Healing Americafor

Catholics & Politics Barometers to Your Health Whatever Happened to Managed Care? Winter 2001 WINTER 2001

University Magazine Entering Class of 2002 and You Prospective students can “pursue the possibilities” of a high-quality Creighton University education through the University’s newly redesigned Undergraduate Admissions website at http://admissions.creighton.edu. The site includes a free online application form.

Or call the Undergraduate Admissions Office at 1-800-282-5835.

For admissions information on Photo by Don Doll, S.J. Creighton’s other schools and colleges, call or visit online... Healing for America

School of Law The Sept. 11 terrorist attacks on the United States have (402) 280-2872 affected us all. In this issue: We share the chilling http://culaw.creighton.edu/ (Fee-waived applications offered to family and friends of Creighton accounts of Creighton alumni who experienced the University alumni. Call the number above or e-mail your name and attacks firsthand. Show a Creighton campus coming address to [email protected].) together in prayer and hope. Remember the lives of 18two Creighton alumni who died in the attacks. Reflect on the American School of Dentistry (402) 280-2695 spirit with an essay by Creighton professor and noted author Brent Spencer, http://cudental.creighton.edu/ Ph.D. And, through the insights of two Creighton Jesuits, probe the School of Pharmacy and Allied Health Professions question, Where is God in these troubled times? (402) 280-2662 http://spahp.creighton.edu/

School of Medicine (402) 280-2799 http://medicine.creighton.edu/

Graduate School (402) 280-2870 http://www.creighton.edu/GradSchool/Webs/index.htm (For information on graduate programs in the College of Business Administration, call 402-280-2829.) About the Cover University College The Creighton community participated in one of many (402) 280-2424 religious services held across the country as part of the http://www.creighton.edu/UnivCol/ (While application for admission is not required, those admitted as either National Day of Prayer and Remembrance on Sept. 14. degree- or certificate-seeking students may apply for financial aid.) The large gathering outside St. John’s Church prayed for the victims of the attacks and for world peace.

Thank you for your support of Creighton University. Photo by Don Doll, S.J. Visit the magazine online at: www.creightonmagazine.org

Features Departments

4 Letters to the Editor

7 University News Pharmacy Reaches Out Creighton University is reaching out to Omaha’s growing Hispanic community through its recently purchased pharmacy in South Omaha. Photo by Michael Kleveter Photo by Jay Langhurst, BSBA‘01 Catholics & Politics California New Degree Program In seven of the last eight Street Sketches Creighton is the first Jesuit university and the first university in Nebraska to offer a 26 presidential elections, a 30 Around a vibrant street majority of Catholic voters have voted with filled with sounds of rattling street cars and major in Native American Studies. the winner. But defining the Catholic vote can shrieking school children, a beautiful campus be very difficult. Eileen Wirth, Ph.D., chair of blossomed and great memories were formed. Creighton’s Department of Journalism and Join Creighton professor Al Schlesinger for a 42 Development News Mass Communication, examines the issue. trip down memory lane. Dedicated to Catholic Education Roland Zarlengo, MD’44, celebrates his family’s lifelong commitment to Catholic education with a gift annuity to Creighton in memory of his late wife.

44 Alumni News A Survivor’s Story Among the personal effects of his late grandfather, Creighton alumnus Oliver Pollak, JD’82, found four haunting letters detailing life in a Nazi concentration camp. Photo by Bob Ervin Photo by Bob Ervin Barometers to Whatever Happened Your Health to Managed Care? 55 The Last Word 32 What can your teeth, eyes and 36 It was billed as the answer to The tree, silent and majestic, limbs skin tell you about your overall health? Plenty, controlling our nation’s rising health care costs, stretching toward the heavens, leaves according to Creighton University health while providing consumers more choice and dancing in the wind, reveals the power professionals. Find out more in this fascinating more efficient care. But managed care never and wonder of God, writes Creighton’s article by Mary Kay Shanley, BA’65. fulfilled all of its promises. What happened John Scott, S.J. to managed care? And where are we headed now? Creighton’s Eugene Rich, M.D., investigates.

Contact Us Creighton University Magazine’s Purpose Executive Editor: Stephen T. Kline Creighton University Magazine, like the University itself, is committed to excellence and dedicated to the pursuit of truth in all its forms. (402) 280-1784 [email protected] The magazine will be comprehensive in nature. It will support the University’s mission of education through thoughtful and Editor: Rick Davis compelling feature articles on a variety of topics. It will feature the brightest, the most stimulating, the most inspirational thinking that Creighton offers. The magazine also will promote Creighton, and its Jesuit Catholic identity, to a broad public and serve as a vital link (402) 280-1785 [email protected] between the University and its constituents. The magazine will be guided by the core values of Creighton: the inalienable worth of each Associate Editor: Sheila Swanson individual, respect for all of God’s creation, a special concern for the poor, and the promotion of justice. (402) 280-2069 [email protected] Visit the magazine online at: www.creightonmagazine.org and the universe is changed forever, for something that did not exist before is created, something new. This new life is then capable

University Magazine of living on its own and capable of reproducing itself, with God’s help, to create new life, and new souls with God’s ever- present role in the miracle of creation. Publisher: Creighton University; Rev. John P. Schlegel, S.J., President; Michael E. Leighton, Summarizing, Nancy rhetorically asks, Vice President for University Relations. Creighton “When did my life begin?” and then answers: University Magazine staff: Stephen T. Kline, “From my point of view I have been a Executive Editor; Rick Davis, Editor; Sheila continuum. I’ve never been dead. I Swanson, Associate Editor; Pamela A. Vaughn, am a continuation of the living state.” Features Editor. Editorial Advisers: Kathryn Kersenbrock Bertolini; M. Roy Wilson, M.D.; This ideology is contrary to Catholic Craig McGarry; Diane Dougherty; Rev. Donald teaching regarding God’s act of A. Doll, S.J.; Ruth Purtilo, Ph.D.; Tamara creation and the human soul. I Buffalohead-McGill; and Therese Vaughn. believe Dr. Schlesinger’s argument Letters that life is present at conception is Creighton University Magazine (USPS728-070) is to right on. However, personalizing published quarterly in February, May, August and November by Creighton University, 2500 the Nancy as a soul in existence as a California Plaza, Omaha, NE 68178-0001. Editor separate egg and sperm prior to Periodicals postage paid at Omaha, Nebraska, conception ignores God’s role in the and additional entry points. Address all mail to Conception is the miracle act of creation, the creation of a new immortal Public Relations and Information, Omaha, NE soul that changes the universe forever. 68178. Postmaster: Send change of address to As a former student of Dr. Allen Peter W. Zimmer, M.D., BS’89 Creighton University Magazine, P.O. Box 3266, Schlesinger’s, I really enjoyed his article Montgomery, Ala. Omaha, NE 68103-0078. “Nancy” in the Fall 2001 magazine. However, I take issue with the notion that the fictional For more enrollment information, contact the Thanks to Dr. Schlesinger Undergraduate Admissions Office at embryo “Nancy” existed prior to her 1-800-282-5835, [email protected]. conception. To quote Dr. Schlesinger, Dr. Schlesinger’s article in the fall issue of speaking as Nancy, “The fact that before I Creighton University Magazine was great. To make a gift to the University, contact the was an embryo I was very small and was in Having delivered some 2,000 “Nancys,” the Development Office at 1-800-334-8794. two parts doesn’t mean that I didn’t exist. ... article reminds one of the awesome miracle of it all. Dr. Schlesinger was the chairman of the For the latest on alumni gatherings, contact the Alumni Relations Office at 1-800-CU-ALUMS Biology Department when I was at Creighton (800-282-5867) or check online at (1968-71) and invigorated my interest in www.creighton.edu/alumni. biology and ultimately medicine at the University of Missouri, residency at Send letters to the editor to Rick Davis at Creighton and practice in Madison, Wis. [email protected]; fax, (402) 280-2549; Thank you, Dr. Schlesinger, for your Creighton University, Office of Public Relations, 2500 California Plaza, Omaha, NE 68178. influence on my choice of profession. Ed Kramper, M.D., BS’71 Update your mailing address or send alumni news McFarland, Wis. (births, weddings, promotions, etc.) electronically through www.creighton.edu/alumni, call 1-800-334-8794 or mail to Development Office, Report offers answers Creighton University, 2500 California Plaza, My DNA, I repeat, my DNA, has been in It was with great interest that I read the Omaha, NE 68178. existence before I was ‘discovered.’” cover stories in the Summer 2001 Creighton To simply state that Nancy, or any embryo, University Magazine about the state of health Visit the magazine website at is simply a pile of DNA, a “continuation of care in the United States. Dr. Donald Frey www.creightonmagazine.org the living state,” is to miss a far greater and outlined several of the criticisms of the more important mystery concerning human current health care system with a special www.creighton.edu life. An egg cannot survive on its own, and emphasis on the funding mechanisms for Copyright © 2001 by Creighton University will soon die after ovulation. Similarly, a U.S. health care. For sure, the current mix of sperm cannot survive long on its own. public and private financing that provides Recycled and Recyclable However, at the moment of conception, a incomplete health insurance coverage for all miracle happens: A new life is born, and a Americans is inadequate. The 1990s Printed with Soy Ink new soul created. This soul has not been in experiment with managed care as a solution existence, waiting in line in heaven for a body for our health care woes has failed for a to jump into. No, it is indeed an act of number of reasons including its singular creation by God at the moment of conception, focus on cost control, irrespective of the effect

4 Winter 2001 University News of the financing structure on access and weren’t illegal for Canadians to spend their I view with suspicion any solution that quality. Too often, this drive to control costs own money on health care. Perhaps that’s promotes increased government involvement. resulted in impaired access to necessary why Canadians spend an estimated $1 billion But our current approach, which I think is services. While we are considering what a year for health services in the United States. fundamentally a private sector approach, should be done to improve our health care Despite a strong cultural commitment to does not appear to be working. I clearly do delivery and financing system, we can learn their single-payor system, the Canadian not embrace Dr. Frey’s “socialistic” proposal from the 2001 Institute of Medicine report government has not adequately funded its in its entirety, nor do I foresee some of the “Crossing the Quality Chasm.” This report health care system. Given the reluctance of outcomes he predicts. But I do appreciate his advocates for the development of financing Congress to address health care issues in a helping to frame the debate, a debate that structures that reward providers for both timely manner, I question Dr. Frey’s must be conducted and acted upon soon. I high-quality and cost-effective health care confidence in governmental funding for the services. The incorporation of “evidence- system he proposes. One only has to look at based practice” and improved quality the multi-year political battles that have measurement in the daily delivery of health raged in Congress over providing care is an important long-term objective for prescription drugs to seniors or the so-called our health care system, regardless of the patient’s rights legislation. Now consider the payor mechanism. (Reference: Institute of gridlock that would ensue if all of our health Medicine, “Crossing the Quality Chasm,” care financing were dependent on Congress Washington D.C.: National Academy and state legislatures. Press, 2001. ) While I do not doubt Dr. Frey’s good Robert Sandstrom, Ph.D., PT intentions, I would question the judgment of Associate Professor, Interim Chair anyone who suggests that our health care Creighton Department of Physical Therapy system be entrusted to the government. applaud your willingness to publish one Michael L. Smart, BS’76, JD’83 viewpoint of the argument, no matter how Kudos to Dr. Frey Omaha controversial. Compliments to you and Dr. Frey on the Thank you for the great work you do with publication of the article on “Is America Surprised at reaction the magazine. I am as proud of it as I am of Ready for Universal Health Care?” The I read with surprise and disappointment being an alumnus of this great University! answer is probably not for awhile, but the harshness of the editorial responses to the Steven E. Pribnow, JD’86 eventually. article concerning universal health care. To Ames, Neb. James Monen Sr., JD’57 assert that you will no longer recommend Omaha that your grandchildren attend the University Add to the list based on your opinion of one article in a It was shocking to have such a socialistic Canadian system ‘in crisis’ university magazine seems a bit of an over- approach exhibited in a publication from In January of 2000, a poll of Canadians reaction to me. Fr. Schlegel did not author Creighton University. Please add my name to found that 78 percent considered their health that article. The Board of Trustees did not the list of alumni who are against more care system “in crisis,” and 60 percent did not sign it. It is the opinion of one professor. If the socialism in America. In the fall 2001 edition think that their provincial government had a University is failing in its mission to teach (I of Creighton University Magazine, William J. good plan for managing the health care do not believe that it is), the failure is not in Egan, BA’52, Col. Wayne Grabow, DDS’78, system. Is this the ideal that Dr. Donald Frey the area of economics; it is apparently in the and Matthew Tucker, BSBA’92, expressed my aspires to for the U.S. health care delivery area of logic and open-mindedness. sentiments very well. system? (“Is America Ready for Universal I fancy myself an economically I was also thoroughly disgusted with the Care?” Summer 2001). conservative, free-trading capitalist. I firmly article by Dr. Frey advocating a socialistic These poll results point to some of the believe that government involvement in system of health care. There is no evidence flaws in Dr. Frey’s arguments. For instance, economic issues nearly always results in that collecting money from taxpayers and Dr. Frey states that Canada spends less than reduced efficiency and misallocation of creating a “single payor” (the federal 1 percent of its gross domestic product on resources. But there is no denying, I feel, that government) would reduce the cost of health health care, while the U.S. spends the cost of medical care in this country is out care. It will increase the cost and the patients approximately 15 percent. However, of control, perhaps disastrously so. Our small will receive less care (just like the “managed Canadian expenditures are limited by company was presented this week with a 32 care” plans have, only worse). The patient government appropriation, and the Canadian percent increase in our group health (consumer) should be in charge again, and system is woefully underfunded. Hospitals insurance premium costs for the upcoming the best approach to this would be “Medical have closed, equipment is outdated, there are year. This follows a 20 percent increase last Savings Accounts.” A high deductible personnel shortages and Canadians must year. We are not alone in this situation and, insurance for disaster should accompany this wait weeks or months for key services such like many others, we cannot continue on this plan. Eliminating the gigantic bureaucracy as diagnostic testing, radiation therapy and course indefinitely. If there are answers to this would be the greatest saving of all. heart or orthopedic surgery. problem, and I hope that there are, we need J. Paul Thomassen, MD’50, FACS The GDP figure would be larger if it to find them! Anaheim, Calif.

5 Winter 2001 Letters to the Editor

Article provides is that our nation has not yet undertaken this problems with our current system that needed perspective debate extensively or seriously. Creighton should be addressed. I would encourage Dr. University Magazine and the University itself Frey to continue to write about the problems I was impressed with Dr. Donald Frey’s should be commended — not attacked — for with health care and respond to appropriate thoughtful article, “Is America Ready for attempting to “stimulate critical and creative comments that have been made on his article. Universal Health Care?” in the summer thinking and provide ethical perspectives” on Thank you, Dr. Frey, for the wonderful article. edition, but equally distressed by two letters the increasingly complex question of access to Joseph Hutter in the fall magazine harshly criticizing Dr. health care. Marmora, N.J. Frey’s perspective and even the University As Dr. Frey argued, our present health care for publishing it. “system,” in its partiality and by denying One respondent was “disgusted” by Dr. Prescription drug equal access to one out of seven Americans, is Frey’s “liberal” views, questioned his article on target patently unjust. This evaluation is made not motives and integrity, and vowed to Congratulations to Creighton University by the standards of liberalism or socialism discontinue support of the University. Magazine and to Drs. Makoid and Garis for but by the moral norms of the Catholic Apparently only certain views — those the informative article on the cost structure of Church. I respectfully submit that efforts to akin to the letter writer’s — should be prescription drugs. This is a subject that find solutions will only be successful in “an allowed at his alma mater. touches the lives of most of us, and yet one atmosphere of freedom of inquiry” and Another respondent stigmatized Dr. that few of us are in a position to understand. mutual respect and not in an atmosphere Frey’s article as “a shameless rant” and The recently interposed layer of middlemen poisoned by ideological closed-mindedness “a ridiculously biased piece of leftist between the major manufacturers and the and name-calling. propaganda.” Although “shocked” that retail pharmacists seems to be an example of Roger Bergman an allegedly “conservative” university like the law of unintended consequences. Instead Director Creighton would publish such views, at of reducing the cost of prescription drugs, Justice & Peace Studies Program least he did not threaten to withhold these newcomers have simply squeezed the Creighton College of Arts & Sciences his support. already modest profit of the retail pharmacist I believe the intemperate language of these and pocketed the difference for themselves. letters speaks for itself, as does the illogic of Article was informative One point of clarification may be in order. attributing one faculty author’s views to that My daughter is a graduate of Creighton. While the authors clearly recognize and of the University as a whole. Needless to say, Your magazine is excellent, and I look describe the time lag between introduction of there is nothing in Creighton’s Mission forward to receiving it. I am writing to you a new drug and the possibility of a generic Statement that names the University as either about Dr. Donald Frey’s article regarding equivalent, one might gather the impression conservative or liberal. What it does say is health care, and some of the responses that from the article that the dominance of brand that Creighton is committed to “an were published regarding the article. My name drugs in the revenue stream is largely a atmosphere of freedom of inquiry ... and to opinion of Dr. Frey’s article was that it was function of advertising and promotion. the promotion of justice.” It is committed to very informative, and raised issues that need However, in many fields, such as doing so through “faculty and staff (who) to be addressed. What he said in his article osteoporosis (my own), approved therapies stimulate critical and creative thinking and needed to be said. Some of the responses to have been available for such a short time that provide ethical perspectives for dealing with his article included very good comments to there are no generics yet available. It is not a an increasingly complex world.” I suspect the which I hope Dr. Frey will respond. However, question of new diseases, but of significant vast majority of readers appreciated Dr. I was surprised at the apparent implication in advances in ability to treat old diseases. Frey’s article in exactly this spirit. some of the responses that everyone should When that occurs — and the public surely Some readers may not be aware, however, be completely financially responsible for their wants it to occur — brand name drugs, and that Creighton’s Catholic identity does give own health care. Yes, ideally people should the revenues associated with them, are bound it a particular way of approaching such be responsible; however, it must be realized to dominate the market. issues as health care. As Pope John XXIII that there are circumstances that occur for Robert P. Heaney, MD’51 first affirmed in his great encyclical Pacem which people through no fault of their own John A. Creighton University Professor in Terris (1963) and as Pope John Paul II can not cope with the magnitude of their (Laborem Exercens, 1981) and the U.S. bishops problems. We should not deny adequate Proud of articles medical care to anyone. People should be (several documents) have reaffirmed, access to I’m very proud of you for the courage to able to choose their doctors, doctors should health care is a universal human right. print those pieces on health reform and Rx make the medical decisions, and measures Thus Dr. Frey is on solid ethical footing drug cost in your summer and fall 2001 should be in place to ensure a high level of when he treats the fact that 44 million U.S. issues. I hope it makes an impact. care and to prevent fraud. citizens do not have health insurance as a Sam Ruben, MD’79 Remember the words, “I assure you, as matter of social injustice. Whether or not a Brookings, Ore. Canadian-style single-payor system is the often as you did it for one of my least best remedy for this infringement of God- brothers, you did it for me.” I would hope given human dignity is a matter of debate. I that graduates from Catholic colleges would happen to believe that Dr. Frey is right on this reflect on this and have compassion for those point. But one of Dr. Frey’s more basic points in need. I believe that there are many

