In 1887 the reporter Nellie Bly of Joseph Pulitzer’s New York World posed as a lunatic to get into the women’s insane ward at Blackwell’s Island. Her goal was to report and write “a plain and unvarnished narrative of the treatment of the patients therein.”
Bly’s exposé got results. Public officials investigated. Politicians passed reforms and appropriated money for mental health treatment. Undercover work, for all its dangers and deception, became a staple of journalism.
In 1970, the Chicago Tribune teamed with the Better Government Association to investigate claims that some of Chicago’s private ambulance companies were padding their pocketbooks by mistreating patients, especially poor ones.
William Jones, a Tribune reporter, and William Rektenwald, an investigator employed by the association, took jobs with ambulance crews. Recktenwald described what they observed as “the most sickening display of mistreatment of human beings I ever witnessed.”
A company owner suspected Jones was a ringer and threatened to beat him. Somehow he kept up the ruse until his series ran in the Tribune. A paragraph in the first story summed up what the job was like:
“The world of the misery merchant is a life filled with 24-hour shifts stacked on top of 24-hour shifts at pay rates as low as $7 an hour. Much of the time is spent in filthy, rat-infested store fronts, waiting for calls from the company dispatcher.”
It was worse for the patients, as Jones’s second story showed. It is reprinted below.
Nowadays most news organizations forbid reporters to misrepresent themselves in pursuit of a story.
By coincidence, Recktenwald, the Better Government Association investigator, took part in a story that accelerated this shift in journalism standards. In 1978, he and a Chicago Sun-Times reporter posed as a married couple, bought a Chicago bar and called it the Mirage Tavern. Public employees who came to inspect the bar took bribes. Accountants offered to cook the books for tax purposes. Hidden cameras captured the corruption.
The paper’s 25-part series led to indictments and became a finalist for a Pulitzer Prize in Local Special Reporting. A Pulitzer jury lauded the Sun-Times for “resourcefulness, initiative and imaginative approach” and said: “The series exposes corruption in a powerful and effective way.” They noted the paper’s “extraordinary commitment in terms of cost and legal risk to reveal widespread abuses by public officials.”
In his book "News Values: Ideas for an Information Age," Jack Fuller, president of the Tribune Co., reported what happened next: “After objections from the Washington Post’s former executive editor, Ben Bradlee, the Pulitzer Prize Board decided not to award the Sun-Times the prize because the series was based on deception. The board concluded that truth-telling enterprises should not engage in such tactics.”
This put a damper on undercover investigation by news organizations. By the time Fuller wrote his book in 1996, it had “gone out of fashion altogether.”
William Jones’s “Sadism Rides an Ambulance” ran in the Chicago Tribune on June 8, 1970, and helped the paper win a Pulitzer Prize.
No training, an emergency, the first of many horror stories
The ambulance siren gave a final growl as we arrived in front of the blighted South Side building.
I leaped from the vehicle, my heart pounding. It was my first day on the job as an ambulance attendant and my first emergency call.
I had good reason to be nervous. Reporting for work less than an hour before, I was immediately assigned to an ambulance. Now, with no training in the handling of a stretcher or the use of oxygen, I was to be confronted with a reported heart attack victim who could be fighting for her life. The city code requires only first aid training to be licensed as an attendant.
With no training in the handling of a stretcher or the use of oxygen, I was to be confronted with a reported heart attack victim who could be fighting for her life.
It was the first in what would quickly become a long list of horror stories involving the misery merchants who operate some of Chicago’s private ambulance companies. The two-month investigation, conducted in cooperation with the Better Government Association, revealed widespread mismanagement, welfare fraud, sadism and payoffs to police in the multimillion-dollar-a-year private ambulance business.
Before this 24-hour shift was over, I would witness some of this mistreatment of the ill and injured. I would also be threatened with a beating when one of my employers suspected I was a private investigator.
On this day, I was working for Mid-Atlantic Ambulance Company, 5651 W. Madison St., a company that billed the state for more than $130,000 in welfare ambulance fees during the first four months of 1970. The company also operates a subsidiary, A-Alamo Ambulance Company, from the same address.
My partner was David Kuhn, a former cab driver. Earlier after, Kuhn learned it was my first ambulance job, he had warned me I would learn things “you never dreamed happened in the ambulance business.”
Now, as we prepared to enter the apartment to answer the heart attack call, I learned what he meant.
“We won’t need the stretcher,” Kuhn said, “I always try to walk these welfare cases out to the ambulance. Some of them are so heavy and you have to watch your back on this job.”
The middle-aged black woman was in a rear bedroom of the second floor apartment, moaning and complaining of severe chest pains. Two Chicago firemen were already on the scene. Kuhn immediately took charge.
“Do you think you can walk down to the ambulance?” Kuhn inquired. “We’ll get you to the hospital a lot quicker that way.”
The woman responded with a moan.
“She’s faking. I know she’s faking,” said Kuhn, whose credentials consist of seven months as an ambulance driver and attendant. “But it doesn’t look like we can talk her into walking. Go down and get the stretcher out of the ambulance.”
I told him I didn’t know how to remove the stretcher. “Then go down and open the door and wait for me,” Kuhn said. He returned to the bedroom to speak to the firemen. A short time later, with the assistance of the firemen, we carried the victim to the vehicle. Kuhn had won a bizarre victory of sorts, however. He persuaded the woman to crawl from her bed to the stretcher in the hallway.
