Tragic Tale

The neighborhood of Far Rockaway, Queens, N.Y. is the picture of urban blight, a crammed mixture of public housing blocks, shuttered storefronts, brownfields and small churches in what used to be homes. Most of the fences are topped with razor wire. Large piles of garbage lay scattered on broken sidewalks. The most recent sign of commercial development is a billboard advertising $300 divorces. No spouse signature required.

Tucked away on Beach 19th Street is the Queens-Nassau Rehabilitation Center and Nursing Home, a bare-bones geriatric and head-trauma facility. Small and tightly quartered, its halls are partially blocked by old, frail-looking patients wearing ragged clothing. 

Bill Mantlo is one of them. At first glance, there is nothing to suggest that he is different from his fellow patients, nothing to suggest the unusually high-profile career he once had, the near-fatal car accident that ended it, or his tortuous transit through the healthcare system from the outside world to Queens-Nassau. And certainly nothing that would point out how his life’s remarkable reversal of fortune illustrates not only some of the worst deficiencies of modern healthcare, but of the effort to reform it, as well.

Bill is gaunt, almost skeletally so. His skin is pale and pasty, the product of getting very little time outside. His short hair is lank and unwashed. His teeth are yellow and have not been properly cleaned in some time. He turns 60 on Nov. 9, 2011, but he looks more like 80.

The victim of a closed-head brain injury from nearly 20 years before, Bill cannot move from his wheelchair to his bed without help, nor can he feed himself, go to the bathroom or conduct any other kind of normal physical activity unaided. He can move his arms, but the fine motor control in his hands is very poor. He needs someone else to put his glasses on for him, and when he wants to take them off, he can only drag his hands across his face and let the glasses clatter to the floor.

Bill can hear and recognize when people speak to him, but his own speech is slow, labored and typically consists of single words or very short sentences. Most times, he simply yells at anybody who enters his room. He has a history of lashing out violently at staff and patients, though in his current condition, the only person he is likely to hurt with a swing is himself.

His room is nearly empty. No television. No radio. No books, magazines or newspapers. No decorations on the walls. No mementos from previous visitors. Nothing at all to mark the individual who has lived here since 1995. A solitary prison cell has more personality than this, even though Bill is not prohibited from going anywhere. He just lacks mobility, and most times, the will. His average day consists of waking up, getting changed and cleaned by the morning shift nurses, and then a sit in his wheelchair, where he stares at nothing. When he has had enough, he is transferred back to his bed, where he closes his eyes and tries going back to sleep. At some point he will be fed, and after that, more sleep.

Today, however, he has a visitor. A man comes to his room, but immediately Bill wants no part of it.

“GO.” he shouts. “GOOO!”

Bill’s social worker is nearby, openly skeptical that this visit will do anything other than agitate Bill into a state that will make him difficult to handle for the rest of the day. But Bill’s nurse, Fatima, moves in and places a hand on his shoulder. For reasons the staff will not disclose, Bill is disturbed by the presence of any men in his room, which is why his nurses are female. Among them, Fatima has the best rapport with Bill and her words soothe him enough to listen.

“Now, Bill, you can’t talk to him like that,” Fatima says. “Do you know who that is?”

“Who?” Bill asks, genuinely perplexed.

“That’s your son.”

Bill’s head turns suddenly, fixing on his visitor. This is more than a surprise.

“Hi, Bill,” says the visitor, a 45-year-old man in a puffy red jacket. “It’s me, Adam.”

Tears come to Bill’s eyes. Then they come to Adam’s. It is the first time either one has seen the other in 17 years.

The Fill-In King

While most people would not know who Bill Mantlo is, comic book fans might. He was, for a time, one of the top writers for Marvel Comics, and to this day he still has a considerable fan base. When Greg Pak recently finished writing a string of issues of the Incredible Hulk, he dedicated the issue to Mantlo. Bill’s impact on the comic world is significant, but even his most ardent fans generally do not know that he has become defined by a cruel irony: Mantlo wrote superhero stories to inspire people to be good to each other, only to become an anguished man in a broken body, in desperate need of a hero himself.

