From the archive, originally posted by: [ spectre ]






“Working first with the D.E.A. and then with the State Department,
Wankel helped create the Afghan Eradication Force, with troops of the
Afghan National Police drawn from the Ministry of the Interior. Last
year, an estimated four hundred thousand acres of opium poppies were
planted in Afghanistan, a fifty-nine-per-cent increase over the
previous year. Afghanistan now supplies more than ninety-two per cent
of the world’s opium, the raw ingredient of heroin. More than half the
country’s annual G.D.P., some $3.1 billion, is believed to come from
the drug trade, and narcotics officials believe that part of the money
is funding the Taliban insurgency.”


New research chal­lenges tradi­tional accounts of why we wallow in
chemical gratification / March 21, 2008

Why do peo­ple abuse drugs? It’s not only a ques­tion wor­ried par­
ents ask their way­ward, sub­stance-dab­bling teenagers. It’s al­so a
deeper ques­tion asked by bi­ol­o­gists. In gen­er­al, na­ture has de­
signed all crea­tures as ex­quis­ite machines for their own pro­tec­
tion and propaga­t­ion. Yet we’re easily and of­ten drawn in­to self-
destruction by noth­ing more than life­less chem­i­cal lures. This
weak­ness seems such a jar­ring ex­cep­tion, such a dis­mal Achilles’
heel, that it calls out for ex­plana­t­ion.

Sci­en­tists typ­ic­ally of­fer the fol­low­ing one. Drugs are chem­i­
cals that in­ap­pro­pri­ate­ly trig­ger ac­ti­vity in brain cir­cuits
de­signed for very dif­fer­ent pur­poses: to pro­vide a sense of re­
ward for hav­ing sat­is­fied or­di­nary needs, health­fully.  The
brain has few de­fenses against this chem­i­cal de­cep­tion, the stand­
ard ac­count goes, be­cause drugs were un­known in the nat­u­ral en­vi­
ron­ment that shaped hu­man ev­o­lu­tion.

This tra­di­tion­al view, though, is com­ing un­der at­tack. A new
study pro­poses the brain evolved to ac­count for and even ex­ploit
drugs. Al­though their abuse is still un­healthy, the au­thors sug­
gest it’s wrong to think they cheat the brain in the sense tra­di­tion­
ally theo­r­ized.

“Ev­i­dence strongly in­di­cates that hu­mans and oth­er an­i­mals
have been ex­posed to drugs through­out their ev­o­lu­tion,” wrote the
sci­en­tists in the stu­dy. The re­search, by an­thro­po­lo­g­ist Rog­
er Sul­li­van of Cal­i­for­nia State Uni­ver­s­ity and two col­
leagues, ap­peared March 19 on­line in the jour­nal Pro­ceed­ings of
the Roy­al So­ci­e­ty B: Bi­o­log­i­cal Sci­ences.

The most pop­u­lar drugs of abuse are plant tox­ins that evolved to
pro­tect plants from preda­tors, as ev­o­lu­tion­ary bi­ol­o­gists
have “con­vinc­ingly ar­gued,” Sul­li­van and col­leagues wrote. For
ex­am­ple, nic­o­tine, the key ad­dic­tive in­gre­di­ent of
cigarettes, helps ward off an ar­ray of in­sects, mam­mals and other
creat­ures from munch­ing on to­bacco plants. Fur­ther ev­i­dence of
the fun­da­men­tally poi­son­ous na­ture of drugs of abuse, the three
sci­en­tists ar­gued, is that first-time users of­ten re­port un­pleas­
ant re­ac­tions.

Since plants long pre­date hu­mans, the pres­ence of these sub­stances
in plants would seem to in­di­cate we and our an­ces­tors have long
dealt with them, the re­search­ers con­tin­ued. But fur­ther ev­i­
dence of this, they added, is in our own make­up. All an­i­mals pro­
duce mo­le­cules known as cy­to­chromes, whose func­tions in­clude de­
tox­i­fy­ing in­gested plant poi­sons. Cy­to­chromes that spe­cif­ic­
ally neu­tral­ize brain-affecting plant tox­ins have re­mained a con­
sist­ent fea­ture of hu­man ev­o­lu­tion, Sul­li­van and col­leagues

All this shows “our an­ces­tors were reg­u­larly ex­posed to plant
neurotox­ins,” they added, so the view of our brains as un­sus­pect­
ing vic­tims of the new chem­i­cal threat is un­ten­able. It remains
unclear what might be the true ev­o­lu­tion­ary ex­plana­t­ion of drug
abuse, they wrote: the “para­dox” stays of why sub­stances de­signed
as poi­sons, are pleas­ur­a­ble to so many.

One pos­si­bil­ity, the sci­en­tists sug­gested, is that an­i­mals co-
opted some plant tox­ins and used them for their own de­fenses against
para­sites. If this is true, then ev­o­lu­tion, the pro­cess by which
spe­cies adapt and change to meet en­vi­ron­men­tal de­mands, might
have de­signed our brains to en­cour­age some drug use. This could in­
volve shap­ing our brains to as­so­ci­ate drug in­take with feel­ings
of re­ward. “But there are, of course, oth­er pos­si­bil­i­ties,” the
re­searchers wrote.

Researchers stumped by drug addiction paradox
BY Lisa Zyga  /  April 16, 2008

Throughout history, plants have created their toxins by mimicking
their own molecules that regulate metabolism, growth and reproduction.
When ingested by herbivores, some of these molecules can interfere
with nearly every step in the animal’s neural signaling process.

In current evolutionary interpretations of drug addiction, these toxic
substances trigger the brain’s reward center by rewiring the brain’s
natural reward circuits, and falsely indicating a fitness benefit and
blocking painful feelings. But, as Sullivan, Hagen, and Hammerstein
show, this explanation makes several assumptions that contradict
evidence from previous studies. Most significantly, it assumes that
humans evolved in environments without exposure to drugs, and that the
brain never evolved to protect itself from plant toxins.

However, the researchers point to several other studies which show
that the detoxification enzymes developed by animals (and which
originally evolved in bacteria about 3.5 billion years ago) expanded
in animals about 400 million years ago – about the same time that
plants were evolving their own toxins. In other words, animals and
plants seemed to have coevolved competitive genes in response to each
other, which contradicts the evolutionary interpretation.

As the researchers investigated further, they compiled other studies
showing evidence that humans inherited these detox genes from their
mammalian ancestors. Interestingly, although many modern animal
species can tolerate plant toxins, different species possess different
detox function levels. Even among humans from different geographic
locations, these functions differ. Often, human populations with
greater numbers of toxin-metabolizing genes originate from parts of
the world that contain an abundance of those plants. For example,
human populations in and near Turkey have a very high frequency of
enzymes that can metabolize opiates, and the opiate poppy is native to
the Turkish region.

