What does it take for people to take the dangers of hot weather seriously? To recognize it as a killer? Heat kills more people in America than all other natural disasters -- tornadoes, floods, earthquakes -- combined. Yet we still treat heat waves as if they were an inconvenience.
Compare the tone of your local newscasters when a heat wave is about to descend and when a blizzard is about to hit. In the latter, you're likely to hear, "The region is bracing for a major winter storm which could paralyze commuters ..." But the former is more likely to produce something like "It's a hot one out there, so head for the beach or turn on the air conditioner." Meteorologists usually warn asthmatics or heart patients if the air quality is "unhealthful," but programming is never interrupted in heat waves the way it is for a hurricane or a winter nor'easter.
There are almost no program breaks for heat advisories the way there are even for severe thunderstorms. In the midst of brutally cold winter weather, no one would ever argue that heating people's homes is a luxury. But during extended periods of hot, humid weather, when the very acts of walking and breathing become not just a misery but unhealthy, when for some people the mildest exertion risks hospitalization or even death, we still talk about those "lucky enough" to have air conditioning as if air conditioning were a luxury.
It's different in places like the tropics or the Middle East, where people are used to the constant fact of extreme heat and have found ways to cope with it. In America, despite the effects of global warming, heat waves are still a break from the norm. I suspect that heat waves trigger a response that's deep in the American character, the impulse to stop complaining, buck up and get on with things. How, though, can ordinary life go on when people are forced to live in meteorological conditions so perilous that they begin breaking the body down after 48 hours of exposure?
And since we largely judge the destructiveness of a natural disaster in terms of media images, how can a heat wave -- which does not lay obvious waste to the concrete, physical environment -- compete with the damage left behind by hurricanes or tornadoes, earthquakes or floods, even the transformation of the landscape that happens in a snowstorm? Streets aren't impassable, buildings aren't falling down, you can still get from one place to another. What's the big deal?
Getting us to think seriously about heat is just one of the aims of Eric Klinenberg's trenchant and persuasive new book "Heat Wave: A Social Autopsy of Disaster in Chicago." The disaster that Klinenberg, an assistant professor of sociology at New York University, refers to is the heat wave that laid waste to Chicago for eight days in July 1995. Higher temperatures in the upper atmosphere trapped humid air in the city, leaving it no place to dissipate.
The heat index (how hot it feels to your body -- the heat equivalent of the wind-chill factor) hit 126 degrees (indoors, the actual temperature -- not the index -- hit 120). The physical damage -- buckled pavement, bridges that had to be hosed down to prevent them from locking when plates expanded, cars that broke down in the street, a power generator that burst into flame, the loss of water pressure and even water to some neighborhoods where kids had opened fire hydrants -- was nothing next to the human toll. By the time the heat wave lifted, 739 Chicagoans had died.
We're not talking about an era before air conditioning. We're talking about a modern American city, seven years ago. To put this in perspective, Klinenberg tells us that that's more than twice the number who died in the great Chicago fire of 1871, and more than 20 times the number who died in Hurricane Andrew. And it tops the casualties of the Oklahoma City bombing and the crash of TWA Flight 800 combined.
In terms of lives lost, the 1995 Chicago heat wave was one of the most catastrophic natural disasters in recent American history. Yet how many of you outside of Chicago have even heard of it? I certainly hadn't before reading Klinenberg's book. And part of the reason for that lies in the way we think about heat, a line of thinking reflected in the judgment of Chicago Mayor Richard M. Daley and many of his city officials that the heat wave was an act of God, and that the deaths were unavoidable. However, an even more ominous attitude than simple complacency about hot weather was in effect during the deadly '95 heat wave: It was a classic case of how deciding to run a city like a corporation can put citizens' lives in danger.
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.
If this story has any heroes, Edmund Donoghue, the city's chief medical examiner, is one. Mayor Daley (whose initial public comment on the heat wave was "It's hot ... It's very hot, but let's not blow it out of proportion ... we go to extremes in Chicago. And that's why people like Chicago"), concerned with maintaining the perception that he was a good "manager" who had made Chicago economically efficient while still providing services (and not wanting anything to ruin his coup of luring the Democratic National Convention back to the city in 1996), publicly cast doubt on Donoghue's numbers. "Every day," he said, "people die of natural causes. You cannot claim that everybody who has died in the last eight or nine days dies of heat. Then everybody in the summer that dies will die of heat."
Resisting immense political pressure from Daley, Donoghue stuck to his guns and insisted that no one who died during the heat wave had died from anything but the heat, an opinion that was later affirmed by medical examiners around the country and by epidemiologists from the Centers for Disease Control and Prevention. Daley's response was to order the Health Department commissioner not to release the numbers of the dead.
Throughout the crisis and when faced with the study the city released afterward, Daley's response was a remarkable blend of political expediency and callousness. He and his officials insisted that the government could not be blamed for the heat. Many in the press, including editorial writers at the Chicago Tribune, took the same tone.
But of course, no one was blaming Daley for the heat. Rather, they were questioning the city's response to a crisis. Eager to paint it as anything but the failure of his administration, Daley attempted to shift the blame to Commonwealth Edison for losing power during the heat wave, and he promised to investigate the utility company.
