Acceptable losses

Klinenberg is not arguing that governments should be held responsible for nature. He is arguing that they must be made accountable for their response to natural disaster, that "act of God" excuses allow the culpable to escape responsibility. He is also arguing that it isn't enough to evaluate social services in terms of how they perform in ordinary circumstances, but on their capacity to perform under extraordinary conditions, especially when they don't respond adequately even though they have the resources they need.

What makes "Heat Wave" such an essential book at this moment in American politics is that, using the 1995 heat wave as his paradigm, Klinenberg has written a forceful account of what it means to be poor, old, sick and alone in the era of American entrepreneurial government. Richard M. Daley's father, Mayor Richard J. Daley, was the king of Chicago machine politics. His son, touting the new idea that government should be run as a business -- which is to say at a profit -- epitomizes the death of his father's way of running things. Or to put it in its bluntest terms: Old man Daley was a bully who used his police force to beat people bloody in the streets during the 1968 Democratic Convention. His son, in the new era of government efficiency, presided over policies that killed Chicagoans in their homes. Klinenberg sees his book as a story of hubris and shortsightedness. But it's hard to put down "Heat Wave" without believing you've just read what's described in the book as a tale of "slow murder by public policy."

The city's response to the heat wave was one of those nightmares that teeters on the verge of being a sick joke. Robert Scates, a deputy chief paramedic who monitored emergency services on Chicago's South Side (home to large numbers of the city's black and poor) realized that a crisis was at hand. His paramedics were working 26- to 28-hour shifts in 100-degree heat, going from one call to another without returning to their base firehouse. Scates called his superior, as well as the chief paramedic and the deputy fire commissioner of emergency services, to persuade them to institute a recall of all personnel who were not working at the time, and to put in a call to the suburbs for more ambulances. The chief paramedic relayed a message to Scates from the deputy commissioner: Stop being "paranoid." The deputy commissioner refused on three separate occasions to honor Scates' request.

The Chicago Fire Department includes both firefighters and paramedics, though firefighters outnumber paramedics seven to one and, in 1995, were overwhelmingly represented in the department's top positions, paying little attention to paramedics' request for more resources. The average waiting time for an ambulance in Chicago was seven minutes, though 20 was not unusual. During the heat wave, the wait stretched anywhere from 30 to (in one instance) over 70 minutes. This is hardly a matter of cost, since the Fire Department, according to Scates, routinely refuses to spend 5 percent of its allotted budget. Coming in underbudget, even if it puts citizens at risk, allows management to look fiscally responsible and to curry favor with City Hall.

In 1995, the Fire Department had no system for monitoring either the number of calls or the nature of them. During the heat wave, hospitals were so overwhelmed with patients that at one time or another, 23 of them had to close their doors to new admissions. At one point, 18 hospitals were closed. But there was no system in place to inform paramedics as to which hospitals could receive new patients, so people in need of dire care (heatstroke can be arrested if a patient receives immediate attention, usually by rehydration and lowering the body temperature with ice packs) were shuttled from one hospital to another. Or another. Or another. The fact that a majority of the city's hospitals are located in the more affluent North Side, thus further isolating the poor who live on the West and South Sides from immediate care, meant that desperately sick people went even longer without treatment.

Obviously, many of those people died. But even in death, the bureaucracy let them down. So many bodies came into the medical examiner's office that eventually nine refrigerated meat trailers had to be set up in the parking lot to house the corpses. With the city's 56 ambulances overworked, police had to transport bodies to the morgue (many in a state of decomposition), where they often had to wait an hour and a half to file their paperwork, thus delaying them from answering calls about elderly neighbors who had not been seen in a few days. The city finally offered parolees the opportunity to cut their parole time if they volunteered to move bodies.

Next Page: "Those people were going to die anyway"

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