6 Winter 2001 University News Race, Technology Divide Explored in Book by CU’s Mack

Raneta Lawson Mack, professor of law at the Creighton University School of Law, explores how the advancement of technology is leaving an ever-increasing gap between the “haves” and the “have-nots” in her new book, The Digital Divide: Standing at the Intersection of Race and Technology. Mack looks at the racial “digital divide” and highlights some

Photo by Dave Weaver historical reasons From left to right are Creighton President the Rev. John P. Schlegel, S.J., Anna Tyler Waite and why minority Don Waite. communities might fear technological Waite Gift Funds New Business advancements and are unlikely to Leadership Center at Creighton immediately The College of Business Administration Leadership offers a four-year program that embrace computer (CoBA) at Creighton University is leading by will give undergraduate students in CoBA Mack technology, even if it example with the addition of the Anna Tyler the opportunity to study and practice is made available on Waite Center for Leadership. An inaugural leadership in a college setting. a widespread basis. She also discusses the ceremony for the Center was held Sept. 25. The Anna Tyler Waite Scholars will legacy of slavery and how it is a The center is made possible thanks to a participate in a series of activities that will contributing factor to the current $1.1 million gift from Donald L. Waite, explore the philosophies and actions of technology gap. BSC’54, executive vice president and chief leaders in varied settings and circumstances. “The digital divide is one area where administrative officer, Seagate Technology, These activities will develop the skills and understanding the role that history plays in Inc. Named for Anna Tyler Waite, the wife of values needed for students to become our current situation is the key to shaping Don Waite, the center will offer two effective leaders in a socially responsible workable solutions,” Mack said. scholarships each fall to students in the environment. According to Mack, “this retrospective program. The first scholarships were Robert H. Moorman, Ph.D., associate approach provides context and furthers awarded to Michael Potthoff, a junior from professor of management in the College of understanding and is not about blaming.” Carroll, Iowa, and Emily Pratt, a senior from Business Administration and holder of the She says the digital divide is everyone’s Bellevue, Neb. Robert B. Daugherty Chair in Management, problem. “If the premise behind The Anna Tyler Waite Center for is the director of the center. e-commerce is access to global markets, then that idea doesn’t work unless a majority of those markets have access to relevant technology.” Whipple Named Jacobson Chairholder The book offers several examples of The chair of Creighton University’s company. He also corporate and community efforts aimed at Department of English, Robert D. Whipple was a leader in narrowing the divide. Although Jr., Ph.D., has been named holder of the A.F. setting community government can play a role in reducing the Jacobson Chair in Communication. priorities and divide by educating the public, Mack Established in November of 1980, the committing the prefers to focus on corporate and Jacobson Chair was the first chair to be private sector to community based solutions, because each endowed in the College of Arts and Sciences public activity. community is different. However, she says at Creighton. It was endowed by an Whipple, an that resolving the digital divide doesn’t anonymous gift to honor the late A.F. associate professor simply mean putting high-speed computers Jacobson, former president of Northwestern Whipple of English and chair in everyone’s home. Instead, it means Bell Telephone Co. and a member of the of the Department of English for the past two educating those who are not aware of the Creighton University Board of Directors. years, has been with Creighton since 1990. benefits of technology, designing content Jacobson was a visionary who oversaw He teaches courses in writing and in that is relevant to those communities and regional expansion of the telephone technology and literacy. increasing access. 7 Winter 2001 University News

of one of the most popular McCullough and well-respected biographies in recent memory, Delivers the Pulitzer-Prize-winning Truman (1992), which spent 43 Governor’s weeks on the New York Times bestsellers list in hardcover Lecture, Visits and 24 weeks in paperback. His works also include The Campus Johnstown Flood (1968), The Great Bridge (1972), The Path Award-winning author David McCullough Between Seas (1977), Mornings delivered the Annual Governor’s Lecture in on Horseback (1981) and Brave

the Humanities on Sept. 20 and visited the Photo by Dave Weaver Companions (1991). In Creighton University campus on Sept. 21. Author David McCullough answers questions at an open forum addition, McCullough has More than 1,000 people attended the lecture held in the Skutt Student Center on Sept. 21. served as the narrator of held at the Joslyn Art Museum. Creighton several television shows, University was the co-host of this event, At the open forum held on campus on including Ken Burns’ The Civil War, and is the along with the Nebraska Humanities Council. Sept. 21, McCullough answered questions host of The American Experience, both on PBS. Bryan Le Beau, Ph.D., John C. Kenefick Chair from Le Beau and the audience about his A graduate of Yale University, McCullough in the Humanities at Creighton and chair of lecture on “First Principles.” His talk was has served as both a writer and editor for the Nebraska Humanities Council, helped largely based on lessons learned during the Time magazine, and held several university organize the event. Fr. John P. Schlegel, S.J., public life of U.S. President John Adams. teaching positions. His most recent book is was Creighton’s host. McCullough is well-known as the author John Adams.

Alumni Honored Graduate School Medicine in 1979, Yakes served in the Kenneth D. Rice, MBA’84, received the U.S. Army for 12 years, including service in with Alumni Alumni Merit Award from the Graduate Operation Desert Storm in the Gulf War. He School on Sept. 10. Rice is chairman and is the first radiologist ever to complete Merit Awards CEO of Enron Broadband Services. He began fellowship training in both Interventional his career in the energy industry as a project Radiology and Interventional Neurovascular College of Business engineer with InterNorth, one of the pipeline Surgery. As a fellow at Walter Reed Army Administration companies that merged to form Enron in Medical Center in Washington, D.C., Yakes Michael Philip Boyle, BSBA’79, JD’83, 1985. Throughout his tenure with Enron, Rice developed a new approach for treating LL.M., received the Alumni Merit Award has held various positions in engineering, vascular malformations without using open from the College of Business Administration marketing, transportation and executive surgery. He published his technique in 1986 (CoBA) on Sept. 10. Boyle joined the management. Prior to joining and has since authored numerous articles Microsoft Corporation in 1986. For several Enron Broadband Services, Rice was and textbook chapters on the subject. In 1991, years, Boyle has directed Microsoft’s chairman and CEO of Enron Capital & Trade Yakes established the Vascular Malformation worldwide tax and internal audit functions, Resources — now Enron North America, the Center at Swedish Medical Center in and was named vice president in May 2000. largest, most diverse energy merchant in Englewood, Colo. It is the only center in the In September 2000, he was among the North America. Today Rice oversees the world totally dedicated to the management attorneys listed as petitioner in the U.S. Tax development of Enron’s emerging of vascular malformations. Patients from all Court case, Microsoft v. I.R.S. Boyle has communications business, which includes an over the world are referred to Yakes. He and chaired the Tax and Finance Committee of 18,000-mile nationwide fiber optic network his wife, Nona (Kaezor) Yakes, have two the American Electronics Association, served dedicated to high bandwidth. Rice and his children, Eric and Alexis. on the board of the National Foreign Trade wife, Teresa Duryea Rice, have four children Council and is a member of the Tax — Nicole, Kirsten, Alex and Erin. School of Pharmacy and Foundation Policy Council. He is an active Allied Health Professions member of the Seattle Alumni Club and has School of Medicine Gomer V. Taylor, BSPha’85, received the served on CoBA’s Advisory Board. Boyle and The School of Medicine presented its Alumni Merit Award from the School of his wife, Rosemary (Kellen), BSPhy’85, 2001 Alumni Merit Award to Wayne F. J. Pharmacy and Allied Health Professions on MS’86, have three children — Elizabeth, Yakes, MD’79, on Sept. 28. After graduating Oct. 5. Taylor is the district pharmacy Connor and Kiernan. from Creighton University’s School of supervisor for Omaha Walgreens, a position

8 Winter 2001 University News

easy-to-use The book will be distributed through the CU Pathologist format. The book’s Learning Disabilities Associations of authors define Nebraska and Texas. It also is available Publishes Book particular skills, through the publisher BC Decker. describe normal Brumback is the editor of the Journal of on Learning development, Child Neurology, the leading journal in its describe behavior field. He conducts research in Alzheimer’s Disabilities associated with disease as well as in pediatric neurology and skill deficits and neuropathology. Brumback joined Creighton Creighton University’s Roger Brumback, offer clinical last year from the University of Oklahoma, M.D., professor and chair of pathology, is co- snapshots of where he held positions in pathology, author of a newly published book, Attention, children who geriatrics, orthopedic surgery, psychiatry and Behavior and Learning Problems in Children: experience a behavioral sciences, and pediatrics. Protocols for Diagnosis and Treatment. particular skill deficit. The book, Attention, Behavior and Learning The book is targeted to physicians, parents The book is a result of a lengthy research Problems in Children: Protocols for Diagnosis and and educators. It provides the basis for collaboration between Brumback and Warren Treatment, is available through publisher recognizing and managing common learning A. Weinberg, M.D., an expert in pediatric BC Decker, Inc., 20 Hughson Street South, disabilities. The book emphasizes brain neurology and learning. Weinberg is a P.O. Box 620, L.C.D. 1, Hamilton, Ontario functions of language, both verbal and professor of neurology and pediatrics at the L8N 3K7. It also is available by calling nonverbal, necessary for learning and University of Texas Southwestern Medical 1-800-568-7281 or by e-mailing communication. Center at Dallas. Caryn R. Harper, faculty [email protected]. Its publication was made From obtaining a detailed family history associate in neurology, University of Texas possible by a donation from the Cimarron to pinpointing specific disabilities, the Southwestern Medical Center at Dallas, is the Foundation to the Creighton University guide provides a wealth of information in an third author. School of Medicine.

Boyle Rice Yakes Taylor McKay he has held since 1991. Taylor served on a the Nebraska Retail Pharmacy Council and others involved with victims of sexual assault. state task force that rewrote the rules, the Nebraska Pharmacists Association. Taylor In 1981, McKay and Jose Gaitan founded regulations and statutes for the practice of has one daughter, Kaylee. McKay & Gaitan. This firm had a strong pro pharmacy in Nebraska. His insightful, bono policy reflecting McKay’s commitment to straightforward and visionary leadership School of Law service by giving roughly 10 percent of the resulted in vital contributions to the practice. The School of Law presented its 2001 firm’s time to pro bono work. In 1989, McKay Taylor also provided key assistance to a state Alumni Merit Award to Michael D. was sworn in as United States Attorney for legislative task force concerning pharmacy McKay, JD’76, on Oct. 19. McKay is an the Western District of Washington. Long technicians. At Creighton, Taylor serves on attorney/partner with McKay Chadwell, active in state and national politics, McKay the School’s Industrial Advisory Board, PLLC, in Seattle. From 1976-1981, McKay ran then Gov. George W. Bush’s presidential which is comprised of healthcare leaders was a member of the King County, campaign in the Seattle area. He has served as from across the nation. Taylor also is a Washington, Prosecuting Attorney’s Office. vice president and president of the Creighton member of the University’s Non-Traditional While in that position, he worked with young University Seattle Alumni Club and as Doctor of Pharmacy Steering Committee. victims of sexual assault, pioneering the president of the National Alumni Board in Committed to helping his community, Taylor protocols for working with young victim 1988. McKay and his wife, Christy Ann serves on the Colo-rectal Cancer Detection witnesses in juvenile court. His efforts were so (Cordwin), BSN’75, have three children — Task Force for the American Cancer Society successful that his techniques were filmed and Kevin, Kathleen and John. and is a board member of the American used around the country to train police Diabetes Association. He also has served on officers, prosecutors, rape relief workers and

9 Winter 2001 University News

group is for first-year Creighton medical local health clinic. They also did a lot of Med Students students and is designed to get them education on public health issues, such as involved in outreach early in their medical proper hygiene and dental care and the Organize education. In addition to visiting India and importance of vaccinations. In addition, they Peru for five weeks in June and July, the developed a calendar with monthly health Project CURE students took part in service projects in tips. Omaha during the academic year. “These people had nothing,” said Tim Outreach stretches from But it was the trips abroad — which were Issac, one of the students who went to Peru. Omaha to India and Peru arranged and financed solely by the students “But they had to be the most loving people I — that really touched these doctors in have ever been around. That was the most Working at a hospital in the poor, rural training. powerful message. I’ve never seen this village of Oddanchatram, located near the “It was the most fulfilling way that I could excitement and love for life.” southern tip of India, Creighton medical have spent the summer,” Desai said. “I hope “I’ve gained a deep sense of respect for student Kumar Desai found himself even this is the first step in a career of these types people who are struggling every day,” said more drawn to his chosen profession. of activities. Neha Sanghvi, another of the students who “There is so much we can do,” said Desai, “This really affirmed why I wanted to go went to Peru. “We’re lucky to have been born who, along with 14 other Creighton medical into medicine,” he continued. “I now realize in the United States. If you have this much,

Fifteen Creighton University medical students took part in Project CURE this past summer. The program, for first-year medical students, is designed to involve them in outreach early in their medical education. In addition to trips to Peru and India, students took part in service projects during the academic year in Omaha.

you should do something with it.” Creighton medical students Kumar Desai, middle, and Brian Pan, right, examine a patient at a rural Steve Schechinger, who traveled to India, hospital in India, while an attending physician looks on. A group of 15 Creighton students, who had was impressed by the compassion of the just completed their first year in medical school, organized summer service trips to India and Peru. doctors at the hospital. “One doctor would hold the patients’ students, served the poor and the sick at sites that this is what I want to do, and I want to hands every time they met. That impressed in India and Peru this summer. be good at it.” me,” Schechinger said. “It really opened my “We can reach out and make a difference in Of the 15 students who took part in the eyes as to what helping people is all about.” the world through the education we are trips, eight traveled to India and seven went Desai, now a second-year medical student, receiving here at Creighton,” Desai said. to Chimbote, Peru. In India, the students has passed the Project CURE torch to this The trips were part of a larger effort by shadowed doctors at the Christian year’s freshman class. Desai and his fellow medical school Fellowship Hospital in Oddanchatram and “They are already out in the community classmates to reach out to those in need. visited local schools, talking about the helping with local health issues and trying to Desai helped form Project CURE importance of proper hygiene and general raise money for the greater global cause,” (CreightonMed United in Relief Efforts). The health. In Peru, the students assisted at a Desai said.

10 Winter 2001 University News

and hypertension, two diseases known to Creighton Family strike Hispanics particularly hard. Santiago also has plans for prevention Pharmacy Serves programs dealing with high cholesterol, osteoporosis and asthma. She wants to South Omaha continue joining forces with other agencies to provide free school physicals, visual and By Eugene Curtin hearing tests, blood pressure tests and immunizations. There is a 91-year-old woman who has Creighton University’s presence in good reason to be grateful that Creighton South Omaha, which includes a medical University purchased an existing South clinic next door to the pharmacy, is an Omaha clinic and pharmacy in June 2000. attempt to improve health among the On those days when she doesn’t feel up immigrant population, according to Sid to the four-block walk to Creighton Family Stohs, Ph.D., dean of the Creighton Pharmacy at 25th and L streets, the University School of Pharmacy and Allied pharmacy comes to her, in the form of a Health Professions. delivery van. She also can count on a call “I truly believe we are in a position to from Sheila Santiago should she fail to pick help improve the general health care in that up her monthly refills. area,” he said. Santiago, a native of Puerto Rico and In addition, Stohs said, the pharmacy a graduate of Purdue University, is the will prove an invaluable teaching tool for chief pharmacist, entrusted by Creighton’s Creighton’s pharmacy students.

