264: Special Treatment

Ira Glass

Everyone in the family agrees. Edie's the youngest, and so she gets more attention. She gets more stuff. Ayla, her 15-year-old sister, puts it this way.

Ira Glass

Even Edie sees it this way. One of our producers, Jane Feltes, is their cousin, and Jane got this out of the 10-year-old under tough, tough questioning.

Ira Glass

This is Kathy, their mom.

Ira Glass

You know, you don't really hear a positive word about favoritism very often. Most of us think that parents are supposed to treat all their kids exactly the same. But the fact is, sometimes it just doesn't matter.

Ira Glass

That's Amanda Kowal. She co-authored a study of 300 kids in 135 families, where they asked everyone in the families questions like, is one child favored over the other? Who gets praised more? Who are the parents stricter with? And OK, let's just start with the big news first, America. We are not giving equal treatment to our kids.

Ira Glass

But here's the other news flash. Most kids didn't care. 70%-- 70, seven, zero, 70% of the time-- when a kid said they or their sibling got praised more or punished more or whatever, they said it pretty much made sense to them. It pretty much seemed fair.

Ira Glass

Which brings us back to Edie and her big sister Ayla. Ayla says it doesn't matter to her that she gets in trouble more and that Edie gets more stuff. Ayla's got band and band camp and choir. She loves school. She loves reading. Edie needs more attention from their parents, Ayla says. So she can have it. Like most of the kids in that study, Ayla understands why the two of them are treated differently. And she is fine with it.

Ira Glass

From WBEZ Chicago, it's This American Life, distributed by Public Radio International. Today in our program, in defense of special treatment here in the land of the free, the place where all men are created equal, and all kids. We have stories of when some people should be treated more equally than others.

Our show in four acts today. Act One, Lunchtime with the King of Ketchup. In that act, Jonathan Goldstein stands up for one man's right to be treated differently than you have ever been treated by waiters, store owners, and takeout delivery guys of every race, creed, and religion. Act Two, Except for that One Problem, It's Perfect. In that act, we hear the story of a woman who is solving something that has plagued prisons for years. And the only thing wrong with her solution is prison guards hate it. Act Three, Mommy's Psychic Helper. One woman gives special treatment to her two kids based on a horoscope given to them at birth. Act Four, The Way to a Boy's Heart Is Through His Stomach. In that act, a nine-year-old who never eats, and what that does to everyone around him. Stay with us.

Ira Glass

Act One, Lunchtime With The King Of Ketchup.

And now the story of a man with a simple mission in life, to give a little special treatment to a group of people whose contribution to society is often overlooked, the men and women of the food service industry, who, when they meet this guy, tend to give him a little special treatment in return. Jonathan Goldstein tells the tale.

Jonathan Goldstein

Howard Chackowicz and I have been friends since we were kids, and so I can say with great authority that almost every day for the past 10 years, Howard Chackowicz has either dined out or ordered in at least one of his meals. Sometimes when Howard isn't sure what he's in the mood for, he'll lift an empty hand up to his mouth and pretend that he's eating. He stares straight ahead, trying to figure out if he likes the taste of the imaginary food he is shoving into his mouth. Sometimes his hand is holding a hamburger, sometimes a fork wrapped in spaghetti, and other times, he's double-fisting either end of an invisible pork rib.

Howard's always loved restaurants. He was raised in a Jewish Eastern European household, where the very idea of a restaurant was a ridiculous piece of decadence, something for Cossacks and cocaine addicts who enjoyed flushing their money down the toilet. Restaurants had a transgressive allure, and as soon as Howard was old enough, he started sneaking away to them after school or sometimes on weekends while the whole family was still asleep.

