Heart: An American Medical Odyssey (2 page)

“Where’s Mary?” I asked.

Liz told me that her sister had a cold and was afraid to expose her father to it.

“Tell her to come,” I said.

Liz understood immediately and, without asking for an explanation, turned to call Mary.

I had taken care of Dick Cheney for about fifteen years. I was young, just a few years out from training, when I assumed his care after his prior cardiologist, Allan Ross, a mentor to me, retired. In many ways, my career and life had become inextricably entwined with this patient. Although deep down I always knew one day we would arrive at this moment, the realization hit me very hard. Dick Cheney was dying.

I loved my mom’s dad, Granddad Dickey, very much. He and my grandmother lived a life that seemed full of adventure. At the start of World War II, they had left their home in Syracuse, Nebraska, when they got work on the Union Pacific Railroad. They lived in a railcar and cooked for the section gangs that repaired and maintained the tracks. For my brother, Bob, and me, visiting grandparents who lived and worked on a train was a dream come true. My granddad taught us two of the most important things a man can learn in life: how to cook and how to fish. He combined the two skills in a “recipe” he had for catching catfish. He’d take the guts he’d cleaned out of a chicken he’d fixed for dinner, put them in a glass jar, and let them “ripen” for a day or two. He swore the ripening made them especially appealing as bait for catfish. Judging from his success as a fisherman, he was on to something.

Granddad loved to laugh. He also loved good bourbon, a game of cards, and a smoke. He had nicotine stains on his fingers from the unfiltered Camels he smoked until his first heart attack in the late 1940s. His doctors tried to get him to quit smoking then, and he compromised with them: he cut down to four cigarettes a day, but he switched from Camels to the much longer, and also unfiltered, Pall Malls.

After my grandmother died in 1951, Granddad Dickey moved between the homes of his three kids every several months. One afternoon when he was staying with us, my parents were working in our yard,
and I heard him call out to me from his bedroom: “Dickey, go get your mother.” I ran to the yard. Mom came inside, and moments later she was on the phone that sat on a desk in our hallway calling the ambulance. My dad sent me outside to wave down the ambulance driver and make sure he found our house.

The paramedics rushed through our front door with their stretcher and medical equipment. Soon they were wheeling my grandfather down the hallway, toward the living room. I stood on the front porch, holding open the screen door as they carried him out to the ambulance. It was the last time I ever saw him. He had suffered a massive heart attack and died later in the afternoon. He was sixty-six. I was fourteen.

•  •  •

My mom and dad both smoked when I was growing up. My dad mostly stuck to pipes and mom smoked cigarettes. I smoked my first cigarette when I was twelve. Our Boy Scout troop met every week in the basement of the Baptist church near our home in Lincoln, Nebraska. There was an older, cooler kid named Jim Murphy who was the head scout in our troop. Jim also had a job at a local drugstore, which gave him access to the packs of cigarettes he brought to Scout meetings. On our way home from the meetings, a group of us would stop by the park near the church and smoke a cigarette or two.

By the time I got to high school, my buddies and I smoked cigars every once in a while. In the winter, we went ice fishing at Alcova Lake near Casper. While we waited for the fish to bite, we split a six-pack of beer and a five-pack of cigars.

I went on to college where I smoked some. I wasn’t a heavy smoker then, mostly because I couldn’t afford it. I was saving every penny I could to make phone calls to Lynne, who was at college in Colorado.

By 1964, Lynne was in graduate school, and I was just about to wrap up my bachelor’s degree. (I had been on a somewhat slower path than she was, but that’s another story.) That year the US surgeon general issued his first report on the dangers of smoking. I remember sitting in Lynne’s
apartment at the University of Colorado campus in Boulder and hearing a story on the radio about the report. It registered enough that I remember it all these years later, but not enough to make me quit smoking back then.

My habit really picked up once I got to Washington and was working for Don Rumsfeld, who was a counselor to President Nixon. In those days, just about everyone smoked in meetings, at meals, at home. It was pervasive. When Rumsfeld and I started working for President Ford, both Don and the president smoked pipes, and I had a supply of free cigarettes. Tobacco companies kept the White House stocked with presidential cigarettes that came in gold-trimmed white boxes stamped with the presidential seal. You could also get matches from Air Force One, Marine One (the presidential helicopter), and even Camp David. There was a certain cachet to pulling out a box of presidential cigarettes and using a match from a pack labeled “Air Force One” to light up.

