The Picture of Health in Northeast Ohio

The Cleveland Indians are young and robust, but in a part of America increasingly known for stories about the ravages of opioids, not even baseball is quarantined from issues of health care.

John Lingan is writing a nonfiction book about the last honky-tonk in the Virginias, to be published by Houghton Mifflin Harcourt in 2018. He lives in...

Paint the Corners is a monthly column about baseball.

On the day before the All-Star break, the Cleveland Indians played their first Sunday night home game in eight years, and under very different circumstances than the previous one. The Tribe of 2009 was on its way to losing nearly 100 games; the 2017 Indians are defending a pennant after an agonizingly close World Series, their first since 1997. They improved more than the Cubs in the offseason, too, adding Blue Jays tater-specialist Edwin Encarnación to a lineup that lacked only for power. And after a 28-29 start, Cleveland finally clicked into gear over the last month. They entered the Sunday game at 47-39, good enough for a 2.5-game lead in the AL Central, and were set to send three starters and two reserves to Miami’s All-Star field of dreams, a tie for most of any team.

O Cleveland! The news gets better. Other than season-ending elbow surgery for pitcher Cody Anderson, the Indians have been lucky, injury-wise. They are what every baseball team—indeed, every human being—wants to be: young and healthy. Take it from star second baseman Jason Kipnis, who told the Player’s Tribune that he emotionally recovered during the offseason by remembering, “It’d be one thing to lose a World Series like that with a team of mostly older guys or players who were about to become free agents… But it’s different when you’re a younger team, or when you’re actually in the process of adding pieces for future seasons.”

During that Sunday-night game, Jim Rosenhaus, lead broadcaster for the Cleveland Clinic Indians Radio Network, agreed: the future is bright. Rosenhaus spent long stretches of the early innings admiring the team’s collective youth and the strength of their farm system. In his perfectly calibrated baseball-man timbre, Rosenhaus assured his listeners: “Lots of reasons to feel optimistic in Northeast Ohio.”

That must be a relief to hear, since Northeast Ohio, the purplest region of the country’s most crucial swing state, is more often embroiled in one political argument or another. Cleveland and environs have been held up as the capital of Rust Belt decline for decades now, leading to outsize commentary on every factory closing. And increasingly, the region is best known as the setting for nightmarish reportage about the ravages of opioids. According to the Plain-Dealer, “this year, 860 overdose cases are predicted in [Cuyahoga] county,” where Cleveland is the county seat, “a 152 percent increase since 2013 and up from roughly 600 cases last year.” Mother Jones reports that in Ashtabula County, about 50 miles east on Lake Erie, “the number of children in court custody quadrupled from 69 in 2014 to 279 last year,” largely from parental overdoses and rehab stints.

Almost exactly a year ago, Donald Trump told a Columbus audience that he felt their pain. “I’m going to stop it,” he said of the opioid crisis, “We’re going to spend the money, we’re gonna get that habit broken.” I doubt he’s read the health care bill that colloquially bears his name, but the first Senate version of Trumpcare infamously cut almost $800 billion from Medicaid, which treats about 30 percent of the country’s addicts and provides health insurance to about one-fifth of Ohioans. Medicaid also supplies about half of the state’s prescriptions of buprenorphine, commonly used to treat opioid addiction. Senator Rob Portman was skeptical of that bill out of concern for its effects on people with opioid addictions in his state, but Mitch McConnell appears to have wooed him with some dedicated, if insufficient, funding for the issue in the newest version. For suckered Trump voters in Northeast Ohio, it’s apparently all too true that “nothing is given.”

Residents of the Forest City haven’t taken this in stride. Protesters have swarmed all of Portman’s offices throughout the state, including the one in Cleveland, and one advocacy group, UltraViolet, even got a plane to fly over an Indians game in June, trailing a banner that warned: “SENATOR PORTMAN: TRUMPCARE HURTS WOMEN.”

The Indians, as one would expect, haven’t touched this topic; what sports team could? And fun as they are to watch on the field, the Indians aren’t the overtly lovable or personality-driven kind of great team. Their players aren’t known for big statements or flashy wardrobe choices. The franchise stud is comically stoic ace Cory Kluber, whose face is so inexpressive he could pass for a Guardian of Traffic on the Hope Memorial Bridge.