In fact, Howard was the very first person I've ever dined out with alone without any family. We were 12 years old, and we ate at Atomics Pizzeria, a place just down the street from us. It was owned by a crotchety, old Greek man named Costa, who served ridiculously large portions of food. We'd get a plate of fries the size of a dead Shetland pony, but right alongside of it, Costa would place one measly packet of ketchup. When we asked for more, he looked at us like we had just asked for more blood from his mother's still-beating heart. Whereas I learned to ration, eating 400 to 500 French fries with a bottle-cap-sized dollop, Howard learned how to talk to Costa, how to win him over, how to make him see that giving us more ketchup was just the right thing to do. Along the way, Howard learned how to say in Greek, "Thank you, kind sir. Bless you for the ketchup," as well as the excellent [SPEAKING GREEK], "Here's many years to your ketchup."

Ever since way back then, Howard has had a very special rapport with the men and women of the food service industry, and he has worked very hard over the years to cultivate this relationship.

Jonathan Goldstein

A couple of weeks ago, Howard took me on a walking tour of the best places to eat in his neighborhood. I've walked into bakeries with Howard where the young girls and old men alike who worked there have dropped their doughnut tongs to cry out with joy, Howard! I've watched him get moved to the front of the line outside restaurants in Chinatown. When he's relating to a waiter or a delivery man, all that Howard sees is one person giving another person food. He talks to them as though they're friends, brothers even. His servers are able to sense his purity of vision, and they bestow on him in every exchange some little bit of special treatment.

Jonathan Goldstein

We come to a little shop on the corner.

Jonathan Goldstein

Howard takes me inside and makes the rounds, saying hi to everyone, even craning his head into the kitchen in the back so as not to snub a soul.

Jonathan Goldstein

When he's done, he stops at the cash to buy a few things, and the owner throws a small box of cookies into his bag. He says they're on the house.

Jonathan Goldstein

I haven't gotten free cookies from a bakery since I was maybe eight years old, and that probably wasn't achieved without the use of fake tears. It pays to be Howard. He always gets a little something extra. In fact, Howard is such a beloved figure in the neighborhood that whenever our friend Tucker goes in to get takeout from Sarah's, a local Middle Eastern restaurant, he'll tell whoever is serving him that, in fact, the food was not for him, but that he was picking it up for Howard. This earned him portions that were almost twice as large as what he'd normally get. "Howard, he is the best man," his server would say, as he piled food onto his plate. "You are so lucky to have a friend like Howard." Indeed, he was.

But the funny thing is that Howard is so doted upon when he eats in restaurants that sometimes it makes it difficult for him to just sit back and enjoy his meal. He feels he has to balance things out, and so he dotes right back. Because of that, it can be hard to carry on a conversation with him. His eyes will nervously scan the restaurant for any way he can be of help to the waiting staff. Howard's ears can detect the muted clink of cutlery falling to the carpet from clear across the room. And when he does, he'll do a kind of concerned gym-coach trot over to the mishandled piece of silverware and pluck it up off the floor.

So as much as Howard loves restaurants, when he really wants to relax, he'll get home delivery. And since it was nearing lunch time, rather than step into one of the many restaurants we were passing, Howard ushered us back in the direction of his house to dial out for our grub. At his place, he pulled open his top kitchen drawer, and I saw the many choices that lay before us.

Jonathan Goldstein

As much as restaurant owners and waiters love Howard, it's delivery men who really, really love him. I mean, who among us even knows their delivery man's name? Howard knows their names and the names of their wives and children. When they come to his door, he invites them in and offers them water. And in return, they'll actually call Howard later on to see if his meal was to his liking, that it was warm enough, that there was enough ketchup.

Jonathan Goldstein

We decide to order from Howard's favorite restaurant, a souvlaki place called The Greek Village.

Jonathan Goldstein

While we wait for the food, Howard waves me over and opens his kitchen cupboard to reveal physical proof of his good standing with the service industry.

Jonathan Goldstein

Then, with vaudeville timing, our delivery arrives.

Jonathan Goldstein

Howard greets the delivery man like an old friend he hasn't seen in quite some time.

