, meanwhile, was widely seen as a fixture of that establishment. After serving in the Justice Department under Eric Holder, he was named secretary of labor, where he inflamed the left by removing penalties on five banks that were convicted of market manipulation.

When DNC members elected Perez as chair, the left wing of the party raised alarms—but Perez quickly installed Ellison as his deputy and the two claimed to begin a “bromance.” Since then, Perez has guided the Democratic strategy for the midterms. His approach has been either pragmatic or erratic, depending whom you ask. He has praised democratic socialist Alexandria Ocasio-Cortez as “the future of our party,” even while promising to support Democrats who voted for Supreme Court nominee Brett Kavanaugh and endorsing the calcified New York Governor Andrew Cuomo against upstart Cynthia Nixon. Perez believes these are tactical choices to help Democrats on November 6. His critics believe his ameliorist tendencies are a threat to the party’s core values. A blue wave could assuage those critics, while anemic returns could lead to his ouster. In a 30-minute discussion five days before the election, under the wary oversight of his deputy communications director, Sabrina Singh, Perez tried to explain why his agnostic approach is the best way to run the map.

This interview has been lightly edited and condensed for clarity.

I wanted to start with a foundational question. Is Donald Trump a racist?
You don’t think we have enough evidence to say he’s a bigot?
This is a guy who has called for a “Muslim ban,” who wants to revoke birthright citizenship, who’s sending 5,200 active-duty troops to the border based on hysterical lies. He’s presided over a 57 percent jump in anti-Semitic incidents. I mean, if a progressive man of color who’s running the party can’t call that “racism” in the heat of an election, what kind of opposition party is this?
But don’t you think—
And yet, his approval rating in one poll is at 47 percent. That’s his highest ever. It’s up to the Democrats to get their message through—if he’s a racist, why are you afraid to use the word?
Nope. But I am interested in that.

Perez speaks at a rally outside the White House after President Trump’s firing of FBI Director James Comey in May 2017. GETTY IMAGES

We’re in the run-up, and we just saw the Tree of Life disaster, we saw Cesar Sayoc…
When you see Chuck Schumer tweeting that both sides commit despicable acts of violence, do you think that’s calling it out enough?
It’s a tweet. He said, “Despicable acts of violence and harassment are being carried out by radicals across the political spectrum—not just by one side.” Do you worry, as the head of the party, about that kind of false equivalence?
Well, I think this is a big part of the political landscape.
Right—“Anybody that can do a body slam, he’s my kind of guy.” "I categorically reject your suggestion that the chances of winning the Senate have collapsed."
Let's talk about the midterms. The House looks solid for Democrats, but the chances of taking the Senate have collapsed. How should we understand that?
OK.
But you must be watching these poll numbers and forecasts. The chance of Democrats taking the Senate has dropped from 34.5 percent to 15.1 percent over the last two months.
Your biggest challenge is that the whole electoral system has structural disadvantages that favor Republicans. Just looking at the Senate, 18 percent of the U.S. population now commands a majority. There’s also massive gerrymandering in the House and, of course, there’s the Electoral College. How can Democrats get back from those structural deficits?

Supporters of Doug Jones celebrate his surprise victory for the Alabama Senate seat in December 2017. GETTY IMAGES

Do you think it’s useful to give D.C. and Puerto Rico voting representation in Congress to balance the structural challenges?
Some of the races coming up are much closer than they should be. I’m thinking of Bob Menendez, for example. He won by 20 points in New Jersey last time, and this year, it’s a toss-up. Should party leaders have demanded that he step down?
What was your thinking when you said that you would continue to support a Democrat who voted to confirm Brett Kavanaugh to the Supreme Court?
Right.
But what’s the point of electing Democrats who don’t even vote with the party on something as fundamental as protecting women from sexual assault?

Senator Joe Manchin ponders the best interests of voters in West Virginia. GETTY IMAGES

Well then, do you think Heidi Heitkamp did the wrong thing by voting against him?
But they had similar political challenges, and she did the opposite.
Let me ask you about the DNC. Why should Democrats accept money from fossil fuel companies?
But the DNC banned donations from fossil fuel companies this summer, and you revoked the ban. Then the committee tried to limit donations to just $200 from workers at those companies, but you pushed to allow executives and political action committees to donate as much as they wanted. Isn’t that taking dirty money?
I just described two.
How does accepting money from fossil fuel companies help stop climate change?
I know you haven’t taken the money. I’m talking about the policy to allow it in the future.

Perez with DNC Deputy Chair Keith Ellison in February 2017, right before Trump’s first address to Congress. GETTY IMAGES

Do you see the Democratic Party as moving to the left?
Are there any positions, like a commitment to women’s reproductive rights, that should be a fundamental requirement for a Democrat, say in 2020?
But you said voting for Kavanaugh is not disqualifying for a senator. What’s the difference?

You know what’s funny? Your jail anklet saved your life. They should put that in an advertisement. They should get a testimonial from you. If it weren’t for that anklet, you’d be dead right now.”

I came to in a hospital bed with a sore head. I reached into my hair and felt the staples in my scalp. A handsome young dark-haired doctor with a bushy mustache and brightly lit, amused eyes was standing at the side of my bed conversing cheerfully with me. I didn’t know how long he’d been talking or if I had been talking back. I seemed to be joining the conversation midstream. But that may have been his manner: Perhaps he simply launched into conversations with his patients and let them catch up when they were ready. I was very thirsty and, still nervously fingering those metal staples, I reached with my free hand for a large plastic cup of water that was on a bedside table. Then I realized that I was handcuffed to the bed.

“Here, let me get it for you.” He tucked the cup between the bed rail and the pillow and bent the plastic straw into my mouth. I drank the water and then spat out the straw. My throat was burning.

“Did I have an operation?” I asked.

“No, you were very lucky. Two minor procedures.” He reached over to gesture at my head, where my staples and my fingers were. “You must have fallen at some point, your head was bleeding. Quite a nasty cut.”

“My throat hurts more than my head. My voice,” I said. “I sound awful.”

“We had to pump your stomach but basically you’re fine. I’m sorry we have to shackle you. They will transfer you to the psychiatric ward tomorrow and then this security won’t be necessary. You ruined your fancy anklet.” He laughed. “It seems to have short-circuited. But not before it sent off its alarm. Modern technology.”

I wanted to explain about my anklet, that it was only to prove I was sober to my then-wife, that it wasn’t a jail thing, but I realized extra details from me would sound defensive. Anyway, I’d been in jail just a few weeks before, for public intoxication, after passing out in a bar near my home in Kansas City.

“Next time, don’t get in the bath. Better yet, don’t have a next time, would you? We’d like to keep you around. And if you want to kill yourself, don’t use pills. Nobody dies from overdosing on pills anymore.” He went into some detail about how to do it, almost as if he were making a suggestion. “There’s even a book you can buy that tells you how. But, you know, you were very lucky, and most people wise up after one attempt. So maybe this can be your get-out-of-jail-free card. That’s how I’d approach it.”

I knew the book he meant. It’s called Final Exit. I don’t recommend it.

“You take care. Try to behave yourself. Things will get better.”

The doctor grabbed my foot, shook it gently, even affectionately, shrugged his shoulders, and left the room.

Well, I thought, that was kind of nice. That was a much more pleasant encounter than you expected with a doctor after you’d tried suicide.

I had an IV in my arm. There was a phone by the bed, but I couldn’t reach it, because it was on the handcuffed side. I had a nurse alert button by my hand, but I didn’t want to beep a nurse to help me make a phone call.

“Three weeks ago I was in bed at home with my girlfriend,” I said out loud, theatrically, to the empty hospital room. “I wouldn’t have done it if I weren’t alone.”

“Three weeks ago everything was normal,” I told myself.

But that wasn’t the truth. My life had been abnormal for a long time.

They woke me up in the middle of the night to transfer me to Research Psychiatric. It was quiet in the ward: Everyone was asleep. Back then, in the winter of 2010, I had extraordinarily vivid dreams, and I loved to dream, because I often dreamt of my children and other good things that were no longer part of my waking everyday life.

“Can’t we go in the morning?”

They took the handcuffs off my wrist but stood very close to me as I got out of bed.

“We don’t decide when you get transferred. Your ambulance is here. You’re going to the psychiatric ward.”

“Why an ambulance?” I asked the ambulance fellows, downstairs at the doors. “Can’t we just take a car?”

The truth was it was walking distance. Maybe two blocks. It’s all on the same hospital campus.

“It’s a liability thing. You’ll get a bill for it. You’re not going to try to run on us, right?” the EMT said. I was shivering in my hospital robe and slippers. It was very cold outside, where the ambulance was waiting. They wrapped a strange, padded vinyl silver blanket around me. I was hot immediately. The field beyond the parking lot was covered in snow. The stars were bright. I thought, that’s what I’d like to be. As far away and indifferent as something in the night sky.

“Run where?”

“You can sit up here with us,” the other EMT said. “It’s not strictly according to regulations, but what the hell.”

It was a bench seat and I sat in the middle, between the driver and his partner.

“It’s like ‘Bringing Out the Dead,’” I said. “Did you guys ever see that movie?”

“Uh-uh,” the driver said. The other one said, “I think I saw it.”

“If you saw it you’d remember,” I said. “It’s about an ambulance driver.”

“Nicolas Cage. And he sees ghosts, right?” the driver said. He had a beard and looked about 20 years old.

“That’s it. You did see it.” I paused for a second. We were pulling up to the psychiatric building.

“You guys ever see any ghosts?” I asked.

I believe that suicidal people can see ghosts in a way that sturdier folks cannot. The Canadian physician and addiction expert Gabor Maté describes addicts like me as living “in the realm of hungry ghosts,” people who have become ghosts while still alive. I think you can almost see when a deeply addicted person, who is killing himself with his drug of choice, is making the transition into the ghost lands.

“Not Scorsese’s best,” the driver said, ignoring or avoiding my question. “I always thought ‘Goodfellas’ was his real masterpiece.”

“Or ‘Raging Bull,’” I said. “That’s one of the saddest movies ever made.”

“I’ve seen a couple of ghosts,” the guy on my right said. “People see them. It’s a real thing. My aunt once had a ghost ask if it could kiss her. A female ghost.”

“No one wants to hear that B.S.,” the driver said briskly, interrupting his buddy. “We’re here. At the psychiatric hospital,” he said, giving the ghost guy a pointed look.

At Research Psychiatric Center, in a tiny claustrophobic office just off the main waiting room—it was, I’d guess, 4 or 5 in the morning—a thirtysomething slender, pale intake nurse asked me: “Are you feeling suicidal right now? Are you having suicidal thoughts?”

I don’t know why, but I was honest with her. Maybe I was still high from the Benadryl they’d given me at the hospital to keep me calm, or maybe I was at the end of my rope.

“Well. Glad you ask. If you leave me alone in here, I will slash my wrists with your scissors. I will hang myself with the blinds. I will electrocute myself with a fucking fork. Yes. What do you think?”

“If you’re feeling violent ... are you threatening me? Are you thinking of attacking me?” She picked up the phone. I noticed she had chubby hands and fingers that tapered down like pyramids. She had a no-nonsense expression and an all-American appearance, with clean, nicely brushed brown hair. She looked like she could have been one of my eldest daughter’s friends, and I regretted what I had said. She was just doing her job.

“No, I’m not feeling violent. I apologize. I’m not having suicidal thoughts.”

I had forgotten to lie about what I was thinking, which is the cardinal rule of intensive psychiatric care: It’s like the “deny, deny, deny” rule for adulterers. With psychiatrists, “lie, lie, lie” is the only way to survive, the only hope of ever getting out of there.

“I just want to sleep. I’m freezing. Are you cold? It’s freezing in here.”

I had the too-hot silver blanket from the EMTs. But it was cold in her office, and I was in the mood to complain. I was still in the hospital robe. I’d lost the slippers, and I was barefoot.

“I’m sorry about the temperature, sir, but I would appreciate it if you would try to use civil language with me. What have they done with your clothes?”

“I need some socks. I don’t have any clothes. They found me in a bathtub.”

“Oh I see.” This did not dismay or even surprise her. In fact, it seemed to reassure her, like now we were making some progress. She typed it into her computer. “Well, there’s a bed opening in the morning in the annex. I think you’ll have to wait for a few hours here. We’ll finish your paperwork, and you’re welcome to take a nap in the waiting room if you like. I’ll find you a real blanket. You should have someone bring you down some clothes.”

“Can I make a phone call? I’m sure I can have someone come right away. That would be really helpful, actually.”

The white office phone sat there on her desk. Her cellphone was beside it.

“No. No, I’m afraid not.”

Unlike when you’re arrested, when they whisk you off to the madhouse, there is no guaranteed right to a phone call.

She went to get me another blanket and I heard her lock the door behind me. She took her cellphone with her and when I tried to dial an outside line on her desk phone I couldn’t get through. It requested a security code. I sat back down in my chair when I heard her at the door. She gave me an irritated, suspicious look when she came into the office.

“There’s a camera right there,” she said, and pointed to the corner above her desk.

She handed me a red cotton blanket and some blue cotton slippers that looked like they had been left behind by another patient. They were too fuzzy to be institutional slippers.

“You’re going to have to wait in here with me,” she said.

I was regretting not making a run for it while they were putting me in the ambulance. Those guys were bigger than I am and no doubt faster, but I could have found a place to hide. Dejected, I put the red blanket around my chest like a towel under the silver blanket so that I’d be more comfortable. And then, on impulse, I stood up abruptly and tried the office door. It was locked. I startled her. She started to rise from her desk.

“Do you need to go to the restroom?”

“Yes,” I said. “Please.”

This was my chance. There were a few chairs in the little waiting room and a security guard was talking to a nurse or orderly who sat behind a desk behind a counter with a sliding glass front, like in a doctor’s office. The door out had a big metal push bar. It was a frozen Kansas City winter night out, but if I were free, there would be opportunities. Something would present itself.

This is how I thought at that time. Everything was one second to the next. I truly couldn’t conceive of tomorrow. Things were just happening, and they were either good or bad, and I wanted to get away from the bad things and find the good things; or, if there were no good things to find, kill myself to get away altogether. It was basically the opposite of what William Blake and Søren Kierkegaard might have been talking about when they wrote about the bliss of immediacy in mystical experience. I had an immediacy of despair, I suppose. Or I just couldn’t bear to think more than a few minutes ahead, because I knew what was coming.

I twisted away from her and ran for the door.