School of Pharmacy and Allied Health Photo by Eugene Curtin “This allows us to provide our students Professions with the important task of Sheila Santiago, right, along with assistant with exposure to a very diverse population reaching out to South Omaha’s rapidly Marisela Galván, is leading Creighton University’s so they can gain experience with other expanding Hispanic community. pharmacy outreach efforts in South Omaha. cultures,” he said. “One of Creighton’s The pharmacy offers extensive patient goals, not just in pharmacy but throughout counseling. Santiago places high priority on Santiago said. the school, is to prepare our students to sitting down with her patients and taking Currently, her counseling is done at a deal with diverse populations.” the time to explain fully the meaning and table in a public area. That will soon importance of their medications. change, as renovations add a private About the author: Eugene Curtin is a free-lance “It’s incredible how much you can help counseling room to the pharmacy. That writer working in Bellevue, Neb. a patient understand their medicines, and privacy also will make it easier to develop encourage them to comply with their outreach programs. Santiago has already schedule, just by sitting down with them,” initiated programs dealing with diabetes

OT Pioneer Creighton University and was one of its White House Conference on Domestic founding faculty members. Since that Issues. In 1975, Gessert was the first Receives Honorary time, Gessert has served the students and occupational therapist to establish a non- faculty as an adviser and a contributed traditional private practice in Nebraska. Alumna Citation service faculty member. She also funded In addition, she was the first non- the occupational therapy program’s first physician to serve as a member of the Virginia G. Gessert received an Honorary endowed scholarship. Nebraska Arthritis Foundation Medical Alumna Citation from the School of Gessert has served and provided and Scientific Committee, and the first Pharmacy and Allied Health Professions leadership for the Nebraska Occupational non-nurse, non-physician on the Omaha on Oct. 5. Therapy Association, the Eastern Nebraska American Red Cross Home Service Gessert received her bachelor of science Office on Aging and the Midwest Area Advisory Board. degree in occupational therapy from Congress on Aging. Much of her work Gessert and her husband, Carl Frederick Washington University in St. Louis in 1959. relates to restorative care, geriatric Gessert, have two married sons, Steven and She came to Omaha in 1963. Gessert served occupational therapy and related areas John, and a granddaughter, Greta. on the committee that led to the formation that support the independence of the frail of the Occupational Therapy Program at elderly. She also was a delegate to the

11 Winter 2001 University News

government, native languages, literature, et provides scholarships for Native American Creighton Offers cetera,” said Herb Grandbois, D.S.W., chair students. Creighton also offers a Red Cloud of the Department of Social Work and Indian Mission Scholarship, and diversity Native American director of the program. “The program is scholarships are available for Native about being a part of a larger community. Americans. Studies Major We want to be involved in projects that are “There are a large number of Jesuits who A first among Jesuit and of value to Native Americans.” have spent time on the reservations and The written goals of the program are to: have a commitment to the Native American Nebraska schools • Promote awareness and appreciation people,” said the Rev. Ray Bucko, S.J., a for cultural diversity, principally professor in the Department of Sociology Creighton University became the first Native American peoples, through the and Anthropology and one of several American Jesuit university and the first academic, research and service architects of the Native American Studies university in the state of Nebraska to offer a functions of the University and College Program. major in Native American Studies with the of Arts and Sciences. Fr. Bucko added that Creighton’s new initiation of its new Native American • Link with area Native American program could serve to both sensitize and Studies Program this fall. organizations and peoples to assist in train Jesuits wanting to work in union with The program was developed with the identifying and alleviating social the Native American population. cooperation of the Native American problems and issues. In addition, program graduates can community and Creighton faculty. • Promote cross-cultural understanding pursue graduate-level education in Native Classes stretch across several academic and reconciliation/healing between American studies or related areas; work in disciplines, including sociology, American and Native American fields such as tribal government, human anthropology, theology, fine and performing communities. rights and indigenous issues, employment arts, social work and journalism. Students • Support and encourage scholarship/ and related services, and education; or are required to participate in foundational research about, with and for Native serve as consultants to non-Native courses that offer an awareness of Native American communities. American programs. The program also can American history, culture, views and The Jesuits, especially those at Creighton, serve those students interested in health values. A service-learning component also have a long tradition of serving Native science careers. is being developed, through which students American populations. Creighton Jesuits “The goals and objectives of the Native will be required to use what they have have been especially active on the Rosebud American Studies Program mirror the learned in the classroom to connect with and Pine Ridge reservations in South University’s mission statement,” Grandbois Native American communities. Dakota. The Morrison Scholarship Fund, said. “It engages students and faculty in the “The program is not about just learning named in honor of former Creighton pursuit of truth and the promotion of about Native Americans, their tribal President the Rev. Michael G. Morrison, S.J., justice.”

landscape of contributed to the creation of a national New Book visual images in public memory. But he says that’s not all the mid-1800s, that people get from them. The political Explores Cultural selling millions cartoons represented not only the of copies of enthusiasms and fantasies of 19th century Impact of lithographs that Americans, they also reflected their biases, adorned ambitions and fears. Currier and Ives countless homes “Currier and Ives created a historical and even barns. record of 19th century America, but not as The mass production of visual images The Currier and conscious historians. They did not was dramatically changed by the Ives catalog necessarily picture America as it existed, publishing business of Currier and Ives. included more but rather as Americans imagined it to be,” They also contributed to the creation of a than 7,000 works by dozens of artists, Le Beau said. national public memory, according to accounting for 95 percent of all lithographs Le Beau is the John C. Kenefick Faculty Creighton University History Professor sold across the country. Chair in the Humanities and chairman of Bryan F. Le Beau, Ph.D., in his new book, Le Beau says Currier and Ives played a the Department of History at Creighton Currier and Ives: America Imagined. role in American culture beyond simply University. He also is the host and co- The book, published by the Smithsonian making these images affordable. Their producer of the public radio program, Institution Press, examines the way the popular historical images covering Talking History. His previous books include publishing company of Nathaniel Currier politicians, the American Revolution, the Religion in America to 1865 and The Story of and his partner James Ives changed the Civil War and life on the frontier the Salem Witch Trials.

12 Winter 2001 University News CU Professors Resurrect Enigmatic ‘Voice of Sanity‘ By Brian Kokensparger

He loved peace, yet designed bombs. He protected an innocent colleague from McCarthy’s political lynch mob, yet listed coordinates targeting thousands of innocent civilians. Who is this man who tirelessly produced calculations for the Manhattan Project, yet was hailed as a “voice of sanity” when appointed to the Atomic Energy

Commission? Advanced Study of the Institute for Archives and Courtesy of the Alan Richards Photo by Eileen Dugan, Ph.D., associate professor of John von Neumann in front of the first computer at the Institute for Advanced Study. history, and Randy Crist, Ph.D., assistant professor of mathematics, are trying to of national policy regarding such weapons.” notes about quantum mechanics were determine just that as they conduct research Dugan believes that the gaps exist because drawings of bombs and missiles, including aimed at reintroducing the enigmatic genius few have dared undertaking the daunting a detailed design of the “Fat Boy” bomb. John von Neumann. task of sorting through the mountains of Among his notes were letters from some “John von Neumann is the smartest guy of the most influential people of his time. you’ve never heard of,” said Crist, as he and Crist remembers holding a letter written by Dugan began recounting their last few Creighton professors Albert Einstein — in Einstein’s telltale hand. months of discoveries regarding one of the Eileen Dugan and Randy “It was fascinating handling a letter that most influential men of the Cold War Crist have been was personally written by Albert Einstein.” generation, yet one of the least known of conducting research on Dugan and Crist also met with von ours. Neumann’s daughter, Marina Whitman (a Crist and Dugan first decided to research John von Neumann, a professor of management at the University von Neumann (pronounced von noyman) brilliant mathematician of Michigan) and brother, Nicholas (who, at when they agreed to team-teach a senior who was one of the most 87, is an attorney in the Philadelphia area). perspective course, “Mathematical History, influential men of the Cold The researchers’ efforts are now focused on Philosophy, and Ethics.” One of the textbooks pulling the documents together, in an attempt for the course, William Poundstone’s War generation, yet one of to reintroduce that same voice of sanity that Prisoner’s Dilemma, discusses von Neumann’s the least known. They captured the ears of military leaders, contribution to game theory, and its influence hope to reintroduce this mathematicians, economists, meteorologists, on Cold War politics. enigmatic voice of sanity biologists, physicists, and electrical engineers “Although the textbook is interesting,” (to name just a few of the areas in which he Crist said, “it really doesn’t have enough to new generations. had significant influence). material about John von Neumann. It doesn’t Dugan and Crist are each preparing dig far enough into how his work shaped a material von Neumann left behind. Dugan journal articles based on their research thus world that was to become embroiled in Cold and Crist recently accepted the challenge, far, and have begun work on a book, which War politics for some 30 years. Eileen and I spending a few days wading through 57 they hope will help fill the void of accurate decided that we needed to do some of our boxes of material in the Library of Congress, materials covering the life and times of this own research to fill the gaps.” and finding notes that chronicled every phase enigmatic voice of sanity. Those gaps were much wider than the two of von Neumann’s career. “And that was just expected. “Recent scholarship on the Atomic the unclassified material,” said Crist, who About the author: Brian Kokensparger is a Age has virtually forgotten John von hopes to gain access soon to von Neumann’s free-lance writer for Creighton University Neumann,” Dugan said. “He was, in fact, a classified documents. Magazine. He can be reached via e-mail at central figure not only in the creation of Their efforts proved fruitful. “He was an [email protected]. nuclear weapons, but also in the formulation incredible note keeper,” said Dugan. Amidst

13 Winter 2001 University News Irish Studies Program Opens Students’ Eyes What you have seen is beyond speech, beyond song, only not beyond love; remember it, you will remember it. — Eavan Boland

The words of noted Irish-born poet Eavan Boland best capture the reflections of Creighton students who spent a month in Ireland this past summer as part of Creighton’s Irish Summer School. The summer school is housed in Trinity College in Dublin, and provides students with an intensive and challenging program of study of Irish literature and cultural history. “It also teaches them a lot about who they are and how to live in a diverse world,” said Students who participated in this summer’s Irish Studies Program outside of Queen’s University in David Gardiner, Ph.D., the program’s Belfast. director. One student wrote in her journal after the “We may have possibly been the last group of the 1997 Initiative for Peace Award for trip: “I caught a glimpse of something I of students this summer to visit the city of his work in the Northern Ireland peace hadn’t seen before — maybe it was myself.” Belfast,” Gardiner later told his students. process; and Noel Cuthbert Mitchel, The students also visited Queen’s By taking a bus tour of the neighbor- author of Ireland’s National Trust Guides. University in Northern Ireland’s capital of hoods, Gardiner said the group was making a The Irish Summer School is operated Belfast. Gardiner said Creighton’s program is statement as “delegates for a normal through Creighton’s Department of English the first among American Catholic life.” and has been in existence for more than a universities to visit Queen’s. “We were testifying to those who have decade. Students earn college credit through The students toured the violence-ravaged gone on in the face of radical groups on both the program, which is open to both Creighton neighborhoods of Belfast, as Gardiner sides,” Gardiner said. students as well as students from other received intelligence reports to ensure the In addition to visiting Belfast, students in universities throughout the United States and group’s safety. Two weeks later, the city the program listened to noted speakers from Europe. would erupt in the worst nationalist riot a variety of disciplines. Guest lecturers “Ireland is something they think they in years. included Katie Donovan, features editor for already know,” Gardiner said. “It’s an The Irish Times; Bill Flynn, chairman entirely different world than what they Pictured below are some of the many murals and CEO of Mutual of America and recipient expected.” of Belfast that adorn the sides of buildings. Photos by Liz Powers

14 Winter 2001 University News

campus mall or while working in the Creighton Offers physics lab or while sipping an espresso Goss Earns at the Java Jay. Wireless Web Creighton University is one of a select Award For number of universities in the United States Creighton University’s window to the offering students on-campus wireless Internet Study world just got a little bigger. Internet capabilities. Creighton students can now search the Ernie Goss, Ph.D., MacAllister Chair in The system, which was installed last Internet while lounging outside on the Regional Economics at Creighton University, spring, was up and running as students received the National Association of Busi- returned for the fall semester. With a special ness Economics (NABE) Edward A. Mennis adapter card and the proper software Award on Sept. 9 in New York City. (which can be purchased for $150 at The award was presented to Goss for his Creighton’s One PC Plaza), students can study on the Internet and U.S. productivity. connect to the Internet at various locations, Entitled “The Internet’s Contribution to U.S. or zones, on campus without plugging into Productivity Growth,” Goss’ paper discusses a data port. the link between the high productivity of Students also can check out a laptop, growth per worker and the use of the with the software and adapter card already Internet. In his paper, he explains that the installed, at the Reinert Alumni Memorial U.S. Bureau of Labor Statistics productivity Library on campus. data show output growth per worker (since “Our goal is to enhance learning by 1995) to be approximately doubling the rate making the network available wherever achieved over the preceding two decades. students study or collaborate,” said Con This period of high productivity growth also Dietz, vice president for Information is the period in which the use of the browser Technology. and Internet technology became In addition to the new wireless system, all widespread. The study also concluded that of Creighton’s residence halls are wired for Internet usage added a quarter percent Photo by Bob Guthrie Internet access. Students can surf the net from the campus mall. annually to productivity growth. The students above are pictured on the steps of NABE is an association composed of the Reinert Alumni Memorial Library. individuals who have an interest in business economics, and who want to utilize the latest economic data and trends to enhance their ability to make sound business decisions. There are approximately 3,000 Catch the Jays members representing more than 1,500 Follow all the exciting Creighton Bluejays to a perfect 14-0 home record last season. businesses and other organizations from sports action and sign up for a free, The 2001-2002 schedule for the Creighton around the world. Since its founding in electronic Creighton athletics newsletter at women’s basketball team includes opponents 1959, NABE has continued to attract the www.gocreighton.com. from the Big Ten, Big 12 and SEC. The attention of the most influential and The Creighton men’s basketball team women’s team is looking to improve on last prestigious economic leaders in business. shoots for its fourth straight 20-win season’s 17-11 record and advance season and fourth consecutive to the postseason for the first NCAA Tournament time since 1998-99. CU Receives appearance in 2001-2002. The men’s team travels to $29 Million in Grants The Jays’ 2001-2002 St. Louis, Mo., and the schedule includes four Savvis Center for the Creighton University received $29 million teams that advanced to Missouri Valley Conference in externally sponsored grants for research the NCAA Tournament in Tournament, March 1-4. The and educational projects in 2000-01, a 2001: Western Kentucky, women’s conference 5 percent increase over last year. Federal BYU, Xavier and Indiana tournament runs March 7-9. sources accounted for 54 percent of the State. Creighton — winner of For more schedule and ticket funds received, while 24 percent came from the Missouri Valley Conference information, visit the Creighton industries and corporations, 14 percent from regular-season title last year — opens athletics website at www.gocreighton.com, foundations and associations, and 8 percent conference play Dec. 16 at home against or call the Creighton Athletics Office at from the state. The School of Medicine Indiana State. Creighton fans helped the Jays (402) 280-2720. Go Jays! received the most grants, 606, for a total of more than $22 million. 15 Winter 2001 Creighton Blossoms Bright colors and beautiful plantings were everywhere this summer and fall. Photos on these pages show the coming-to-life of President John P. Schlegel’s vision for a campus with a garden-like atmosphere.

All photos by Bob Guthrie, unless otherwise noted. *Photo by Nick Constantino, BSBA ’00

16 Winter 2001 “Bread feeds the body, indeed, but flowers feed the soul.” — The Koran

Top, from left: law school entrance, near the fountain looking toward the Kiewit Physical Fitness Center’s east entry, looking east across the mall from near the Humanities Building, in front of the Administration Building.

Bottom, from left: near the Humanities Building, east campus mall looking west toward the Administration Building, in front of the Skutt Student Center*, near Ignatius House, in front of McGloin Hall, looking toward Brandeis Hall between Deglman and Swanson residence halls. 17 Winter 2001 Left: Photo by Dave Weaver Right: Photo by Don Doll, S.J. Left: Photo by Dave Weaver The Creighton University community gathered in prayer and mourning following the terrorist attacks of Sept. 11. Above, from left, Creighton students Regina Zeleski and Mubeen Kahn, president of the Muslim Student Association, along with Lori Spanbauer of Campus Ministry, observe a moment of silence during the National Day of Prayer and Remembrance, Sept. 14. Healing for America reighton University and Creighton University Magazine remember all those who Cdied and all those who mourn the loss of family, friends and colleagues from the terrorist attacks of Sept. 11. These attacks — as Creighton President the Rev. John P. Schlegel, S.J., said in an address to the Creighton community — will be forever “seared on our memories.” In this issue, we share the stories of terror and kindness revealed by Creighton alumni living and working in New York City. We examine the reaction of the Creighton community. We search for the essence of the American spirit, with an essay by award- winning Creighton author Brent Spencer, Ph.D. We remember two Creighton alumni who died in the attacks — retired Lt. Col. Gary Smith, BA’68, and Michael Tinley, BA’67. And we explore — through essays by Creighton’s Bert Thelen, S.J., and Richard Hauser, S.J. — the question, Where is God in these troubled times?

that moment to exit and took the main Alumni see escalator instead. terror ... and As he left the building, he was right below when the second plane hit, this kindness time striking tower two at 9:03. “I called On the morning of Tuesday, Sept. 11, my wife, Elizabeth, right away to let her at about 8:55 a.m., Dennis Kadian, know I got out of the building. She Photo by Dave Weaver More than $500 was collected for the Red BA’90, was just exiting the PATH train, always knows the news before I do — Cross through donation boxes in front of six floors beneath the World Trade and she was really worried. I’m glad I St. John’s Church. Center, north tower, and heading for his called her then, because after that the office on the 68th floor. Luckily, he never cell phones were of no use.” made it. Kadian, father of 4-year-old Juliana “As I got nearer the parking garage, and soon-to-be-father of a second child, there was some smoke and it looked started walking away. He would walk like an evacuation going on in the 13 miles. building. I thought it was just another “There were people falling and grease fire in the deli and planned to jumping out of the towers. At about six ignore it. But there was a great deal blocks away, there was a jet engine lying more smoke in the sub-grade on the ground,” he said. passageways ... and I knew it was On the streets, Kadian saw people 18 something more.” Kadian decided at surging away from ground zero, but it Winter 2001 Healing for America

was a crowd generally marked by order company moved Schneider walked from Manhattan to and helpfulness. “People behaved in a from the World her apartment in Queens. Amid the mannerly way; there was no pushing or Trade Center unbelievable destruction, she began to shoving.” complex to a feel lucky. Kadian, a law clerk for the Port disaster recovery “I just feel so fortunate, every time I Authority, later learned that he had lost site in think of this, that I’m alive. You never six immediate colleagues in his office, Westchester, know when you are going to die. I think plus many more from the Port Authority N.Y., and she’s every day when I get up, how grateful I and its police force. “They were helping grateful to be am. A lot of things were working for Schneider people get out,” he said. “One of the away from us,” she said. “The rescue crews were greatest things about working there was downtown Manhattan. guardian angels. They kept everyone that people took care of each other.” “I need to get used to the idea of calm. It was really moving to see every Kadian recently recalled a going back to work downtown. I don’t religion, every race, the entire city conversation that took place the day think I’m ready for that today,” she said. working together. It was an unfortunate before the attack. “We looked out and Schneider witnessed the hellish scene way to see the good side of a lot of saw a rainbow, just about at eye-level, at the World Trade Center as images of people.” and we all commented on how crashing airplanes, falling bodies and fortunate we were to be able to look out imploding buildings shocked the world. ••• at something so beautiful from the “At first, I thought it was thunder,” “It is amazing to see evil in the raw,” towers. And the next day, everything she said. “We hadn’t received any said Chris (Galigiuri) Davis Ruland, was gone.” announcements. It looked like a BA’60, who toured the site of the World Currently officing in Newark and tickertape parade. I saw paper floating Trade Center devastation nearly two attending law school at Seton Hall, the down and then I looked closely and saw weeks after the attack. Ruland’s Creighton alumnus says he feels so fire, debris and parts of what I thought husband, Don, is a retired New York lucky to be alive. was a plane. I saw the first person jump City fire chief, who lost many friends “We’ve had so many calls from and that was when the second plane hit. and colleagues when the two 110-story friends we seldom see. It’s wonderful to After that, there was no doubt about buildings crashed to the ground. feel their concern and kindness.” what was happening.” “The sight is far beyond what stills or Following the orderly evacuation of TV pictures are able to show. The ••• her building, Schneider and co-workers devastation is beyond belief. There are It may be possible for Maggie walked to Washington Square. “We not only buildings that fell, but others Schneider, BA’97, a systems security weren’t in tears, we were in shock,” she burnt out. There are windows blown analyst for the German investment bank said. “We didn’t know if there were out for blocks around. We looked up Commerzbank AG, to return to work at other targets for attack.” and stories above, there were still flames Two World Financial Center in about a After making sure a co-worker with breaking out — 13 days after the year. Following the attacks, her foot problems would have a ride home, attack,” Ruland said.

