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Above, a snapshot of fraying Portland: A surveillance image of the at-large suspect in the attack on Dr. Mary Costantino, shown below just afterward. She notes her assailant’s hand splayed in “hypertonic tension,” suggesting a psychotic episode. “I recognize this as a physician a mile away,” she says.

By Nancy Rommelmann, RealClearInvestigations
October 10, 2023

It was a great first date, two-plus hours of conversation and martinis at Portland’s Driftwood Room, with its Rat Pack vibe and lighting that makes everyone look 25. Mary Costantino was twice that, as was her date, a fellow physician from out of town. By 10:40 he was walking Costantino to her car, on a block she’d been on thousands of times. She’d lived in the neighborhood 20 years; the city’s best public high school, which her sons attended, was in eyesight. The couple held hands and chatted as they moved down the street.


Mary Costantino: “Just us walking and talking and then I was hit on the side of the head.”

Courtesy of Mary Costantino

And then Costantino wasn’t moving. She was on the ground, her vision blurring, her mouth full of blood.

“There was no yelling, there was no sound of feet hitting the pavement,” she recalls, of the July 28 incident. “It was just us walking and talking and then I was hit on the side of the head.”

More like her face. What Costantino says “felt like a brick” turned out to be a metal water bottle, hurled by a man who, surveillance video would show, looked like any number of men on the streets of Portland: white, 30s, beard, dark hoodie, backpack. A man who, when confronted by Costantino’s date, shouted “She knows what she did!” before stumble-running into the night.

Costantino registered none of this. She was concerned with getting the bleeding under control, bleeding and shaking that made it difficult for several minutes to unlock her phone and call 911. She did not hear her assailant yell that she had somehow harmed him. It was only later while watching the video that she noticed his hands.


Mary Costantino: “It is inhumane, how we are allowing people who are psychotic or on drugs to live,” she says.

Courtesy of Mary Constantino

“They were in hypertonic extension,” she says, of her assailant’s fingers, which he held splayed and tensed and away from his body. Having tended to people in drug and mental health crises, it looked to Costantino as though her assailant was in the midst of a psychotic episode.

“I recognize this as a physician a mile away,” she says. “And the fact that he backed off when my friend confronted him, this poor person has seen some hard, hard times. This person needs to be in a safe place for himself, be fed, be nourished, be medicated, be cared for.”

Instead, he and thousands of others living on the streets of Oregon’s largest city are on their own, despite the safety nets Portland has in place to help the homeless, the addicted, the mentally ill. Which is among the reasons Costantino does not so much hold her assailant accountable as the city itself.

“It is inhumane, how we are allowing people who are psychotic or on drugs to live,” she says. “It’s inhumane.” 

The City of Roses, Wilting

US Customs and Border Protection via FOIA/Wikimedia

A city buckling under its ostensible benevolence: Portland during the 2020 BLM riots.

US Customs and Border Protection via FOIA/Wikimedia

The question of what constitutes humanity is at the heart of Constantino’s attack and the tensions in Portland, a city buckling under the weight of its ostensible benevolence. Few U.S. cities have offered as fertile an environment for drug addiction and homelessness to take root, via hands-off policies and the idea that a moral society is a tolerant society — all of which might have stood a fighting chance, had the riots and violence of 2020 not kneecapped a city already struggling under COVID.


That was then: In 2017, permissiveness toward sleeping rough, a problem that only got worse.


With whole blocks boarded up, people exploited Portland’s liberal public camping policies and overtook much of downtown, as well as other parts of this city of 635,000. There are 6,297 homeless recorded in surrounding Multnomah County today, compared with 3,120 in 2020. Many, like the man some believe to be Constantino’s assailant, are in the grip of addiction. (The 2020 National Survey on Drug Use and Health ranked Oregon as having the second-highest drug and alcohol addiction in the nation by percentage of population, after Montana, and last in access to drug treatment.) The criminality that often attends addiction has risen accordingly. Robberies were up 50% in 2022 alone, and according to the Portland Police Bureau, there were more than 10,000 assaults between July 2022 and July 2023.