But Daley's buck-passing seems like small potatoes next to that of his cronies. Klinenberg gives an account of a press conference where one public official after another took to the microphones to lie -- as Fire Commissioner Raymond Orozco did when he said his department "was not overwhelmed by the heat wave" -- or to blame the victims -- as Human Services Commissioner Daniel Alvarez did when he said of the dead, "We're talking about people who die because they neglect themselves. We did everything possible. But some people didn't want to even open their doors to us."
For Klinenberg, Alvarez's quote is key. On the surface, "Heat Wave" appears to be a piece of sociological reporting on a total civic breakdown. The horror of the story Klinenberg tells here, though, is that the Chicago city government operated exactly as a government is intended to operate when it's following the entrepreneurial model.
When saving money takes precedence over providing adequate services, even in an emergency, then we can no longer expect government to do the basic job of saving the lives of citizens in danger. The city health commissioner, Sheila Lyne, perfectly expressed the city's attitude toward the inability of its overwhelmed emergency services to respond to calls when she said, "it wasn't going to matter ... I think the people were going to die anyway."
But as Chief Medical Examiner Donoghue had initially said, there has never been any scientific evidence to suggest that the victims would have died of anything other than the heat. However, Lyne and other proponents of "government as business" can give thanks that, to borrow a line from Ebenezer Scrooge, the dead at least had the grace to decrease the surplus population.
The entrepreneurial government, Klinenberg explains, replaces the idea of government's sacred obligation to care for its citizens (and the care he's talking about includes such basics as emergency medical services, that is, adequate police, fire and paramedic personnel) with a model in which people are expected to act as informed consumers. The trouble, as Klinenberg notes, is that the people most in need of those services -- the old, the sick, those who have outlived family and friends -- are often the least able to access the information they need.
The victims of the heat wave were overwhelmingly poor, old, sick and alone. Equal numbers of blacks and whites died, but blacks died at a higher rate. To illustrate his point, Klinenberg offers a picture of two adjoining neighborhoods: North Lawndale, which suffered some of the heaviest casualties, and Little Village, where the toll was not nearly so pronounced.
Alvarez's description of the people who "didn't want to even open their doors to us" might apply to the residents of North Lawndale. A once-busy section where the original Sears Tower and businesses like Western Electric had provided jobs, North Lawndale saw a precipitous decline when those businesses moved out and many residents followed suit. Today the area is a mass of overgrown vacant lots whose tall grass provides cover to the drug dealers doing business there.
The residents, often old people who have "aged in place" -- that is, stayed in the neighborhoods where they lived while their friends and family in the neighborhood have either died or moved -- are afraid to open their doors to strangers. They are often afraid to go out on the street. When fear is a permanent condition of life, as Klinenberg points out, the social structures that create a true neighborhood -- the businesses that provide for, in Jane Jacobs' phrase, "eyes on the street;" neighbors who aren't afraid to visit one another or sit on their stoops; churches that link people to a social circle -- can't exist. And since police in Chicago are not assigned to patrol areas in quantities that take account of the crime rate, the cops who work North Lawndale often have shifts that are strings of arrests with no chance to develop ties with the community or to get to know the residents' routines.
Little Village has approximately the same poverty rate as North Lawndale. But this predominately Latino area has a thriving business district (including street vendors) that allows for busy, and thus safer, street life. Moreover, the area's stability and ability to provide jobs have meant that generations of the same families often live close to each other. Klinenberg's account suggests that even the Little Village residents who have "aged in place" are not cut off from their neighbors. And because they feel safe walking the streets, going to church or to the markets, they don't live in isolation.
"Heat Wave" is not the easiest book to read. As befits his discipline, Klinenberg uses sociological jargon that isn't always graceful or concise. But the occasional clumsiness of his language is small potatoes next to his compassion, his reason, his refusal to demonize even the most foolish people here and his insistence that the deaths in Chicago were rooted in government's abandonment of responsibility and in the breakdown of the social structures that keep people in touch with their neighbors and communities.
Klinenberg is too gentlemanly to pat himself on the back even when he could. His analysis of how the Chicago media handled the story, how they relied on those in power for their information and thus parroted official "wisdom," and his understanding of the way the news cycle continuously drops developing stories in favor of new ones, suggests why the story of the 1995 heat wave had to be written by a sociologist. (For example, the Chicago media regularly talked about the "debate" over what caused the deaths. But there was no debate: There was scientific fact and there were Mayor Daley's efforts to cover his ass.)
Klinenberg doesn't offer solutions, though a few basic ones seem obvious. If we believe that one of the functions of housing is to give people shelter from the elements, then in areas subject to severe heat, air conditioners should be considered as necessary to health and safety as heat or smoke detectors are, and landlords should be required to provide units that meet a standard of efficient performance (costlier to buy, cheaper to use). Congress should be pressured to restore funding for the Low Income Home Energy Assistance Program, which would help seniors and the sick afford to use air conditioning. (Some of the dead actually had units but, subsisting on a fixed income, couldn't afford to turn them on.) While hundreds were dying in Chicago during that week in 1995, the Republican-controlled Senate was pushing to scrap the program, but settled for cutting $100 million from its budget.
But even those measures won't address what Klinenberg sees as the crisis of isolation that affects so many city residents, a crisis that will only be exacerbated as the idea of government as business, regardless of the human cost, becomes further entrenched. During the upheavals of the '60s, politicians in big cities used to talk with trepidation each spring of the long hot summer ahead. "Heat Wave" shows how, in the name of governmental efficiency, one group of politicians rode out a long, hot summer while conveniently ignoring the corpses piling up at their door.