Nick Reding (9 page)

CHAPTER 4

FAMILY

I
n 2005, when I called Dr. Clay Hallberg, the Oelwein general practitioner, and asked him to characterize the meth epidemic
in his hometown, Clay had told me that meth was “a socio cultural cancer.” What he meant, he said, was that, as with the disease,
meth’s particular danger lay in its ability to metastasize throughout the body, in this case the body politic, and to weaken
the social fabric of a place, be it a region, a town, a neighborhood, or a home. Just as brain cancer often spreads to the
lungs, said Clay, meth often spreads between classes, families, and friends. Meth’s associated rigors affect the school, the
police, the mayor, the hospital, and the town businesses. As a result, said Clay, there is a kind of collective low self-esteem
that sets in once a town’s culture must react solely to a singular—and singularly negative—stimulus.

It was clear from the minute I got to Oelwein that Clay’s position as a small-town doctor put him in the best possible place
from which to observe the meth phenomenon. What would become clear to me over the next three years, though, is that the very
thing he hoped to treat in others, the “collective low self-esteem,” also took a brutal, withering toll on Clay himself. The
first time we talked, he’d likened each day at work to running into a burning motel and having fifteen minutes to get everyone
out. The motel was Oelwein, and Clay never had enough time before he had to retreat, fearful he too would burn alive. Indeed,
three years later, Clay would need saving. It’s partly in this way that his story parallels that of his hometown.

Clay and his twin brother, Charlie, were adopted when they were one year old from the orphanage in Waterloo, Iowa, by Doc
Hall-berg, Oelwein’s general practitioner since 1953. Clay and Charlie are identical twins. They have opposite dominant eyes
and hands, and part their hair on opposing sides—Clay on the right, Charlie on the left. Clay plays the bass and Charlie the
drums. Clay earned degrees in biology and chemistry; Charlie, meanwhile, majored in philosophy and theology, with a minor
in Egyptology.

From an early age, the boys had promiscuous interests, including chemistry; they used their chemical know-how to make pipe
bombs and once blew up a neighbor child’s sandbox. They had a shared active sense of humor as well, and delighted in giving
guests glasses of water, only to announce minutes later they’d gotten the water from the toilet. For the first few years of
their lives, their mother would turn their shared crib upside down and stack books on top of it to keep them from getting
loose in the house and wreaking havoc. As teenagers in the 1970s, neither twin was, to put it politely, unfamiliar with narcotics.
After graduating together from the University of Northern Iowa, in Cedar Rapids, Clay went to medical school at Southern Illinois
University at Carbondale, and Charlie to law school at Creighton University. In 1987, Clay, recently married and finished
with his residency, came back home to join his father’s practice. Shortly thereafter, Charlie moved into a house down the
street from Clay’s and began work as the Fayette County public defender.

Clay is five feet eight and weighs 160 pounds. He has a welder’s forearms and the hands not of a musician or a surgeon, but
of a farmer: thick in the meat, with large fingers and deep creases in the palms. Clay’s brown hair is going gray (“salt-and-turd,”
he calls it), and he wears it combed back. He has a short, manicured goatee and intense grayish-blue eyes behind fashionable
frameless glasses. In contrast to his wife’s deep northern Missouri drawl, Clay’s accent is more Minnesotan, extending each
opening syllable toward the innards of a word. His lexicon is unmistakable and specialized; he often says “how ’bout” and
“okay,” as when responding in the negative to a request: “How ’bout no way, okay?” Young men and women with multiple piercings
“have gone face-first into a tackle box.” Bars are “unsupervised outpatient stress-reduction clinics that serve cheap over-the-counter
medications with lots of side effects.”

Clay goes to work every day in a small brick building across the street from Mercy Hospital. Mercy, as it’s called, is an
imposing monolithic structure built sixty years ago by the Catholic church. Next door is the high school and a small residential
neighborhood. Beyond that, the prairie starts in earnest, lonely and flat and constant. From the window in the waiting room
of the Hallberg Family Practice, you can see a lot of sky, which makes the clutter of Clay’s tiny office at the back of the
building feel that much more profound. There’s a desk and two chairs, one of which is inaccessible given the boxes of patient
files that line the floor in stacks. On one wall are shelves covered with antique doctor’s implements; many of them once belonged
to Clay’s father, who finally retired when his wife was killed in a car accident in 2003. Next to these are a hundred or so
books attesting to the extent of Clay’s duties:
Clinical Neuroanatomy
,
Pathophysiology of Renal Disease
,
General Ophthalmology
,
Patten’s Foundations of Embryology
.

