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Tapping Into The Wire

AMONG THE THOUSANDS INSPIRED to enter journalism by the 1972 Watergate reporting of Bob Woodward and Carl Bernstein was a young, Bethesda, Maryland, teenager named David Simon. A writer for his high school paper and, later, editor of the Diamondback at the University of Maryland, Simon pursued his dream of becoming a reporter steadily and efficiently. He joined the staff of the Baltimore Sun only ten years later, in 1982. For most of the next thirteen years, he covered the paper's police beat.

The cop shop is not a glamorous reporting assignment. It is safe to say that most reporters who have covered the police department were not sad to leave it behind for something less chaotic and more predictable. The hours are awful, weekend shifts and night shifts are plentiful, and the information surrounding most crime stories is maddeningly difficult to pry loose from suspicious or personality challenged cops.

Simon, however, thrived at it, turning in solid copy marked by numerous inside sources and a gritty, readable style. He earned the trust of enough local cops that the department allowed him to spend a year practically living with the homicide squad while researching a book. When it was published, Homicide: A Year on the Killing Streets was grabbed up by

Baltimore native Barry Levinson, who turned it into an award-winning TV series with Simon writing many of the scripts.

During his newspaper days, it was clear to the reporters who worked with him-myself included-that Simon was a different breed of journalist. Besides being a tenacious reporter who knew how to get information, he was a writer of evocative prose. Sometimes forgotten is the notion that a journalist is one who strives to master two arts: reporting and writing. Often, those who approach such mastery are known by their passionnot merely for the job, for the career, or even for the paper. Rather, it's a passion for telling a story well. David seemed always ablaze with the righteousness of whatever story he was working on. He would defend his ideas long and hard against editors who thought they could impose their own vision of the story on him.

In my view, the Baltimore Sun was never a writer's paper. It was not the paper of H. L. Mencken-that was the Evening Sun, the afternoon paper that eventually died or was killed off, depending on how close you were to the body on the sidewalk. The morning paper, simply The Sun, proudly waved the banner of hard, serious news; it stood proud, sometimes to the point of overbearance, behind its laudable record in covering wars and international intrigue. It never quite figured out what it had in Simon or how to deal with his ever-broadening streak of independence. That he would one day leave seemed inevitable to many and became fact in 1995.

That year, Simon teamed up with former Baltimore homicide detective Ed Burns to write The Corner. It's a true-life look at an impoverished family living near the corner of Fayette Street and North Monroe-the heart of the west Baltimore drug world where dealers often sell their goods from street corners. Simon adapted the book into a six part mini-series for HBO. He wrote five of the six scripts and earned a credit as a producer. The series won three Emmy awards.

Simon then conceived the idea for a new HBO series called The Wire and was given the go-ahead to film a pilot. Again, he teamed up with writing partner Ed Burns. The series, which ran for five seasons, premiered on HBO in 2002. It introduced the world not only to Baltimore-its cops, politicians, drug addicts, union leaders, crime lords, and newspaper editors-but also to the state of crime, poverty, official indifference, and general urban decay found in most American cities. Its characters were

FOREWORD

fictional but drawn from the street reality Simon and Burns had observed and interacted with for years as newsman and detective.

Following that success Simon produced and wrote Generation Kill, a six-part HBO series based on a book of the same title by Evan Wright. It told the story of the First Reconnaissance Marine battalion during the 2003 Iraq invasion. His latest work for HBO, a series called Treme, focuses on a group of New Orleans musicians whose lives were dramatically affected by Hurricane Katrina.

In 2009, after Peter Beilenson asked me to join him in writing this book, I suggested that it include the voice of David Simon. In the fall of 2010, I interviewed David at his home in Baltimore's Locust Point. What follows are the highlights of that talk as they relate to the subject of this book: public health imperatives that are at the heart of every episode of the program David Simon called The Wire.

Patrick A. McGuire

Patrick McGuire: A relatively new model of public health is taking hold in many areas of the country. It goes beyond the traditional role of dealing with issues such as immunizations and safe-water initiatives. It views the spillover effects of drug-related chaos in our inner cities as a threat to the health and well-being of all citizens-not just those in certain neighborhoods. The Wire seems to mirror this view in depicting poverty, gun violence, and addiction as unsolved problems of public health and not just criminal justice. Was that an intentional focus?

David Simon: We made those points in The Corner. Since it was nonfiction, we made a much more fundamental argument in that show. The Corner was the reporting, whereas The Wire was like a big op-ed piece.

I remember having lunch with Peter Beilenson and Kurt Schmoke in the late nineties. Schmoke had read The Corner and asked to meet with Ed Burns and me. Schrnoke basically said, "You guys get it. This is why 1 came out for decriminalization:' [ told him he was a prophet without honor in his own country. In many ways Schmoke was a pragmatic man in terms of filling potholes and getting stuff done and getting everyone moving the city forward. A little ethereal. He would have made a great senator. Being mayor is a much more prosaic thing. But as an idea guy he was smart as a whip.

A CONVERSATION WITH DAVID SIMON xi

Schmoke started to sour on the drug war with the killing of narcotics detective Marty Ward in '84. The guy who hit all over him for suggesting a discussion about decriminalization was Congressman Charlie Rangel. He wasn't addressing himself to what Schmoke was saying, which was ab

solutely accurate. He wasn't offering any other solutions and wasn't accepting the notion that the War on Drugs wasn't working. He savaged Schmoke.

At the time I thought, "\'(fow, Schmoke just wants to talk about it but we can't even talk about if' I don't know that I was as confirmed in my belief then that the drug war had to end. I was working on Homi-

cide. I was surrounded by guys who were working drug-related murders. I didn't really start thinking about it until 1993-95 when I was researching The Corner. And then, all of a sudden, what Schmoke had said and done was prescient. In The Corner, we basically said it's an intractable war and unwinnable, it's destroying police

work, destroying health initiatives. It's not succeeding.

