‘Bloodless’ Lung Transplants for Jehovah’s Witnesses

Eric Kayne for The New York Times

SHARING HOME AND FAITH A Houston couple hosted Gene and Rebecca Tomczak, center, in October so she could get care nearby.

HOUSTON — Last April, after being told that only a transplant could save her from a fatal lung condition, Rebecca S. Tomczak began calling some of the top-ranked hospitals in the country.

She started with Emory University Hospital in Atlanta, just hours from her home near Augusta, Ga. Then she tried Duke and the University of Arkansas and Johns Hopkins. Each advised Ms. Tomczak, then 69, to look somewhere else.

The reason: Ms. Tomczak, who was baptized at age 12 as a Jehovah’s Witness, insisted for religious reasons that her transplant be performed without a blood transfusion. The Witnesses believe that Scripture prohibits the transfusion of blood, even one’s own, at the risk of forfeiting eternal life.

Given the complexities of lung transplantation, in which transfusions are routine, some doctors felt the procedure posed unacceptable dangers. Others could not get past the ethics of it all. With more than 1,600 desperately ill people waiting for a donated lung, was it appropriate to give one to a woman who might needlessly sacrifice her life and the organ along with it?

By the time Ms. Tomczak found Dr. Scott A. Scheinin at The Methodist Hospital in Houston last spring, he had long since made peace with such quandaries. Like a number of physicians, he had become persuaded by a growing body of research that transfusions often pose unnecessary risks and should be avoided when possible, even in complicated cases.

By cherry-picking patients with low odds of complications, Dr. Scheinin felt he could operate almost as safely without blood as with it. The way he saw it, patients declined lifesaving therapies all the time, for all manner of reasons, and it was not his place to deny care just because those reasons were sometimes religious or unconventional.

“At the end of the day,” he had resolved, “if you agree to take care of these patients, you agree to do it on their terms.”

Ms. Tomczak’s case — the 11th so-called bloodless lung transplant attempted at Methodist over three years — would become the latest test of an innovative approach that was developed to accommodate the unique beliefs of the world’s eight million Jehovah’s Witnesses but may soon become standard practice for all surgical patients.

Unlike other patients, Ms. Tomczak would have no backstop. Explicit in her understanding with Dr. Scheinin was that if something went terribly wrong, he would allow her to bleed to death. He had watched Witness patients die before, with a lifesaving elixir at hand.

Ms. Tomczak had dismissed the prospect of a transplant for most of the two years she had struggled with sarcoidosis, a progressive condition of unknown cause that leads to scarring in the lungs. The illness forced her to quit a part-time job with Nielsen, the market research firm.

Then in April, on a trip to the South Carolina coast, she found that she was too breathless to join her frolicking grandchildren on the beach. Tethered to an oxygen tank, she watched from the boardwalk, growing sad and angry and then determined to reclaim her health.

“I wanted to be around and be a part of their lives,” Ms. Tomczak recalled, dabbing at tears.

She knew there was danger in refusing to take blood. But she thought the greater peril would come from offending God.

“I know,” she said, “that if I did anything that violates Jehovah’s law, I would not make it into the new system, where he’s going to make earth into a paradise. I know there are risks. But I think I am covered.”

Cutting Risks, and Costs

The approach Dr. Scheinin would use — originally called “bloodless medicine” but later re-branded as “patient blood management” — has been around for decades. His mentor at Methodist, Dr. Denton A. Cooley, the renowned cardiac pioneer, performed heart surgery on hundreds of Witnesses starting in the late 1950s. The first bloodless lung transplant, at Johns Hopkins, was in 1996.

But nearly 17 years later, the degree of difficulty for such procedures remains so high that Dr. Scheinin and his team are among the very few willing to attempt them.

In 2009, after analyzing Methodist’s own data, Dr. Scheinin became convinced that if he selected patients carefully, he could perform lung transplants without transfusions. Hospital administrators resisted at first, knowing that even small numbers of deaths could bring scrutiny from federal regulators.

“My job is to push risk away,” said Dr. A. Osama Gaber, the hospital’s director of transplantation, “so I wasn’t really excited about it. But the numbers were very convincing.”

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ComEd chief hopes to spark positive change

Every organization has its low point. For Commonwealth Edison, it was in summer 2011 when a storm left more than 850,000 people without power, some for days.