The decline of civic safety was driven by another 2020 event, the passage of Oregon Ballot Measure 110, the Drug Addiction Treatment and Recovery Act. Measure 110’s stated aim – that “a health-based approach to addiction and overdose is more effective, humane and cost-effective than criminal punishments” – was in line with Oregon’s promotion of harm reduction policies over incarceration, and the measure passed with more than 58% of the vote.

KGW8 Portland
This is now: For a semblance of safety, Portland this summer enacted a conditional ban on public drug use.

KGW8 Portland

The problem proved to be in implementation. Although the 2014 legalization of cannabis for adult use authorized the allocation of tax revenue to treat substance abuse, the $302 million earmarked for 110’s “treatment and recovery” went mostly undistributed; an April 2022 audit showed that, due to bureaucratic hold-ups, $276 million failed to reach providers. With the spigot for treatment and recovery services essentially turned off, the city was flooded with people under no threat of punishment for public drug use, and little to no state help to stop using. And the opiate of choice was now synthetic fentanyl, stronger and as addictive but cheaper than heroin – as little as $1 a pill, which, crushed and smoked, can keep a user high for about an hour. Eleven people overdosed downtown during a 12-hour period in April, many around an abandoned retail plaza turned open-air drug market; three died. Bike cops in downtown Portland can find themselves using Narcan – a medication that reverses opioid overdose – multiple times a day, sometimes on the same people.

“It’s like an episode of meth-fentanyl TV down here,” a downtown restaurateur said in June. “We need triage.”

With a public increasingly demanding a semblance of safety downtown, the Portland City Council voted 5-0 in August to ban public drug use. Hurdles include getting Oregon to change state law, as well as policies imposed by the Multnomah County Health Department. The county was set to distribute free tin foil and straws to fentanyl smokers — given that heroin use was down and with it demand for free needle exchanges — but a public outcry in July scotched the plan.

“Oregon’s become a guinea pig for the rest of the free world to see if this would even work. And it hasn’t,” says Ben West, commissioner for Clackamas County, which borders Portland but shares few of its social ills. West, a first-term Republican and registered nurse, has pushed his county to fund recovery-oriented systems and make addiction and mental health treatment available. Like Costantino, he is familiar with the physical and emotional hardships those living on the streets face, and sees the policies pushed by Portland, which he characterizes as “perpetually caught in adolescence,” as cruel and enabling.

“They created the environment that fostered the behavior,” he says. “They want to make the argument that autonomy is so sacred that you should watch people slowly kill themselves. It’s a nihilistic, postmodern worldview.”

Recovery, but Not Closure

Advanced Vascular Centers (Portland and Eugene)
Above, the doctor at work. The shredding of the social fabric is seen as normal, or not seen at all.

As she sat propped against the wall, Costantino gave herself a little self-examination. She did not think she had an intracranial hemorrhage. She was pretty sure she had a concussion and knew she had swallowed some blood. Despite her date’s repeated entreaties, she refused to go to the emergency room.

“I don’t want to answer questions; I want to go home and be left alone,” she remembers thinking. And so, about 20 minutes after she was assaulted, and with police yet to arrive, her date drove her home. She drank some water. She put ice on her face. She slept, and feeling woozy the next morning, took her first-ever day off from work. Lying in her bedroom with a big headache, she texted a photo of her injuries to a few friends.


“They were super upset, very angry,” she recalls of her friends, some of whom stay attuned to the vicissitudes of Multnomah County politics. “These yappity-yaps will be, ‘Can you believe they’re giving people [fentanyl] smoking materials?'” says Costantino. “I’m like, ‘Portland’s great. The trees are awesome. What’s the problem?'”

Her friends impressed her that there was a problem and she needed to get in front of it. Costantino agreed to meet with a reporter from Fox News, which did a segment on the incident. Local outlets picked up the story. Mayor Ted Wheeler’s office called the attack “horrific,” and a detective from the Portland Police Bureau made contact with Costantino, saying, in her recollection, “We already have the video and we think we have identified the guy.”

