Peace & Health: How a group of small-town activists and college students set out to change healthcare

By Charles Barber

The story of how the work of one small group of people grew to meet the size of their calling: to ensure that Health Care is a Right, Not a Privilege.

Peace & Health is the story behind this improbable effort: the 20-year-old who plants the flag in his small hometown of Middletown, Connecticut; the daughter of

• Language: English
• Publisher: OctoberWorks
• Release date: Oct 25, 2022
• ISBN: 9781959262015

Charles Barber

Charles Barber is a Writer in Residence at Wesleyan University and a Lecturer in Psychiatry at Yale.  He has written widely on mental health and criminal justice issues, both in popular and scholarly publications, including The New York Times, The Washington Post, Salon, The Nation, and Scientific American Mind. Charlie has appeared on the BBC, CNN, CBS News, and NPR’s Fresh Air. He lives in Connecticut with his family.

Book preview

Published by

Community Health Center

Middletown, Connecticut

and

OctoberWorks

North Haven, Connecticut

Copyright ©2022 Community Health Center, Inc.

All rights reserved.

This book may not be reproduced, in whole or in part, including illustrations, in any form (beyond that copying permitted by Sections 107 and 108 of the U.S. Copyright Law and except by reviewers for the public press), without written permission from the publishers.

Library of Congress Control Number: 2022916116

ISBN: 978-1-959262-00-8

eISBN: 978-1-959262-01-5

Designed and set in Georgia, with Amboy display,

by Jeanne Criscola | Criscola Design, North Haven, Connecticut

Printed in the United States of America

by GHP Media, West Haven, Connecticut

First Edition

COVER

1972–1973 | Community Health Center, 115 College Street, Middletown, Connecticut

DEDICATION

This book is dedicated to the patients — past, present, future — of Community Health Center, Inc.

LAND ACKNOWLEDGMENT

The Community Health Center, Inc., acknowledges the indigenous peoples and tribal lands on which each one of our primary care centers stands. In recognition of the original inhabitants across the state of Connecticut, we honor the Hammonasset, Lenape, Massacoe, Mattabesett, Matetacoke, Mohegan, Munsee, Niantic, Norwalke, Paugussett, Pequonnock, Pequot, Podunk, Quinnipiac, Schaghticoke, Siwanoy, Tunxis, Wangunk and Wappinger tribes. CHC, Inc., remains committed to respecting and protecting the lands on which we work, serve, educate and commune.

c. 2012 | The North End of Main Street, Middletown, Connecticut, seen from the roof of Community Health Center’s Peace & Health building.

TABLE OF CONTENTS

PROLOGUE : A DEPTH CHARGE IN THE LAND OF STEADY HABITS

DISRUPTION

TOUCH, Inc.

One Inch Too Narrow

The Outsiders

The Family Doctor

FOUNDATION

Parallel Tracks: Local & Global

The Nurse Practitioner

The Roaring Nineties

INSPIRATION

The Institute

What the Heart Feels

Vaccine Village

POSTSCRIPT : THE LABYRINTH

Appreciations

Notes

Index

Credits

Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.

— MARGARET MEAD

Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.

— MARTIN LUTHER KING, JR.

LATE IN THE EVENING on a day in October 1973, a bearded and ponytailed young man, age 22, walked down the sidewalk of Main Street in the North End of Middletown, Connecticut. He carried a sleeping bag with him. His plan was to sleep outside for the night, or maybe a few nights. Cars and trucks rushed past him on the four-lane street, the widest Main Street in Connecticut, paying him no notice.

The North End was, and always had been, the grittiest of Middletown’s neighborhoods, the place where each successive wave of newcomers seeking work — first the Irish, then Italians, then Blacks and later, Hispanic families and others from around the globe — lived when they first came to town. By the ’70s, the manufacturing base that had sustained the small city for a century was well into a decades-long decline, and the neighborhood, like many others in Middletown for that matter, had taken on a seedy complexion. The North End had become well-known regionally for its drug trade, its dive bars and its itinerant population.

The young man, whose name was Mark Masselli, stopped at 631 Main Street, a handsome, brick, Federal-era building set back from the street, with a small, decayed patch of lawn in front. Mark unfurled his sleeping bag, lay down and tried to sleep.