She said, “Sir,” and the security guard turned. But I was too quick for them. He didn’t have time to get up.

I’d made it! Bang! Hit the metal bar! Dropped my silver blanket.

The door was locked. I pushed against it again with my whole body. For a moment, imagining liberty, I rested my forehead on the cold glass. Then I turned around, shrugged, and tried to act like it was their fault.

“Why did you do that?”

“I’m sorry,” I said. I knew I had betrayed her trust. Plus, I was stealing her slippers.

“Do you still need to use the restroom?”

They didn’t say anything else about it. I expected some kind of formal reprimand, perhaps a punishment or restraints. But it was like it never happened. It must happen more often than you think.

“Yes, I need to use the bathroom,” I said. There was a door with a men/women/wheelchair sign on it. I went in and saw there was no lock, nor was there an air duct you might climb into like in a movie. The architects clearly knew what they were doing.

I sat on the toilet and cried. Then I stopped and looked in the mirror. It was a normal mirror, not a stainless steel one like you find in many institutional settings, and it was the one thing you might use to kill yourself with. I could smash the mirror and slash myself with a shard of glass. If I had been a different person, I could perhaps have used a shard of glass to menace someone into an escape. But all of my fight was exhausted by my useless dash for the door. I was defeated. I doubted I could break the mirror if I tried.

In the mirror, in my great self-pity, I looked like I was about 12 years old. My eyes were large and red, my face was pink from the cold and my hair, freshly washed from my stitches, was tousled and boyish. I wiped the tears off my face and for a moment relaxed the armor of irony about my ridiculous situation. I let myself feel very, very sorry for myself. I wanted my mom.

"You don't die. You just wake up some place much worse."

For years, growing up, I was consumed with the thought of suicide. My awareness of my inadequacy seemed to require a resolution. This sounds shamelessly self-gratifying, but there’s really no other way to put it. Among my earliest memories is the desire to run in front of an oncoming bus. I was already thinking about suicide in a daily way when I was 3 or 4 years old, and this didn’t stop until I was in my early thirties. Every day, for as long as I could remember, I fantasized about suicide. When I was young, I imagined that I might even get to watch the funeral and the aftermath. As I grew older, I accepted that it was not because I wanted to see what would happen, but because I was sure I wouldn’t have to live any longer. Essentially, I started with the “Fame” version of suicide and transitioned to the “Consolation” version.

My parents divorced when I was 4, and my mother married a man who had seven children. That made 10 of us kids in the house, including me and my two brothers. One of my early memories of that new, dangerous family is attending my stepbrother Paul’s funeral after he leaped from an office building in downtown Calgary. It may be for this reason—the usual dysfunctional family reason—that both of my brothers have talked to me about suicide, and that my older brother seems to have it on a default setting, like I do (though, happily, he has never made an attempt, so far as I know). When we were in the jewelry business together, my older brother and I, we would sit and joke about killing ourselves, or in darker moods coming down off cocaine, we would commiserate about how much we needed to kill ourselves, and make each other promise not to do it.

As I tell my philosophy students when they come to me with their worries about suicide, I think it can be helpful to remember that suicide often seems to run in families. Maybe if you believe you have a genetic predisposition, it’s easier to resist the view that the desire to kill yourself is well-motivated. One example I sometimes mention is the Wittgensteins. Three of Ludwig Wittgenstein’s four brothers killed themselves, and Wittgenstein himself often reported the desire. The Wittgensteins were brilliant, hugely wealthy, important members of Viennese society: people who, superficially speaking, ought to have had every reason to live. Of course that’s not the way suicide or even just the very ordinary experience of the difficulty of life works. We don’t know exactly why we are miserable, no matter what our circumstances may be, and that is a significant part of the problem. I ought to be happy! I have every reason to be happy! And yet I am filled with self-loathing, with unhappiness, with self-pity. Meanwhile, other people around the world are dealing with the unexpected deaths of their children and are still waking up in the morning to make a meager breakfast for their hungry families. More proof that I don’t deserve to live.

When I talk to my mother about suicide, she changes the subject. Emotions frighten her, and she believes that talking about things makes them more dangerous. When I was 13 or 14, I told my father I was thinking about suicide very often. He explained that people who kill themselves go to “the astral hells.” My father was a New Age guru and believed in reincarnation and many different planes of existence. “Don’t do it, son,” he told me calmly. “You don’t die. You just wake up some place much worse. But call me if you’re feeling that way. Are you feeling that way now?” I knew to lie to him, naturally: He was my dad. Thinking about it now, I realize he was right about suicide for me. Every time I’ve tried it, I’ve woken up someplace worse.

Once the hospital admission formalities were complete, they took me through some hallways and a couple of security doors and showed me to my room. It had two beds, a nightstand by each, two small dressers, a toilet and a shower. It wasn’t too much unlike a cheap motel room, only cleaner, unadorned and without the well-worn hominess that most motel rooms get. I took the bed by the door instead of the one close to the bathroom, which seemed less prestigious.

The floor was gray vinyl tile, but there were two big squares of yellow and one of red in the middle of all the gray, and I wondered about the tile layer who had installed the floor. Did he miss his home where maybe there was a tree with yellow and red fruit or flowers, or did he simply want to add a little color to the rooms of the people he knew would be sleeping here, people he knew would be scared and sad?

A nurse came in, checked my blood pressure and heartbeat, and then took a blood sample. This is something they do all night long, for reasons that seem diabolical. Every two hours. Wake you up, stick a thick needle into your arm, take your blood.

“It’s almost time for your meds and breakfast. You want to go on and wait with the rest of them.”

There were more people in the main entrance area—men and women, younger than me and older than me. There was also a round receptionist area, which separated our side from where they kept the dangerously crazy people. That was where they sent you if you really misbehaved. They had honest-to-God padded rooms, I was told, like in the movies, and many different kinds of restraints. Personal Safety Rooms, they called them. Aldous Huxley couldn’t have come up with a name so sinister. I had never been in a Personal Safety Room and I knew that, if they put me in one, I would go crazy.

People were crowding around one of two portable medication stands—they look like the kind of tall rolling tool chests you see at Home Depot—and I sat and waited on the floor for the walk to breakfast next to a woman who was being released. “You going to line up for your medications? That’s the best part of the day,” she said and smiled at me, a gentle, resigned smile that was like shrugging her shoulders. “I don’t think they have my prescriptions yet,” I said. She had red hair and a drawn face. She was too skinny. She didn’t ask me why I was entering, and I didn’t ask her why she was leaving. She told me she was a high school math and science teacher. She said her husband hadn’t divorced her yet, but he had moved out and wouldn’t let her see the kids.

“Mine hasn’t divorced me yet either,” I said, “but we’ve been separated a while. Sometimes she lets me see the kids and sometimes she doesn’t.”

“That’s how they do you,” she said.

“I guess technically she’s my wife, not my ex-wife. But she’ll be my ex-wife soon enough, I’m sorry to say. Sorry, I’m talking too much. I’m nervous.”

A nice thing about the psychiatric hospital is that you’re allowed to say how you’re feeling—so long as you’re not talking to your psychiatrist, who will use it against you. But I knew if we talked about our children for long we’d both start crying, so I was grateful when she changed the subject.

“Do you want to go outside and smoke? They give out the drugs and then they let everyone out to smoke. Then it’s breakfast. You’ll get a smoke break every two hours. You can have the rest of my pack.”

“I don’t smoke,” I said. “But I’ll go outside with you. The outside is the only good thing about this place.”

“What are you doing here, anyway? It’s none of my business. Hey, Debbie,” she told one of the nurses, “we’re going to smoke. If my paperwork comes up, that’s where I am. I’ll be right back. Don’t forget I’m out there! You’re going to be too cold without a coat,” she said to me. “Here, why don’t you just put on my coat, since I’ve got two sweaters on and my boots.”

We stood and she put her big jade-green parka over my shoulders. She was wearing well-worn, expensive-looking brown leather riding boots.

“Martin? Clancy Martin?” The nurse at the med station was looking around and calling my name.

“Those are your meds,” the teacher said. She smiled at me kindly. “You sure don’t want to miss those.”

“That’s me,” I said. “I’m Clancy Martin.”

“I don’t want to have to look for you next time,” the nurse said. He was a soft-featured man who looked a bit like Barney, the sympathetic psychiatric nurse from the Hannibal Lecter movies.

“I’m sorry.”

“I’m just teasing you,” he said. “I know it’s your first day. What’s up with the coat?”

“It’s hers,” I said. We both looked at the science teacher, who had sat back down on the floor. Barney gave her a smile and a little wave, and she smiled and waved back.

“Rosalind? She’s a buddy of mine,” he said. “OK, let’s see what we’ve got here.”

There was my regular antidepressant, an “antidepressant booster” and three new medications I hadn’t taken before. They were also putting me back on lithium, which was not a good drug for me. Six drugs.

I asked Barney what the new medications were for.

“I don’t need all this medication. I do need my Valium, though.”

“They don’t have you down for Valium,” Barney said. “I’ve got Ativan here. It’s less addictive.”

It had taken me months to get off Ativan, which I had done the year before, using Valium to taper down.

For me it has gone:

1985 - 2009
Booze, and occasionally a little cocaine, speed or weed

2009 - 2010
Baclofen, Ativan, lithium, Wellbutrin, Zoloft, and two or three others with chemical names

2010 - 2011
Baclofen, Ativan, Zoloft

2011 - 2015
Valium and Zoloft

2015 - December 31, 2016
Valium

2017 - Present
Drug-free. (I sometimes still take Valium from an old prescription on plane flights and long taxi drives for nausea. I stored up about 3,000 mgs when I was tapering off for the purpose of using them to kill myself, if necessary.)

“I’ll take the Ativan. At least until I can get Valium,” I said. I was starting to get those little waves of electricity that run through your arms and legs and make your mouth dry when you need your benzo. “What are the others for? I don’t want to get started on a bunch of new drugs. It’s too much work to get off them.”

“You’d better ask your psychiatrist. Let’s see who they got you down for. Dr. Ellis. He’s all right. You’ll like Dr. Ellis.”

“That’s my doctor,” Rosalind told me from the floor. “That’s good luck. He doesn’t like to keep people in here for more than a few days. He diagnoses everyone as bipolar and mood disorder. He’ll put you on lithium.”

“Yeah, they just put me on it. I don’t like it. I’ve taken it before.”

“It’s harmless, though. I’ve been taking it for three years now and I don’t notice any difference at all. It sounds scary but it doesn’t have any kick. The ones you should watch out for are the ones that give you a high.”

“Yeah,” I said. For the past year or so I’d been trying to avoid the stronger benzos. But during AA meetings, when I was first getting sober, I ate Ativan like they were Altoids. I came to love the flavor. They are a little sweet.

“Klonopin, that’s the worst drug I’ve ever been on,” she said. “I’d rather be back addicted to Oxycontin than have to come down off Klonopin again.”

“One psychiatrist told me to cut back to three glasses of wine a day and two Klonopin,” I said. He was an interesting fellow from Egypt who had his medical practice near my university. “I tried to kill myself after about a month on that regimen.”

“I like the sound of that,” she said, and laughed. “Come on, let’s smoke a cigarette. I’m about to get out of here. The principal of my school is coming to get me. He’s a good guy. I guess I’ll stay tonight at his place.”

I raised an eyebrow.

“Come on, it’s nothing like that. He’s married. Not that I’m saying I wouldn’t. I would. He’s very attractive. But married is off-limits. That’s what started all this for me. Married men. They’re more like heroin than heroin. That’s my thing: downers. Watch, I’ll be back on dope three months from now. Then in six months I’ll be back here.”

“Come on, now, Rosie. That’s no way to talk,” Barney the nurse said.

“Yup, downers. That’s why I like married guys rather than single ones, I guess.” Rosalind gave me the same shrug and smile.

“I’m married,” Barney said, and that made me laugh. It was the first time I remembered laughing because something was honestly funny in a long time. It was my normal laugh.

I repeated it when we went outside into the yard so that Rosalind could smoke: “I’m married.” Rosalind started laughing too. There were a couple of trees in the yard and a wooden fence, probably 12 feet tall, and a wooden door on the far side of the fence. If you climbed one of the trees you could probably walk out on a limb and jump over the fence. But you’d have a 15-foot drop or so. My ankles broke easily. I had broken both of my wrists and both of my ankles at least once when I was a kid, climbing trees and jumping off our garage into the sand, plus my elbow at a roller rink. I broke my foot as an adult stepping off a four-foot ledge.

Anyway it didn’t seem like a practical escape plan, climbing the tree and leaping out into whatever was on the other side of that wall. Probably a parking lot for cops.

“I’m getting my feet all wet,” I said. My slippers were muddy. I liked watching Rosalind smoke. She hid her cigarette under her hand like it was a secret. I kicked at the snow. It was mostly melted in the wet paving-stone-and-grass courtyard but there was a crust running against the brick wall of the building. Rosalind looked over her shoulder, threw the cigarette into the grass and lit a second one. A kid in a black wool hat bent over and picked up her half-finished cigarette.

“I just got out of jail,” I said. It seemed relevant. In fact it had been a couple of weeks, but it felt fresh.

“They brought you over from county?” Rosalind asked.

“No. I just woke up in the hospital and then they brought me over here.”

“You’re lucky. Usually they’d put you in the tower. It’s awful up there—like you’re stuck in somebody’s bad dream. I was up there once for a week before they even knew who my psychiatrist was. They give you your meds and forget about you. If you have lousy insurance that’s where you go. All the homeless wind up there. They don’t even separate the violent offenders from the regular ones like us.”

I had been up in the tower. It was indeed an awful place. My father had died in a tower like the one we were talking about, in a mental hospital for indigents in Palm Beach, Florida.

“Yeah, I’ve spent some time in the tower,” I said.

Rosalind looked at me with surprise.

The sun was out and it was warming up a little.

The whistle blew, and we went back inside. Rosalind’s paperwork was ready, and she gave me a hug before she left. She wrote down her email address for me. She fished around in a big yellow canvas duffel bag and pulled out a coffee-stained hardback copy of Richard Yates’ Liars in Love.

“Did you ever read this?” I shook my head no. I had read it, but I believed she would be happier if she thought she was introducing me to the book. I had almost pretended to be a smoker and taken her cigarettes. “He spent a lot of time in mental asylums. He was an alcoholic. He was crazy, too, really crazy. So we all have that in common. I didn’t know about him, but the last time I was in here someone showed it to me, and it’s great. It was still here when I got back, and I was going to steal it because basically it’s the only good book we have, the rest is romance novels and Stephen King and the Bible, though we have The Shining, which is good, of course, but since you came now I think I should leave it. It’s yours if you want it. Nobody here reads. They all just argue about what channel to put the TV on.”