[See also: 9 of Bill Mantlo's Best Comic Covers]

Bill Mantlo was born in Brooklyn, NY in 1951, the first of three brothers—himself, Mike and Adam. Bill became an avid reader and artist early on, with a love for comic books. But it was in 1962, as the Amazing Spider-Man began to hit the shelves, that he became a die-hard fan of Marvel Comics in particular.

Bill got into the Marvel fandom on the ground floor. Although the company had been publishing comics since the 1930s, it was in 1961 when Marvel began evolving into the engine of pop culture that it is today. Writer and editor Stan Lee and artists such as Jack Kirby reinvented the superhero genre, telling stories that were set in real-world New York, filled with characters who were more human (at least to readers) than their counterparts at other comic companies. Characters who are now household names, such as Spider-Man, Captain America, the Incredible Hulk, Iron Man, the Avengers and the Fantastic Four were all getting their big start. For kids who were into comics, it was a special time— the likes of which have never been repeated.

Bill’s connection with Marvel went even deeper, as Jack Kirby was a neighbor of his. Bill often spent his teenage afternoons at “the King’s” house, picking up on drawing tips, geeking out on superheroes and talking about storytelling. It would prove to be a formative relationship for Bill.

After graduating from the Cooper Union School of Art in 1973, Bill scored an internship at Marvel. He started as a gofer and soon began working as a colorist, which was not glamorous, but it got him into the trade.

At that time, comics were produced on an assembly line: a writer wrote a 17-page script which went to a penciller, who would follow the script to draw the panels in light blue non-repro pencil. Then the pages went to an inker, who went over the initial art, cleaning it up and adding light and shadow with black ink. Then it went to a colorist, who would paint the panels and send the page to a letterer, who would hand-write every word of dialogue and exposition. As a rule, the process worked fairly well unless the writer missed the deadline, at which point the whole show would grind to a halt.

In the early 1970s, Marvel was plagued with writers who regularly missed deadlines. Comics rarely came out on time, often running a full month late (or more). This had become a huge problem for Marvel because at the same time, comic sales had shifted from general newsstands to direct-sales specialty shops that would order issues in advance. Not knowing when or if a certain issue would be in was cause to withhold orders, and Marvel was feeling the hurt in a big way from that.

Bill’s big writing break came in 1974, when a writer had missed his deadline for an issue of Deadly Hands of Kung-Fu. Bill offered to write the issue on the spot, and quickly turned in a script that saw publication and landed him a gig writing Deadly Hands full-time. Deadly Hands was a minor title on the verge of cancellation anyway, but Mantlo did not care, and he took the job, and its deadlines, seriously.

Shortly afterward, Marvel mandated that all ongoing titles would have fill-in stories written in advance and held in reserve just in case the regular writer blew a deadline. Many of these fill-in jobs went to Bill, who became known for his utter reliability and a knack for turning out stories quickly, even overnight. Most of the titles he worked with were minor ones, like Deadly Hands, but eventually he got a chance to work on larger titles, such as Marvel Team-Up, Iron Man and Peter Parker, the Spectacular Spider-Man. At the same time, he also became the go-to guy for writing stories for properties Marvel had licensed, such as movie and television adaptations.

One such title was the Micronauts, which was based on a line of science-fiction action figures already popular in Japan and introduced to the U.S. market in 1976. Bill himself suggested that Marvel license the toys so he could develop a comic around them. Marvel agreed and began publishing the Micronauts comic in 1979. The toy line had little in the way of backstory, metaplot or character development, but that did not stop Mantlo from building an entire universe around the toys, inventing numerous additional characters and even a fictitious alphabet for the setting. The toy line died in 1980, a casualty of pretty much any science fiction-themed brand that tried to compete with Star Wars merchandising. But by then, it did not matter. The Micronauts was a hit in its own right, popular enough with the fans that it won the 1979 Eagle Award for Favorite New Comic Title. The series continued until 1984, with Mantlo writing all but one of its nearly 60 issues, including spin-offs.

