The Fifth Risk

by The Fifth Risk (epub)

  Salerno and her partner built and ran the new company in Little Elm and called it Retractable Technologies. They received their first patent in the early 1990s and FDA approval in 1997. The first year in business they sold one million syringes, the next year three million. By the third year her company employed 140 people in Little Elm. She repaid the bank her government loan—and she still didn’t realize it was a government loan. For the first time in her life she had money.

  She also now had a view of the inner workings of the health care industry. The company that had made the old syringes, Becton, Dickinson & Co., controlled more than 80 percent of the market and felt threatened. It wasn’t long before Becton started to require hospital systems to buy its clumsy new version of a safe syringe, by bundling it with other products. Salerno assumed Becton was counting on her inability to pay for the lawsuits required to fight them. But she did and wound up with a settlement of $100 million in 2004.

  Even then, Becton found ways to keep her new product from gaining full access to the market. Her company survived but didn’t become what it might have. It now employs 130 people, instead of the 200 at its peak. Salerno concluded that increased corporate power was one of the forces that had reduced the opportunity available in rural America. The rapacity of companies with monopolistic power, and their ability to have their way with the government, got her thinking about the big American systems. “The entire health industry lies about what things cost to make,” she said. “I know what things cost because I made them.”

  Her outrage led her to support Hillary Clinton’s presidential campaign in 2007, but she soon switched to Obama. (“I switched because I got so angry at how they were beating him up.”) After Obama won, Salerno was a natural candidate for a job she had no idea existed: helping people in rural America to help themselves. “Someone said,‘Why don’t you become an administrator in rural America, at the Department of Agriculture?’ I said,‘There’s an administrator in rural America?’”

  She’d come to her job inside the little box marked “Rural Development” without any particular ambition to be there. The sums of money at her disposal were incredible: the little box gave out or guaranteed $30 billion in loans and grants a year. But people who should have known about it hadn’t the first clue what it was up to. “I had this conversation with elected and state officials almost everywhere in the South,” said Salerno. “Them: We hate the government and you suck. Me: My mission alone put $1 billion into your economy this year, so are you sure about that? Me thinking: We are the only reason your shitty state is standing.”

  She was a small-business person first and had no affection for the inefficiencies she found inside the federal government. “You have this big federal workforce that hasn’t been invested in forever,” she said. “They can’t be outward-facing. They don’t have any of the tools you need in a modern workplace.” She couldn’t attract young people to work there. Once, she tried to estimate how many of the USDA’s 100,000 employees had been taught how to create a spreadsheet. Fewer than fifty people, she decided. “I was always very aware how we spent money. When I would use words like‘fiduciary duties’ or say,‘Those are not our dollars,’ they would say,” Are you sure you aren’t a Republican?’ But I was really sensitive to the fact that this wasn’t our money. This was taxpayer money. This was money that had come from some guy working for fifteen bucks an hour.”

  The big messy federal government was still the only tool for dealing with what she saw as a growing crisis: the deconstruction of rural America. “It’s hard to quantify what it means not to have your entire town’s businesses shuttered up because Walmart moved there,” she said. There was a hole in the American capital markets: they simply didn’t reach small towns. And there were lots of stats that suggested that society benefited from having small towns—and that small-town life made some important, perhaps undervalued, contributions to the whole. Fifteen percent of the country lives in towns of fewer than 10,000 people, for instance, but a far greater proportion of the armed services come from rural areas than from urban ones.

  But the more rural the American, the more dependent he is for his way of life on the U.S. government. And the more rural the American, the more likely he was to have voted for Donald Trump. So you might think that Trump, when he took office, would do everything he could to strengthen and grow the little box marked “Rural Development.” That’s not what has happened.

  The Trump administration wanted to show early that it was serious about foreign trade. This desire expressed itself in the Department of Agriculture by a splitting of the little box marked “Farm and Foreign Agricultural Services” into two little boxes—one for farm programs and another for Foreign Agricultural Affairs, or trade. Oddly, at that very moment, Trump was removing the United States from the Trans-Pacific Partnership and costing American farmers an estimated $4.4 billion a year in foreign sales, according to the American Farm Bureau Federation. As there’s a rule against having more than seven little boxes on the USDA’s org chart, they had to eliminate one of the little boxes. The little box they got rid of was Rural Development. “I worked in the little box in the government most responsible for helping the people who elected Trump,” said Salerno. “And they literally took my little box off the organization chart.”

  This troubled Lillian Salerno, and not just because she’d spent five years of her life inside that little box. It troubled her because it made her wonder about the motives of the people who had taken over the Department of Agriculture. She’d worked inside the little box for a reason. And if you wanted to understand what was at stake inside these little boxes, you could not neglect the motives of the people who ran them. “You want to know what worries me most?” she says after I ask her the question I’d come to ask her. “I am absolutely convinced about one thing: there are conversations going on right now in New York and Washington between people in the Trump administration and Wall Street bankers about how to get their hands on the bank portfolio. Folks in banking: I’m sure they are nice people—they just can’t help themselves.”