“Thank you,” I said. “I was hoping I would have a book to read.”

I didn’t know if there was anyone who would bring me books. During one stint at Research, I had Rebecca, my wife at the time, bring me The Collected Shakespeare, for the volume and the variety, and that was a mistake. I must’ve thought it would make me look cool and smart, but I felt silly reading it in the common room. It was good for going to sleep at night.

“I’ve read it about 30 times now and honestly I think it’s probably not helping me with my recovery. Dr. Ellis says we should stay away from books that are written by other addicts or about other addicts. He says even literature about recovery can trigger a relapse. But I mean ‘Heroin’ is my favorite song. Am I really never going to listen to Lou Reed again?”

“Don’t ever read Alvarez’s The Savage God,” I said. “I read it and Styron’s Darkness Visible in a hotel room downtown a few years ago, and I tried to kill myself about a month later. Back in 2008. Well, 2008 or 2009. It was New Year’s Eve.”

That was the first time I’d tried hard to kill myself in Kansas City. I was working on a book and my editor, who didn’t know me very well yet, recommended I take Alvarez as a model. I was still a drunk at this time and one morning with a blistering hangover I skipped classes, checked myself into a nice hotel downtown and spent the day in bed reading Alvarez and Styron and drinking myself back onto my feet to come home to Rebecca and our children at 5:30 that afternoon. But the Alvarez—which is a study of suicidal poets—and the Styron—which is a study in the depression he suffered when he quit drinking—stayed in my head. A few weeks later, on New Year’s Eve, I was drunk on champagne I’d snuck out of the refrigerator and although Styron and Alvarez were not romanticizing suicide, they did make it seem inevitable. I hanged myself in a closet with a sheet. My wife found me when I started kicking at the door.

“Well, hell. I wish I was going to get to know you.”

“Me too,” I said. “I’ve never had a real friend in one of these places.” Which was true.

“Email me if you want when you get out. We dingwingers always say we’re going to email each other and then we never do. We’re not supposed to do that either, really. I dated a guy I met in here. Yup, you guessed it. He was married.”

“OK, Mrs. Maxwell, time to go,” the nurse who had Rosalind’s paperwork said.

“OK, time to go,” Rosalind said, and she hugged me. She was weeping. I felt like I had made a real friend and I didn’t want to let go of her. She was a mom who couldn’t see her kids. We could get an apartment together, just friends, when I got out. We could help each other raise our children.

Then she was gone. Later when I looked for the slip of paper with her email address on it I discovered I had lost it. But of course I could find her if I wanted to. How many Rosalind Maxwells were high school teachers in Kansas City?

"If I could have killed myself painlessly, I would have been dead back in elementary school."

The first time I was checked into a psychiatric hospital was after a suicide attempt back when I was 16 and living in Calgary, where I grew up. A psychiatrist had prescribed Librium for anxiety associated with a girlfriend who had broken my heart by dumping me for a basketball player at a different high school. Nevertheless, or rather for that reason, I was living with the girl and her family at the time—I had lied and told them my parents had thrown me out, so that I could stay with them and I could keep an eye on her, and they had kindly taken me in—and I swallowed the bottle of Librium with about half a twenty-sixer of rye in a snow-covered playground not far from their home. I took off my clothes and laid down in the snow. I remember the snow turning from white to blue to green to pink. I remember going from being so cold that I couldn’t bear it and then being very thoroughly wrapped, almost overwhelmed, in a blanket of warmth and contentment. I passed out, and should have frozen, but someone found me, saved me, and I woke up in the hospital and then spent a few days in the psychiatric wing.

I learned about other people who always fantasized about suicide—we already said “suicidal ideation” back then—and I learned the crucial fact that they won’t release you until you learn to say that you are no longer feeling like “hurting yourself.” I never wanted to hurt myself. I don’t like pain: If I could have killed myself painlessly, I would have been dead back in elementary school. I’ve always suspected that if we all had a switch on our hip we could casually flip, to turn off life like you turn off the light, none of us would make it to legal drinking age.

Not long after, the girlfriend’s parents threw me out, and I moved home again. That was back in 1983.

In 1991, in Austin, Texas, in my first year of grad school, I tried to kill myself again—slashing my wrists—and again I wound up in the hospital and later a mental ward. It was then that I started getting arrested for drunkenness. In the ’90s I was in the jewelry business, married to my first wife, and I thought about killing myself often, mostly early in the mornings when I was just opening the store. I would stand in front of the mirror with the gun in my mouth—it was an oily-tasting Glock with a squarish barrel—all very theatrical, safety off, and try to pull the trigger. I couldn’t do it. In 1996 I left my first wife and not long after that I tried suicide again—with a rope—and wound up in a psychiatric hospital in North Carolina. My alcoholism was accelerating, and with it, my depression. I married once more, moved to Kansas City, was arrested several times—always for drunkenness—and then in 2008 I tried to kill myself yet again, the Styron-Alvarez attempt, which led to repeated visits to psychiatric hospitals and eventually, after an affair with someone I worked with, my divorce in 2012.

This long litany of failure doesn’t explain much, though, except that I was a drunk and a bad husband. I guess in all of these things I can see now that I had developed a habit of running away: running away from myself with drinking, running away from one lover to the next, running away from life with an attempted suicide when I couldn’t bear the sight of myself. So I should confess it here: I am a coward.

A friend of mine asked me recently: How is it that you continue to live a normal, productive life as a philosophy professor, father and writer with this brain chemistry? And one answer is: What other option do I have? Either I’d be dead or I’d be locked up. I’m alive, and I have a terrible fear of being locked up. So, like the rest of us, in our many different ways, I’m making the best of a bad situation. My present wife, Amie, who has been a Buddhist all of her life, once remarked to me that she found enormous consolation in the Buddha’s observation that life is suffering because, as she said, “I realized that it wasn’t something wrong I was doing. Everybody feels this way.” Of course, like all suffering, the suffering of needing to escape is worse some days and better others, and I suppose if it ever got so bad that, as David Foster Wallace says, it was like the choice between being burned alive and jumping out of a burning building, maybe I’d do myself in properly rather than making another failed attempt. Today, for example, I’m a bit discouraged but otherwise happy to be here with the rest of us.

Another answer to the “How are you seemingly keeping your shit together?” is: practice. Still another is: well, wait. In the past, I’ve held it together for a while, and then things fall apart.

There were three phones on the wall near the smaller rec room that we could use almost whenever we wanted—between 10 a.m. and 8 p.m.—and unlike at jail, a phone was always available.

The phone was important to me. It kept me from growing too claustrophobic. We could call out when we wanted to, but it was a complex system because you had to ask the nurses to turn on the phone and then usually it disconnected as soon as the other person answered and then they would have to call you back. Some patients who answered the phone actually tried to find you, but others just said, “I don’t see him” or “He’s not here” or “Clancy who?” and then hung up. It was hard not to get angry at these people—many of us were desperate for any kind word from the real world—but I never saw the point of losing my temper with another crazy person.

I knew very well that I had only one person I could call: my older brother Darren, who would tell our mom what had happened, who would in turn tell everyone else. I knew I shouldn’t call either of the mothers of my children because I felt certain they would conclude this was further proof that I shouldn’t be around my daughters. Previously I’d called the dean of my college or whoever I happened to be dating at the time. Curiously, although people always take your calls from jail, they do not like to take your calls from the psychiatric hospital. Or maybe it’s just that I have more access to a phone in the psychiatric hospital and so call more often. In both places, the problem is killing time without losing your mind, without panicking.

I called Darren at his jewelry store and asked him if he could come down from Calgary to get me out.

“I don’t know, Clance. It sounds like things are kind of dangerous for you right now. There’s an edge in your voice. Have you been having violent thoughts?”

“Come on, Darren, you know me better than that. I’m not dangerous to myself or to anyone else. I didn’t even exactly try to kill myself. I got drunk, and I got maudlin, and I called an ex-girlfriend, and then it was like she wanted me to kill myself, so I started making threats, and then I was drunk so I thought I had to act out the threats. It was stupid, yeah, but it wasn’t an actual suicide attempt.”

This was a lie, but it wasn’t entirely a lie. I don’t think I would have taken 40 Valium if I hadn’t been drunk, and if I hadn’t taken 40 Valium, I wouldn’t have tried to cut my wrists in the bathtub. So … it certainly wasn’t planned.

“You were in the hospital. They pumped your stomach. Come on, Clance.”

“I chose to kill myself at some point, sure, but it wasn’t deliberate in the rich sense of the word. It was like, spur of the moment. I need to get sober again but trust me, I have no desire to drink.”

I heard the sigh on the other end of the phone. “I know that’s not true, Clance.”

“Please. I just need to get out of this psych ward before they make me crazy. I need to get off of all these medications. I feel like my brain is nothing but chemicals. You don’t know what it’s like to have this chemical-y buzzing in your head all day. It’s horrible.”

There was a long silence on the other end.

“Clance, they have you on a 72-hour suicide hold—”

“Stop right there. Please don’t say ‘suicide’ to me right now. I am so sick of the word suicide. I am not going to kill myself.”

He spoke right over me. “—and then they have to release you. As long as you don’t do anything else. As I understand it, you just keep your cool for three days and you’ll be out.”

“They can renew those holds indefinitely, Darren. There are people who’ve been in here for six months. Just do me a favor and have your lawyer call. Please. Get your lawyer to call my psychiatrist. He controls the whole thing for me. His name is Dr. Ellis.”

More silence.

“Hello? Darren? Are you there?”

“You know you really need to try to put things back together with Rebecca, Clance.”

“Oh, please.”

“But listen, bud, I’ve got a customer. I’ve gotta—”

“What I need, Darren—”

He had hung up.

I finally got sober and stayed that way in 2012, and since then things have been much easier, though yes, there have been relapses and suicide attempts. These attempts have increasingly been conducted as secret experiments, because I can’t bear the thought of explaining to anyone, ever again, why I am giving up. But the time I’m telling you about now was 2010, a year when I tried to burn everything to the ground, and very nearly did.

I don’t know why the people who continued to love me through this time didn’t give up and cut me out of their lives. They must have been tempted to do so. My first wife, my second wife, my daughters (especially my oldest, who had to live through so much of this), my brothers, my colleagues at my university: They all continued to believe in me and support me. I was a petulant, deceitful, unreliable, manipulative, outrageously selfish and self-absorbed person. How do you repay that kind of a debt? How do you start to apologize for all of this? I guess you try to become a more honest and trustworthy person, you try to keep your promises, pay your bills, help them with their homework, call them on the phone. Don’t lie to them, if you can help it. You try to stay out of the hospital. If you’re a drunk, like me, you quit drinking. You tell them you’ll try to do better, and then you try to do better. You pray every night for some unknown power to make you a little less selfish.

One thing you don’t do is kill yourself. But I can see this clearly and then a moment comes when I am a child again and I see a subway coming and I have the familiar struggle of not leaping in front of it, just to be free, or sitting in the bathroom with a bottle full of more than 100 Valium that I have saved for a long time, sure that it is enough, and reminding myself of my promises. It’s no coincidence of course that I don’t choose the irrevocable methods. But then again, I have owned a gun, and many times stood on the edge of a building trying to jump.

A psychiatrist once told me: “Don’t not kill yourself because your children need you. They do need you, but they’ll be fine without you. Everyone’s parents die sooner or later. Here’s the real reason you shouldn’t kill yourself. Think of the example you’re setting for them.” A friend of mine thinks this view is bonkers, but to me it’s the only really persuasive reason I’ve ever heard for not killing myself.

Many people were in for three or even four days before they got to see their psychiatrist. The doctors looked at their charts and prescribed medications based on the case history but didn’t actually meet with their patients until they’d decided they were good and ready. Nobody could explain any of this to you except other patients. In this way it was exactly like jail. The only reliable information came from the inmates. They were also the only people who looked away from you when they lied. The nurses were like jail guards. They stared you straight in the eyes and said whatever they wanted. It was like they were talking to cartoons instead of humans so the normal rules of communication didn’t apply.

“What are you doing here, Clancy?” Dr. Ellis asked me. (That is not his real name.)

He was short and round and very Kansan. He wore an earring in one ear and cheap gray suits and shiny shoes. His cropped black hair was going gray, though I guessed he was in his late thirties or early forties. I was in no mood to tolerate his platitudes. To me he was just another lying psychiatrist I had to escape. But his hands were fine-boned and handsome, and I liked the way he rested them on his desk while we spoke.

“I don’t want to be on all of these medications. I don’t know why you have me on so many drugs. I take six pills twice a day. I don’t need to be on lithium.”

“Let’s talk about why you’re here. You tried to kill yourself, Clancy. You were in your bathtub and you overdosed on Valium and alcohol and slashed your wrists. How do you feel about waking up and learning that you could be dead?”

“Do you have any clue what you are talking about? You know they have a DSM-5 now, right?”

“Clancy you have no reason to be angry with me. I’m trying to help you.” He picked up a folder on his desk and turned through the pages. He tried to look focused. “It says here you’ve been doing fine. I’d like to recommend your release this weekend. But not until I’m certain that you’re stable. Maybe you’d like to talk about your drinking. Have you had any withdrawal symptoms since you’ve been here? I notice you’re not shaking. Your skin looks bright. Your eyes are clear.”

“No, I did not have any withdrawal symptoms when they checked me in and I don’t have any withdrawal symptoms now. I’m not in denial about my drinking. I know I’m an alcoholic. I am open to attending AA meetings, though in the past they haven’t helped me much. I’ve been going to the 12-step meetings here.”

We went back and forth like that until he wore me down and I sat there and said quietly: “Yes. Yes. Yes.” He knew what he was doing much better than I did, he understood who was in charge, and so of course I submitted, which was what everyone has to do. We were going to have weekly office visits after he released me. Then we’d switch to phone consultations if all went well. We’d moderate the drugs as necessary. If I continued to do as well as I had been doing, he’d release me on Sunday or Monday. He recommended I join the AA group that I had in fact previously attended.

“They’re very smart people, Clancy. I’ve never met a stupid alcoholic. Many UMKC professors attend those meetings. I think you’d feel very welcome there.”