Photo by Don Doll, S.J. Photo by Don Doll, S.J.

The Rev. Ted Bohr, S.J., presides over Creighton’s noon Creighton President the Rev. John P. Schlegel, S.J., speaks at a multi-faith prayer service the day of the attacks. Mass on the National Day of Prayer and Remembrance. 19 Winter 2001 Healing for America

Ruland was heartened to see fire multiple faiths — was held outside the fighters from across the country — A Community of church. Phoenix, Colorado Springs, California, Hope and Prayer A message board was soon erected in New Jersey, to name a few — assisting front of St. John’s, so passersby could with the clean-up and rescue effort. She Creighton University, true to its share their thoughts and hopes for also was struck by the sight of a prayer mission, was a community of prayer, a peace. White ribbons were distributed. tent set up for the rescue workers. community of hope and a community Students began collecting donations for “So many people are contributing to in conversation in the wake of the the Red Cross. More than $500 was the effort,” she said. “The workers on horrific terrorist attacks on Sept. 11. collected from donation boxes on the site will need our prayers for a long About 1,000 people filled St. John’s steps of the church. time to come.” Church for the noon Mass on the day Creighton counselors, University of the attacks to pray for the victims of Ministry staff and residence hall leaders ••• the tragedy, for the nation and for reached out across the campus to help Brian Nagel, BSBA’95, was in his world peace. students in need of emotional support. office at CS First Boston, about 30 blocks Creighton President the Rev. John P. Several question-and-answer sessions, from the World Trade Center, waiting Schlegel, S.J., told those gathered that featuring faculty experts from a wide for the markets to open, when the the tragic events of that morning would variety of disciplines, were held on frightening headlines scrolled across his be forever “seared on our memories.” campus, as members of the University computer screen. “From our building, “No words can encapsulate the scope community probed for answers and on the 22nd floor, we had a perfect view of the human and material tragedy,” Fr. wrestled with the implications of the of the World Trade Center,” Nagel said. Schlegel said. “No one can give a attacks. “We could see the hole in the first rational interpretation of these events. “A small minority of people (in the building. And we could see the flames All of us have confronted the fragility of world) are celebrating (the attacks),” coming out of the second tower.” human life. All of us, from whatever John Calvert, Ph.D., said during a panel Nagel, a California native who has religious tradition, see the need for a discussion just days after the tragedy. been living and working in New York comforting and peace-giving God.” Calvert is an assistant professor of for just over a year, said watching the More than 500 people gathered history at Creighton and an expert on events unfold was chilling. around the fountain in front of St. John’s Middle East affairs. “The mood in “Everyone here knew people in those Church later that evening for a multi- Amman and Cairo is solemn and buildings. We have offices in those faith prayer service, which included bleak,” he said, “and filled with a sense buildings. We’ve all been down there prayers from a variety of religious faiths of foreboding.” numerous times. We knew people who and traditions. At the same discussion, Terry Clark, were in those buildings at the time,” The noon Mass that Friday was part Ph.D., associate professor of political he said. of the National Day of Prayer and science, warned that international Brian’s wife, Joy (Epperly) Nagel, Remembrance commissioned by terrorism is actively pursuing the BSN’96, a nurse, who was home at the President George W. Bush. The bells of destruction of Western capitalism. time of the attack, went to the hospitals St. John’s were tolled at 12:30 p.m., so “This was not a symbolic strike,” he to see if she could help. “Unfortunately, that all on campus could observe a said. “It was an attempt to destabilize there was not that much she could do,” moment of silence, and afterward, a world capitalist markets so thoroughly Brian said. prayer service — again incorporating as to put them on the brink of collapse.” The end of the Cold War left Western liberal democracy dominant, Clark said, and threatened to create a single global social system hated by radical Islamic terrorists. “They want an end to the international system as it currently exists, and that carries enormous consequences for all of us,” he said, “a degree of anarchy in which we do not want to live.” The Creighton experts, like many, grappled with what would be an appropriate American response. “I pray that we do not turn into that Photo by Dave Weaver which attacked us — vigilantes,” said Patriotism was on display during services at Creighton.

20 Winter 2001 Healing for America

Kenneth Wise, Ph.D., associate professor the name “America” has been used and slicker set out stacks of fliers and of political science and international abused, praised and pilloried, bent to brochures on a table, weighing them studies. the needs of each passing moment. down with stones. But no one wanted to Fr. Schlegel, in a message to the What would it mean now? And what brave the rain. What little crowd there campus, wrote: “As a community would it come to mean in the weeks was took shelter in the barn. Creighton must respond to these events and months ahead? The anthems tell us the spirit of in a positive and responsive manner. We The sky hung heavy with dark America is alive and well in the are a community who cares about its clouds. A wet wind buffeted the car. It mountains and valleys, from sea to many parts. This is a time to listen, to had been raining on and off throughout shining sea. And it’s easy to believe that hold, to help and to heal one another. ... the morning, as if God himself were in times of safety and prosperity. As I So let us remain the wonderful unified telling us that today was not a day took my seat in the old barn, I wasn’t community that we are. meant for celebration. We drove in sure what those words meant. What “... Let us be a community of prayer silence, the wet pavement uncoiling in was the spirit of America now? All I and a community of hope.” front of us, the damp fields drifting past. could picture were the crumbled pilings I found myself wondering what it of New York and the charred girders of means to be an American. And what is the Pentagon. All I could see were the On the spirit of America? Too often in our thousands of faces staring from past, the spirit of America has been handmade fliers. Who were they? What Shattered invoked to justify every degree of rage, had become of them? And what will Wings hatred and small-mindedness. Is this, become of us? There are no adequate By Brent Spencer, Ph.D. too, American? Who are we as a nation, answers to these questions. and what do we stand for? Freedom. Not now, not yet. Perhaps not ever. It was a few days after the Sept. 11 Yes, freedom. A noble word. But our On Sept. 11 we awoke to a world we attack. My wife and I had history has never imagined. There are no words planned to take part in a taught us that to adequately describe what lies on celebration of the tallgrass one person’s our hearts as we stumble through prairie sponsored by the local freedom is this darkness. branch of the Audubon Society. another The Audubon program started, Like most Americans, we person’s though not many of us had come out on weren’t in the mood to prison. And this somber day. We sat in the old barn celebrate anything so soon now our new listening to thoughtful speakers and after that black day. We hoped history, the era gazing out at the wet fields. Rain the Audubon event would be beginning pattered against the tin roof as the canceled, but no such luck. Sept. 11, has speakers told us about the need to What we wanted was to stay changed honor the land you come from and the home on our farm and do whatever we land as it used to be. And each of us what we had done for hour thought we was thinking not only of the lost prairie after hour — stare with shock, knew about but of the lost city, of a ragged skyline, grief and rising waves of panic ourselves. and of a people who would never be at the television news. But the After a while, we drove past a small the same. organizers informed us that the handmade sign reading “Prairie” with Then a small woman stepped celebration was still on, and deciding an arrow beneath. We were getting forward with a cardboard carryall, as if that maybe it was for the best, we close. What was once a measureless she’d just come from the mall with a climbed into the car and set off down ocean of grasses so vast that pioneers new pet. She had planned to do this out the back roads of Nebraska, the back would lose their way is now so in the field, she explained, but because roads of America. localized it has an address. This way to of the rain and the small crowd, she’d America. The word, so burdened with the prairie, up the road a mile or so, the decided to do it in the barn. She was hype and hope, has been a second driveway on your left. Watch Betsy Finch from Raptor Recovery problematical one throughout our where you park. Nebraska, a program of the Wachiska history. We in the United States can’t lay We pulled the car up next to a new Audubon Society, and she was there to exclusive claim to the name, as barn, got out, and walked the lane to the release a red-tailed hawk back to the countries to the north and south remind old barn, where the main events of the wild. It had been hit by a car, its wing us. And yet its use persists, perhaps celebration were to be held. broken, she said, and now, after surgery because it has more poetry — more Out in the fields, a half-hearted rain and weeks of care, it was ready to be unity, even — than the corporate sound fell on the tents that had been set up. released. When she opened the box and of “United States.” From the beginning, Under each, a lonely figure in a rain brought out the hawk, I found it hard to

21 Winter 2001 Healing for America

breathe. With its serrated wings half Young Gary Smith attended extended, the bird was huge, brown and Attacks Claim Creighton on one of the University’s white, its black pupils rimmed with the Lives of Two first ROTC scholarships. Following gold, its head cocked back, its hooked graduation and his wedding to Ann beak open wide, ready for attack. She Creighton Alumni Smagacz of Omaha, he began his 23- turned it to show the four-foot Creighton University has learned of year military career. It was a career that wingspan and the ruddy tail as broad two alumni — retired Lt. Col. Gary F. saw action in Vietnam and earned Gary and ornate as an antique fan. She led us Smith, BA’68, and Michael Tinley, BA’67 the Soldier’s Medal for heroism when outside, carrying the bird past me, — who died in the Sept. 11 terrorist he rescued a fellow soldier from the where I could look deep into its shining attacks on America. We share their wreckage of his downed helicopter. eyes, somehow at once both fearsome stories below, and mourn the loss of all By the time Gary retired from the and fearful. those who died in this tragic event. military in 1991, he had achieved the We gathered in a ragged half-circle rank of lieutenant colonel. He then around her. In a quiet voice choked with Pentagon Attack Takes Gary F. Smith began his civilian job as chief of Army tears, she said, “Today’s release is Tuesday, Sept. 11, promised to be an Retirement Services. “We used to joke,” dedicated to the memory of those who ordinary morning for retired Lt. Col. said Mason, “that I was alumni director died in the World Trade Center and the Gary F. Smith, chief of U.S. Army for Creighton — and he was alumni Pentagon.” Then she released the bird, Retirement Services. director for the Army!” hoisting it high into the cloudy sky. As it Gary, BA’68, sent a quick e-mail to his In his civilian post, Gary was rose and wheeled away, the light shone brother Mark, Arts’73, before leaving his responsible for coordinating the red through its tail feathers like the sun office in Alexandria, Va., for the retirement benefits for U.S. Army through a church window. A few strong Pentagon. It would be the last word that personnel. Ironically, his last meeting wingbeats and the bird disappeared into any family member would have from at the Pentagon was called to help the trees, gone in an instant. I stayed a the father of four. coordinate proposed legislation to while in the rain, watching the treetops. By 9:45 a.m., Gary’s meeting in the ease the burden of loss upon families I wanted something but couldn’t say conference room of the Army’s Chief of of deceased former servicemen what or why. Surely there was more to Staff for Operations was only minutes and women. the moment than this. under way, but in the split seconds that Even with a vibrant career, Gary And then, just as I was about to give followed, Gary and all in attendance made time for serving his community up, I got my wish. From a hidden would perish in the fiery crash of and enjoying his family and friends. branch at the top of a tree, the hawk American As a coach, he was a “natural.” took off, broad wings lifting effortlessly, Airlines Flight Following a Creighton baseball career, the hawk veering along the treeline, 77 as it slammed Gary became a coach at Omaha’s Holy heading west. I stood staring, my face into the Name High School, where he teamed filled with rain. Hope filled me, too, Pentagon. The up with then-baseball coach Frank with each stroke of the strong wings conference room Solich, now head football coach for the carrying the bird forward through the at the E-Ring Nebraska Cornhuskers. gray, slanting rain. The injured hawk, Second Floor lay Another special love was soccer. made well again by kind hands and in the direct Parents and former players note that hearts, was flying bravely toward its Smith path of the on- few Saturdays ever passed without destiny. The sight of that strong bird coming 757. “Coach Smith” at the sidelines of local flying free was a sort of answer for all It was days until the fates of Gary and soccer matches. The Washington Post my questions, a truth as deep as blood others in the path of the crashed airliner reported: “He was just the sort of soccer and bone, a vision of the spirit of were known, as rescue crews ultimately coach you dream about having for your America. failed to unearth survivors in the kid. He was funny and patient and Pentagon’s rubble. As a result of the kind.” Gary also followed Creighton About the author: Dr. Brent Spencer is an attack, 125 people were killed in the sporting events with great enthusiasm, associate professor of English at Creighton Pentagon strike or remain unaccounted his brother said. and author of the books The Lost Son and for, not including the 64 passengers on He was active with his church, the Are We Not Men? the plane. Parish of the Good Shepherd in Mount Former Creighton University Alumni Vernon, where parishioners got used to Relations Director Mason Smith, BA’66, seeing Gary delivering a load of MA’75, remembers his brother Gary as a furniture for the church housing project person whose life was filled with in his “little red truck.” humor, compassion, warm family ties Gary’s loss leaves a great void in his and a “great affinity for Creighton. He family. He is survived by his wife, Ann, was a person for others.” of Alexandria, Va., his mother, Dorothy,

22 Winter 2001 Healing for America of Vienna, Va., and four daughters: Creighton. His father, Emmet, received In another tragic twist of fate, Mike Natalie Smith (Selfridge), Nicole Amato, both his undergraduate degree (BA’38) Tinley and Lt. Col. Gary Smith, BA’68, and Kristi and Tracy Smith. Siblings and law degree (JD’41) from Creighton. who is believed to have died in the include Mason and Mark. Gary’s father, His mother, the late Jeanne (Stech) strike on the Pentagon, both attended Daugherty M. Smith, who attended Tinley, earned a bachelor’s degree from Creighton in the mid-’60s. The two Creighton before enrolling in West Creighton in 1941. families, Susan said, have been Point, precedes him in death. Mike grew up in Council Bluffs the in contact. Gary and all those Department of second oldest of eight children. Six of At a memorial service in Council Defense members who died in the the eight children, including Michael, Bluffs on Sept. 26, Mike was Pentagon attack will be awarded the would graduate from Creighton. The remembered as a loving son, brother Defense of Freedom Medal by Secretary others were Emmet Tinley III, BSBA’68, and father, who was quick to share a of Defense Donald H. Rumsfeld, it was MPA’84, Kathy (Tinley) Payne, BA’68, warm smile. As the mourners left the announced Sept. 27. and Chris Tinley, JD’86, all of Council church, red, white and blue balloons Bluffs; Mary Ann (Tinley) Smith, BS’71, were released into the air. Mike Tinley of Valley, Neb.; and Suzanne Tinley Memorial services in California and at Had Strong Ties Fishkin, BA’80, of New York. Michael is New York’s St. Patrick’s Cathedral also to Creighton also survived by sister Jeannie Gilmore have provided comfort to the family. The morning of Omaha, and preceded in death by a “We’ll sure miss him,” said his of Sept. 11, brother, Tim Tinley, who died in an brother Emmet. “September 11th Creighton industrial accident in 1973. will forever be etched in all of alumnus Being from a large family, Mike was our memories.” Michael Tinley, blessed with 24 nieces and nephews, Tinley with his daughters Lisa Kennedy, BA’67, was on including six of whom are Creighton left, and Jenna. the 100th floor graduates or current students. Where Is God? of One World “He was the favorite uncle,” said By Bert Thelen, S.J. Trade Center chatting on the phone sister-in-law Susan (Ternus) Tinley, with his sister Suzanne, a 1980 BSN’66, MSN’84, a genetics nurse Where was God when terrorists Creighton graduate. specialist at Creighton’s Hereditary turned airplanes filled with kidnapped Suzanne, her husband Charles Cancer Institute. “He ran interference passengers into deadly missiles that Fishkin and their two young children with the parents when some of them toppled buildings and killed thousands live a mere seven blocks north of New became teen-agers.” of people? York’s famed Twin Towers. (Charles’ Mike was a vice parents, Arthur and Jane Fishkin, both president with work at Creighton.) insurance broker Tinley teased his 7-year-old nephew, Marsh USA, which Henry, that he could see him from the had offices in both building’s window. They ended their World Trade Center phone conversation, as Suzanne hurried towers. While he lived Henry off to school. in Dallas, his job often Thirty minutes later, American took him to New Airlines Flight 11 ripped through the York. north tower. It was the first of two His daughters, Lisa hijacked airliners that would eventually Kennedy, 29, and Photo by Dave Weaver reduce the World Trade Center to Jenna Tinley, 25, who Students gather at a prayer service. rubble. Mike Tinley is believed to have live in Southern died in the attack. He was 56 years old. California, said their father loved New Does our faith in God offer any Mike Tinley was a third generation York. “He absolutely loved the theater, answers to this agonizing question? Creighton graduate. His maternal the many restaurants, and the hustle It does, but it requires us to dig deep grandparents, Wenceslaus James Stech and bustle among the lights and into the sources of the Judeo-Christian and Cecil Bessie (Durham) Stech, both excitement of New York City,” Lisa said. revelation, to accept the darkness of graduated from the Creighton School The daughters received a call from terror, loss and grief as part of the of Medicine in 1913. His grandfather one of Mike’s friends and colleagues human condition, and to trust practiced medicine in Nebraska shortly after the attack. “Apparently, he unreservedly in the promises of God. and Council Bluffs, Iowa, and his (the friend) was supposed to be in the What do the Bible and tradition grandmother practiced in meeting, but he ran down to the first tell us? Council Bluffs. floor to get something to eat,” Susan God lets the sun shine and the rain Mike’s parents also graduated from Tinley said. fall on the good and the bad alike.