  She’s worried that an only partially adequate tool for helping people who were raised in the country’s unlucky places will be turned into a source of profits for the biggest financial firms. She thinks that was why they eliminated her little box and moved the $220 billion bank into the office of the secretary: so they could do new things with the money without people noticing. “At the end of the day, what do I think they are going to do?” she said. “Take all the money and give it to their banker friends. Do things like privatize water—so people in rural Florida will be paying seventy-five dollars a month for it instead of twenty dollars.”

  Lillian Salerno had observed the Trump administration for a long moment. Virtually all the people Trump had sent into the Department of Agriculture were white men in their twenties. They exhibited no knowledge of, or interest in, the problems of rural Americans. She decided there was only one thing to do: move back to Texas and run for office. She had no illusions about herself as a political candidate. She was still a small-town girl from Little Elm, Texas. “I’m still basically a waitress,” she said. “I still feel like this. If I get to be a congressman, I’ll still feel like that.” Ali Zaidi had asked a question: Where would the political capital come from to help people in rural America? Well, it would come from her.

  Zaidi marveled at how hard it was for Americans to see the source of their society’s strength. People who came to the United States from other countries had this one advantage: they didn’t take it for granted. “The immigrant journey has a time compression to it,” he said. “Within a generation you’re able to see how the rungs of the ladder of opportunity are laid out in front of you, and you can see the hands that pull you up. You see people pull you up and you say,” Okay, I’ve got to do the same thing for other people.’ I came up that ladder of opportunity, but even I didn’t know the names of the government programs that made up the ladder itself. Growing up, what was obvious to me was
the kindness of community members. But government was less visible. You need to work really hard to appreciate it.”

  And who wants to do that?

  III

  ALL THE PRESIDENT’S DATA

  AS SHE WALKED the path that the tornado had torn through the American town, she was struck by how hard it would have been to imagine what she was now seeing. Two days earlier, on May 22, 2011, the wind had cleaved Joplin, Missouri, in two, leaving behind a lot of you-have-to-see-it-to-believe-it stuff: a rubber hose run entirely through a tree trunk; a chair sideways, all four legs piercing a wall; a giant Walmart tractor trailer thrown two hundred yards onto the top of what had been the Pepsi building; a full-size SUV folded in half around a tree. The metal had been flayed from the car, and the tree was no longer a tree but a tree trunk, as all the branches had snapped and blown away. “I felt like some giant had taken an egg beater and run it through a town,” said Kathy Sullivan. “It was toothpicks.”

  Then she realized that the egg beater metaphor was not exactly right, as the edges of the destruction were eerily undisturbed. What the tornado had narrowly missed was as perfectly preserved as what it had hit was perfectly eliminated. “It was like when you run your finger through the icing on top of a cake,” she said. “A clean line of total destruction.” Doctors in the local emergency rooms were seeing trauma they’d never seen. Body parts strewn on the ground outside the hospital. A small child, back stripped of flesh right down to the bone: they could count his vertebrae. People impaled by street signs. People with wounds that looked as if they were caused by automatic rifles—except that the objects deep inside them were not bullets. Seriously injured people had driven themselves to the hospital with dead loved ones in their cars and apologized to the hospital staff. They didn’t know what else to do with the bodies.

  Tornado outbreaks in the middle of the United States that spring had killed more than five hundred people. In Joplin alone 158 people had died, and thousands had been injured, many critically. That was more than had been killed by a single tornado since the U.S. government had taken on the job of warning people about them. In and of itself this was shocking, but to Kathy Sullivan it was especially so. These people had been informed; the warnings from the National Weather Service, which would soon be reporting to her, had been even better this time than they usually were. The initial tornado watch had come four hours before the event—but then a tornado watch is different from a tornado warning. The average National Weather Service tornado warning comes thirteen minutes before a tornado strikes: Joplin’s sirens had sounded the warning seventeen minutes before the tornado touched down and nineteen minutes before it entered Joplin. But the citizens of Joplin had ignored it. “The majority of surveyed Joplin residents did not immediately go to shelter upon hearing the initial warning. . . ,” as the report Sullivan would soon oversee noted.

  One day someone will write the history of the strange relationship between the United States government and its citizens. It would need at least a chapter on the government’s attempts to save the citizens from the things that might kill them. The first successful tornado prediction was made on an air force base in Norman, Oklahoma, in 1948. The men who made it had been lucky: they wouldn’t be able to do it again. Knowing this, the government had taken the view that people were better off not being warned. The Weather Bureau, as it was then called, was banned from using the word “tornado.” It just frightened people, the bureau believed. But word got out: the government meteorologists had this mysterious new skill. And people demanded to hear what they had to say, even if what they had to say was of little value.

  Since then, the government meteorologists had gotten better at their jobs. The billions of dollars they’d spent on satellites, radar, computing power, and better forecast models had led to, among other things, truly useful tornado warnings. And yet people didn’t seem to realize that the government’s weather information was more and more reliable—or even that it was their government giving it to them. It no longer shocked Kathy Sullivan to hear otherwise educated citizens say that they got their weather from the Weather Channel. Or some app on their phone. A United States congressman had asked her why the taxpayer needed to fund the National Weather Service when he could get his weather from AccuWeather. Where on earth did he think AccuWeather—or the apps or the Weather Channel— got their weather? Where was AccuWeather when winds of two hundred and something miles per hour were churning through an American town, killing people?

