
People dealing with new, glaring, massive changes happening right where they live.
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Ira Glass
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back in June, Rick Cole was sitting in a meeting of the Pasadena Municipal Services Committee in City Hall. There, that's about as dull a sentence as you could start a podcast with. But then things happen. Rick's a council member and I get
Rick Cole
a text that I glance at from the police chief to the city council that says, at 5:30 we're making a public announcement that there will be military exercises in northeast Pasadena. They will take place at St. Luke Hospital, but do not reveal the location. This is at 5:24, six minutes before the public is to be informed.
Ira Glass
So you saw that and you thought what?
Rick Cole
Well, I thought that's really strange.
Ira Glass
It's unprecedented. There'll be military exercises in a residential area. That happens in America, but still it's strange when it's Europe area. With no notice at all, the meeting ends. Rick runs to another event.
Rick Cole
Meanwhile, I had told my assistant to post on our Instagram account that this military exercise was happening and to actually identify the location. And she told me, you know, they told us very sternly not to say the location. And I said, the people deserve to know where this is happening.
Ira Glass
And did she post the name of the hospital?
Rick Cole
She did.
Ira Glass
Because you just figured, what are they going to do to me? I'm just going to do this.
Rick Cole
Exactly. I mean, that's the way I've lived my life.
Ira Glass
Ira, he's got stories. If you ever run into Rick, get him to tell you the one about how he tried to stop Christopher Columbus's great, great, great, great, great, great, great, great, great, great, great, great, great, great, great, great, great, great grandson from becoming Grand Marshal of Pasadena. But I digress. Anyway, that night in June, he heads over to this hospital, a creepy old building with broken windows and peeling paint that's been abandoned for years. And sure enough, sometime around 8pm These
Rick Cole
giant helicopters can be heard in the distance getting closer and closer. Then they disgorge paratroopers Clamoring down ropes onto the roof of the hospital. Flashbang grenades are going off. Simulated gunfire is rattling through the neighborhood. I mean it was jaw dropping.
Ira Glass
This was all supposed to end by 8:30, but in fact wasn't over until about 2:00am To Rick, this was outrageous. Why do this in a residential neighborhood with no warning? So people had no chance to prepare, maybe go elsewhere for the night, maybe give their pets tranquilizers so they don't freak out. Now people were hearing all the commotion, probably going onto their phones to figure out what was happening. And he thought he needed to jump in and explain.
Rick Cole
Councilmember Rick Cole here in front of the former St. Luke's Hospital.
Ira Glass
As you can hear, he's in the dark. Explosions are flashing behind him like he's some sort of suburban war correspondent.
Rick Cole
Flashbangs and simulated gunfire are going on. They're going to be going on for the next half an hour we're told. I was focused on the fact that I should tell people what's going on because their dogs are going to bark, their kids are going to ask questions and they're going to wonder why are helicopters descending on Pasadena? Why are they hearing gunfire in the neighborhood?
Ira Glass
He'd done videos like this in the past in the wake of the Eaton fire last year, letting people know when it was safe to drink the water or eat vegetables from their gardens, that kind of thing.
Rick Cole
And this is going to go on for a while and good luck to the people that have got to get up and go to work tomorrow morning.
Ira Glass
It's funny, the weird thing about this is that it seems like you all were supposed to act like this was not a weird thing to happen?
Rick Cole
That's exactly.
Ira Glass
Did it make you feel sort of crazy to be told like, oh no, this isn't normal, don't sweat it.
Rick Cole
I wouldn't say crazy, it infuriated me. Yeah, you know, we owe to the people we serve to treat them with respect and to, to keep them informed about things that affect them. And this was such an egregious breach of that trust.
Ira Glass
Rick couldn't help but notice that nobody in the military seemed to care how everyday citizens were experiencing all this. And as a 73 year old council member he felt a duty to take what he saw as a more old fashioned approach. I reached, by the way, nearly 8 million people with his videos informing the public, succeeding more than he ever imagined. Today on our program we have stories of people who see a future arrive that feels uglier and meaner than the past. And it's not like they can turn that around. It's way too big. But in every story today, there is somebody who takes a stand and tries to clean up the mess that's around them. I'll call attention to that mess and say no. We have stories today of some very stubborn and idealistic people from a small town in Maine from to a school in Russia from WBEZ Chicago CIS American Life from Ira Glass. Stay with us.
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Dr. Rose Fuchs
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Ira Glass
this is American Life Act 1 closing time sometimes, as things change in a country because of big historic forces, doctors get put in some weird and difficult situations. That's what happened in this first act in Maine, way up north in Aroostook County. That's so far north that the Canadian border is closer than the nearest US City. The local hospital there is Houlton Regional Hospital, and last year they announced they were going to close their labor and delivery unit with one month's notice. Even the unit's nurse manager, Heather Quinn, had no idea this was actually coming.
Heather Quinn
It was delivered very abruptly and matter of factly. I guess this is what's happening. Our birth rates are going down. We can't recruit. It's not basically a money maker. So we're closing. There was no. I'm sorry, you know, we hate to, you know, it was just Very matter of factly.
Ira Glass
It is a pretty matter of fact reality at this point in America. Rural hospitals closing, but labor and delivery departments in particular, they've been vanishing in lots of rural areas. And when a community loses its place to have babies in the first weeks after that happens, that's when you really see what it means in people's lives. And the story in Maine unfolded just after Houlton Regional Hospital packed up its labor and delivery department and closed the doors there. As that was happening, a woman who lives in the area named Katie Gowell was pregnant with her fifth child. This was a low risk pregnancy. She was planning to give birth at home, just like she'd done with her fourth child. Her family doctor, who was a midwife before she became a doctor, was going to deliver the baby. So that was the plan. 29 days after Houlton closed its labor and delivery department, Katie Gao went into labor at home. Reporter Elaine Appleton Grant has the story of what happened next. Quick heads up before we start, some of us here on staff found ourselves thinking about the TV show the Pit as we were making this story. Because there's no way to explain what happened without diving into some very vivid medical details during childbirth. Just want to say, if that's not for you, please know that is part of this story. Here's Elaine Appleton Grant.
