In Illinois: Victims of Grand Boulevard

By RICHARD CONNIFF

In the snapshot, the woman presents herself to the world as a picture of flash and gaiety: thin, arched eyebrows penciled in high above blue-shadowed eye lids, metallic blue fingernails, hair swept up in waves and clasped on one side by a polka-dot barrette. She is 23 years old. On her lap she holds her first child. He is two months old and wears an infant baseball uniform that says "All Pro." The mother's expression is both proud and sad, full of tenderness for this child and yet uncertain of him, or of herself; she has not played this part before. The dimples above the corners of her mouth look like quotation marks around her smile.

It is a poignant picture, not least of all because the child, plump, sleeping with his mouth open, would be dead soon afterward. He died at 4 o'clock one morning in the motel room occupied by his mother, of malnutrition, or dehydration, or congenital defects--the precise cause is no doubt listed somewhere in the medical records.

Like a lot of children in the area, he had been born too early in his mother's pregnancy, short of weight and development time, a "viable" baby in a hospital Isolette, less so on being discharged into a neighborhood where most babies do not have cribs.

In the bleak Chicago community called Grand Boulevard, this sort of thing happens all the time. "For children to die is part of the life-style," says Linda Edwards, a social worker who counsels high-risk mothers in the area. In the U.S. as a whole, roughly one baby in 100 will die before its first birthday. In Grand Boulevard, one in every 38 dies, and there are streets where the rate is closer to one in 27.

Grand Boulevard is a slum, and maybe a worse slum for having had a splendid past. In little more than a century, it has known both wealth and glory, as home to the gentry of two distinctly separate societies.

White urbanites began moving there at about the time of the Great Fire of 1871, when the area, four miles south of the Loop, was still a prairie. The main street, then called Grand Boulevard, became a popular carriage route. It is still lined with great stone houses--most now disused or broken up into grimy cubicles--characterized by bow fronts, Greek columns, turreted towers, bay windows with pilasters, and beveled-glass fanlights. "The potential is so wonderful," a social worker remarks, driving down the boulevard, now called Martin Luther King Jr. Drive. She is talking about the architecture. The splendid ostentation of these buildings makes their present inhabitants look somehow unfeathered.

Grand Boulevard now houses 54,000 people, almost all of them black and poor. Most are in high-rise projects on the western edge of the neighborhood. A four-year-old living on the dismal eleventh floor of one such building recently set fire to his brother's bed. "He wanted to move," his mother explains, "and he thought that if he burned the place down, we'd move." The fire was put out quickly; there is no money to move.

For a time, between World War I and World War II, segregation concentrated all levels of black society in Grand Boulevard, and a thriving nightclub scene attracted both blacks and whites to hear Duke Ellington, the Mills Brothers and Cab Galloway. Growing up in Pennsylvania, Alfred L. Bishop, now a funeral director on 47th Street, used to listen on his radio to Earl ("Fatha") Hines broadcasting "from the beautiful Grand Terrace theater in Chicago, Illinois." A dreamy, romantic-sounding place.

"All gone," Bishop says, his hands exploding down and out, dismissively. The blacks who could afford it got out, like the whites before them. On 47th Street, once the heart of the community, no one objects now when a loudspeaker on a police wagon addresses those who have stayed behind as if they were refuse: "All right, clean off that corner. Now." On the streets of the neighborhood, one sees only an occasional sign of social or spiritual uplift. One, outside a church, inquires, HAVE YOU RECEIVED THE HOLY GHOST? The other, a billboard, says, DARE TO BE MORE. It is an ad for cigarettes.

Babies born into this world do not necessarily die for lack of skilled medical care. The technology employed to keep newborns alive is formidable, even frightening. In the intensive-care nursery at nearby Wyler Children's Hospital, a part of the University of Chicago, an unnamed 2-1b. boy, born in the sixth month of pregnancy, is sustained with the help of something called a radiant warmer bed, plus a phototherapy unit, an infant ventilator, three volumetric infusion pumps, a transcutaneous oxygen monitor and a cardiac-respiratory monitor.

He lies naked on an open diaper, his toy legs sometimes kicking and his left hand resting on an ECG sensor just above his hiccuping diaphragm. A cloth shield protects his eyes. His diet, called "hyperalimentation," runs through an intravenous catheter to his umbilical artery. A nurse, who cares for two such children, checks his vital signs every two hours. On a piece of tape holding an endotracheal tube to his cheek, one of the nurses has written, "Hug me."

The urge to cuddle does not arise naturally here. "When I first saw these babies," says Virginia Spear, a social worker in the intensive-care nursery, "all I could think of is that they looked like an exhibit at the Museum of Science and Industry--all the fetuses in the jars. Some of them aren't much more than fetuses. But then I saw a mother whose baby weighed 1 1b. 5 oz. She was a typical teenager, liked to have a good time, dance, listen to rock music. What she did with that baby was a revelation. I like it when they put their hand under the baby's head. There's something tender about it. Mainly, she talked to him, and she made that child human for me. Because of her tremendous desire for that child to make it, I realized that she loved that baby more than anything that ever happened to her. And it was heartbreaking, because the baby died."

What kills the babies, most people agree, is Grand Boulevard itself, a problem that is not likely to be solved by technological heroism in the intensive-care nursery. It is easiest to blame the mothers. They are often teenagers who have got pregnant through carelessness and gone through the pregnancy in secret, with no prenatal care and little social pressure to eat right, say, or give up smoking. Some of the mothers are alcoholics, drug addicts, prostitutes.

"Some of them forget that they've had a baby," a social worker says. "They pick up their life at home," leaving a marginal baby in the hospital's care. Some literally do not have bus fare to visit. Nurses tend to get frustrated and move on quickly. "Why don't these parents love their babies?" one asked when she quit recently.

Others see Grand Boulevard as en forcing a destructive life-style on its residents, if the word life-style can be applied to living with few jobs, a poor education, little money or food, no network of family or social support, no cultural emphasis on child rearing, and a resulting world view that is abjectly fatalistic.

Hannah Meara, who works on such problems in Grand Boulevard with a group called Centers for New Horizons, describes a typical case. Having been saved by the hospital's routine miracles, the baby goes home to a mother whose welfare check runs out three weeks into the month. When the food also runs low, she is reduced to stretching the formula by adding too much water. The child may look healthy, but the dietary imbalance can cause severe growth retardation and infections that could ultimately lead to death. Meara tends to be quietly angry with the shortsightedness of a society that will readily spend $50,000 to save a premature infant's life while cutting back programs that might keep mother and child healthy in the first place.

And so the babies die. A funeral for a child under three months of age costs $300 in Grand Boulevard, not including the grave. The coffin is pine, covered with white doeskin on the outside and crepe within. It measures between 24 in. and 30 in. in length by 12 in. in width. Sometimes, as a courtesy, the funeral director will include a pink or blue ribbon across the inside of the coffin lid.

The funeral reading is generally the Twenty-Third Psalm: "The Lord is my shepherd; I shall not want." It is hi all regards routine ceremony. --By Richard Conniff