Thinking of Dr. Ellis, I paced the hallways and stayed in the common areas to read so that the nurses couldn’t accuse me of being reclusive, which would get you extra time. I went to the group sessions for the same reason, though you could skip group as much as you liked. We knew this was a chessboard, a movie set, a scary game we all agreed to play, and really therapy wasn’t the goal. Recovery wasn’t the goal. The goal was just to get you to talk and act like everyone else who wasn’t presently in a psychiatric hospital, to make you pretend to be some made-up idea of ordinary. I wanted to approach the nurses at the station and say: “Let’s take five minutes and just be normal.” But I knew better than that.

I once mustered my courage, or was simply foolhardy, and addressed this point with Dr. Ellis.

“Do you have like a form? A list? I’m just asking. How do you decide whether or not I’m in a better frame of mind?”

“No, Clancy, I don’t have a checklist. I do try to assess whether or not you have accepted the fact that you are struggling. Whether or not you can see that you have some work to do on yourself.”

“But don’t you ever worry that we’re just telling you what you want to hear?”

“I’ve been doing this a long time, Clancy. I think I can tell when someone is faking it. Do you feel like you have to fake something in order to show me that you’re ready to leave?”

I was a jewelry salesman for years, and I specialized like any other salesperson in the art of seeming to be what someone needed me to be, of telling people what I knew they wanted to hear. But any child would know better than to answer a question like Dr. Ellis’ honestly. It was like he was feeding me the right answers.

“Of course not. I just mean that we all have fears we are afraid to express, we all have self-destructive ideas now and then, and it’s hard to know, in here, what you can be honest about.”

“You can be honest about everything. That’s the therapeutic process. Are you having self-destructive thoughts?”

The same question the intake nurse asked me.

“No, no, thank goodness,” I lied. “But I do worry they may return, you know, once I’m dealing with my ordinary stresses.” More bullshit. “But I guess that’s why we continue therapy after I’m released.” I was appalled, listening to myself. Like I could just sit there for hours, repeating clichés from movies about recovery, and his confidence in me would grow and grow.

“Exactly.”

"While I lay there in bed or during the times I would get up, I watched the many ghosts that paraded through the halls and rooms."

Before landing inside Research Psychiatric this particular time, I’d once, as part of a DUI deferral, spent a long weekend in a minimum security prison that everyone was free to leave if he chose. Of course as soon as the guards discovered that you’d left, they issued a warrant for your arrest. But the fact that you saw the exits and understood you could walk out at anytime made it so much easier to be there, and in a more humane penal system, these prisons would be commonplace. There, the choice to remain was an exercise of the will, and it felt good.

I didn’t know it, but my desperation to escape from Research, like the panicked claustrophobia I suffered in every psychiatric facility or jail, was an expression of health and strength. As long as I still believed that I could live in the outside world, if only they would let me go, I still had some hope for myself. I still believed in Clancy.

But as I began to worry that I was fading from the minds of the people who had cared for me, that hope was dissipating. My regular psychiatrist from outside told me to “trust the people there. They know what they’re doing.” I called an old girlfriend and yelled at her for leaving me for the lead singer of a band, seven years earlier. She stopped picking up after that. I called my brother again and he said, “Clance, I can’t help you this time.” I screamed “Fuck off!” into the phone and hung up on him, refusing to call back until he called me first, which he sensibly never did. I didn’t understand why no one would believe that I would be OK if they’d just give me another chance, if they’d only help me get out.

One night, I was lying in bed because I had asked Dr. Ellis for something stronger. He had agreed immediately. But the new pills made it impossible to walk without falling down.

I guess I stayed there for a while, because people started to visit me. Veronica, a frightening woman whom the other patients avoided, with hair turned bright yellow from electric shocks (or so everyone said), came and sat at the end of my bed.

“So you’re going to stay with us, I guess,” she said. “I like it here just fine. I think it’s safe here. I’m glad you’re staying.”

“It doesn’t matter to me. I hate to be anywhere,” I said. “I don’t know why anyone is alive.”

“I do,” she said, and her eyes grew large and truthful. “Fear.”

Another time, after breakfast—I had lost my appetite but still went to most meals, because I knew they kept a chart on that sort of thing—I was lying in bed and thinking about my three daughters, and how I had let them down. I thought about watching “The Secret of NIMH” together and making them spaghetti carbonara, their favorite meal from dad. I thought about walking through snowy nights with my youngest in her Boba Wrap when she was a baby. It was the only way she could get to sleep back then. I doubted I could ever be a good father again, the father they deserved.

There was a knock on my door. “Come in,” I said, not knowing what to expect. It wasn’t a nurse. The nurses knocked before they entered, sometimes, but it was always just a tap and then the door opened. No one knocked for politeness.

The crier came into my room. We only called him the crier when he wasn’t around, obviously. He was a slender, tall, lean-faced man with a light beard, in his early thirties, handsome, a bit intimidating. He looked like the soulful guy all the girls liked when you were in college, even though they agreed that he wasn’t traditionally handsome. He cried constantly, unceasingly. He came into my room and loomed over me at the end of my bed.

We all knew this guy from group therapy and from meals, but we gave him his space. He never spoke to any of us. He walked through the hallways or sat in the TV room with his long, mournful expression and silently wept.

Suddenly I got really angry. What right did he have to come into my room and gawk at me with his gloomy face? Weren’t things bad enough?

“You really have just given up, haven’t you?” I asked him. I couldn’t look him in the eye. I stared at my feet in their oversized, gray cotton hospital socks. Then I felt him looking at me so I glanced up. He looked quickly away. I grew even angrier.

“It’s like you’ve found an easier way than suicide,” I told him. “It’s really chickenshit. You’ve just decided you’re going to live here. I could do it too. I could just say, ‘Fuck it, I quit.’ It’s better than killing yourself. No one’s angry at you. They keep feeding you your drugs and feeling sorry for you. And you just keep on crying like that. But no one feels sorry for us.”

He was still weeping, but he looked me straight in the eye. I don’t think I’d noticed before that he had green eyes. His grief seemed much more real than my self-pity, and that made me sick to my stomach. I got up to leave my room, but it really was hard to stand up, because my morning medication had kicked in. I sat back down on the edge of the bed. He sat on the bed across from mine, and we both looked at the wall, not at each other. Then, after two whole minutes of silence, he got up and left.

I never learned why he came into my room. Maybe he’d planned to speak to me. Maybe he just needed someone to be kind to him for once. Maybe he also felt abandoned by the people he loved. And then I’d told him the truth, and that was just the opposite of what he’d needed to hear.

I was afraid to speak to him because I knew that, in this moment, I had more in common with him than with anyone on the outside. I knew we’d actually be able to help each other. I knew that I was exactly where I belonged.

I went to the bathroom and vomited. Then I lay on the bathroom floor and cried for a long time. It was then that I gave up hope. I decided to become a resident.

And then my ghosts came. It was the first time you maybe could say I had gone crazy, in the traditional way. To be perfectly clear, I believe in ghosts. I am one of those people who claims to see them, albeit infrequently and in odd circumstances. Since early childhood, in fact, I have sometimes been able to see ghosts. But when I was in Research, heavily medicated, they suddenly became vivid to me. While I lay there in bed or during the times I would get out of bed and try to walk around and behave like a good patient, I watched the many ghosts that paraded through the halls and rooms.

The ones I came to know best were regulars, like most ghosts are, and they kept their routines. I grew to care for the ones who visited my room: a red-headed old woman in a formal hospital gown like people hadn’t worn in 50 years and her husband, who wore a suit and who I thought must have died long after her but decided to come stay with her, and a young man, bookish, earnest, who trailed after them asking questions I could never quite hear. They would sometimes sit on the bed next to mine, the three of them, and watch me, and I wasn’t afraid to watch them back, though I did not try to speak to them.

There was a teenage girl who I knew from college—she had drowned one summer trying to surf with friends of ours during a hurricane—and she walked through my room without even seeing me, with her long black wet hair, naked, and I supposed she was waiting for me, that she had been sent to welcome me, and there was a middle-aged man with a beard, naked too, who shrank down on the toilet and turned away to show me a blood-red weal across his back. When I saw his face he was crying.

There was a doctor who told me his name: “I am Doctor Reynold Fox,” he said, and he bent over for me, eager for me to touch him the way the bad ones are, but I hid under the covers when he came in. And there were the ordinary-looking patients who were all in hospital robes: They walked down the hallway like they were lining up for med call, and they could be hard to tell from the real patients, and sometimes they would mingle with us when we were standing in line for our drugs, mostly twenty- and thirtysomethings, with the same pale frightened and irritable faces we had, some of them livelier than us and some of them somber or vacant.

There was one family of Christians—a father and a mother and three sons, aged probably 5, 9 and 12, something like that—who sat and played Scrabble together in the main common area and would often hold hands and pray, and sometimes their prayers were so loud I would turn up the volume on the television set until a nurse or a patient yelled at me. They watched the rest of us with enormous kindness and patience, though once I saw the mother look at me fearfully and pull her youngest close to her.

The worst one was a hungry ghost who looked like he had come straight up from the hell of burning iron. I saw him only occasionally and I always ran away from him. He wore white workman’s boots and muddy jeans and an open madras shirt and his ribbons protruded from his chest and his belly was swollen up like a starving child’s. I noticed him clinging to the shoulders of many of the patients and he’d reach out for their pills with his scrawny hands, and once I saw him attack another ghost, a young girl, beating her head against the floor, which I had not ever seen before or even known was possible. Her shrieks sounded like a badly blown whistle.

Down at the end of the hallway on the opposite side of my wing, around a corner, there was a group of ghosts who all told me their names and occupations: Bob Ramsey, architect; Susan Martin, sales rep at a cleaning supply shop in Houston; Wendell Wright, bartender; and a teenage boy named John Barrow who said he hoped to be a web designer. None of them knew they were dead. Susan told me she’d gotten so drunk on St. Patrick’s Day that she had stood on the hood of her ex’s Range Rover and peed on it and then fallen off and broken her elbow, and her best friend Sally talked her into staying here for a few days after they put the cast on her arm. All of us pretended not to notice that she didn’t wear a cast. There was a couple who stayed in that hallway too, the Culvers, who both drank chocolate milk from little cartons, and a woman named Monica, who must have been nearly 100 when she died, and Warren who told me he’d sell me a car when we got out, and two pretty sisters about my age whose names I could never remember.

In the courtyard there were two heavy-set black men in baseball caps who kept to themselves and a lovely Greek woman, about 30, with a Liv Tyler smile, whom I would have wanted to flirt with if she were alive, and a distinguished old-fashioned Texas man with a bamboo cane who looked like a judge or a senator, and a Mexican woman who might have been a witch and who stood still leaning against one of the trees with her hair in her face glaring at all of us and controlling anyone who fell under her gaze, and a 7-year-old girl who pushed a two-wheeled green aluminum scooter in circles, the handlebars set a bit too high for her, and three splendid-looking blond teenage girls, bursting with life who must have died suddenly—they sat against the fence and smoked cigarettes with their knees tucked up against their chests—and a fat man with no hair who walked up to me one day with his hand extended and said: “I’m Clyde. We’re all grateful you’re here.” But I knew better than to touch him, and he turned away from me with a disappointed expression that made me so sad.

There was another hungry ghost that crawled on its stomach like that man in the dominatrix bar in the Mary Gaitskill novel. It was as small as a large dog and it would only stand to try to suck the cigarette smoke out of people’s mouths when they exhaled. Its mouth was tiny and its legs were like stalks of grass. I wanted to warn them, but it couldn’t get as high as their waists so it was only dangerous if you were sitting on the ground, which none of us did, because it was cold and wet. And there was a man who told me he had strangled his wife and then lied to his psychiatrist about it for three years, pretending she was still alive, and then he’d broken down and told her the truth and hanged himself later that night.

Somebody named Forester came to my room so often and stayed for so long that I started to think of him as my roommate. I never saw him in the hallways or outside. In addition to all these were the ghosts I saw only for a day or an hour or even one time, for a moment, many of whom were the most beautiful ones and who left aromas behind them like lemons or ginger or roses or the smell of fresh wet wood.

And there were those who didn’t look like humans at all anymore, who were there in the way a tree branch is there shaking outside your window, or the sun is there in your face when you first open the front door in the morning, or like the chill when you get out of the bath, or sparks in your eyes, tiny flashing lights, or the way black tea releases a smell when it’s brewed and you pour milk into it, or the good feeling of having brushed your teeth and climbing into bed wearing a clean pair of pajamas. All suicidal people are almost already ghosts, and to be clear I couldn’t be certain which of these were living patients like me and which were already gone or mostly gone or gone and determined to return. But they kept me company during my time at Research, and I expect many of them are still there. I understood then that my suspicions all along were true. “For in that sleep of death what dreams may come.” Just because I killed myself, it didn’t mean I was getting out of here.

When they lowered my dosages, the ghosts went away.

Then, one day, they let me out. It was the first time I’d been released from the psych ward when there was no one to get me. I didn’t even know they did that. I’d had to borrow clothes from a friend inside to go home in. The woman at the front desk asked if someone was coming to get me, and I said, “Of course,” a touch indignantly, in case that was required. “I’ll wait outside,” I said, though it was freezing and I hadn’t borrowed a coat. I walked four miles up Troost Avenue to my apartment, and I didn’t have my keys, so I had to break in.

I would like to be able to report that it was my last stay in Research, but it wasn’t. I tried to kill myself again. I would like to be able to report that I will never go back, but I can’t.