But nothing, not even baseball, is fully quarantined from health care in this part of Ohio. Recall that Jim Rosenhaus’s employer is sponsored by the Cleveland Clinic, one of the premier medical facilities in the world and one of the city’s main economic engines. With annual gross revenue of $9.14 billion and recent expansions to Florida, Toronto, and Abu Dhabi, the Cleveland Clinic is arguably the best-known ambassador for the city’s name besides LeBron James. Their success is so great that Trump invited CEO Dr. Toby Cosgrove, who presided over the international expansions and boosted the Clinic’s revenue, to join a business council that also includes Jamie Dimon and Disney chief Bob Iger.

Cosgrove has been publicly critical of this year’s GOP efforts to repeal and replace Obamacare, though he has delicately avoided full-throated endorsement of the ACA as well. His association with the president has drawn widespread rebuke, especially after one of his own doctors was prevented from reentering the country as a result of the Muslim ban. Cosgrove announced in May that he is stepping down from his role at the Clinic, though he will remain an advisor to Trump. He leaves behind a business that is monumentally wealthy and growing, serving a community whose efforts to fight an epidemic are being endangered by men who will never lack for medical care in their lives.


At that Sunday night game, the Indians were missing one crucial part of their personnel. Manager Terry Francona was recovering from a coronary ablation to correct an irregular heartbeat. The procedure was performed (where else?) at the Cleveland Clinic, and though everything went as planned, he stayed at home through the All-Star Game to recover.

Francona is a delight, one of the most colorful and respected managers in the game. He’s also celebrated for his famously unhealthy appetites, from a daily mouthful of tobacco that has claimed at least one of his dental crowns to a propensity for late-night sugar binges that would shame a stoned OU freshman. There’s no reason to think that this recent heart problem resulted from his room-service habits, but Francona treats his teeth and stomach with a jolly abandon that only a rich man can manage.

In a rightfully renowned essay on the relationship between poverty and dental health, Kansas writer Sarah Smarsh notes that nearly half the U.S. population lives without dental insurance, and those that have it usually forego treatments anyway because of high premiums. In the course of her own working-class childhood, she was warned to brush every day and never eat candy. “My family’s distress over our teeth—what food might hurt or save them, whether having them pulled was a mistake,” she writes, “reveals the psychological hell of having poor teeth in a rich, capitalist country: the underprivileged are priced out of the dental-treatment system yet perversely held responsible for their dental condition… Often, bad teeth are blamed solely on the habits and choices of their owners, and for the poor therein lies an undue shaming.”

“Privileged America, ever striving for organic purity,” Smarsh continues, “judges harshly the mouths that chew orange Doritos, drink yellow Mountain Dew, breathe with a sawdust rattle, carry a lower lip’s worth of brown chaw, use dirty words and bad grammar.” I’d only add: unless those mouths are in a major league dugout. Fewer players may dip these days, and MLB has caught on to the training benefits of dietary nutrition, but baseball has always been a sport that celebrates regular-guyness and even unhealthiness. Years of steady sunflower seed and chewing gum consumption—not to mention daily Gatorade intake—would seem ill-advised for people in any other line of work, especially anyone without the money for a dentist. Certainly there are many people who listen to the Cleveland Clinic Indians Radio Network who couldn’t afford to be treated there. Certainly there are listeners who don’t have the security to gobble ice cream and Skoal with impunity. Bad habits aren’t cute affectations when the consequences might bankrupt you or worse.

Whatever their coverage level, anyone listening on Sunday night heard Kluber pitch a disappointing game, walking three Detroit Tigers in only five innings while ending his streak of ten-strikeout starts. For the second game in a row, his offense fizzled behind him, and eventually the team took their fortieth loss, 5-3. A disappointment, but no matter. The Indians have something no single setback can erase, something enviable and rare, especially in Northeast Ohio: optimism for their long-term health.

John Lingan is writing a nonfiction book about the last honky-tonk in the Virginias, to be published by Houghton Mifflin Harcourt in 2018. He lives in Maryland.