Also in 1979, Mantlo took on ROM the Spaceknight, also a licensed property based off a toy line. The toy was a talking cyborg doll produced by Parker Brothers, but sales were so poor, the toy was cancelled within a year of launch. Again, this failed to faze Mantlo, who had already written a detailed origin, backstory, setting and supporting cast for the title, which remained popular (and more importantly for Marvel, profitable) enough to merit publication for seven years, ending in 1986 after 75 issues.

During this time, Mantlo remained Marvel’s “fill-in king”, ultimately writing for nearly every title Marvel produced at the time. He had long runs on Peter Parker, the Spectacular Spider-Man, the Incredible Hulk and Alpha Flight. At his most prolific, Bill’s work would appear in as many as eight different Marvel titles a month, and his total output exceeded 500 issues.

“Bill was in a class of his own,” recalls Chris Claremont, a colleague and close friend of Mantlo. Claremont’s 17-year writing stint on the Uncanny X-Men and various spin-off titles, from 1975 to 1991, made him one of the most famous writers in modern comic book publishing. Mantlo was different, Claremont says, because he lacked the prima donna ego of most comic book writers. He did not mind sharing story-writing credit on any given issue, often making a point of thanking in the credits anyone who helped him with the script.

While Mantlo wrote certain titles for long stretches, he never bonded with them so deeply that it prevented him from writing other titles. Even when he was writing monthly scripts for Micronauts and ROM, Mantlo was still doing fill-ins. “You gave him the call, and 72 hours later, you’d have a story. That’s something the editors grew to depend on. It was natural to think of him as a go-to guy,” Claremont says.

But Mantlo’s writing itself was also deeper than most other comic writing, especially for the time. Mantlo used comics as a form of social commentary, especially on topics that became flashpoints during the protest era of the 1960s. A comic series about an injured stuntman became an allegory for disabilities awareness. A space opera comic about a talking raccoon became an allegory for taking proper care of the mentally ill. A story about why the Incredible Hulk is powered by rage became an allegory about child abuse.

A lot of writers, including Claremont, did this sort of thing, but few did it as regularly or as effectively as Mantlo did.

“He was one of the writers who thought that comics should be more than just guys in skin-tight suits hitting each other and saving the world,” Claremont says. “He was asking, ‘What kind of a world are we trying to save? What kind of lessons can we impart to our young and impressionable readership?’ The trick was to find a way to do it so that you’re not preaching, but you’re also telling a cracking good story that will make the reader turn the page and bring the reader back next issue so you can have an ongoing and more lasting effect. Bill did that.”

Rough Drafts

But Bill’s writing was not perfect, and nobody knew that better than Jim Shooter, Marvel’s editor-in-chief and the guy who worked most directly on overseeing Mantlo’s work. Shooter became a comic industry legend in his own right during his nearly 12-year stint with Marvel, from 1975 to 1987. More than any editor before him, Shooter worked to make every Marvel title inhabit the same overall setting, creating a universe of thematically linked titles in which characters and storylines could easily cross over from title to title. Fans often refer to Marvel comics produced under Shooter’s watch simply as the Shooter era. More than a few of them contend that the Shooter era is the high point of all Marvel publishing.

Shooter notes that back when he was first editing comics—and Mantlo was just beginning to write them—publishers paid writers by the page, and it was a pittance, at that. The job was so pathetic, Shooter recalls, that one only did it because they truly loved the medium or they had no other choice. Those who could make a living at it had to be very fast at what they did. And Mantlo was fast. But his work often required a great deal of editing, if not full rewriting.

“I think it amused him that I was staying up all night fixing his stuff and making him look better while he’s staying up all night cranking stuff out and making more money,” Shooter says. He kept a file that consisted of entirely rewritten Mantlo script pages. If a single word of Mantlo’s remained on the page, it did not make the file. At the end of a single year, Shooter recalls, he would have a ream of paper in the file.