23 Winter 2001 Healing for America

Unlike us, God does not interfere with our sense of well being and our way of moment in the life of our nation. We ask human choices and plans, nor does God life. I think God now looks at us, You (God) to bless in a particular way punish evil deeds and reward good especially those whose lives and all those who must now be engaged in deeds in this life. families and communities have been that just response, who must be Does “God bless America” more than shattered by this deliberate and concerned about our safety and security, other nations? Of course not. Every senseless mass murder, with preferential about the safety and security of all on human being, without exception, is compassion and special healing. this globe. Root out any sense of infinitely precious in the eyes of God, Do you need evidence? Look at the vengeance or hatred from our hearts and God wills the salvation of every unbelievable outpouring of heroism, and from the hearts of all called to serve person, created as we are in God’s own generosity, empathy, mercy, help and our nation, lest we or they, through passion and uncontrolled zeal, fall into the same kind of evil acts against innocent people that we set out now to combat.” WE need this prayer if we want God on our side. About the author: Fr. Thelen is director of campus ministry at Creighton and pastor of St. John’s Church. He has been at Creighton for five years and is former provincial of the Wisconsin Province of the Society of Jesus.

Photo by Dave Weaver Where Is Creighton students comfort each other outside St. John’s Church. Your God? image and likeness. All of us are companionship that has been part of the beloved children of God regardless of response to this atrocity! And A Reflection our race, color, culture, sex, age or experiencing our vulnerability so By Richard J. Hauser, S.J. behavior. This also happens to be the painfully has also helped us realize how foundation of our country: the God- valuable we are to one another, as well My tears have become my bread, given dignity and eternal destiny of as how precious we are in the eyes of By night, by day, human beings. God. Hopefully, it will also teach us As I hear it said all the daylong: But God “hates” (a manner of solidarity with ALL who suffer. “Where is your God?” speaking) injustice, cruelty, violence and It has taken a long time, in our Judeo- — Psalm 42 murder. From the death of Abel, the first Christian-Muslim tradition to replace victim, through the crucifixion of Jesus, the God that inflicts violence with the A few days after the terrorist attacks The Divine Victim, until now, in the true God who only suffers violence. We on the World Trade Center and the recent mass murder in our own country, have now a golden opportunity to live Pentagon, I was accosted by a very “your brothers’ and sisters’ blood cries out the truth of the Prophets, realized troubled woman who steadfastly out to me from the soil.” Like us, God perfectly in Jesus: Non-violent love is asserted: “There are no accidents. God’s deplores and mourns the death of the only truly revelatory (religious) plan is perfect. Everything happens for beloved daughters and sons. If God has power because it escapes from the spirit a reason.” Then she waited for my any preference at all (and I believe God of revenge, recrimination and retaliation assent to her declarations. does, in a human manner of speaking), that keeps human beings from their true What to say? How can I respond in a it is for victims. Salvation and prophetic dignity and destiny as sons and way that speaks to the suffering of this history clearly reveal that. daughters of the One, True, Living God. woman? Her faith is the foundation of For the first time in decades, we Does this mean we are not to her life. And her faith teaches her that Americans are the victimized instead of respond? No, but we are not to respond God is not only all-loving but also all- the victimizers. And so we can truly say in kind. A recent prayer of Archbishop powerful. Doesn’t this mean that now, “God is on our side.” It is no Rembert Weakland of Milwaukee says it everything that happens in this world is accident that we now have the world’s very well: somehow willed by God? Don’t these sympathy rather than resentment. “We come to beg gifts of wisdom and events — terrible as they are — also fall Something new for us! We deserve it, prudence, a sense of justice, and a desire within Divine Providence? for we have taken a crushing blow to for peace as we respond to this tragic As I look at this good woman I am

24 Winter 2001 Healing for America touched. Nothing in her life is more My help comes from the Lord, maker of us in Christ Jesus our Lord” important than faith. She clings to it Heaven and earth’ (Ps 121). He does not (Rom 8:35, 39). even though it leads to a terrible say, ‘My pain comes from the Lord,’ or And so Jesus discovered on Easter conclusion: God — somehow or other in ‘My tragedy comes from the Lord.’ He Morning after the ordeal of Good a perfect plan — wanted this to happen. says, ‘My help comes from the Lord.’ Friday: His most dear Father, never Her world view is being pushed to the Could it be that God does not cause the abandoning him, had raised him from breaking point, but she will not give up bad things that happen to us? ... Could the dead — transfigured and glorified. her faith. I admire her! it be that ‘How could God do this to Where was our God during our I begin responding tentatively, me?’ is really the wrong question?” national tragedy? Our God in Christ wanting to help but fearful of upsetting (When Bad Things Happen to Good People, was with us! With us in the hearts of her further. Yes, I too believe that God is Avon Books, 1981). our grieving, praying nation. With all all-loving and all-powerful. But I don’t So Paul concluded reflecting on his working to alleviate suffering of fellow believe God wanted this to happen. experience of coping with his “thorn in citizens, neighbors, friends. With the God did not cause the events of Sept. 11; the flesh.” Paul discovered to his soot-covered, exhausted rescue workers. people did. complete astonishment that his With the firemen laying down God created us in God’s own image, weakness (which some scholars believe their lives. making us “a little less than gods was encroaching blindness) did not The Jesuit poet Gerard Manley crowned with glory and honor” (Ps 8). indicate God’s absence but actually Hopkins in his poem “Kingfishers” And God, all-powerful and all-loving, occasioned a fuller manifestation of catches the mystery of our God’s blessed us with the gift that makes us God’s presence. presence to us in Christ, especially most like God: freedom. And from the “About this thing [the thorn], I have in suffering: very beginning of creation God allowed pleaded with the Lord three times for it For Christ plays in ten thousand places, us to use this gift as mature adults, to leave me, but he has said, ‘My grace Lovely in limbs, and lovely in eyes not his absolutely, not like puppets is enough for you; my power is at its To the Father through the features of manipulated on a string. God doesn’t best in weakness.’ So I shall be very men’s faces. limit human freedom. happy to make my weakness my special But, sadly, from the very beginning human beings have abused this gift of freedom and rebelled against God’s commandments. Humans sinned in the Garden of Eden — Adam and Eve. Humans sinned in New York and Washington on Sept. 11. And so this lovely planet, God’s Garden of Paradise, becomes a Vale of Tears. Throughout history, when confronting suffering, non-believers have taunted believers justifying non- Photo by Fr. Don Doll, S.J. Photo by Fr. belief with the Psalmist’s painful A large crowd gathers outside St. John’s Church during the National Day of Prayer and Remembrance. lament: “Where is your God?” But believers confronting the same boast so that the power of Christ may About the author: Fr. Hauser is director of suffering, reaching deep within their stay over me, and that is why I am quite the master’s program in theology, ministry hearts, have come to a different content with my weaknesses, and with and Christian spirituality and the rector of conclusion: Our God is with us in insults, hardships, persecutions, and the the Jesuit Community at Creighton. He also suffering, indeed, especially in suffering! agonies I go through for Christ’s sake. is the author of several books, including So Rabbi Harold Kushner finally For it is when I am weak that I am Finding God in Troubled Times: The concluded as he struggled to reconcile strong” (2 Cor 12:7-10). Holy Spirit & Suffering to be republished his belief in an all-loving and all- Later facing martyrdom in Rome, this spring by Loyola Press. powerful God with the premature Paul exulted, “Who will separate us death of his son at age 12. God was from the love of Christ? Trial, or distress, not to blame. or persecution, or hunger, or nakedness, “Maybe God does not cause our or danger, or the sword? ... I am certain suffering. Maybe it happens for some that neither death nor life ... nor any reason other than the will of God. The other creature, will be able to separate psalmist writes, ‘I lift mine eyes to the us from the love of God that comes to hills; from where does my help come?

25 Winter 2001

C tholicsBy Eileen Wirth, Ph.D. P litics ‘Catholic& Leaders Offer Heartburn To Both Parties’ The Wall Street Journal, July 18 By Eileen Wirth, Ph.D.

John Cavanaugh, JD’72, a former Democratic congressman from Omaha, and John McGraw, BSBA’84, a former AP Photo/Reed Saxon chair of the California Republican Party, Creighton alumnus John McGraw, are practicing Catholics who disagree BSBA’84, talks with reporters with both their parties and the U.S. following a news briefing at the bishops on some political issues. 2000 GOP state convention in Cavanaugh supported his longtime Palm Springs, Calif. McGraw served as chairman of the friend Al Gore for president in 2000 California Republican Party. despite the fact Cavanaugh is pro-life and Gore is pro-choice. Cavanaugh also Photo courtesy of John Cavanaugh opposes the death penalty, which Gore Creighton alumnus and former Nebraska congressman John supports. Cavanaugh, JD’72, meets with former Vice President Al Gore. Cavanaugh said he remains a Democrat because of the party’s efforts Catholics whose religious values Cavanaugh outlined the dilemmas to protect workers, the elderly and the influence their votes. Catholic voters face. environment and to promote civil rights “An American Catholic who takes the “It is clear that there is not a single and equal rights, stands generally whole Church (political) program acceptable and conflict-free answer,” consistent with Catholic social teachings. seriously is a conflicted voter,” said Law Cavanaugh wrote. “Both the Democratic McGraw of Santa Clara, Calif., Professor Richard Shugrue, a political and Republican parties have embraced supported President George W. Bush analyst and commentator. public policies which are in conflict with despite the fact that he disagrees with Even Catholics who agree with Church basic Roman Catholic moral teachings. Bush’s support for the death penalty. positions in theory often disagree with What does seem clear is that Catholics do He cited their mutual opposition to Church applications of the theories have a moral and civic duty to participate abortion and their common and/or its priority on opposition to in the American political process.” conservatism as reasons for his support. abortion, said Andy Alexander, S.J., vice Catholics have trouble finding McGraw said he agrees with many president for University Ministry. This candidates who fully support Church Church aims on social justice issues but sometimes leads to clashes between views, he said. disagrees with many bishops on the best Catholics in politics and Church officials. The way millions of Catholics resolve means to achieve them. Cavanaugh is acutely aware of this. such questions can determine the Cavanaugh and McGraw are far from In 2000, he wrote a newspaper editorial outcome of elections. Catholics are the alone, Creighton experts said. disagreeing with Omaha Archbishop nation’s key swing voters. In seven of Church stands on political issues Elden Curtiss’ assertion that opposition the last eight presidential elections, a don’t fit conventional American political to abortion was the most important majority of Catholic voters have voted divisions, creating dilemmas for issue for Catholic voters to consider. with the winner.

27 Winter 2001 Catholics and Politics

Catholic voters are avidly courted patterns of churchgoing and non- by both parties and heavily analyzed churchgoing Catholics, Catholics of Catholic by reporters who sometimes have different racial and ethnic groups and difficulty moving beyond stereotypes Catholic men and women. Political Statistics such as “ethnic, blue-collar, For example, a 1996 voter exit poll • There are 62.3 million conservative Catholics.” found that 59 percent of Catholic women Catholics in the U.S., Shugrue said that understanding had voted for Clinton vs. 47 percent of Catholic voting patterns begins with Catholic men, both percentages higher including 44 million analyzing the complexities of the than Clinton received from all female registered voters — diverse groups which comprise the and all male voters. Black and Hispanic 33 percent of all registered Catholic population. Catholics voted for Clinton at much voters. For starters, most American Catholics higher rates than white Catholics with say the Church has little impact on higher percentages of minority Catholic • 40 percent of Catholics who how they vote, said Shugrue. A survey women voting for him than minority voted in 2000 identified firm that tracks Catholic voters found Catholic men. Black Catholic women themselves as registered that only 25 percent said the bishops’ gave Clinton 89 percent of their votes — views were important in making a his highest percentage among Catholics. Democrats, 35 percent as voting decision. This firm found that In 2000, Gore received 49 percent Republican and 22 percent Catholic voters’ views on abortion and of the votes of all Catholics but only as Independents. stem-cell research mirror those of the 43 percent from churchgoing general public. Catholics, compared with Bush’s (Sources: Catholic Almanac Researchers also have found overall percentage of 47 percent and 2001 and Voter News Service Poll) significant differences in the voting 57 percent of churchgoers, according to

Religion and federal regulation of packinghouses tend to result in immigration raids and Politics at Creighton deportations. Creighton mirrors the split political He also said Creighton’s Jesuit identity personality of the American Catholic gives students global ties and outlooks community and is strongly marked by its on issues they would otherwise lack. Jesuit charism of trying to change the For example, Jon Cortina, S.J., a world for the good, said Andy Alexander, member of the Jesuit community of El S.J., vice president for University Salvador who was away from home the Ministry. Political/religious/social night of the massacre, spoke at Creighton activism and service at Creighton reflect last year. Cortina was the guest of his the vision of St. Ignatius that “all of us seminary classmate, Charles and Mary are called into the mindset of basing our Heider Endowed Jesuit Faculty Photo by Bob Ervin lives on finding God and seeing service Andy Alexander, S.J., said Creighton reflects Chairholder Don Doll, S.J. of our neighbors as our identity,” he said. the Jesuit tradition of service to others. Creighton has a Center for the Study He cited these examples: of Religion and Society. A senior • Students have had “immersion • Students have become involved in perspective course taught by Drs. Sue weekends” in North and South Omaha, the movement to pressure manufacturers Crawford of political science and Julia including visiting a packing plant. to stop producing athletic apparel and Fleming of theology focuses on faith and • President John Schlegel, S.J., is a logo items in Third World sweatshops. political action. Dr. Bette Novit Evans of strong advocate of racial justice and has • Hundreds of employees participate the Political Science Department is the hosted a conference for business leaders in the annual Holiday Spirit program, author of a book, Interpreting the Free on workplace diversity. assisting the needy. Exercise of Religion: The Constitution and • A busload of Creighton students • Students and employees built a American Pluralism. joined students from other Jesuit house for Habitat for Humanity — just Alexander said Creighton’s policies universities protesting at Fort Benning’s one example of Creighton service mirror its social justice values. For School of the Americas on the 10th endeavors far too numerous to list. example, the University has found that anniversary of the assassination of the Alexander said involvement in causes contracting some services to outside Jesuits in El Salvador. helps students understand the firms wouldn’t save much money if • A student pro-life group annually complexities of issues and even the workers received health insurance — puts up a display of crosses to unintended side effects of some efforts to something Creighton insists on as a commemorate victims of abortion. do good. For example, calls for state and justice issue. 28 Winter 2001 Catholics and Politics