PM: The theme of The Wire seems to be the inability of our public institutions to function without corruption, self-interest, or a political motivation behind every turn of a wheel. \Xfhen you initially conceived the idea of The Wire, had you already decided which institutions to go after?

os: First, I needed to see ifHBO liked it. They only asked for the one season. It was entirely possible we would have only one season. I knew that we only had room enough in that one season to start an argument about undoing the drug war. Once they asked us, "Do you want to come back? Do you have more?" we said absolutely.

At that moment we could open it up and go into different things. So then there was a discussion with writers-myself and Ed Burns and later George Pelecanos, who was extremely influential. Richard Price kicked in after Season 3. We threw it open to the idea of what would we need to do

xii FOREWORD

._-" -_ .. __ .-

to paint the city. The second season I was adamant about going to the port. Underlying all of that was reforming the underclass, which effectively is the drug war. That needed to be the second season.

The third season needed to introduce the political infrastructure because we needed that in place to speak to reform. We also needed in place somewhere in the series the futility of any attempt to reform the school system or address the school system. You could see the inertia there. And then the last piece had to be the media. Because you basically wanted to say, as a coda to the piece, by the way if you thought any of the problems that we've depicted are going to be addressed, the external watchdog has

no teeth anymore.

So those were the five seasons, if we got five. We still had to beg. They

gave us two and three pretty easily. We were almost canceled after three. Four was a hard fight. A lot of begging. After four there was talk about canceling the last season. It wasn't a hit. They had a limited production budget. They said, "\Ve'll give you money to try something else, to shoot a pilot." They were looking for another Sopranos, and they said, "Why don't you take another shot at having a hit?" I kept saying, "I don't do hit:' And then it turned out that The Wire became The \.(fire. Somewhere around the end of the fourth season the DVDs began to sell incredibly well. And they continue to sell to this day. Overseas it's huge. Nobody had seen that. I certainly hadn't. I didn't know people would want to watch it that way. Anyway they gave us a fifth season.

David Mills came in later and said, "Why don't you do something about

the Latinos coming into Upper Fells Point?" Immigration. He was dead right. As soon as he said it I realized it was one that we'd missed. By the time he said it we were gearing up to do season four with the young kids-which also started the rise of Marlo's crew. It was a two year story are, and we'd already planned the ending. Immigration is the one 1 wish we had done.

PM: What advantage did your background as a police reporter give you in writing The Wire?

os: The Sun gave me an opportunity to observe at every level the systemic roots of an issue. I joke that my great success was never having been promoted at the Sun. I was always a police reporter. I covered the same things

for thirteen years. Most of my shifts were shifts of rewrite and of police. In 1985 they were going to send me to Howard County. I said, don't let them send me out there. I refused, but that's like refusing the way out of the cops beat. Not the best career move. Once you cover counties well, you're maybe asked to be the third guy covering the legislature. Then maybe you work your way up to covering the state house. Maybe you get into the Washington bureau.

The problem with most police reporting is that people want to get off the beat. So, typically, you only cover the beat long enough to have written the usual eighteen-inch stories. Stories about cops showing the dope on the table after a police drug raid. And police reporters would cover it straight-as opposed to saying to themselves, "Wait a second. I've seen this for six or seven years, the drugs on the table. In fact, the corners are only getting worse. Drugs on the table don't matter:'

So readers would get the same institutional dog and pony show and there would never be depth reporting on the drug war. Or what policing had become. Policing was being destroyed. The police department was learning mediocrity and learning stat work because what they were abandoning was police work.

By letting me into the homicide unit for the book Homicide: A Yea ron the Killing Streets, I met three hundred to four hundred cops. I had phone numbers and beeper numbers for half of them. The best of them were being wearied by the transformation in the police department. Not a II of them agreed with me about the drug war, but all of them certainly agreed with me that the level of professionalism was dying. And they couldn't quite understand why. Some of them clearly understood that the easiest thing in the world is a drug arrest. And so you don't need to learn to do police work. Which is exactly what happened in the Baltimore police department. They raised generations of cops who didn't know how to make a case. Because you're not making a case. You're going out on the streets to get stats, whether or not those cases were ever prosecuted-that was not even of interest.

I stayed on the beat long enough that they couldn't wheel out the same old bullshit.

PM: The Wire starts out as a police story, but it quickly becomes much

xiv FOR EWOR D


more than that, touching heavily on social issues. How did your social consciousness evolve?

DS: There's an ennobled version of me out there on the Internet that gives me too much credit. To me it's not social conscience. I just don't think of it in those terms. The W'ire was getting all of the stuff you couldn't get into the paper and doing it with narrative forms and fictional storytelling. It's like reporters sitting around complaining about the things you can't get into the newspaper because those things are "editorial" in nature. The kind of stuff you tell each other over lunch. You tell each other the truth about what the mayor's really like or the truth over the flummery of what some institution is claiming as progress. Proving a lot of this stuff, particularly the personal stuff about people-especially the personal ambitions of people-is the hardest thing in journalism.

There was a police commissioner who was a genuinely good soul but who was not equipped to run a police department. And everybody knew he didn't have the acuity to run the police department. To be able to write that in a newspaper story would be epic. Or to write that another commissioner was going senile and would forget where he was and that people covered for him. These stories were throughout the department.