Despite the growing evidence that smoking was bad for your health, we all did it. Even in a meeting in the Oval Office, it wasn’t unusual for most of the participants to be smoking. In one photo, taken by President Ford’s official photographer, David Kennerly, I am reaching across the president’s desk—while the president is sitting there—to put out my cigarette in his ashtray. We didn’t even think twice about it. Smoking seemed to keep you from gaining weight, and all the advertising made it appear cool and sophisticated.

By the time I was in my early thirties, I’d developed a heavy smoking habit, my diet was terrible, and I didn’t get nearly enough sleep or exercise. I basically ate whatever anyone put in front of me. Many nights, dinner consisted of high-calorie, high-fat hors d’oeuvres at Washington receptions. Other nights, I’d arrive home late and whip up some eggs and bacon for dinner. Sunday mornings meant a trip to the local Krispy Kreme for a dozen doughnuts. I told myself the doughnuts were a treat for the kids, but Liz and Mary didn’t eat nearly as many as I did.

I rarely got regular exercise. I was more of a weekend warrior, not
always with good results. One weekend, I was playing a game of touch football and tore the cartilage in my right knee, leading to two months in a cast and ultimately surgery to remove all the cartilage. My sporadic activity increased my risk of injury without giving me much, if any, cardiac benefit.

At that stage of my life, I believed there was a direct relationship between how well I did my job and how many hours I was at the office. I hadn’t yet learned to pace myself or recognize the difference between quantity of hours and quality of work. Nor did I feel that I was under stress. The fact that I was in a high-pressure job tackling challenging problems enhanced its attractiveness. I literally couldn’t wait to get up and go to work each morning. At thirty-four, I was White House chief of staff. I began and ended most days in the Oval Office with the president of the United States, the most powerful and influential man in the world. And not just any president but Gerald Ford, a man for whom I had and have tremendous admiration, a man who healed the nation after Watergate and the first-ever resignation of a sitting president. The war in Vietnam was coming to an end. We were negotiating major arms control agreements with the Soviet Union. We had signed the Helsinki Accords, putting human rights on the table for the first time in negotiations between the United States and the Soviets, and by late 1975 we were gearing up for a historic presidential campaign. Most of the people I knew in Washington would have killed for this job. And I absolutely loved it. I knew we were living through historic times, and I wasn’t just an observer; I was a participant.

Like most other people in their thirties, I didn’t give a lot of thought to my mortality, and I operated as though I’d live forever. Bad habits and their long-term consequences frankly didn’t concern me much.

•  •  •

Although we came very close, we didn’t win the 1976 election. One of the hardest things I’ve ever had to do in politics was read President Ford’s concession to Jimmy Carter the morning after the election. While the campaign hadn’t seemed to take much of a toll on my health,
by Election Day the president was suffering a bout of laryngitis. The next morning, just after 11:00, sun streaming through the windows of the Oval Office, his family gathered around him, he told me to have the White House operator get Governor Carter on the line. After some brief words of congratulations, President Ford turned things over to me, and I read the concession telegram that was on its way to Plains, Georgia:

Dear Jimmy:

It is apparent now that you have won out in our long, intense struggle for the presidency, and I want to congratulate you on your victory. As one who has been honored to serve the people of this great land—both in Congress and in the presidency—I believe that we must now put the divisions of the campaign behind us and unite the country once again in a common pursuit of peace and prosperity.

Certainly there will continue to be disagreements over the best means of reaching our goals, but I assure you that you will have my complete and wholehearted support as you take the oath of office this January. I also pledge to you that I and all the members of my administration will do all we can to ensure that you begin your term as smoothly and effectively as possible.

May God bless you as you undertake your new responsibilities.

Sincerely,

Jerry Ford

The call lasted three minutes.