Elaine Appleton Grant
Sunday, June 1, 2025. Just after midnight, Katie starts having contractions. She calls her mom and eventually her doctor. Lots of family members show up. They live nearby. She and her family run a business together, a big wilderness resort up the road. There's snacks. It's fun, but slow. Here's Katie.
Katie Gowell
I'm like, well, mom, maybe I shouldn't have called them already because it was sort of. I sort of kind of went like a standstill for a while.
Elaine Appleton Grant
It's so slow that her doctor, Dr. Rose Fuchs, takes a nap on the couch, even with all the noise.
Dr. Rose Fuchs
But all of a sudden, it was like someone poked me awake. And I sat bolt upright and I said, what did Katie say? And Katie was down the hallway in the bathroom at that point. So I went down there and I said, did you say something? And she said, yeah. I said, my water broke.
Elaine Appleton Grant
Katie's sitting on the toilet. Everything's fine.
Katie Gowell
And then I just sat there for a few minutes. So then I'm like, well, I'm going to get up now. And then I went to wipe and I felt something.
Dr. Rose Fuchs
And she said, what's that? And I looked down on the toilet and there was probably 8 inches of cord hanging out, not quite Touching the toilet water, but close. So I was like immediately, this is very bad. Right? This is a prolapse cord, which rarely happens. I just said it looks like the cord. We need to check you out. Let's get in the bed.
Elaine Appleton Grant
A prolapsed cord is a dire medical emergency. It just happens sometimes. Katie didn't really have any risk factors. In a normal delivery, the baby's head comes out first. Its umbilical cord, which is the baby's blood and oxygen supply, follows. But not this time. The cord slipped out first. It's squiggly, like an old fashioned telephone cord. You can see the red vein and purple arteries through the thin skin. If it's outside the body, it's a huge risk to the baby's life unless Katie can deliver now.
Dr. Rose Fuchs
And we got her on the bed and I was checking to see, like, if she's completely dilated, you know, ready to push the baby out. I thought if I, you know, it's her fifth baby, I thought if we could give one push and finish this, I'll do that. But that wasn't the case. She was probably about 6 centimeters.
Elaine Appleton Grant
Fully dilated is 10 centimeters. Katie's nowhere near giving birth. It could still be hours. Dr. Fuchs isn't saying any of this out loud. She spent years cultivating her doctory Persona. Calm, confident, in command. She is 60, elegant, and somehow old fashioned. She wears a lot of ankle length skirts, sometimes pulls her long silver hair up in a bun. She's been a primary care doctor for decades. She was a midwife before med school. In almost 40 years of practicing, she's attended about a thousand births. She has never seen a prolapsed cord before. But she knows that the only way to save the baby is for Katie to have an emergency C section. Now, if they were in a hospital, they'd be running down the hall to surgery. Speaking of hospitals, this is the first time Dr. Fuchs has attended a birth without a hospital labor and delivery unit nearby to back her up.
Dr. Rose Fuchs
I was terrified because I didn't want the baby to die.
Elaine Appleton Grant
And so then what happened?
Dr. Rose Fuchs
I turned around and my nurse has beautiful big blue eyes. And they always comfort me in the middle of anything. And I turned around and I looked in her eyes and I said, Call 911. And her eyes went two sizes bigger because she's actually never heard me say that in working with her 12 years. Yeah.
Elaine Appleton Grant
Dr. Fuchs calmly advises Katie.
Dr. Rose Fuchs
I started to coach her that the life of the baby is at stake and you're gonna have to go through quite a bit if we're gonna hope to save your child.
Elaine Appleton Grant
Katie's shocked. So stunned, in fact, that the day becomes hazy. So she wants Dr. Fuchs to tell the story.
Katie Gowell
Cause me being in the moment, I don't remember every detail where she would remember every detail. And I trust her with telling my story. I trust her completely with everything.
Elaine Appleton Grant
It's about 6:35am here's what Dr. Fuchs knows. Best practice for a prolapsed cord is for Katie to be in surgery in five to 10 minutes. So the clock is ticking. She is 90 minutes away from any working obstetrics department. Just a month earlier, Katie's local birthing unit at Holton was still up and running. An entire institution designed to handle exactly this kind of emergency. But now there's just Dr. Fuchs. So there in Katie's bedroom, Dr. Fuchs makes her first important decision. If the cord gets cold, if it dries out, the baby could die or possibly suffer brain damage.
Dr. Rose Fuchs
I chose what I thought was the best course of action, which I gently replaced it into the vagina. Is that okay? To Santa. Okay. Gently replaced it inside so that the warmth of her body would keep the cord warm. Because I knew we're in Maine, and although it was June, it wasn't that warm.
Elaine Appleton Grant
But there's another problem. The baby's head is pressing down on the cord, which could also cut off the blood and oxygen supply. She has to protect the cord from the weight of the baby's head coming down the birth canal right on top of it. So she gets into a position that obstetricians call riding the bed.
Dr. Rose Fuchs
I shifted myself and climbed onto the bed between her legs, crouching, sort of on all fours, kneeling, crouching down.
Elaine Appleton Grant
Then she starts pushing the baby's head back, back up the birth canal to make space for the cord.
Dr. Rose Fuchs
I, you know, was internally inside the patient, pushing upward toward her head as basically hard as I could, using two fingers to push up, the rest of my fingers to lightly be touching the cord, to keep track of the heart tones at all times. Because if they slowed down, I knew something's pinching. If they slowed down, I also knew I needed to push up higher and get the head up, up higher.
