Clay goes to work every day in a small brick building across the street from Mercy Hospital. Mercy, as it’s called, is an imposing monolithic structure built sixty years ago by the Catholic church. Next door is the high school and a small residential neighborhood. Beyond that, the prairie starts in earnest, lonely and flat and constant. From the window in the waiting room of the Hallberg Family Practice, you can see a lot of sky, which makes the clutter of Clay’s tiny office at the back of the building feel that much more profound. There’s a desk and two chairs, one of which is inaccessible given the boxes of patient files that line the floor in stacks. On one wall are shelves covered with antique doctor’s implements; many of them once belonged to Clay’s father, who finally retired when his wife was killed in a car accident in 2003. Next to these are a hundred or so books attesting to the extent of Clay’s duties: Clinical Neuroanatomy, Pathophysiology of Renal Disease, General Ophthalmology, Patten’s Foundations of Embryology.
True to his roots, Clay not only sees patients in the exam room across the hall; he drives to their houses and farms, and also works two nights a week in the emergency room. He has delivered babies in the backs of cars, and once, in a barn. A few years ago, he served as assistant county coroner, which is to say, assistant to his father. He’s also chief of staff at Mercy. In terms of what there is to see around Oelwein, Clay has seen it.
Contrary to what many people might think, the rural United States has for decades had higher rates of drug and alcohol abuse than the nation’s urban areas. If addiction has a face, says Clay, it is the face of depression. Bad genes don’t help, either, says Clay, but all genes, bad or good, are susceptible to a poor environment. He knows of what he speaks. Back in the mid-1970s, after getting his B.S., Clay was back in Oelwein, casting about for something to do with his life. His father, Doc Hallberg, was abusive—a disciplinarian who limped around the rural towns of Fayette County for forty years performing minor medical miracles, all the while suffering from debilitating arthritis in his right leg, which, thanks to polio, is eighteen inches shorter than his left and compensated by a substantial shoe lift. Clay was good at giving his father reasons to be stern. He played in a band, had long hair, and did a lot of cocaine. His love of homemade explosives had not abated. One time, when the high school was closed because of a snow day, Clay set off a pipe bomb on the campus lawn, just to see what would happen. The next morning, the Oelwein newspaper called it a terrorist attack and demanded that the culprit be hunted down and prosecuted federally. (Clay was never caught.) The more Clay bounced around intellectually beneath his father’s brutal, withering glare without being able to land on something either of them found meaningful, the more Clay did drugs. Finally, he says, he realized he was either going to medical school or going to jail.
Things in Oelwein at that point were just starting to deteriorate economically. It would be a few more years before the sky fell, once the Chicago Great Western and Illinois Central closed operations in town and the farm crisis struck, but Clay attributes much of his anger and malaise to a simple socioeconomic postulate: “If you got no money, you can’t go see the band. And if you can’t see the band, you’re fucked.” What he means is that, without good jobs, little disposable income remains in the community to be spent at all manner of locally owned businesses, including at the bars. And during the last good days of the 1970s, Oelwein bars were known from Waterloo to Wenatchie for having the best local bands in the Upper Mississippi River watershed.
Once known as Little Chicago, says Clay, Oelwein boasted the best Italian food in the Midwest, every bar fielded a pool league in the winter and a softball team in the summer, and the Sportsmen’s Lounge served the best prime rib in Iowa, thanks to the fact that Oelwein was the first overnight stop west from the Chicago stockyards. In the 1930s and 1940s, Count Basie and Glenn Miller regularly played Tuesday nights at the Oelwein Coliseum on their way from Minneapolis to St. Louis. According to Clay, the Coliseum’s owner stipulated in the bands’ contracts that they couldn’t play any other venue within five hundred miles for at least one week following a show in Oelwein. Such was the clout of a town that employed two thousand people, or almost 60 percent of the working-age male population, in the lucrative rail business and could therefore be relied on for sold-out shows. In the 1950s, Buddy Holly played the Oelwein Armory four times. Once it was all gone, says Clay, the deep sense of disappointment that pervaded Oelwein only magnified the Hallberg twins’ sense of loss.
Ever since then, the twins have fought to maintain a sense of balance through music, and in doing so, to share that feeling of wholeness with their community. Clay likes to say that he has been strumming and Charlie has been “banging on shit” since birth. When the boys were five or six, Clay, the aspiring bassist, would string fishing lines in the doorway to the kitchen; Charlie would hammer on pots and pans to bring the babysitter running, only to howl with delight when she tripped and fell over the strings. Clay, who still relishes a good bar fight, once reputedly pushed another band member out of a moving VW bus, then casually noted how the thud that resulted was in B minor. To this day, the brothers play venues all over northeastern Iowa in a variety of ensembles and make their own recordings in a studio that Clay bought, two blocks away from the IGA grocery store. For Clay, performing is an act of communal symbiosis; nowhere does he feel more at home and more complete than onstage with his twin, trying hard to make people dance and sing along to an ageless repertoire of good old-fashioned rock and roll.
Music visibly calms Clay, who smoked a pack and a half a day and drank heavily when I met him in 2005. Conversations could be measured not by minutes and hours, but in pots of coffee or cans of Bud Light. The breadth of his knowledge is staggering; keeping pace with the abrupt, multidimensional movements of his thoughts is like trying to keep track of a hummingbird. He is apt, say, while riffing on the history of Sioux medicine men, to be reminded of his favorite philosopher and to ask if you would like him to “distill Kant into three sentences, so that you’re with me here”—all this as an addendum to a Chomskyan critique of the critical-care program at Mercy Hospital. Clay’s is both an all-consuming and a consumptive energy; without music, he would be consumed for sure.
Eighty-five percent of what Clay does as a doctor is to minister to one form or another of the mental illness that he says ravages Oelwein. Mostly, he says, it’s depression or anxiety, though there are plenty of bipolar people walking around town. In this way, says Clay, Oelwein is no exception; one in three Americans, by his estimate, suffer from some sort of psychological malady. It’s just that, in places like this, where there is no money for proper help, the effects are magnified. Every year, Oelwein’s population dwindles. The senior class at the high school shrinks, on average, by five students each fall. In 2004 alone, Oelwein lost $147,000 in tax revenues. It cannot absorb the social and financial cost of malady in the way that Waterloo (which lost $2 million in revenues in 2004) can. Nor is the problem aided, Clay says unapologetically, by the inbreeding and lack of education endemic to a place that is literally shriveling up: “How ’bout the first people to leave are of course the smart ones, and the people with enough money to get out. What you’re left with—and I’m sorry, okay?—doesn’t qualify Oelwein High as a feeder school for Harvard, okay?”
What Clay laments more than anything is that there is so little recognition of the complexities Oelwein faces. No one wants to talk about what’s right in front of their eyes, a direct result, he says, of the tight-lipped, stolid stock that helped settle this area. A hundred years ago, it was socially advantageous for people not to speak of hardship, to act instead of to think. Now, says Clay, there’s too little money to act. Talking, at a minimum, he says, would help alleviate the sense of helplessness. Looking for ways to cope, many people head to the church, where the best intentions of a wonderful man like Darwin Moore, the minister at Grace Methodist, cannot be mistaken for real job training in social and psychological programs. Or, unable to afford a visit to Clay, never mind the antidepressants he might prescribe, people self-medicate in one of Oelwein’s eleven bars. That, he says, is where the meth dealers have easy pickings.