Customers flocked to the phones for information and were shocked to find that they were not only in the dark, but in the dark ages. They waited on hold for hours, only to hear the same message every 45 minutes. They couldn't find out when their power would be restored, what had caused the outage or how many other people were affected.

Residents raged about ComEd on Facebook and Twitter and to mayors, state representatives, and fire and police departments. Dealing with wires that blocked roadways, nursing homes without power and angry residents with spoiled groceries, these public officials turned back to ComEd — only to receive misinformation or no information at all.

For soon-to-be-instated CEO Anne Pramaggiore, it was a blaring wake-up call: Customers hated the utility.

"We heard our customers loud and clear that summer," Pramaggiore said. "Everything else in the world is instantaneous, and they don't understand why they have to sit and wait without power or information."

Fast-forward to today, and customers can text, call, look online, use an iPhone or Android app or communicate with a ComEd representative on Twitter or Facebook. In less than a year, the company's smartphone app has generated more than 1 million transactions and 59,000 downloads.

"We're on a mission to improve service to our customers," said Pramaggiore, 54.

The good news is that the company has nowhere to go but up. Since 1999, ComEd has consistently ranked among the worst utilities in the Midwest for customer satisfaction in surveys conducted by The American Customer Satisfaction Index and J.D. Power and Associates.

Two months ago, the company had zero pending complaints for the first time in its history after working its way out of backlog in "the thousands," according to Miguel Ortega, director of customer technology and support for ComEd.

"Anne gets it," he said. "I've been around for quite a while. I've been through a lot of CEOs. She has made it a priority to put the customer in every aspect of our business, which is a huge cultural change."

The shift comes at a time when ComEd's parent company, Exelon Corp., is squeezing its three regulated utilities for revenue. The money Exelon receives for producing its mostly nuclear-powered electricity is not what it once was because of increased competition from natural gas and wind.

As a regulated utility that is paid by customers to deliver electricity regardless of which supplier they choose, ComEd is in a position to provide a steady, predictable stream of income to its parent if it can garner support from the General Assembly to pass legislation that will benefit its bottom line. But to get there, Pramaggiore must convince legislators — the same ones who have spent years fielding complaints from constituents about ComEd's abysmal service — that the company can change.

Legislation related to funding the so-called smart grid, passed into law in 2011 as part of the Energy Infrastructure Modernization Act, is making its way through Springfield and is worth about $1 billion to ComEd.

Within four years, Pramaggiore wants the utility that customers love to hate to be the utility that customers actually like, a plan she has spent countless hours communicating to every employee in the company.

"Whether you'll love your utility, I don't know. It's not the kind of business you ultimately love," said David Kolata, executive director of the Citizens Utility Board consumer advocacy group, a frequent opponent of ComEd. "We are encouraged and do think generally that her heart is in the right place. She does want to transform the company. Will that play out? It's too early to tell."

Inspires trust

While Pramaggiore's lawyerlike ability to boil down complex regulatory issues is impressive, her power lies in her charm. Gracious and savvy, she laughs easily and often, winning over opponents with humility and a down-to-earth speaking style that inspires trust.

Gloria Castillo, a personal friend of Pramaggiore and president of Chicago United, said her ability to listen is one of her greatest assets.

"Anne is really one of the highest-ranking women in energy anywhere in the country, but you never get the feeling that she thinks about herself in a way that's different," she said. "She's so striking. She has a unique ability to be so present in a conversation."

Indeed, Pramaggiore, a soccer mom who fits in at a Paul McCartney concert as easily as in a contentious hearing in Springfield, is disarming in her remarkable ability to appear unremarkable. She described her childhood in Dayton, Ohio, as a "quiet, suburban upbringing with good schools," with a father who was a civil engineer and a mom who was president of the local PTO.

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2 hurt in melee near Ford City Mall

Two people suffered minor injuries in a disturbance involving large crowds of "kids" tonight at Ford City Mall on the Southwest Side.
 
A Chicago Lawn District police sergeant confirmed officers were called to the mall, 7601 S. Cicero Ave., where a “bunch of kids are running around.’’

Police News Affairs Officer Veejay Zala said, “A large group of teens got out of hand,’’ a little while after an autograph-signing appearance by a teen band.