Elaine Appleton Grant
How much of your hand was inside Katie's body?
Dr. Rose Fuchs
Probably up to my wrist. Starting forearm. Meanwhile, Katie's own body wants to push the baby out, right Contractions, push down. So, you know, to have my hand that's painful for her. And I knew it was painful, and I told her I'm very Sorry, but I can't care about your pain. It's a very weird pain. It's a deep pain. Anyone who's had a cervical biopsy, an endometrial biopsy, an IUD put in, I think it's a pain no one can describe. And then this is times a whole lot more because there's a baby in there too. And now someone's hand as well.
Elaine Appleton Grant
It's 6:40. Sasha, Katie's husband, is on the phone with 911, the Penobscot county dispatch center, the busiest in the state. The dispatcher tells Sasha that an ambulance is on the way. Meantime, she's giving instructions. Have her roll up and get onto her knees and elbows, she tells Sasha, meaning tell Katie to get up onto her knees and elbows. Sasha, he's in another room because he has to move a dog gate to make a clear path for the ambulance crew when they arrive. So he yells these instructions to Dr. Fuchs.
Dr. Rose Fuchs
I said, no, we're not. And they said, well, that's what they're saying. I said, I don't care what they're saying. We are not doing that. You tell them a doctor's on site.
Elaine Appleton Grant
The dispatcher also says through Sasha, do not try to prevent the birth. Make sure that nothing is being pushed back into her vagina. But Dr. Fuchs knows that if she stops pushing the baby up, the baby will die. It's now been about seven minutes since the cord dropped. While Sash is on the phone with the dispatcher, Dr. Fuchs Nurse calls Holton's emergency department because at least the ER is still running. And the nurse says they plan to bring Katie to the er, but the ER says no, they can't handle this and Katie needs to be flown to a much farther hospital. So the 911 dispatcher switches gears and contacts Life Flight, that's Maine's air ambulance service, and then warns the nurse that due to some bad weather, they're not sure a helicopter can fly. They're also not sure yet where Life Flight will pick Katie up and where the local ambulance will have to take her to meet them. It is mayhem. A month ago, when Holton's OB was open, the medical sequence of events would have been clear. 911 orders an ambulance, which takes Katie to Holton's labor and delivery department. There, a trained obstetrician would perform an emergency C section. There would have been no need to airlift Katie somewhere else. OBs in hospitals do C sections all the time. Now Dr. Fuchs realizes with dawning horror that because of Holton's closure, no one seems to know or agree on who's actually in charge or where Katie can go and even what should be done to save this baby. She's hunched over counting the baby's heartbeats, and she attempts to take charge over her shoulder. She speaks to her nurse and I
Dr. Rose Fuchs
said, you call Holton Regional. You know, you're telling them we're coming. And I mean, we're coming.
Elaine Appleton Grant
Holton Regional, the hospital that closed its labor and delivery department, but still has an emergency room. Dr. Fuchs thinks someone might be able to do a C section there. It's about 6, 48, 13 minutes have passed at the house. The ambulance crew has arrived and they can't get in. It's an old main house. They can't get the gurney through the narrow hallway and around a sharp corner into the bedroom. The EMS crew, who don't seem to understand the situation, ask Katie to get up and walk to the gurney.
Dr. Rose Fuchs
I said, sasha, then get a chainsaw and cut the wall down.
Elaine Appleton Grant
What did he say?
Dr. Rose Fuchs
He was ready to go get a chainsaw and cut the wall down. Because they knew I wasn't moving and I wasn't allowing her to get up. I didn't care if it was EMS in their truck. I was not giving over my place of authority because I did not see that they had adequate knowledge or understanding of the situation.
Elaine Appleton Grant
Finally, they managed to maneuver the gurney down the hall and into the bedroom. Now they have to lift both Katie and the doctor together onto the gurney, locked in their position, like lift the sheet they're both on and transfer them together. And while they do, Dr. Fuchs cannot move her hand at all. Meanwhile, she's waiting for the lead paramedic to get things going.
Dr. Rose Fuchs
We always count to three, and then we all pull together like, you know, a bunch of he men, right? So he's like, who's going to count? How are we going to do this? Are you going to count? Who's going to count? You know, they just kept on like that. And I looked at my nurse and I said, you count. So she took over, like she heard me say that and that was it. And I hate to get real loud on this mic, but she proceeded to just roar, we're gonna count. One, two, three. And honestly, I think she almost single handedly pulled me, Katie, over to the gurney with them helping some.
Elaine Appleton Grant
It's about 6, 58. Katie should have had a C section 25 minutes ago. 7:10. Katie and the doctor have been locked together for about 33 minutes. The EMTs load them into the ambulance. Dr. Fuchs is under the impression that a nurse has convinced Holton to accept them. And they are now heading to the Holton emergency room for the C section. Katie's in terrible pain. Dr. Fuchs is on the gurney, balancing on both knees. And one hand, her other hand is inside Katie as the driver navigates the winding roads.
Dr. Rose Fuchs
It's a very bumpy road. These are the back roads of the county, right? So potholes, bumps, very curvy at times. I thought I was going to fall off the gurney and the paramedic would grab the waistband on the back of my skirt and hold me so I would hold steady. And I needed to hold steady. My hand had to hold steady. And her leg at one point slipped off the gurney and sort of fell down. And so I was trying to. I grabbed her leg and pulled it back up, and I was holding her leg on the gurney with me, so it was a tight squeeze. I was beginning to feel exhausted. I myself don't have the best back. And this was a very awkward position. And, you know, your legs are all curled up under you, so you're in an intense kneeling, you know, sitting on your legs, squatting. So my legs are falling asleep. My hand is starting to fall asleep from the angle that I'm at.