Jonathan Goldstein

When I order in, like most people, I figure these guys want out of my house as badly as a bird that's accidentally flown in down the chimney, and I assist in their passage, usually having the exact change with a tip all ready for them at the door. But at Howard's house, delivery men stay a long time. They seem to want to.

Jonathan Goldstein

After about 10 minutes of this, I just want to eat. I find myself eyeing the bag of souvlaki lying on the floor like a campground bear. I realize then that I'm just not made of the same stuff as Howard. And I never will be.

Jonathan Goldstein

When we finally sit down to eat, I can't even get Howard to admit that he's doing anything so special with guys like Shamir. We go back and forth on this.

Jonathan Goldstein

Howard's worked all kinds of food service jobs himself, as a waiter, a bus boy, a short order cook. And he says that, as a result, he absolutely loathes the feeling of being served. There's something that just feels embarrassing and unnatural about it. But it even goes further than that.

In his interactions with the service industry, he's looking for a particular feeling, a kind of cozy moment where he can palpably sense that the waiter has forgotten that he is a waiter and that they are both simply relating as human beings. And then, once he knows this, once he knows they're both getting along and everyone's happy, he can move on. He isn't looking for anything else from them. His motives are pure that way. But these kinds of special moments don't come without strings attached, and sometimes Howard gets into trouble.

Earlier in the day, during our walking tour, there was one place we didn't stop into, a little convenience store around the corner. Howard became uncharacteristically somber and quiet as we walked by the storefront window. The owners, a Greek woman in her 60s named Vula, and her older sister, used to be pretty friendly with him. Sometimes Vula wouldn't charge him the tax on his chocolate bar, and on occasion, she'd have him sit behind the counter with her on a plastic milk crate. It wasn't much, but it was still more than what the other customers got, and it made Howard feel special. But then, at a certain point, things started to get more intense.

Jonathan Goldstein

She would call him for all kinds of reasons, to have him come by and fix things or to run errands for her, and he would try his best to be accommodating. She'd even call him just to chat. Even though all of this was more than Howard could shoulder, he was reluctant to put an end to it. It was only after the calls got later into the night at 1:00 and 2:00 in the morning that Howard's friends started insisting he tell her that enough was enough. And against his better judgment, he did so. Howard wonders if it was right to give her his number in the first place.

Jonathan Goldstein

There have been other disasters for Howard, disasters where he was the one who went a little too far. Like, there's the time he became so consumed with helping this neighborhood Chinese restaurant that, without being asked, he took it upon himself to draw pamphlets for the place. The owner accepted Howard's flyers but never circulated them. Later, the owner picked a screaming fight with Howard over an order, and Howard never went back.

And then there was the time he brought in beautiful framed photos of Lebanon to his favorite Lebanese restaurant so they could be reminded of home, but the photos were never hung up nor were they ever referred to again.

But for Howard, those things don't matter, and I know that he'd probably even do them all again. There are so many other moments that make his good intentions feel repaid in full. Some of his favorites are when delivery men he knows pass him by in their cars as he's walking down the street. It shocks him out of his reverie when they honk their horns in a quick, affectionate burst. For a brief moment, it feels like a reassuring slap on the back. Howard thinks to himself that they're the best, and it fills him with so much gratitude that if he had a pear or a peach in his coat pocket, he would wave them over and give it to them.

Ira Glass

Jonathan Goldstein is currently writing his own version of the Bible. He is the host of a new upcoming series on CBC Radio called Wiretap.

[MUSIC - "MAKE ME SMILE (COME UP AND SEE ME)" BY STEVE HARLEY & COCKNEY REBEL]

Ira Glass

Act Two, Except For That One Problem, It Is Perfect.

Prisons operate on the idea that if inmates don't control themselves they get consequences, punishments. So what do you do with inmates who don't understand consequences, whose emotions take over? Well, there's this thing called Borderline Personality Disorder.

