Nick Reding

by Methland: The Death;Life of an American Small Town

  Murphy and Nathan and Clay all thought the change to Oelwein, at least as measured by food, was great. Overstating the case more than slightly, Murphy slipped into mayor mode while perusing the margarita list and said, “Where else in this county—or even in Iowa—can you get good Mexican, Chinese, and Italian food on the same block?”

  Clay was smoking a Marlboro Light as he looked at the menu, tilting his head by degrees, trying to line up his eyes with the reading-glass half of his bifocals. Looking over the frames, he said, “Um, have you heard of Des Moines, Murph? If I’m not mistaken, isn’t that in Iowa?”

  “Even Greek food,” said Murphy, pressing the point. He was referring to Two Brothers Greek Restaurant, a block north, whose windows had neon signs advertising steaks and pizza. Nowhere on the menu was there a trace of tsatsiki, taramosalata, or even a gyro.

  “Since when does Salisbury steak count for Greek food?” said Nathan.

  Murphy was unfazed, though his smile served as a slight crack of irony in his facade. “To me, it’s just incredible the ethnic diversity in our little town.”

  “Scribe,” Nathan said to me, “my guess is that Murph wants you to write that down.”

  Heritage in Oelwein is not something that is taken for granted; in a farming culture predicated on the changeability of seasons, history is in some ways what there is to hold on to. And yet the Irishman, the German, and the Norwegian sitting in Las Flores that night truly celebrated the influx of Mexicans into their town. It seemed only fitting, therefore, that Las Flores occupies the ground floor of one of the oldest and prettiest buildings in Oelwein. Four stories tall and made of hand-laid stone with a vaulted entryway, it’s one of the most interesting as well, the street-level windows tinted nearly black, adding a sleek, modern aesthetic to the place. The restaurant itself is sixteen hundred square feet, enough to accommodate fourteen tables and nine booths. The smoking section seems to expand and contract depending on shifts in the clientele. The walls are fake brick from the baseboard to the sconces, and above that, synthetic adobe painted a pale yellow. Every few feet, and in no apparent pattern, hangs some kind of artisanal memento—a garish poncho, a gigantic sombrero, and a photo of a shoeless peasant strumming his guitar next to a burro. The cheesiness in no way undermines the authenticity. To the contrary, what makes Las Flores enduring—in an old building in an old American town—is in some ways the paradox of its novelty.

  That Mexican immigrants stereo typically work hard, I was told, is considered the highest form of praise in Oelwein. That they are brown-skinned and speak a language which sounds fast in a town where people typically take their time formulating their sentences is, just as with the Italians in the early twentieth century, going to take some getting used to. There is respect, to be sure, though with predictable limits. As the real estate broker told me, “Not many landlords are lining up to rent to Mexicans.” The feeling that the new arrivals are taking away jobs from the locals is up for debate, and does not seem—by my count, anyway—to be the flash point it is sometimes portrayed as being in newspapers across the country. On the other hand, the fact that the immigrants lack medical insurance, says Clay, is a tremendous strain on the already overtaxed local hospital. And then there is the question of the drugs, particularly meth. According to Jeremy Logan, meth is distributed by a few well-placed Mexican dealers who are increasingly busy ever since the Combat Meth Act went into effect.

  Still, no one was on a witch hunt. Far from it. Everyone at the table—the doctor, the mayor, and the prosecutor—accepted that Eduardo, the owner of Las Flores, was probably an illegal immigrant without feeling the need to verify it as fact. As Nathan said, you wouldn’t have to look very far into anyone’s history around those parts, his own included, to find a similar story told in another time. He instinctively grasped what Representative Souder—for one—did not, which is that if you encourage people to come to your country, you cannot then hold it against them for showing up. As a prosecutor, Nathan simply didn’t ask people’s status. That way, he wouldn’t be party to forcing someone out “through the gate,” as he put it, “which is left perpetually and invitingly open.”

  One of the attractions at Las Flores is the sixty-four-ounce margarita, which is drawn from a clear plastic machine inside of which three large mechanical spatulas stir separate vats of red, green, and yellow slush. Murphy ordered strawberry, no salt, while Nathan asked for regular, extra salt. Meantime, Clay lit another cigarette. In front of him was a twenty-four-ounce Diet Coke in a brown plastic glass with crushed ice. Clay had been sober five months and counting—long enough to have had the Intoxilock removed from his truck.