Elaine Appleton Grant
That scares her. Without her hand, she can't count the baby's heartbeat and keep the baby alive. Her hand is the only instrument she has.
Dr. Rose Fuchs
But, you know, my hand would periodically feel like it was completely numb, and I would worry, like, am I going to be pinching this cord? And then it would sort of wake up again, you know, intermittently. But it was painful. Like when your hand falls asleep and it's very painful. It was becoming physically very painful to continue.
Elaine Appleton Grant
Dr. Fuchs has scoliosis. This position is excruciating. She tells herself, hang on, it's not much longer. Just until we get to Holton. But then they tell her the plan is still for Life Flight, Maine's air medical service, to airlift them to Bangor. The helicopter is apparently going to pick them up at Holton.
Dr. Rose Fuchs
Life Flight still headed to Houlton Regional?
Dr. Monica Shearhart
Correct.
Elaine Appleton Grant
The Life Flight dispatcher and the hospital are mapping out these plans While Katie and Dr. Fuchs bounce around the ambulance.
Dr. Rose Fuchs
Yeah, they just started schooling up.
Ira Glass
I'm looking in my window at them. So, yeah, okay, that's our plan.
Dr. Rose Fuchs
They are just now leaving the scene,
Ira Glass
headed to the hospital.
Dr. Rose Fuchs
I did not agree with that plan at all because I knew that I could not take another. However, Many minutes it would take to get into Life flight and then to fuel up and then to stay like that till a C section can be done at Eastern Main Hospital in Bangor. There's just no way.
Elaine Appleton Grant
So bear with me for just a second. We're going to leave the ambulance and go over to another important place, ivy's Motor Lodge, three minutes from Holton Hospital. That's where Dr. Monica Shearhart, an OB GYN, is sleeping. She's been on call here once a month for three years, and on this weekend, she's coming to the end of her time at Holton Hospital when the phone on her bedside table rings.
Dr. Monica Shearhart
I think they woke me up from sleep. So it was one of those like, ring, ring, phone call. What's going on? Okay, I'll be there in five minutes.
Elaine Appleton Grant
She throws on her leggings and goes to the hospital to meet the ambulance that's on its way with the patient who has a prolapsed cord. At the er, they lay out the plan. They want her to stabilize Katie so she can take the life flight helicopter to Eastern Maine Medical center for the C section. That would take another hour.
Dr. Monica Shearhart
But I'm here at that point, I'm like, no, we'll have the baby here. Let's go ahead and call in the OR team and we should deliver her here. We still have that capability. And everyone at that point was like, oh, yeah, we can do that.
Elaine Appleton Grant
So basically they hadn't realized that they had the capability to do this to still.
Dr. Monica Shearhart
Yeah, they didn't even really think about the fact they still had that capability, but at that transition time, they did.
Elaine Appleton Grant
So I reached out to Holton to ask them why they wanted to transfer Katie in the first place. They said they couldn't comment on any specific patient. We asked Holton to comment on other decisions they made throughout this story. They responded. We have no further comment regarding the closure of the OB department. Back to Dr. Shearhart waiting in the Holton ER. She's making the case to the team there that she wants to perform the C section at Holton and she prevails. But they can't do it without OB nurses. The birthing unit closed almost a month ago, so the ER has to call up the OB nurses who used to work in labor and delivery and ask them for help. A couple of them volunteer and rush in. Dr. Fuchs and Katie arrive at Holton at about 7:53am and there are people there to greet them.
Dr. Rose Fuchs
And so we pulled up at the ambulance entrance and the obstetrician came outside. To meet us, which I was so glad for. Started taking the history from me while we were unloading.
Dr. Monica Shearhart
And I was like, hi, I'm Dr. Sherhart. I'm an OB GYN. I'm the one on call today. Recommendation is, you know, emergency C section, if it's okay with you. And we're going to roll you right into the operating room and deliver the baby. And Dr. Fuchs also was giving me kind of a sign out about what was happening with her, what her background was, and, you know, that she could still feel the cord pulse.
Elaine Appleton Grant
They speed the gurney down the hall to the operating room. Katie is far from out of the woods. The baby has to survive through the surgery. And if she does, what about the possibility of brain damage or cerebral palsy? An anesthesiologist puts Katie under. At this point, Dr. Fuchs has been riding the bed for almost 90 minutes. Remember, no more than 10 minutes to C section is best practice. She still can't leave her post, which means now they have another problem. The nurses can't fit the surgical tool table over Katie the way they normally would because Dr. Fuchs is in the way. So her back will have to serve as the table. They throw a drape over her, basically a plastic bag. Dr. Fuchs will become part of the surgery.
Dr. Monica Shearhart
So we basically put the surgical drapes over the top of Dr. Fuchs through the, you know, Betadine sterilizing fluid on Katie.
Dr. Rose Fuchs
They opened a bottle of iodine and dumped it over. Over her belly, over my top of my arm, my forearm that was, you know, near her. So my. My cheek is laying on Katie's thigh. I have my head sideways trying to breathe in a little air. Air pocket in this drape. It's a very awkward position, to say the least, for her and me.
Dr. Monica Shearhart
We have surgical equipment and tubing and electrocautery and suction kind of sitting on top of Dr. Fuchs because she's right there between Katie's legs.
Dr. Rose Fuchs
They are. I can feel they are putting their
Elaine Appleton Grant
tools on my back, but they're missing some usual tools, like a Doppler to monitor the baby's heartbeat.
Dr. Rose Fuchs
And nurses sort of scurried about looking for a Doppler. They either couldn't find one or they didn't have one available, but they had no Doppler anyway. And so I told her it's okay because I can feel the heartbeat. And so, you know, it had been 1 20s, but then at one point, while they were still prepping, it went down to, like, 90. And so I called that out to her. I said, so we're down to 90. You all better hurry.