I think it’s fair to say I am a more-or-less average middle-aged white male human being. I get out of bed early, most mornings, sometimes to make tea just for myself or, if my wife is awake, to bring us both tea and some yogurt or berries on a breakfast tray. I teach my classes and try to help my students with their plans and ambitions. Once or twice a month I go out to Lansing Correctional Facility to talk about aesthetics or the philosophy of mind for an hour and a half with several of my students and some inmates there who are interested in philosophy. I sit at the kitchen table with my 11-year-old and help her with her math homework. I make a good roast chicken, and gazpacho, and other simple dishes that require not too much work but some practice to get right. I try to write every day, at least a little, and I go to the gym regularly, because it helps me to avoid anxiety and depression. In the past few years I’ve learned it’s easier just to take phone calls rather than dodge them, to pay my bills rather than delay them, to live on a budget rather than beyond my means, even to be careful to check myself to see that what I am saying is true or close to the truth. I return my friends’ texts and emails, and though I don’t have many friends, the ones I have, I am getting closer to every year. I am in reasonably good health for a man who is 50 years old, though I have a shoulder blade that bothers me from a bad twist during a yoga class. I love my wife and my children, and I believe they love me in return. I even think that if they were asked, they would say, yeah, I have a great dad, or yes, I have a very good husband. My friends and students might be more ambivalent and admit that “he’s kind of selfish with his time,” which is true, even if I’m trying to work on that. I watch more movies than I read books, these days. I walk my dog, a 50-pound white Labradoodle named Simha. We live in a neighborhood I like in an urban part of Kansas City not far from the Nelson Atkins museum. I have an unusually comfortable, desirable, easy life, which I like to think I do not take for granted, because for so many years I was a drunk watching everything I lived for—my friends, my family, my career, my money—poison and wither. I often wake up feeling optimistic, and if anyone ever asked me if I were grateful for my life, I would insist truthfully that I am very, very grateful. But in a way gratitude misses the point. You can be grateful for something and still not be up to the task. I have not escaped from this desire to die. It waxes and wanes. It should be incompatible with the thought of how lucky I am—especially given the mess I’ve so often made of my own life and the lives of those I love—to have the life I do. And I understand if you think: This guy is just a complete selfish asshole. Well, yes, you’re right, I have to try to do better.

The last time I tried to kill myself was about a year ago in my basement with a dog leash. I did not write a note. I don’t think I have ever written a note. I carried a green leather-and-wood chair from my office down there as my dog watched from the stairs. She is afraid of the basement: There is a ghost sometimes who sits with her knees folded near my work bench. I took the heavy blue canvas leash, looped it, latched it, put my head through and checked it for strength. Then I kicked the chair away like the gentle old institutionalized suicide Brooks Hatlen does toward the end of The Shawshank Redemption. I hung there, kicking. But I wasn’t dying, I was just in terrible pain. Hanging yourself really hurts. I started to panic, I resisted the panic, I panicked some more, and in a moment that I can’t exactly recall, I lifted myself up and got out of the leash. I dropped to the floor and lay there for a while. I still haven’t moved that chair back upstairs. It’s too spooky to move, and I don’t want it in our house.

Later that day I spoke to my wife Amie on the phone—she was away on a trip—and she asked me what was wrong with my voice.

“I have a sore throat,” I said. My throat was very painful for a week or more, and several of my students asked me what I had done to my neck.

A new friend of mine at Ashoka University, a computer scientist, killed himself back in May. The news hit the campus hard. My students have been emailing, asking questions that no one can answer. Then, in August, another professor died by suicide. I didn’t hear as much from them about him.

One of my students contacted me not long ago to say that she had been hospitalized after a suicide attempt. She knew I was the person to write because we talk candidly about suicide and other “meaning of life” questions in my Existentialism and 19th Century philosophy classes. She’s one of my brightest—one of my few students ever to really get Kierkegaard. She’s 21 years old, charming, popular: a double major, English and philosophy. She told me that she wasn’t sure when they were going to let her out of the hospital. When I went to visit her there, she had an ironical way about her. Like she wanted to laugh at herself, but wasn’t sure whether that was allowed.

I told her that we all need her, and that she should try to rest. She gave me a baleful, disappointed look, which I suppose I deserved. But there is no perfect sequence of words that can decode the mystery of why we should keep on living. There are some problems that last a lifetime and do not have solutions. When I see her next, if I do, I hope that we can sit down and talk together honestly about why we’re both still here.

CREDITS

Story - Clancy Martin

is a philosophy professor and a story editor at The Small Bow, a website about addiction and recovery. His books include the award-winning novel How To Sell.

Research - Ben Kalin,

formerly of Vanity Fair, is a veteran fact-checker and the founder of Fact-Check Pros, a full-service fact-checking agency.

Creative Direction & Design -

Donica Ida is the creative director of Highline.
Kate LaRue is a freelance creative director.

Development & Design - Gladeye

is a digital innovations agency in New Zealand and New York.

It was still dark outside when Amanda woke up to the sound of her alarm, got out of bed and decided to kill herself. She wasn’t going to do it then, not at 5:30 in the morning on a Friday. She told herself she would do it sometime after work.

Amanda showered. She put on khakis and a sweater. She fed Abby, her little house cat. Before walking out the door, she sent her therapist an email. “Not a good night last night, had a disturbing dream,” she wrote. “Got to try and get through the day, hope I can shift my mind enough to focus. Only plan tonight is to come home and take a nap.”

Amanda was a 29-year-old nurse, pale and thin—a quiet rule-follower. She had thought about taking a sick day, but she didn’t want to upset her co-workers or draw attention to herself. As usual, she arrived at the office earlier than just about everyone else, needing the extra time to get comfortable. She had taken a pay cut to join this clinic outside Seattle, in part because she wanted to treat low-income mothers and pregnant women. Some of her patients were in recovery, others were homeless, several had fled physically abusive men. She was inspired by their resilience and felt only slightly jealous of the ones who had found antidepressants that worked. That day, September 28, 2007, was her first shift seeing patients without a supervisor watching over her.

Amanda’s schedule was relatively light: three, maybe four patients. She measured their blood pressure, their weight. She ran through her mandated checklist of questions. Have you relapsed since your last visit? Can you afford your newborn’s car seat? Do you have a history of mental health problems? She hated those questions. There was no way she would answer them herself. Too invasive, too personal. In an email she’d sent her therapist a month earlier, she confessed that she would occasionally put on a “mask of normalcy.” Sure, patients were always commenting on how upbeat she was, but “the part they didn’t see,” she wrote, “was me turning around, me leaving the room, me getting in my car at the end of the day, taking a deep breath and me crying all the way home. I have always done what is needed to be done and when I can stop pretending I let it out.”

Her first thoughts of suicide had come shortly after her 14th birthday. Her parents were going through an ugly divorce just as her social anxiety and her perfectionism at school kicked in hard. At 20, she tried to kill herself for the first time. For about the next decade, Amanda didn’t make a few attempts. She made dozens. Most times, she would take a bunch of pills just before bedtime. That way, her roommates would think she was sleeping. In the mornings, though, she would wake up drained and spaced out, despairing that she could fail even at this. Then she would resolve not to speak of it to anyone. To her, suicide attempts weren’t cries for help but secrets to be zealously guarded.

“What in the world is it going to take for me to feel better?” Amanda asked in an exasperated diary entry from 2004. Therapy wasn’t much help—too often, her pain was met with baffling ignorance or worse. A counselor at her church suggested that her depression would go away if she prayed more. Once, a therapist refused to talk during their session unless she opened up; she never went back after that. The college where she studied nursing forced her to take a leave of absence over her depression and anxiety. The day she got the news, she made another suicide attempt.

Ursula Whiteside, Amanda’s new therapist, was different. She was just 29 years old, a graduate student working under supervision at a University of Washington lab. Amanda was one of her first clients. But Whiteside was preternaturally sensitive. She could tell how just sitting in the waiting room stoked Amanda’s social anxiety. And she made it clear that she would go to creative lengths to get Amanda talking. During one session, Whiteside stood on her head. In another, she took Amanda into a children’s playroom, thinking the absurd change of scenery would shake something loose. The rare moments when Amanda responded with a dry joke were gold.

Still, there were sessions that ended in frustration, so they agreed to email between appointments. Amanda wrote to Ursula whenever the mood hit her, late at night mostly. The emails could be short, no more than a few paragraphs, but here, more than anywhere else, she was matter-of-fact about her suicidal thinking. “I wanted to tell you what went on this weekend and I’m pretty sure I will not be able to tell you in person,” she wrote on August 26. “I survived the weekend, which I guess was the goal. … I panicked Fri. night and I took 2 extra pills. I usually just take 1, Friday night, I took 3. It was stupid, I just wanted to sleep, it was stupid because it wouldn’t do anything. … I also ended up going over to my friends house last night. She kept me safe last night, even though she doesn’t know it.”

Whiteside’s replies often teemed with exclamation points and underlined words. She knew it was important to remain upbeat. But a month later, when she received the email Amanda sent that Friday morning before work, she wrote back quickly and with little of her typical flair. They’d had a session the day before, and Amanda seemed to be hiding more than usual. Whiteside felt it was necessary to jolt her into being more forthcoming.

“If you are planning on killing yourself this evening or this weekend, I need to know,” Whiteside wrote just before 7 a.m.

Then she waited. 10 a.m. Noon. No reply. By 1:30 p.m., Whiteside called her supervisor to discuss strategy. If Whiteside’s instincts were correct, and she asked the police to do a welfare check, she could save Amanda’s life. If she was wrong, she could destroy the trust they had built over their months together, and Amanda might not return for another session. Whiteside started typing up notes. “I’m glad that she is telling me something,” she wrote. “But something is getting in the way of her being completely forthright. … As good as I am, I can not magically help someone feel better. … So terrifying that she is going to go all the way to the bottom.”

Amanda left work at 4:30 p.m. and stopped at a local pharmacy to refill a prescription. She wanted to make sure she had enough antidepressants to successfully overdose. She then went home and gathered up other sleeping meds so that she could mix them together with the new pills. She never replied to Whiteside. She didn’t write a suicide note. After dark, she put on her pajamas and brushed her teeth. She took a deep breath, methodically swallowed one pill after another, dozens and dozens of them, laid down on her bed and drifted off to sleep.

Meanwhile, Whiteside had a lot of work to do, but her mind kept returning to Amanda. She was so worried that she forgot that she had driven to the university that morning and took a bus home. She kept leaving voicemails and texts, telling Amanda that she cared about her, that she was confident the therapy could work. That night, she finally called the police. She knew the risks; she just didn’t care anymore.

But when the cops arrived, Amanda was nowhere to be found: The address Whiteside had was out of date. Helpfully, an old neighbor gave the police the number of one of Amanda’s friends. The friend, though, insisted on meeting the police in person, eating up valuable time. By the time she took them to Amanda’s studio apartment, it was late, maybe five or six hours after Amanda had ingested the pills. They found Amanda in bed, alive but clearly out of it. There were empty pill bottles nearby, cat toys underfoot. Her friend shook her awake. In a sleepy whisper, Amanda confirmed what she had done.

Several hours later, Amanda came to in the emergency room. She had an IV drip in her arm. An oxygen mask covered her face. Medical personnel monitored her extremely low blood pressure and x-rayed her chest. She could hardly speak, but the staff got enough information to describe her in their medical records as “a 29-year-old previously healthy, except for her psychiatric history.”

In time, Amanda was transferred to another part of the hospital, where a “sitter” was assigned to observe her in case she tried to harm herself. During a psychological assessment, she frequently dozed off. She couldn't believe she was here again. She didn’t call any friends or family members. Her state of mind was exactly the same as it was when she started downing the pills. Amanda still wanted to die.

Over the last two decades, suicide has slowly and then very suddenly announced itself as a full-blown national emergency. Its victims accompany factory closings and the cutting of government assistance. They haunt post-9/11 military bases and hollow the promise of Silicon Valley high schools. Just about everywhere, psychiatric units and crisis hotlines are maxed out. According to the most recent figures from the Centers for Disease Control and Prevention, there are now more than twice as many suicides in the U.S. (45,000) as homicides; they are the 10th leading cause of death. You have to go all the way back to the dawn of the Great Depression to find a similar increase in the suicide rate. Meanwhile, in many other industrialized Western countries, suicides have been flat or steadily decreasing.

What makes these numbers so scary is that they can’t be explained away by any sort of demographic logic. Black women, white men, teenagers, 60-somethings, Hispanics, Native Americans, the rich, the poor—they are all struggling. Suicide rates have spiked in every state but one (Nevada) since 1999. Kate Spade’s and Anthony Bourdain’s deaths were shocking to everybody but the epidemiologists who track the data.

And these are just the reported cases. None of the numbers above account for the thousands of drug overdose deaths that are just suicides by another name. If you widen the lens a bit to include those contemplating suicide, the problem starts to take on the contours of an epidemic. In 2014, the federal government estimated that 9.4 million American adults had seriously considered the idea.

There’s an inherent lack of closure to suicide. Even when people write notes, they can reveal so little. Suicides often leave loved ones, acquaintances and co-workers to question themselves for the rest of their lives. And in their own grief, they, too, can entertain dangerous thoughts. “With suicide you have that added trauma to it,” said Julie Cerel, the president of the American Association of Suicidology. “The ‘why’ question of trying to search for meaning when there’s no meaning available—If I only had a note. If I only talked to the last person that they talked to. The ‘onlys’ can be torturous.’” Last year, Cerel published a study examining the consequences of suicide and found that each one could affect as many as 135 other people.

The fundamental mystery of suicide has long made it an object of fear and contempt within the medical establishment. Since the 1950s, public health officials have tried hotlines, individual therapy, group therapy, shock therapy and forced hospitalizations. Doctors have taken away people’s shoelaces and belts and checked in on attempt survivors every 15 minutes to make sure they are still safe. They have coerced patients into signing contracts swearing that they would not kill themselves. They have piled on psychiatric medications with ever-more invasive side effects, only to watch the number of suicides continue to climb.

Even now, most mental health professionals have no idea what to do when a suicidal person walks through their door. They’re untrained, they’re under-resourced and, not surprisingly, their responses can be remarkably callous. In an emergency room, an attempt survivor might be cuffed to a bed and made to wait hours to be officially admitted, sometimes days. Finding help beyond the ER can be harder yet.

“You take someone who is not doing well, shutting down, and throw them in a system that requires them to have the highest problem-solving abilities and emotional regulation,” said Jeff Sung, a psychiatrist colleague of Whiteside’s who works with high-risk clients and trains others to do so. According to federal data, the majority of those in need of mental health services do not receive it.

When confronted with the coldness of her colleagues, Whiteside grows exasperated. Because while the dead are invisible to most, she knows them. She gets how suicidal thoughts have their own seductive logic, how there is comfort in the notion that there is a surefire way to end one’s pain. She sees why people might turn to these thoughts when they hit a crisis, even a minor one like missing a bus to work or accidently bending the corner of a favorite book. That’s why suicidal urges are so much more dangerous than depression—people can view death as an answer to a problem. And she knows that many patients of hers will always feel vulnerable to these thoughts. She has described her job as an endless war.

Whiteside was born in Colville, Washington, 40 years ago, the first child of parents drawn to adventurous work wherever they could find it: building an oil pipeline in Alaska, raising cattle and conducting child health screenings in rural Washington, driving trucks through the Midwest. By the time she attended junior high, in Minnesota, Whiteside had enrolled in six different schools in three different states. But instead of turning her bitter or shy, all the moving seemed to sharpen her empathic powers. She became one of those canny little people who could intuit when those around her were in pain.