  Clearly, citizens didn’t understand their government. But that had been true for some time. Now Kathy saw that the government didn’t really understand its citizens, either. Why had they not saved themselves? If anyone should know the answer to that question, it was Kathy herself—and she had no clue. In some curious way, the United States government had a better handle on the weather than on its own people. It had spent billions of dollars to collect data about the weather, and none about how people responded to it.

  She could not help but admire the people of Joplin. Walking through the ruins, she saw all over again what she had seen so many times: how much better Americans were at responding to a disaster than preventing it. Everybody who could was pitching in to help. The border of the devastated area looked like a tailgater at a college football game. The people who had been spared were cooking food for the people who had not. “No one asked questions,” said Kathy. “No one asked if your home had been destroyed. If you walked up and said you were hungry, you got food.”

  No one could say she hadn’t done her job. She was not by nature or upbringing a political person, but her ambition had led her to become one. She had made all the little compromises—done all the little deals with others and with herself—required to survive in the upper reaches of American government. She was now second-in-command—and soon to be first—at the National Oceanic and Atmospheric Administration, or NOAA. NOAA oversaw the National Weather Service, among other things. The National Weather Service had seen the tornado and had issued a warning. Her people had given these people what they needed to survive. And yet on May 22, 2011, more Americans had been killed by a single tornado than on any day in the past sixty-four years.

  She might have said nothing. Just thrown up her hands in the privacy of her office and told herself that it wasn’t her job to save people from their own stupidity. Instead she asked herself: What don’t we understand about our own citizens? She flew back to Washington and gathered the relevant parties—all of whom might have claimed credit for a job well done—and asked them, “Is anyone here happy about the outcome?”

  To their credit and hers, no one was.

  Before she had been given her first paying job by the United States government, Kathy Sullivan had been put through a battery of tests. Some were physical, some were psychological, and others—well, she didn’t know quite what they were. At no point during them had she figured out what her testers were looking for. She survived two virtually identical interviews with the National Aeronautics and Space Administration, one with a good NASA cop, the other with a bad NASA cop. “The bad cop made you feel uncomfortable,” she said. “The room was ill-lit. He sat behind the desk, and you sat in an exposed chair. You weren’t facing each other. He was mumbling and not friendly. Then they did it all over again with a warm, sunny guy who was your best friend.” Only much later did she learn that they wanted to see if she answered questions the same way whether she was at ease or not. “I didn’t have anything to compare it to,” she said. “You might try to manipulate the system, but you need to know the system, and I didn’t.”

  Later she decided that they weren’t even really trying to figure out who she was. All they had wanted was the answer to a question: Will she be that same person that she appears to be now when she is traveling at 17,500 miles per hour 140 miles above Earth and something goes bang?

  This was her first job interview, and she was applying to be an astronaut. It was 1977, but the work was still risky. “Every flight was still proving that
you can get up there and come back alive,” she said. “It’s like riding bombs.” Still, 8,078 other Americans had applied for the job. Five thousand six hundred eight of these had satisfied the basic job requirements. Of those, NASA invited 208 people to the Johnson Space Center, outside Houston, for a week of interviews. “They interviewed us in groups of twenty,” Kathy said. “I got there and saw this cluster of other people. It was all guys. That was okay. I’d been the only woman in a field camp and the only woman on a ship.” The difference was that this wasn’t just guys but a club. “My sense was a lot of these guys knew each other. They’re fighter pilots or whatever. I’m twenty-five. I’m a grad student. I’m broke. They seem to be settled in and knew what they’re doing—and I didn’t. I thought, Well, Kathryn, enjoy the week.”

  The main event was a ninety-minute interview at a long table filled with strangers. One was the famously inscrutable head of the astronaut program, George Abbey. At the start he leaned back in his chair, eyes half-closed, and did not so much ask as mutter, “Tell us about yourself. Start with high school.” That was it. Nothing more. “It was deliberately underspecified,” Kathy said.

  Telling people about herself wasn’t her strong suit. “I’ve never been a self-revealing person,” she said. She went ahead and told them about herself anyway. How by the age of thirteen she’d learned from her father, an aerospace engineer, to fly a plane. How, as a girl growing up in the fifties and sixties, she assumed that her ticket to adventure was not a pilot’s license but her gift for languages. Before she graduated from high school, without setting foot in France or Germany, she became fluent in both French and German. She planned to learn a bunch more languages. “My simple theory was: learn lots of languages and use them to see the world,” she recalled, in an oral history for the Johnson Space Center. She entered UC Santa Cruz in 1969 as a language major. But there was a science requirement, and to fulfill it she took two classes in ocean science. There she learned that human beings were now descending fourteen thousand feet in tiny submarines and mapping the ocean floor. “It was endlessly fascinating. This mix of things I’d always seen on the pages of National Geographic.”