Elaine Appleton Grant
And what is optimum?
Dr. Rose Fuchs
A normal fetal heart rate is 120 to 160. And so we allow a little bit outside that range, but 90 is definitely getting in trouble. It's often the signal that there's an impending disaster. My fear was the next beat was gonna be 60, and the next beat, you know, nothing. And then I did my usual, which I pushed a little harder on the head, tried a little harder to protect the cord, and I felt the heart rate go back up to, like, the 120s. So then I sort of called out again to reassure them. We're back up to the 120s. You're okay. We're doing all right.
Elaine Appleton Grant
Dr. Shearhart starts the surgery.
Dr. Monica Shearhart
As soon as she went to sleep, I made the incision, got down to her uterus.
Dr. Rose Fuchs
I could feel them start to cut the skin and the muscle layers, you know, to enter the abdomen. And I thought, oh, dear, my fingers are awfully high up there. What if they cut my fingers? I better pull back a little bit at just the right moment, but not too soon to lose the heartbeat. So I withdrew a little bit, and then I could sort of feel them, that they were in the uterus.
Dr. Monica Shearhart
And my hand reached down to pull the baby's head out, and our hands touched. So my hand touched Dr. Fuchs's hand as I was lifting the baby's head out of the incision.
Elaine Appleton Grant
The C section is done in two minutes, and the baby is breathing. She's born at 7:58am She's 7 pounds, 12 ounces. Dr. Fuchs, gasping for air under the drape, slithers out and climbs off the table. When she leaves the or, she's shaky, starts to see black before her eyes. She almost passes out from the sheer effort of the delivery. Her nurse, the one with the big blue eyes and the loud voice, she runs and gets her a chair and a glass of water. When Katie wakes up, her baby is alive, but she's in an incubator that has lots of tubes. Katie can't be with her, and they can't stay here in the hospital. With the department closed, the nurses gone, Holton has no way to admit a newborn, no one to take care of the baby or of Katie, who should recover in a hospital for a couple of days. The life flight medics are there, and they start getting the baby ready to fly to a bigger hospital. Katie doesn't understand what's happening.
Katie Gowell
I could see her off to my left when they Were she was getting worked on. And then when I was in the recovery room, she was still getting worked on because then that's when they put her in their incubator type thing. I still didn't get to hold her.
Elaine Appleton Grant
Then they load the newborn into the Life flight helicopter and it takes off for Eastern Maine Medical.
Katie Gowell
I cried. I cried. I mean, like, I didn't know at that time. I didn't know how she was. I didn't get to see her. I didn't get to know anything. And then I just saw her wheel her away. It's just a. I don't know how to describe. It's a very hard thing, especially seeing her leave. I don't know. It's just hard. It was hard. Very hard.
Elaine Appleton Grant
Katie has to follow her new baby to the other hospital by ambulance, but she's just out of a major surgery. She needs an OB nurse to accompany her, and Holton doesn't have anyone. So the ER makes another call to Heather Quint. Heather's the nurse you heard at the opening of this story, the one who used to run labor and delivery and got the sudden matter of fact news that the OB department was closing. They ask her to go with Katie in the ambulance. Heather races to the hospital and walks into the recovery room. I asked Heather why she showed up that day.
Heather Quinn
I wanted to be like. When they closed it down, I wanted to be like, okay, this is what you guys want. This is what you're gonna get. But the nurse in me, the person in me, that's. That's my patient. Hell, yes, I'm gonna be there. I threw on my clothes and I was there. And I went to Bangor with her and I sat and I held her hand and I talked to her the entire time. So no. Oh. When I got the call, I wanted to be like, figure it out. But not when my patients are involved. I'm like, yep, I'll be right down.
Elaine Appleton Grant
When I think about what it took to deliver this one baby, this is the thing I've been struck by the most. So many people's instinct to save a life no matter what. Right now in America, the majority of rural hospitals no longer have labor and delivery departments. And instead, here is a collection of people choosing to jump in to fill in gaps. This is a success story. Katie's baby is fine, healthy, no brain damage, no cerebral palsy, which is remarkable because this baby was much more likely to die than to, say, survive. This is what success can look like today in some places. We're creating a hero based health care system and we can't rely on the Avengers in order to have a baby. The whole Marvel universe showing up to help a person give birth safely. That's what hospitals are for.
Ira Glass
Elaine Appleton Ground that story was produced by Lily Sullivan and edited by Thea Bennen. Elaine originally learned about this story from reporting by Emily hedegaard and Stephanie McPheeters of the Main Monitor. Coming up. Raise your hand if you know what Trud Della Chestia means. That's in a minute, comrades, from Chicago Public Radio when our program continues.
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Dr. Monica Shearhart
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Pasha Tolankin
this is
Ira Glass
American Life from Ira Glass Today's Program I couldn't help but notice we have stories where people see a new future arrive, one that is not quite as pleasant as the past. And they can't help themselves. They take action in some way or another in their own little corner of the world. We've arrived at Act 2 of our program. Act 2 Conversations about important things. So the documentary that won this year's Academy award is called Mr. Nobody against Putin. It was co directed by a Russian guy and an American, Pasha Tarantkin and David Borenstein. And it's about the propaganda campaign that was rolled out in Russia after Russia invaded Ukraine in 2022, and the shock of that propaganda push. For one person in particular, if you haven't seen the film, it is really worth seeing. I am one of the people on staff here at this American Life. Valerie Kipnes has watched it four times. She'll tell you why. Here's Val.