  Clay had also, though, been having trouble at Mercy Hospital, where he was chief of staff. After ordering tortillas and salsa, chimichangas, and fajitas, Murphy and Nathan listened as Clay launched into a critique of the hospital’s owner, Wheaton Franciscan Health Care, which drew heavily on the anti-corporate formulations of Noam Chomsky—Clay’s latest hero. Clay, a devout but non-churchgoing Methodist, was a fan of God in his specific way and suspicious of churches generally—especially the Catholic church. According to him, the Wheaton Franciscans, technically a nonprofit order of the church, had “systematized their disrespect for human life to such a degree” that Clay was either going to quit or be fired as chief of staff. What galled him even more than what he deemed the hospital’s substandard equipment was the fact that, in order to save money, patients’ tests were being sent by computer to doctors in Australia and India to be read and analyzed, with the results e-mailed back.

  “I mean, what the fuck?” said Clay. “How ’bout no, okay? How ’bout, I’m not trusting my mammogram to some guy in Mumbai? It’s not that they’re not talented doctors,” he went on, “it’s that they’re not here. Part of being a doctor is holding your colleagues accountable. If some guy in India misreads my patient’s biopsy and the patient dies of cancer, do you think we’ll get the guy from India deposed at the civil hearing that takes my license and sues me for all I’m worth?”

  Clay stared at Nathan, who stared back impassively. As things around him heated up—Clay’s temper, for instance—Nathan’s heart rate seemed to slow considerably.

  “Not likely,” said Clay, finally answering his own question.

  “Okay,” said Nathan.

  Murph said enthusiastically, “I’ll be darned.”

  As Clay saw it, the hospital and insurance systems lacked critical oversight. For example, Wheaton Franciscan had recently begun placing physicians, most from India, in underserved areas across the rural United States. Like the Mexicans who worked in the slaughterhouses, the Indian doctors would work for less money than the American doctors. The trouble was, said Clay, few of the foreign doctors stayed for the entire two-year rotation, for the reason that the Indians’ cultural milieu didn’t mesh with that of places like Oelwein. These shortened terms, said Clay, drove the quality of care down and destabilized the staff. At Mercy, he continued, three doctors had left early in the past eighteen months, keeping the ER in utter turmoil. What’s more, insurance companies used high doctor turnover as a criterion for raising premiums. Practicing medicine in Oelwein felt more and more difficult, said Clay, and morale was low.

  Murphy nodded sympathetically. He said, “The insurance companies have a monopoly. What can you do?”

  What Clay was considering doing was quitting. He’d been thinking about “freelancing,” as he put it, by taking pay-by-the-hour jobs in rural emergency rooms.

  “That’s the only place I can do any good,” said Clay. “I mean, who needs you more than an elderly lady with no insurance who comes to the ER at two P.M. on a Tuesday?”

  “What’s stopping you?” asked Nathan.

  “My dad,” said Clay. “This hospital—it’s where Dad practiced for half a century. Our family practice is our family. This whole town, kind of, is our practice. I don’t know how to just walk away from that.”

  “That’s just the rub,” said Nathan.


  “Yes,” agreed Murphy, “it truly is.”

  Still, the men had a lot to be happy about that December. One of Clay’s two daughters had just had her first child out in Sacramento, California, where she lived with her husband. Nathan had won convictions against the twin brothers Tonie and Zonie Barrett—the former for first degree murder, the latter for conspiracy—in the June 2005 killing of Marie Ferrell. And Murph was getting good feedback on the improvements around town. The new library was a smashing success, and its patrons enjoyed two dozen computers with free high-speed Internet connections. Not only had Oelwein High School avoided bankruptcy, but 2006 was the first year in a decade that the student body had grown—by three students. Though the call center talks had stalled, Murphy and the city council had persuaded Northeast Iowa Community College to build a campus at the Industrial Park. The Regional Academy for Math and Science was also planning to move there, just west of the college. Murphy and the city council had decided to build a technology center on the remaining land as a gamble to lure more businesses, especially now that they could offer a new septic system. Finally, the second-largest ethanol plant in Iowa had recently been built seven miles west of town; this had resurrected some traffic on the local rail lines, allowing several Oelwein businesses to save significantly on transportation costs. Thanks to the plant, corn prices had risen by five cents a bushel. The hope was that things would just keep getting better and better.

