Mind in Chains

by Bruce M Perrin

  “No, you can’t. He’d kill me,” Diane whispered. She stepped into the room, her hand shooting out to grab his arm. But the sudden move threw her off balance, and she dropped her hand to the bed to keep from falling. Her arm trembled with the effort. She inhaled deeply and released a long, ragged breath. “I need to go to the emergency room. They’ll fix me up, and we’ll be home before Mom and Dad know anything.”

  Jimmy stared, seeking understanding in his sister’s face, but finding only darkness. “I don’t know, Diane.”

  “I’ve got the money and I’ll be fine … if you get moving. I’ll be in the car.” Diane started toward the door, shuffling her feet. The night was cool, as October evenings in the Missouri Ozarks could be. But even so, the long coat she wore spoke of a snowy winter day, not the cool night air from his open window. She disappeared into the hall.

  Jimmy stood and then dropped back to his bed. He raised a fist to his mouth, biting his flesh as if the pain might bring an answer. He should wake his dad. He’d know what to do. But he couldn’t. Diane had always been there for him, whether it was something with their parents or school … or even girls. He couldn’t let her down. And if there was another answer, Diane would have thought of it. She was the smart one.

  Jimmy got up quietly and pulled on a pair of jeans, T-shirt, and tennis shoes. Tiptoeing down the stairs, he found the light on in the entry hall, the front door still ajar. Diane must already be in her car. He started for the door but stopped short, noticing a dark spot on the wood floor. He looked closer, learning only that it was wet; the hall light reflected back into his eyes from its surface. His gut, however, already knew what he would find when he dabbed at it with a finger. Even so, his heart rate spiked when he saw the bright crimson on his pale skin.

  Jimmy looked back toward the room where his parents lay sleeping, his breath catching in his throat. He started for the stairs, only to stop and turn back to the door. Surely, it was just a matter of an hour or two at the hospital and Diane would be fine, just as she had said. Jimmy left the house, closing the door quietly behind him and hurried to Diane’s car.

  Diane was already sitting in the passenger seat, so Jimmy slid behind the wheel, closed the door, and started the engine with the keys he found in the ignition. His fingers came away sticky. In the glow from the dashboard, they looked black, but he knew better. He cracked the door, needing to see his sister’s face, needing to know this was the right thing to do. But before he could ask, he saw more blood dripping to the floor mat from the hem of her coat.

  Jimmy drew back, his hand flying to his face where it left a trail of red across his cheek and chin. “Diane, there’s blood everywhere.”

  Diane turned to him, her face ashen, her eyes glassy and unfocused. “An abortion …. Something went wrong,” she said so softly Jimmy could hardly hear.

  Jimmy started trembling, his eyes becoming moist. “I can’t do this. I have to get Dad.”

  “No time. Drive. Now.” Those four words took the last of Diane’s energy, and she collapsed against the car door.

  Jimmy glanced back at his home, wiping tears from his eyes. He could wake Dad and they’d be on their way within minutes, but he wasn’t sure Diane had even that much time. He put the car in drive and sped down the street toward the hospital.

  He hardly had the car in park before jumping out and running into the emergency entrance, yelling for help. The sight of a fourteen-year-old covered in blood galvanized a medical team, and within moments, Diane was loaded onto a gurney and moved into a treatment room. Jimmy identified himself and his sister, but the admitting nurse balked when he promised to pay in cash. ‘Where are your parents?’ she wanted to know.

  Jimmy hated to betray his sister, but he couldn’t do this alone. He gave the nurse the information she sought and was then shown to a waiting room. Some of the staff came out to console him, but he ignored them all. He sat in a corner, his head in his hands, his lips trembling as he fought against the tears.

  How could this have happened? He had his suspicions.

  His sister had only broken up with her longtime boyfriend a few weeks ago. A pregnancy she refused to terminate seemed the likely cause. But if so, why had she changed her mind? And where had she gone for help? He glanced at his surroundings, his tears of pain now laced with anger. Where was her old boyfriend? Where were these doctors and nurses when she needed them earlier? If anything happened to her …. He couldn’t finish the thought, didn’t want to consider the possibility.