Zala said officers did their best to control the disturbance, "trying to get everyone out of there safely.’’

By 6:25 p.m. two people had been taken to hospitals from the "fluid"  situation, according to Chicago Fire Department Chief Joe Roccasalva, a department spokesman.
 
A CTA bus driver suffered minor injuries and was taken to Holy Cross Hospital, said Roccasalva, who added he did not know what happened to him.
 
A “kid’’ was also hurt, and that person was taken to Advocate Christ Medical Center in Oak Lawn, also in good condition, said Roccasalva.

By 7 p.m. the Fire Department confirmed the one adult and one pediatric patient with minor injuries were the final tally.
 
At 4:45 p.m. police responded to a battery in progress report at the Cicero Avenue address, police said.

About 50 police squad cars assigned to multiple South Side districts, including Chicago Lawn, Englewood and Deering, and a helicopter responded to the scene, police said.

During the disturbance the CTA had to reroute the No. 79 buses, which travel on 79th Street, as well as other buses in the immediate area.

Earlier in the afternoon, members of the teen band Mindless Behavior had appeared at the mall food court from 2 p.m. to 4 p.m. to promote their new release, "All Around the World," said John Sarama, the mall's senior general manager.

The band's autograph signing drew approximately 1,000 parents and children, primarily mothers and girls between the ages of 6 and 13, Sarama said.

About 45 minutes after the band left, the chaos began, Sarama said.

"A group of older youths came into the mall with the intent of causing havoc and chaos and were running through the mall, screaming, yelling and so forth," he said.

Security staff contacted the police department, and mall officials closed the mall about 5 p.m., Sarama said.

The mall did not sustain any property damage apart from a single broken planter, and it will reopen Sunday at 11 a.m. as usual, Sarama said.

In the meantime, mall officials are at a loss as they try to understand what happened.

"Ford City is a family-oriented mall," he said. "We have not had an incident like this [in the past], and I’m still in a little bit of a state of shock actually.

"What would make these youths comes here to try and cause this kind of commotion and trouble?" he continued. "I don’t know. But they did have a plan in mind."

Tribune reporter Adam Sege contributed.

rsobol@tribune.com

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Off the Dribble: Salley Offers a Healthy Assist

When Carmelo Anthony went on a vegetarian diet a few weeks ago and caused the biggest culinary conundrum in sports since fried chicken and beer had starring roles in the Red Sox clubhouse, John Salley could only shake his head.

Anthony’s diet was blamed for his sluggish play and the Knicks’ 3-4 record during the 15-day fast.

Anthony admitted that his body felt “depleted out there.”

But Salley, the former N.B.A. player, said that if Anthony had eaten a vegetarian diet correctly, he would have felt invigorated and anything but depleted.

And not just for two weeks but for the entire season.

For Salley, many of his salad days in the N.B.A. really were salad days. Particularly kale salad.

Salley, a 6-foot-11 power forward and center, became a vegetarian in January 1991 after he felt he had to make changes in his lifestyle, much like Anthony’s stated desire for “clarity in his life.”

Vegetarians do not eat meat, fish or poultry, but may eat dairy products like cheese, eggs, yogurt or milk.

Salley had read a story about the Celtics’ Robert Parish, whom he had always admired, and his interest in yoga and a red-meat-free diet.

While Parish’s regimen was not total vegetarian, he recently said that it made a difference in his career, helping him withstand the rigors of playing center against behemoths in the paint.

“My diet consisted of chicken, fish, seafood, salad, pasta and organic when possible,” he said. “I had very little sugar and drank a gallon of water every day. I also ate rice and beans, peas, cabbage, mustard, collards greens and assorted nuts. I would always focus on healthy eating. My success depended on my body and I tried to do right by it. ”

His body responded with 20 years of service in his Hall of Fame career. Parish retired at 43.

Salley was striving for similar health and success.

“I was 27, and I felt I had to change my life,” Salley said. “My knees were sore, my joints ached, I had back problems and my cholesterol was 275. ”

When he was with the Pistons, Salley visited a nutritionist in Detroit who advised him to eliminate fried foods and adopt a macrobiotic diet (grains and vegetables).

Salley, invigorated and healthy, had his best season in 1991. A defensive specialist, he had more energy and quickness and averaged a career best 9.5 points a game.