Valerie Kipnis
Here are some scenes from my family growing up. Someone, let's say my mom, would say this to me. Glory to labor. She'd say it in Russian. Then she'd hand me a broom. Or she'd say, trudge, labor is a matter of honor. She used to say that on Sunday mornings when she woke me up for chores. These are all propaganda slogans from her upbringing in the Soviet Union. She and my dad both grew up there. My dad would say things like this, too. So did my grandmothers. They both live with us. And these lines always got a laugh from each other. Like my mom would say, partia natur, the party is our helmsman. And my grandmother Bella would laugh and say, last time I saw that one was on the wall of an auditorium. Unlike them, I grew up here, which meant I was always behind, always playing catch up in a household full of inside jokes, always trying to see into this world they had in their heads. I was obsessed with it. So I'd ask the same questions over and over again. And they would answer my questions patiently, kindly, on long car rides, on the subway to school, on our walks near the bqe. But I kept going. I wanted to understand what it actually felt like to live surrounded by banners and slogans. My grandmother would shrug and say, shtabwila tabula. It just was what it was. It didn't feel special to us. We didn't know another version of life. And then she'd call me by my family nickname, Pachimuchka, which means, roughly, kid who drives us crazy by asking why all the time. Being a Pachimuchka and all. It's only natural that I watch this new documentary four times, three times before it won the Oscar. Just saying. And the thing I couldn't get enough of was that here was a movie that answered some of the questions I'd been asking for so long. The documentary starts less than a month after Russia invaded Ukraine, the beginning of the full scale invasion. And it focuses on one school and one town in Russia, as the Ministry of Education rolls out a massive nationwide propaganda campaign. A new patriotic curriculum which would include new lesson Plans for teachers, nationalistic poem recitations for students, mandatory school wide salutes to the flag. And mandatory lessons called Conversations about Important Things, where teachers are asked to talk about stuff like the importance of war songs or the heroism of Russian fighters. Also, a single approved set of history textbooks written by two people closely affiliated with the Kremlin. High schoolers would start paramilitary training in gym class. And in the school that's in the documentary. One teacher captures how this all plays out. Pasha Tolankin. And I called him up. Here is a person who made a whole film about what it felt like to see slogans in the auditorium. Different slogans than the ones my parents and grandparents grew up with. A very different time, but with an undeniable similarity both then and now. The state had a tight grip on its own people. And here was Pasha, who wasn't just seeing what was happening around him. He wanted the whole world to see what he was seeing. This is Pasha. He's got a round, wide eyed baby face, big glasses. He's an impish kind of person who talks through a smile like he's in on some joke you don't know about. The school in the film is actually the same school he once attended. He loves the school, loves his students, loves his grumpy mom. She's the school librarian. And when the film begins, he's the school's event coordinator and videographer. He films the piano recitals, graduations, performances. And under the brand new patriotic curriculum at Pasha School, Pasha was told he now had a brand new role. He would be filming teachers and students performing the new lessons. He'd be filming the new flag salutes and paramilitary trainings. And he'd be sending all of that footage to the government as proof of compliance. I wanted to know what he thought of his new role as he was doing it, how it actually felt. He answered by telling me a story that never made it into the film.
Pasha Tolankin
What was I thinking about when I filmed this? I mean, at first I was just. How do you say this in Russia? I started like sweating under my visor. I just lost my mind about what was happening. I just totally freaked out. When I was going to film computer class, it didn't end up in the final cut. I asked myself a question. Who is that idiot who is going to be watching all this shit? I mean, who is he? Who is that moron? I mean, it should be some sort of paid job sitting and watching all this shit. I mean, they should pay you some money for that, at least a little bit. Anyway, I did this one little bit of trickery where I left in only the beginning of the class, where the teacher says, hello, kids. And the end where they say, okay, class is over. But the shot itself went the whole time of the class, 45 minutes. So in the middle, there was just a black screen, as if something had gone wrong with my camera. And I sent the video in, and I sat there waiting as they looked over the footage. And I kept waiting for them to say, you know, we can't see it. Something went wrong. It's just a blank screen. And they didn't give me a single note. And I thought, Holy shit, I'm here not to actually record, but to surveil the teachers. You know, watch out, we're watching you. We have a camera here. It is recording you. And in that moment, I thought, I'm being used. I'm being used.
Valerie Kipnis
He figured, yeah, okay, they were using him. But he was simultaneously and obsessively filming the changes at his school for his own purposes. And the footage that Pasha captured was really eye opening for me. It answered so many of the questions I'd badgered my family with over the years. Because the propaganda, as it rolls out, is sort of the opposite of what I'd always imagined it would be. You know, the classic images of state. The seamless, crisp obedience, massive signs, arms being raised in unison, echoey speeches delivered to neat rows of thousands of people. Pasha shows scenes that are so intimate and small and messy. A teacher stumbling over new words she's now required to say. Denazification, demilitarization. He films teenagers bored out of their minds, staring blindly into space as another teacher tells them, If you were born in this country and you don't believe we're doing the right thing, then leave. Go to the country that you think is better. Pasha films young kids with these tiny red berets chanting new slogans in an assembly. They're excited, but looking at each other like, right, we're saying the right thing. The school days in the film look kind of normal in so many ways. Despite all the changes, kids still horse around and tease each other. There are still piano recitals. It's still just school. But Baja was like the kid in the emperor's new clothes. Every change stood out to him, and he couldn't stop talking about it. His own mother was like, of. Of course these things are happening. They've always been this way. Shut up. And he argued with her. He lived in a sort of continuous state of shock about the war, about the propaganda. And he told me that when the patriotic curriculum started. He kept sort of waiting for the people around him to freak out as much as he was about what they were being asked to do. But most people just went along with it, adapted or chose to stay quiet. I wondered why he didn't do that. Then when I talked to him, I got it. For starters, Pasha and I are almost the same age, in our 30s. And part of why he's so stunned by what's happening is because of the era he grew up in. It was right after the Soviet Union fell apart, but before Vladimir Putin really started consolidating power. So Pasha was raised in this short window of time when students weren't flooded with slogans and propaganda in the schools, when schools were left mostly untouched by the state apparatus because the state apparatus had fallen apart. And so what Pasha was seeing was something my parents and grandparents never got to see. The beginning of a propaganda push in the schools, which meant he understood what his school was losing when it adopted these changes. And he knew what he was personally losing as nationalism became more and more strictly enforced. Over and over again. In the film, he addresses people in his life in the camera directly, like, can you believe this? Why is this happening? He told me that off camera. He had many more exchanges like that, especially with the other teachers.