  “Jimmy, are you all right?”

  “Mom.” Jimmy jumped up from the chair and ran to her, no longer able to fight the tears. “How’s Diane?” he managed to ask between sobs.

  “Your dad’s talking to the doctors, but I’m sure she’ll be fine.” Jimmy recognized the emptiness of her words, even without the crack in her voice. “Go wash your face in the bathroom.”

  “But, Mom, I want to wait for Dad.”

  “It’ll only take a second. Now go, before you get blood on anything else. And bring back a damp paper towel.” Jimmy pulled back from his mom, seeing the smear of red on her shoulder. He dropped his head and shuffled to the men’s room.

  He scrubbed the trails left by blood-laced tears from his cheeks, dampened a few paper towels and left the bathroom. As he came into view of the waiting area, he saw his mother collapsed into the arms of his dad, her shoulders shaking in time with the sobs that reached his ears. James Sr., perhaps sensing the presence of his son, turned. His eyes were moist, the muscles working in his jaw as he fought the despair that had overtaken his wife. He raised a hand to his son, welcoming him to their embrace.

  Jimmy, however, couldn’t accept their comfort. He dropped the towels in the hall, turned, and ran from the building.

  ✽ ✽ ✽

  Guilt and shame had kept Conroy from talking about his sister’s death for years. But when catharsis came six years ago, it had been sudden and unexpected, over dinner with a woman he hardly knew. That evening meal became a night of self-recrimination and tears, as he slowly and painfully unburdened his soul. And when it was over, all his earlier days of political activism felt unfocused, ineffectual. It was as if his sister was whispering in his ear, “there’s a better way. They need to hear your story.” And so, for the last six years, he had told it.

  Conroy approached the curtain covering the entrance to the ballroom, hearing familiar words, “… followed by two years on a presidential science and technology panel investigating stem cell research.” His introduction was drawing to a close. One more lap would cover comments about his testimony before Congress and his work with a Missouri representative on House Bill H.R. 7872. He turned and started for the back wall, five steps away.

  His story always rekindled forgotten memories in his audience, but with Sister Constance’s killing of Dr. John Huether this morning, he thought his message might stir even deeper, darker passions. That appeared to be the case, as both tonight’s and Thursday’s shows—the latter in a much larger venue downtown—had sold out within two hours of her attack.

  The final lap ended, and Conroy peered through the curtain at the standing-room-only crowd in the 500-seat ballroom.

  “And now, I give you, Dr. James Conroy, Jr.” It was showtime.

  Conroy wiped his hands on his pants legs and stepped through the curtain. The sea of faces he had studied only moments ago faded to apparitions behind the glare of the stage lights. But they were there. He could feel them. He could hear them—usually not words, but he knew their thoughts in the low murmur of the crowd, the shuffle of their feet, the readjusting of their positions. And occasionally, a confidence from the front row would reach his ears. “He’s taller than I thought.” “Now, we’ll see if he’s as good as everyone says.” “A lot more people here than I expected.”

  Conroy said nothing, moving his gaze across the space, right to left, then back. Letting the crowd’s anticipation build was just the first, small step in his fully choreographed dance. After a moment,
they quieted. Still, he waited, three seconds, four, five. He could feel the tension in the room grow. He raised his hands into the air and shouted his trademark phrase, “We must take back our health.”

  The applause was loud but hardly the frenzied response he’d get to the same words when the evening was done. He knew that for a fact; he’d seen it too often in the past to have doubts.

  “We’re the greatest nation on Earth.” The remark elicited a few scattered claps, as he anticipated. “There’s a car in every garage. No, make that two … or three. There’s a chicken in every pot unless, of course, you’re planning a visit to KFC.” A chuckle or two. “We’re five percent of the world’s population, and yet, we consume twenty-five percent of its resources. We want for nothing … except our health.”