To conclude their argument against the evolutionary interpretation,
the researchers explain that (pre-human) animals and plants did appear
to have evolved the relevant genes simultaneously. If that’s the case,
then the brain shouldn’t treat drugs as if they contained a fitness
benefit, giving strong support to the paradox.

“We have been surprised by how robust the paradox is – that is, in
presenting the arguments at scientific meetings for several years now,
no one has been able to refute the basic argument that plant
ecological models and neurobiological models of drug use are in direct
conflict,” Sullivan said.

Many more questions also remain unanswered, but they may contain clues
to an explanation. For example, there is contradictory evidence for
whether commonly used drugs have become more or less potent as they’ve
been domesticated. Also, as the researchers point out, current models
explaining drug reward mechanisms don’t differentiate between
different drugs – even though the pathways taken by opiates, cannabis,
or any other drug are vastly different. Models of multiple-drug
pathways might better explain drug appeal, the scientists suggest.

Based on evidence from previous studies, Sullivan, Hagen, and
Hammerstein note that plant toxins may actually have some kind of
benefit for animals. For instance, because plant toxins are more
harmful to some species than to others, the less affected species
might actually consume levels of toxin that are tolerable to
themselves but much worse for the parasites or pathogens that feed on
them in order to protect themselves. For example, earlier humans that
consumed nicotine (in much smaller amounts than today) could have
received the benefit of fewer parasitic infections. Of course, the
benefits also come with trade-offs.

“The main implications for future research are that neurobiological
theorists must consider facts emerging from plant ecology,” Sullivan
said. “We are also planning field studies looking for relationships
between human drug use and protection from helminth parasites.”

“Neurobiological models of drug abuse propose that drug use is
initiated and maintained by rewarding feedback mechanisms. However,
the most commonly used drugs are plant neurotoxins that evolved to
punish, not reward, consumption by animal herbivores. Reward models
therefore implicitly assume an evolutionary mismatch between recent
drug-profligate environments and a relatively drug-free past in which
a reward centre, incidentally vulnerable to neurotoxins, could evolve.
By contrast, emerging insights from plant evolutionary ecology and the
genetics of hepatic enzymes, particularly cytochrome P450, indicate
that animal and hominid taxa have been exposed to plant toxins
throughout their evolution. Specifically, evidence of conserved
function, stabilizing selection, and population-specific selection of
human cytochrome P450 genes indicate recent evolutionary exposure to
plant toxins, including those that affect animal nervous systems.
Thus, the human propensity to seek out and consume plant neurotoxins
is a paradox with far-reaching implications for current drug-reward
theory. We sketch some potential resolutions of the paradox, including
the possibility that humans may have evolved to counter-exploit plant
neurotoxins. Resolving the paradox of drug reward will require a
synthesis of ecological and neurobiological perspectives of drug
seeking and use.”

Roger Sullivan
e-mail : sullivar [at] csus [dot] edu

Edward Hagen
email : hagen [at] vancouver [dot] wsu [dot] edu

Peter Hammerstein
email : p [dot] hammerstein [at] biologie [dot]







YES, #1 IS NEW YORK,1518,450078,00.html,1518,384456,00.html
Quiet Spanish city is Europe’s coke capital
Miranda de Ebro second only to New York says UN
Study of waste water is mistaken, say residents
BY Dale Fuchs  /  June 29 2007

Miranda de Ebro, a small industrial city in northern Spain, was once
known for small blood sausages, a three-day fiesta after Holy Week and
its strategic location as highway stopover – on the way to somewhere
else. But now the city has a new distinction: cocaine capital of

The United Nations World Drug Report this year ranks Miranda de Ebro
as the city with the highest incidence of cocaine use in Europe and
second in the world after New York, with a rate nearly five times as
high as in St Moritz, London, Zurich and Madrid. The city’s 40,000
residents, mostly factory workers and small shopkeepers, are
astonished by the findings. They can not understand how the UN study
of waste water could have found a consumption rate of 97 lines a day
for every 1,000 people, in a city whose big event is the traditional
Sunday evening stroll. “It’s absolutely absurd,” the mayor, Fernando
Campo, told the Guardian. “This is a tranquil, working-class city.
What the people like to do is have a little glass of wine with their
tapas, not white lines.”

With no large discos and few other clubs to attract a party crowd,
Miranda de Ebro had little in common with the wild atmosphere of
Ibiza, Mr Campo insisted. He suggested the findings were an error
possibly caused by a nearby chemical plant. City waste is purified
before reaching the river, he said. Miranda de Ebro may be in denial,
but nobody in Spain disputes the rest of the UN report, which ranks
Spaniards as the most avid cocaine users in the world. Of the
population aged 15 to 64, 3% inhales the white powder, compared with
2.4% in England and 2.8% in the US. The percentage of youths aged 14
to 18 using the drug has roughly quadrupled in the past decade.

The UN report blames Spain’s avid use of cocaine partly on cultural
and linguistic ties to cocaine-producing countries of Latin America,
and its expansive coastline, especially the dangerous and hard-to-
patrol coves of northern Galicia, which invite smugglers. The UN
report dubs Spain a drug-trafficker’s “gateway to Europe”. The number
of police seizures of the drug far surpasses any other Mediterranean
country. Sociologists also point to the liberal, feel-good youth
culture that blossomed since the end of the Franco dictatorship – now
coupled with historically high purchasing power that keeps suburban
mega-discos and chic city bars doing a lucrative business until dawn.

Parents who came of age under the repressive Franco years are also
generally wary of imposing too many restrictions on their teenagers
and young adults who live at home, sociologists say, allowing generous
budgets for once unthinkable luxuries, such as a breast implants or
trips to Ibiza. The health ministry, alarmed by the trends, announced
this week a €7m (£5m) campaign to take the glamour out of cocaine so
young people no longer associated sniffing with success. The ministry
is also trying to persuade hotel owners to fight against drug use in
their establishments.

Miranda de Ebro, meanwhile, is battling to clear its name. The mayor
has sent a letter to the UN asking for an explanation of the findings.
Police are investigating to see if the river, at a transport
crossroads, could be used by smugglers passing through. Many
residents, though, have taken the report as a joke. “I laughed when I
heard about,” said a youth hostel worker. “There is no nightlife here.
You can run through the town in 10 minutes. Everyone is joking, ‘Who’s
the person sniffing the 97 lines each day’.”