The Associated Press. In many respects, said Shugrue, Catholic voters are not very different from all other voters, public perception to the contrary. “Lazy journalists” sometimes try to fit Catholics into stereotypical Sample Issues that “soundbites,” especially on issues like abortion, but this does not reflect reality. the Bishops Support “Every point on the political spectrum According to a July 18 Wall Street is represented by the Catholics I know,” Journal article, U.S. bishops’ stands on Shugrue said. issues range widely across the Most Catholic voters are no longer conventional political spectrum. Here “blue collar ethnics” and instead reflect are examples of the bishops’ the nation’s educational and economic viewpoints: mobility, he said. Shugrue and Alexander agreed that • Opposition to abortion. Catholic affluence and assimilation into • Support for use of faith-based the mainstream have affected both Photo by Bob Ervin institutions to deliver more Catholics’ voting patterns and their Creighton’s Richard Shugrue said Catholics represent every point on the political spectrum. social services. relationship with the Church on • Opposition to the death penalty. political issues. teachings “because both separated them • Rejection of mandatory-minimum Long gone is the era when most from the culture they were sentences and three-strikes-and- Catholic immigrants were Democrats mainstreaming into,” he said. you’re-out laws as “simplistic while Republicans sometimes “Too many Catholics bought into solutions” to crime. campaigned against Catholicism as a capitalism and they bought into the • Support for ending the economic foreign threat to American freedom. complexities of political life,” Alexander boycott of Cuba. Alexander said the Catholic said. “Too often this led to a decreased • Opposition to permanently immigrants had a sense of community loyalty to the Gospel, Church teaching, normalizing trade status with that contrasted with the American ideal the common good and the responsibility China until it improves its human of individual autonomy. This was of each for others.” rights record. partially because the Catholic religious Many American Catholics evaluating • Opposition to the 1996 welfare experience “has never been exclusively candidates who disagree with various reform act. about my salvation. It has always been a Church teachings “tend to demand their mediated experience of faith and a sense individual political rights without being “What ties all these views that (salvation) happens in community.” influenced by the teaching of the together?” the Journal asked. “Put Catholic loyalty to the universal Church,” he said. This has led to some simply, America’s bishops think it’s community of the Church also of the clashes between Church officials their responsibility to argue for distinguished them from other and Catholic political officials. society’s weakest and most Americans, he said. Many Catholics, Alexander said, vulnerable, and that includes the As they moved up the educational seem to agree with Church premises on unborn, the poor, the elderly, and economic ladders and to suburbs, abortion and social justice but want to immigrants and those who can’t Catholics tended to become more like maintain their right to disagree with afford fancy lawyers. That kind of other Americans, Alexander said. Their Church conclusions about what should social conscience is bound to make relationships with their parishes often be done. almost everybody, including became less intense. Pope Paul VI’s Shugrue said that Catholic voters practicing Catholics, squirm from time encyclical on birth control, Humanae share another trait of voters as a whole to time. That’s what makes the Vitae, further weakened some Catholics’ — a growing percentage are registered bishops’ views powerful. It’s also institutional loyalty. Independents. what makes them hard to be used in “The educated Catholic population of Alexander said that highly committed the political arena.” the U.S. heard something from Rome Catholics today often “find themselves that many did not accept,” he said. “This attempting to do what they feel called to led to a deeper Americanization and an do by Vatican II, forming their investment in a culture that is about consciences.” choice and individual freedom.” Many American Catholics About the author: Dr. Wirth is chair of simultaneously rejected both the Creighton’s Department of Journalism and Church’s sexual and social justice Mass Communication. 29 Winter 2001 SUBJECT: PERFORMANCE. Your continuing substandard teaching and scholarly performance is a disgrace to this institution. You will be terminated at the end of the present semester. There were scrawled initials. My California hands were shaking, rattling the paper. I turned in shock to John. He was calmly reading the rest of his mail. Without looking up he said, “Leo Kennedy.” Street Sketches Kennedy and Sheehan, colleagues and By Allen B. Schlesinger, Ph.D. friends for a lifetime, exchanged such Editor’s note: It’s been cut off, paved messages to assure one another of their over and trampled on. But California continued combative affection. Street (now California Plaza or “The Skinner Mall”), once a bustling The building that refused to fall thoroughfare, remains at the heart of California Street witnessed one of its the Creighton campus. Come along most bizarre events in 1959. Following with Creighton Professor Emeritus that year’s baccalaureate ceremony in St. Allen Schlesinger as he takes a trip John’s Church, the entire graduating down memory lane. class, faculty and guests were paraded out onto California Street. We were to When I stand on California watch as the adjacent Creighton Plaza, it is not the sights of Auditorium — a squat, red-brick building yesterday that first return to me but — was sacrificed for construction of the its sounds. Reinert Alumni Memorial Library. A I hear streetcars, jammed with crane was drawn up in front of the passengers, rattling atop steel rails. Auditorium, its diesel engine idling I hear the constant background menacingly. The wrecking ball hung rumble of hundreds of automobiles from its cable, slowly rotating in the soft and trucks traveling across the evening light. Fr. Reinert climbed into bricks. I hear the shrieks of children Photo by Jay Langhurst, BSBA ’01 the crane’s cabin, where he donned a running to St. John’s School. I hear the to class. It’s a tumultuous environment, hard hat and stood next to the crane buzz of activity at corner drug stores, in which lectures are sometimes operator. The diesel roared and black taverns and barbershops. momentarily suspended as the shriek of smoke belched. As I stand on “The Mall,” streetcar wheels overwhelms all but the The ball gained amplitude and remembering when I first came to most bull-throated professors. Around momentum as the operator increased its Creighton in 1952, there are no high-rise this street a campus blossomed and arc until finally, with a satisfying thud, it residence halls, no sprawling Kiewit many fond, and amusing, memories struck the building. The ball bounced off Center, no Skutt Student Center, no Criss were formed. without a single brick being dislodged. buildings, no Rigge Science building, no There was a moment of silence and then Reinert Alumni Library, no Eppley Mail call laughter arose from the assembled building. There is the Administration Faculty mail was delivered to a small students. The crane swung again, a Building, St. John’s Church, then a squat, room on the first floor of the much longer arc, with the ball racing terribly ugly Auditorium. Beyond that is Administration Building. When I last toward the building and a massive thud a series of homes and duplexes and looked, that room had been converted that shook the ground. Not a brick rearing up out of their backyards, the into a bathroom. But in 1952, everyone stirred. A cheer arose from the students, Law School (now the Hitchcock assembled daily in that tiny room to who were now rooting for the old Building). Then the School of Dentistry retrieve their mail. I remember one building. In the cab, Fr. Reinert was (now the Humanities Building). Beyond particular visit with biology colleague hanging on for dear life as the crane that, the neighborhoods stretch west. John Sheehan. John riffled through his pivoted viciously to give the ball With no Rigge and Eppley, I see again mail, and after reading one letter, he maximum energy. A third time the ball the stadium, reminding me that football handed it to me. It was an InterOffice swung, resulting in only a small shower was once a passion on the Hilltop. Memo, of dust. Wilder cheering from the University students, grade school TO: John Sheehan students. The crane cab swung back in a children and high school students all FROM: Creighton President huge arc and then raced forward as the dodge streetcars and automobiles to get Carl Reinert, S.J. operator delivered his next shot with a

30 Winter 2001 California Street Sketches

ferocity that revealed that the battle had I met Carl Reinert in 1952 under Reminiscing about California Street, I turned nasty. The ball dislodged 10 or somewhat strained conditions. I taught have a reverie in which I imagine myself 12 bricks that tumbled to the ground. General Biology at 8 a.m. in the basement standing on today’s Mall on a beautiful Fr. Reinert signaled that the building of the Old Dental Building. I had an spring day. Throngs of students pass by had been defeated and the diesel quieted assigned parking place immediately deeply involved with one another and in to a rumble. Not so the students. They adjacent to the building, but on this day the wonderful experience of being at cheered mightily. The next day it was someone had taken it. This left me driving college. One student, noticing an elderly learned that the Auditorium walls were wildly around the neighborhood trying to man at the side of the Mall leaves her solid brick, at least four courses thick. find a spot. No luck. It was 7:58. In Room group and asks thoughtfully, “Can I be D-7, 120 students were assembling. I of help, sir?” “Thank you for your Dining was the pits pulled my car onto the sidewalk in front kindness,” I reply, “I’m waiting for the The term Faculty Dining Room has of the building and raced to class. When I streetcar.” been applied to several locations. The returned, I found a ticket for illegally worst was in the Old Beanery, located in blocking the sidewalk. I was in a state of the basement of a residence hall. I absolute outrage. I went to the top. A Road Well-Traveled: remember very little of this place (having I walked into Fr. Reinert’s office; he was California Street rarely eaten there) other than it had the dictating a letter to his secretary. The two • California Street was part of the most inappropriate wallpaper ever of them looked up to see this madman original map of Omaha in 1854. installed in an eating establishment. The waving his arms and shouting about an • It was so-named because it was wallpaper was a garish representation of outrageous fine. Fr. Reinert gently seen as a westward route to New York City skyscrapers as seen from separated me from the ticket, assured me California. above at an improbable angle. The result that he would take care of it and out I • The first streetcars began was a tipped view that triggered instant went. I assume he asked his secretary to operating on California Street vertigo. One glance and you gripped the make sure that I never entered the office in 1889. table to keep from reeling uncontrollably. again. If he did, it didn’t work. I entered • California Street’s bricks were That wallpaper, added to the abominable his office constantly, not for ticket-fixing covered with asphalt sometime food, made eating at nearby Walt Beal’s but for a much more expensive purpose. I after the streetcars stopped Cafe, in comparison, an experience in hounded the man ceaselessly for the running in 1955. haute cuisine. construction of a science building. • Construction of the I-480-North One Friday during Lent, Sheehan and I Freeway interchange between visited Beal’s. We sat down at the Knobs and hinges 1968 and 1971 cut off California counter; Walt Beal glowered at us. We and valves, oh my! Street between 27th and 30th each ordered a grilled cheese sandwich I discovered that dreaming about a streets. and coffee. We watched Walt flip the science building is a lot more fun than • California Street’s evolution to a sandwiches on his oil-soaked grill. He building one. I complained to Fr. Reinert campus mall began in 1978 with wrapped the sandwiches, put them on that the Leo Daly architects designing construction of the piazza and the counter, and drew two mugs of Rigge were, in my view, not consulting fountain in front of St. John’s coffee. He stared at the sandwiches for a the science faculty sufficiently as to Church. moment, a coffee mug in each hand. laboratory details. He said he’d call Leo. A • Deglman Circle (the traffic circle Putting down the mugs, he tucked one few days later, the project’s lead architect at 24th and California) was sandwich under each arm, picked up a asked me to meet with him. Explaining created in 1980, along with the mug in each hand and came toward us. that his boss had chastised him, he led me walkway and benches in front Raising one arm and then the other, he into a room filled with blueprints and of the Administration Building. dropped the sandwiches in front of us. catalogs. He explained that my job was to • Soon thereafter, the asphalt was Sheehan slowly pushed the sandwich identify the thousands and thousands of removed from the section away and, in a weak voice, said, “I guess hardware items called for on the extending from the fountain to I’ll just have a cookie.” blueprints and select, from the catalogs, Gallagher Hall, revealing again doorknobs, hinges, drawer pulls, faucets, California Street’s shiny rails That’s the ticket toilet valves, wall switches, electrical and ruddy bricks. The transformation of California Street outlets, well, you get the idea. Accepting • In 1982, the campus mall was into today’s Mall began with the that I had been outfoxed, I told the named in honor of Creighton construction of the high-rise dormitories architect that I had absolute confidence in benefactors Lloyd E. and — the early manifestations of the “brick his selection of these items and withdrew. Kathryn G. Skinner. Lloyd, a and mortar” Reinert years. Fr. Reinert About a month later, while working in my 1936 Creighton graduate, served served as Creighton’s president from backyard, I looked over my back hedge to as president of the family- 1950-1962 and deserves a great deal of find that my new neighbor was the very owned Skinner Macaroni Co. credit for the transformation of the campus. same architect.

31 Winter 2001 Barometers to Your Health: What Your Teeth, Skin, Eyes Have to Say By Mary Kay Shanley, BA’65

ouAnn Evans of Council Bluffs, a different diagnosis, a systemic cause, While there is no known cure for LIowa, had her 15 minutes of fame by asking questions.” Sjogren’s syndrome, over-the-counter last April, but it undoubtedly was not Furthermore, Evans’ condition and prescription medications can treat packaged the way she would have reminded Nilsson of a case described to symptoms. Early diagnosis and wished. You see, she made the news him when he was a resident at an Air treatment are important for because of her teeth. Force facility years ago. So Nilsson the preventing complications, according to After losing three teeth in four weeks, dentist became Nilsson the sleuth and, the New York-based Sjogren’s she called the Creighton University luckily for Evans, he was able to Syndrome Foundation. School of Dentistry clinic. When Scott identify the culprit. Often, the dentist’s diagnosis comes DiLorenzo, D.D.S., assistant professor of While a carbon monoxide diagnosis is as a surprise to the patient. “Certainly, prosthodontics, saw an entire row of not all in a day’s work for Nilsson, that that happens with diabetes,” Nilsson missing or blackened teeth, he called in sleuthing part is. That’s because teeth — said. “There’s a reciprocal cause-effect Dennis Nilsson, D.D.S., associate along with eyes and skin — serve as relationship between diabetes and professor of prosthodontics. windows to the body. More often than periodontal disease, with one leading to (Prosthodontics deals with the we realize, health professionals can look the other or making the other worse. restoration of missing teeth and other at our teeth, eyes and skin, and tell “Sometimes, a patient comes to us complex treatments.) Nilsson asked much about our body’s overall, or because of periodontal disease,” he Evans if she lived in an old house and if systemic, health. continued. “If the patient’s hygiene is she had been having headaches. After reasonably good, we ask questions and she said yes to both questions, he About Our Teeth may move on to find that the patient’s suggested she have the carbon- “Unusual conditions in and around condition is because of diabetes.” monoxide level in the house checked. the mouth tell a lot about what’s going For the dentist, this connection is not Indeed, her house had dangerous on elsewhere in the body,” Nilsson said. surprising. Said Nilsson, “Certain levels of carbon monoxide when the “For example, when the tongue’s biochemical events connect diabetes furnace was on. And Evans’ chronic surface lacks normal papillae or taste with periodontal disease. That’s exposure to that poisoning caused buds, that condition can indicate something we have intuitively headaches, abscessed teeth and multiple nutritional problems or anemia. known for some time, but now, it’s root canal fillings. Still, the levels were Xerostomia (zero-stoh-me-a) or dry scientific fact.” not high enough to cause death. mouth can lead to decay around the Still, he adds, the presence of diabetes Certainly, this is an interesting story, gum line and may be caused by comes as a surprise to the patients, who but what may be most curious — for the medications prescribed for other are referred to their physician for tests to layperson at least — was Nilsson’s on- problems. Sjogren’s (show-grin) confirm the diagnosis. In fact, if any target identification of the problem. syndrome is a condition in which a systemic disease is suspected, a referral “This patient had no history of trauma patient’s own immune system targets is made. and/or decay,” he said, by way of mucous-producing glands, causing dry Another diagnosis that dentists can explanation, “so we began searching for mouth, eyes and vagina.” make may surprise patients: Bad teeth

32 Winter 2001 Barometers to Your Health Photo by Bob Ervin

The skin lesion above is an indication of lymphoma. At right, blood vessels in the eye can provide Said Nilsson, “Oral disease and ophthalmologists with clues to other problems, like high blood pressure. systemic disease are not necessarily distinct entities. Dentists are trained to Christopher Huerter, M.D., head of the School of recognize both, and as experts on the Medicine’s division of dermatology ... “a skin former, are critical members of the exam can provide clues as to a more serious, underlying disorder.” health care team.” The Skin can be caused by methamphetamine As with dentists, dermatologists use. Said Nilsson, “Unfortunately, we “Because people often see diagnose medical conditions that are see a lot of abusers with horrible dental their dentist on a more seemingly unrelated to visual problems problems — patients in their late teens such as a skin rash. “An experienced or early 20s with every tooth destroyed. regular basis than they see dermatologist can see from a skin You would not normally expect that to their doctor, the dentist may condition that something is going on internally,” said Christopher Huerter, happen today with fluoride and good be the first one to identify a water supplies, and I don’t think the M.D., head of the division of patient makes the correlation between problem. In fact, we dermatology at Creighton’s School of use of meth and tooth problems.” encourage dentists to take Medicine. “We might look at the skin Methamphetamine use destroys tooth condition and, without doing enamel. Meth users also may crave patients’ blood pressure anything else, say, ‘Let’s check out this sweets, lack proper hygiene and fail to because it provides a patient’s kidney function,’ or, ‘Let’s get a eat nutritiously — all of which can lead chest X-ray to rule out certain to poor dental health. “We have also baseline for the whole body. underlying causes.’ noticed (among meth users) a lowered Frequently, people are “In other words,” he continued, “a skin exam can provide clues as to a pain threshold with over-reaction to unaware that they have minimal stimuli that most others more serious, underlying disorder — a tolerate without objection,” high blood pressure.” systemic disease. You will have to go somewhere else to cure or solve the Nilsson said. Creighton dentist Dennis Nilsson, D.D.S. Some of these patients state that they skin problem.” are recovering drug users and are until their teeth begin being overly One of the most common problems receiving treatment; some simply deny sensitive to cold beverages. We usually seen by dermatologists is pruritus or using illegal drugs. If a Creighton get them into a psychological and itching. The itching can be caused by dentist suspects a patient is abusing nutritional support group.” drugs, the dentist will provide that Dentists can connect dental problems patient with a list of local drug with rheumatoid arthritis, autoimmune treatment organizations. diseases and even the potential for Dentists also pick up on eating stroke. Tarnjit (Bob) Saini, D.D.S., and disorders such as bulimia and anorexia Thomas Meng, D.D.S., of Creighton’s nervosa because vomiting and School of Dentistry discovered that a regurgitation soften and destroy the patient was at high risk for stroke after a enamel on the tongue side of the teeth. panoramic X-ray during a routine “Often,” said Nilsson, “the patients check-up showed severely blocked don’t know they have a problem with carotid arteries. The patient their teeth or with an eating disorder subsequently underwent an emergency Panoramic dental X-rays, like the one above, can procedure to clear the arteries. detect blocked carotid arteries. The blockage is circled in red. 33 Winter 2001 Barometers to Your Health

skin disorders such as psoriasis, xerosis, atopic eczema, a drug reaction, scabies “If changes in the skin persist, or fungal infections. But the itching can you should at a minimum also signal a serious — and sometimes fatal — condition such as iron deficiency talk to a health care provider. anemia, viral hepatitis, multiple A starting point may be the sclerosis, Hodgkin’s disease, lymphoma, family physician or, for AIDS or kidney failure. “I have patients come in with scratch women, their gynecologist. marks all over themselves,” Huerter That doctor may refer you to said. “They’ll say, ‘I’m crawling out of my skin I am itching so much.’ In a dermatologist. Just don’t many of these patients — particularly stick your head in the sand. the elderly — a diminished kidney Find out what’s going on function may be the cause. Then, a Photo by Bob Ervin simple blood test helps sort things out. because so much of this is Sade Kosoko, M.D., associate professor of ophthalmology ... “We know that high blood If necessary, a referral is made to a easy to diagnose and treat.” pressure has an effect on the eye.” kidney specialist.” Other times, diagnosis isn’t that easy, Creighton dermatologist Christopher Huerter, M.D. and that’s when the dermatologist turns sleuth. “I’ll see a young person who has mean hair is coming out in clumps a in her family, I knew right away that’s always been healthy, but he comes in full three months after the event. what she had.” itching like crazy. He’ll say, ‘I’m itching “So you have this woman in your Her lesions leave permanent marks to the bones. I’ve got bruises on my skin office asking, ‘What’s going on?’ as she on the skin, which, Huerter admitted, from scratching so hard. And I haven’t gives you a handful of hair,” Huerter was disappointing for his young slept for a week,’” Huerter said. “So you said. “I ask what happened in her life patient. “Still,” he said, “that ask questions to find out what else is three months ago and she says, ‘I was in disappointment was offset by early going on. Eventually, you learn that the the hospital with pneumonia,’ or, ‘I was detection of diabetes, and early patient is losing weight and waking up in a car wreck,’ or, ‘My mother died.’ In detection may make a difference in her in the middle of the night soaking wet. most instances, you can back up and tell life expectancy and quality of life.” This can be a manifestation of her what the cause is and that she will The underlying causes of some skin Hodgkin’s lymphoma, so you get a slowly get better.” problems can run the gamut. Consider chest X-ray and examine the lymph Like the dentist, the dermatologist acanthosis nigricans (ak-an-thosis nigri- nodes. If there is cancer present, you also can identify signs of diabetes. kanz), which causes the skin under the send the patient to the oncologist.” Huerter tells of a young girl who came arms and/or around the neck to take on That scenario has happened a handful to him with a skin lesion called a velvety texture and brown of times in Huerter’s career, and he calls necrobiosis lipoidica diabeticorum. “Most discoloration. This is associated with it “dramatic.” physicians would look at it and say, ‘I conditions ranging from stomach cancer Sleuthing can lead the dermatologist don’t know what that is. You better see to obesity. “This disease is not as in all sorts of directions. Consider a dermatologist,’” Huerter says. “When common as many we see,” said Huerter, Huerter’s story about telogen effluvium, I learned there was a history of diabetes “so you have to take a patient history. In a condition that results in unusual hair the end, the cause may be as simple as loss. (Dermatologists treat skin, hair and obesity in children. Then, your message nail problems.) is, ‘Mom, Junior needs to lose about 80 A bit of background here: Basically, pounds, because the underlying cause 90 percent of the hair on a person’s of his rash is obesity, and the rash won’t head is in a growing phase and go away until we get rid of the cause.’” 10 percent is falling out. But when some people experience stress — The Eyes perhaps from surgery, a broken bone, “Every time I look at a patient’s eyes, childbirth, a death, divorce or severe I can tell what that person has done in illness — the body reacts. One reaction the past,” said Creighton ophthalmologist may be that the percent of hair falling Sade Kosoko, M.D. out goes up to 20 or 30 percent. This For some patients, that may be a loss of hair begins about 90 days after scary thought. Indeed, Kosoko — the stressful event occurred and can The above skin lesion, known as necrobiosis Creighton’s associate vice president for persist for several months. That can lipoidica diabeticorum, is a sign of diabetes. Multicultural and Community Affairs and