There was a story about these two high-ranking cops who hated each other. They were in competition for rank. One day one of them was the duty officer and he went out and saw that the word "police" was written backwards on the front of an emergency vehicle. And he called up the guy responsible and said, "I got you. You fucked this one up:' That guy told him they write it backwards so that in your rearview mirror it reads frontwards. And the first guy says, "Oh, you got an answer for everything:' That's the guy they made the police commissioner.

There's no way you can put that in the paper. The paper is fearful of being seen as opinionated. Or making a qualitative judgment like saying that the drug war doesn't work. That would be "provocative:' The attitude was "you can't say that:' 1 said, "Well, why not? I've been covering it for ten years:' But you can say it in a TV show.

Everybody grafts onto me a motive because just telling a good story is never enough for people. So I'm either civic minded and socially responsible and passionate about those things (which I don't feel unpassionate

about). But I never expected the world to get fixed. I came from a place where you tell a story and if it's shocking enough they pass a law and they make it worse. Telling a good story is the end in itself. And if something magical happened and they say we all watched The Wire and we're going to end the drug war because this is a disaster, then great. But it's never the expected result and not the intention. It was just a good story.

PM: Our current War on Drugs started out as a national policy. Do you think we'll invent a new national policy to replace it? Can the drug issue be resolved without a national policy?

DS: People are going to have to lead. I don't think there is political leadership. That sounds like pontification. Ed Burns had a great line. In order to lead you need to plant olive trees. You plant olive trees, and seven years later they give you the first crop of olives. There's no incentive if you're a politician on a four year election cycle to do that. Schmoke proved that. He proved there's no incentive. O'Malley learned the lesson well, and he has ascended and everyone who pretends to be tough on crime and tough on drugs has ascended.

I had lunch with Senator Jim Webb recently. His son was in Afghanistan, and when he came back he shoved The Wire at his father. Webb has since sponsored legislation trying to rationalize drugs. He's not for decriminalization. But he said we are the jailingest country in the world. \'{/e have put more people in prison and more per capita, more of a percentage of our people than China. More bodies. \V'e're either the most evil people on the planet or something is really, really wrong.

What it is, is a war on the underclass and it will probably require a Republican president to say, "This is dumb. We're going to have jail cells for people we really need them for:' \Vhen you target violent offenders and ignore the drug use, your crime rate goes down. You're taking people off the street who are violent. Most people who have drug problems are not violent. The average heroin user goes to work and cuts meat. At lunchtime he gets paid in cash because his boss knows he's a good meat cutter but has a problem. He gets a shot to maintain and gets paid the rest at the end of the day.

xvi FOREWORD

Heroin users are one of the most docile population groups. The violence is related by and large to the gangsterism that is a direct result of the

illegality, not to the usage. Yes, there

are people who go on a coke binge and end up shooting the mailman. But they're already violent. And I'm not suggesting there are good drugs. They are a disaster for people. But this notion that we are locking them up for drugs ... first of all you can't hold

them for drugs, because there's no room for them. If you lock up ten drug

users, you'll get seven genuinely nonviolent people. Maybe two and a half people who can make a car radio disappear in a heartbeat and maybe half

a soul who'll take a gun to sornebody's head.

When somebody finds a way out, or someone takes pity on someone and

gives them a job, that person is held up as "See you can get out, look at this guy who got out:' But the validation of anybody as a human being allows you to be inhuman to everybody else. It's the moral equivalent to saying, "Some of my best friends are black:' Or "There's a black family down the street and my kids play with their kids:' We're past race-well, not everyone-but not past class. Class is huge. It's not that they're born black in the inner city; it's that they're being born poor. And white kids in Pigtown, they're as fundamentally extraneous and irrelevant as the black kids.

This is about class. In 1980 we started believing that if it makes money it's good. If it doesn't make money, why is government doing it? And that is a perfectly good way to maximize short-term profit. But it's not a good

way to build a just society.

PM: Why did you cast Kurt Schmoke as the public health commissioner on The Wire?

DS: It was honoring Schmoke as a prophet. We were doing Hamsterdam and focusing on the idea of harm reduction. Schmoke's character was arguing that if we're gonna do this, let's put the health department into that area and do a needle exchange. Do outreach, so if people want to come

off corners for treatment we can help them. It was the argument for harm reduction. I guess that was Beilenson's great ambition: to rationalize the reality, to make it coherent with what was possible and what was not.

PM: Among all the lines you wrote for The Wire, which is your favorite?

DS: My favorite line was something in Season 5 that, when I saw how good the director had set up a shot, I wrote it right on the set. The camera was panning these people who had been arrested. And they're all waiting on the bench to be processed. The camera is following Wendell Pierce, who plays Detective Bunk Moreland. And you see Squeak, this woman harridan. She was the one who was driving around to buy the cell phones with her boyfriend Bernard. And you see her on camera saying to Bernard, "You are the dumbest rnotherfucker" Originally that was the only scripted line. But on the day of shooting, I said once the camera is off Bernard, I want to hear him say, "I can't wait to go to jail." When we were editing it, I just laughed out loud. And then we brought Squeak back in and we had her say, "You did not just say what I thought you did:'

In terms of a dramatic line that speaks to the whole theme: in Season 2 there's a scene where Frank Sobatka is talking to the lobbyist he bribed to get a measure passed in the state legislature. This is when Sobatka's learning that his ambitions are not going to get to the legislature. He says, "We used to make shit in this country. We use to build shit. Now we just put our hand in the next guy's pocket:'

When we wrote that, the WorldCom scandal had just happened. I was writing a sort of generalist feeling about the unease with the economy. We wrote that scene two years before the collapse of the economy. Looking at what the mortgage bubble was and what Wall Street did to the world economy, that line makes us sound smarter than we are.