Gary Slutkin
e-mail : gslutkin [at] uic [dot] edu

Blocking the Transmission of Violence
BY Alex Kotlowitz  /  May 4, 2008

Last summer, Martin Torres was working as a cook in Austin, Tex.,
when, on the morning of Aug. 23, he received a call from a relative.
His 17-year-old nephew, Emilio, had been murdered. According to the
police, Emilio was walking down a street on Chicago’s South Side when
someone shot him in the chest, possibly the culmination of an ongoing
dispute. Like many killings, Emilio’s received just a few sentences in
the local newspapers. Torres, who was especially close to his nephew,
got on the first Greyhound bus to Chicago. He was grieving and
plotting retribution. “I thought, Man, I’m going to take care of
business,” he told me recently. “That’s how I live. I was going
hunting. This is my own blood, my nephew.”

Torres, who is 38, grew up in a dicey section of Chicago, and even by
the standards of his neighborhood he was a rough character. His
nickname was Packman, because he was known to always pack a gun. He
was first shot when he was 12, in the legs with buckshot by members of
a rival gang. He was shot five more times, including once through the
jaw, another time in his right shoulder and the last time — seven
years ago — in his right thigh, with a .38-caliber bullet that is
still lodged there. On his chest, he has tattooed a tombstone with the
name “Buff” at its center, a tribute to a friend who was killed on his
18th birthday. Torres was the head of a small Hispanic gang, and
though he is no longer active, he still wears two silver studs in his
left ear, a sign of his affiliation.

When he arrived in Chicago, he began to ask around, and within a day
believed he had figured out who killed his nephew. He also began
drinking a lot — mostly Hennessey cognac. He borrowed two guns, a .38
and a .380, from guys he knew. He would, he thought, wait until after
the funeral to track down his nephew’s assailants.

Zale Hoddenbach looks like an ex-military man. He wears his hair
cropped and has a trimmed goatee that highlights his angular jaw. He
often wears T-shirts that fit tightly around his muscled arms, though
he also carries a slight paunch. When he was younger, Hoddenbach, who
is also 38, belonged to a gang that was under the same umbrella as
Torres’s, and so when the two men first met 17 years ago at Pontiac
Correctional Center, an Illinois maximum-security prison, they became
friendly. Hoddenbach was serving time for armed violence; Torres for
possession of a stolen car and a gun (he was, he says, on his way to
make a hit). “Zale was always in segregation, in the hole for fights,”
Torres told me. “He was aggressive.” In one scuffle, Hoddenbach lost
the sight in his right eye after an inmate pierced it with a shank.
Torres and Hoddenbach were at Pontiac together for about a year but
quickly lost touch after they were both released.

Shortly after Torres arrived in Chicago last summer, Hoddenbach
received a phone call from Torres’s brother, the father of the young
man who was murdered. He was worried that Torres was preparing to seek
revenge and hoped that Hoddenbach would speak with him. When
Hoddenbach called, Torres was thrilled. He immediately thought that
his old prison buddy was going to join him in his search for the
killer. But instead Hoddenbach tried to talk him down, telling him
retribution wasn’t what his brother wanted. “I didn’t understand what
the hell he was talking about,” Torres told me when I talked to him
six months later. “This didn’t seem like the person I knew.” The next
day Hoddenbach appeared at the wake, which was held at New Life
Community Church, housed in a low-slung former factory. He spent the
day by Torres’s side, sitting with him, talking to him, urging him to
respect his brother’s wishes. When Torres went to the parking lot for
a smoke, his hands shaking from agitation, Hoddenbach would follow.
“Because of our relationship, I thought there was a chance,”
Hoddenbach told me. “We were both cut from the same cloth.” Hoddenbach
knew from experience that the longer he could delay Torres from
heading out, the more chance he’d have of keeping him from shooting
someone. So he let him vent for a few hours. Then Hoddenbach started
laying into him with every argument he could think of: Look around, do
you see any old guys here? I never seen so many young kids at a
funeral. Look at these kids, what does the future hold for them? Where
do we fit in? Who are you to step on your brother’s wishes?

THE STUBBORN CORE of violence in American cities is troubling and
perplexing. Even as homicide rates have declined across the country —
in some places, like New York, by a remarkable amount — gunplay
continues to plague economically struggling minority communities. For
25 years, murder has been the leading cause of death among African-
American men between the ages of 15 and 34, according to the Centers
for Disease Control and Prevention, which has analyzed data up to
2005. And the past few years have seen an uptick in homicides in many
cities. Since 2004, for instance, they are up 19 percent in
Philadelphia and Milwaukee, 29 percent in Houston and 54 percent in
Oakland. Just two weekends ago in Chicago, with the first warm
weather, 36 people were shot, 7 of them fatally. The Chicago Sun-Times
called it the “weekend of rage.” Many killings are attributed to gang
conflicts and are confined to particular neighborhoods. In Chicago,
where on average five people were shot each day last year, 83 percent
of the assaults were concentrated in half the police districts. So for
people living outside those neighborhoods, the frequent outbursts of
unrestrained anger have been easy to ignore. But each shooting, each
murder, leaves a devastating legacy, and a growing school of thought
suggests that there’s little we can do about the entrenched urban
poverty if the relentless pattern of street violence isn’t somehow

The traditional response has been more focused policing and longer
prison sentences, but law enforcement does little to disrupt a street
code that allows, if not encourages, the settling of squabbles with
deadly force. Zale Hoddenbach, who works for an organization called
CeaseFire, is part of an unusual effort to apply the principles of
public health to the brutality of the streets. CeaseFire tries to deal
with these quarrels on the front end. Hoddenbach’s job is to suss out
smoldering disputes and to intervene before matters get out of hand.
His job title is violence interrupter, a term that while not artful
seems bluntly self-explanatory. Newspaper accounts usually refer to
the organization as a gang-intervention program, and Hoddenbach and
most of his colleagues are indeed former gang leaders. But CeaseFire
doesn’t necessarily aim to get people out of gangs — nor interrupt the
drug trade. It’s almost blindly focused on one thing: preventing

CeaseFire’s founder, Gary Slutkin, is an epidemiologist and a
physician who for 10 years battled infectious diseases in Africa. He
says that violence directly mimics infections like tuberculosis and
AIDS, and so, he suggests, the treatment ought to mimic the regimen
applied to these diseases: go after the most infected, and stop the
infection at its source. “For violence, we’re trying to interrupt the
next event, the next transmission, the next violent activity,” Slutkin
told me recently. “And the violent activity predicts the next violent
activity like H.I.V. predicts the next H.I.V. and TB predicts the next
TB.” Slutkin wants to shift how we think about violence from a moral
issue (good and bad people) to a public health one (healthful and
unhealthful behavior).

EVERY WEDNESDAY AFTERNOON, in a Spartan room on the 10th floor of the
University of Illinois at Chicago’s public-health building, 15 to 25
men — and two women — all violence interrupters, sit around tables
arranged in a circle and ruminate on the rage percolating in the city.
Most are in their 40s and 50s, though some, like Hoddenbach, are a bit
younger. All of them are black or Hispanic and in one manner or
another have themselves been privy to, if not participants in, the
brutality of the streets.