True to his roots, Clay not only sees patients in the exam room across the hall; he drives to their houses and farms, and
also works two nights a week in the emergency room. He has delivered babies in the backs of cars, and once, in a barn. A few
years ago, he served as assistant county coroner, which is to say, assistant to his father. He’s also chief of staff at Mercy.
In terms of what there is to see around Oelwein, Clay has seen it.

Contrary to what many people might think, the rural United States has for decades had higher rates of drug and alcohol abuse
than the nation’s urban areas. If addiction has a face, says Clay, it is the face of depression. Bad genes don’t help, either,
says Clay, but all genes, bad or good, are susceptible to a poor environment. He knows of what he speaks. Back in the mid-1970s,
after getting his B.S., Clay was back in Oelwein, casting about for something to do with his life. His father, Doc Hallberg,
was abusive—a disciplinarian who limped around the rural towns of Fayette County for forty years performing minor medical
miracles, all the while suffering from debilitating arthritis in his right leg, which, thanks to polio, is eighteen inches
shorter than his left and compensated by a substantial shoe lift. Clay was good at giving his father reasons to be stern.
He played in a band, had long hair, and did a lot of cocaine. His love of homemade explosives had not abated. One time, when
the high school was closed because of a snow day, Clay set off a pipe bomb on the campus lawn, just to see what would happen.
The next morning, the Oelwein newspaper called it a terrorist attack and demanded that the culprit be hunted down and prosecuted
federally. (Clay was never caught.) The more Clay bounced around intellectually beneath his father’s brutal, withering glare
without being able to land on something either of them found meaningful, the more Clay did drugs. Finally, he says, he realized
he was either going to medical school or going to jail.

Things in Oelwein at that point were just starting to deteriorate economically. It would be a few more years before the sky
fell, once the Chicago Great Western and Illinois Central closed operations in town and the farm crisis struck, but Clay attributes
much of his anger and malaise to a simple socioeconomic postulate: “If you got no money, you can’t go see the band. And if
you can’t see the band, you’re fucked.” What he means is that, without good jobs, little disposable income remains in the
community to be spent at all manner of locally owned businesses, including at the bars. And during the last good days of the
1970s, Oelwein bars were known from Waterloo to Wenatchie for having the best local bands in the Upper Mississippi River watershed.

Once known as Little Chicago, says Clay, Oelwein boasted the best Italian food in the Midwest, every bar fielded a pool league
in the winter and a softball team in the summer, and the Sportsmen’s Lounge served the best prime rib in Iowa, thanks to the
fact that Oelwein was the first overnight stop west from the Chicago stockyards. In the 1930s and 1940s, Count Basie and Glenn
Miller regularly played Tuesday nights at the Oelwein Coliseum on their way from Minneapolis to St. Louis. According to Clay,
the Coliseum’s owner stipulated in the bands’ contracts that they couldn’t play any other venue within five hundred miles
for at least one week following a show in Oelwein. Such was the clout of a town that employed two thousand people, or almost
60 percent of the working-age male population, in the lucrative rail business and could therefore be relied on for sold-out
shows. In the 1950s, Buddy Holly played the Oelwein Armory four times. Once it was all gone, says Clay, the deep sense of
disappointment that pervaded Oelwein only magnified the Hallberg twins’ sense of loss.

Ever since then, the twins have fought to maintain a sense of balance through music, and in doing so, to share that feeling
of wholeness with their community. Clay likes to say that he has been strumming and Charlie has been “banging on shit” since
birth. When the boys were five or six, Clay, the aspiring bassist, would string fishing lines in the doorway to the kitchen;
Charlie would hammer on pots and pans to bring the babysitter running, only to howl with delight when she tripped and fell
over the strings. Clay, who still relishes a good bar fight, once reputedly pushed another band member out of a moving VW
bus, then casually noted how the thud that resulted was in B minor. To this day, the brothers play venues all over northeastern
Iowa in a variety of ensembles and make their own recordings in a studio that Clay bought, two blocks away from the IGA grocery
store. For Clay, performing is an act of communal symbiosis; nowhere does he feel more at home and more complete than onstage
with his twin, trying hard to make people dance and sing along to an ageless repertoire of good old-fashioned rock and roll.