THE NEW PUBLIC HEALTH CRISIS

WALLACE'S WORLD

McKEAN AVENUE IS ONE OF BALTIMORE'S shorter streets, only four blocks long. It is sandwiched between two busy thoroughfares, a block east of North Monroe Street and just one block west of North Fulton Avenue. For decades in the early 1900s, Fulton was the westernmost border of a legally sanctioned zone of segregation-the only area in the city where blacks were allowed to live.

Though Baltimore's segregation laws were overturned long ago, an un-

official discrimination continued well into the twentieth century. By the 1930s, blacks represented one-fifth of the city's population, but they were confined to 2 percent of the city's area. After World War II, thousands of blacks migrated north from southern states and settled in the city to look for work. Black neighborhoods, already overcrowded, began a slow expansion in all directions as more and more families, mostly white, moved to the suburbs. Despite these changes, the heart of those old zones of segregation became the place where federal money built high-rise towers and low-rise, low-income housing projects. By the end of the last century, the only things that really thrived in those neighborhoods were poverty and

drug addiction.

3

It may give you some sense of the saturation level of drug dealing in Baltimore to know that, in the first years of the new millennium, a drug gang led by a fourteen-year-old boy named Corey did not even control all four blocks of McKean Avenue. Yet the gang proudly laid claim to its small piece of turf with a name of almost innocent bravado: the Top of McKean Avenue Boys.

Those were the days when drug runners communicated with each other by pager, a system that soon evolved to using cell phones. Once the police proved capable of wiretapping even those, gangs moved to disposable cell phones, or "burners;' which are much more difficult to trace. Corey, though, carried his pager proudly, and, caught up in running his gang, he skipped school 90 percent of the time. He lived in a dilapidated row house with his younger half-brother and his maternal grandmother. In the chill of November, the electricity had been turned off because they couldn't pay the bill. A space heater provided the only warmth, run with an extension cord that snaked out the front door of Corey's row house to an outlet in the equally seedy house next door.

Hopelessly ensnared in the often violent drug culture that pervaded Baltimore's inner city, Corey had a rap sheet that contained more than a dozen arrests. Corey's mother was long dead of AIDS, and his father was in prison in South Carolina on a drug charge. The grandmother he lived with was a heavy using, long-term heroin addict. As Corey's legal guardian, she was the beneficiary of a monthly social services check to cover the boys' needs. Most of that check went to support grandma's heroin habit.

My path first crossed with Corey's in 2002, my tenth year as Baltimore's commissioner of health. It was also the year that an HBO- TV series called The Wire began filming and showing its brutally realistic drama about Baltimore's drug culture. Not being an HBO subscriber, I knew the show only by the furor it caused in city hall, where its depiction of Baltimore's drug problem was viewed as a political negative.

I finally got around to watching the DVDs of The Wire a year after the show ceased production. I realized then that it was a perfect crystallization of all of the public health and social problems I had faced in real-life Baltimore during my thirteen years as health commissioner.

For instance, in the fall of 2002 the city's statistics for Corey's age group were alarming. The police had investigated thirty-two murders of

4 TAPPING INTO THE WIRE

It may give you some sense of the saturation level of drug dealing in Baltimore to know that, in the first years of the new millennium, a drug gang led by a fourteen-year-old boy named Corey did not even control all four blocks of McKean Avenue. Yet the gang proudly laid claim to its small piece of turf with a name of almost innocent bravado: the Top of McKean Avenue Boys.

Those were the days when drug runners communicated with each other by pager, a system that soon evolved to using cell phones. Once the police proved capable of wiretapping even those, gangs moved to disposable cell phones, or "burners;' which are much more difficult to trace. Corey, though, carried his pager proudly, and, caught up in running his gang, he skipped school 90 percent of the time. He lived in a dilapidated row house with his younger half-brother and his maternal grandmother. In the chill of November, the electricity had been turned off because they couldn't pay the bill. A space heater provided the only warmth, run with an extension cord that snaked out the front door of Corey's row house to an outlet in the equally seedy house next door.

Hopelessly ensnared in the often violent drug culture that pervaded Baltimore's inner city, Corey had a rap sheet that contained more than a dozen arrests. Corey's mother was long dead of AIDS, and his father was in prison in South Carolina on a drug charge. The grandmother he lived with was a heavy using, long-term heroin addict. As Corey's legal guardian, she was the beneficiary of a monthly social services check to cover the boys' needs. Most of that check went to support grandma's heroin habit.

My path first crossed with Corey's in 2002, my tenth year as Baltimore's commissioner of health. It was also the year that an HBO- TV series called The Wire began filming and showing its brutally realistic drama about Baltimore's drug culture. Not being an HBO subscriber, I knew the show only by the furor it caused in city hall, where its depiction of Baltimore's drug problem was viewed as a political negative.

I finally got around to watching the DVDs of The Wire a year after the show ceased production. I realized then that it was a perfect crystallization of all of the public health and social problems I had faced in real-life Baltimore during my thirteen years as health commissioner.

For instance, in the fall of 2002 the city's statistics for Corey's age group were alarming. The police had investigated thirty-two murders of

4 TAPPING INTO THE WIRE

juveniles, earning Baltimore the unenviable reputation as the city with the highest juvenile homicide rate in the country. Looking for ways to intervene, the Baltimore City Health Department reviewed everyone of those homicide reports. \XThat we found, while disturbing, was almost predictable. Of those thirty-two murders, all were committed with a gun. Among the victims, twenty-eight were boys and four were girls. All of the girls had been innocent bystanders, hit by errant bullets. All of the boys had multiple arrests for drug distribu-

tion and handgun violations. All of them had been shot at close range with largebore weapons that imprinted the body with burn marks from the muzzle flash. Clearly, these murders were hits ordered by drug gang leaders.