On a Wednesday near the end of March, Slutkin made a rare appearance;
he ordinarily leaves the day-to-day operations to a staff member. Fit
at 57, Slutkin has a somewhat disheveled appearance — tie askew, hair
uncombed, seemingly forgetful. Some see his presentation as a
calculated effort to disarm. “Slutkin does his thing in his
Slutkinesque way,” notes Carl Bell, a psychiatrist who has long worked
with children exposed to neighborhood violence and who admires
CeaseFire’s work. “He seems kind of disorganized, but he’s not.”
Hoddenbach told me: “You can’t make too much of that guy. In the
beginning, he gives you that look like he doesn’t know what you’re
talking about.”

Slutkin had come to talk with the group about a recent high-profile
incident outside Crane Tech High School on the city’s West Side. An 18-
year-old boy was shot and died on the school’s steps, while nearby
another boy was savagely beaten with a golf club. Since the beginning
of the school year, 18 Chicago public-school students had been killed.
(Another six would be murdered in the coming weeks.) The interrupters
told Slutkin that there was a large police presence at the school, at
least temporarily muffling any hostilities there, and that the police
were even escorting some kids to and from school. They then told him
what was happening off the radar in their neighborhoods. There was the
continuing discord at another high school involving a group of girls
(“They’d argue with a stop sign,” one of the interrupters noted); a 14-
year-old boy with a gang tattoo on his forehead was shot by an older
gang member just out of prison; a 15-year-old was shot in the stomach
by a rival gang member as he came out of his house; and a former
CeaseFire colleague was struggling to keep himself from losing control
after his own sons were beaten. There was also a high-school
basketball player shot four times; a 12-year-old boy shot at a party;
gang members arming themselves to counter an egging of their freshly
painted cars; and a high-ranking gang member who was on life support
after being shot, and whose sister was overheard talking on her
cellphone in the hospital, urging someone to “get those straps
together. Get loaded.”

These incidents all occurred over the previous seven days. In each of
them, the interrupters had stepped in to try to keep one act of enmity
from spiraling into another. Some had more success than others. Janell
Sails prodded the guys with the egged cars to go to a car wash and
then persuaded them it wasn’t worth risking their lives over a stupid
prank. At Crane Tech High School, three of the interrupters fanned
out, trying to convince the five gangs involved in the conflict to lie
low, but they conceded that they were unable reach some of the main
players. Many of the interrupters seem bewildered by what they see as
a wilder group of youngsters now running the streets and by a gang
structure that is no longer top-down but is instead made up of many
small groups — which they refer to as cliques — whose members are
answerable to a handful of peers.

For an hour, Slutkin leaned on the table, playing with a piece of
Scotch tape, keenly listening. In some situations, Slutkin can appear
detached and didactic. He can wear people down with his long
discourses, and some of the interrupters say they sometimes tune him
out. (On one occasion, he tried to explain to me the relationship
between emotional intelligence and quantum physics.) But having seen a
lot of out-of-control behavior, Slutkin is a big believer in
controlling emotions. So he has taught himself not to break into
discussions and to digest before presenting his view. The interrupters
say he has their unqualified loyalty. Hoddenbach told me that he now
considers Slutkin a friend.

It became clear as they delivered their reports that many of the
interrupters were worn down. One of them, Calvin Buchanan, whose
street name is Monster and who just recently joined CeaseFire, showed
the others six stitches over his left eye; someone had cracked a beer
bottle on his head while he was mediating an argument between two men.
The other interrupters applauded when Buchanan told them that, though
tempted, he restrained himself from getting even.

When Slutkin finally spoke, he first praised the interrupters for
their work. “Everybody’s overreacting, and you’re trying to cool them
down,” he told them. He then asked if any of them had been
experiencing jitteriness or fear. He spent the next half-hour teaching
stress-reduction exercises. If they could calm themselves, he seemed
to be saying, they could also calm others. I recalled what one of the
interrupters told me a few weeks earlier: “We helped create the
madness, and now we’re trying to debug it.”

IN THE PUBLIC-HEALTH field, there have long been two schools of
thought on derailing violence. One focuses on environmental factors,
specifically trying to limit gun purchases and making guns safer. The
other tries to influence behavior by introducing school-based
curricula like antidrug and safe-sex campaigns.

Slutkin is going after it in a third way — as if he were trying to
contain an infectious disease. The fact that there’s no vaccine or
medical cure for violence doesn’t dissuade him. He points out that in
the early days of AIDS, there was no treatment either. In the short
run, he’s just trying to halt the spread of violence. In the long run,
though, he says he hopes to alter behavior and what’s considered
socially acceptable.

Slutkin’s perspective grew out of his own experience as an infectious-
disease doctor. In 1981, six years out of the University of Chicago
Pritzker School of Medicine, Slutkin was asked to lead the TB program
in San Francisco. With an influx of new refugees from Cambodia, Laos
and Vietnam, the number of cases in the city had nearly doubled.
Slutkin chose to concentrate on those who had the most active TB; on
average, they were infecting 6 to 10 others a year. Slutkin hired
Southeast Asian outreach workers who could not only locate the
infected individuals but who could also stick with them for nine
months, making sure they took the necessary medication. These outreach
workers knew the communities and spoke the languages, and they were
able to persuade family members of infected people to be tested.
Slutkin also went after the toughest cases — 26 people with drug-
resistant TB. The chance of curing those people was slim, but Slutkin
reckoned that if they went untreated, the disease would continue to
spread. “Gary wasn’t constrained by the textbook,” says Eric Goosby,
who worked in the clinic and is now the chief executive of the Pangaea
Global AIDS Foundation. Within two years, the number of TB cases, at
least among these new immigrants, declined sharply.

Slutkin then spent 10 years in Africa, first in refugee camps in
Somalia and then working, in Uganda and other countries, for the World
Health Organization to curtail the spread of AIDS. During his first
posting, in Somalia, a cholera epidemic spread from camp to camp.
Slutkin had never dealt with an outbreak of this sort, and he was
overwhelmed. The diarrhea from cholera is so severe that patients can
die within hours from dehydration. According to Sandy Gove, who was
then married to Slutkin and was also a doctor in the camps, infection
rates were approaching 10 percent; in one camp there were 1,000
severely ill refugees. “It was desperate,” she told me. Slutkin drove
a Land Cruiser two and a half days to an American military base along
the coast to the closest phone. He called doctors in Europe and the
United States, trying to get information. He also asked the soldiers
at the base for blue food coloring, which he then poured into the
water sources of the bacteria, a warning to refugees not to drink.
“What Gary is really good about is laying out a broad strategic plan
and keeping ahead of something,” Gove told me. There were only six
doctors for the 40 refugee camps, so Slutkin and Gove trained birth
attendants to spot infected people and to give them rehydration
therapies in their homes. Because the birth attendants were refugees,
they were trusted and could persuade those with the most severe
symptoms to receive aid at the medical tent.