  Perhaps the most encouraging yardstick was that methamphetemine, measured by the number of labs that had been dismantled, had all but ceased to be an issue around Oelwein. In fact, the Cop Shop hadn’t had a single call about a lab in nearly six months, dating back almost exactly to the week when ground was broken for the Main Street refurbishments. Things truly felt different around Oelwein since I’d first been there. In June 2005, it was not uncommon to see meth cooks in the headlights of your car late at night, riding around the town’s more peripheral neighborhoods single-batching dope in bottles strapped to their mountain bikes. Just a year and a half later, the streets no longer felt unsafe, or like you weren’t sure what would happen if you got a flat tire in the wrong place at the wrong time. Houses no longer blew up in the middle of the afternoon, and no one phoned in reports to the police about a strong smell of ether coming from a neighbor’s garage. Even the Do Drop Inn felt vaguely (if somewhat lamentably) secure.

  In fact, by Christmas 2006, Oelwein had come to represent the hopefulness of thousands of small towns across the nation that had seen major drops in the number of lab busts. The Combat Meth Act had been in place for six months, and national newspapers had largely stopped reporting on the epidemic; the rural United States was no longer portrayed in the sour, Lynchian light in which it had been cast since 2004. These were all reasons to celebrate, indeed, sitting in a booth at Las Flores as the snow began to fall outside the window.

  The basic functions of the Combat Meth Act were to limit the amount of cold medicine consumers could buy in the United States; to allow the State Department to withdraw foreign aid from nations that fail to stop the diversion of pseudoephedrine and ephedrine to the illicit market; and to impose quotas on how much pseudoephedrine and ephedrine U.S. pharmaceutical companies could import. In a way, the Combat Meth Act accomplished what Gene Haislip, long since retired from DEA, had considered the most important aspect of the battle against meth for nearly twenty-five years: to monitor the importation and exportation of its precursors.

  The quotas imposed by the Combat Meth Act set off a chain reaction of economic events that Haislip could have imagined only in his wildest dreams. Fearful of restrictions on pseudoephedrine, Pfizer, the world’s largest cold medicine manufacturer and the maker of Sudafed, began using a chemical called phenylephrine to make 50 percent of its cold products. Phenylephrine, approved in 1976 by the FDA, cannot be made into methamphetamine. The switch caused the nine companies that produce the world’s supply of pseudo to decrease their production, thereby reducing the amount of pseudo available for narco-traffickers to turn into meth. According to one of the last meth articles written by Steve Suo for the Oregonian, U.S. drug companies cut imports of pseudo by more than two thirds in 2006, to 275 tons from 1,130 tons the year before. The U.S. State Department convinced the Mexican government to halve imports of pseudo and to bar middlemen from the process, causing North America’s aggregate imports of meth’s principal precursor to drop 75 percent between 2004 and 2006. Suo also reported that, based on DEA statistics, meth’s purity had fallen to an average of 51 percent, down from 77 percent the year before. The degradation in quality, Suo wrote, was a sure sign that far less meth was being produced. Mom-and-pop meth production was down not just in Oelwein, but everywhere.

  Also in 2006, drug czar John Walters unveiled a plan that would expand drug courts, in which addicts are monitored by judiciary process for eighteen months and allowed to hold a job. (Nathan Lein, a longtime proponent of the drug courts, said their very existence was an admission that the standard procedure with drug addicts—putting them in jail for short periods and giving them little or no counseling—wasn’t working and resulted in high recidivism rates.) Walters allocated money for nationwide anti-meth TV ads, the likes of which had shown great promise in a number of states, particularly Montana, where private citizens had funded such campaigns in 2005. Walters also promised high-level trafficking prosecutions by DEA. The very fact that he was trying—now that Congress had taken meth on—to catch up to the trend was itself a reason to feel good about what was happening nationwide. And worldwide: the United Nations Commission on Narcotic Drugs offered to broker deals between countries and pseudo manufacturers; and the International Narcotics Control Board, in Vienna, initiated plans to halt shipments of illicitly gotten precursors beginning in 2007.