In response, we started a program whose goal, I thought, was modest. As an urgent matter of public health, we set out to find the next thirty-two juvenile

homicide victims in Baltimore-before

they became victims. I would soon learn just how monumentally ambitious that idea was. Later, when I began watching The Wire, I realized that its producers, directors, and writers already knew that. And although those people had never met Corey, many of the characters portrayed on The Wire were very young teens, almost duplicate fictional versions of kids

exactly like him.

UTTER THE WORDS "PUBLIC HEALTH" to almost anyone and watch their eyes glaze over. That's not the reaction you get when you talk about The Wire, which holds a viewer's attention as if at gunpoint. But this was not just a crime drama. In addition to portraying violence and drug dealing, it also concentrated on drug addiction and poverty with the kind of depth and realism that leaves stippling marks on the soul.

The Wire lays out social and environmental problems like an oil spill. \Vhat you see on the surface is the sheen from the underlying problems gushing upward and contaminating every aspect of civic life. In episode after brilliantly staged episode one sees instances of disintegrating families, unchecked teen pregnancy, single-parent child rearing, homeless heroin addicts spreading AIDS through dirty needles, concentrated poverty, endless violence, the failure of schools, and the inability of the police to stop the drug trafficking.

If nothing else, The Wire is a microcosm of all the consequences of our country's failed War on Drugs: deep poverty and hopelessness and very little access to good jobs or a good education. When people don't have those things, they turn to drugs-either as users or dealers-and chaos follows. By the time I had seen the last episode, I knew The Wire was a perfect tool for changing perceptions and misconceptions about the deadly connections between drugs, crime, and poverty-as well as the role of public health in addressing them.

I knew very little about public health when I got out of medical school in the early 1990s. If I'd been asked to define it, I probably would have said it had to do with controlling diseases, providing immunizations, and safeguarding the food and water supply. Some public health officials today refuse to let go of that restrictive view. Certainly in the pecking order within the medical world, all rights to glamour and prestige (not to mention the lion's share of funding) go to those who provide specialized care to individuals-not to those who deal with the collective health of diverse populations.

Although it's not surprising that someone would have a limited view of public health, I do think that in today's world it's a mistake. My own definition-and that of many others tuned to the inevitable changes, both good and bad, that were wrought by twenty-first-century progressincorporates social and environmental elements with traditional clinical health.

The guiding principles of public health are to promote health and to prevent unnecessary illness, injury, and death. If you look at it in terms of years of potential life lost, this construct begins to make sense. For instance, the average life expectancy in the United States in 2010 is just shy of seventy-eight years. But if you live in the inner city and die of AIDS at thirty-eight, that's forty years of potential life lost to you, your family, and society. That's not just theory. There are some parts of Baltimore's poverty-ridden inner city that statistically show a twenty-year lower life expectancy than in an upscale neighborhood such as Roland Park, just a

6 TAPPING INTO THE WIRE

couple of zip codes away. This new rationale of public health argues that attempting to modify social and environmental conditions to prevent early morbidity (the onset of significant illness or injury) and mortality (death) is as important to keeping people healthier and alive over the long run as promoting flu shots or treating wastewater to prevent typhoid.

AMERICA RISES AND FALLS with the health of its big cities. Although this country began as a predominantly agrarian society, it was only with the development of its large urban centers and their respective economic engines that the United States emerged as a major global economic and

political power.

Even with today's suburbanization of America, the success of our

large metropolitan areas hinges largely on the strength of the major cities they are centered on. Thus, metropolitan areas like those in northwest Washington state and eastern Massachusetts are doing well because of the generally sound economic and social health of Seattle and Boston, respectively. Other metropolitan areas, like those in south-central Michigan and northern New Jersey, have significant problems because of the economic and social challenges facing Detroit and Newark.

What many people do not realize is how much the economic and social strength of our major cities depends on the health of their citizens. But health can be broadly defined. Of course it includes the burden of chronic diseases and conditions like diabetes, hypertension, and obesity that can limit the ability of individuals to be fully employed, pay taxes, and function effectively in society. Those conditions also trigger the need for more local social and clinical services for the individuals afflicted.

But while violence, drug addiction, homelessness, and like conditions are not always viewed broadly as public health issues, their existence directly affects everything from the way a city is perceived nationally (cities with high crime rates are constantly held up as examples of failing urban areas), to the quality of its public schools (high rates of substance-abusing parents or school violence lead to middle-class flight from the school system), to its economic vitality (businesses and families are less likely to relocate to a city with substantial public health problems).

How a city addresses these major public health issues can make a big difference in its chances to successfully compete in challenging times as

THE NEW PUBLIC HEALTH CRISIS 7

well as to improve the daily lives of its citizens. Since the early 1900s. it has been the role of local public health agencies to take on this challenge. In the first half of the twentieth century, significant strides were made in public health-including widespread immunization and vastly improved sanitation practices-that have led to a dramatic increase in the average American's life expectancy.

In 1900, a baby born in the United States could expect to live to the age of forty-seven; a baby born in 1950 could expect to live to sixty-eight. And, as noted earlier, by 2010, life expectancy for an American baby had increased to seventy-eight years. Although such a phenomenal jump is unlikely to be repeated over a similar period of time, there is much we can do to improve the health of our citizens by using the first half of the twenty-first century to address a host of new public health challenges.

That is why drug abuse and the despair and violence it spawns are as much a health issue as the flu. Drug addiction isa chronic disease. It's not unlike high blood pressure or diabetes: you have it for a lifetime, you have relapses, your behavior is impacted, and ongoing treatment is needed. But there's a lot more stigma attached to being a substance abuser than to being a diabetic. Oddly, if you look at it in terms of an individual's compliance with treatment measures-drug abusers versus diabetics or those with high blood pressure-the substance abusers do better.