After leaving Africa, Slutkin returned to Chicago, where he was raised
and where he could attend to his aging parents. (He later remarried
there.) It was 1995, and there had been a series of horrific murders
involving children in the city. He was convinced that longer sentences
and more police officers had made little difference. “Punishment
doesn’t drive behavior,” he told me. “Copying and modeling and the
social expectations of your peers is what drives your behavior.”

Borrowing some ideas (and the name) from a successful Boston program,
Slutkin initially established an approach that exists in one form or
another in many cities: outreach workers tried to get youth and young
adults into school or to help them find jobs. These outreach workers
were also doing dispute mediation. But Slutkin was feeling his way,
much as he had in Somalia during the cholera epidemic. One of
Slutkin’s colleagues, Tio Hardiman, brought up an uncomfortable truth:
the program wasn’t reaching the most bellicose, those most likely to
pull a trigger. So in 2004, Hardiman suggested that, in addition to
outreach workers, they also hire men and women who had been deep into
street life, and he began recruiting people even while they were still
in prison. Hardiman told me he was looking for those “right there on
the edge.” (The interrupters are paid roughly $15 an hour, and those
working full time receive benefits from the University of Illinois at
Chicago, where CeaseFire is housed.) The new recruits, with strong
connections to the toughest communities, would focus solely on
sniffing out clashes that had the potential to escalate. They would
intervene in potential acts of retribution — as well as try to defuse
seemingly minor spats that might erupt into something bigger, like
disputes over women or insulting remarks.

As CeaseFire evolved, Slutkin says he started to realize how much it
was drawing on his experiences fighting TB and AIDS. “Early
intervention in TB is actually treatment of the most infectious
people,” Slutkin told me recently. “They’re the ones who are infecting
others. So treatment of the most infectious spreaders is the most
effective strategy known and now accepted in the world.” And, he
continued, you want to go after them with individuals who themselves
were once either infectious spreaders or at high risk for the illness.
In the case of violence, you use those who were once hard-core, once
the most belligerent, once the most uncontrollable, once the angriest.
They are the most convincing messengers. It’s why, for instance,
Slutkin and his colleagues asked sex workers in Uganda and other
nations to spread the word to other sex workers about safer sexual
behavior. Then, Slutkin said, you train them, as you would
paraprofessionals, as he and Gove did when they trained birth
attendants to spot cholera in Somalia.

The first step to containing the spread of an infectious disease is
minimizing transmission. The parallel in Slutkin’s Chicago work is
thwarting retaliations, which is precisely what Hoddenbach was trying
to do in the aftermath of Emilio Torres’s murder. But Slutkin is also
looking for the equivalent of a cure. The way public-health doctors
think of curing disease when there are no drug treatments is by
changing behavior. Smoking is the most obvious example. Cigarettes are
still around. And there’s no easy remedy for lung cancer or emphysema.
So the best way to deal with the diseases associated with smoking is
to get people to stop smoking. In Uganda, Slutkin and his colleagues
tried to change behavior by encouraging people to have fewer sexual
partners and to use condoms. CeaseFire has a visible public-
communications campaign, which includes billboards and bumper stickers
(which read, “Stop. Killing. People.”). It also holds rallies — or
what it calls “responses” — at the sites of killings. But much
research suggests that peer or social pressure is the most effective
way to change behavior. “It was a real turning point for me,” Slutkin
said, “when I was working on the AIDS epidemic and saw research
findings that showed that the principal determinant of whether someone
uses a condom or not is whether they think their friends use them.”
Daniel Webster, a professor of public health at Johns Hopkins
University who has looked closely at CeaseFire, told me, “The guys out
there doing the interruption have some prestige and reputation, and I
think the hope is that they start to change a culture so that you can
retain your status, retain your manliness and be able to walk away
from events where all expectations were that you were supposed to
respond with lethal force.”

As a result, the interrupters operate in a netherworld between
upholding the law and upholding the logic of the streets. They’re not
meant to be a substitute for the police, and indeed, sometimes the
interrupters negotiate disputes involving illicit goings-on. They
often walk a fine line between mediating and seeming to condone
criminal activity. At one Wednesday meeting this past December, the
interrupters argued over whether they could dissuade stickup artists
from shooting their victims; persuading them to stop robbing people
didn’t come up in the discussion.

LAST DECEMBER, at the first Wednesday meeting I attended, James
Highsmith came up to introduce himself. At 58, Highsmith is one of the
older interrupters. He wears striped, collared shirts, black
rectangular glasses and often a black Borsalino, an Italian-made
fedora. He reminded me that I had mentioned him in my book, “There Are
No Children Here,” about life in a Chicago public-housing project in
the late 1980s. I wrote about a picnic that some Chicago drug kingpins
gave in a South Side park. There was a car show, a wet T-shirt contest
and softball games for the children. About 2,000 people attended,
dancing to a live band while the drug lords showed off their Mercedes
Benzes, Rolls-Royces and Jaguars. Highsmith was the key sponsor of the
event. He controlled the drug trade on the city’s South Side. He owned
a towing business, an auto-mechanic’s shop and a nightclub, as well as
a 38-foot boat. In January 1994, he was sentenced to 14 years in
federal prison on drug-conspiracy charges; he was released in 2004.
Highsmith was just the kind of recruit CeaseFire looks for: an older
man getting out of the penitentiary who once had standing on the
streets and who, through word of mouth, appears ready, eager even, to
discard his former persona. “I’m a work in progress,” Highsmith told

One evening we were sitting in Highsmith’s basement apartment when the
phone rang. It was Alphonso Prater, another interrupter. The two had a
reunion of sorts when they joined CeaseFire; they shared a cell in the
county jail 34 years ago. Prater’s voice is so raspy it sounds as if
he has gravel in his throat. He told me that he became permanently
hoarse after a long stint in segregation in prison; he had to shout to
talk with others. When Prater called the night I was there, all
Highsmith could make out was: “There’s some high-tech stuff going on.
I need you to talk to some folks.” Highsmith didn’t ask any questions.

