First, Do No Harm? The Johns Hopkins System’s Toxic Legacy in Baltimore

A long-read of labor abuses, tax avoidance, back-channel political donations, shady development, human experimentation, and official non-apologies by Baltimore’s most powerful institution.

August 18. 2015

submit to reddit

First, Do No Harm? The Johns Hopkins System’s Toxic Legacy in Baltimore

A long-read of labor abuses, tax avoidance, back-channel political donations, shady development, human experimentation, and official non-apologies by Baltimore’s most powerful institution.

The Johns Hopkins Campus

Johns Hopkins Hospital has for over a generation been considered one of the world’s preeminent hospitals, ranking as the USA’s top hospital in US News & World Report from 1991 to 2011, and again in 2013. The same publication has ranked Johns Hopkins University as one of America’s top 15 universities since 2008. The Hospital and University, though officially run separately, comprise the Johns Hopkins System, Baltimore City’s largest and ostensibly most important employer. On the macro level, Johns Hopkins has absolutely earned its world class reputation: Hopkins has some of the most brilliant minds from around the globe among its faculty, in the field of medicine, certainly, but also in politics at its School of Advanced International Studies in Washington DC, and in everything else, from literature to urban planning, back on its flagship Homewood Campus in Baltimore.

Walking up the perfectly manicured rolling lawns to the palatial Georgian red-brick facades and their spotless white columns, the white towers of this cathedral of knowledge shining in the sun, the majesty of Johns Hopkins as a center not just of thought but of power becomes clear. From the inside, the awesome power of the church remains an ideal analogy: austere, perfectly clean, high-ceilinged, and the stillness of arduous study gives an undisturbed moment to stare out the stained glass windows of the reading room and onto the forever-continuing campus.

Through the back of this building, the green hills continue to roll, lined by further red brick and white, seemingly-marble doorways. The students walking by look as though their only care in the world is the pursuit of knowledge, or at least a passing exam grade (it can be difficult to differentiate the two in this world). Those whose noses are not buried in their books on the cathedral steps are engaged in discussion with their classmates over theory or campus politics: it’s just as likely to overhear a critique of a professor as a debate on medical ethics as a discussion of who is sleeping with whom. The façade begins to crumble: this is definitely an American college campus.

Continuing along the red-brick path, one reaches The Hopkins Club, a squat, understated building of the same Georgian design, unremarkable from the outside but surrounded by a lush forest of vastly-differing greens, from grass to ivy to evergreen to oak. Entering the Hopkins Club, by invitation only, as it is the prestigious faculty-and-alumni-only meeting and dining place, the same attention to projecting power, control and majesty can be seen as in the first cathedral. Marble steps and iron railings lead you to a hallway along which stand marble statuary and at the end of which stand two impressive marble columns. Through these sits the dining room whose gleaming white walls are adorned with antique pictures of famous Hopkins alumni and, around the windows, drawn red velvet curtains. Of course this is just one of the Club’s many impressive rooms, but in this one, it can be noticed how the white of the walls and tablecloths matches the largely-monochromatic nature of the Club’s clientele, which is at stark odds with the majority-Black serving-and-cleaning staff (though their gloves are white).

We pause our tour here for two reasons. The first, because to continue on would not be to describe anything particularly new: more perfect lawns; more Georgian architecture; more solemn austerity in the face of awesome power and knowledge. The second reason, because the Hopkins Club, and the racial service of its minimum-wage black employees to its white upper-class membership, reminds us of the history of the Johns Hopkins system, and its place within Baltimore’s society, a history that is viewed by Hopkins and its supporters as thoroughly in the past.

Johns Hopkins University and Hospital were created in 1873 by a $7,000,000 bequeathal (adjusted for inflation, that would be equivalent to over $137,000,000 today), split equally between the two, in the will of Quaker banker, financier and abolitionist Johns Hopkins. The Hopkins family, a dynasty of unbelievable plantation wealth, freed their slaves when Johns was 12 years old, out of a commitment to the Quaker faith. Despite this rejection of slavery, the house of Hopkins did not seem to suffer materially, as Johns died one of the wealthiest men in America at age 78. It is always possible to find fault after the fact with historical figures such as Hopkins, but his anti-racism was among the most impressive of his era, mandating as he did at his death that his hospital admit black patients, while leaving additional sums to care for the poor black former-slaves-cum-citizens of Baltimore and additionally leaving the funds for an orphanage for black children.

Johns Hopkins the man loved the Union under Abraham Lincoln, loved the state of Maryland, and loved the city of Baltimore. His commitment to the places he loved, and to the causes of abolitionism and equality, are clearly illustrated by his life’s work, and by what he left in death. The custodians of the institutions that bear his name claim to live up to his hopes and his legacy. Yet despite turning these institutions into world-renowned centers of science and knowledge, one wonders just how proud the man described by the University’s own newspaper as “an abolitionist before the word was even invented” would be.

Walking away from the Hopkins Club in any direction, a description, as already mentioned, is unnecessary. That is, until one reaches the very obvious end of the campus. The Johns Hopkins Campus Safety and Security website explains that on campus are deployed “55 full-time and 4 part-time Special Police Officers commissioned by the State with full arrest powers”. This keeps the members of the Hopkins community safe on-campus. But what it keeps them safe from becomes obvious when one notices that “Off-duty Baltimore City Police Officers are deployed on Charles Street/Charles Village and University Parkway areas”. The borders of campus are the dividing lines between the affluence and comfort of the Johns Hopkins community and the Baltimore community that lies just beyond it.

This form of campus bubble is certainly best illustrated by the Johns Hopkins University Homewood Campus through which we’ve just toured, but it is merely exemplary, not unique. The Johns Hopkins Hospital campus, from the Sheikh Zayed Tower to the Kennedy Krieger Institute (according to Hopkins: “While not officially part of Johns Hopkins Medicine, Kennedy Krieger Institute is a partner with which we share faculty, collaborate on research and send some patients for rehabilitation”) to the Bloomberg Children’s Center, is equally insulated, with its own Metro station, the campus taking up around 8 square city blocks, uninterrupted and never forced to make eye contact with the Baltimore residents in whose midst they work.

