Casa Central

Mayor Rahm Emanuel is doing a big favor for the University of Chicago, commandeering parkland to bolster its bid for the Barack Obama Presidential Library.

His magnanimous gesture boosts U of C's chances of beating out Columbia Universityin New York to become the library's home. A win would add new luster to the university's already considerable prestige.

Emanuel shouldn't let his generosity go unappreciated. Favors like that deserve something in return—something significant. But what's an appropriate thank-you gesture for 20 acres of supposedly sacrosanct land in Washington Park or Jackson Park? Though the university wouldn't get this land—it would belong to the library—the parks are two crown jewels of the city's world-renowned park system.

As it happens, there is something U of C can do in return, something the South Side of Chicago needs more than a presidential library. The university's hospital could upgrade its emergency room to a Level 1 adult trauma center. Level 1 trauma centers are capable of handling the most serious injuries, such as gunshot wounds.

It's no secret that a disproportionate number of gunshot wounds in Chicago happen on the South Side, often in neighborhoods bordering U of C. But there's no Level 1 trauma center on the South Side.

LIFE-AND-DEATH MATTER

Ambulances carrying shooting victims from Woodlawn, Englewood or Grand Crossing speed past the University of Chicago Medical Center on the way to Northwestern Memorial Hospital or Stroger Hospital. Or they drive out to Christ Medical Center in Oak Lawn.

Minutes count in situations requiring Level 1 trauma care. The sooner you get proper treatment, the better your chances of survival. According to the Illinois Department of Public Health, people shot more than 5 miles from a trauma center have a 23 percent higher chance of dying than those who are injured closer to an ER.

That's why community activists, and even some U of C doctors, have been pushing the hospital to open an adult Level 1 trauma center. A report earlier this month by the public health department supports their argument, ranking U of C as the South Side hospital best positioned to operate one, based on its resources and capabilities. The report also noted, however, that U of C “indicated no interest” in becoming such a trauma center.

That has been U of C's position for years. It briefly offered Level 1 adult trauma care in the 1980s, but stopped. More recently, it agreed to raise the age limit for the Level 1 pediatric trauma center at its Comer Children's Hospital to 17 from 15. Late last year, U of C submitted to state hospital regulators a proposal to enhance adult emergency services, but not to Level 1. That application was withdrawn with little explanation a month later.

U OF C IS EXCEPTIONAL

Hospital spokeswoman Lorna Wong said the withdrawal “will allow us to complete a thorough study of the needs of our patients and the community. She went on to explain “the decision to close our adult trauma center more than 25 years ago was not made lightly. Trauma services overwhelmed the hospital's other surgical facilities and delayed lifesaving procedures for other patients. Even today, our operating rooms are often fully booked for lifesaving and advanced surgeries, many of which are not available at other hospitals in the region.”

There's no question Level 1 care is expensive—about $20 million a year, according to estimates, not all of which can be recouped from private insurers or medicare and Medicaid—and takes a lot of time, effort and equipment. Yet somehow, U of C's North Side rival, Northwestern Memorial, manages to provide Level 1 care to adults without going broke or forgoing cutting-edge procedures.

In fact, most other leading medical centers atop U.S. News & World Report's “best hospitals” list have Level 1 adult trauma centers, including Johns Hopkins in Baltimore, UCLA Medical Center in Los Angeles, New York-Presbyterian in New York and Massachusetts General in Boston. This is one area where U of C appears to have slipped back from “the forefront of medicine.”

With an endowment of about $7 billion, U of C could afford to subsidize a Level 1 adult trauma center. The same can't be said of other South Side hospitals.

COST-BENEFIT ANALYSIS

“There were no hospitals among those surveyed in Chicago that have sufficient resources to meet the Level 1 designation with the exception of University of Chicago, which expressed no interest in an adult Level 1 or Level 2 trauma center,” the public health department noted in its report.

Notwithstanding the department's finding, Wong said, “Building an adult Level 1 trauma center on the South Side is not something the University of Chicago Medical Center can undertake alone or in a vacuum.”

OK, don't do it alone or in a vacuum. Even if U of C hospital itself doesn't establish a Level 1 trauma center, it could help finance and staff one at another South Side hospital. According to the public health department, Advocate Trinity, Roseland and Jackson Park hospitals indicated “moderate to high interest in becoming a trauma center” but lack necessary resources. U of C could help fill that gap.

Veronica Morris-Moore, of the Trauma Center Coalition, a group pressing U of C to provide Level 1 adult care, told me the group "would be open to” such a cooperative venture.

And it's in U of C's interest to do so. Filling the void in high-level emergency care on the South Side would show serious commitment to the well-being of surrounding neighborhoods that have come to view U of C with suspicion despite its many good works in the area. It could also repair damage done to university-community relations a few years back, when the hospital instituted a program perceived by many as diverting local patients from its emergency room.

CITY HALL'S POSITION

“We've discussed the topic with South Side health care providers as well as medical directors of trauma centers in the Chicago area,” the hospital's Wong said, adding, “The University of Chicago Medical Center remains open to working with the state, city, county and other health care providers to evaluate the needs of the South Side and the long-term financial and operational realities of running an adult Level 1 trauma center.”

I see upside for South Side residents, the U of C and even for a mayor facing re-election who's anxious to shore up support among African-American voters. A Level 1 trauma center on the South Side would be meaningful, tangible evidence the mayor cares about more than just the Loop and North Side.

Neither the mayor nor the U of C warmed to my proposal to tie parkland for the library to a Level 1 trauma center for the South Side.

A City Hall spokesman wouldn't directly address the idea but said, “We are working with the University of Chicago to expand their trauma center, and we know they've heard from the community and are thinking more generally about how to add clinical services.”

'SEPARATE ISSUES'

At the university, spokesman Jeremy Manier said, “The collaborative proposal for the Obama Presidential Library has overwhelming support across the South Side because it is designed to inspire and bring transformative benefits to South Side communities. We have held hundreds of meetings with community members on a wide range of issues related to the presidential library, and we were impressed by the range of voices at the Chicago Park District's public hearings on sites for the library.

"We will continue to have a community dialogue on these issues," he continued. "One message that emerged clearly is that as we work together on other issues, it is vitally important to stay focused on bringing the presidential library to the South Side. These separate issues should not jeopardize the benefits a presidential library would bring to our communities.”

He also hastened to point out that the Obama library, not the U of C, would get the parkland. Fair enough, but that's not the real point. What matters is that parkland would be taken to help U of C get something it wants.

That's a big favor.The university should reciprocate.