He kept his healthy diet a secret from his burly Bad Boy Piston steak-and-pork-chop teammates, who included Bill Laimbeer, Rick Mahorn and Dennis Rodman.

“I would tell them all the time,” Salley said, “if you go into a steak house it’s not that they have a certain thing inside the dead flesh or they cook it differently. They make it the same way everybody else does. All you’re doing is eating dead food.”

Salley would search out health food restaurants with a few tables or just counter service for his diet staples of quinoa, kale, spinach, stir fried vegetables, brown rice and wheatgrass on the menu.

“It was hard to find places in 1991,” he said. “So many times I would go into restaurants and ask the cook to steam my vegetables and make me the lightest fish.”

But it was worth it.

“I was playing so well it was crazy,” he said.

During his career, Salley, who retired in 2000, won four championships with the Detroit Pistons, the Chicago Bulls and the Los Angeles Lakers.

He now follows a vegan diet, which eliminates all dairy foods in addition to animal products.

“I’m eating raw,” said Salley, 48. “And I make all my food with no sugar, no salt and no oil.”

Salley is familiar with Anthony’s foray into vegetarian living. The Knicks star followed the Daniel Fast based on the book of Daniel in the Bible, which espouses a diet of mainly liquid and vegetables.

“He felt depleted because you need to find a natural source of vitamin B12,” Salley said.

B12 is not found in any significant amounts in plant food, and a deficiency can cause fatigue, weakness and tingling in the legs.

It can also cause irritability. Anthony said his diet might have caused him to lash out at Kevin Garnett in a game against the Boston Celtics.

“He didn’t take any supplements to help his body,” Salley said. “He did not get his body to heal. It’s like cutting yourself and not putting a Band-Aid on. He just got part of the plan right.”

Salley is working to make sure children get the plan right with food choices. He spreads the word about healthy eating in the community, having lobbied Congress for more vegetarian options in school lunches.

Although Anthony may have struggled to maintain his vegetarian diet, other N.B.A players and athletes have embraced it.

James Jones of the Miami Heat and Anthony’s teammate A’mare Stoudemire are vegetarians.

Baseball’s Prince Fielder, the triathlete Brendan Brazier, the mixed martial artist Mac Danzig, the bodybuilder Derek Tresize and the tennis player Serena Williams are among athletes who are vegans or vegetarians.

Dr. Joel Kahn, a clinical professor of medicine at Wayne State University School of Medicine and medical director of wellness programs, preventive cardiology, and cardiac rehabilitation at Detroit Medical Center, has counseled Salley and other athletes about the benefits of vegan and vegetarian diets.

“A plant-based, whole-food diet low on sugar and gluten is very anti-inflammatory and ideal for rapid recovery from workouts,” he said.

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Promise, peril seen for crowd-funding investors

Crowd funding is widely seen as a revolutionary idea.

A 2012 federal law known as the JOBS Act opens the door to allowing small, privately owned businesses to market ownership stakes in their ventures to people over the Internet.

Companies will be able to sell up to $1 million in equity a year to ordinary investors without having to register the offering with the Securities and Exchange Commission or state regulators.

Before the average person can use crowd funding to stake a claim in a startup, the SEC still must draft rules that the Obama administration hopes will result in U.S. businesses growing and adding jobs. At the same time, the securities cop needs to include safeguards that protect less sophisticated individual investors drawn to inherently risky startups.

That's why equity crowd funding under JOBS, or Jumpstart our Business Startups, has some longtime regulators and securities lawyers squirming.

"It can be an invitation for fraudsters to steal money," Matthew Brown, a Katten Muchin Rosenman lawyer, said last month at a CFA Society of Chicago event at 1871, a center for digital startups in Chicago.

But Brown also noted that equity crowd funding also democratizes small-business financing, a process that historically has given access mostly to wealthier — or, as they're known in high-finance circles, "accredited" — investors.

"The world has changed dramatically, and who's to say who is smarter than anyone else?" Brown added.

Many existing crowd-funding platforms such as Kickstarter don't sell equity stakes in businesses to average investors. Rather, they give consumers the chance to donate money to an enterprise or to get an early or discounted crack at a new product. Since Kickstarter's launch in April 2009, more than $450 million has been pledged by more than 3 million people funding more than 35,000 projects, the New York-based company's website says.