What is Johns Hopkins protecting itself from?

Well, based on 2013 statistics (and everything has gotten worse in 2015), Baltimore’s violent crime rate is nearly four times higher than the American average, it’s murder rate more than eight times the norm. 24% of Baltimore citizens live below the poverty line, the national average being only 14%. Insulated in this academic and professional bubble, not only are Hopkins students, professors, doctors and other faculty graciously detached from the plight of the community to which they claim to belong, but they are also blissfully unaware of their own role in the city’s sad fate.


The Decline of Baltimore’s Industry and a Sorry Replacement

In the 1950s, Bethlehem Steel, Baltimore’s economic engine, employed 35,000 people, the bulk of them members of United Steelworkers (formerly the Steel Workers Organizing Committee), earning decent pay and decent benefits. In 1971, the Bethlehem Steel’s Sparrows Point facility was America’s largest steel mill. In the decade that followed, though, global economic changes in the steel industry led to mass layoff, and by the end of the ’80s, Bethlehem Steel was providing Baltimore with only 8,000 jobs, and none of them with the kind of middle-class benefits and pay that had so long persisted.

As the jobs left, so did the residents, and Baltimore fell from nearly a million citizens down to 650,000, a third of the population fleeing to the suburbs in the half-century leading up to 1997. This process was in large part “white flight”, and as privileged white wealth left the city, so too did small businesses, dropping both manufacturing and retail jobs by nearly two-thirds in the same time period. At the same time, the city’s black population nearly doubled, but very few profitable businesses came with this population explosion. The 1990s saw the emergence for the first time of a real black middle class, and in Baltimore this middle class followed their white predecessors’ suit, leaving for the suburbs instead of building new wealth and jobs in the city.

By 2004, according to the Bureau of Labor Statistics, over 90% of all of Baltimore’s jobs were in the service sector. And according to a report by Washington’s Economic Policy Institute, 71% of the low-paid service jobs went to African-Americans, despite African-Americans making up only 59% of Baltimore’s population at the time. According to the Service Employees International Union (SEIU),

“Service industries such as hospitals, nursing homes, and tourism ha[ve] become the primary source of employment for poor and minority workers [in Baltimore]. Service jobs are largely characterized by low pay, high turnover rates, irregular or part-time schedules, lack of benefits, job insecurity, and lack of union representation.  Few offer vocational training or skills-building opportunities for advancement.  Low pay forces many service workers to work second jobs, increasing their weekly work hours to more than 60 in some cases. Also, many workplaces are located far from the neighborhoods where service workers live, adding to transportation and child care costs for working families.”

The proponents and stewards of the Hopkins system would argue that, despite their insulation, Hopkins, as the primary provider of these service jobs, is the major force turning the city around after Bethlehem Steel’s departure. And they have a good deal of data on their side: according to the State of Maryland’s own governmental count, Johns Hopkins is Baltimore City’s largest employer, employing 43,651 people when you combine the university and the medical facilities. That many jobs could turn around an entire state’s economy. Of those jobs, 14,585 went to Baltimore residents. The Hopkins system itself generates over $7 billion of revenue annually (nearly 4% of all business done in the state of Maryland) and brings in over $200 million in income (these numbers from 2004). This is huge money for a suffering city. In fact, last year Hopkins opened its new $1.1 billion healthcare facility in economically-depressed East Baltimore. Construction, by Hopkins’ own count, created 4,700 short-term jobs, in addition to the pre-existing 14,585. While only 280 of these jobs went to residents of the East Baltimore neighborhoods over which the new building would tower, a total of 1,000 short-term positions popped up for Baltimore City residents.

But as the SEIU explained in their 2004 publication “Putting Baltimore’s People First: Keys to Responsible Economic Development of Our City”, these jobs are not actually a boon to the city, though they may be a temporary boon to its people:

“As Baltimore struggles with a dwindling tax base, the City’s charitable institutions, and Hopkins in particular, generate an ever greater portion of overall income — and these institutions are exempt from taxes. Within Baltimore City alone, Hopkins Institutions own $505 million worth of tax-exempt property, according to current tax assessments [in the 11 intervening years that has increased dramatically]. Were these properties subject to taxation, Hopkins would have to pay $12 million a year in property taxes to the City. Instead, the burden of paying for schools and other services falls on the rest of Baltimore’s residents and businesses.”

In addition to this tax dodge, the SEIU report goes on to explain how Johns Hopkins’ jobs actually cost Baltimore and Maryland taxpayers enormous amounts of money. To summarize the numbers from the SEIU,

“A Hopkins Hospital environmental service worker who earns an annual income of $20,800 a year ($10/hour) while supporting two children, qualifies for the following public assistance programs: Maryland Child Care and Development Fund – $2,853.37; Federal CCDF expenditures – $8,222.12; Maryland Children’s Health Program – $498.00; Baltimore City public Schools Reduced Price Meal Program – $1,222.00; Women, Infants, and Children Program (if pregnant, nursing, or has an infant child) – $770.25. Total Annual Costs to Taxpayers Per Worker:


On the other side of the wealth spectrum, according to coverage by In These Times, “the non-profit hospital reported a $145 million surplus last year,” with top earners like President Ron Peterson earning $1.9 million annually. And according to the Baltimore Sun “Edward Miller, CEO of Johns Hopkins Medicine, made $729,297. He also gets paid separately for his position as dean of the School of Medicine at Johns Hopkins University [for which] Miller collected $1.4 million [in 2009]”. This is not unusual in the health care industry (former University of Maryland Medical System CEO Edmond F. Notebaert resigned in 2008 and left with a $7.8 million severance package) and this kind of compensation is justified by its recipients by the massive acquisitions performed under their tenure, or because of projects such as the $1.1 billion building erected in East Baltimore under Miller’s leadership. But President Peterson takes his paycheck out to his home in the peaceful suburbs of Bel Air, MD, thus avoiding any possible minimal “trickle down” into the economies of the urban neighborhoods near Johns Hopkins.