Others who saw the news reports also identified the guy. They instantly recognized the bearded man with the tensed hands as a regular at the missions downtown. They knew his name, his age, and that he’d been in trouble with the law. They recalled him standing in the free food lines in the morning; the rigidity of his body, his fingers stained dark from smoking meth or fentanyl, his occasional flashes of elation but mostly what seemed a deep depression, perhaps from substance abuse, perhaps schizophrenia. Concerned that he was not okay, one local scoured the Facebook pages said to be of the bearded man’s family, looking for clues as to his whereabouts. No luck. Someone else searched the homeless encampments downtown but found no sign of him. The bearded man was gone.

JB in The Pit

Nancy Rommelmann

He calls himself JB: At six-foot-three, he’s better able to handle the ever-present danger of being assaulted in The Pit.

Nancy Rommelmann

The man who identifies himself to a reporter only as JB stands in front of his tent holding one of his machetes. “I don’t pull them out if I need to fight somebody or anything,” he says by way of reassurance of the two blades he recently accepted in lieu of some money owed him. Bicycle tires, broken generators, cases of Pringles, and a closet-size tent in which one can take a water-bottle shower or a poop in private, everything in the spit of land beside an on-ramp to Portland’s Steel Bridge, known as The Pit, is bartered, shared, abandoned, stolen. Last month JB came back to find everything he owned gone.

Nancy Rommelmann

Home to some: The Pit, spit of land beside an on-ramp to Portland’s Steel Bridge.

Nancy Rommelmann

“I should be able to go to the store and not have my house ransacked, you know?” he says.

JB and the bearded man who may have attacked Mary Costantino have things in common. JB is 38; as is the bearded man; both grew up in Oregon, and each is the father of three children. Each is a heavy drug user and wound up on the streets. JB is a fentanyl addict; police records show the bearded man has seven arrests for possession of meth. As for services provided by Portland or Multnomah County, JB says they are scant. “You sometimes have people drop off water or food,” he says, but no authorities come down offering access to detox or health care or job training or housing.

“I had this one guy say that he could get me into a tiny home, and another tell me, ‘We could get you housing,’ but they never come back,” he says, as the light rail rumbles over the bridge, a sound JB says you get used to. At six-foot-three, he’s better able to handle the hardships of being homeless, including the ever-present danger of being assaulted; he says women are sexually assaulted “every day.” The tenuousness of every aspect of life is especially hard for those experiencing mental illness.

“A lot of meth users, they go into psychosis,” he says. “They’re unpredictable.”

Homicides More Than Double

Portland Police Bureau

Police stretched thin: Double overtime and upper-five-figure salaries are offered to shore up the force. 

Costantino heard no more from the police. The Portland Police Bureau today classifies the case as an open and active assault investigation. Contrary to what Costantino was told about the alleged assailant being identified, Sergeant Kevin Allen says the name of the bearded man “is not in the case file” and even if it were, “we virtually never name persons of interest publicly [as] doing so would put the criminal investigation in serious jeopardy.” (Lacking official confirmation of the bearded man’s identity and because he has not been charged in the assault, RealClearInvestigations is not identifying him.)


Julia Brim-Edwards, county commissioner: “Somebody appears in arraignment court and there’s no public defender? You can’t hold them.”


Allen said police arrived at the scene about 12 minutes after the attack was reported at 10:51 p.m., but could locate neither the suspect nor the victim. The response time is better than the average 21 minutes it takes Portland police to reach the scene of high priority 911 calls (83 minutes for lower priority calls), and Allen mentions that the department is “piloting a temporary double-overtime rate to help cover patrol shifts, to encourage more officers and sergeants to come in on their time off to help meet minimum staffing.”