People with this disorder are ruled by their emotions. They are hypersensitive. They demand attention. They mutilate themselves. They attempt suicide. And in prison, they end up spending a lot of time in isolation cells. They require a lot of time from guards and medical personnel. They clog the system. They cost millions of dollars. They are a huge management problem. Medication doesn't work on this disorder, and psychoanalysis only makes them worse. They're too unstable.

There is a new program to deal with them, and it's getting some results. But unfortunately, it goes against some of the basic rules of prison life. In particular, it goes against the rule that everybody in prison should get treated the same. Gregory Warner went to Springfield, Missouri, to check out the program, to the oldest and largest prison hospital in the country.

Gregory Warner

It's more prison than hospital, the United States Medical Center for Federal Prisoners. It was built in 1933, back when they were still designing prisons to look like fortresses. It stands alone in a huge field like something that should be approached on horseback.

Inside are some of the more advanced medical services for inmates in the country: a dialysis unit, a cancer ward. But there's still a feel of the prison stockade: bars, guard stations, a wheelchair-accessible chow hall. Another building houses the mental health ward. A few people in Springfield, even the guy who rented my car at the airport, warned me about running into Hannibal Lecter here. But inside the prison, the mention of Hannibal gets only an embarrassed shrug.

The controversial inmates are on the third floor in the unlocked unit for inmates with Borderline Personality Disorder, some of the most problematic inmates in the entire federal prison system. The unit is surprisingly calm, given these guys' histories. Unless there's a therapy group in session, we find the men clustered around card tables or reading, or just pacing down the narrow corridor. The whole unit is one L-shaped hallway with brooms and cells off of that.

This is where I find Randy Nielsen, 45 years old, he's been in for bank robbery since he was 19. He's tall with graying hair and shining gray eyes. The scars on his arms actually overlap, new scars on top of old ones, from all the times he's tried to hurt himself.

Gregory Warner

Keith Smith is a treatment specialist who works with Nielsen and the other guys on this unit.

Gregory Warner

What makes people with Borderline Personality Disorder so difficult to deal with is they can be incredibly hostile and manipulative, and at the same time, phenomenally needy. They crave attention and approval. They can't deal with people, but they can't bear to be alone, and they fear being abandoned. And the littlest things can throw them into a crisis, someone not saying hello in the hallway, or not getting the right amount of food. And once they're upset, they're uncontrollable. They'll mutilate themselves if they don't get their way. They'll threaten suicide, and they'll mean it for as long as the crisis lasts.

In prison, they start fights and sew drama. They attempt suicide, and then sue the prison for rescuing them. Generally, prison has two ways of dealing with these inmates. They can transfer them to a new facility with the idea that a change of scenery might change the behavior, a temporary solution that works often enough there's even an unofficial term for it: diesel therapy. Or they could use punishment to deter the behavior: solitary confinement. The hole, it's called.

But diesel therapy is expensive and only works temporarily. And the hole for borderlines can often exacerbate the symptoms. Mostly, prisons don't know what to do.

Gregory Warner

This is psychologist Georgina Ashlock. Two years ago, the Federal Bureau of Prisons hired her to launch the experimental program here in Springfield to stop borderline inmates from mutilating themselves or attempting suicide. It's a daunting task. She didn't have much competition landing the job. Only one other psychologist in the entire Bureau of Prisons applied for it.

Gregory Warner

So the experimental program that Dr. Ashlock started uses a treatment called DBT: Dialectical Behavior Therapy. DBT was developed in the '90s, and it's still the only treatment that's ever shown to work on borderlines. What it is, it tries to stop borderline behavior by teaching them techniques to deal with emotions, skills like breathing deeply to relax, or keeping an emotion diary to gain self-awareness.

Because mostly this disorder is diagnosed in women, a lot of the skills are specific to women, like taking a bubble bath or painting your nails. The worksheets had to be modified for men, of course, and Ashlock said modified further for men in prison.