•  •  •

Shortly after Election Day, job offers began coming my way. Lynne and I decided we would take a much-needed vacation and spend some time carefully considering what we’d do next. I decided this would also be a good time to see a doctor for a routine physical exam. I wasn’t having any problems and thought of myself as very healthy. The doctor told me
that given my smoking, cholesterol levels, bad diet, and family history on my mom’s side, I was a prime candidate for a heart attack.

I didn’t believe him.

•  •  •

Losing a presidential campaign is painful, as anyone who has ever been through it will tell you. I had huge admiration for Jerry Ford and still believe he should have won that race. But the loss convinced me that I didn’t want to be in that position again with my future dependent on someone else. I loved politics, and I loved public policy even more.
If I am going to continue to do this,
I thought,
I want it to be my name on the ballot.
I knew if I were going to run, I had to get out of Washington and go home to Wyoming. When school ended that June, Lynne and I packed up the girls and our basset hound and headed out in a U-Haul for our hometown of Casper.

On June 11, 1977, at the annual convention of the Wyoming Stock Growers Association, Wyoming’s senior senator, Cliff Hansen, announced he would be retiring the following year. “When my wife, Martha, and I go home at the end of the 1978 session,” Hansen said, “we are coming back for good.” A rancher and member of one of the first families to settle in Jackson Hole, Cliff had also served as Wyoming’s governor and was loved throughout the state. His decision to retire meant that a lot of folks would be thinking about a run for the Senate. I was one of them. Later that summer, after we’d gotten settled in back in Casper, I drove down to Cheyenne to visit one of my mentors, former Wyoming governor Stan Hathaway. Hathaway had given me my first political job as an intern in the state legislature when I was a student at the University of Wyoming. He knew Wyoming politics and issues better than just about anyone else.

I sat across from Stan in his law office and told him I was considering running for Cliff Hansen’s seat. “Well,” Hathaway said, “you could do that, but Al Simpson is going to kick your butt.” At that point, Al had served for twelve years in the Wyoming State House of Representatives. He was a natural: he loved people and they loved him. He remains
one of my closest friends to this day. And I remain glad I took Hathaway’s advice and didn’t run against Al in that first campaign. In 1977 I didn’t yet know Al well, but Stan’s warning meant a lot. I headed home to Casper resigned to the possibility that I wouldn’t be running for office after all in 1978. All that changed on September 17, 1977, at a football game in Laramie between the University of Wyoming and the University of Texas at El Paso. During half time, Congressman Teno Roncalio, a Democrat who held Wyoming’s only House seat, went up to the press box in the stands and announced he would not be seeking another term. Three months later, on December 14, 1977, I announced I would be a candidate for Congress. I was thirty-six, and there was no doubt in my mind that I was perfectly capable of running for and serving as Wyoming’s congressman. As far as I was concerned, I had no health problems whatsoever aside from a bum knee.

The idea of a statewide campaign in Wyoming was daunting, but I didn’t think of it as jeopardizing my health. Any obstacles to success in my mind were purely political, and I was confident I could overcome them.

At the beginning of the campaign, I traveled the state alone, talking to as many Wyoming citizens as I could, looking folks in the eye, asking for their support, and building an organization. Wyoming covers nearly a hundred thousand square miles and has only one congressman, making it one of the largest congressional districts in the country geographically. In a primary, I could expect there would be less than one voter per square mile. Running for office for the first time meant long hours and many miles of travel.

In November 1977 I attended my first political event—a spaghetti dinner at the high school gym in Lusk, Wyoming, hosted by the state auditor Jim Griffith—and spoke for the first time as a candidate for Congress. Lots of candidates were in attendance, and each of us was given ninety seconds to make our case. I had worked hard to prepare my remarks. I had rehearsed in front of Lynne and had my notes in large print on a stack of note cards for the event. Unfortunately, when I got to the gym, I discovered there was no podium, so no place to put
my cards. There was just a bare microphone. I had to do the best I could from memory, and I was very nervous. The master of ceremonies for the event had a huge gong—
The Gong Show
was a big hit on TV in those days—and the challenge for all candidates was to say what we had to say before our time ran out and we were gonged off stage. I slid in under the wire. The whole thing was a bit disconcerting, but it taught me a valuable lesson: never to assume I could predict the conditions under which I’d have to speak.