There were other problems, too. Because he was writing so fast, and under tight deadlines, Mantlo was known to rehash stories that had already run in earlier issues, or crib an idea too closely from another source while searching for a storyline to develop. Mantlo was hardly the only Marvel writer to do this, but he was one of the few who caused some problems along the way. In one case, while scripting an issue of the Incredible Hulk, Mantlo borrowed from an Outer Limits episode written by Harlan Ellison. Ellison called Shooter to complain, and settled things for a standard writer’s payment for the issue, an acknowledgement in a later issue’s letters page, and a lifetime subscription to all Marvel comics.

In another case—and one that remains a point of debate within comic book fan circles—Mantlo was accused of plagiarizing an unfinished story treatment written by artist Barry Windsor-Smith, again for the Incredible Hulk. Shooter’s version of the story is that Windsor-Smith had brought to the Marvel office an unfinished treatment for a story explaining the origin of Bruce Banner, the Hulk’s mild-mannered, but easily enraged, alter ego. Shooter wanted to buy the story on the spot, but Windsor-Smith insisted on finishing it first, and he left rough drafts behind. Mantlo, while visiting the Marvel office, found Windsor-Smith’s work, figured it was open for use, and wrote a story off of it. The Incredible Hulk itself was between editors, and the story’s lineage was not noticed until the issue was in print. The story remains one of Mantlo’s most popular, and it was developed as a core element of the script for the 2003 film adaptation of the Hulk. Windsor-Smith never stopped holding a grudge over it.

“He did a tremendous amount of good work for us,” Shooter says, stressing that Mantlo’s good far outweighed his bad. “The nice thing about Bill was that other writers could be picky fanboys, but Bill would do anything. Book about a stuntman? Sure. Book on a toy? Sure. And he gave it a good effort, no matter what it was. He could do any job and he was always polite, always nice. You couldn’t help but like him.”

Where Shooter noticed this most was the ease and frequency with which Mantlo created new characters. Until Shooter got Marvel to implement a policy that gave writers a small percentage of any licensing for characters they created, any new intellectual property belonged to Marvel. While Shooter was working on that incentive, he told his writers to not create any new characters, to ensure they got a piece of whatever they would be worth. There was substantial money to be had once the incentive program was in place—$30,000 checks for the action figure rights on a single character were not unheard of. This is why Shooter had wanted the writers to hold off for a bit.

“Not Bill. Are you kidding? He was making characters like they were going out of style. He was irrepressible. He was a font of ideas. There was no limit to his creativity,” Shooter recalls. “I appreciated it on behalf of Marvel, but I felt bad for Bill that he had created these things that if he had waited a little while, he would have owned a piece of them. You know what his attitude was? ‘I’ll make more.’ I really admired that.”

The Boisterous One

By the mid-1980s, however, Mantlo’s writing assignments were dwindling. The days of lax deadline management were long gone, and most writers were doing their own fill-ins. Plus, Mantlo had locked horns enough with Shooter and Marvel top brass (including Stan Lee) that new editors were not particularly willing to work with him. Mantlo did not help matters with a failed attempt to unionize his fellow Marvel writers. He spoke his mind with such freedom and bluntness that he earned the nickname “Boisterous” Bill Mantlo, or merely, “The Boisterous One.”

In 1985, Mantlo took advantage of a tuition reimbursement program Marvel offered and put himself through law school, writing scripts by day and taking classes by night. In 1987, he passed the New York State Bar and while he still wrote the occasional comic book, as well as starting various novels and screenplays, he considered himself a full-time lawyer. He received a number of offers to work for real estate legal firms but he opted to work for the Legal Aid Society, a private not-for-profit that provides free criminal defense representation.

Mantlo made about $40,000 a year at Legal Aid, which was  considerably less than he was making at Marvel. But that was  almost the point: he became a lawyer mainly because he felt he had done all he could with comics to send messages about social causes. In law, he could help people more directly.

In court, Bill lived up to his reputation as the Boisterous One, earning numerous warnings from the bench for his fiery brand of delivery, especially while cross-examining police officers. As one justice recalled, Mantlo was the nicest person he ever had to hold in contempt of court. Once, Bill was arrested as part of a sweep against a sit-in by a local school union he was representing. He used his phone call not to arrange for bail, but to order pizza for himself and everybody else in the holding cell.