We drove to a poorly lighted side street on the city’s West Side.
Empty beer bottles littered the side of the road. Prater, who is short
and wiry and has trouble keeping still, was bouncing on the sidewalk,
standing next to a lanky middle-aged man who had receded into his
oversize hooded sweatshirt. Highsmith, Prater and another interrupter
joined the man in a parked car, where they talked for half an hour.
When they were done, the car peeled away, two other sedans escorting
it, one in front, the other in the rear. “Protection,” Highsmith
commented. Apparently, the man in the hooded sweatshirt, whom I would
meet later, had been an intermediary in a drug deal. He had taken an
out-of-town buyer holding $30,000 in cash to a house on the South Side
to buy drugs. But when they got there, they were met by six men in the
backyard, each armed with a pistol or an automatic weapon, and robbed.
The out-of-town buyer believed he’d been set up by the intermediary,
who, in turn, was trying to hunt down the stickup artists. In the car,
Prater, who knew the intermediary, had worked to cool him down, while
Highsmith promised to see if he could find someone who might know the
stickup guys and could negotiate with them. The intermediary told
Prater and Highsmith, a bit ominously, “Something got to give.”

After the intermediary drove off, Prater joked that there was no way
he was getting back in a car with him, that he was too overheated and
too likely to be the target or the shooter. “I’m not sure we can do
anything about this one,” Highsmith told Prater.

RELYING ON HARDENED TYPES — the ones who, as Webster of Johns Hopkins
says, have some prestige on the streets — is risky. They have prestige
for a reason. Hoddenbach, who once beat someone so badly he punctured
his lungs, is reluctant to talk about his past. “I don’t want to be
seen as a monster,” he told me. Hoddenbach’s ethnicity is hard to
pinpoint. His father was Dutch and his mother Puerto Rican, and he’s
so light-skinned his street name was Casper. He has a discerning gaze
and mischievous smile, and can be hardheaded and impatient. (At the
Wednesday meetings, he often sits near the door and whispers
entreaties to the others to speed things up.) Hoddenbach’s father had
an explosive temper, and to steal from Slutkin’s lingo, he seems to
have infected others. Two of Hoddenbach’s older brothers are serving
time for murder. His third brother has carved out a legitimate life as
a manager at a manufacturing firm. Hoddenbach always worked. He did
maintenance on train equipment and towed airplanes at a private
airport. But he was also active in a Hispanic street gang and was
known for his unmitigated aggression. He served a total of eight years
in the state penitentiary, the last stay for charges that included
aggravated battery. He was released in 2002.

In January, I was with Slutkin in Baltimore, where he spoke about
CeaseFire to a small gathering of local civic leaders at a private
home. During the two-hour meeting, Slutkin never mentioned that the
interrupters were ex-felons. When I later asked him about that
omission, he conceded that talking about their personal histories “is
a dilemma. I haven’t solved it.” I spent many hours with Hoddenbach
and the others, trying to understand how they chose to make the
transition from gangster to peacemaker, how they put thuggery behind
them. It is, of course, their street savvy and reputations that make
them effective for CeaseFire. (One supporter of the program admiringly
called it “a terrifying strategy” because of the inherent risks.) Some
CeaseFire workers have, indeed, reverted to their old ways. One
outreach worker was fired after he was arrested for possession of an
AK-47 and a handgun. Another outreach worker and an interrupter were
let go after they were arrested for dealing drugs. Word-of-mouth
allegations often circulate, and privately, some in the police
department worry about CeaseFire’s workers returning to their old

Not all the interrupters I talked to could articulate how they had
made the transition. Some, like Hoddenbach, find religion — in his
case, Christianity. He also has four children he feels responsible
for, and has found ways to decompress, like going for long runs. (His
brother Mark speculated that “maybe he just wants to give back what he
took out.”) I once asked Hoddenbach if he has ever apologized to
anyone he hurt. We were with one of his old friends from the street,
who started guffawing, as if I had asked Hoddenbach if he ever wore
dresses. “I done it twice,” Hoddenbach told us — quickly silencing his
friend and saving me from further embarrassment. (One apology was to
the brother of the man whose lungs he’d punctured; the other was to a
rival gang member he shot.) Alphonso Prater told me that the last time
he was released from prison, in 2001, an older woman hired him to gut
some homes she was renovating. She trusted him with the keys to the
homes, and something about that small gesture lifted him. “She seen
something in me that I didn’t see,” he told me.

Though the interrupters may not put it this way, the Wednesday
meetings are a kind of therapy. One staff member laughingly compared
it to a 12-step program. It was clear to me that they leaned on one
another — a lot. Prater once got an urgent call from his daughter, who
said her boyfriend was beating her. Prater got in his car and began to
race to her house; as he was about to run a stop sign, he glimpsed a
police car on the corner. He skidded to a halt. It gave him a moment
to think, and he called his CeaseFire supervisor, Tio Hardiman, who
got another interrupter to visit Prater’s daughter. Not long ago,
three old-timers fresh out of prison ruthlessly ridiculed Hoddenbach
for his work with CeaseFire. They were relentless, and Hoddenbach
asked to sit down with them. But when it came time to meet, he
realized he was too riled, and so he asked another interrupter, Tim
White, to go in his place. “I was worried I was going to whip their
asses, and wherever it went from there it went,” Hoddenbach told me.
“They were old feelings, feelings I don’t want to revisit.”

Recently I went out to lunch with Hoddenbach and Torres. It had been
four months since Torres buried his nephew. Torres, who looked worn
and agitated (he would get up periodically to smoke a cigarette
outside), seemed paradoxically both grateful to and annoyed at
Hoddenbach. In the end, Hoddenbach had persuaded him not to avenge his
nephew’s murder. Torres had returned the guns and quickly left town.
This was his first visit back to Chicago. “I felt like a punk,” he
told me, before transferring to the present tense. “I feel shameful.”
He said he had sought revenge for people who weren’t related to him —
“people who weren’t even no blood to me.” But he held back in the case
of his nephew. “I still struggle with it,” he said. On the ride over
to the restaurant, Torres had been playing a CD of his nephew’s
favorite rap songs. It got him hyped up, and he blurted out to
Hoddenbach, “I feel like doing something.” Hoddenbach chided him and
shut off the music. “Stop being an idiot,” he told Torres. “Something
made me do what Zale asked me to do,” Torres said later, looking more
puzzled than comforted. “Which is respect my brother’s wishes.”

When Slutkin heard of Hoddenbach’s intervention, he told me: “The
interrupters have to deal with how to get someone to save face. In
other words, how do you not do a shooting if someone has insulted you,
if all of your friends are expecting you to do that? . . . In fact,
what our interrupters do is put social pressure in the other

He continued: “This is cognitive dissonance. Before Zale walked up to
him, this guy was holding only one thought. So you want to put another
thought in his head. It turns out talking about family is what really
makes a difference.” Slutkin didn’t take this notion to the
interrupters; he learned it from them.