Pasha Tolankin
The teachers came to me. They said, pasha, we don't like all this. And then they come into class and started to say what the Ministry of Education had sent over to them. The teachers are hostages of this system, too.
Valerie Kipnis
Pasha also saw himself as a hostage before the war and the new curriculum. Pasha was the teacher with the Pussy Riot poster on his wall. The cool guy, the weirdo whose office all the theater kids hung out in. The teacher who had different politics than what was on TV every night. And for a while, even after the war was underway, he was able to continue being that guy. He wore blue and yellow paperclips on his clothing as symbols of support for Ukraine. He hung an image of an anti war flag in his office, flipped a Russian flag outside the school upside down. One time, he even played Lady Gaga singing the Star Spangled Banner during a flag assembly instead of the Russian national anthem in the movie. He does things that I could not believe he was getting away with. In a country that was introducing laws to criminalize things, like even saying that the war was, in fact, a war. How on earth could he just do these things and not get in trouble?
Pasha Tolankin
People sort of saw me as a jester, a holy fool, you know, there he goes, walking around, being foolish. In Russia There is this historical tradition that the jester, the holy fool, could speak out even to the tsar. You know, the lowest level of society, the most seemingly worthless people, they could say exactly what they thought, tell anyone right to their face.
Valerie Kipnis
But that didn't mean the tsars would just ignore him forever. When I talked to Pasha about how his constant provoking was playing out in real life, he told me that behind the scenes in making the film, he could feel his status changing from holy fool to Persona non grata. This isn't in the film, but at some point at Pasha's school, compliance started being supervised in person via a new advisor on student affairs. And this advisor took a special interest in Pasha.
Pasha Tolankin
This advisor was supposed to monitor student activity on social media, establish contact with them, basically sniff everything out. And so one day this advisor came to me and said, close your little bullshit factory, your office, in other words. Right, I'm going to close it. And so I took my door off its hinges and put it in front of her door and said, how are you going to close this bullshit factory if it doesn't have any doors? This performance eventually ended, and I returned the door to its place. But in the meantime, she got really committed to this work of telling the students not to come see me, and
Valerie Kipnis
fewer kids were showing up at his office. The domain he'd carved out inside the school. Not just the physical space of his office, but. But the permission he represented for kids who wanted to joke around, talk freely, ask questions, and for him to be able to do that, that was being shrunk down to nothing. When I asked Pasha what this period of his life felt like, he gave me an answer that I can't help but classify as literally the most Russian thing I've ever heard. He said it was like this one painting he loves, Barge Haulers on the Volga, which is an oil on a canvas painting by Ilya repin. It depicts 11 men hauling a barge along the banks of a river. These men are at the point of collapse from exhaustion, oppressed by heavy, hot weather, leaning into these big leather straps attached to the boat they're pulling. They're exhausted, covered in dirt, but among them stands a younger man whose face is in the path of the sun. He looks in a different direction. He looks up, and his body refuses to pull the boat. He seems to be the only one questioning the work they're being asked to do.
Pasha Tolankin
Like, why are we doing all this? And the rest of them just keep their head down, keep pulling the ship along the Volga, as if they don't hear what he's saying. It's like you're speaking different languages. You won't understand each other. You don't have points contact. You don't have common views on basically any questions. You can't discuss issues that demand discussion. They require it. Not because you can change something, but because you need to not be alone. You need to speak in order to feel support, to find at least one person that you can talk about this with. But there's no one.
Valerie Kipnis
There's one last scene in the film that really got to me. It's so inside, in a way that lets you really feel how much has changed. In this one school, this one town, Pasha gets invited to this party of a recent graduate, Vanya, who's heading off to the army. It's his going away party. All his friends toast to him and wish him luck in the future. They post for pictures of Vanya. Instead of cheese, they say, army. Then they take turns shaving his head with a shaver that breaks. Halfway through the process, Pasha takes a turn at shaving Vanya's head. As he does it, he asks, you decided to sign up on your own? Vanya says, didn't have time. They sent for me. Pasha says, why didn't you call me? Lanya sort of shrugs, as if Pasha's question is dumb and annoying. But then quietly, he mumbles, it just all happens so fast in a split second. Besides that, it's all laughs and jokes and debauchery. The shaving part is funny. Everyone's kind of wasted. But then, as it gets late, Banya and his friends start embracing. One guy cries and hugs him, tells him that he really loves him so much that he won't forget him. He tells him, you're like a brother to me. Not by blood, but by soul. Vanya doesn't look so brave in the dark. He looks small and scared. His friends also do. And that's when it hit me. Before now, Vanya and the others seem like they maybe believed in this war, like they wouldn't mind going to fight for Russia. But in this moment, it feels like you can see everyone grasp the realness of the thing they'd been saying and then immediately understand that there was now no turning back, like a joke gone too far. Because at this point so many Russians have gone to fight this war and well over 100,000 Ukrainians have been killed in it. Do people believe the propaganda? I wondered this question over and over again as I was watching. Does Vanya actually believe in the war he's going to fight? Do the teachers believe that Russia is denazifying Ukraine? Do the kids throwing fake grenades believe in the country they are being trained to defend? It's a version of the question I've been asking my family my whole life. But did you believe in the things you were being taught? The things you were doing? The slogans hung up in the gym? Those are the questions they seem the most frustrated by. It took me asking Pasha to figure out why, when I asked him if the people around him believe in all this, he scoffed at me the way my grandma does. Like, that's a bad question, you dummy journalist. Don't you understand? He told me it doesn't matter if people believe in it or not. What matters is that they say it, that they hang the slogans, teach the lessons, sing the anthems
Pasha Tolankin
first. It's a routine that's like, I believe, I don't believe, but I say it. Then it becomes culture. These lessons are already in the schedule. Everyone's used to it. You got to say this, you got to listen to that, you got to raise the flag or whatever else. And then it becomes a cage, and you think, this is normal. And I'd also add that the cage actually remains open, and you can leave it at any moment. But as soon as you do, you realize that everyone else is in the cage. You walk out and you realize that you've become an outcast loner. That, like your opinion, you yourself, you don't matter to anyone. And that's also the work of propaganda. That's what it does.