This incredible wealth flowing to executives and top doctors from what has been described as “a $6.5 billion integrated global health enterprise” (and that really only covers the medical part, not the University itself), contrasts starkly with the reality of those 14,585 Baltimore residents working in the Hopkins system, when Johns Hopkins refused to negotiate with the SEIU last year to pay its workers a $15 minimum wage, saying the total $3 million increase in payroll costs was unaffordable. Even some of Hopkins’ own physicians, like Dr. Benjamin Oldfield, have been “surprised they [Hopkins] haven’t gotten this one right yet,” as a medical institution should “know that financial insecurity leads to bad health outcomes.”

Since then, improvements have, at least ostensibly, been made. After significant pressure in the form of strikes by SEIU employees, Hopkins finally agreed on a $12/hour wage for union workers, still short of the desired $15/hour living wage, in 2014. However, Hopkins then imposed a new health insurance plan that costs workers $1,800/year, an expense greater than any gains made. This year, the non-specialized workers of the Johns Hopkins system will be even poorer than before.

Responding the outcry over this, Hopkins issued a statement officially avoiding the ethics of underpaying their staff and instead addressing non-Baltimore concerns of their status as a nationally- and globally-recognized health-care institution:

“Our patients and their families are always our first priority, so it is important they understand that the employees represented by SEIU1199 work primarily in service and maintenance jobs and are not involved in providing direct patient care.”

In a city as depressed and oppressed as Baltimore, these thousands of jobs have been seen by the city’s government as salvation. In actuality, those jobs are worse than simple stop-gap unskilled positions with no future: starting salaries earn Baltimore citizens poverty-line wages and below. So, if they are supporting a family, they qualify for $13,570 in subsidies per year. But as a non-profit institution, despite its billions in earnings, Hopkins pays no taxes and therefore does not even pay into the pot that its employees are forced to pool from. In their annual report in 2010, the University claimed to pay $175 million dollars in taxes and fees to the state of Maryland. However, $171 million of this was “state income taxes withheld from the earnings of its employees”, meaning that Hopkins itself, from its massive revenues, paid at maximum $4 million in taxes, not nearly enough to make up for what it costs.

Certainly, not each of the 14,585 Baltimore-resident workers is supporting two children, though most of them are supporting families of some kind. And not all of them earn a mere $10/hour, though some, in fact, earn less. So perhaps it costs taxpayers more like $10,000 annually to support each of Hopkins’ workers. This is definitely less costly than unemployment or other forms of subsidies for indigent and homeless citizens. But instead of saying, well, it’s better than nothing, it needs to be recognized that Hopkins could easily afford to pay all of their employees sufficient wages that they would not require the city and the state to pay millions of dollars to supplement a full-time worker’s meager income, especially on top of everything else the city ends up paying out towards Hopkins’ projects.

Now, nationwide, hospitals and universities are non-profit organizations and do not pay taxes. This is as true in Boston as it is in Baltimore. The difference, though, is that in Boston those organizations are merely a part of the city’s economy, not the vast majority of it. This means that a city like Boston, thriving and wealthy, can afford to forego the taxes from universities and hospitals because these institutions still bring business to the surrounding areas. Hopkins is so isolated within the city of Baltimore, and the city itself is so segregated, that the economic benefits that smaller businesses in Boston see from its health and education sectors are not mirrored in Baltimore.

Malcolm Gladwell recently sparked a heavy debate after decrying the foolishness of donating to Harvard, but at least those donations are made of an individual’s free will. If instead of milking the tax exemptions they enjoy at the expense of Baltimore and Maryland citizens, Johns Hopkins were taxed at Maryland’s going corporate tax rate of 8.25% on its $7.62 billion annual revenue, the taxes would come to $628,650,000 annually, or $12.5 billion over the past 2 decades, in addition to the $12-million-plus in annual property taxes cited by the SEIU. In effect, by saving Johns Hopkins the burden of paying for their own development, Maryland and Baltimore taxpayers have unknowingly put billions of dollars into Hopkins’ endowment, already the country’s 25th largest at $2.6 billion. If instead of investing in palatial campuses, manicured lawns, political lobbyists and private police forces, this money had gone into the city, it would have been more than enough to repair and upgrade every single one of the city’s failing public schools, fund addiction recovery programs for all the city’s addicts, renovate the crumbling public transit infrastructure, and invest in job training and housing assistance for the city’s unemployed and homeless.

Baltimore’s corporate tax structure is frequently decried in the news as wildly anti-business. While there is legitimacy to this claim, it is also compounded by the ease with which small businesses have been able to relocate mere miles away, just over the city limits in Baltimore County whose taxes are less than half of the City’s. Some Hopkins protectionists might suggest that to tax Johns Hopkins at a normal rate would be to drive them out. However, in addition to the difficulty it would cause in rebranding after Johns Hopkins has so thoroughly publicized its Baltimore connections, the Hopkins institutions are so inextricably linked to the city that to leave would be to forfeit billions of dollars of investment and in all likelihood bankrupt the system as a whole.

It is worth noting that non-profit tax code for so-called “charitable institutions” is not written in stone. In the 1980s, there was a movement across the country, from Vermont to Utah to California, to rescind the tax exemptions that non-profit hospitals enjoyed if those hospitals did not provide charitable services of a value equal to or greater than the amount of taxes they avoided. It was not successful everywhere. Under the leadership of then-Mayor Bernie Sanders, in 1988:

“The city of Burlington, Vermont assessed a $2.83 million property tax against the Medical Center Hospital of Vermont, a not-for-profit teaching hospital. The hospital responded by challenging the action in a civil court suit. The city argued that the hospital had ceased to be a charitable institution as the term was used in state statutes. The Vermont Superior Court found for the hospital, over-turning the assessment by the city and prohibiting collection of the tax. The court held that the hospital retained its charitable nature in spite of changes in the organization and the health care environment.”

However, in Utah, the court found differently.

“The argument was simple, said [the] chief deputy assessor of Utah County: ‘We think that they’re not really a charitable institution.’ The assessors define charitable care as something more than just community service; a hospital must also provide a certain amount of care to those who cannot pay for it.
The Utah Supreme Court backed the assessors in 1985, declaring unconsitutional [sic] the state law that guaranteed property tax exemptions for nonprofit hospitals. Voters, in turn, narrowly rejected a constitutional amendment to bar taxes on the hospitals in 1986.”

