Kathleen Yosko came to Chicago in 1978 as director of nursing for Schwab Rehabilitation Hospital, recruited to help close it down. Instead, she ended up fighting to save Schwab, eventually becoming an advocate for violence prevention, improved health care for people with disabilities and ultimately being appointed as president and CEO of Schwab Rehabilitation Hospital and Care Network.
Yosko, who had specialized as a nurse in rehabilitative work with paralyzed Vietnam veterans, rose through the ranks of nursing to administration. She says her zeal for turning Schwab around was met with skepticism initially.
“People would say to me, `You’ll never have any programs at Schwab, you’ll never have any doctors to speak of, patients won’t come there,’ ” Yosko recalls. “They’d say, `You’re a nurse. How can you be an administrator?’ I felt I had to prove myself, and I was confident they were wrong.”
Yosko threw herself into creating a financially viable and stable organization.
“In order to make this place survive,” says Yosko, 48, “I had to focus on the business of running a hospital. I couldn’t be as directly involved in patient care.”
Yosko was completely unprepared for what happened next. In November of 1983, she came home one night to find an armed intruder in her house. The man threatened Yosko with a gun and a knife and sexually assaulted her. When police arrived on the scene, he held her hostage.
“The nightmare didn’t end in the house,” Yosko says. “The assailant used me to try to escape, pulling me, at gunpoint, through my neighborhood.”
Even though he used Yosko as a protective shield against numerous police officers, the assailant was killed, while she miraculously survived.
“More than 100 bullets were fired, but I escaped with just some shrapnel in my right arm,” says Yosko. “I remember waking up in the hospital and thinking, You’re alive. So what are you here for? Is there something else you’re supposed to be doing?”
People expected her to quit and go back to Pittsburgh or at least take some time off. Yosko’s usual tenacity prevailed, and she ultimately found lessons behind the nightmare she had endured.
“I didn’t want to let the incident defeat me,” says Yosko. “I received some therapy and did a lot of reading. I thought, Why me God? My answer, as I look back, was that I was better able to understand people who have experienced crises. If a person has a stroke or is paralyzed by gunfire or an automobile accident, it is just as unexpected for them as the attack I experienced. It made me feel a renewed commitment to helping Schwab become a stronger hospital in serving people with disabilities.”
The gunshot victims Schwab was beginning to treat more regularly reminded her of her Vietnam-vet patients, and while she had already been concerned about violence, her own experience that November night strengthened her resolve to do something about it.
“I also realized that I wanted to prevent other people from being victimized by violence,” continues Yosko. “At that time, we were just beginning to see a few persons injured by gunfire. I felt, after my own experience, that I wanted to make a difference. I became committed to preventing this from happening to other people. I became active in violence prevention, particularly gun violence. I became an advocate. I will do anything to get this issue out on the table, if it can help reduce the number of people victimized in our society.
“This happened (to me) for a reason, and my message is that it’s far time for us to say enough is enough. When we all decided as a country that enough was enough with the Vietnam War, that everyone was outraged, it ended. One day it just ended.”
Yosko believes the same can be done with street violence.
“We can get the message out and make a difference. Because gun violence can and does happen everywhere.”
Yosko’s platform against violence is an integral part of Schwab’s mission as well.
“Almost everyone at Schwab, including the physicians, nurses and therapists, shares our mission of advocacy,” Yosko says. “It’s not just the initiative of the CEO. As a not-for-profit hospital, Schwab’s most important mission is to serve the community, and there are many causes of disability. If we reduce the number of gunshot victims, there may be fewer trauma patients at Schwab. That may seem ironic for a rehabilitation hospital, but that is our mission.”
With her reinforced commitment to addressing gun violence after her experience, she and her staff came up with a multi-level approach.
“We felt, We’re one hospital, who’s going to listen? So we looked for liaisons with organizations and public officials who are working to reduce violence. We have provided the media with human interest stories that show what violence does to individuals. And we continually try to think about ways to raise awareness, both through education and changing public policy.”
Yosko continued her battle against gun violence by getting involved in many key initiatives such as the enactment of the Brady Bill in 1993, which calls for a five-day waiting period and criminal background checks when purchasing guns nationwide.