It's hard to argue against the main theme of The Wire that drug abuse and the violence it engenders foster serious social consequences. If a city doesn't deal with them effectively, it won't be long before related problems join them-absenteeism from work, kids not being ready to learn, and kids dropping out of school and causing violence.

Those who hold this broader view believe that practitioners and policy makers should cast a wide net to encompass the different aspects of pu blic health. For example, racial relations become relevant and determine people's outcomes in life-not just vocational outcomes but their health. Another example of the expanded view of public health is taking into account the disparity in access to health care between the poorest and everyone else. That is why public health must be viewed as writ large rather than follow the circumscribed, old-fashioned model of standard communicable disease control.

8 TAPPING INTO THE WIRE

ON THE SURFACE, CHARACTERS IN The Wire like Johnny and Bubs, Stringer and Avon, Bodie and Poot are fictions drawn from the imaginations of the program's creators. But the firsthand street experience of writers David Simon, a former Baltimore Sun police reporter, and Ed Burns, an ex-city school teacher and homicide detective, make it clear that the names of their characters are the only real fiction in the story.

When I watched the first season, I was particularly taken by the story of \1ifallace, one of the young teenage boys pushing heroin in the courtyard of the city's old low-income housing projects. He is portrayed as an innocent, a boy who grew into his teen years without parents, emerging into the only life he had ever known-the world of drugs. But his heart isn't in it, and he certainly isn't a good fit in this world. And that lands him in trouble.

There's a poignant scene in Episode 6, Season 1, in which Wallace wakes up one morning in a derelict row house surrounded by a passel of sleeping kids. They are much younger than he but, like him, they are kids without mothers or fathers. The scene opens with the camera following a very long electric cable that snakes across the backyards of other row houses and into Wallace's bedroom. This, we realize, is the only source of power in the house. As Wallace gets the younger kids ready for school, giving each a bag of chips and a juice box, police outside are examining the body of a man tortured to death by drug lords.

In a subsequent episode, after \xrallace hides out on Maryland's rural Eastern Shore, he returns to his old city haunts. He is asked by a friend why he came back. I had to laugh at hearing this question, as you might as well ask Wallace why he couldn't have simply said no to drugs, gotten a job, worked hard, and gone to Harvard to become a brain surgeon. Wallace says something to the effect that this is his home; he is a corner boy, not a country boy, and that's who he will always be.

We know he speaks the truth, for at that young age, bereft of education,

guidance, and opportunity, his future has been sealed irrevocably. At the end of the episode Wallace is murdered by two of his fellow crew members, both close friends who rationalize the killing by noting that Wallace had simply paid the price for screwing up.

During those episodes, 1 was struck by the eerie similarities between Wallace and the boy I've called Corey. Confidentiality laws prohibit me

from using his real name and so, like Simon and Burns, 1 have made one up. Bear in mind, however, that Corey is a real boy who lived in a surreal world that few who live outside of it can imagine. And that's what jolted me. Watching The Wire, I realized Corey's story could easily have fit in as one of the many subplots of the series.

THE PLAN WE LAUNCHED IN 2002 was called Operation Safe Kids and was modeled after a similar program in Boston. The idea wasn't just to get kids treatment or counseling or a helping hand. \Xfhat the thirty-two boys-whose names we did not yet know-needed went beyond normal interventions. Unless some big changes were made in their lives, each was a statistic waiting to be counted.

The plan called for an extraordinary level of cooperation across many city and state agencies. It required meaningful input from police, social services, the school system, the criminal justice system, and others. I think what ultimately made it successful was not simply getting such agencies to work together but getting high level leaders of each agency to sit together at a table once a week and, with no nonsense, work out a unique plan for each boy.

That we were able to convince those leaders to attend meetings every week had much to do with the ignominy of Baltimore's reputation regarding juvenile murder. But it also had a lot to do with helping each leader to see the value in this unusual plan. We could lower our homicide rate, yes, but literally we could save and rebuild the lives of severely troubled kids who were considered beyond help.

We started working with the Maryland Department of Juvenile Services (DJS) to establish criteria for exactly which teenage boys we were targeting. Then DJS, with the public defender's office and the Baltimore Police Department, identified juveniles who matched our criteria. Basically, we were seeking kids with multiple arrests for drug distribution and a history of handgun violence.

Corey was literally the first kid in the program. His case was presented to our group of agency leaders by a DJS probation officer and then turned over to one of our case managers.

We made it a point of recruiting our case managers from the very inner city communities we were targeting. We had learned, sometimes the hard

10 TAPPING INTO THE WIRE

UBLIC HEALTH CRISIS 11

way, that assuming people would trust counselors from outside their world was a formula for failure. At the same time, it was a disheartening fact of inner city life that many adults from those neighborhoods died prematurely in their fifties, often of cancer or diabetes. I remember particularly one of our case managers, a mother whose own child had been shot and killed on inner city streets. She was extremely effective as a case manager, but when she died suddenly at forty-nine, she looked sixty-five. Without doubt, there's a connection between shortened life expectancy, poverty, and difficult life circumstances.

The first thing our leadership group did was review Corey's immediate needs. We got the electricity in his house turned on. We got him food through various emergency programs. Still, his set-up was far from ideal. He wasn't going to school, and his grandmother needed treatment for her drug problem.

Corey's case manager offered the grandmother entry into a residential

drug treatment program, but she refused. It turned out she was afraid of losing the money sent to her each month by social services for the guardianship of Corey. In the meantime we got Corey moved to a new home. He was taken in by his paternal, working-class grandparents. They were solid citizens and a courageous, remarkable couple. They lived in a wellkept row house in Fort Washington on the east side of Baltimore. They had never met Corey's maternal grandmother or his mother. But since Corey's father was their son who had fallen off the deep end, they were willing to take in not only Corey but the grandmother-if she got clean.