Tax codes are state by state and city by city, and in certain cases, such as Utah, the movement worked out to everyone’s benefit:

“The key factor in the [Utah hospital system] deal reached last fall was an agreement that hospitals would have to provide charity care in excess of the taxes it would otherwise pay, according to hospital executives, legislative leaders and local officials.”

And it’s not just Hospitals whose non-profit statuses are questionable. In 2013, the city of Princeton, New Jersey brought a similar lawsuit against Princeton University, and the Mayor of Providence, Rhode Island suggested willingness to do the same against Brown University while the Mayor of Pittsburgh, Pennsylvania sued the University of Pittsburgh Medical Center, with even The Wall Street Journal lauding these efforts, saying:

“The conflict isn’t going away. In June, a state tax court judge said the case [against Princeton] had merit and refused the school’s request to dismiss the case… There is certainly something to be said for schools being accountable to students and parents. But a relentless focus on expansion and profit can diminish the importance of teaching and learning. Either way, this trend isn’t going away, and residents and local business owners in university towns may no longer be willing to buy the line colleges are selling.”

It is unclear exactly how much charity care the Hopkins system provides. What is clear is that, if a similar agreement were reached between Baltimore and Hopkins as was between Utah and Intermountain, it would cost Hopkins nowhere near the billions in taxes that they have avoided through their nonprofit loophole and, as will be shown, certainly pales in comparison to the amount of care that became necessary through their toxic developmental methods.

And this might be a good time to talk about that construction project that brought the city 1000 jobs.


Hopkins as Developer

Slum clearance area with Johns Hopkins Hospital in the background, Source: Citizens' Planning and Housing Association (CPHA) Collection. Creative Commons license: Attribution-NonCommercial-NoDerivs 2.0 Generic (CC BY-NC-ND 2.0)

Slum clearance area with Johns Hopkins Hospital in the background, Source: Citizens’ Planning and Housing Association (CPHA) Collection. Creative Commons license CC BY-NC-ND 2.0

Hopkins’ recent expansion in 2001 came with a supposed makeover in its treatment of the city. East Baltimore Development Inc., known throughout the city as EBDI, was created under the tenure of then-Mayor Martin O’Malley and led by Johns Hopkins as the largest urban redevelopment project in America. Hopkins was to build a giant biotechnology park and a series of housing complexes for students and faculty. In so doing, however, it also was to raze 750 existing homes and remove over 600 Baltimore residents by force. According to Maryland-based The Daily Record,

“East Baltimore Development Inc. has spent $6.4 million per acre since 2002 to revitalize a largely vacant chunk of inner city bounded on three sides by slum and blight. The money has gone to buy homes, demolish buildings, relocate residents and build underground infrastructure for water, sewer, state-of-the-art fiber-optic and electrical systems. Of the $564.7 million tab so far, $212.6 million has come from the cash-strapped … governments.”

Despite publicly-stated goals of bringing Baltimore’s people up with the jobs coming with EBDI, $212.6 million seems a steep price to pay for a project that benefits students and other non-Baltimore-residents at obviously great cost to Baltimore’s actual, long-time community. The Daily Record goes on to call the initiative itself a failure, as, after a decade, only one of the biotech buildings was completed and barely any of the housing complexes were even begun. However, this should not be particularly surprising, according to Mint Press News:

 “This is not a one-off event. Johns Hopkins’ expansion has been instrumental in the slumification and gentrification of neighborhoods surrounding its property for decades. The university buys properties, including homes in areas where it plans to expand up to 60 to 80 years in advance of redevelopment, and allows those neighborhoods to socially and economically wither away until it can buy up even more property at fire sale prices.

As Johns Hopkins is one of the city’s most economically powerful institutions, the local government and real estate developers respond in kind by divesting resources and allowing those areas to rot, rather than investing in redevelopment plans that could revitalize communities.”

To prove this point, a key text on Hopkins development practices is Marisela Gomez’s Race, Class, Power and Organizing in East Baltimore. Gomez was a key organizer for Save Middle East Action Committee, or SMEAC, the organization responsible for the protests that significantly increased what Hopkins and EBDI were forced to pay in reparations to those East Baltimore residents pushed out of their homes. Gomez’s book shows just how long Hopkins’ developmental practices at the expense of Baltimore’s poor black communities has been going on. Synopsized by Dax-Devlon Ross:

“in the early 1950s … 1,100 families living on 39 acres west of the hospital were informed that their community was being cleared. Like the current project, that community was 90 percent black and largely poor. It was sold as a landmark project that would result in a beautified neighborhood that included the first new housing for blacks in the city’s history. The city demolished residences and businesses and cleared the land, only to allow it to sit undeveloped for the next four years.

When work did start up again, plans had changed: 100 percent of the development would belong to the Hopkins community. No new homes would be built for black residents. Local activist groups protested the change to no avail. The completed development contained housing for students and staff, a shopping center, a hotel and a medical office building. A fence arose around its perimeter, making it impossible for local residents to walk the very streets they’d once lived on.

Thirty years later a Hopkins-led group called the Historic East Baltimore Community Action Coalition (HEBCAC) leveraged $34 million in federal financing from the U.S. Department of Housing and Urban Development to rebuild homes in Middle East. Under the plan, Hopkins would buy properties from residents and sell them to HEBCAC for $1. HEBCAC would then fix the properties up and sell them to residents in exchange for their old ones, which would then be torn down. HEBCAC’s leaders believed this process would facilitate a smooth transition from blight to brighter days. In six years the program built fewer than 50 homes and the neighborhood vacancy rate doubled. By late 2000, HEBCAC’s executive director conceded that he had miscalculated the rate of disinvestment in the community. It was just a few months after HEBCAC’s admission that Middle East residents opened the Baltimore Sun and read that Hopkins would be spearheading a new type of renewal experiment in their neighborhood [this is a reference to EBDI]. This time around, the entire neighborhood would be leveled and rebuilt. Everybody had to go.”