34 Winter 2001 Barometers to Your Health

associate professor of ophthalmology — absorbed by the blood vessels and is can tell if someone has had syphilis or carried to different parts of the body, gonorrhea or has done drugs simply by including the eye, where changes occur. looking into their eyes. But those eyes “We also can tell when a patient’s can also alert an ophthalmologist to the medicine is causing negative side possibility of such systemic diseases as effects, or notice when a physician may heart trouble, diabetes, anemia, have prescribed certain medication osteoporosis, cancer or hypertension. without knowing about that patient’s Those indicators come from any additional medications.” number of sources — the blood vessels Other times, the ophthalmologist’s around the retina, the cornea or even questions may lead to the discovery of a discharge within the eye. systemic health problem such as “Also,” Kosoko added, “the eye is diabetes. “We see patients who may connected to the brain via the optic have had symptoms of diabetes, for nerve, so in a way, ophthalmologists are example, but they weren’t paying brain surgeons because the eye is an attention to those symptoms,” Kosoko ‘out-pouching’ of the brain.” said. “So a diagnosis of diabetes is Perhaps the most common systemic surprising to them.” disease seen is hypertension or high It’s different when patients are blood pressure, which is present in referred for ophthalmology counseling approximately 50 million Americans by a primary care physician. “Then, you Photo by Bob Ervin over age 18. Of those, about 70 percent might be dealing with a patient who has Dennis Nilsson, D.D.S., associate professor of have mild hypertension, but even they had diabetes for a long time,” Kosoko prosthodontics ... “Unusual conditions in and around the mouth tell a lot about what’s going warrant therapy. “We know that high said. “Now this person comes in with on elsewhere in the body.” blood pressure has an effect on the eye,” blurry vision and we must determine if Kosoko said. “We can see it in the blood vessels around the retina. I’ll ask the the vision is beginning to be affected by patient, ‘Do you have history of high the diabetes or if it is caused by blood pressure?’ If the patient says no, I “My advice is to make sure something else.” reply, ‘Well, someone needs to check you are looking out of both Kosoko constantly advises patients your blood pressure because I see signs eyes every day. We assume with chronic medical problems such as of hypertension in the eye.’” high blood pressure and diabetes to While it is true that the eyes tell an we are doing that, and we make sure they get eye exams at least ophthalmologist much about what is assume that both eyes are once a year. The same is true for those going on inside the body, diagnosis isn’t who are taking steroids because of a as simple as one-two-three. Like Nilsson functioning well. But we chronic condition. “They should have and Huerter, Kosoko must become a need to be sure that each eye their eyes checked every three to six sleuth. This is especially true for those months because steroids can induce patients who come to the clinic for a is contributing its share. So glaucoma and cataracts as well as other regular eye exam. every day, you should close problems in the body,” Kosoko said. “If we think we see something that one eye and then the other might indicate a medical problem, we About the author: Shanley is an author depend upon the process of asking to make sure you are seeing and free-lance writer living in West questions,” Kosoko said. “We may find well out of both eyes.” Des Moines, Iowa. that the patient has been taking medications such as birth control pills or Creighton ophthalmologist Sade Kosoko, M.D. arthritis medication over a long period of time. In such cases, the medication is

35 Winter 2001 Whatever Happened to Managed By Eugene Rich, M.D. Tenet Professor and Chair of the Department of Medicine Care

Editor’s note: This is the last in a yearlong powerless, the victims of exploitation national public health insurance. series on health care in the United States. by HMOs.” Employees, stunned by the rising cost So what happened to managed care? of their own insurance premiums, hen managed care burst onto seemed willing to accept less choice Wthe United States health care Managed care is born over their physicians or hospitals in scene in the early 1990s, it was heralded In the 1960s, when overall U.S. order to save money. Entrepreneurs as a way to control our nation’s medical expenditures were relatively saw new opportunities for profit by spiraling health care costs while low (less than 7 percent of the Gross developing new types of health providing consumers more choice Domestic Product, or GDP), lawmakers insurance and new ways of managing and more efficient care through ?began to tackle the problem of the delivery of care. All of these factors increased competition. providing affordable medical care for contributed to an emerging market for Indeed, in the early to mid-’90s, as the elderly, the disabled and managed care. Health Maintenance Organizations, or impoverished children. Through this HMOs, sprung up across America, effort, the federally sponsored health Managed care’s alphabet soup: health insurance premiums plummeted insurance programs, Medicare and HMOs, IPAs, PPOs and the nation’s escalating health care Medicaid, were born. The first, and perhaps best known, costs were seemingly halted. Over the next 20 years, Medicare and managed care organization was the But by the end of the decade, the Medicaid eased the financial barriers HMO. The term HMO was coined promise of managed care had given for the elderly and poor. But the United during the Nixon administration with way to a chorus of consumer and States’ health care bill grew rapidly, the passage of federal legislation physician complaints regarding limits outpacing inflation. By 1990, health enabling the establishment of prepaid and restrictions on care and patient care expenditures accounted for more systems of medical care. Policymakers choice. When the Senate passed its than 12 percent of our GDP. had in mind the example of prepaid version of a Patients’ Bill of Rights this In response, businesses explored medical group practices that had past summer, Sen. Edward Kennedy ways of restructuring their employee existed in a few U.S. cities since World called the legislation, “a giant step health insurance programs and War II. These groups of physicians were forward in giving power to the lawmakers sought reforms of state and reimbursed through fixed periodic

36 Winter 2001 Whatever Happened to Managed Care? payments made on behalf of each officials, however, had difficulty physician services, expensive testing or person or family enrolled; these replicating these early HMOs on a large hospitalizations. Physicians had to physician organizations were scale. Therefore, regulations allowed obtain approval from insurance committed to providing all necessary HMO-type health insurance to be companies before performing expensive health care services to their prepaid established through arrangements that tests and procedures. Some health plans patients. Thus these prepaid group were very different from the original monitored and had to approve hospital practices were reimbursed on the basis prepaid medical group practices. One admissions and continued hospital of per member (or capitation) strategy was Independent Practice stays. Others required second opinions payments. Obviously, health plan Associations (IPAs), which were prior to elective surgery. members had to use the prepaid group insurance networks of traditional From the late ‘80s to mid-’90s, local of physicians in order for care to be medical groups that received HMO- health insurance markets consolidated, covered. type capitation incentives to care for and only a few dominant HMOs These early prepaid medical groups IPA members. Preferred Provider survived. Physician-Hospital were organized in a fundamentally Organizations (PPOs) were another. Organizations (PHOs) developed, different way than most other physician PPOs attempted to save costs for teaming physician practices with practices at the time. Typical physician employers (and plan members) by hospitals. Alliances formed between practices were supported by negotiating preferred rates from medical groups and health insurance reimbursements directly from patients physicians and hospitals. Both PPOs companies. Health care financing (or from their indemnity insurance and IPAs required physicians and shifted from traditional fee-for-service coverage) under the age-old tradition hospitals to participate in insurance to new HMO-style capitation of fee-for-service. Early research company-run utilization management payments. By the early 1990s, many suggested, however, that prepaid programs, which were developed to U.S. health care experts confidently medical groups could provide high- hold down costs. predicted that the health care market quality care at reduced cost. It appeared These programs included many would mature to a situation called the savings resulted from additional of the burdensome managed care managed competition. Each city, it was investments in preventive care and in features so disliked by physicians and believed, would have a few dominant efforts to avert serious illnesses and consumers. Patients had to get approval HMOs, which would contract with costly hospitalizations — hence the from a designated physician (or medical groups and hospitals for name health maintenance organization. gatekeeper) in order to have insurance delivery of care. Each system would Employers, insurers and government coverage for ER visits, specialized price its services based on an annual

Health Insurance Premium Increases Compared With Other Indicators, 1988-2001

PERCENT 12

HEALTH INSURANCE PREMIUMS 10

8

6 OVERALL INFLATION WORKERS' EARNINGS

4

2

0 1988 1993 1995 1996 1997 1998 1999 2000 2001

Sources: Kaiser/Health research and Educational Trust (HRET) Survey of Employer-Sponsored Health Benefits, 1999, 2000, 2001; KPMG Survey of Employer-Sponsored Health Benefits, 1988, 1993, 1995, 1996, 1997, and 1998-2001; and Bureau of Labor Statistics, 2001. Notes: Estimate is statistically different from the previous year for 1997-1998, 1998-1999, 1999-2000, and 2000-2001 (p < .05). No tests were done on years prior to 1997 or for workers’ earnings or overall inflation. Sample included firms with 200 or more workers only.

37 Winter 2001 Whatever Happened to Managed Care?

cost per member, and employers and consumers joined in pressing for a insurance companies are providing health plan members would make national Patients’ Bill of Rights to services like case management and care choices based on cost and overall protect citizens from what were coordination, which have been shown quality of care. perceived as dangerously powerful to improve the cost and quality of managed care corporations. The health care in a number of settings. Managed care backlash legislation has been delayed by the war Case management involves the By 1998, however, the predicted on terrorism. identification of patients at risk for evolution of health care markets to In the absence of convincing costly illnesses (such as diabetes and managed competition was slowing, and information on the quality of care, heart failure) or complicated disabilities a very different environment was consumers wanted greater choice of (such as trauma). These programs use a taking hold. providers and greater control over the clinically skilled case management team In the mid-’90s, a growing U.S. care process. to assist the patient and the patient’s economy and low unemployment regular physician in accessing special forced employers to offer attractive Managed care changes tracks services, adhering to complicated health care benefits to recruit and retain As a result, the late 1990s saw a medication regimens and monitoring workers. That was coupled with several rapid increase in open access types of the status of often-dynamic illnesses. years of slow health insurance managed care organizations, which Some managed care plans have premium growth, reducing employer allow patients greater choice of developed robust patient information demand for the strictest forms of providers and greater ability to obtain systems, which include 24-hour managed care. Health plan and hospital care without prior authorization. New telephone advice lines and regularly entrepreneurs found that creating the variations of PPOs and HMOs (called scheduled outreach telephone calls. organizational infrastructure to help Point of Service plans) have emerged, Plans are experimenting with e-mail, physicians succeed in capitated medical wherein patients can access a wide telephonic monitoring devices and care was much more difficult than network of hospitals and physicians, sophisticated uses of the Internet to expected. The result was severe albeit at some increased cost. Insurance assist patients in coordinating care. financial hardship for many capitated companies have also been revamping provider networks and very public traditional cost-control efforts, What comes financial collapse for some large, highly repositioning themselves as “kinder after managed care? visible health care systems. and gentler” health plans. Gone are the New problems on the horizon, Even more distressing to patients, gatekeepers and the myriad approvals however, threaten to burden employers, however, were increasing concerns for referrals, medical tests and consumers and taxpayers with regarding the quality of health care procedures. Capitation is being phased additional health care costs. Open- delivered by these rapidly growing out in many communities, and access plans allow consumer choice by HMOs. A 1998 Kaiser-Harvard- physicians are often negotiating higher adding new out-of-pocket costs, such as Princeton survey showed that 60 fee-for-service payments. Finally, health co-pays and co-insurance. The recent percent of respondents from highly plans have been managed care health plans were discontinuing marginally Factors Contributing to the worried that their plan was more profitable product lines like concerned about saving money; only Medicare HMOs and 18.8% ($20.8 billion) Increase 30 percent trusted their health managed Medicaid. in Retail Prescription Drug insurance plan to “do the right thing for These strategies result in Spending, 1999-2000 their care.” A New York Times survey the less insurance company same year showed that 50 percent of regulation of physician respondents believed managed care practice, elimination of

harmed health care quality. HMO-type capitation INCREASE IN Many physicians were concerned payments and increased NUMBER OF that reimbursements based on choice for consumers. Not SHIFT TO HIGHER PRESCRIPTIONS COST DRUGS 36% capitation were just “paying doctors to surprisingly, the results 36% do less.” Not surprisingly, community- include higher insurance tracking surveys conducted by the premiums, fewer affordable Center for Studying Health System options for health insurance PRICE INCREASE Change (CSHSC) showed that and the disappearance of 22% members of tightly managed care many managed Medicare Source: The National Institute for Health Care Management Research organizations had significantly less and Medicaid plans. and Educational Foundation, May 2001 trust in their physicians. Physicians and Sophisticated health

38 Winter 2001 dramatic rise in employee choice and financial pharmaceutical costs is liability are greater while another new and important employer costs are factor. predictably contained. Many In the 1970s, the cost of members of a 1999 bipartisan prescription drugs grew much congressional committee more slowly than overall U.S. recommended similar health care expenditures. By changes for Medicare. the mid-1990s, that had These trends are worrisome reversed. Analysts expect to many public health medication costs to continue professionals. Research from to rise for at least the next the 1970s demonstrates decade, with prescription convincingly that, for lower drug costs projected to income workers, even modest increase 10 percent annually. co-payments for chronic Health plans have tried to disease management and control their expenses for preventive services reduce AP Photo/Rick Bowmer prescription drugs by changes While he was president, Bill Clinton makes remarks at a Patients’ Bill of patient receipt of life- in members’ benefits. Those Rights rally in Washington, D.C., in March 2000. Clinton urged lawmakers to prolonging care. This concern on Medicare are particularly pass a bill that would allow patients to sue their HMOs. is compounded by numerous affected. While Medicare anecdotes from physicians’ recipients can buy supplementary drug may be struggling with rising, and, if offices about patients seeking coverage, rising costs have so neglected, potentially unhealthy, out-of- expensive, highly advertised lifestyle complicated this form of insurance that pocket expenses for medical care. medications while skimping on their a large majority of recipients currently In addition, over the next 20 years, purchase of needed drugs to control have no prescription drug coverage. the Baby Boom generation will diabetes or hypertension. Nonetheless, Previous research has shown that such transition from employment-based these trends may be consistent with the underinsured individuals often defer health insurance to Medicare. Some consumerization of health care that has needed services, such as buying projections suggest by the year 2015 been predicted by health policy medications to control chronic diseases. Medicare payments for health care futurists. These pundits see the next Approximately 45 million Americans services could exceed revenue by generation of health care consumers as have no form of health insurance; when almost 30 percent. highly educated, sophisticated and combined with the estimated 40 million Faced with these cost pressures, computer literate, and anticipate a shift underinsured and the 38 million in employers may further reduce their of the health care system to meeting Medicare, almost half of Americans management of employee health these consumers’ demands for more benefits by shifting information and more personal choice. toward a “defined Other health policy experts, however, Annual Out-of-Pocket contribution” rather are deeply concerned that life- than the current prolonging health care services Health Care Expenditures “defined benefit” type represent a public good that should be of health insurance. In equally available to all citizens. Perhaps $350 the defined important health care decisions do not

$300 contribution model, lend themselves to marketplace models the employer simply of consumer choice as easily as do $250 specifies the dollar refrigerators or automobiles. These

$200 value of the health policy experts are concerned employee’s health that patients may be reluctantly $150 insurance benefit and forced into the role of empowered

$100 facilitates employees consumers as health care financing securing health shifts from an insurance model to an $50 insurance from an out-of-pocket model. If this analysis is array of options, each correct, then the current trend toward

BILLIONS $0 1990 1993 1997 1999 2001* 2007* offering different consumerization of health care will * projected

Source: Health Affairs, August 1999 benefits and costs to likely be followed by public demand the employee. Both for sweeping health system reform. For

39 Winter 2001 Development News

the present, though, neither U.S. voters Hospitals and physician offices have and patients to investigate how nor politicians appear ready to promote reorganized to provide enhanced information systems and the Internet can any of the various systems for universal services at lower cost. Chronic disease improve health outcomes. These are all access to health care. management programs and care important advances that might not have The U.S. managed care revolution has coordination systems have proven developed as quickly under the old provided many powerful and helpful important enhancements to traditional methods of fee-for-service and indemnity new ideas for how to manage our episodic medical care. Health insurance insurance. Americans have built the increasingly complex health care system. companies are working with physicians world’s most extensive, effective and