It was also at this time, however, that his marriage fell apart. Mantlo had married Karen Pocock years before when they were both working at Marvel (Pocock was a letterer). Pocock had a young son, Adam, from a previous marriage whom Mantlo accepted and raised as his own. In 1981, the couple had a daughter, Corinna. And when Bill entered law school, Karen left her own career as a photographer to become a teacher; their calling to help people had been a joint life change. But by 1988, he and Karen were bitterly divorcing. The experience was hard on both children. Adam, 21 years old and an accomplished bicycle mechanic, stayed far from home to distance himself from the emotional carnage. Corinna was only seven and stayed with her mother, but the stress of the divorce also had a long-lasting effect on her. To this day, she does not readily share details about it. Regardless, Bill, Adam and Corinna still saw each other regularly and maintained a close relationship. Both Adam and Corinna describe Bill as a great father.

Throughout his time at Marvel and at Legal Aid, Bill was an avid runner, biker and rollerblader, keeping himself in excellent shape. A favorite activity was to take Adam and Corinna dirt biking in Central Park. Bill always wore a helmet, and insisted that his kids did likewise. But when rollerblading, Mantlo did not wear any head protection, like many other early rollerbladers. It was an oversight that would destroy his life.

Hit and Run

On Friday, July 17, 1992, Bill left work early for the weekend, and made his usual three-mile rollerblade journey through Brooklyn traffic to his apartment near Morningside Park. Just four blocks from home, a car came around a corner and hit Bill. The left side of Bill’s head impacted the windshield. He rolled across the hood of the car, and the right side of his head impacted the pavement. The driver never stopped and was never identified.

The accident jostled Bill’s head so violently that his brain squashed against the inside of his skull, and his brain stem severed. This did not paralyze him, but it would make it very difficult for Bill’s body—particularly his extremities—to accurately receive and process electrical messages from his brain.

Bill spent the next two weeks in a coma at Saint Luke’s hospital in midtown Manhattan, after which he remained in critical care for another two months. During this time, he was still on a ventilator and a feeding tube, as his brain was too damaged to tell his body how to swallow or breathe.

The acute care needed to save Bill’s life cost more than $1 million, according to Bill’s brother Mike, who at the time was a dispatcher for FedEx. Mike became Bill’s legal guardian once Bill could no longer make decisions for himself. The Legal Aid Society had provided Bill with group health insurance through CIGNA—one of the country’s largest health insurers.

According to Mike, in October 1992, CIGNA declared that Bill’s immediate recovery was complete and that he would have to be moved to a rehabilitation facility for further recovery. CIGNA instructed Mike to find a facility for his brother, but offered no help in doing so. Mike researched and interviewed seven different facilities before settling on one in Pennsylvania that appeared to be ideally suited for handling patients with Bill’s particular problems. CIGNA approved the choice and told Mike to move Bill in. Mike had Bill transported to Pennsylvania but a week after Bill moved in, CIGNA told Mike that Bill would have to go somewhere else, as CIGNA no longer covered the facility. It would be the first of a number of unwelcome conversations between Mike and the insurance company.

Bill was moved to Gaylord Rehabilitation Hospital in Wallingford, Conn., best known at the time as the facility that had treated Tricia Meili, the “Central Park Jogger” who had suffered severe head injuries from an assault and rape in 1989. Gaylord was Mike’s second choice.

Bill stayed at Gaylord for nearly a year-and-a-half, during which time a number of disputes between Mike and CIGNA began over the continuation of Bill’s care. According to Bill’s policy wording, he was eligible for 90 days of rehabilitative care, after which he would have to show that he was making recuperative progress in order to justify further rehabilitation. This is where being the “Boisterous One” came back to haunt Bill when he could least afford it.

Bill’s memory was shattered by the accident, though he was aware of what had happened to him, and he had a sense of how grievously he had been injured. Throughout his early rehabilitation, Mike says, Bill was consumed with rage, both at the state of his own health, and that whoever had hit him had successfully fled the scene. This made him combative during rehabilitative therapy sessions. He was still quite fit and strong enough to resist therapists physically, which became a problem and prevented Bill from making much progress.

