Des Moines

THE LARGEST PRIVATE HOSPITAL in Iowa is the Iowa Methodist Medical Center, a cluster of buildings occupying a 42-acre campus near downtown Des Moines. It is over 100 years old. It was founded in 1901 in a small office here, and over time it has grown to half a dozen buildings, four parking garages, a cancer center, and a trauma center. The School of Nursing is next door. All told, hospital officials say, the medical center employs about 4,000 Iowans.

One of the buildings is the Conference and Learning Center. It occupies the southwest corner of the campus, is several stories tall, and, like most of the other buildings, is built of red brick. Inside are a library, several classrooms, an auditorium, and a large conference room. The conference room is underground. One day last week, it was packed with a few hundred locals, as well as a few dozen members of the press. For over an hour, the Iowans and journalists sat in folding chairs 9 or 10 rows deep, listening to Democratic presidential nominee John Kerry talk about the election, health care, and, he said, "exactly where I stand on everything."

For the most part, the Iowans had not traveled far. Most were from Des Moines, and the hospital is only half a mile from the city center. To get there from the east, you follow Grand Avenue until you reach 10th Street, take a right, and then, two blocks later, take a left on Woodland Avenue. It is a brisk walk, and on a late summer morning there is little traffic, the sidewalks are empty, and the cloudless sky stretches for miles.

For Kerry, however, the road to the Iowa Methodist Medical Center was long and harsh. Just look at the numbers. Last week was filled with polls that showed Kerry behind President Bush. On September 9, the morning Kerry visited Des Moines, Bush was ahead in the USA Today/CNN poll, ahead in the CBS News poll, and ahead in the ABC News/Washington Post poll. Early last week, shortly after the Republican National Convention, Newsweek and Time both released polls of their own, and both showed major post-convention bounces for the president. Polls change, of course, and yet, as the presidential race headed into its final stages, a trend had been established. The pollster John Zogby best captured the mood. "Mr. Kerry," he wrote, "is on the ropes."

For Kerry, August was littered with missteps, and mangled words, and strategic shuffles. Looking back even further, there was Kerry's nominating convention, held at the end of July. At the time, the convention was thought a success. However, in retrospect, things look different. The convention focused so intensely on the senator's Vietnam record that it left the candidate vulnerable when the independent Swift Boat Veterans for Truth stepped forward to criticize Kerry's war record and antiwar activities in television ads. And things got worse. On August 9, a few days after the Swift vet ads began to air, Kerry stumbled when he told reporters, "Yes," he "would have voted for the authority" that allowed President Bush to invade Iraq, even knowing what he knows now about Saddam Hussein's apparent lack of weapons of mass destruction. "I believe it's the right authority for a president to have," Kerry said. In the course of a few brief sentences, as he stood in front of the vast, empty Grand Canyon, Kerry had undermined the foreign policy rationale of his campaign.

By the end of August, things were not any better. On September 2, the night Bush gave his acceptance speech in New York, Kerry flew from his vacation home in Nantucket to Springfield, Ohio, for a midnight rally. It was a last-minute addition to his schedule, and it was a disaster. "The vice president even called me unfit for office last night," Kerry said. (Cheney had said no such thing.) "Well, I'm going to leave it up to the voters to decide whether five deferments makes someone more qualified than two tours of duty." Every now and then, Kerry was interrupted by his own supporters, who screamed, "Take the gloves off!" And every now and then, Kerry smiled wanly. "I will not have my commitment to defend this country questioned by those who refused to serve when they could have, and who misled America in Iraq," he said. It was a rambling talk.Attacked and attacked at the Republican National Convention for his voting record in the Senate, Kerry's only response was to point out that he served in Vietnam.