When it happened again in the early 2000s, it was under the guise of EBDI and supposedly in partnership with the community. However, the money originally offered as reparations for wipe out the homes of East Baltimore’s residents was a pittance. Through SMEAC’s efforts upped those reparations in some cases as much as ten-fold, but it was not enough. SMEAC disbanded in 2010 and in their wake, many activist organizations popped up. According to one of them, Community Housing and Relocation Work Group, “In the Minority Inclusion Agreement signed in April 2002, EBDI and its founders promised 8,000 new jobs and the establishment of a community reinvestment fund.  As of today, both of these promises have been broken and thousands of lives have been changed for the worse.” The work group cites one specific, horrific failure to prove their point:

“EBDI displaced [Lucille] Gorham from her longtime home and placed in a house that was not fit for her needs.  EBDI promised to repair her home, but never fulfilled their promise.  She lived in miserable conditions

‘Despite a home inspection paid for by EBDI on Nov. 9, 2005, the stove stopped working, followed by the microwave, the washing machine and the hot water heater. The house was infested with rodents. Rotting floor boards gave way to holes in two places on the first floor, and the enclosed front porch ceiling gushed with water whenever it rained.’”

According to the article and post-SMEAC community activists, these conditions resulted in Ms. Gorham’s death.

Outright eviction or relocation is far from the only way Hopkins’ expansion has harmed Baltimore’s communities. Back in 2007, this journalist was told by a former Black Panther and present-day reverend and community activist the story of Johns Hopkins’ toxic East Baltimore construction projects in the 1960s and ‘70s. Glass particles and asbestos that filled the air from the demolition of old homes had caused scarring in the residents’ lungs. When it came to the Hopkins administration’s attention that this construction had caused astronomical rises in asthma and cancer rates in the local black community, those administrators tried to literally sweep the issue under the rug, by giving the residents each a handheld vacuum to clean the carcinogenic particulates out of the air and calling it even. While no medical records or articles have been found to confirm this story, Glenn Ross, who Baltimore City Paper awarded the title of Baltimore’s Best Community Activist in 2001, gives support to the claim:

 “These houses were built in the ‘20s, they were built with plaster, with horsehair, asbestos, lead, other contaminants. When they tore this building down, they left all this stuff right on this area. When they started tearing down blocks of houses years ago, they didn’t do anything with it. So that means that that whole block of houses that was demolished, all that soil was contaminated. Children played on it. Most of them were small streets, so that was the rear of people’s houses. What’s at the rear of peoples’ houses? Their yard, it’s where you hang your clothes in, it’s where your pets are, it’s where your kitchen door is, where people’s bathrooms are. So that means all this dust is coming into the homes and people are [mumbled, likely “inhaling it”].”

Outside of Mr. Ross, there is indeed little to be found on the subject of glass particulate inhalation, and certainly no apology, yet again, from Johns Hopkins.

It would be not simply outrageous but also blatantly wrong to say that Hopkins benefits from the death and mistreatment of Baltimore’s citizens. No, it seems to the observer that Hopkins has simply become so preoccupied with expansion and rankings that it lost sight of its foundation as an institution dedicated to the common good. What’s more, due to the departure of the major employers that once made up the city’s economy, Baltimore City finds itself so psychologically dependent on the jobs created by the Hopkins system, despite the evidence that those jobs benefit neither the city nor its citizens, that no one in a position of power will willingly call the institution on any wrongdoing. In an echo chamber like this, it would be easy for those within the system, even those responsible for such villainy, to view themselves as the heroes. But how did it come to this? The answer is a sad mix of money and politics, and the loyalty bred by the combination of the two.

Read Zachary’s first-hand account of “The Money Trail of Baltimore’s White Supremacist Politics” here.

 The Money and Influence Trail of Hopkins’ Dominance of Baltimore City

Then-Governor Martin O’Malley at a press conference on the progress of Hopkins’ “job creation” in 2013. Source: Photo collections from the Office of the Maryland Governor, managed by the Maryland State Archives. Creative Commons license Attribution 2.0 Generic (CC BY 2.0)

Then-Governor Martin O’Malley at a press conference on the progress of Hopkins’ “job creation” in 2013. Source: Photo collections from the Office of the Maryland Governor, managed by the Maryland State Archives. Creative Commons license CC BY 2.0

Finding data on where Hopkins development money is being funneled is incredibly difficult. In addition to the old practice of major businesses having their employees make donations and then reimbursing those donations in unspecified “bonuses”, Maryland politics has long been haunted by a corrupt precursor to Citizens United known as “the LLC loophole”: Maryland law forbids individuals and businesses from donating more than $4000 to a single candidate in an election cycle. However, before this year this rule could be easily circumvented by opening an infinite number of limited liability corporations (LLCs) or other corporate entities and using each of these to donate the $4000 maximum to one’s candidate of choice. In one case, a single developer used LLCs to donate over $250,000 to a series of candidates in a 2-year election. Maryland wisely closed this loophole in 2015, but problematically this does not stop a Johns Hopkins development project from doing similar things.

Johns Hopkins development projects are massive enterprises, pulling in multiple different firms to undertake different parts of the project, and each of these firms can donate $4000 per candidate, as can the subcontractors they employ. On the other hand, the Hopkins system gets to keep their hands clean, rarely if ever contributing directly to political campaigns. So, for example, the developers involved in constructing the new Hopkins bio-tech park can donate thousands and thousands of dollars to a single candidate, as they did to newly-reformed former-Hopkins-critic City Councilman Carl Stokes, without that money looking like it came from the Hopkins system. The same applies to City Council President Jack Young, whose campaign coffers are being filled by some of those same Hopkins-affiliated developers in the run-up to his mayoral campaign. This seems more than coincidental, as Marisela Gomez, SMEAC activist and author of the aforementioned monograph,

“said in an interview that she was one of the appointed members of the board that was to be overseen by City Council members Bernard “Jack” Young and Paula Johnson Branch, who represented Middle East at the time. But Young and Branch apparently dropped the ball. Gomez said she kept calling City Hall, asking when the board would meet, “but it never met. I kept thinking, what’s going on?”

In Stokes’ case, this money coincides with an utter cessation of public positions regarding Johns Hopkins: In January 2015, Stokes, who had previously described the EBDI project as a “land grab,” said of the whole project:

“The community feels that the project’s a failure, and I don’t think it will improve any more in the next three years than it has in the past 15. You go over there, you’ll see new development that [master developer] Forest City has built, new development that the state of Maryland has built, new development that Johns Hopkins has built. You don’t see housing and dog parks for the community.”

