Rabble Rouser tells the remarkable story of how a coalition of citizens fought to preserve a cornerstone of public health care. What ultimately convinced you that this story needed to be preserved in book form?

The plan of the University of Illinois President to give the U of I Hospital to Cook County and move clinical education to Michael Reese Hospital was an important pivotal episode in the history of Chicago, and of public health care in the city. The events of that time determined the future of the U of I College of Medicine and had a major impact on Chicago’s West Side. People were fascinated by the story of the fight to defeat the plan. Whenever I related the saga, they responded that it was a story that needed to be told, and I was encouraged to write it. As time passed a new generation was unaware of this history, and I thought that it was important for them to know it. I had collected bankers boxes full of notes, letters, and newspaper clippings that I carted around with me during various moves after I left the U of I, intending to sometime write the book. When my wife threatened to toss the boxes into the recycling bin if I didn’t get started, I had no choice but to begin.

Before this experience, you had relatively little exposure to public advocacy and political organizing. What was the steepest part of that learning curve, and how did your understanding of leadership evolve during the campaign?

It’s true that overnight I was swimming in uncharted waters. As I was President of the Hospital’s Medical Staff, people began to approach me, telling me that I had to do something. I knew that something had to be done but had no idea what, or where to start. At an ad hoc gathering U of I faculty and staff founded CAUSE, the Coalition Against the University Sell-out Endeavor. It was an informal organization that had a “charter” membership of over four hundred which soon grew to over five hundred members. CAUSE became the voice of the opposition. This provided a forum for people to voice their dissent. An early lesson was that although it was important to represent a large constituency, the administration wasn’t going to be swayed by votes, petitions, or other demonstrations of opposition to the plan. The usual academic processes were not going to be effective.

A small group of us were meeting each morning, brainstorming on how to proceed. We were soon joined by other members of the medical center community, and then by leaders of community organizations who had prior experience “fighting city hall.” This small group of a dozen or so front-line troops was what was needed for effective day-to-day action.

Before this any leadership position that I held was not associated with significant controversy, and when one was the issue usually could be dealt with at a monthly meeting preceded by a little preparation. Now I was in a position which required daily (and sometimes nightly) attention. Learning to balance this with ongoing obligations presented a challenge. Fortunately, I had colleagues willing to relieve me of some of my clinical responsibilities.

Looking back, what would the consequences of closing the hospital have been for Chicago’s West Side?

There was no coordinated system for public health care in Chicago. Legally, it was Cook County’s responsibility. Chicago Board of Health Clinics played a part. Some care was given in private hospitals. The University of Illinois Hospital and Clinics played a key role — seventy percent of its patients were either “self-pay” (i.e., no-pay) or underinsured (Public Aid). The loss of the U of I Hospital would have created a big hole in the system.

The medical school would have been severely damaged, if not destroyed. Collaboration between basic scientists at the medical center and clinicians, six miles to the east at the new primary teaching hospital, would have been difficult, if not impossible. And as it turned out, Michael Reese was in worse shape financially than the U of I Hospital. It’s not likely that it would have survived, even with an infusion of state funds when the U of I programs moved there, leaving the University with no teaching hospital.

The Illinois Medical District would have lost a major component. And Chicago’s West Side would have lost a major anchor, impeding further growth and development of that part of the city.

What advice would you offer professionals who suddenly find themselves serving as advocates for their institutions?

First of all, you will be in a foreign arena and won’t know the rules of the game. I was fortunate that I was joined by people who had been in similar situations. Learn from those people if they are available.

Meet with your team often, if not daily. Listen. Two heads (multiple heads) are better than one.

There will be many at the institution who are only peripherally involved. Have frequent large group meetings to boost their morale and keep them informed and engaged.

It’s likely that there will be small defeats and setbacks along the way. If you are discouraged, be discouraged in private. Be honest with your constituents but project a positive outlook.

Choose your words carefully, especially when speaking to the press. Anything you say could end up in tomorrow’s paper or the 6 o’clock news. Be optimistic, but don’t overstate. Know the facts and stick to them. If you make an error, and you certainly will, admit it and correct it.

Develop a thick skin. You’re going to need it.

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