Gregory Warner

What prisoners do have access to are things like photos ripped from magazines of puppies or beaches to focus on. They have rubber bands to snap on their wrists when they feel like cutting. And they also have the distraction of the weight room.

DBT also teaches interpersonal skills, like how to ask a nurse for aspirin. A lot of these guys have no idea. They'll demand aspirin, and the nurse will tell them to wait, and then they'll start screaming, and the whole situation just escalates. They don't get the aspirin, and they get thrown in the hall for making a scene. So DBT has all this worksheets on how to break the interaction down, like how badly do I want to aspirin? Does the nurse have any aspirin? Is she really busy? Or is she in a giving mood? And what's the body language of someone in a giving mood?

DBT is like a Berlitz guide to dealing with the world. As basic as all this seems, Ashlock says these are skills that these guys never learned, in large part because of abusive childhoods. And all these little skills add up. You learn how to ask for aspirin, people see you as a nice person. Your personality begins to change. Even the big things can start shifting, like one's ability to empathize with others. But sometimes that can cause more problems in prison, where being a nice guy can be seen as a sign of weakness. Acting reasonably can be difficult or even dangerous.

Gregory Warner

This is Edwin Torres. He's 33 and has served two years of a 20-year sentence for drug dealing.

Gregory Warner

The inmates throw these terms around. Emotional mind, which refers to an excited emotional state, versus wise mind, which is more balanced. A lot of DBT jargon derives from Eastern philosophy. Here's C.J., a 31-year-old inmate.

Gregory Warner

My interview with C.J. had been rescheduled at the last minute. And in the past, he told me that would have spun him out of control, ruined his whole day. This time, he knew what to do. He went back to his cell and did the things he knew would calm himself down. He made coffee. He changed his shoes. He used his skills.

The DBT program's only two years old, and most of the success is anecdotal, but the initial statistics are promising. Out of 21 inmates who finished at least half the program, suicide attempts are down by 94%. And the same inmates are spending 73% less time in the hole. And this is after they leave the program or they go to a new prison.

But that doesn't mean all the prison staff is happy with the program, because the operative word in Dialectical Behavior Therapy is behavior. And for it to work, the therapists have to be involved in deciding how misbehavior is punished. And this brings them directly in conflict with the guards, who traditionally have control over that. So DBT has set off a turf war between the corrections staff and the therapists.

For instance, sending prisoners to the hole is one of the main tools the corrections staff has as a form of punishment. But under DBT, Dr. Ashlock can actually take an inmate out of a hole. That's a pretty big deal. And she also allows the inmates to voluntarily place themselves in the hole if they feel like it's the only way they can get control of themselves. Instead of acting out to get there, they can just go, like taking a sick day for work. Guards hate all this special treatment.

Dr. Ashlock tells me this story about an inmate who attempted suicide. Normal procedure is that the prison guards would strip him and place him in a suicide cell. But Dr. Ashlock spoke to him and decided that the suicide cell wasn't the best place for him.

Gregory Warner

Larry Caudle has been a corrections officer at Springfield for 13 years and was president of the guards' union when the DBT program was introduced. He says in prison you have to be suspicious of everything to protect your own safety, and you're trained to resist inmates who want to manipulate you.

Gregory Warner

It all just looks wrong, one officer told me. Even the idea of calling inmates "patients" sends some guards into a cussing fit. They're not there to help cure anyone. They're there to keep control.

The prison anticipated trouble from officers even before the DBT program started. So they launched a Hearts and Minds campaign to convince officers that DBT would help them control inmates. There was a DBT role-play at the annual staff training, but the message wasn't getting through. The officers asked Dr. Ashlock if the inmates would get flowered curtains and pizza parties. They told another therapist to expect gladiator battles and daily rapes.