Their acceptance suggests that consumers are willing to engage with companies on a deeper level. As such, enabling unaccredited consumers to invest in companies in small increments online has promise and could become part of the fundraising "ecosystem," says one Chicago entrepreneur.

Abe's Market, a Chicago-based e-commerce site selling natural and organic products from more than 1,000 suppliers, said it would consider crowd funding under the JOBS Act, saying it and its vendors have "die-hard fans" and "a core group of customers" who might like to invest in their vision.

Last month, Abe's raised $5 million from Carmel Ventures, Index Ventures, Beringea and Accel Partners, a Groupon backer. New backers include OurCrowd, a crowd-funding site for accredited investors.

"If you can get passionate people to invest in your business, you're not just gaining investors, you're gaining evangelists," Abe's Chief Executive Richard Demb said. "The challenge for any consumer brand is: How do you find not just customers, but the right customers who are going to tell their friends?"

But there would also be potential headaches for companies raising equity financing through crowd funding, he said.

"You have to make sure that expectations would be set fairly, that no one is putting their life savings into the investment, and that they don't also come back and become a challenge to manage as the business grows," Demb said. "You don't want someone who invested $250 to come back and say, 'I don't think we should expand to the West Coast.'"

Safeguards for average investors exist in the JOBS Act. They include capping nonaccredited individuals' crowd-funding investments at $2,000, or 5 percent of annual income or net worth of less than $100,000, whichever is greater.

Snapclass, launched a few weeks ago at 1871, provides software enabling businesses to provide training online. Co-founder Scott Mandel, who has financed the company himself, doesn't expect to take advantage of equity crowd funding in the future and instead would seek, say, venture capital funding.

"Not all checks are the same," said Mandel, previously a trader and professional poker player. "I'd want someone who could add more than just the cash, such as connections and experience and help with things that I'm not an expert in."

One of 1871's fastest-growing startups is MarkITx. It recently raised $1.2 million from wealthy individuals in its first fundraising round, has seven employees and is looking to add sales jobs. It's an online exchange for businesses wanting to buy and sell used information technology equipment, from iPads to Oracle servers.

"For us, it wouldn't be the sole way to raise money, but it definitely is a viable vehicle to look at raising money," MarkITx partner Marc Brooks said of equity crowd funding under the JOBS Act.

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Drew Peterson transferred to Pontiac prison

Drew Peterson’s new life as an Illinois Department of Corrections inmate has begun.

Peterson was transferred this morning to the Stateville Correctional Center near Crest Hill, where he was evaluated for placement based upon factors such as his conviction, length of sentence, program needs and medical and mental health requirements.

Peterson stayed at Stateville only a few hours before being sent to his new home at Pontiac prison northeast of Bloomington, a maximum security facility that has a protective custody unit.  The assignment was based upon factors such as his conviction, length of sentence, program needs and medical and mental health requirements, per Illinois Department of Correction protocol.

Officials have not said whether he has a cellmate or if he will be in solitary confinement like he had been during his jail stay.

As part of his daily routine there, he will remain in his cell for most of the day, though he will be allowed out for meals and showers. Most inmates also get about five hours of recreation time outside per week, Illinois Department of Corrections spokesman Stacey Solano said.

The Will County jail – which had held Peterson in solitary confinement since his May 2009 arrest for his own safety – had the paperwork prepared for his transfer by the time he returned from his sentencing hearing Thursday, officials said.

The sheriff’s department, which oversees the jail, kept the former Bolingbrook police sergeant segregated from the general population there amid concerns that his high-profile case and law-enforcement background would make him a target of inmates looking to build tough-guy reputations.

Jail supervisors began preparing Peterson at 8:30 a.m. and he left without incident by 9:22 a.m., officials said.

Drew Peterson wanted to make sure he was heard when he was given one last chance to speak Thursday, shortly before being sentenced to 38 years in prison for the murder of his third wife, Kathleen Savio.

Declining to speak from the defense table, where there was no microphone, the former Bolingbrook police sergeant shuffled to the witness stand in his jail-issued blue scrubs and orange shoes and began quietly.

"I hope I don't aggravate the situation," he turned and told the judge. Then Peterson screamed into the microphone, "I did not kill Kathleen!" startling almost everyone in the courtroom.