Before we departed for the hospital, Kuhn inquired if I knew how to operate the oxygen tanks. I told him I had received no training in the operation of anything in the ambulance. He opened the oxygen valve briefly and told me to hold the mask over the woman’s face.
Kuhn later explained that he had turned the oxygen on for a few seconds and then closed the valve in order to make the woman think she was getting oxygen. This practice permits the company to charge an additional fee of $10. As he filled out the admitting form at County Hospital, Kuhn joked about the oxygen and asked if the patient had indicated it helped her breathing.
Several days later, after I had quit Mid-America and sought employment with another ambulance company, William Recktenwald, an undercover Better Government Association investigator, rode in the same seat and observed the same horrifying treatment of the ill and injured.
Recktenwald became so sickened by what he saw during a 31-hour shift with the firm that he walked off the job. Some of the faces of the victims are still vivid in his memory.
“I remember one call where a very old woman was bedridden with blood clots on her legs,” Recktenwald said. “The driver made sure we collected the $44 for the trip; then he said, ‘She can walk to the ambulance.’ I knew she couldn’t make it; so I carried her out to the vehicle in my arms. We never took the stretcher out of the ambulance.”
A short time later, Recktenwald recalled, they answered a call regarding a victim with a possible fractured foot in a third floor apartment on Indiana Avenue.
“The driver told me to wait in the ambulance while he went upstairs,” Recktenwald reported. “He came down about 15 minutes later and told me, ‘I got the s.o.b. ... to walk down the three flights of stairs; so we just have to take him from here.’” The victim, a man in his forties, was being helped by a sister and a neighbor.
“Next we transported a blind woman in her seventies, who was having a problem with her left foot, from County Hospital to her South Side home. While tucking in the blanket around her feet, it became evident that [the ambulance driver] was causing some pain to the patient.
“I told him to be careful, that was her bad foot. He replied: ‘These damn welfare cases are lying most of the time anyway.’ Then he gave the foot another twist.”
Responding to another call, for a young woman who needed emergency transportation after an apparent miscarriage, Recktenwald watched the driver hurl insults at the patient’s mother for “not having the patient ready.”
“The daughter was screaming in the bedroom,” Recktenwald recalled. “After insulting the mother, the driver walked into the bedroom and announced: ‘She looks alright. She can walk down the stairs.’”
“The apartment was on the third floor and I helped her walk down. It was raining outside and the driver ordered her to crawl in a side door of the ambulance. After this call, I didn’t know how much more I could take.”
As I left County Hospital with Kuhn that first day on the job, I also wondered how long my nerves would last. Before the day was over, I watched a cancer victim, so weak he couldn’t move from his bed, crawl around the bedroom floor on his hands and knees searching for his welfare card while Kuhn ogled a photo of a female relative of the patient.
I also incurred Kuhn’s wrath after we arrived in front of a South Side tenement in response to an apparent heart attack call. Kuhn sent me inside the building to “take a look” at the victim. The middle-aged woman was stumped across a bed and was having obvious difficulty breathing.
I dashed outside and told Kuhn she appeared to be in bad shape.
“I know all that,” he barked. “But I sent you in there to see if she would walk out here.” He reluctantly removed the stretcher from the ambulance. Once inside the building, Kuhn convinced the woman we would save time if she walked from her apartment to the stretcher in the hallway.
During the day we also were assigned to stand-by for calls at a North Side substation of Mid-America. The location, only slightly filthier than the firm’s main office, is in a small garage once used as an auto transmission repair shop. I dozed on a discarded auto seat while Kuhn read comic books.
During such breaks, Kuhn also decided I needed about 5 minutes’ training in the use of the stretcher and oxygen equipment. While showing me how to operate the oxygen, he exploded a regulator bag.
I was also shown an inflatable splint, but Kuhn noted he could tell me nothing about it “because I don’t know what it is myself.”
Late that night, as I waited in the Madison office of the company to begin working the overnight shift with another driver, I was confronted by an owner and the general manager in a small rear office of the building.
The owner demanded to see my “hard card,” the laminated ambulance attendant’s license issued by the city’s Public Vehicle Commission.
Moments before he asked me for my license, he had been discussing the “crackdown” by the commission following a $1 million damage suit filed against Mid-America. The suit charges that while en route to a hospital with a heart attack victim, the ambulance crew was ordered by the dispatcher to make another stop to pick up a pregnant woman.
The suit was filed by the widow of the heart attack victim, who was dead on arrival at the hospital.
“Well, well,” said the owner as he looked at my license. “Mr. William Jones — private investigator.” The private investigator statement was an apparent attempt to catch me off guard.
I laughed off the statement and said I was really James Bond.
“I had you pegged for a reliable, long-term man when I hired you,” the owner said. “But if you’re a private investigator you’re going to wind up with a rap in the head. You understand what I’m saying?”
I laughed off the threat and then was ordered to produce my driver’s license. They compared it with the ambulance permit and seemed satisfied.
Recktenwald and I also received instructions on ambulance fees while we worked for the firm. If the patient is a welfare recipient, we were told, the company was assured of payment from the state. On a cash call, however, the policy was “no bread, no bed.”
When I asked what we were to do if a family had no cash, I was told: “Turn around and leave.”
Another driver put it this way:
“They [the victim] can go in a blue star ambulance. That’s the police. If they’re bad enough the police will take them. And if they don’t move them while they are sick, they do remove stiffs.”