A Patient’s View: the physicians and hospitals based on Organization’s (MCO) membership customary fee schedules. card and calls the card’s emergency 800 Medical Care in Cost: The Smiths pay 20 percent; number. A nurse asks Mr. Smith some the Past, Present their health insurance pays 80 percent. questions, recommends a visit to the and Future emergency room and provides costs on Fictional patient John Smith, 50, is Managed care to the max (1990s) the different hospitals in town. After the experiencing chest pains. How would Mr. Smith arrives at the emergency ER visit, the MCO’s care coordinator Mr. Smith be treated — and what would room and, while he is being evaluated, e-mails Mr. Smith, inquiring about his he pay — under traditional fee-for-service, his wife learns that the hospital does health and his care. She tells Mr. Smith managed care and some future system not participate with their HMO and about the MCO’s website, which we’ll call empowered, connected health care that their insurance may not cover the includes the names of several internal consumer? Below are possible scenarios. cost of the visit. (In the coming weeks, medicine physicians, along with their the Smiths appeal the insurance average costs and patient satisfaction Traditional fee-for-service (1970s) decision and, ultimately, the ER visit is ratings. Mr. Smith selects Dr. Jones, Mr. Smith arrives at the emergency covered.) whom he has seen before. room, where he is found to have high Mr. Smith later visits his primary care After recommending anti- blood pressure but no evidence of a physician, Dr. Jones, who tries to hypertensive drug therapy and heart attack. Mr. Smith visits his schedule the radiographic studies at his radiographic testing, Dr. Jones directs internal medicine physician, Dr. Jones, usual hospital. But Mr. Smith’s HMO Mr. Smith to a patient education who prescribes a high blood pressure won’t cover tests there, so he makes computer, where he selects a medication and arranges for special arrangements at a radiology prescription that fits his budget from a radiographic tests, which are performed center across town. Meanwhile, Mr. list of recommended medications. Mr. at Dr. Jones’ hospital. Dr. Jones Smith learns that the medication Dr. Smith also reviews the cost and quality diagnoses the chest pains as Jones prescribed is not on his HMO’s of the radiographic centers and makes symptomatic of gallstones and refers preferred drug list. Dr. Jones calls the an appointment online — selecting a Mr. Smith to a general surgeon, Dr. pharmacist and eventually the more expensive center convenient to Adams, who performs the gallstone prescription is filled. his work. surgery at her usual hospital. Dr. Jones tries to refer Mr. Smith to Dr. Jones e-mails Mr. Smith with the Note that Mr. Smith went to the the general surgeon, Dr. Adams. But test results and recommends a visit to a emergency room and internal medicine Dr. Adams is not on the HMO’s list of general surgeon. Mr. Smith goes online physician of his choice. Dr. Jones participating physicians, so Dr. Jones and reviews the list of general surgeons recommended the surgeon, Dr. Adams. refers Mr. Smith to a physician he is affiliated with his MCO. Dr. Jones Dr. Jones and Dr. Adams obtain unfamiliar with but who is on the list, recommends Dr. Adams, a more radiographic studies and arrange Dr. Baker. Dr. Baker calls the HMO to expensive, but better rated, surgeon on surgery at their hospitals of choice. The approve the surgery, but the HMO asks the MCO’s list. Mr. Smith schedules the hospital bills (for charges for the for more information. A week later, the appointment online. emergency room, radiographic studies surgery is finally scheduled and The MCO’s care coordinator e-mails and surgery) and the bills for physician performed. Mr. Smith before the surgery — which fees (for Dr. Jones and Dr. Adams) are Cost: The Smiths pay 10 percent; Dr. Adams schedules at her usual sent to the patient’s home. Mr. Smith their HMO, 90 percent. hospital — and suggests checking the either pays these bills directly and MCO website for an online education requests reimbursement from his The empowered, connected program to prepare for the operation. indemnity-style health insurance health care consumer (2010) Cost: The Smiths pay 40 percent; company, or he submits the bills to the When Mr. Smith gets chest pains, he their MCO, 60 percent. insurance company, which reimburses consults his Managed Care

40 Winter 2001 Development News technically advanced system of medical directs Creighton’s Center for Practice “The Effects of Medical Group Practice care. Our continuing challenge is Improvement and Outcomes Research. and Physician Payment Methods on Costs determining the best way to pay for it. A widely published author of studies of of Care,” published in the August 2000 medical care, Rich was part of a team of issue of the journal Health Services About the author: Dr. Rich is professor scholars recently honored with the Research — describes the relationships and chair of the Department of Medicine “Article of the Year” award from the between the structure of physician at Creighton University and holder of the Academy for Health Services Research practices, payment methods to physicians Tenet Healthcare Endowed Chair. He also and Health Policy. The article — titled and costs of patient care.

Health Plan Enrollments For Covered Workers, Selected Years 1996-2001

POS 14% Conventional — Traditional indemnity insurance. Patients pay for health care services by submitting fee-for-service CONVENTIONAL 27% bills to their health insurance companies, which pay the physicians and hospitals from a fee schedule. 1996 HMO — Health Maintenance Organization. Patient groups in which providers are paid on a fixed, periodic per-member PPO 28% basis, regardless of the amount of actual services provided. Patients must use HMO physicians or have a referral to go outside the HMO in order for their medical care to be HMO 31% covered.

PPO — Preferred Provider Organization. A managed care CONVENTIONAL 14% organization that contracts with a network of doctors, POS 24% hospitals and other health care providers who deliver services for set fees, usually at a discount. Patients must choose their physicians from an approved list and pay extra for medical services received outside the PPO network. 1998 POS — Point-of-Service plan. Similar to an HMO, but HMO 27% enrollees have the option of obtaining care from non- participating providers. The HMO charges enrollees for out- of-plan physician services.

PPO 35%

CONVENTIONAL 8% CONVENTIONAL 7%

POS 22% POS 22%

HMOH 23%

HMO 29% 2000 2001

PPO 41% PPO 48%

Sources: Kaiser/Health research and Educational Trust (HRET) Survey of Employer-Sponsored Health Benefits, 2000, 2001; and KPMG Survey of Employer-Sponsored Health Benefits, 1996, 1998. Notes: POS is point-of-service plan. PPO is preferred provider organization. HMO is health maintenance organization.

41 Winter 2001 Development News

between colleagues. I want to perpetuate Annual Fund dollars are critical to the Creighton the mission beyond my individual daily University because they provide efforts to touch the lives of students, unrestricted support to purchase new University Faculty community members and employees,” classroom and library resources, recruit Pfannenstiel said. and retain notable faculty, and provide and Staff Go the Every year, Creighton employees like scholarship assistance to students with Pfannenstiel go above and beyond the call financial need. Extra Mile of the morning alarm clock, making an The caliber of any institution depends impact throughout the University. largely upon the dedication of its When Gerard Pfannenstiel, assistant Contributing tens of thousands of dollars employees. Creighton University’s job director of University Relations each year to the Annual Fund, they ensure force of 2,569 makes it the 23rd largest Information Systems, opens his monthly that Creighton continues to expand its private employer in Nebraska. Thanks to pay stub, he finds listed among various programs and services for Creighton the hard work of Jesuits, faculty, staff tax, health insurance and parking students and the greater community. members, administrators, full-timers, part- deductions a record of his contribution timers, faculty emeriti and retirees, back to his employer. A longtime supporter Creighton University continues to take its of the University, Pfannenstiel believes that mission to new levels of distinction. working at the University involves more Committed to providing a values-centered than showing up at work in the morning. It educational experience to more than 6,000 involves actively taking part in a dynamic students, Creighton employees make this Jesuit community. campus an exceptional place to learn, live “Creighton University has given me a and work. great opportunity to develop my talents,” This past year, Creighton’s faculty and Pfannenstiel said. “I would like to help staff showed their commitment to the ensure that other Creighton community students by contributing more than members have the same chance to benefit $100,000 to the Annual Fund, a record. from all that the University has to offer.” The money will ensure that all students are Through his generosity, Pfannenstiel and able to benefit from a Creighton University many others are making a difference in the education, regardless of their financial lives of thousands. situation. In addition, the University’s “Creighton provides a working

Photo by Dave Weaver reputation continues to reach new heights environment not easily found elsewhere. Gerard Pfannenstiel, assistant director of as Annual Fund dollars help to provide Supporting the institution is an easy University Relations Information Systems, greater opportunities and noteworthy decision for me since I have experienced supports the University through monthly advances in scholarship and research. payroll deduction. firsthand the extraordinary care extended New director of the Annual Fund, Carrie Albers, is thrilled with the tremendous level of gifts contributed New Endowment Honors Dr. Urban by the University’s faculty and staff. “The work of the Annual Fund is visible The School of Dentistry is pleased to announce the establishment of a new across campus. It provides support for a endowment to create the Dr. T.J. Urban Memorial Lecture Series. long list of resources that are vital to Theodore J. Urban, Ph.D. (1926-1990), joined Creighton in 1954 and was a faculty Creighton University. The success of the member, chair of oral biology and associate dean in the School of Dentistry. He Faculty/Staff Annual Fund shows that our received the University’s Distinguished Service Award in 1984, and was honored campus donors realize the necessity of the four times as Outstanding Teacher of the Year. Annual Fund and are willing to support it Urban was a tireless advocate and mentor to his students. He never failed to offer with their generous gifts,” Albers said. a guiding hand for the personal welfare and professional development of all his Through their tireless efforts and students. generous gifts, Creighton’s faculty and Through this newly established endowment, his memory will be permanently staff are truly making a difference at preserved through an annual lecture, part of the continuing education program at Creighton. Living as “men and women for the School. and with others, for the greater glory of The Dr. T.J. Urban Memorial Lecture Series was founded by the generous support God,” they are a testament to the power of one of Urban’s former students. Additional contributions are welcome. of a Jesuit community. The first lecture was held this fall on Nov. 9. John Kanca III, D.M.D., presented a lecture on “Adhesive Dentistry for the New Millennium.”

42 Winter 2001 Development News

of Nursing, said because of today’s nursing Zarlengo Gift shortage, scholarships are very important recruitment tools. Celebrates Family “Students who may not have the funds to consider going into nursing may do so Commitment to when scholarships are available,” Kitchens said. Catholic Education Roland and Peggy had six children, two Roland Zarlengo, MD’44, of Denver of whom, David, PharmD’76, and Suzanne, recalls his parents’ mantra, “It is better to BA’71, attended Creighton. leave your children with an education than He said his parents’ example encouraged with money.” His father, an Italian him to provide Catholic education for his immigrant who did not attend school children. beyond the fifth grade, and his mother, “It was just understood that religion was whose education stopped with high school, one of the main facets of family life,” he

fostered in him a profound respect for the Photo by Robert Skrydlak said. opportunity to attend college. Dr. Roland Zarlengo will fund a gift annuity in By setting up a charitable gift annuity, Large families and Catholic education memory of his late wife. Zarlengo will receive an income for life, were integral to Zarlengo’s childhood. realize income tax benefits and will direct With eight brothers and sisters of his own Denver-area Catholic high school or college the proceeds from his gifts to his areas of and an aunt and uncle who were also every year for a span of 50 years. interest. If you would like more raising nine kids just two blocks away, Zarlengo will celebrate his family’s information about gift annuities or family was at the core of their lives. As the lifelong commitment to Catholic education charitable giving to Creighton University, next generation of Zarlengos was born, by funding a gift annuity to Creighton in please contact Steve Scholer or Robert reunions between the families grew to a memory of his late wife, Cecilia “Peggy” Skrydlak in the Office of Estate and Trust crowd of 125. (Kaminski) Zarlengo, SCN’43. The gift Services at (402) 280-2885 or (800) 334-8794. A 1969 Rocky Mountain News profile of annuity will ultimately benefit the Schools “Creighton is where I met my wife,” the families reported that, starting in 1917, of Nursing and Medicine. Zarlengo said. “I figure, in that alone, they there was at least one Zarlengo in a Edeth Kitchens, Ph.D., dean of the School gave me more than I gave them.”

and well spent helping to shape the future (402) 280-2885 or (800) 334-8794 for the Year-end Charitable leaders of our country and the world. necessary forms and guidance on how to Gift Planning Guidelines Here are some general guidelines to transfer stock and mutual funds to the assist you with your year-end charitable University. By Steve Scholer, JD’79, gift planning: • If you are interested in converting Director of Estate & Trust Services • Gifts made by check and credit card cash, securities or land into a life income continue to be the most popular way to arrangement with Creighton, please call or The events of Sept. 11, 2001, defied support Creighton. Please note that only write for a personalized proposal. description, but so too has the response of gifts completed by Dec. 31 can be used to Charitable remainder trusts and gift the American people. As a community reduce your tax bill in April of 2002. Your annuities can be ideal for individuals who united, Americans freely gave of gift is generally considered complete upon want to explore ways to increase their themselves — a response that was not only the date of mailing. annual income, realize immediate income of much needed assistance but also of • Gifts of stocks and mutual funds to tax benefits and also make a deferred gift tremendous symbolic significance. Creighton have grown dramatically over to the University. In my role at Creighton, I am reminded the years. For gifts of appreciated stock In early February, the University will on a daily basis of the generosity and owned more than one year, you are entitled send you a summary receipt listing the goodness of people. Alumni, friends, to deduct the fair market value of the stock total amount of your support for the year parents, faculty and staff, corporations and without having to report the capital gains and if you received “any goods or services” foundations continually and freely give of you would have realized had you sold the in exchange for your gifts. Generally their time, talent and treasure to the investment. If stock you own has decreased speaking, the IRS requires you to have this University. Their gifts help to support in value, you should consider selling the receipt as proof of your tax deductible Creighton’s mission, which seeks to instill stock and giving the net proceeds as your contribution. in its graduates a deep desire to use their gift. Then, you may be able to claim a loss On behalf of the students, faculty and education and Creighton experiences in on the stock and also claim a charitable staff of Creighton University, thank you for service to others. Please be assured that contribution deduction from the same your continued and steadfast support. Your your generous gifts are deeply appreciated transaction. Please call our office at gifts are making a real difference.

43 Winter 2001 If you are as observant as Dulles and Kilmer, trees reveal A God’s power and wonder. Tree branches in the winter may Toast to appear as dead as broomsticks. But look at them again in spring The Last the and behold the miracle! The “sticks of wood” are pushing Word Trees delicate green leaves into the sunlight or, in some instances, are blossoming with juicy, fuzzy-chinned peaches, delicious apples, By John M. Scott, S.J. plump plums, golden oranges and appetizing apricots. The broomstick in your closet may speak of that day when it, too, was a magic wand in the hand of God and wore a handsome batch of leaves, clothed in snug- fitting bark, and whispered its secrets to the When the Rev. Avery Dulles, gentle zephyrs. S.J., was created a cardinal by In a delightful poem by the Rev. James J. Daly, Pope John Paul II at a consistory in titled Spring Magic, a winter chorus of barren Rome last February, some people trees intones, “You think we’re dead: trust not may have been surprised to learn your eyes — life quivers in our veins.” The poem that at one time Dulles had neither ends with the author returning to the woods in belief in God nor his own soul. the spring: Dulles, 82, a theology professor at Fordham University in New “... Oh, the surprise York, is widely regarded as the The wizard trees had sprung! dean of American Roman Catholic theologians. In 1946, “Their outstretched arms were laden now Dulles wrote a little book about With green new leaves of tender hue. his conversion, titled A Testimonial And whence they came, or why, or how, to Grace. Thanks to the kindness of I cannot tell, can you? the publisher (Sheed and Ward), I have permission to share with you “‘What magic, say, is it that weaves this fascinating story. This miracle?’” I asked each tree, In 1936, Dulles entered Harvard It only shook its million leaves University. One February And chuckled gleefully.” afternoon, he was in the Widener Library reading a chapter from St. Augustine’s City of God. Indeed, there is more magic in a tree branch than we can “On an impulse,” Dulles wrote, “I closed the book. I was shake a stick at. When the golden rays of the sun shake hands prompted to go out into the open air. It was a bleak rainy day, with the pigment (chlorophyll) in a leaf, magic is in the rather warm for this time of the year. The slush of melting snow making. The green chlorophyll takes energy from sunlight, formed a deep mud along the banks of the River Charles which the energy it needs to change water and carbon dioxide into I followed down toward Boston. I enjoyed the cool rain on my food. This process is known as photosynthesis or “building face and the melancholy of the scene. with sunlight.” “As I wandered aimlessly, something impelled me to look in a Every time you drink a glass of orange juice, you are bending spirit of contemplation at a young tree. In its frail branches were your elbow in a toast to the trees. And when you peel an young buds eagerly awaiting the spring which was at hand. orange, notice how cleverly the contents are divided into “While my eyes rested on them, the thought came to me sections that you can pry apart and eat one by one. How did the suddenly with all the strength and novelty of a revelation, that tree ever figure out such a homework assignment in long these little buds followed a rule, a law of which I as yet division and packaging? knew nothing. The answer, of course, is that every phase of “Operation “How could it be,” Dulles asked himself, “that this delicate Orange” shows God’s guiding hand behind each tree. Every tree sprang up, grew erect, and knew when to bring forth leaves time you bite into an orange (or apple or pear) it is God, and blossoms?” Himself, who is feeding you. Not directly, of course, but By a process of reasoning, Dulles realized the truth expressed through the cooperation of our friends, the trees. No wonder by the poet Joyce Kilmer, “Only God can make a tree.” Kilmer wrote: “I think that I shall never see, a poem lovely as a Through the thoughtful contemplation of a tree, Dulles came tree. Poems are made by fools like me, but only God can make to admit that there is a God who rules the world. He became a a tree.” Catholic and then a Jesuit priest and, most recently, the first U.S. theologian and first American Jesuit to be named to the College About the author: Fr. Scott is a former high school physics teacher of Cardinals. living in the Jesuit community at Creighton and the author of numerous books.

55 Winter 2001 Christmas Creightonat Photo by Jay Langhurst, BSBA’01 Come celebrate the 16th annual Christmas at Creighton on Thursday, Nov. 29. The celebration begins at 5 p.m. with a tree-lighting ceremony near St. John’s Church. A special dinner and Christmas concert will follow in the Skutt Student Center. The concert includes performances by Creighton’s symphony orchestra and jazz ensemble, as well as an audience sing-along. For ticket information, call the Lied ticket office at (402) 280-1448.