He has since then, after taking campaign money directly from Forest City and other affiliated developers, been uncharacteristically quiet. There’s no better way of changing a politician’s mind than with a little campaign cash, yet the money itself cannot be linked to the Hopkins system.

A similar case is Beatty Development Group, whose projects are often linked to Johns Hopkins, such as the recently-begun 327 thousand square foot development project that includes new Johns Hopkins University student housing. Campaign finance reports show that Beatty has donated significant capital to City Councilmembers William “Pete” Welch, Warren Branch, Jim Kraft, Helen Holton, City Council Vice President Ed Reisinger, as well as Stokes and Young again, and over $16,000 to Mayor Stephanie Rawlings-Blake. Johns Hopkins never had to spend a dime, publicly.

In addition to the direct payoffs, there are other important links between the Hopkins system and the Baltimore and Maryland legislatures. Maryland State Representative Maggie Macintosh, chair of the House Environmental Matters Committee, is herself a Johns Hopkins lobbyist. There are, however, very few lobbyists so powerful and so connected to the Hopkins system as Van Scoyoc Associates, a bipartisan Washington, D.C. lobbying firm that makes sure that Johns Hopkins’ interests are taken into consideration on the national level, and that Hopkins is one of the go-to institutions for major federal research grants. To this effect, Johns Hopkins pays Van Scoyoc somewhere around $300,000 annually, according to federal lobbying-and-campaign-contribution database OpenSecrets. The already close relationship between the Hopkins system and Baltimore City’s government became outright perverse when, on top of more than $1 million in fees paid to Van Scoyoc by Baltimore City since Martin O’Malley first hired the firm in 2000, the City hired Van Scoyoc Associates as their own full-time lobbyist in November 2014, removing all barriers between Hopkins lobbying and Baltimore’s government.

There are very few elected officials in Baltimore who stand against Hopkins. The bonds of campaign contributions are the bonds of complicity: when you’re earning money for supporting a multi-million-dollar project, you’re very quick to defend the project’s merits. But the reasons for support are not always economic: City Councilman Bill Henry earned his bachelor’s degree from Johns Hopkins University and served on the board of the Johns Hopkins Society of Black Alumni, while Councilwoman Helen Holton sits on the Johns Hopkins University Alumni Council. Councilwoman Mary Pat Clarke was a Johns Hopkins University professor, and before that an administrator at the Hospital’s School of Medicine. The bonds of loyalty, of having spent one’s formative educational young adulthood indoctrinated in the glories of Johns Hopkins, these are stronger bonds even than campaign donations.

Johns Hopkins itself uses the cutesy “Johns Hopkins <3 Baltimore” on their medical website, while O’Malley called Hopkins “a world-class institution that has done so much for Baltimore and Maryland” upon joining the University as a visiting professor and additionally called it “our place of healing”. In fact, the strongest criticisms of Hopkins’ projects from Baltimore’s elected officials, coming from Nathaniel McFadden, State Senator from the district worst-effected by eviction and environmental factors, are so weak as to be little more than lip service to the effected community: “‘We don’t want to stop the train. We want to slow it down and get on board.’” Meanwhile, current Mayor Stephanie Rawlings-Blake calls Hopkins’ redevelopment work “awe-inspiring”.

Throughout American politics there are several subjects, from Social Security to farm subsidies to race, which have been called “The Third Rail”, meaning, quite simply, you touch it and you die.

In Baltimore, that third rail is Hopkins. Criticism of Johns Hopkins, in any form, be it low wages or gentrifying development projects, is viewed as biting the hand that feeds Baltimore. Any attack on Hopkins is not simply an attack on unethical development and tax avoidance, it is an attack on education, on public health, and above all on jobs. For this reason, Baltimore’s politicians treat Hopkins with a timid deference that permits the institution to run amok in East Baltimore while continuing to wear the mantle of the city’s savior.

It is this slavish bond between the city’s power players and the Hopkins system that perpetuates and maintains the toxic relationship that facilitates the coordination between Hopkins police and city police, Hopkins development and city development. Just how close? Well, according to that same 2011 Daily Record report,

“Although two members of the Baltimore City Council sit on EBDI’s board as nonvoting members, the nonprofit is not audited or overseen by City Hall in any formal way. City Comptroller Joan Pratt has no fiscal oversight over EBDI because of its nonprofit status. … Mayor Stephanie Rawlings-Blake said … she sees no need for [a public] audit. ‘I don’t think a public audit is anything to run from, but I am sure in accordance with regulations for them as a 501c3 that their financial books have been audited as regularly as they should be,’ the mayor said. … The mayor approves the hiring of EBDI’s CEO as a matter of protocol… [T]he city’s housing commissioner and a nonvoting member of the EBDI board, receives monthly reports from EBDI on the project’s progress but discards them after reading them… [C]ity officials are in ‘regular communication’ with EBDI. City Council President Bernard C. ‘’Jack’ Young held hearings in April 2009 about EBDI’s minority hiring and relocation practices. But he and the two council members who now represent the area said they knew next to nothing about the project’s public funding when interviewed last fall. … EBDI … is not legally required to make [its internal audits] public because of its nonprofit status.”

The Council gets to know how Hopkins plans to develop the City, but not how much public money they spend on that development. They get to approve the hiring of developmental leadership but have absolutely zero control over their actions. This connection is treated more like a heads up to Baltimore, allowing them to know what Hopkins plans to do so that the city government can coordinate its own developmental plans accordingly. In fact, Glenn Ross talked about this planning back in 2008, before the new $1.1 billion dollar construction had even begun:

“I saw how they [City Hall] talked about moving the “drug culture” people, taking resources out of the community, because 20 years down the road there’s another development plan coming. So I say, poor neighborhoods are created [speaker’s emphasis]. … The biotech science park area, where they relocated hundreds of families… This was another neighborhood that was allowed to decay.”