"Yes, you did!" Savio's sister Sue Doman yelled back from the gallery, prompting Will County Circuit Judge Edward Burmila to order her out of the courtroom.

It was an odd end to a case replete with oddities and circuslike sideshows. For the next 40 minutes, Peterson cried, raged and whispered, challenged the state's attorney to look him in the eye and indulged in self-pity as he unleashed his multitudinous thoughts like a character in a Dostoevsky novel.

The 59-year-old said he expects to die in prison. Barring any successful appeal, he won't be eligible for release until he's 93.

Peterson claimed that lies and mistakes by witnesses, prosecutors and police led to his conviction, and made disparaging remarks about Savio's family, attorneys and others involved in the case. His defense attorneys called the monologue an impassioned plea for leniency, but prosecutors said it was proof that Peterson is a psychopath.

"When he got up on the stand and (in) that shrill, kinda-feminine screech that he didn't kill Kathy — that's the guy that killed Kathy," Will County State's Attorney James Glasgow said. "You got a glimpse into his soul."

But in describing himself on the stand Thursday, Peterson said he was maligned and misunderstood.

"Until this happened, I thought I was viewed as a great guy," Peterson said, giving a litany of public and private good deeds before announcing he planned to tattoo the phrase "No good deed goes unpunished" across his shoulders.

"The state took an accident and staged a homicide," Peterson said, before turning to the judge. "Can I get some water?"

Once refreshed, Peterson said he had upheld the oath he swore when he became a police officer.

"I always took my job seriously, I never violated the public trust," he said, his voice husky with emotion before quoting one of the Ten Commandments. "And I never beared false witness against anyone."

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Well: Savory Pie Recipes for Health

Pie is an indulgence often saved for holiday time. But this week Martha Rose Shulman shows us how to bake a pie and eat it too, without the guilt. She offers savory vegetable pies, showcased in whole grain crusts. She writes:

This week I slowed down and made pies: savory ones filled with vegetables … I used a number of different crusts for my winter pies. My favorite remains the whole wheat yeasted olive oil crust that I have used before in this column, but I also worked with a simple Mediterranean crust made with a mix of whole wheat flour, all-purpose flour and olive oil. And for those of you who are gluten-free, I made another foray into gluten-free pastry and produced one I liked a lot, which was a mix of buckwheat flour, millet flour and potato starch. It had a strong nutty flavor that worked well with a very savory, very vegan, tofu and mushroom “quiche.” They are all simple to mix together and easy to roll or press out. And if you don’t feel like dealing with a crust, just use Greek phyllo. The important things, after all, are the savory vegetables inside.

Here are recipes for a pie crust and four savory winter vegetable pies.

Whole Wheat Mediterranean Pie Crust: A simple Mediterranean crust made with a mix of whole wheat flour, all-purpose flour and olive oil.

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Mixed Greens Galette With Onions and Chickpeas: A tasty way to use bagged greens in a dish with Middle Eastern overtones.

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Goat Cheese, Chard and Herb Pie in a Phyllo Crust: A garlicky mix of greens and your choice of herbs inside a crispy phyllo crust.

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Tofu Mushroom ‘Quiche’: A vegan dish with a deep, rich flavor.

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Winter Tomato Quiche: Canned tomatoes can be used in the off season for a delicious dinner.

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16 airport investors show interest in Midway

An international array of airport investors and operators have shown interest in developing bids to privatize Midway Airport, the city announced Friday evening.

Sixteen parties responded to the city's "request for qualifications" by a 4 p.m. deadline, indicating they had interest in leasing, operating and improving the Southwest Side airport, the nation's 26th busiest, with about 9 million passengers passing through annually.

"The response generated from the  ... process is encouraging and provides the city with a sense of the strong level of interest in a potential lease," said Lois Scott, the city's chief financial officer. "We must evaluate fully if this could be a win for Chicagoans."

The city and its advisers will review the responses to identify qualified potential bidders.

Of the 16, seven had both the operational and financial capabilities sought in the RFQ. The city identified them as:

-- ACO Investment Group, an investor and operator with global airport experience.

-- AMP Capital Investors Limited, a manager and investor in airports, including Melbourne Airport in Australia and Newcastle Airport, in Britain.