And she could be impulsive in her efforts to help. When she was in eighth grade, one of her best friends called her frantic and in tears. The friend didn’t go into detail, but said that she needed to escape her house immediately. So Whiteside planned a rescue. Shortly after midnight, Whiteside snuck out of a window in her family’s basement apartment and stole her mother’s sedan. She didn’t think about the fact that she couldn’t drive legally or that her friend’s house was 8 miles away or that the roads were icy and covered in snow. She didn’t care that she weighed only 80 pounds and could barely see over the steering wheel. She made it past the McDonald’s, down the hill, to the one-lane country road where her friend lived before crashing the car into a ditch in front of the house.

The older Whiteside got, the clearer it became that she was better at looking after others than herself. In high school, she struggled with her body image along with depression and anxiety. Like her future clients, she found it excruciatingly difficult to talk about what she was experiencing. The idea of asking for help was “the scariest thing I could imagine,” she said. During one point in college, she sent her mother, who had lost her own brother to suicide, a lengthy letter detailing her ups and downs. “I’m writing you this letter because I often have a hard time saying out loud what I mean,” she confessed. “I am just chicken.”

She wanted so badly to understand the mechanics of despair, including her own. “Everything I do has to be extreme,” she wrote in her diary. “I go through phases where I absolutely love myself—I go through others where all I can think about is knives and bridges.” At the University of Minnesota-Duluth, she read mental health textbooks and academic journals in her spare time. She was drawn to the field as a practical way of untangling life’s most intractable problems. “I took my first psychology class and I was like, ‘Oh my God, you can actually change things,’” she said. “It’s not magic.”

Before her junior year, Whiteside transferred to the University of Washington so she could learn from Marsha Linehan, a legend in the field of suicide research. Linehan had pioneered a powerful form of treatment called dialectical behavior therapy, or DBT, which trains patients how to reroute their suicidal impulses. It can be grueling, emotionally exhausting work that requires people to spend several hours a week in individual and group therapy, and therapists to do check-in calls as needed throughout the week. Linehan had a principle for all of her students: Clients came first, your own life came second.

It couldn’t have suited Whiteside better. “I’ve found some semblance of passion,” she wrote in her diary at the time. “I have to think of myself and I have to think of my soul and I have to remember those in most need, those experiencing suffering beyond my imagination.” In a letter of recommendation, Linehan wrote that Whiteside had “become unflappable.”

And then Whiteside sprinted nose-first into the wall of the modern-day behavioral health care system. She took a clinical internship in the psychiatric department of Harborview Medical Center in downtown Seattle, an under-resourced, grim institution. The main goal, she kept hearing, was triage. She was there to stabilize suicidal patients, nothing more, because no one had the time to do more.

Whiteside was tasked with probing patients for their treatment history and state of mind. There was the man who killed his dog and shot himself in the stomach. The immigrant who set himself on fire. The college student who had been found walking in the middle of a street clutching a teddy bear. Each one, she felt, was desperate for any form of help or kindness.

“I was absolutely insane, completely unconcerned with life,” one former patient from that era said. “They had no idea what to do with me. But Ursula was looking at me in a way where she was actually waiting for me to respond. … It wasn’t, ‘What are your symptoms? What medications are you on?’ It was, ‘Tell me a little bit about your story.’” Whiteside knew that people who leave the hospital after a suicide attempt are at a greater risk of harming themselves again within 90 days. And yet the doctors at Harborview were only providing referrals for clinics most patients would never visit or putting patients on waiting lists for therapists who might not be right for them. “These patients were basically at this critical juncture,” Whiteside said, “and we were fucking blowing it.”

After her patients left the hospital, she couldn’t stop thinking about them. So she began tracking them down, calling to see if they needed help or just to let them know they were on her mind. She handed out her phone number to patients before they left the hospital. On the back, she’d also leave a personal note. Anything to keep them tethered to the world. For six months, she called a woman who had made an attempt after a breakup. The woman took Whiteside’s calls for a while, until she didn’t. Whiteside still doesn’t know what happened to her.

“It was almost an existential crisis for her,” says Sarah Stuckey, one of Whiteside’s best friends from the clinical world. “She’s the velvet hammer in so many ways. She’s this beautiful woman talking in this soft voice about these horrible things. You lose people. That takes a toll. You have very close calls with people. That takes a toll.”

Whiteside was becoming so anxious about her work that she had days when she could hardly sleep or eat. One night after her internship was over, she uncorked a bottle of wine. She drank until she didn’t care if she ever woke up. This scared her. For just a few moments, she realized how it felt to be suicidal.

Months later, Whiteside met with her therapist to discuss how she could handle these feelings of powerlessness. Whiteside brought up the work of a long-retired psychiatrist and suicide researcher named Jerome Motto. He wasn’t well-known. But Whiteside’s mentor Marsha Linehan was enamored of him because he was the only American to devise an experiment that dramatically reduced suicide deaths. His technique didn’t involve a complicated thousand-page manual to follow or $1 billion in pharmaceutical research and development. All he did was send occasional letters to those at risk.

Right there in therapy, Whiteside found herself spouting out everything she knew about Motto’s approach and career. She began to cry. “Oh my God,” she said. “What if this is what we should be doing? What if it’s that simple?”

It was December 1944, during the Battle of the Bulge, and the 3989th Quartermaster Truck Company had been stuck for days in a farmhouse in Bastogne, Belgium, surrounded on all sides by German forces. In the quiet moments, when the sky was the color of bleach, and snow blanketed the ground, First Lieutenant Jerome Motto prayed for Allied planes to save him and his fellow soldiers. And just often enough, C-47s would appear with the precious cargo that kept them alive. The men would dash outside, trying to avoid detection or dodge enemy fire as food, clothes and medicine fell in gigantic bundles tethered to red and blue and green and yellow parachutes. To Motto, it looked like a sky wearing polka dots.

The tall, blue-eyed son of Jewish immigrants, quiet and self-effacing, Motto had grown up in Santa Barbara, California, harboring dreams of becoming a concert pianist. But when the war broke out, he had been eager to contribute what he could. During his Army intake, he requested to be assigned to clerical duty or perhaps a military band with the other introverts and artists. Instead, he was placed in a truck regiment, responsible for the safety of 39 other men.

The 23-year-old mostly kept to himself, driving through occupied Europe with a French grammar book on his lap. For the first time, he saw the world as a landscape of the traumatized. His convoy passed villages pocked with shattered storefronts and roofless homes, the streets empty of any young men like him.

Amid the devastation, Motto was always on the hunt for small things to ease his mind. Photography helped. So did writing letters to his family. He told them about his burgeoning interest in psychology, brought on by seeing even the most macho of his fellow soldiers struggle to keep it together. His family’s replies, though, didn’t always bring comfort. They chided him for not writing enough, and when Motto read about an older sister’s divorce or his father’s mysterious illness, he only felt guilty, since there was nothing he could do from so far away.

To his surprise, his greatest solace came in the form of letters from a woman he barely knew. Motto had gone out with Marilyn Ryan about a half-dozen times while he was doing training in northwest Arkansas in the summer of 1943. It wasn’t serious: a few shows, a double date. But after he shipped out, she wrote to him. At first, he didn’t quite recognize her name. He answered simply to maintain the correspondence.

Her letters kept coming, whether he replied or not. Over time, he grew so attached to them that he felt the need to analyze why. They weren’t love letters exactly. “She just wrote of commonplace things—what she did during the day, and how cold it was getting, and what tunes were on the hit parade, + hello to Jim, and all that stuff,” Motto confided in a letter to an older sister. “Once in a while a wistful remark about how nice it would be if we could see each other again. No passionate drivel, though—just the implication that anyone writing so consistently must be sincerely interested.”

Almost inevitably, months into their correspondence, Motto found himself falling for Ryan. He tried to broach the subject of a deeper relationship: “Why in hell don’t we get it off our chests instead of remaining so painfully noncommittal?” But her response is lost to history. All that is known is that they continued writing each other, that Motto told his family several times about a girl in Arkansas (“a mighty potent morale builder”) who was “marking time” until he got back—and that although they flirted with the idea of a reunion, Jerome Motto would die in 2015, more than 60 years later, never having seen her again.

Still, her influence would shape the rest of Motto’s life. After the war, he studied psychology at Berkeley, completed medical school at UC San Francisco and then took a residency at Johns Hopkins in Baltimore before returning to the Bay Area. He was drawn to suicidal patients, men and women who resembled the shell-shocked soldiers he once transported. “Somebody has to speak for those who are not so strong, who are fearful, who are discouraged, who are distrustful of helpers, who are despairing, who are timid,” he recalled thinking at the time.

That was a fairly radical philosophy in the postwar years. In almost every social and medical circle back then, the act of killing oneself was considered to be more of a sin than a tragedy. Obituaries whitewashed suicide deaths as accidents. Catholics wouldn’t allow suicide victims to be buried in consecrated ground. In some states, attempting suicide was a criminal act. Medical schools tended to ignore the subject entirely, and many doctors considered it a “success in their practice” if they avoided suicidal patients, said Seymour Perlin, a colleague of Motto’s. Some years later, another colleague was in the emergency room when a young woman was rushed in. She had slashed her wrist and was barely conscious. The surgeon arrived, made sure she was alert enough to understand him and then said, “Next time, why don’t you just jump off the Golden Gate Bridge?”

All around him, Motto saw suicidal patients being made to feel alone. In 1965, he chanced upon a collection of papers by a German psychoanalyst named Hellmuth Kaiser. Kaiser argued that the most disturbed patients could be helped if they felt a sense of connection, even on a subconscious level. This got Motto thinking about Marilyn Ryan and how her letters had gotten him through the war, her sincerity dispensed as steadily as an intravenous drip.

“My own experience—it didn’t prove anything, of course,” Motto told me years later. But he wondered if the simple act of showing people that he was there for them—and expected nothing in return—would make suicidal patients feel less isolated, less in conflict with themselves.

So, in the late ’60s, with a grant from the National Institute of Mental Health, Motto devised a research project. He would track patients who had been discharged from one of San Francisco’s nine psychiatric facilities following a suicide attempt or an extreme bout of suicidal thinking—and he would focus on the ones who refused further psychiatric treatment and therefore had no relationship with a doctor. These patients would be randomly divided into two groups. Both would be subject to a rigorous interview about their lives, but the control group would get no further communication after that. The other one—the “contact group”—would receive a series of form letters.

It was a wildly ambitious undertaking. To produce meaningful data, the study would take years and require the participation of thousands of patients, the maintenance of hundreds of thousands of pages of notes and the constant writing of letters in the spirit of Marilyn Ryan’s. Motto secured office space right above the emergency room at San Francisco General and assembled an unorthodox squad of researchers to interview and correspond with all the patients. At various times, his team included a woman studying to be a rabbi, a man who had recently left seminary to get his Ph.D. in psychology, a gay minister shunned by his congregation and a former nun.

“One thing I realized in working with suicidal people was that the problem spanned so many disciplines,” Motto told the writer Peter Shore in 2006. “It wasn’t just a psychiatric problem. It was a psychological problem, a public health problem, a social problem, a philosophical problem, a theological problem. When I say theological, I mean when the patient says to you, ‘What’s the point in going on? It’s just painful. I’m going to die sooner or later anyway. What am I here for? What’s the meaning of my life?’ Well, I realized they hadn’t given an answer to that question to me in medical school.”

For the willing study participants, Motto created a 39-page questionnaire to document the finest details of their lives. He had researchers ask patients how old their next-younger sibling was, what their spouse did for a living, how many moves they had made in the previous five years and whether they were currently living in an apartment or a hotel. (And how big was the hotel?) Unlike other medical professionals, he also had his team pose pointed questions about patients’ suicide attempts: What had led to their decision? Had they sought help beforehand? What effect did the attempt have on their consciousness? How would they make their next attempt?

Motto insisted that his researchers memorize the questions so the exchanges wouldn’t feel clinical and instructed them to show unconditional acceptance. The interview might start with something like, “Tell me more about how you got here.” Certain patients badly wanted to talk. Others couldn’t. Some bore fresh wounds along their throats from attempted hangings. In the first year and a half, 16 patients died by suicide before they were randomized into the trial. Even the more experienced researchers were taken aback by the severity of the pain people were living with. Chrisula Asimos, who would become the study’s longest-serving researcher, once sought Motto’s advice about a participant who was particularly closed-off. “Motto just said, ‘You sit with the person and you be with that person for as long as it takes. At some point, they will get it,’” Asimos recalled.

The former nun, Patricia Conway, spent many hours over several days with a mother who was barely able to utter a word after her suicide attempt. One afternoon, the woman seemed transfixed by another patient who was screaming and thrashing nearby. After a long silence, she said, “Isn’t he lucky?”

Conway asked why.

“You may think he’s crazy, but he’s able to tell you what he’s feeling,” the woman replied. “He’s able to scream and yell and talk about it. But I can’t.”

It seemed so ridiculous: letters that could pull a person out of an abyss that deep. Not personal messages, but form letters typed out on one of the office’s IBM Selectrics. Motto wanted them to be simple and direct, with no clinical jargon or ass-covering fine print. Most importantly, they had to demand nothing. “No expressions like ‘you really should try to resume therapy’ or ‘would you fill out this depressive scale so we can determine what your status is?’” he said. It ought to convey a genuine sense of kinship—“simply what one might say to a friend.”

Motto didn’t take long to write the first letter a patient would receive. He knew what he wanted to say, hitting upon two sentences—37 words—that felt just right: “It has been some time since you were here at the hospital, and we hope things are going well for you. If you wish to drop us a note we would be glad to hear from you.”

With each letter they sent out, the research team’s secretaries enclosed a self-addressed envelope. Motto insisted that it not include a stamp. “That’s important,” he later explained, “because some of these persons were so sensitive that putting the stamp on the envelope would be pressure, that they’d feel obligated that we wouldn’t waste our stamp.”

The letters were to be mailed on a set schedule: once a month for the first four months; every two months for the next eight months; every three months for the next four years. In all, the correspondence would include 24 letters, sent over the course of five years, that would vary subtly. Some of the subsequent templates included:

“This is just a note to assure you of our continuing interest in how you are getting along.”

“Just a note to say that we hope things are going well, as we remain interested in your well being. Drop us a line anytime you like.”