If you’ve got 74 minutes available to learn what “environmental racism” means, you’d do well to watch Glenn’s 2008 Toxic Tour of the city, from whence these quotes originate. However, the highlights as they apply to Hopkins feature here:

“when people in East Baltimore talk about Johns Hopkins, we think of one Johns Hopkins. [But] there’s five Johns Hopkins, with different themes, different boards, and neither one of them knows what each others doing. So what’s happening is, each institution is buying up whatever available property they can acquire, without sitting down and looking at the damage that they’re doing to the community.”

 After describing four different low-income public housing neighborhoods in a row whose residents have all been relocated over a period of only a few months, Mr. Ross explains:

 “What’s happening there is, Hopkins wants their students to live closer to their campus, so they’re gonna displace a lot of low-income families, to turn these housing units into housing for Hopkins people… All those houses, all those streets that you see to your left, will be demolished.”

In the video, it is an obviously massive area, and in a few short years, Glenn was right: they were all destroyed.

“Now, if you look at how many homeless people we have here in Baltimore, just look at all these vacant houses. Some of these houses have been vacant for 20 or 30 years… But you see, as they buy up each house, the properties depreciate, so you see there’s only a few families living in this area. But there’s a future development plan also, to tear all these houses out. This is the second phase of the biotech science park.”

So, with all this power and influence, we come back to the question: What is Johns Hopkins Protecting Itself From?

The answer, in summation, is that Johns Hopkins, with its firmly secured borders patrolled by city police and university security alike, is protecting itself from the Baltimore that it helped create, the poverty and illness and hopelessness that turns into desperation, nihilism, violence and death. The structured tax avoidance, segregation and underhanded development of the Johns Hopkins system is in large part responsible for the poverty that has enveloped the Baltimore that exists just over Hopkins’ borders, the poverty that begets the violence that necessitated the Baltimore Uprisings. But perhaps what’s worst is that the rhetoric that surrounds Johns Hopkins can allow for no criticism and therefore no administrative and political change to their devastating approach to their coexistence with, or more to the point their existence within, Baltimore City.


Hippocratic Hypocrisy: Scientific Contributions at Baltimore’s Expense

Regardless of politics and economics, Johns Hopkins is a hospital, and a hospital is an inherently good institution aimed at the renewal and maintenance of health. This is most certainly the goal upon which Johns Hopkins Hospital was founded, and its achievements globally towards human health are undeniable. Yet in the name of the greater global good, Johns Hopkins has sometimes done great evil to the people of Baltimore.

A human immortal cell line is one of the most important tools in biological research: an infinitely reproducible series of human cells allowing for consistent testing. Johns Hopkins is responsible for the first successful cloning of human cells and thereby the first human immortal cell line, HeLa. HeLa has been widely used across the globe for “research into cancer, AIDS, the effects of radiation and toxic substances, gene mapping, and countless other scientific pursuits”. HeLa is a shortened version of Henrietta Lacks, the black Baltimore woman who was, unknown to her, treated with a radium rod in her cervix, and 2 radium plaques placed on her skin, for a cervical tumor. Additionally, unknown to her, her cells, taken in this procedure, became the subject of incredible research by Hopkins, the HeLa line. As the Henrietta Lacks Foundation puts it: “Henrietta was a poor black tobacco farmer whose cancer cells, taken without her knowledge, became one of the most important tools in medicine, with damaging consequences for her family who today can’t afford access to the health care advances their mother’s cells helped make possible.” Johns Hopkins saved countless lives, by ignoring the value of Henrietta Lacks’.

Henrietta Lacks’ human immortal cell line, Credit: Anne Weston, LRI, CRUK. Wellcome Images. Creative Commons license: Attribution-NonCommercial-NoDerivs 2.0 Generic (CC BY-NC-ND 2.0)

Henrietta Lacks’ human immortal cell line, Credit: Anne Weston, LRI, CRUK. Wellcome Images. Creative Commons license: CC BY-NC-ND 2.0

At the same time as Lacks’ maltreatment, Hopkins was engaged in further radium experimentation, and further stretching of the boundaries of medical ethics.

“Between 1948 and 1954, funded by the federal government, researchers at the Johns Hopkins Hospital inserted radium rods into the noses of 582 Baltimore, Maryland schoolchildren as an alternative to adenoidectomy.” It’s a case of impressively unethical medical experimentation, and none of those affected were informed that the experiment was taking place, nor were they provided with follow-up care. In fact, after a follow-up study in 1995 on the long-term health effects to those who received the treatment found a cancer rate 62% higher than normal, the decision was made not to alert those affected. One of the victims blames the treatments for her “six miscarriages, a pituitary tumor and other health problems,” while another “appeared on a Baltimore medical television show as a success story. But by age 20, she had lost all her teeth. She also suffers from Graves’ disease, a thyroid condition. Her identical twin, who didn’t have the treatment, has a full set of teeth and no Graves’ disease, even though the pair of sisters have both suffered from gall bladder and other health problems at the same time.”

Johns Hopkins released an official non-apology in a press release after a 2010 book on the life of Henrietta Lacks:

“Johns Hopkins Medicine sincerely acknowledges the contribution to advances in biomedical research made possible by Henrietta Lacks and HeLa cells. It’s important to note that at the time the cells were taken from Mrs. Lacks’ tissue, the practice of obtaining informed consent from cell or tissue donors was essentially unknown among academic medical centers. Sixty years ago, there was no established practice of seeking permission to take tissue for scientific research purposes. The laboratory that received Mrs. Lacks’s cells had arranged many years earlier to obtain such cells from any patient diagnosed with cervical cancer as a way to learn more about a serious disease that took the lives of so many. Johns Hopkins never patented HeLa cells, nor did it sell them commercially or benefit in a direct financial way. Today, Johns Hopkins and other research-based medical centers consistently obtain consent from those asked to donate tissue or cells for scientific research.”

No such non-apology was forthcoming on the case of the adenoidectomy radium, but it seems safe to assume that the response would be similar. In fact, such non-apologies have continued all the way to modern Hopkins human experimentation. In the 1990s, Hopkins partner institution The Kennedy Krieger Institute performed a lead-paint-based experiment on Baltimore’s children in which they:

“enticed [children] into living in lead-tainted housing and subjected to a research program which intentionally exposed them to lead poisoning in order for the extent of the contamination of these children’s blood to be used by scientific researchers to assess the success of lead paint or lead dust abatement measures,”

“[Kennedy Krieger] selected children and their parents who were predominantly from a lower economic strata and minorities, [using] these children as known guinea pigs in these contaminated houses to complete this study.”