After two weeks of wrangling with Corey's grandmother, she agreed to enter a treatment program for heroin addiction. \Ve worked it out with social services that she could keep getting the guardianship money for the time being. The result was that Corey got away from the people, places, and things on the west side of town that got him into trouble.ln Baltimore, Charles Street separates the east and west sides of the city and is viewed with trepidation by drug gangs as the line of demarcation. The traditionan outgrowth of the parochial nature of the city-held that corner boys from one side of the city never set foot on the other side. Thus, moving Corey across Charles Street to the east side was almost like sending him to a new country for a fresh start.

Things went well for a time. Corey was willing to take part in the pro-

gram (his younger half-brother stayed on the west side with the boy's birth father). The city school system got Corey placed in a Fort Washington middle school. He was out of the drug trade. His grandmother eventually got clean and moved in with him and his other grandparents.

The city's police commissioner, Ed Norris (who later played a detective by the same name on The Wire), had given me a police pager so I could be notified of major crimes as they occurred. I didn't see any real use for it and mostly thought of it as a curious perk of the job. But one night three months later, in February 2003, I got a jolting page. A fourteen-year-old black male juvenile had been found shot to death on the west side. At first I breathed a sigh of relief because we didn't have many fourteen- year-olds in the program on that side of town. It didn't sound like any of our boys. Then I got a call from the woman who supervised our case managers. The dead boy was Corey.

We found out later that Corey had gone back to the west side to attend the birthday party for his half-brother. A thirteen-year-old boy who'd had a beef with Corey months back during his Top of McKean Avenue days saw him on the street and promptly shot him in the back.

Corey's death was tragic and discouraging. My immediate thought, beyond grief at the loss of another young life, was: here was a very expensive program with lots of high-level officials, from the police homicide division to the chief juvenile public defender, the chief of the juvenile division of the states attorney's office, the director for Region I of the Department of Juvenile Services, and more. Together we provided all of the services that a typical kid in trouble would not normally get to help solve his family problems. And yet with all of that, this tragedy still happened.

Several of us from the health department attended Corey's wake, held in a funeral home in a west side row house. As a city official, I'd attended quite a number of wakes and funerals, often witnessing spontaneous and understandable emotion. But not at this one.

When we arrived we found Corey's grandmother sitting on the front steps drinking out of a paper bag. With Corey dead, she had lost her principal source of income. Inside, the majority of the people in the crowded viewing room were teenage girls carrying babies. Most wore tee shirts that said "R.I.P. Corey" and listed his date of birth and death. It occurred to me that someone out there was making those tee shirts because there was a

12 TAPPING INTO THE WIRE

market for them and that this was not the first time such shirts had been ordered and worn. Nor would it be the last.

The dozens of teens making up the mourners chattered on cheerfully like it was a high school lunch hour-as if this wake was a common occurrence. Noone seemed to be paying any attention to Corey, who lay in an open casket looking like a sweet, sleeping fourteen-year-old kid. A couple of boys trying to look tough stood in a corner dressed in trench coats and saying nothing. I wouldn't have been surprised at all to find out

they were armed.

I remember projecting my own feelings of distress onto what I felt

was a surreal experience. When I was eight years old, my fourteen-yearold neighbor died of leukemia, and it was a huge blow to me. It actually changed my life and made me want to go into medicine. I wondered how I would react had I been fourteen and Corey was my friend who'd been shot and killed. I knew I'd be devastated. Yet here, none of the mourners seemed devastated or even upset. This is exactly the dead-end atmosphere so honestly, and heartbreakingly, portrayed in The Wire.

While we were there, a pastor spoke, and then the funeral director.

Finally a man who identified himself as Corey's father, freshly released from prison in South Carolina on a drug conviction, stood up. His first words were painful to hear. "I never met my son;' he said, "but if I had, this

is what I'd say to him .. :'

Sadly, this was a reality all too common. My thoughts went immedi-

ately to a study we had conducted sometime earlier. A striking number of the men in neighborhoods like Corey's who had fathered a child were at least ten to fifteen years older than the fourteen- to fifteen-year-old mothers-to-be. Plenty of them were twenty to thirty, even forty years older, men who obviously had taken advantage of these girls before disappearing from their lives. Another study showed that a stunning percentage of teenage mothers not only didn't know the fathers before becoming pregnant by them but never saw them after the birth, as was the case with Corey's

parents.

Corey's father ended his brief remarks by calling for those present to

spread the word: avenging Corey's death with more violence would solve nothing. "Please don't retaliate;' he said. But only a couple of days later, the thirteen-year-old boy arrested for Corey's murder and then surpris-

THE NEW PUBLIC HEALTH CRISIS 13

market for them and that this was not the first time such shirts had been ordered and worn. Nor would it be the last.

The dozens of teens making up the mourners chattered on cheerfully like it was a high school lunch hour-as if this wake was a common occurrence. No one seemed to be paying any attention to Corey, who lay in an open casket looking like a sweet, sleeping fourteen-year-old kid. A couple of boys trying to look tough stood in a corner dressed in trench coats and saying nothing. I wouldn't have been surprised at all to find out they were armed.

I remember projecting my own feelings of distress onto what I felt was a surreal experience. When I was eight years old, my fourteen-yearold neighbor died of leukemia, and it was a huge blow to me. It actually changed my life and made me want to go into medicine. I wondered how I would react had I been fourteen and Corey was my friend who'd been shot and killed. I knew I'd be devastated. Yet here, none of the mourners seemed devastated or even upset. This is exactly the dead-end atmosphere so honestly, and heartbreakingly, portrayed in The Wire.