“We realize that receiving a letter periodically expressing our interest in how things are going may seem a bit routine. However, we continue to be interested in you and how you are doing. We hope that our brief notes will be one way of expressing this.”

Motto’s study had the potential to be reputation-killing. Charlotte Ross, who founded a suicide prevention and crisis center in the Bay Area and frequently collaborated with Motto on research papers, put it bluntly: At that time, the idea of following up with suicide attempt survivors after they called a hotline was “as reputable as ambulance-chasing.” When Asimos told her colleagues at the psychiatric hospital about the project, they found it hysterical. “Are you kidding?” one gasped. “Why would you think just sending out a little letter was going to make a difference?”

There were other, more practical obstacles. The researchers had little way of knowing if their letters would make it to their targets—maybe they’d go to an old address or get lost between department store catalogs in the mail. All Motto and his researchers could do was enroll patients, send the form letters and wait. Between 1969 and 1974, Motto’s researchers interviewed more than 3,000 patients.

Even as staff members came and went, leaving for new jobs or graduate school, the nature of their work with Motto—the long hours, the lives at stake—brought everyone close. They organized potlucks and tennis matches, which Motto always won. Conway remembers going to jazz shows with another researcher who warned her: “This is not going to be very nunny.” The secretaries attended a feminist rally and then persuaded Motto to let them wear pants to work. And the researchers kept finding new ways to connect with suicidal people. They designed a support group for attempt survivors and took them out dancing. When the stress of the project got to be too much, they turned to each other for encouragement. This being the early ’70s, there were a lot of office shoulder rubs.

Conway often found herself talking to Motto over coffee in the morning or at his desk during lunch. They would chat about what they were reading—Motto was fond of the countercultural poet Kahlil Gibran—and she was immediately attracted to how passionate he was. She liked that he fumed about the Vietnam War, shooting off so many letters to his congressman that a staffer wrote back telling him to stop. (Motto kept writing him anyway.) Their talks soon developed into something more, and within a year of their first date, the 48-year-old Jew-turned-Unitarian and the 33-year-old former nun were married. Conway’s mother gushed that Motto was “the most Jesus-like person” she had ever met.

By late 1970, after Conway had left the study to start a family, clues started emerging that Motto’s experiment was working. Patients were finally writing back. Some of their notes were extremely brief; a tidy “I’m fine, thank you”—what Motto liked to call a “kiss-off.” (“Of course, we didn’t leave them alone,” Motto said years later.) Others were more revealing. One patient asked for a prescription for Valium. Another requested help finding a home for her fluffy gray cat. A young man feared being shipped off to Vietnam and hoped that Motto’s team could send the Army a letter confirming his previous hospitalization. “I would rather take my own life than destroy another’s,” he wrote. One person, who had survived a jump from the Golden Gate Bridge, sent a letter in which every sentence began with the letter p.

Motto recalled receiving letters that thanked him and his team for remembering them, while one replied, “You will never know what your little notes mean to me.” Even when the subject matter was dark—“Please call I don’t care what time it is. I love my kids but I need a rest because I think I am having a nervous breakdown,” a woman wrote in 1973—there was a sense of intimacy there.

The most pivotal response was sent to Douglas Kreider, one of Motto’s researchers, by a study participant who lived in an apartment in San Francisco’s Haight-Ashbury district. The man, who 18 months earlier had written a “kiss-off” letter, now described himself as a broken vase held together by his own hands. His letter spanned five single-spaced typed pages and read as if it had taken days to write. Forty years later, Motto could remember the first sentence: “You are the most persistent son-of-a-bitch I’ve ever encountered, so you must really be sincere in your interest in me.” There it was, a perfect encapsulation of the study’s aims. Motto called it “the bingo letter.”

Still, as promising as these replies were, they were just anecdotal evidence. For solid proof, Motto would pile a few researchers into his station wagon about once a year and drive an hour and a half northeast to Sacramento. They would arrive at the Department of Public Health at 8 in the morning and review the state’s death records, staying until they had looked up the names of every single study participant. They wanted to see if any of them had died by suicide.

“It was kind of a solemn duty,” Kreider said. “There was an undertone of ‘I hope I don’t discover something about someone I know.’” On one occasion, he did. He, like so many of the other researchers, had made real connections with his patients. This one was close to his age. The man had trouble making eye contact and suffered from paranoia. Kreider remembers that no one talked much on the rides home from Sacramento.

After about four years of these trips, Motto and his team had enough data to determine that their work was unprecedented in the history of suicide research. In the first two years following hospitalization, the suicide rate of the control group was nearly twice as high as that of the contact group. And it wasn’t only that no other experiment had ever been able to show a reduction in suicide deaths. Motto had also demonstrated something more profound: People who attempted suicide and wanted nothing to do with the mental health system could still be reached.

When Motto released his data in 1976, the field of suicidology was still very small and very new. The results were published in the country’s only journal dedicated to suicide research—circulation: 1,002—and his remarkable finding was mostly ignored. Still, Motto kept on with the study; his team sent out letters for nearly the rest of the decade and continued to track outcomes for each participant for 15 years. In an updated report on his findings, Motto showed that those who received letters continued to have slightly lower suicide rates for years—even as the letters decreased in frequency and then stopped altogether.

Motto didn’t do much to hype his achievement beyond speaking to small crowds at conferences and award ceremonies. In his quiet way, he was pleased that his work had meant something, and he turned to other projects. He continued to teach and publish articles. He advocated tirelessly for suicide barriers to be erected on the Golden Gate Bridge.

And Motto held on to people. Every day, he called his sister Sandy, the one who had gone through a divorce during the war. Long after his retirement, and even when he was basically deaf, he allowed a few former patients to call him regularly. “Some of my most prominent memories,” his son Josh said, “are of Christmas Day or Christmas Eve. The phone would ring, and he would go upstairs and be gone for an hour.” The act of listening was sacred to him. It was what made Motto feel most alive—to ask: Tell me more.

A psychiatrist once asked Motto, “Am I my brother’s keeper?” Motto replied, “No, you aren’t, but you are your brother’s brother.”

He seemed never to stop, even when his posture began to stoop and his office had turned into a labyrinth constructed of towers of academic papers and yellowing books, overlooking the pool he never used and the garage filled with still more papers and books. And tucked right there within a folder among his files was the bingo letter, which he kept in mint condition until the day he died, waiting to be rediscovered.

Ursula Whiteside is, above all else, a bad pun and cat-based humor kind of person. She seems never to have met a GIF of a penguin, or of Beyoncé, she didn’t like. And her therapeutic practice draws heavily on these cornball ways. One of her clients had trouble getting out of bed in the morning, so Whiteside regularly texted her things like: “Here comes the magical wake up goat to make this day less baaahhh.” And the next morning: “The rabbit needs feeding! Only you can make this happen by hopping out of bed.” When that same client went on vacation last year, Whiteside sent a text urging her to feel “FREEEEEEEE!” accompanied by a cartoon of a dog sticking his head out the window. (These texts, like all others in the piece, were provided not by Whiteside, but by the patients.)

While her messages don’t mimic Motto’s plainspoken voice, they fully capture the spirit of his work. Whiteside started sending them when she went into private practice four years ago and immediately discovered how powerful they were. So many of her patients struggled between sessions. They bristled at the artificial boundary of a 50-minute conversation. The texts acted like evidence of a relationship, tokens her patients could hold on to as proof someone cared about them. It’s hard to overstate how different this is from the correspondence patients usually receive from the medical establishment. Whiteside has a therapist friend who calls the typical automated notices people get when they miss an appointment “I Hate You Letters.”

Still, Whiteside sets rules for her patients: They must agree to receive the texts. They don’t have to text back. If they do, they need to understand that they might not receive a response for at least an hour. She might be in a session with another client, or on her way to lunch. She also wants her patients to give her clear feedback on what they like and don’t like. One person said she hated the penguin memes and would prefer to receive pictures of nature instead. “You’re always paying attention to what they find funny, to what they are saying when they cry,” Whiteside said.

She sets rules for herself, as well: Typos are OK. Being a little annoying is OK. Each text should take no more than 90 seconds to write, because anything longer might read like it’s been workshopped too much, not enough like a message between friends. She also makes sure to time her texts so they don’t arrive only when patients are in crisis. Mostly, they should appear for no particular reason. She had been thinking about them, that’s all.

“I think people die when they feel completely alone,” Whiteside explained.

By the time she developed her sense of mission, a small band of therapists and researchers from all over the world had also recognized the value of Motto’s approach. Gregory Carter, who ran a psychiatry service in New South Wales, Australia, orchestrated a study in which Motto’s words were typed onto a postcard illustrated with a cartoon dog clutching an envelope in its mouth. The notes were sent eight times over the course of 12 months to patients who were among the hardest to treat. The majority had histories of trauma, including rape and molestation. Some had made repeated suicide attempts. But Carter found there was a 50 percent reduction in attempts by those who received the postcards. When he checked in on the study’s participants five years later, the letters’ effects were still strong. And the cost per patient was a little over $11.

In Tehran, researchers ran a similar experiment, tweaked to fit the local culture. “In my mind, [the Motto text] was maybe boring for our patients,” said Hossein Hassanian-Moghaddam, an associate professor at Shahid Beheshti University of Medical Sciences. “Maybe you think that it is somehow a robot that is sending you this kind of message.” Instead, the Iranians wrote sentimental greeting cards packed with inspirational sayings or religious text. Some were inscribed with quotes from Albert Einstein. Others drew from Buddha or President John F. Kennedy. They also sent cards on the patients’ birthdays (a favorite among the participants). The results were similarly positive.

Kate Comtois, a renowned suicide researcher based in Seattle, sought to test these methods out on a new audience—one close to Motto’s heart. For her randomized control trial, funded by the Department of Defense, she and her team sent out text messages to hundreds of active duty Army soldiers and Marines. Each one got 11 Motto-style texts throughout the course of a year.

When the researchers focus-grouped the messages on active-duty servicemembers, they were told that for this to work on Marines, texts should never imply weakness. “We were schooled,” Comtois said. “They didn’t want us to use the word ‘need.’”

So she and her team kept the texts to the point: “hope life is treating you well” and “hope all’s well and you’re taking good care of yourself.” Because they were texts, the researchers could reply to the soldiers with emoticons or whatever else felt natural. The study, which recently concluded, showed that recipients were less likely to have suicidal thoughts or make an attempt. Comtois was struck by how different the text interactions felt. “Most of the time we were reaching out to somebody who was happy to hear from us,” she said. “That’s just not how suicide care is.”

But perhaps the most ambitious Motto-related work taking place right now can be found in a small mental health clinic in Bern, Switzerland. One of the clinic’s co-founders, Konrad Michel, centered his entire approach around patients’ storytelling. He initially recorded his therapy sessions with patients and then had them reflect on the experience in filmed follow-up interviews conducted by a colleague. They told him what they thought of his questions, his mannerisms, the way he made them feel. The work was humbling.

Over time, he and the clinic’s other co-founder, Anja Gysin-Maillart, developed a new therapeutic model called the Attempted Suicide Short Intervention Program, or ASSIP. It’s a far more intense and compassionate way of treating the suicidal—an add-on to regular therapy and medications. In the first session, which lasts about an hour, a patient is recorded telling the story of a suicide attempt and what led up to it while a therapist tries not to influence the narrative. In the next session, the same therapist sits with the patient as they watch the recording together. The therapist hits “pause” whenever there is an opportunity to dig deeper, searching for breakthroughs. In the third session, they outline potential triggers and vulnerabilities that could lead the patient back into a suicidal mode. Then they jointly plan long-term goals and strategies that minimize the risk of another attempt. If a fourth session is needed, they’ll watch the recording of the first session again and tweak the safety plan to fit the patient’s needs.

The work, Gysin-Maillart says, brings clarity to patients, who often feel overwhelmed after an attempt. And if it all seems dramatic, that’s the point. The therapist and the patient are expected to bond over the experience. The patient then receives Bern’s version of a Motto letter at regular intervals for two years.

So far, the outcomes have been astounding: In 2016, the findings of a clinical trial were published, showing an 80 percent reduction in the risk of attempts and fewer costly days in hospitals following treatments. New clinics have been set up in nearby Zurich, as well as in Finland, Sweden and Lithuania. Late last year, Michel began training therapists in Syracuse, New York, to start their own practice with federal funding.

When I visited the clinic in Bern, I was more interested in what I didn’t see. There were no doctors giving patients a diagnosis or prescribing them medications. Instead, it was a place of vigilant listening. I watched a first session between Gysin-Maillart and a patient with a long, complex history of suicide attempts. Gysin-Maillart asked what had led her to consider suicide as an option. And for the next 25 minutes, she listened without a single interruption. “Did you have the impression that I disappeared?” Gysin-Maillart asked me afterwards. She worried that her body language was too much, especially her head nods. “It’s best not to nod,” she said. “But her story was so hard I had to give her something back.”

Several of her patients told me that unlike other doctors, Gysin-Maillart never tried to assess their risk. Instead, she made them feel understood and hopeful. Watching themselves on the videos helped them understand the severity of what they had been through. They couldn’t minimize what they had done. And the letters only solidified their sense of connection to her.

Of all the patients I met, no one seemed as invested in the letters as a college student named Anna, who told me that before coming to the clinic she had felt “very lost in the world.” Her replies to Gysin-Maillart ended up taking the form of long confessionals, filled with details about her life that she hadn’t shared with her therapist (whom she admired) or her mother (with whom she was on good terms). Anna came to see Gysin-Maillart as the keeper of all her secrets.

“I got your letter and almost didn’t want to open it, because I wanted to preserve that feeling of joy a little while,” Anna replied after Gysin-Maillart’s first note. “Like when I don’t open a present right away.”

For the next two years, Anna wrote Gysin-Maillart about how hard it was to fit back in following her attempt, how even her friends didn’t understand her and why she couldn’t cry. To cope, she had taken up rowing. “Rowing on the Rhine,” she wrote, “when everything is still quiet and undisturbed, and the fog drifts over the water, and the sun slowly begins to warm up, the quiet slap of the oars and the rush of the water around me, that gives me an indescribable feeling.”

Three months after receiving her last letter from the clinic, Anna’s insomnia was raging and she started thinking about suicide again. So she took what she’d learned from her sessions and began writing an email to Gysin-Maillart. Just as she had in previous letters, she poured out all of her thoughts. But when she was done, she realized she didn’t need to send it. Writing it was enough.