Music visibly calms Clay, who smoked a pack and a half a day and drank heavily when I met him in 2005. Conversations could
be measured not by minutes and hours, but in pots of coffee or cans of Bud Light. The breadth of his knowledge is staggering;
keeping pace with the abrupt, multidimensional movements of his thoughts is like trying to keep track of a hummingbird. He
is apt, say, while riffing on the history of Sioux medicine men, to be reminded of his favorite philosopher and to ask if
you would like him to “distill Kant into three sentences, so that you’re with me here”—all this as an addendum to a Chomskyan
critique of the critical-care program at Mercy Hospital. Clay’s is both an all-consuming and a consumptive energy; without
music, he would be consumed for sure.

Eighty-five percent of what Clay does as a doctor is to minister to one form or another of the mental illness that he says
ravages Oelwein. Mostly, he says, it’s depression or anxiety, though there are plenty of bipolar people walking around town.
In this way, says Clay, Oelwein is no exception; one in three Americans, by his estimate, suffer from some sort of psychological
malady. It’s just that, in places like this, where there is no money for proper help, the effects are magnified. Every year,
Oelwein’s population dwindles. The senior class at the high school shrinks, on average, by five students each fall. In 2004
alone, Oelwein lost $147,000 in tax revenues. It cannot absorb the social and financial cost of malady in the way that Waterloo
(which lost $2 million in revenues in 2004) can. Nor is the problem aided, Clay says unapologetically, by the inbreeding and
lack of education endemic to a place that is literally shriveling up: “How ’bout the first people to leave are of course the
smart ones, and the people with enough money to get out. What you’re left with—and I’m sorry, okay?—doesn’t qualify Oelwein
High as a feeder school for Harvard, okay?”

What Clay laments more than anything is that there is so little recognition of the complexities Oelwein faces. No one wants
to talk about what’s right in front of their eyes, a direct result, he says, of the tight-lipped, stolid stock that helped
settle this area. A hundred years ago, it was socially advantageous for people not to speak of hardship, to act instead of
to think. Now, says Clay, there’s too little money to act. Talking, at a minimum, he says, would help alleviate the sense
of helplessness. Looking for ways to cope, many people head to the church, where the best intentions of a wonderful man like
Darwin Moore, the minister at Grace Methodist, cannot be mistaken for real job training in social and psychological programs.
Or, unable to afford a visit to Clay, never mind the antidepressants he might prescribe, people self-medicate in one of Oelwein’s
eleven bars. That, he says, is where the meth dealers have easy pickings.

The methamphetamine problem, along with the sense of desperation that had developed in Oelwein, is what finally drove Clay’s
brother, Charlie, away. He got tired, he says, after seven years as public defender, of addicts showing up at his house at
two o’clock in the morning, wondering why Charlie hadn’t gotten their friends out of jail. He didn’t feel that Oelwein was
a safe place for his two middle-school-aged children to grow up. Charlie’s wife, says Clay, was ready to leave him. So Charlie
moved an hour and twenty minutes south, to the city of Cedar Rapids, where he went into private practice. As Clay tells the
story, his jaw muscles flex, as though he could chew his way through the details in order to come to an understanding of how
this had happened. They’d come home together, after all, to be part of a solution in Oelwein. Now Charlie was gone. The town’s
meth problem was the first thing that had separated the twins since medical and law school.

Charlie left in 2003, the same year that their mother was killed in a car accident. Clay was bereft. With his own children
now out of the house and Charlie and his mother gone, he felt totally alone. He poured himself into his work, redoubling his
efforts to help his increasingly beleaguered patients. But with his insurance rates rising each year, he hasn’t found it easy.
“Even if we get a hold of meth next month,” Clay told me in our initial phone conversation, “we’ve already got three human
stages of history to clean up. But seeing that we won’t have it under control next month, we’re going to have four, five,
maybe six generations to deal with: the medical problems, the psychological ramifications—we don’t even know what else. We’ve
only settled into a long-term siege.”