While we were there, a pastor spoke, and then the funeral director.

Finally a man who identified himself as Corey's father, freshly released from prison in South Carolina on a drug conviction, stood up. His first words were painful to hear. "I never met my son;' he said, "but if I had, this is what I'd say to him .. "

Sadly, this was a reality all too common. My thoughts went immediately to a study we had conducted sometime earlier. A striking number of the men in neighborhoods like Corey's who had fathered a child were at least ten to fifteen years older than the fourteen- to fifteen-year-old mothers-to-be. Plenty of them were twenty to thirty, even forty years older, men who obviously had taken advantage of these girls before disappearing from their lives. Another study showed that a stunning percentage of teenage mothers not only didn't know the fathers before becoming pregnant by them but never saw them after the birth, as was the case with Corey's parents.

Corey's father ended his brief remarks by calling for those present to spread the word: avenging Corey's death with more violence would solve nothing. "Please don't retaliate;' he said. But only a couple of days later, the thirteen-year-old boy arrested for Corey's murder and then surpris-

THE NEW PUBLIC HEALTH CRISIS 13

ingly released on bail was shot dead. His killers were Corey's cousin and a second boy. Not long after that, both of Corey's avengers were shot and the boy with the cousin that day was killed.

At that point, four months into Operation Safe Kids, we had identified and intervened-mostly successfully-in the lives of many boys like Corey. We would eventually top one hundred success stories before I left the city health department in 2005. Corey's would be the only instance of a tragic return to violence, and the memory of it still hurts.

I THINI( AN INEVITABLE QUESTION one asks after viewing The Wire is, what would I have done? Had I grown up in that environment without parents, without knowing I'd have food every day, without the chance of a decent education, without knowing basic truths about the world around me (a Wire episode has corner boys marveling at the invention of Chicken McNuggets), without a guiding hand to point me in the right direction and advise me on right and wrong, with violence and fear being common occurrences, would I not seek out whatever support system was available that could provide for me? And if that support system was involved in the selling of drugs or killing those who stood in my way, and if I expected to be dead by twenty-five anyway (as so many corner boys casually predict of themselves), what realistic chance would I have of escaping that life?

There are many lessons to be learned from The Wire, and ever since viewing it I have sought to work those points home in the courses I teach at the Johns Hopkins University. It's not that The Wire presents solutions. The crime, poverty, and social chaos it depicts in Baltimore haven't gone away. In fact, many in Baltimore regard The Wire the way the city's mayor angrily responded during a cabinet meeting I attended in 2003. Martin O'Malley believed The Wire was a terrible program because, he said, as he was trying to make changes and improvements in the city, all that people anywhere knew about Baltimore was its drug problem.

Another take, however, is that because of its honesty and popularity The Wire has focused a bright light on serious problems-not just in Baltimore but any city with rampant poverty and drug-related crime. As long as that light is on (and fortunately The Wire continues to sell well in DVD long after its last episode was shown on HBO), an opportunity exists to use it to help change preconceived notions about poverty and drugs.

14 TAPPING INTO THE WIRE

People do get it that crime is related to drugs and that we should provide treatment to nonviolent addicts. At the same time a prevailing attitude seems to be this: "Not in my backyard; get these people away from us; and do something about the crime:' But no plan can expect much success

without, at the very least, a begrudging awareness that stuffing prisons full of low-level drug users or dealers, almost all of them nonviolent of-

fenders, has not worked.

A more realistic solution would be in everybody's best interest, but very few people have really thought about the benefits of a more practical approach. If you live in Baltimore's surrounding suburbs, then in order for the state to have the best economic engine it can have, you need to care that Baltimore City kids are

achieving. At rock bottom it makes a real financial difference to you, so it's in your self-interest to want good city schools.

A large percentage of suburban dwellers in the Baltimore area-both black and white-came originally from the city. Among them I believe there remains a significant number who regard people like Corey, his grandmother, his murderer, and others like them with the complaint, "We pulled ourselves up by our bootstraps, why can't they?" Yet many of these same people diminish the importance of the strong family support systems that provided them their bootstraps to begin with. Antagonism toward those who need help spends a lot of energy but doesn't address the real problems, tending instead to demonize people and polarize the discussion.

I HOPE THAT IN THIS BOOK The Wire can be a road map for exploring the real-life connections between inner city poverty and drug-related violence. With a firm grip on the hard truths one can then take part in the serious

dialogue that will lead to solutions.

Solutions, by the way, are not as simple as identifying what needs to

be done. In my lectures I speak of the four-legged stool formula for a sue-

F NFW PUBLIC HEALTH CRISIS 15

cessful city. Such a city must have decent, affordable housing; available jobs with benefits that pay a livable wage; a more than adequate education system; and accessible health care and healthy food. The daunting task is negotiating the particular mechanics in politics and government for achieving each of those conditions. Even so, nothing will ever happen until misconceptions are replaced by understanding.

In a 2008 TV Guide interview, Michael Kenneth Williams, the actor who played the shotgun toting Omar Little, said, "I hope some kid in the 'hood will see The Wire and take a different turn. It isn't a white or black story. It isn't a Baltimore story. It's an American story. It's a social problem that's been going on in our country-though the country may not realize it:'

So even though this roadmap bears the name of Baltimore and will focus on these problems in terms of our successes and failures in Baltimore, I tend to view the larger picture in terms of Everycity. In other words, in terms of public health, the city behind The Wire is whatever city you're in or near right now as you read this.

DMU Timestamp: March 08, 2013 19:51