So then the prison set up a special website with a thing called an Ask-It Basket, where Dr. Ashlock would field anonymous questions to dispel the various rumors, but that just led to more hostility. Officers basically accused Ashlock of tossing out misbehavior reports to make the program look good and said the program was just a cozy hideout for inmates to go masturbate. The Ask-It Basket was shut down after two weeks.

Keith Smith has seen both sides of this argument. He was an officer in the prison, and then he became a treatment specialist in the DBT program. And ever since he took the job, his best officer friends won't talk to him. They stopped going bowling with him on Friday nights, and their families don't get together anymore.

Gregory Warner

Dr. Ashlock doesn't see what the big deal is. She thinks officers should be in favor of a program that helps them handle these inmates, that leads to fewer outbursts and less violence. She says what the officers don't understand is that by giving these prisoners special treatment, by bending the rules for them, she's not giving into their manipulation, she's trying to stop it. She tells the story of an inmate who swallowed a piece of razor blade and was sent to the hole. And then she discovered that he did that so he could avoid guys he owed gambling debts to.

Gregory Warner

The problem is, when a prisoner mutilates himself or tries to kill himself, the guards see it one way, the therapists see it another. There's a jail in Kentucky that reportedly uses something officers call the fingernail test to tell the difference between a real suicide attempt and a manipulative one. The officer basically uses his fingernail to measure if the wound is deep enough to be a real suicide. That's a pretty gross example, but it's an issue that every prison struggles with it and that's at the heart of this disagreement. No one wants a suicide on their watch, but no one wants to be sucker either.

Ira Glass

Gregory Warner lives in New York. Coming up, mommy knows best, but sometimes she needs the power that comes with cassette tape. That's in a minute, from Chicago Public Radio and Public Radio International, when our program continues.

Ira Glass

It's This American Life. I'm Ira Glass. Each week on our program, of course, we choose some theme and bring you a variety of different kinds of stories on that theme. Today's program, Special Treatment. We have stories about the pros and cons of not treating everyone the same.

We've arrived at Act Three of our show. Act Three, Mommy's Psychic Helper.

When Aimee and Andrew were babies in Southern California, their Vietnamese mom got their horoscopes done by a fortune teller, and had them recorded onto a cassette tape.

Ira Glass

Aimee Phan has just missed four student loan payments. Her brother Andrew is in medical school, as his horoscope predicted. Aimee has a book of short stories called We Should Never Meet. That will be published by St. Martin's Press in September.

Ira Glass

Act Four, The Way to a Boy's Heart is Through His Stomach.

Lisa Carver's son was born with a rare chromosomal disorder, and one of the things that it does to him is that his throat does not function properly. The biggest problem it causes is this: he can't eat at all. He has to be fed in a special way. And that's just where his special treatment begins. His name's Wolfgang. He's nine and a half. Here's Lisa.

Ira Glass

Lisa Carver lives in New Hampshire.

Ira Glass

Well, our program was produced today by Diane Cook and myself with Alex Blumberg, Wendy Dorr, Jane Feltes, Sarah Koenig and Lisa Pollak. Our senior producer is Julie Snyder. Elizabeth Meister runs our website with production help from Todd Bachmann, Will [? Reichel ?] and Kelsey Dilts. This is Kelsey's last day with the program, which means that it is a terrible day for all of us. We wish her the very best.

[ACKNOWLEDGEMENTS]

Our website, www.thisamericanlife.org, where you can listen to our programs for free or buy CDs of them. You know, you can download audio of our program at audible.com/thisamericanlife, where they have public radio programs, best-selling books, even The New York Times, all at audible.com.

This American Life is distributed by Public Radio International.

[FUNDING CREDITS]

WBEZ management oversight by Torey Malatia, who installed a new suggestion box here at WBEZ with a stack of paper forms, and some pencils, and these instructions:

Ira Glass

Management tips from the greats. I'm Ira Glass. Back next week with more stories of This American Life.