Valerie Kipnis
Pasha became more and more isolated, retreated from his friends and family. They stayed away from him, too. An unmarked vehicle showed up outside his home, and he got scared and left the country without telling anyone where he was going or why. And he can't go back. I should probably fess up now and say, all those times I was asking my family about how they felt growing up, when I was posing those exact questions to Pasha, in the back of my mind, I was always wondering, who would I be if I was put in that situation? What kind of person would I be able to see what was happening and push back? When I saw the film and when I talked to Pasha, I found all these similarities between us. We're both similar ages, similar tendency to ask questions. And I did think quietly to myself, that had I been put in the situation, I probably would be like Pasha. I told my dad this big mistake. He said, really? You'd be like that? What are you doing right now in this country? There are things happening here that you don't like. Then I said, I'm doing my best, I think. Then he said, well, isn't that great? Your best? What's that got to do with anything?
Ira Glass
Valerie Kipnis is one of the producers of our show. The actor who's reading Pasha's quotes in English was Elias Kleinbach.
Elias Kleinbach
Can it be the mismatch wrong? Have I waited waited way too long? Have I played life like the game of bone and then press fade into a song? How can it be that it's all my fault? Will I ever reach the tippy time? Am I able to untie the KN that found me all alone? Now that I've seen it, I can't
Ira Glass
unsee World Program is produced today by Nadia Raymond and edited by Nancy Updike. The people who put together today's show include Hana Jaffe, Walt Adrian Lilly, Tobin Lowe, Molly Marcelo, Kathryn Raimondo, Stone Nelson, Ruthie Petito, Ryan Rummery, Ruby Schwartz, Francis Swanson, Christopher Sotala, Marisa Robertson, texter Julie Whitaker and Diane Wu. Our managing editor, Sara Abderrahman. Senior editor, David Kestenbaum. Our executive editor is Emmanuel Berry. Special thanks to David or Emanuel, Paul Perret, David Borenstein, Katja Kita, Bella Shayevich, Daniel Pyom, Kathryn Emery, Ruth and Mark Fitzpatrick. Henry Frank, Chris Lavoie and Brett Morse. Elaine Appleton. Grant's story in Act 1 was supported by a grant from the National Institute for Health Care Management. This American Life is delivered to public radio stations by prx, the public radio Exchange. Special thanks today to this American Life partners Sean Collins and Stonewall and Traveler Peak. Sean Collins, I know you. We work together at npr. Nice to see you here in this ad. How's Oklahoma? They and all of our life partners have subscribed to help us keep making our program. When you do that, you get to listen to ad free and you get other stuff, including bonus episodes. Our most recent one that I did with one of my co workers, Diane Wu, turned out so much more emotional and personal than I think either of us expected. Anyway, if you want to hear that, you gotta join, go to ThisAmericanLife.org LifePartners. That link is also in the show notes. Thanks as always to our program's co founder, Ms. Tory Malatea. You know, his dream job was actually to be on Sesame Street. When he auditioned, he was told his performance was not quite right for children.
Dr. Rose Fuchs
We're gonna count. One, two, three.
Ira Glass
I'm Hour of Glass back next week with more stories of this American Life.
Elias Kleinbach
Now that I've seen it, I can't don't see it. Now that I've been in it, I can't don't be it.
Pasha Tolankin
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Air date: August 2, 2026
Host: Ira Glass
Theme:
This episode explores the experience of witnessing abrupt, unsettling changes as a new reality takes hold—where the future feels “uglier and meaner” than the past. Through personal narratives from Pasadena, rural Maine, and a Russian school, the show focuses on individuals who find themselves compelled to act, to bear witness, or to resist, even when change feels overwhelming and impossible to reverse.
Story by: Elaine Appleton Grant
Location: Houlton, Maine
Timestamps: [07:18]-[35:25]
Reported by: Valerie Kipnis
Focus: Russian schoolteachers under new patriotic curriculum
Timestamps: [37:23]-[57:32]
The episode is marked by frank, vivid first-person narratives, often laced with dry or wry humor amid distressing circumstances. The speakers are candid and emotionally honest, drawing empathy through details and the immediacy of their recounting. The reporting often uses direct quotes and exchanges to ground the stories in the language of those living them.
This episode offers gripping personal stories about what it means to see and respond to dramatic, unwelcome change—whether in a town where a hospital closes, in the halls of a school recast as a stage for propaganda, or during a night beset by military helicopters. The stories focus less on policy or politics than on lived experience, and the stubborn refusal of some individuals to normalize what shouldn’t be normal, offering humanity and resistance, however small, in the face of impersonal forces.
[Summary covers non-ad, non-intro segments through 59:11, ending before closing credits and music.]