Chicago is a body. Its heart and its head sit in the same place: City Hall. The heart pumps resources, money, services, attention, out to every neighborhood. The head sets direction: what to fund, what to fix, what to build. When both work, the body thrives. When either fails, the whole body suffers.
I know failing hearts, because I have spent my career as a cardiologist treating them. A heart rarely fails because of one thing going wrong. It fails because many small failures compound until the organ can no longer feed the rest of the body. That is what is happening at City Hall, and it is what is happening to Chicago.
Right now, Chicago’s heart and head are failing.
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The heart isn’t pumping. Housing costs eat family budgets. Healthcare is out of reach for too many. Public safety has grown uncertain, and more women feel it walking home at night. Young people are leaving. Older residents follow them. Each departure means fewer people to share the cost of running the city, so taxes rise, and more people leave. That is what a failing heart does: It starves the very parts of the body it is supposed to feed.
The head isn’t thinking clearly, either. City leaders defer debt instead of paying it down. They recycle programs that have already failed and expect new results. They make decisions without input from the people who will live with the consequences. A head that won’t take in new information, or won’t listen to the rest of the body, cannot direct it well.
This is how systems fail: not in a single collapse but in a cascade. A weak heart weakens the head. A poor decision weakens the heart further. Fewer residents mean less revenue. Less revenue means fewer services. Fewer services drive out more residents. Chicago is not failing all at once. It is failing in a cycle, and each failure feeds the next.
You cannot fix a failing heart and a failing head with medication. You need a transplant: a new heart at City Hall and a new way of thinking to go with it.
A new heart means governing that reaches every neighborhood, not only the ones with political capital. A new mind means decisions built on evidence and made with the people affected by them, not for them. That requires real collaboration: with the state, with Cook County, with aldermen, with community leaders and with residents themselves, from the start of a policy, not after it has already been written.
The new mind also has to solve the math problem sitting in front of it. Chicago’s debt was built when the city had hundreds of thousands more residents than it has today. That debt has not shrunk to match the smaller population now paying for it. Every year Chicago loses residents, the taxpayers who remain carry a larger share of a bill written for a bigger city.
Controlling spending is part of the answer, but it is not the whole answer. The other part is growing the base that pays the bill. Chicago needs a real strategy to bring people back and keep them here: housing people can afford, neighborhoods safe enough that families choose to stay, and a reason for businesses to hire and grow here instead of in the suburbs or another state. More residents mean more taxpayers. More taxpayers mean each one owes less. That is how you pay down debt built for a bigger city: by rebuilding the city, not by rebalancing its books.
As a cardiologist, and as mayor, I will treat City Hall’s failures for what they are: a heart that has stopped serving the body and a mind that has stopped listening to it. I will rebuild both, through real collaboration with every level of government and every community in this city, and through a serious plan to grow Chicago’s population so the debts of the past do not fall on a shrinking few.
Chicago does not need another round of budget cuts and old promises. It needs a City Hall with a working heart and a clear head. That is how Chicago works again.
Lisa Nee is a cardiologist and a candidate for mayor of Chicago.
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