  Now, the room was silent. He had their attention.

  “So, how bad is our healthcare, you ask? If we’re not number one, we’re second, right? No, sorry. Top ten? Nope, off again. Surely, we’re in the top twenty, you say. But you’re still wrong.” He paused, waiting for some of the unrest to dissipate.

  “Let’s look at life expectancy. You all want to live a long, happy, healthy life, right?” A murmur of agreement passed through the crowd.

  “And yet, we aren’t. Not compared to our neighbors across the globe. Of course, you’re thinking that these nations where people live longer—they’re all small, rich lands that can afford the best healthcare, right? Wrong again. Chile’s per capita income is less than half of the United States, but their citizens live longer. How about the United Kingdom? The financial discrepancy is less, but they too outlast us by years. Our neighbors to the north, Canada? Same story. So, just where do we rank in terms of life expectancy? North of 30. Did you hear me? The citizens of more than thirty nations live longer, healthier lives than we do. Countries that are rich and poor. Big and small.”

  He paused again. The fraction of his audience that was primarily analytical in disposition would be pondering those numbers, forming their own conclusions with the data he had provided. But the thoughts of the vast majority would be starting to wander. Numbers didn’t stir most people, so now he’d give them something to engage their emotions.

  “So why, you’re asking yourself, aren’t we doing better? I won’t lie to you. The reasons for our shortened life expectancy are many and varied: the stress of our rat-race lives, our poor diets, the lack of exercise. But each and every one of you ….” He paused, letting his accusing finger point track across the room. “You control those things. You can take a day off when you need it. You can order the salad in place of those cheesy fries. You can take the stairs and skip the elevator. Those factors are not the problem.

  “The problem is, what you don’t control. You don’t control your own healthcare. As strange as that sounds, it’s true. You’ve surrendered that responsibility to backroom politics and special interests. You let others dictate the treatments you can receive and the ones beyond reach. You allow big pharma to tell you what it costs. And don’t even think about getting drugs from another country. That is, unless you want to wade through mountains of bureaucratic red tape or risk time in a prison cell. We have surrendered our most basic human right to care for ourselves and that’s wrong. We must take back our health.”

  The applause was a bit louder this time and somewhat longer. Slowly, they were warming to his message, right on plan.

  “And what do we get when we surrender the rights to our health? Waste, fraud, and abuse!” He paused a beat, imagining the news stories under that rubric that would be coming to the audience’s minds.

  “We’ve created government behemoths to oversee our nation’s healthcare that are so immense no one could manage them. No wonder we have abuse and fraud. It’s easy money. No one will notice a hundred thousand here, a million there, ten million somewhere else. And what does this vast health bureaucracy look like? One special interest group or government agency targets a specific socioeconomic need, while another wants to help people of a certain age, and a third focuses on a geographic region. How can we allocate health services to so many, distinct slivers of the population—rich or poor, young or old, black or white—and not have overlaps with excess existing next to pockets of neglect? We can’t and we don’t. And so, inequality and inconsistency in healthcare are the rule, not the exception.”

  He waited for the applause to end.

  “Fraud, however, is the root problem, but perhaps not the type of fraud you’re thinking. I’m talking about the lies we’ve let the politicians tell us for far too long. We’ve looked the other way when they’ve said, ‘we know what’s best for you.’ They don’t. They know what’s best for themselves and the organizations that have bought them.”

  The strength of the audience’s response increased again. It was time to galvanize the worries that now cluttered their thoughts.

  “Giving someone else responsibility for our health only leads to tragedy,” he said softly, forcing the crowd forward in their seats to catch his words. “I was only fourteen when I learned this hard, brutal fact. By making a simple, nearly foolproof, medical procedure—an abortion—available only from a backstreet butcher, my sister bled to death sitting in a car seat next to me. Of course, you may ask, why didn’t she seek our parents’ aid. And, yes, she should have; I should have. But curing teenage naiveté is a much taller order than simply taking back the rights to our own bodies.”