Both Adam and Corinna visited their father regularly while he was at Gaylord, and they could see that he was becoming ever more angry and distraught at his condition. During one visit, Bill asked Adam and Corinna to kill him. After that, neither could bear to see their father in person again, confining contact to letters and telephone calls.

Three months later, CIGNA declared there was nothing more to do and informed Mike coverage would cease. Mike argued that his brother was still progressively recovering, and that even though some of Gaylord’s therapists refused to work with Bill, the family was assisting with therapy. Mike would visit Gaylord every weekend. Bill’s mother Nancy would sit with him and go through speech therapy. Bill’s father William would visit three times a week to assist with physical therapy.

And the work was paying off. Mike recounts that by November 1992, Bill regained his ability to speak and could sit up in a wheelchair. He was no longer on a ventilator or a feeding tube, and his family could even take him out to dinner. Bill could now read a menu and place his own order, and it could be understood by the wait staff.

But it was not enough. On one occasion, Mike recalls, a staff psychologist pulled Mike aside and told him that Gaylord was being pressured by CIGNA to cut Bill off. Despite the progress being made by the family, if CIGNA saw that Bill was not working with facility therapists, the company would say that Bill did not need any further help. That is exactly what happened.

Mike successfully lobbied for another 90 days of rehabilitation coverage while he scrambled to find a new facility where he could move Bill. He found Whittier Rehabilitation Hospital in Westborough, Mass., an 88-bed facility that specialized in acute and specialized rehabilitation, including a memory clinic. CIGNA approved the transfer, but the problems that complicated Bill’s stay at Gaylord did the same at Whittier. At the end of his first 90 days there, CIGNA decided that Bill was resisting therapy and not showing signs of progress, so coverage would have to cease. At this point, the total cost of his care totaled more than $2 million, nearly half of which went to rehabilitative therapy.

Mike fought with CIGNA on this ruling as well, with some help from Whittier’s physicians. CIGNA reportedly turned up the heat, requesting updates every 30 days to determine if continued care was still medically necessary. “The primary physician was siding with me and was really fighting with CIGNA,” Mike says, adding that CIGNA eventually brought in its own physician, who examined Bill and filed a report to CIGNA stating that no further rehabilitation was medically necessary for Bill. Mike says he was never given a copy of the report.

Bill’s primary physician at Whittier protested the report with Whittier’s management itself, arguing that it could not allow the insurer to bring in its own medical personnel to reverse the medical opinion of a department head within the hospital. The doctor insisted Mantlo could still make progress, but he needed more intense therapy than what Whittier could provide.

“Thank God for him,” Mike says. “That guy did everything he could for Bill.”

Collateral Damage

Round three. Mike found the Meadowbrook Nursing Home in Tucker, Ga., about 15 miles northeast of downtown Atlanta. Although Mike was still working and living in Manhattan’s upper West Side, he could fly for free on FedEx cargo flights, which meant he could still visit Bill on the weekends.

Bill arrived at Meadowbrook in 1994. Mike describes it as a “very small, very intense” rehabilitation center where Bill made progress in both speech and vocational therapy during the first few months. Bill recovered to the point where he was able to type at a computer and maintain his concentration long enough to begin writing once more. He started keeping a journal in which he recorded random creative thoughts as well as some personal reflections. During one therapy session, he even produced a two-paragraph short story for one of his doctors about an invasion from Mars.

[See also: Tragic Tale - Bill's Last Words]

Sensing an opportunity to advance Bill’s recovery even further, Bill’s treating physician informed Mike that she had a new medication she wanted to try on Bill that might produce radical rehabilitative results. Mike does not recall the name of the medication, just that he approved its use on his brother.

“She started him on a very low dose, half a milligram a day,” Mike says. In one day, Bill came back the furthest he had come in any of the facilities he had been in. He picked up the phone, dialed his parents and talked to them for an hour. “It was unbelievable. They were on Cloud Nine.”