ONE JANUARY NIGHT at 11 p.m., Charles Mack received a phone call that
a shooting victim was being rushed to Advocate Christ Medical Center.
Mack drove the 10 miles from his home to the hospital, which houses
one of four trauma centers in Chicago. Two interrupters, Mack and
LeVon Stone, are assigned there. They respond to every shooting and
stabbing victim taken to the hospital. Mack, who is 57 and has a
slight lisp, is less imposing than his colleagues. He seems always to
be coming from or going to church, often dressed in tie and cardigan.
He sheepishly told me that his prison term, two years, was for bank
fraud. “The other guys laugh at me,” he said. LeVon Stone is 23 years
younger and a fast talker. He’s in a wheelchair, paralyzed from the
waist down as a result of being shot when he was 18.

Advocate Christ has come to see the presence of interrupters in the
trauma unit as essential and is, in fact, looking to expand their
numbers. “It has just given me so much hope,” Cathy Arsenault, one of
the chaplains there, told me. “The families would come in, huddle in
the corner and I could see them assigning people to take care of
business.” Mack and Stone try to cool off family members and friends,
and if the victim survives, try to keep them from seeking vengeance.

The victim that night was a tall 16-year-old boy named Frederick. He
was lying on a gurney just off the emergency room’s main hallway. He
was connected to two IVs, and blood was seeping through the gauze
wrapped around his left hand. Mack stood to one side; Stone pulled up
on the other. “You know, the most important thing is —” Mack ventured.
“You’re alive,” Stone chimed in. Stone then asked Frederick if he had
heard of CeaseFire. The boy nodded and told them that he had even
participated in a CeaseFire rally after a killing in his neighborhood.
“We try to stop violence on the front end,” Stone told Frederick.
“Unfortunately, this is the back end. We just want to make sure you
don’t go out and try to retaliate.”

The boy had been shot — one bullet shattered his thigh bone and
another ripped the tendons in two fingers. Nonetheless, he seemed
lucid and chatty. “My intention is to get in the house, call my
school, get my books and finish my work,” he told Mack and Stone. He
mentioned the school he attends, which Mack instantly recognized as a
place for kids on juvenile-court probation. Frederick told his story.
He was at a party, and a rival clique arrived. Frederick and his
friends sensed there would be trouble, so they left, and while
standing outside, one of the rival group pulled a gun on them.
Frederick’s friend told him earlier he had a gun. It turned out to be
braggadocio, and so when his friend took off running, so did
Frederick, a step behind. As he dashed through a narrow passageway
between buildings, he heard the shots.

“Can I ask why you’re in the wheelchair?” Frederick asked Stone. “I
got shot 15 years ago,” Stone told him. Stone didn’t say anything more
about it, and later when I asked for more detail, he was elusive. He
said simply that he had gotten shot at a barbecue when he tried to
intervene in a fistfight. “You doing good,” Stone assured him. “You
got shot. You’re here. And you’re alive. What you do when you get out
of here?”

“You got to stop hanging with the wrong person, thinking you’re a
Wyatt Earp,” Frederick said, speaking in the third person as if he
were reciting a lesson. At that point, Frederick’s sister arrived. She
explained that she was bringing up her brother. She was 18. “He just
wants to go to parties, parties, parties,” she complained. “But it’s
too dangerous.” She started to cry. “Don’t start that, please,”
Frederick pleaded. Mack left a CeaseFire brochure on Frederick’s chest
and promised to visit him again in the coming weeks.

LAST MAY, after a 16-year-old boy was killed trying to protect a girl
from a gunman on a city bus, Slutkin appeared on a local public-
television news program. He suggested CeaseFire was responsible for
sharp dips in homicide around the city. Slutkin, some say, gives
CeaseFire too much credit. Carl Bell, the psychiatrist, was on the
program with Slutkin that night. “I didn’t say anything,” he told me.
“I support Slutkin. I’m like, Slutkin, what are you doing? You can’t
do that. Maybe politically it’s a good thing, but scientifically it’s
so much more complex than that. Come on, Gary.”

Last year, CeaseFire lost its $6 million in annual state financing —
which meant a reduction from 45 interrupters to 17 — as part of
statewide budget cuts. One state senator, who had ordered an audit of
CeaseFire (released after the cuts, it found some administrative
inefficiencies), maintained there was no evidence that CeaseFire’s
work had made a difference. (The cuts caused considerable uproar: The
Chicago Tribune ran an editorial urging the restoration of financing,
and the State House overwhelmingly voted to double CeaseFire’s
financing; the State Senate, though, has yet to address it.)

It can be hard to measure the success — or the failure — of public-
health programs, especially violence-prevention efforts. And given
Slutkin’s propensity to cite scientific studies, it is surprising that
he hasn’t yet published anything about CeaseFire in a peer-reviewed
journal. Nonetheless, in a report due out later this month,
independent researchers hired by the Justice Department (from which
CeaseFire gets some money) conclude that CeaseFire has had an impact.
Shootings have declined around the city in recent years. But the study
found that in six of the seven neighborhoods examined, CeaseFire’s
efforts reduced the number of shootings or attempted shootings by 16
percent to 27 percent more than it had declined in comparable
neighborhoods. The report also noted — with approbation — that
CeaseFire, unlike most programs, manages by outcomes, which means that
it doesn’t measure its success by gauging the amount of activity (like
the number of interrupters on the street or the number of
interruptions — 1,200 over four years) but rather by whether shootings
are going up or down. One wall in Slutkin’s office is taken up by maps
and charts his staff has generated on the location and changes in the
frequency of shootings throughout the city; the data determine how
they assign the interrupters. Wes Skogan, a professor of political
science at Northwestern (disclosure: I teach there) and the author of
the report, said, “I found the statistical results to be as strong as
you could hope for.”

BALTIMORE, NEWARK and Kansas City, Mo., have each replicated
components of the CeaseFire model and have received training from the
Chicago staff. In Baltimore, the program, which is run by the city,
combines the work of interrupters and outreach workers and has been
concentrated in one East Baltimore neighborhood. (The program recently
expanded to a second community.) Early research out of the Johns
Hopkins Bloomberg School of Public Health shows that in the East
Baltimore neighborhood there were on average two shootings a month
just before the program started. During the first four months that
interrupters worked the streets, there had not been a single incident.

“My eyes rolled immediately when I heard what the model was,” says
Webster of Johns Hopkins, who is studying the Baltimore project.
Webster knew the forces the interrupters were up against and
considered it wishful thinking that they could effectively mediate
disputes. “But when I looked closer at the data,” Webster continues,
“and got to know more about who these people were and what they were
doing, I became far less skeptical and more hopeful. We’re going to
learn from it. And it will evolve.” George Kelling, a Rutgers
professor of criminal justice who is helping to establish an effort in
Newark to reduce homicide, helped develop the “broken window” theory
of fighting crime: addressing small issues quickly. He says a public-
health model will be fully effective only if coupled with other
efforts, including more creative policing and efforts to get gang
members back to school or to work. But he sees promise in the
CeaseFire model. “I had to overcome resistance,” Kelling told me,
referring to the introduction of a similar program in Newark. “But I
think Slutkin’s on to something.”