--  Corporacion America Group, an Argentina-based airport operator with 49 airports in seven countries.

-- Global Infrastructure Partners (GIP), which is the controlling investor and active manager of London City Airport, London Gatwick Airport and Edinburgh Airport.

--Great Lakes Airport Alliance, which is a partnership of Macquarie Infrastructure and Real Assets and Ferrovial. Its airport operations include London's Heathrow, Brussels Airport and Copenhagen Airport.

-- Incheon International Airport and Hastings Funds Management, which is the sole owner and operator of Incheon International Airport in South Korea and an investor with 16 airport-related investments.

--  Industry Funds Management and Manchester Airport Group, an investor with interests in 13 airports, including Melbourne Airport and Brisbane Airport, both in Australia, and operator of Manchester Airport and East Midlands Airport, in Britain.

If the city moves forward and seeks proposals, a privatization plan could be submitted to the City Council this summer.

This is the second time Chicago has looked at privatizing Midway. A 99-year lease that would have brought in $2.5 billion died in 2009 when the financial markets froze. That deal had drawn six serious bidders.

Mayor Rahm Emanuel has said any second attempt would have to provide city taxpayers with a better deal than the widely criticized 75-year agreement to privatize parking meter operations, carried out during former Mayor Richard Daley's administration. Proceeds from the earlier deal were used to plug operating deficits, and meter rates rose sharply.

This time, proposed leases must be less than 40 years, which locks in the city for a shorter period.

Rather than making only an upfront payment, the private operator also must share revenue with the city on an ongoing basis. Initial proceeds would be used to pay down debt issued since 1996 to rebuild the airport, the mayor's office said. There is about $1.4 billion in outstanding debt.

Longer term, cash flow would be directed to city infrastructure needs. The mayor has pledged proceeds would not be used to pay for city operations.

kbergen@tribune.com

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Retired general: National Guard could help curb Chicago violence

To reduce the homicides and shootings plaguing Chicago streets, elected officials should consider calling on the state and federal governments for help, even the National Guard if necessary, said a retired Army lieutenant general who spearheaded the military response after Hurricane Katrina.

"Just like we do with any disaster. When the tornado comes, or the floods come, the federal government comes in to help," Russel L. Honore said Thursday at a news conference in Chicago.

"Let's not let this be about pride. 'We are big ol' Chicago, we are too proud, we can handle this.' Maybe you can't handle it. If you need help, get the federal government here. But let's control the streets so children and elderly people can be in a safe community."

Honore, known for his no-nonsense leadership, was in Chicago as part of The HistoryMakers project to record and archive the stories of African-American military leaders. The nonprofit organization houses the largest collection of recorded histories of African-Americans.

As part of his visit, Honore met with high school students to discuss his career.

At the news conference at the Chicago Military Academy in the Bronzeville neighborhood, Honore spoke out against the gun violence that affects the lives of so many of the students.

Honore was mild in his tone and fell short of demanding action. Instead he suggested a strategy he thinks could work.

To tackle the violence here, Honore said, the state police and other law enforcement agencies could lend a hand to local police. And the National Guard could take over routine duties, patrolling the streets and handling traffic, while police concentrate their efforts on solving crimes and increasing their presence in troubled neighborhoods.

Last year, Chicago homicides exceeded 500 for the first time since 2008, a 16 percent jump from 2011. And January saw the most homicides for that month since 2002. In addition, the shooting death of Hadiya Pendleton has placed an international spotlight on the random violence in Chicago because the 15-year-old honors student with so much promise was killed less than a mile from President Barack Obama's home.

To reduce the violence, more attention needs to be paid to poor communities infested with drugs, Honore said.

"Trust me, we can tap this down," Honore said of the shootings. "It would take a commitment, and it's not going to be popular. Many people are going to say why are you bringing that to my community? (But) do you want law enforcement or do you want people shooting day and night and destroying the lives of innocent people like the little girl who lost her life here a few weeks ago?"

Rondell Freeman, a 17-year-old junior at Prologue Early College High School who was among the students to hear Honore's remarks, said he feels afraid on the streets or even visiting the local park in his Garfield Park community. Honore's suggestion to bring in state police and National Guard seems radical, but it may be necessary, he said.