Not only did she increase her efforts in the community after her traumatic experience, Yosko examined Schwab for ways to improve care for victims of violence.
“We strengthened our programs here at Schwab,” Yosko says. “A lot of our patients have post-traumatic stress disorder. We put more emphasis on counseling people with respect to being survivors of violence. We revamped our spinal-cord-injury program and brought in more specialists.”
Yosko and Schwab have continued to strengthen their commitment to education as well, as prevention for kids and as opportunity for survivors. For several years, Schwab has teamed up with local colleges Robert Morris and Malcolm X to promote college readiness in survivors and ex-members of gangs. One former Schwab patient and gang member went back to get his high school equivalency and is now preparing to get a degree from the University of Illinois at Urbana-Champaign.
Schwab’s partnership programs attempt to reach children at a young age to teach gun-violence prevention.
“My feeling is it’s too late already when they’re in their teens,” Yosko says. “Education needs to go way down into the grade-school levels.”
Yosko and Schwab are working with the Chicago Board of Education on anti-violence curriculum.
In 1996, Schwab teamed up with the Cook County Juvenile Court System to develop a program for offenders called In My Shoes to teach them about the consequences of gun violence.
Yosko says the “court assigns misdemeanor offenders to the program. Our staff therapists volunteer, and the young offenders hear from people who’ve been victims, and some young men who have shot others and are now spiritually and physically rehabilitated.”
The juveniles attend this session as part of their sentencing, to learn what it feels like to be paralyzed as a result of being shot. Counselors address explicit, attention-grabbing issues paralyzed gunshot victims face: sexual dysfunction, bowel and bladder management and self-catheterization, for example.
“Not only do they listen, but they participate,” Yosko says. “In various ways, they feel what it is like to have a disability. Their legs are tied up, and they have to try to get up out of a wheelchair. Or their arm is bound so they have to use just one arm to put their shirt on. Sometimes their mouths are anesthetized with a harmless topical anesthetic. It’s a very powerful learning experience.”
While deeply sympathetic to the trauma of the victims, Yosko sees far-reaching financial implications from gun violence as well. Schwab treats 5-10 gunshot victims a day, and more than 60 percent of the hospital’s spinal injury patients received their injuries from gun shots. Care for these patients can run from $60,000 to $100,000 for the first year. One paralyzed gunshot victim can average several million dollars in government resources in a lifetime.
Yosko’s agenda for the future includes educating young children about the repercussions of gun violence, ensuring that people under 21 do not have easy access to handguns, increasing violence-prevention programs and improving independent living opportunities for the disabled.
“It’s one thing to be physically rehabilitated, but that’s only part of it,” says Yosko. “If all we’ve done is physically rehabilitate someone, we haven’t done everything, because they still have to live in the world. Although as a society we have come a long way in accepting people with disabilities, it’s still a challenge being in the real world in terms of accessibility. We try to integrate people back into the community and help them decide what the rest of their life is going to be.”
Yosko’s concerns about care for the disabled extends to other health issues affecting them as well.
“Historically, people come for rehab, then they need lifelong care,” explains Yosko. “And disabled people are going to live a long life. No one has really been looking at the health-care issues of people with disabilities. We think, They come here for rehab and then go somewhere else for their health care. So what we took on was sort of a primary health-care movement for people with disabilities.”
To illustrate her views about patients who become disabled through preventable violence, Yosko uses Chicago resident Girl X, age 9, a highly publicized victim of violence and a patient at Schwab, as an example.
“People were sending cards and money and setting up trust funds and sending 12-foot-high teddy bears,” Yosko says. “It was a testimony to how outraged people were about what happened to this little girl. But if we could only harness that energy and say this should never happen to one child ever again. The real issue is, when are we going to say enough is enough and protect our kids?”
In the meantime, Yosko continues to get her message out, teaching in local medical schools and overseeing an expansion to Schwab.
“I think there was a reason for me to come to Chicago, for not quitting, and a reason for me to keep on with what I’m doing here,” says Yosko. “And I’m going to continue doing it until we can say, `What’s next?’ “
