Childhood Hunger

Bill Shore’s Letters

Letter About a Transplant Surgeon

March 1999

Dear Friend,

It's 41 degrees and there are scratchy silver patches of ice on the ground, but the Colorado sky is blue and the sun is so bright that shirtsleeves suffice. Chuck and I are at a breakfast at Strings for 35-40 community leaders to discuss what The Cathedral Within and community wealth creation could mean for Denver. One of the guests who showed up early -- I noticed him standing alone by the exposed brick wall -- was a priest in black shirt and collar. With a full head of fine, sandy hair and a smooth complexion, Rev. Everett Spees looks like he could be Jon Voight's older, more settled, brother. We had not met before but he was the one who invited me to Colorado this time and he was the reason I came. He shook my hand warmly, but shyly, self-conscious about monopolizing my time with so many others around, and especially since Chuck and I planned to spend the rest of the morning and early afternoon with him.

Two months ago, Rev. Everett Spees sent me an e-mail saying he'd read The Cathedral Within and was struck by the parallels to his own experience working at the Cleo Wallace psychiatric clinic for children in Westminster, Colorado. He served as chaplain there, having been ordained as a priest just four years before. For almost half a century before that, he was a surgeon, rising to Chief of Organ Transplants at Walter Reed U.S. Army Medical Center, with a caseload that ranged from Eritrea to the Persian Gulf. He held professorships at Johns Hopkins and the University of Colorado where he was also head of transplantation. In describing his new work with the kids at the clinic, many of whom had been abused, neglected or so damaged they'd attempted suicide, he wrote: "This work has been transforming for me. I enjoy it as much as transplanting organs."

Dr. Spees has the steady, deliberate demeanor of the surgeon he was for 42 years. He planned our day like an operation, leaving little to chance, ensuring we'd see what we needed to see for an accurate diagnosis. We talked to the administrators, educators and toured the campus, classrooms, and residential units. Almost every wall is covered with handwritten reminders of rules, procedures, times to do things, and "self-control sequences." Structure is a valued commodity here, and the "quiet room" in each and every building, with door swung open to yield a barren view, provides a substitute for it when all else fails. The patients, in jeans and t-shirts look like kids anywhere, though most are on meds and there is little sign of the aggression, violence, or self-destructive tendencies that landed them here.

Fourteen states send their most troubled kids to the Cleo Wallace clinic. Most are between the ages of 7 and 14, and have been in "the system" their entire lives. It is this or jail. 15 years ago the average length of stay, which doctors complained was too short, was 76 days. Today it is about 15-20 days, and for many it is just five. The insurance constraints of managed care push many out the door before they're ready. The administrator, Mike Montgomery, told us of a girl they feared would commit suicide if released, and then did. Too often a discharge is predicated on essential outpatient services that in fact are nonexistent.

"These are the people that will be the homeless population 10 years from now," Montgomery says with certainty, as if the relationship were obvious. Many of the "kiddos", as the staff affectionately refers to them, will struggle with mental health issues their whole lives. The best Cleo Wallace can do is stabilize them. When Mike Montgomery goes into a drawn-out explanation of the continuum of care, budgets, changes in insurance, and the kinds of services they wish they could provide but don't, Spees interrupts for the first and only time of the day to punctuate the point. "This is about saving children's lives," he says quietly.

I asked Dr Spees if he missed surgery, and how he came to affiliate with the Cleo Wallace clinic. "No, 42 years was enough", he said without a moment's hesitation. "You never get to sleep because you're jumping on planes at all hours to harvest organs." Kidneys, pancreas and livers were his work. Then he explained his own connection to this psychiatric clinic. It was one I never would have guessed. In the course of harvesting organs for transplant, he came to realize that one of the largest categories of donors was adolescent suicides. It shocked and sickened him -- "all of us" -- to be taking these organs.

Colorado has the third highest adolescent suicide rate in the country. Nobody seems to have even a theory, let alone an adequate explanation, as to why. Spees tried to convey how little hope the kids have, and how far we are from even being able to understand or relate to such despair: "I do a values group, tell stories, and try to get the kids to talk about their lives. Afterwards I ask the kids to tell me what their happiest memories were, and what were their worst memories. One 12-year-old boy said: ‘My happiest memories are the ones I can't remember. My worst are all the rest."

Spees' exasperation hangs in the air like a punt at Mile High Stadium. Through his entire career his surgical skills have enabled him to fix things. A sick child could be made well by taking out a faulty organ and stitching in a good one. Not as simple as changing a car battery, but the impact was almost as immediate. Cause and effect were clearly understood. Long hours, dedicated staff, and well-rehearsed procedures predicted a certain result. But it doesn't work that way here. This takes longer. It's more expensive. Fewer people care. Some treatments are a guess. We can't yet do for the soul what we do for the liver.

If there were a way for this institution to create community wealth, Spees tells me, they might be able to develop the programs and keep the staff they need to succeed. "If this hospital closed, the repercussions in the community would be devastating. More and more children would be shut up in jails, and many children would be dead of suicide, homicide, gangs and drug deals, and many of the girls would go the next small step to prostitution and life in crack houses."

Everett Spees has devoted more than four decades to salvaging life where others saw only carnage. His hands have literally reached deep into other human beings to search for hope and strength that can be shared. Now he has reached out to us from the foothills of the Rocky Mountains. He hopes that we at Share Our Strength and Community Wealth Ventures have answers for a clinic that saves children's lives. And if we don't, he hopes he's shown us what's at stake in pursuing them. A priest as well as a surgeon, he seems to have the faith that if he has at least succeeded at that, we'll figure out the rest. And so we must.

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