A lawsuit was brought against Kennedy Krieger, accusing them of

“negligence, fraud, battery and violating the state’s consumer protection act, alleging that children who participated in the study served as “canaries in the mines” … “These children’s health was put at risk in order to develop low-cost abatement measures that would help all children, the landlords, and the general public as well.”

The experiment was performed in the interest of public health, attempting to inform public housing policy with the best possible data. However, as is too often the case with Hopkins, this data was collected outside the boundaries of medical ethics, or indeed of morality, taking their toll on the bodies and minds of the next generation of Baltimore citizens, starting in their infancy.

In a 96-page ruling, Maryland’s highest court compared the study to Nazi experimentation and the Tuskegee syphilis experiment. Two legal scholars described the ruling:

“The court’s remand focused on 3 main issues: (1) informed consent, declaring that parents cannot give consent for their children to enroll in ‘non-therapeutic’ research; (2) a duty to warn because of the ‘special relationship’ between the researchers and participants; and (3) the inadequacies of the institutional review board’s review, referring to the Johns Hopkins institutional review board as ‘in-house organs’ who were not ‘as sufficiently concerned with ethicality of the experiments they review as they are with the success of the experiment.’”

However, in classic Hopkins non-apology style, a follow-up journal article was written and released by Johns Hopkins Hospital lead counsel (and Vice President) Joanne Pollack, that sought to discredit the judgment and defend and explain the contextual need for the study, declaring:

“the record before the court was overwhelmingly incomplete. Notwithstanding this limited record, however, the court came to the conclusion that the study was flawed and placed children at risk for lead poisoning. What, in fact, was flawed was both the court’s analysis and its rush to judgment on a thin record.”

The Johns Hopkins system seems constitutionally incapable of apologizing for their crimes against Baltimore’s poor and minority citizens. Even within a broader defense of the public health benefits of the work, a simple apology for the uninformed or nonconsensual methods used would symbolize an interest in avoiding the continuation of such crimes in the future, but none have been forthcoming.

In the aftermath of these unapologetic lapses in medical ethics, rumors of further experimentation on Baltimore’s black citizens abound. Certain black activists for economic and racial justice claim with absolute confidence that Johns Hopkins doctors implanted the long-term sub-dural contraceptive Norplant in hundreds of black women without their knowledge or consent. No evidence of this crime, heinous if true, has been found during the course of research for this article. In fact, quite the opposite. What has been found was that “[a]s one element of Baltimore’s effort to combat its high rate of teenage pregnancy, the Baltimore City Health Department added the implantable contraceptive Norplant to the array of services offered at one of its school-based health centers in early 1993”. Nothing in this was non-consensual or uninformed.

The fact that such rumors are rampant, however, in the face of Hopkins’ actual wrongdoing in the recent past, is in no way surprising. The progress and breakthroughs that have made Hopkins a world-renowned institution of learning and medicine have come at the cost of countless black lives, and hundreds more mangled black bodies, courtesy of the city of Baltimore. As Glenn Ross puts it, “Johns Hopkins is the biggest recycler in the state of Maryland. They recycle people. They recycle us. And they literally make us sick.”

These are certainly not Johns Hopkins’ only lapses. The Hospital system is being sued by 774 Guatemalans over an experiment in the 1940s and 50s where Hopkins doctors, at the behest of the United States government, infected Guatemalans with Syphilis, Gonorrhea, and other STDs in what could be described as a vicious colonial version of the Tuskegee Experiment. And in a similar act of gross humanitarian negligence to the radium experiments, Hospital administrators chose to withhold a report on Black Lung from the effected miners of Pennsylvania, thereby preventing them from receiving proper care and treatment. But these are relatively small acts of deviousness in an otherwise prestigious, world-class even, humanitarian record.

This record, however, is built upon a toxic foundation of decades of disastrous trauma to Baltimore’s urban poor. The Hippocratic Oath, frequently synopsized with the phrase “First, Do No Harm,” is about more than simply patient care (for which Johns Hopkins is, again, world-renowned). It is a foundational institutional philosophy for the entire medical profession, a duty of which the Johns Hopkins system has been wildly derelict in its taxpayer-funded Baltimore home.

Johns Hopkins’ political influence is so deeply correlated to the primary factors that sparked the Baltimore Uprising – poverty, disease, education, policing and politics – that it would not be a stretch to call Hopkins a direct cause of the city’s strife. The two could have risen together, Baltimore and Hopkins, as a symbiosis, instead of the parasitic relationship that exists. If there is such a thing as a welfare leech, Johns Hopkins is the exemplar, sucking Baltimore’s poor communities dry as it grows like a cancer upon the City.

It doesn’t have to be this way. A change in Hopkins’ governance, an alteration to institutional priorities from expansion to enlightenment, from legal tax avoidance to community engagement, and from historical amnesia to responsible recovery, it could be more than the simple avoidance of harm and could truly do good for the city, not just well for its Board.

History shows that Johns Hopkins is unlikely to do this of its own accord. In this case, as in Utah, Baltimore’s politicians, and Maryland’s as a whole, must break Hopkins’s death grip on the city and legislate them into goodness, removing their tax breaks until they have repaid the billions they have taken from the city, and thereafter until their charitable works make up for the damage they have done. The city cannot do it alone: Hopkins would simply threaten to leave for more appealing tax codes in surrounding Baltimore County. With a concerted effort throughout the state of Maryland, however, the Hopkins system could be made to finally show its <3 for Baltimore by living up to the ideals it represents, doing actual good and allowing Baltimore’s poor and oppressed to truly rise up. Johns Hopkins did not first, nor even second, do no harm, and the institution has a responsibility to now, after the Baltimore Uprisings have laid bare Hopkins’ impact on the city, remedy the harm it has done.



First, Do No Harm? The Johns Hopkins System’s Toxic Legacy in Baltimore by Zachary Gallant is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

August 18. 2015