The Motto approach is like a promising experimental cancer drug. It has the power to send suicidal urges into remission or reduce them to a manageable level. It is the best hope for some of society’s most despondent people. But that doesn’t mean therapists are eager to try it or that it’s easy to scale up, particularly within a health care system as downright messy as ours.

April Foreman, an executive board member of the American Association of Suicidology, uses the term “virtue theater” to describe the current state of mental health care in America. It outwardly signals hope, but on the inside, clinic personnel are consumed by paperwork, funding stress, liability concerns, impossible caseloads and the ever-changing and byzantine ways people qualify for help. “We train mental health professionals to be terrified of all things,” she said. The job becomes about avoiding litigation and high-risk patients, not experimenting with new ways of treating the people who need it most.

This helps explain why insurance companies have yet to embrace Motto’s methods. The industry has a long history of not wanting to pay for mental health services, too often covering them only when required to do so. Up until about a decade ago, strict limits on treatments were the norm; only a relatively small number of therapy visits were covered per year. The financial incentives are still out of whack today. Insurers pay therapists the same rates whether they’re seeing a mildly depressed 20-something or a chronically suicidal 50-year-old with an opioid problem and a gun in his nightstand. As a result, solo practitioners may be less likely to accept clients with a history of suicide attempts. Without additional grant money, many hospitals and clinics aren’t inclined to devote resources to an intervention they can’t reimburse for.

Even more frustrating is that there are plenty of people within the insurance industry who know how powerful the Motto approach can be. A medical director at Cigna admitted to me that he “absolutely” believes in it, while one from Premera Blue Cross deemed it “incredibly valuable.” The Premera director told me that she sends messages to clients in her private practice, but couldn’t see her company ever reimbursing people for individual texts or emails.

That’s not to say that the Motto approach doesn’t come with real risks. The idea of having to defend penguin GIFs in a wrongful death lawsuit is genuinely frightening. And because of privacy concerns, many hospitals and clinics do not allow their doctors to communicate with patients outside secure portals. If the contents of these conversations were hacked and made public, it could be catastrophic for everyone involved. Some therapists even expressed concern that a spouse could see the messages and believe them to be evidence of an affair.

And then there’s the difficulty of writing the messages themselves. Think of all the times a text of yours didn’t land just right and you had to respond explaining that, No, what I really meant was this. Or the instances when you couldn’t decipher whether a sarcastic message from a partner was playful or taking a subtle dig at your personality, so you just sat there stewing for a while. Then imagine that interaction taking place when somebody’s life is at stake.

These kinds of issues become harder to manage at the institutional level. Kate Comtois, who oversaw the successful military study, said that with so many therapists untrained in how to treat attempt survivors, it may be difficult to handle a wave of patients if they seek help after receiving a caring letter or text. And writing the letters can be tricky at scale. When the U.S. Department of Veterans Affairs first encouraged its facilities to send out cards to ailing vets, nobody imposed specific language, and many of the messages ended up straying from the therapeutic ideal. Some bugged patients about not answering the phone when a therapist called; others pestered them to eat better. They asked too much in return from the patients (breaking Motto’s rule) and, just as bad, they expressed worry. Worry, Linehan told me, sends the wrong message because it’s “a statement that you don’t really believe in them.”

But perhaps the biggest obstacle preventing the Motto approach from becoming more universal is that it crosses one of the most inviolable lines in therapy: the one between in session and out. From the beginning of medical school, doctors are instructed to keep an emotional distance from their patients to prevent burnout and guard their objectivity. Psychologists and social workers are taught similar principles. Basically, when the work day is over, you leave your patients’ struggles behind and return to your own life. There’s a reason a therapist’s voicemail message tells patients to call a suicide hotline or 911 if they’re in crisis after hours.

Paul Appelbaum, a professor of psychiatry, medicine and law at Columbia University, believes that texts are dangerous because they can be “the first step to the crossing of other boundaries.” He mused: “Is this once a day? Every hour? Can you have a drink even if that means you might not be as sharp? Can you enjoy a family wedding without retreating to a corner to answer text messages?”

At least one study cuts against these concerns. In 2004, researchers found that the more open therapists were to receiving calls from clients in between sessions, the fewer they ended up taking. Stacey Freedenthal, a clinical social worker and associate professor at the University of Denver, believes that one way to manage the boundary problem is for all mental health care workers to have a better understanding of risk. Therapists need to be able to differentiate between acutely suicidal patients (those who are in danger right now) and people who have contemplated suicide for years but who often do not intend to act on those thoughts.

Everyone in mental health, she said, should know how to treat the acutely suicidal—to develop a plan to keep them safe, to talk to family members about getting a gun out of the house. It’s akin to every doctor knowing CPR. But she thinks that therapists who don’t believe they’re emotionally adept enough to handle the chronically suicidal should get training when they take on that responsibility. “Some therapists stand in the light and call out to the person in the darkness, ‘Come out, there’s light here, there’s hope here,’” she says. “But sometimes what the suicidal person needs is for the therapist to join them in the darkness and show them a way out.”

On a sunny June morning, I made my way to Whiteside’s modest postwar bungalow in the Capitol Hill neighborhood of Seattle so that I could see what a normal day looked like for her. I knew she’d have sessions with clients and paperwork to churn through, but I was most interested in what happened during the in-between times.

She arrived at the door full of energy, her face elastic and expressive. The living room was a hodgepodge of thrift-store furniture, and she apologized for the walls being mostly bare. The two picture frames sitting on the dark wood coffee table both contained stock photos of smiling models. She’d lived here for more than a year but hadn’t found time to replace them with pictures of her own. In her kitchen cabinets, she had stored research files among the pots and pans.

Whiteside cocooned herself inside a fuzzy red blanket on her sofa and decided to check back in with Mary, one of her regulars. Whiteside has about 10 patients at a given time, and she worries most about the ones who aren’t texting or calling. She hadn’t heard from Mary in a couple days.

Mary (not her real name) was 41 at the time, with a good job in a nearby school system, and she worked very hard to hide her thoughts of suicide from friends and co-workers. But at night, she had trouble staying off gun websites. She had run through dozens of medications and several psychiatrists over the years. She told me she saw Whiteside as her last chance at getting better. Still, many of their sessions hadn’t been easy, and Mary would leave therapy angry about all the emotional work Whiteside required. She set up a ring tone to alert her when Whiteside sent a text because there were times she couldn’t look at it until she was ready.

It had been Mary’s birthday the day before, and Whiteside wasn’t sure how she’d handled it. She’d sent Mary a text before I arrived—just a jokey meme from “The Shining” in which a cat (instead of Jack Nicholson) breaks down the bathroom door with an ax. Whiteside was fully aware that Mary hated cat humor, but these texts had become in-jokes between them.

“As I was sending it, I was like, is this going to be harmful? Could this be interpreted another way?” she said. At first, she didn’t expect a reply. Now, hours later, she was craving one.

Whiteside sat still on the couch for nearly a minute, blinking at her phone. She wasn’t sure what to text, or if to text. Maybe she should sound a little scared. Maybe she shouldn’t. She started playing with language, saying words out loud to test their weight.

“Did you do anything for your birthday?”

No, that wasn’t right. Too judge-y. She was silent for another minute. She picked up her phone. She checked Facebook. Still no message from Mary.

“Did you do anything for yourself for your birthday?”

A short pause. Yes, she liked that one. The message might have seemed innocuous. But for someone like Mary who could isolate herself, it carried a subtle reminder of a therapeutic goal: learning always to be conscious of your state of mind, to anticipate and head off destructive thinking. For yourself, the message said. Maybe she’d get it. Whiteside tapped it out quickly and hit send.

About five minutes later, Mary responded that she was OK, but offered no further details. Maybe the exchange annoyed her; maybe it didn’t. Either way, she had responded with something warmer than silence.

The episode was both a success and a perfect case study of why therapists who don’t possess Whiteside’s superhuman patience can struggle with the Motto approach. Treating the suicidal means that your clients are never far from your mind. You have to be an expert at interpreting their messages and noticing troublesome shifts in personality that are imperceptible to just about everyone else. For years, Whiteside has excused herself from dinner dates to soothe clients. She leaves her phone on at the movies and when she boards planes. She knows—and her friends agree—that she doesn’t do enough for herself.

But she finds herself more at peace when she’s in regular communication with her clients. The people who create the most stress for their therapists are the ones who don’t engage at all. The people who talk about their pain, on the other hand, are extending an invitation to help. Shortly before I visited her, Whiteside was about to fly home from San Francisco when she received a text. “I do not want to be here. I do not want to breathe. I do not want to talk,” a client wrote her. This middle-aged single mother had been drinking and then heard a song that reminded her of an old boyfriend. She was spiraling. But Whiteside knew precisely how to defuse the situation. “OK, now time to get ready for bed,” she texted after some back-and-forth. “Lots of water. Comfy pajamas.”

The client followed the instructions, and the next morning, she texted Whiteside her plan to get through the rest of the week, adding, “I know the first step was to get me through last night. We did that.”

Only rarely has Whiteside ever buckled from the demands of her approach. In 2017, she was going through a rough patch on a research project, and although she kept her appointments with Mary, she stopped sending text messages between sessions for a week and skipped two weekends. When she started to feel guilty, she asked herself how many doctors texted their clients on their days off. All of a sudden, she felt like an outlier; perhaps her entire method was risky.

At their next session, Mary brought up the lack of communication, worrying that their relationship had hit a snag. “I don’t want to interrupt your week…” Whiteside began to explain. Mary’s reply was quick and firm. “No, no, no, no, no, no. Don’t stop,” she told her. “Don’t stop.”

Over time, Mary has built up a support system and finally feels comfortable enough to go to softball games with friends or on trips to see her family. She also no longer feels unworthy of Whiteside’s attention. And yet, she still has days when she plays with the idea of “maybe just getting it out of the way now.” On the morning before a new round of electroconvulsive therapy, Mary was feeling particularly depressed and afraid. But there was Whiteside again, popping up on her phone. “Remind yourself: I believe in you,” Whiteside texted. “You’ve done this before. You know how to do very hard things.” Suddenly, Mary felt fortified.

On another bad night, Mary made a scrapbook of some of her favorite things in the world. Along with pictures of her nieces and nephew and a photograph of a shimmering pool, she pasted screenshots of a few texts from Whiteside. Yeah, some of them were corny. (“Wouldn’t it be nice if black clouds offered sprinkles?”) But Mary was in awe of them because they worked.

Whiteside would quibble with that. She’d say they are working for now. “Caring messages are a nice acceptance bath, and that’s great and often what’s needed first,” she told me. “But then the person needs support in actually changing, otherwise they end up staying in hell.” Too often in suicide care, that support simply doesn’t exist. It’s not like when you’re diagnosed with cancer and are introduced to a team of caregivers: oncologists, surgeons, pain specialists, nutritionists, even wig experts. Suicide treatment is a far lonelier enterprise. Most of the time, it’s just two people, talking back and forth, trying to figure out what it takes to keep living.

Whiteside will never fully know what’s in her patients’ minds. She’ll always worry that she won’t be able to reach them in the moment they need her help the most. All she can do is send out a message and hope.

A few days after my visit to Whiteside’s house, I met Amanda, the nurse who swallowed all those pills a decade ago. She showed up in the fading light of rush hour in front of Whiteside’s office building and greeted me in a library voice so slight I could barely hear her. Although she stopped seeing Whiteside around two years after that attempt, they stayed in touch and had agreed to meet me so that we could review their years of correspondence.

The building’s other tenants had gone home for the evening, leaving it dark and quiet inside. It felt almost as if we shouldn’t be there. To put us at ease, Whiteside phoned the bar across the street to order a hummus plate and a six-pack of root beer. As we waited for the food, I asked Amanda about her first impression of Whiteside.

“I thought she was naïve,” she said. “Everybody else I’d worked with seemed overwhelmed and scared and frustrated. … I always worried that I was too much.”

“I understood that you felt like you were too much,” Whiteside replied. “I think if it was anything, I doubted my abilities.”

Suicide “always felt like my problem,” Amanda said. “Everybody blamed me and I needed to fix it.”

“Do you think that you could feel that I cared about you, though? Or were you not able to believe it?”

Amanda considered the question. The only sound in the room was the cord from the blinds clicking against the window. A full 15 seconds went by.

“I thought that you cared about me as much as a provider was allowed to care for their client,” Amanda said.

“Did that ever change? Or was that…” Whiteside stopped herself. “You can definitely say ‘no.’”

“I think in my head I just had to keep thinking, ‘She’s not my friend, she’s my therapist,’” Amanda said. “I think it would have made it harder if I felt like there wasn’t a boundary.”

Eventually, they made their way to the early morning of September 28, 2007, and their last exchange before Amanda’s suicide attempt. Whiteside reviewed her old email with embarrassment. Read aloud, the words now seemed harsh and demanding. Motto wouldn’t have approved. “Take a hope pill,” she had written, reinforcing a theme of theirs from therapy. “I need you to make a specific plan for this weekend.”

Whiteside started rewriting on the spot, testing it out on Amanda. “If I were to do it over again, I might say, ‘Listen, Amanda, I need you to hear me right now. I can feel your suffering through this email. And I want you to know that I am really—literally—holding on to you. And you can’t leave,’” Whiteside said. She paused. After what seemed like a long while, she thought of a last line, one that possibly could have kept Amanda on the hook: “And can we talk at your lunch break?”

For a moment, Amanda was silent, then tears began to slide down her cheeks. She just wasn’t sure. She thought maybe nothing would have stopped her, but there was no way to know after all this time.

About a year later, I called Amanda up, and she told me something about her attempt that she’d never told anyone before. It now seemed significant to her that after picking up the pills, she’d waited for hours before she took them. Maybe she was wavering. Maybe she was waiting for someone to reach out to her with just the right words. “I don’t know if I set it in stone,” she said. “I think I could have changed my mind.” There was still a chance.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HOME to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.

And if you’d like to use the treatment methods described in the piece, check out a nonprofit that Whiteside founded called Now Matters Now. The site teaches basic DBT skills and provides a sample Motto-style card anyone can download and send to someone in need.

CREDITS

Story - Jason Cherkis

is a reporter for HuffPost. He is working on a book about suicide for Random House.

Research - Matt Giles

is a freelance writer and the head of research and fact-checking at Longreads.

Creative Direction & Design -

Donica Ida is the creative director of Highline.
Kate LaRue is a freelance creative director.

Development & Design - Gladeye

is a digital innovations agency in New Zealand and New York.