The force has been stretched thin since Portland’s 2020 “defund the police” effort and a concurrent rise in violent crime, including a soaring murder rate. Portland recorded 36 homicides in the pre-pandemic, pre-George Floyd year of 2019 and 101 in 2022. There are currently fewer sworn members of the Portland police of any rank – 803 – than the 1,035 on the force in 2005, when 100,000 fewer people lived in the City of Roses.

“Once you have a reduction in the police force, you can’t just overnight turn it back on,” says Julia Brim-Edwards, a Multnomah County Commissioner elected in 2023, speaking to what the public wants today, not what the electorate was shouting it wanted in 2020.

Compounding the problem, according to Brim-Edwards, is Multnomah County District Attorney Mike Schmidt. During the pandemic, she said, Portland residents saw its prosecutions essentially “grind to a halt” and it never caught up. (Brim-Edwards notes that nearby Washington County managed to keep pace.) A shortage of taxpayer-provided defense lawyers further ensures that many crimes never reach the prosecutorial stage. “Somebody appears in arraignment court and there’s no public defender? You can’t hold them,” she says.


Mike Schmidt, District Attorney: from May to November 2020, his office dropped charges more than 90 percent of the time.


In a March 2022 op-ed, Schmidt agreed the backlog was due to a critical shortage of public defenders. He further wrote that police are failing to bring most crimes to his office for prosecution, while omitting that of the more than 1,000 protest-related arrests from May-November 2020, his office dropped charges more than 90 percent of the time.

Whether lawmakers anticipated a rise in crime when Measure 110 decriminalized drugs is unclear. What is known is that they were ill-equipped to handle it. The cascade of problems that follow people engaged in sustained hard drug use has been disastrous to both users and the city, including a doubling of drug overdoses between 2019 and 2022, and a downtown office vacancy rate that hovers around 30%, contributing to streets that can feel ghostly and unsafe. And while the public use of drugs is still legal, it is nevertheless jarring to see, for instance, two college-age guys shooting up on the steps of a Victorian home as casually as if they were sipping a beer.

Or jarring to some. Until recently, Portlanders sang in two equally strong voices, those who supported people’s rights to do drugs and camp on the streets without fear of arrest, and those who wanted stricter social norms. The ideological battle has seen the two camps move closer. There are few people happy with the current decline in public safety, with those in the throes of addiction languishing and dying in record numbers; or with the sense that the city, so recently a jewel of the West Coast, is being sacrificed to good intentions. 

“It’s not compassion fatigue, because this isn’t compassion, to have people living like this,” says Brim-Edwards. “It’s not good for the people who aren’t getting services, and it’s also not good for our community.”

Both ‘Horrific Case’ and ‘Everyday Event’

In the weeks that followed the assault, Costantino experienced headaches, a high-pitched ringing in her ears, and fatigue that kept her from doing anything much after 2 p.m. Still, she considered herself lucky, both because her assailant had not escalated the attack – as she lay on the ground she’d braced, she said, “for a kick to my head” – and also because she had every opportunity to heal.


Nathan Vasquez, DA candidate: “Just saying, ‘Hey, we’re going to be progressive and have essentially zero accountability,’ just isn’t going to work,”


“I had a house to come back to, I took a shower the next day, I had Uber Eats deliver food to my door,” she says. “If I’m in a tent, I’m a target for further assault and I can’t defend myself. And I lay there until I manage to heal? And somehow try to get something to drink and to eat? If I’m living on the street, I don’t think I can get out of this without long-term damage. And then what? Nobody’s on my side. Not one person knows or cares what happens to you.”

The weeks would pass with no new information or with leads that seemed to evaporate. Her date spoke with police but was never shown a photo of the bearded man, who records show has previously been arrested in Multnomah County for assault, robbery, and unlawful possession of methamphetamine. A detective told Costantino’s attorney that they thought they could identify the suspect via a piece of clothing, but that didn’t go anywhere.