Most of the police officials I spoke with, in both Chicago and
Baltimore, were grateful for the interrupters. James B. Jackson, now
the first deputy superintendent in Chicago, was once the commander of
the 11th district, which has one of the highest rates of violent crime
in the city. Jackson told me that after his officers investigated an
incident, he would ask the police to pull back so the interrupters
could mediate. He understood that if the interrupters were associated
with the police, it would jeopardize their standing among gang
members. “If you look at how segments of the population view the
police department, it makes some of our efforts problematic,”
Baltimore’s police commissioner, Frederick H. Bealefeld III, told me.
“It takes someone who knows these guys to go in and say, ‘Hey, lay
off.’ We can’t do that.”

Like many new programs that taste some success, CeaseFire has
ambitions that threaten to outgrow its capacity. Slutkin has put much
of his effort on taking the project to other cities (there’s interest
from Los Angeles, Oakland and Wilmington, Del., among others), and he
has consulted with the State Department about assisting in Iraq and in
Kenya. (CeaseFire training material has been made available to the
provincial reconstruction teams in Iraq.) Meanwhile, their Chicago
project is underfinanced, and the interrupters seem stressed from the
amount of work they’ve taken on.

THE INTERRUPTERS have certain understandings. At the Wednesday
meetings, no one is ever to mention anyone involved in a dispute by
name or, for that matter, mention the name of the gang. Instead they
refer to “Group A” or “Group B.” They are not investigators for the
police. In fact, they go out of their way to avoid knowing too much
about a crime. When Highsmith and Prater left me the night of the
failed drug deal, they began working their contacts. Highsmith found
someone who knew one of the stickup men and who, at Highsmith’s
request, negotiated with them. Highsmith’s contact persuaded the
robbers to return enough of the money to appease the drug-buyer’s
anger. When I met with the intermediary a few weeks after things were
resolved, he was still stirred up about the robbery. “I was mad enough
to do anything,” he told me, making it clear that he and his friends
had been hunting for the stickup guys. “This could’ve been a hell of a
lot worse than it was.” To this day, neither Highsmith nor Prater know
the identities of anyone except the intermediary — and they want to
leave it that way.

The interrupters often operate by instinct. CeaseFire once received a
call from the mother of a 15-year-old boy who wanted out of a gang he
joined a few weeks earlier. The mother told Hoddenbach and another
interrupter, Max Cerda, that the gang members chased her son home
every day from school threatening to beat him. They had shot at him
twice. Hoddenbach found the clique leaders and tried to talk sense to
them. If the boy didn’t want to be in the gang, he told them, he’d be
the first one to snitch. The gang members saw the logic behind that
but insisted on giving him a beating before releasing him. Hoddenbach
then tried another tack: he negotiated to let him leave the gang for
$300 — and no thrashing. The family, though, was only able to come up
with $50, so Hoddenbach, Cerda and another interrupter came up with
the rest. At their next Wednesday meeting, some interrupters were
critical of Hoddenbach for paying what they considered extortion
money. “It was kind of a messed-up way, but it was a messed-up way
that works,” Hoddenbach said.

It was nearly three months before Charles Mack could find time to
visit Frederick, the young shooting victim. Frederick had since moved
in with his great-grandmother in a different part of town. In his old
neighborhood, he told Mack, “there always somebody who knows you. And
I had a reputation.” He complained to Mack that he had never been
interviewed by the police but then declared he would never identify
the person who shot him anyway. “I’m going to leave it alone,” he
said. As is so often the case, Frederick couldn’t remember the genesis
of the disagreement between his clique and the other. Mack promised to
stay in touch, and as we dropped him off, Mack turned to me and said,
“I think he’s going to be all right.” It sounded like both a
proclamation as well as hopeful aside.

Not long ago, I stopped by to visit with Hoddenbach at the Boys and
Girls Club, where he holds down a second job. It was a Friday evening,
and he was waiting for an old associate to come by to give him an
introduction to a group of Hispanic kids on the far North Side.
Apparently, earlier in the week, they bashed in the face of an African-
American teenager with a brick. From what Hoddenbach could make out,
it was the result of a long-simmering dispute — the equivalent of a
dormant virus — and the victim’s uncle was now worried that it would
set off more fighting. As we sat and talked, Hoddenbach seemed
unusually agitated. His left foot twitched as if it had an electric
current running through it. “If these idiots continue,” he told me,
“somebody’s going to step up and make a statement.”

Hoddenbach also worried about Torres, who had recently gone back to
Texas and found a job working construction. Hoddenbach says he
originally hoped Torres would stay in Chicago and establish some
roots, but then decided he’d be better off in another town. “I kept
him out of one situation, but I can’t keep him out of all of them,”
Hoddenbach said. This may well speak to CeaseFire’s limitations.
Leaving town is not an option for most. And for those who have walked
away from a shooting, like Torres, if there are no jobs, or lousy
schools, or decrepit housing, what’s to keep them from drifting back
into their former lives? It’s like cholera: you may cure everyone, you
may contain the epidemic, but if you don’t clean up the water supply,
people will soon get sick again.

Slutkin says that it makes sense to purify the water supply if — and
only if — you acknowledge and treat the epidemic at hand. In other
words, antipoverty measures will work only if you treat violence. It
would seem intuitive that violence is a result of economic
deprivation, but the relationship between the two is not static.
People who have little expectation for the future live recklessly. On
the other side of the coin, a community in which arguments are settled
by gunshots is unlikely to experience economic growth and opportunity.
In his book “The Bottom Billion,” Paul Collier argues that one of the
characteristics of many developing countries that suffer from
entrenched poverty is what he calls the conflict trap, the inability
to escape a cycle of violence, usually in the guise of civil wars.
Could the same be true in our inner cities, where the ubiquity of guns
and gunplay pushes businesses and residents out and leaves behind
those who can’t leave, the most impoverished?

In this, Slutkin sees a direct parallel to the early history of
seemingly incurable infectious diseases. “Chinatown, San Francisco in
the 1880s,” Slutkin says. “Three ghosts: malaria, smallpox and
leprosy. No one wanted to go there. Everybody blamed the people.
Dirty. Bad habits. Something about their race. Not only is everybody
afraid to go there, but the people there themselves are afraid at all
times because people are dying a lot and nobody really knows what to
do about it. And people come up with all kinds of other ideas that are
not scientifically grounded — like putting people away, closing the
place down, pushing the people out of town. Sound familiar?”