  All the good news was buoyed further by two reports that seemed to confirm meth’s retreat. Every four years, the National Institute of Drug Abuse (NIDA) issues a report called the National Survey on Drug Use and Health. NIDA, an arm of the National Institutes of Health within the U.S. Department of Health and Human Services, is the de facto research arm of the Office of National Drug Control Policy (ONDCP), which is headed by the president’s drug czar. As such, NIDA’S recommendations, which seem implicit in its research, guide legislative drug policy perhaps more than those of any other U.S. government institute. What NIDA reported just before the Oelwein Christmas pageant of 2006 was that meth use throughout the United States remained stable or dropped between 2002 and 2006. The nation’s second-most-influential narcotics survey, Monitoring the Future, funded by the University of Michigan, reported something even more encouraging: meth use among high school students between 1999 and 2005 had sharply declined. Pointing to these studies as real-time indicators of the effects of changes in government policy, John Walters told the Oregonian in an August 2006 interview that the United States was “winning” the war on meth.

  More surprisingly, Walters hinted something heretofore unimaginable: that the meth epidemic was over. “Was meth an epidemic in some parts of the country?” he said in his interview with Suo. “Yes . . . Is it the worst drug problem? Is it an epidemic everywhere? The answer is no.”

  But the questions that had to be asked that December night at Las Flores was why, if everything seemed so much better, had the number of meth cases that Nathan Lein was getting not declined? And why hadn’t the number of meth-related complaints of Clay Hall-berg’s patients dwindled? The answers to those questions require an understanding of what exactly a drug epidemic is and how a report like the National Survey on Drug Use and Health gets made. But the most important aspect to understanding why Oelwein’s meth problem seemed to have become “invisible,” as Clay put it that night, was a recent shift in the narcotics market. As had been happening for twenty years, since the days of Gene Haislip, meth had not gone away or been eradicated. It had reassorted its genome.

  Ask any drug epidemiologist the question “What is a drug epidemic?” and the answer will likely be,
“I don’t know.” It may seem counterintuitive that a drug epidemiologist can’t define the very concept for which the profession is named, but consider the difficulties of the related field of viral epidemiology. Say you ask your doctor these elemental questions: What is the flu? Where exactly does it come from? What exactly does it do? How does it do that? What can I do to confront it? What will be the outcome of that confrontation? The best your doctor can do is take the little that is known beyond a doubt about the flu; combine it with common sense, anecdote, and theory; and recommend a solution without any guarantee of success. The epidemiology of a drug is no different: it is unquantifiable in absolute terms.

  Consider again the opinion of Dr. Stanley Koob, the neuropharmacologist at the Scripps Research Institute and a highly regarded drug addiction specialist. When he says that “meth is way up there with the worst drugs on earth,” only part of that opinion can be proven. It can be scientifically measured that smoking a drug—as opposed to eating, snorting, injecting, or taking it anally—is the fastest delivery system to the brain. It is further supposed, though not proven, that the speed of delivery affects a drug’s addictiveness. So, because meth can be smoked, it (like nicotine, but unlike alcohol) has entrée into the category of “most addictive.” From there, Koob’s statement veers into the realm of instinct mixed with common sense. The bulk of Koob’s evidence regarding meth’s “unique dangers” stems from his theory of the drug’s social identity. In Koob’s opinion, much of meth’s danger lies in the drug’s long history of usefulness to the sociocultural and socioeconomic concepts American society holds dear, many of which stem from the pursuit of wealth through hard work.

  Now take national drug studies. Though the term implies technical exactitude, it is simply impossible to know how many people become addicted to any drug, methamphetamine included. It’s impossible to know how many people are using a drug—addictively, regularly, episodically, or singularly. Furthermore, there is no set number or percentage of drug users that signals a drug “epidemic.” It’s this very lack of a quantifiable foundation that prevents any honest drug epidemiologist from being able to define a drug epidemic. Saying there is a meth epidemic is just as unverifiable as saying the meth epidemic is over. In this odd way, the newspaper columnists who, in reaction to Suo’s reporting and the work at Newsweek and Frontline, had begun asserting in mid-2006 that there had never been a meth epidemic—that it was an invention, a myth—were partly correct.