“It’s a truly horrific case but it’s also kind of an everyday event. That’s the saddest part,” says Nathan Vasquez, senior deputy district attorney for Multnomah County. “I could name you 10 cases over the past two years, man walking down street minding his own business, is attacked. We see this over and over. You have someone having a mental health crisis, or a substance abuse crisis, or both, they’re not getting the help they need and it spirals out of control.”

Vasquez will be running for his boss Mike Schmidt’s job in 2024, in part because he believes Portland must do better. “In terms of [Measure] 110, the idea of just saying, ‘Hey, we’re going to be progressive and have essentially zero accountability,’ just isn’t going to work,” he says. “We should lean into people’s life issues. Is it substance abuse? Is it mental health? We should look for long-term tools and resources. But it can’t just be, ‘Here are the resources, go forth.’ There has to be supervision and accountability. ‘Hey, okay, drug addict, you relapsed? It’s okay; you should go back to treatment. It’s your third relapse? You should get some jail time.'”

Costantino mentions jail in a different context. “What really actually pisses me off about a lot of this is that anyone thinks that the best place for this person is to be left alone on the streets,” she says of her alleged assailant. “If my son has psychotic breaks, I want you to throw him in a cell or take him anywhere off the streets. Ideally, we have a beautiful rehabilitation center, with excellent mental health care. But if we don’t have that, I want you to put him in a car and take him right to some isolated cell. Please feed him and protect him from the streets because that guy is not safe either.”

A Son Who Does Not Return


Not the only sign of Portland’s troubled times.


The bearded man’s mother does not know where he is. He hasn’t called in a year, has not contacted her on Facebook for months. While she declined to publicly identified, she is eager to talk about her son, to learn what she can. The last she heard, he’d left Portland, maybe for Seattle, and was scared to go back. She does not know why. She does not know that earlier in the year he’d been found by police sleeping on the sidewalk, cradling a fake gun. She fears he is suffering. She knows that in the latest photos he texted, he looks as bad as ever – gaunt, eyes hooded, face showing an inch of beard – and that she is more worried about him than she ever has been.

She can look on Facebook at photos of him before, clean-cut with chubby cheeks, his eyes shining as he cradles his newborn. Before he had warrants out in both Washington State and Oregon. How long ago was that? Five years? Fifteen? It doesn’t matter how long. Though she has to borrow money to pay her cellphone bill this month, she will find a way to make a home for her son, a current post on her Facebook page reading, “How do u as a parent sit back and watch your child struggle??… I will not leave my child out here 2 be homeless, hooked on drugs or killed because the struggle was 2 hard 4 them!”

The bearded man’s struggles are decades in the making, growing up in poverty south of Portland, losing his father at 12, a teenage brother in 2012. After a stint in rehab in 2014 did not take, the mother of his children left him. It was then, his own mother believes, that her son let go of the rope that tethered him to them, and still she tugs, every one of her communications transmitting the message, come home come home come home.

He doesn’t, he disappears again, another man in an army of bearded men marching toward self-annihilation, men acting out of desperation or madness, men who cannot remember or no longer care that there are people waiting for them to come home.

Abetting Criminality and Waste


Costantino: “People walk up and they punch women in the face … knowing nothing will happen.”


It’s been more than two months since the assault. Costantino has seen his photo and was told an arrest depended on whether police could find him and get enough evidence, which as far as she knows, has not happened.

She finds this unsurprising, a feature of the systems Portland has fought for and funded or not funded, practices that abet criminality and waste, until the shredding of the social fabric is seen as normal, or not seen at all.

“People walk up and they punch women in the face, and then they turn around and walk away, knowing nothing will happen. And the thing is, we don’t expect anything to happen anymore,” Costantino says. “When this happened to me, people did not stop. Think about that. It’s dystopic. We’re so used to seeing bodies on the ground.”

One of those bodies is almost certainly the bearded man, who may or may have not set out for Seattle, who may or may not be assaulting others or finding himself under assault. There can be no resolution for Costantino or the bearded man, there is only the continuation of the bind Portlanders find themselves in, until they realize an essential catalyst of the destruction is them.

X (formerly Twitter): @nancyromm 

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