But he didn’t want to sleep too deeply because he had a purpose that night. Mark needed to find a man, Paul Carrie, whom he’d spent weeks seeking out. Carrie, at least theoretically, was the commercial tenant in the building immediately adjacent to the lawn on which Mark was camping for the night. Carrie had once run a plumbing and heating company out of the building but now seemed to have disappeared. Mark had stopped by the shop dozens of times in the daytime, but Carrie was never there. Having exhausted all the possibilities of finding Carrie during normal hours, Mark figured the only way he might find him was on the off chance that Carrie showed up in the middle of the night. This was an unusual idea but not an illogical one: Mark presumed that Carrie had stopped paying rent and was avoiding the landlord.

On the first night, there was no sign of Carrie. Mark returned to the patch of lawn for a second night; again, Carrie didn’t show. Mark wondered how much longer he could do this: the weather was getting cold, the temperature falling into the low 40s. But he figured he would try one last time.

Sometime in the middle of the third night, Mark heard a creak from the door of Carrie’s Plumbing & Heating, Co. He jumped out of his sleeping bag and burst into the dismal office.

I have a lease for this place, Mark said to the startled Carrie. The landlord said that you should give me the keys.

This was mainly true. Mark had indeed talked to the landlord, who indeed wanted the keys, which the landlord had lost. But in no way did Mark have a lease.

Carrie was shaken but not uncooperative. He politely handed over the keys. Actually, he seemed almost relieved to give them up.

Mark looked around inside. The building — 635 Main Street — had a storefront along with two upper floors. It looked unimposing from the street but actually had a good deal of space inside.

In the coming weeks, Carrie removed what was left of his equipment, and Mark took occupancy on a handshake with the landlord. With the help of local carpenter Bob Mansfield, Mark spent the next six months renovating the first floor, creating offices and treatment spaces, which he hoped would eventually be filled with dentists and doctors and social workers providing services to the people of the neighborhood for free.

Mark was not a very good carpenter. You’ve never swung a hammer in your life, Mansfield would say to him each morning.

I have, Mark would say, but I’ve never hit a nail.

Mark also had no money to speak of. Mansfield mainly worked for free, on the understanding that Mark would pay him after the clinic was open. Mark borrowed money from his father to buy paint, drywall and two-by-fours. Mansfield, with his contacts, also worked out deals with very understanding building supply companies. Nonetheless, Mark and Mansfield, later joined by a bunch of Mark’s friends — mainly college dropouts — spent weeks on end working away and reconfiguring the first floor into the shell of a community clinic.

At the end of the project, they installed a sign over the door. Where it had once read Carrie PLUMBING & HEATING, Co. Mark painted Community Health Center. Then he waited for the doctors and patients to arrive.

NO CREDENTIALS

In many ways, Mark Masselli’s vision was a terrible idea. Building a free clinic for the poor in Middletown, Connecticut, in 1972 was an impractical, even absurd, goal for a number of reasons.

The first and most obvious problem was the fact that Mark had absolutely no credentials to do clinical or administrative work whatsoever. He had grown up in Middletown and the surrounding area and, upon graduating from the local Catholic boys high school in 1969, chose, almost at random, to attend a small college in the Midwest. He lasted exactly one semester. He spent the subsequent months hitchhiking from Florida to California and up to Canada and, upon returning home, taught a course on the art of hitchhiking at a summer alternative education program supported by Wesleyan University, the nationally prominent liberal arts institution in Middletown. He then ran a free breakfast program for underprivileged kids.

In the early 1970s, he fell in with a group of Wesleyan students who created a drop-in center, first in donated space in a local Episcopal church, then out of an old store in a ramshackle building off the south end of Main Street. The initial purpose of the organization, which was called TOUCH, Inc., was not entirely clear — but the general idea was to provide support for young runaways, drug counseling, draft counseling for young men seeking to avoid the Vietnam War, and a 24/7 crisis telephone line. TOUCH quickly grew into Middletown’s version of San Francisco’s Haight-Ashbury scene — replete with beads hanging from the doors and windows, the smell of incense, bean bag chairs and young people trying to come down from bad acid trips.