"We should do whatever it takes to end the violence, so we won't have to feel scared," he said. "These kids have guns. We need experienced people that can stop them."

When he's not working as a Chicago police officer, Richard Wooten said he's in the neighborhoods — Auburn Gresham, West Chesterfield and Chatham — helping residents develop neighborhood watch groups.

"Crime in Chicago is just running rampant," said Wooten, who does community work as part of his own organization, the Gathering Point Community Council. He attended Honore's news conference.

"This is going to require more than just the Chicago Police Department," he said. "We are in a state right now where we need not only to get the community activated and mobilized and dealing with the issues in their community, but somewhere along the way, we're going to have to tap into some federal funding."

lbowean@tribune.com

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Living With Cancer: Arrivals and Departures

After being nursed and handed over, the baby’s wails rise to a tremolo, but I am determined to give my exhausted daughter and son-in-law a respite on this wintry evening. Commiserating with the little guy’s discomfort — gas, indigestion, colic, ontological insecurity — I swaddle, burp, bink, then cradle him in my arms. I begin walking around the house, swinging and swaying while cooing in soothing cadences: “Yes, darling boy, another one bites the dust, another one bites the dust.”

I kid you not! How could such grim phrases spring from my lips into the newborn’s ears? Where did they come from?

I blame his mother and her best friend. They sang along as this song was played repeatedly at the skating rink to which I took them every other Saturday in their tweens. Why would an infatuated grandma croon a mordant lullaby, even if the adorable one happily can’t understand a single word? He’s still whimpering, twisting away from me, and understandably so.

Previously that day, I had called a woman in my cancer support group. I believe that she is dying. I do not know her very well. She has attended only two or three of our get-togethers where she described herself as a widow and a Christian.

On the phone, I did not want to violate the sanctity of her end time, but I did want her to know that she need not be alone, that I and other members of our group can “be there” for her. Her dying seems a rehearsal of my own. We have the same disease.

“How are you doing, Kim?” I asked.

“I’m tired. I sleep all the time,” she sighed, “and I can’t keep anything down.”

“Can you drink … water?” I asked.

“A little, but I tried a smoothie and it wouldn’t set right,” she said.

“I hope you are not in pain.”

“Oh no, but I’m sleeping all the time. And I can’t keep anything down.”

“Would you like a visit? Is there something I can do or bring?” I asked.

“Oh, I don’t think so, no thanks.”

“Well,” I paused before saying goodbye, “be well.”

Be well? I didn’t even add something like, “Be as well as you can be.” I was tongue-tied. This was the failure that troubles me tonight.

Why couldn’t I say that we will miss her, that I am sorry she is dying, that she has coped so well for so long, and that I hope she will now find peace? I could inform an infant in my arms of our inexorable mortality, but I could not speak or even intimate the “D” word to someone on her deathbed.

Although I have tried to communicate to my family how I feel about end-of-life care, can we always know what we will want? Perhaps at the end of my life I will not welcome visitors, either. For departing may require as much concentration as arriving. As I look down at the vulnerable bundle I am holding, I marvel that each and every one of us has managed to come in and will also have to manage to go out. The baby nestles, pursing his mouth around the pacifier. He gazes intently at my face with a sly gaze that drifts toward a lamp, turning speculative before lids lower in tremulous increments.

Slowing my jiggling to his faint sucking, I think that the philosopher Jacques Derrida’s meditation on death pertains to birth as well. Each of these events “names the very irreplaceability of absolute singularity.” Just as “no one can die in my place or in the place of the other,” no one can be born in this particular infant’s place. He embodies his irreplaceable and absolute singularity.

Perhaps we should gestate during endings, as we do during beginnings. Like hatchings, the dispatchings caused by cancer give people like Kim and me a final trimester, more or less, in which we can labor to forgive and be forgiven, to speak and hear vows of devotion from our intimates, to visit or not be visited by acquaintances.

Maybe we need a doula for dying, I reflect as melodious words surface, telling me what I have to do with the life left to be lived: “To love that well, which thou must leave ere long.”

“Oh little baby,” I then whisper: “Though I cannot tell who you will become and where I will be — you, dear heart, deliver me.”

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Susan Gubar is a distinguished emerita professor of English at Indiana University and the author of “Memoir of a Debulked Woman,” which explores her experience with ovarian cancer.

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