  Conroy returned once again to the night of her death, recounting the details of her appearance in his room, her pleas for help. He spoke of his sweaty hands on the steering wheel, driving faster than any fourteen-year-old should. He painted a vivid picture of his mother collapsing in his father’s arms, a young doctor looking anywhere but their faces as he broke the news. And when Conroy finished, he paused again, this time as much for himself as the crowd. The cracks in his voice, the moistness in his eyes had not been feigned. He still felt the pain. He always would.

  For their part, the crowd was silent, save the sounds of a few sniffs or a soft sob. They shared some of his agony.

  When he had first started giving these talks, he had expected his audience to lash out against the current laws on abortion. He had been sorely mistaken. The religious and societal beliefs surrounding those laws were simply too deeply ingrained for a single talk to precipitate more than an evening’s unease. He had come to accept that. And in its place, he had adopted a broader goal—to start a national discussion on the rights and responsibilities of personal healthcare. Simply put, if all the splintered concerns of the public could be brought together in one place, they would show medicine and big pharma for what it was—the largest, self-serving, special interest in the world. Concerns about humanity were lost in the race to be first-to-market, blocked by the barriers to foreign competition, overlooked in the administration of clinical research, and on and on.

  “That’s my story,” Conroy said softly when he finished. “I’m sure yours is different. Maybe it was Aunt Betty dying of breast cancer because she couldn’t afford to travel to a foreign country for treatment. Maybe it was a son, Johnny, denied a full life because a research company with an experimental treatment for autism hadn’t yet jumped every hoop of every oversight agency known to man. Or a drug company, supplying a life-saving medicine that increased in cost 500, 1,000, 3,000 percent in one year. It happens. And much too often.

  “But tell me. Since when does ‘do no harm’ apply only to doctors? Doesn’t the government, the insurance industry, the drug companies—don’t they harm us every time they say, ‘trust us. We know what’s best.’ And all the while, they’re lining their pockets. Of course, the politicians and the regulatory agencies should keep the scam artists at bay, make sure we have the best information science can provide on effectiveness and safety. They need to inform and educate. But after that I say, get the hell out of our way because we must take back our health.”

  The applause was longer and louder than ever. It was time to close, give them something to
remember, something to talk about around the watercooler tomorrow at work. And for that purpose, last night he had penned a new ending to his talk. He thought it was good. Soon, he’d know.

  “Is this change going to be hard? No, it’s not. It’s going to be a war!” Some rumbles returned, and Conroy waited for the crowd to settle.

  “And if you don’t know what I’m talking about, you must have canceled your subscription to the paper, turned off the TV, and stayed offline all day because medicine is under attack by a group with the name of the Crusaders for Common Sense. Common sense? It should be crusaders for nonsense. Crusaders for the senseless murder of prominent doctors and medical researchers. They slaughter people who could make a difference in our lives and the lives of our children. And once those pioneers are gone, those great minds that would have illuminated our future are extinguished, we have no recourse except to accept a shorter, less fulfilling existence.”

  Conroy paused. The sound of a single cough somewhere off to the right came to his ears; otherwise, the ballroom sat in silence. The tension was palpable. It rolled off the crowd in waves he could feel.

  “Is this your war? Damn right it is. Because if we don’t push back just as hard as the Crusaders—not violently, but with the same full devotion to cause—there’ll be more Aunt Bettys dying of cancer and Johnnys suffering from debilitating conditions. Is that what you want? I say, no. I say … we must take back our health!”

  His words had touched the collective nerve he sought. The crowd rose to its feet in thunderous applause and shouts of resolve. Soon a chant of “take back our health, take back our health” broke out. Conroy held his hands extended in the air for several moments, bowed deeply three times and left the stage.

  Over the years, he had finely tuned his expectations. He had come to believe that an hour from now, no one would remember his words beyond his trademark rallying cry. He didn’t think anyone would bequeath their estate to medical research just because of what he had said. He didn’t expect to see a headline on the nightly news that read, “Thousands of Conroy Followers March on Washington.”