Mark’s indifferent relationship to schooling was certainly influenced by a difficult home life. When he was in high school, his parents’ marriage was falling apart, and the household was chaotic. Many mornings, Mark had no way to get to school, six miles away from home. Often he would walk or hitchhike, arriving hours late. His father, Nicholas, was a research chemist at Wesleyan and his mother, Ida, was a talented woman who was increasingly bored and unhappy in her role as a housewife. They were both gifted people, but his father was often taciturn and remote, no doubt in part because of his time as a POW during World War II. His mother became depressed during Mark’s adolescent years and began to drink. Mark also had to contend with the legacy of his brother David, two years older, who had been an academic prodigy, going on to college at Dartmouth and then Yale Law School. Mark often thought of his brother as a kind of genius and figured there was simply no point in trying to compete with him, at least in school.

But his parents, however fraught their relationship, also inspired young Mark. His father had grown up poor in Middletown’s North End, a son of recently immigrated laborers from central Italy. Nicholas had been personally selected by the president of Wesleyan for admission and went on to earn a bachelor’s and then a master’s degree in chemistry. But without a PhD, he didn’t teach students and instead became a full-time researcher, studying the pollution in the Connecticut River for decades. In the rigid world of academic politics, Nicholas, for all of his expertise, was never perceived as a full-fledged faculty member. Ida, for her part, was highly politically engaged. In the 1960 Kennedy-Nixon election, she had 30 telephones installed in their small house and marshalled friends to call registered Democrats to get out the vote. When people shirked on the job, nine-year-old Mark was instructed to tell them to get back to work. A few years later, Ida brought the family to the Deep South to educate her sons about structural racism in the United States and the nascent Civil Rights movement. Mark was shocked by the shantytown-like poverty he saw in Alabama: the tin houses, the lack of running water and electricity, and the almost complete separation of communities based on skin color. Just a few years later he would witness similar depths of poverty — and segregation — in the Black community in Middletown.

Starting in 1972 — and over the next five decades — Mark would constantly run up against the rigid mores of the land of steady habits, and often he would be rebuffed.

THE LAND OF STEADY HABITS

The second glaring problem with Mark’s vision of creating a free health center was that, in some ways, he could hardly have picked a worse place to do it than Middletown. Then and now, Connecticut is famously called the Land of Steady Habits.¹ This widely used phrase to characterize the state’s essential staidness and complacency had first appeared in print in the early 1800s and had immediately caught on. It perfectly captured something about Connecticut’s now centuries-long resistance to change. Starting in 1972 — and over the next five decades — Mark would constantly run up against the rigid mores of the land of steady habits, and often he would be rebuffed. Usually, it was the older medical and political establishment which lay in wait, ready to spring on a young man whom it deemed unqualified and unprofessional.

Connecticut, too, was a particularly difficult place to enact lasting change in any kind of regional or systemic way. The state had abandoned county government in the 1950s, believing that Connecticut’s relatively small size made a county structure redundant. But this left Connecticut’s 169 towns and cities to act on their own. Each municipality operated as a separate fiefdom, and usually those fiefdoms were dominated by a small group of wealthy and interconnected individuals. Generally, these local elites looked askance at upstarts and outsiders.

Mark (with ball) played on the Wesleyan Men’s Rugby Club.

Finally, Mark’s core premise, that healthcare should be a right and not a privilege, was not universally embraced by the hard-working, majority-white citizens of Middletown. The United States was — and still is — the only industrialized country that does not guarantee healthcare to its citizens.² Mark and reformers like him were up against an old, entrenched American idea: that if people wanted or needed healthcare, they should pay for it, either by bartering, paying cash or — beginning in the 1940s — by using the employment-based health insurance programs that began during World War II. But of course attaching health insurance to employment was inherently inequitable: women and people of color were less likely to have health insurance and more likely to lose their jobs if they did. Embedded in the notion that only some people deserved healthcare were the pernicious realities of racism and a deep cultural animosity toward the poor.

By the 1970s, thanks to Black activists in the Civil Rights movement for whom access to healthcare had been a top priority for decades, the ground was shifting fast. The federal government’s Medicaid and Medicare programs, one serving the poor and the other the elderly, had been created in 1965 but were still only a fraction of the size and impact of what they would become. The notion of giving away healthcare for free amounted to a depth charge to many in the local community — especially, as Mark would soon learn, to the local medical establishment.

HIDDEN ADVANTAGES

But at the same time, in setting his aims high, Mark had some advantages, too. Chief among them was the