Man of the World: The Further Endeavors of Bill Clinton (30 page)

He still had it.

By necessity if not choice, Bill and Hillary Clinton led largely separate daily lives ever since she began her service in the Senate. He spent little time in Washington, while she came up to Chappaqua roughly two weekends every month. They also spent vacations together and usually escaped for a week in August to Martha’s Vineyard, the island off Cape Cod long favored by literary intellectuals, artists, Democratic political figures, and an assortment of celebrities like their friends Mary Steenburgen and Ted Danson. The actors had a beautiful oceanside home with plenty of private space for the Clintons to relax. It was a pleasant habit they had established during White House days, when the presidential couple had visited the Vineyard every summer but one.

Late that August, both Clintons went up to stay with Steenburgen and Danson at their home. One afternoon, following nine holes at the
Farm Neck Golf Club, he returned complaining of a terrible pain in his back. Their hosts sent him and Hillary to their personal chiropractor on the island.

When they arrived at her office in Vineyard Haven, both Clintons noticed that the place had a slightly hippie, New Age atmosphere, with statues of the Buddha decorating the room, which he considered a bit much. But he hoped that she might do something to relieve the pain.

“I haven’t had a backache in so long,” he told the chiropractor, “but this
really
hurts.” She asked him to extend both arms, and then began to tap on his chest with her fingers, directly over his heart.

“I sense blockage,” the chiropractor said as she tapped harder on his chest. “I think there’s blockage.”

Looking directly at his wife, Clinton rolled his eyes slightly. “You know, I was just at the Mayo Clinic in Arizona, they gave me a lot of tests, and they said I was fine.”

It was quite true that Clinton had submitted to a complete physical at the Mayo Clinic’s campus in Scottsdale, Arizona, at the end of July, mostly because Hillary had insisted that he go. He had chosen Mayo because that was where Dr. Connie Mariano, the Navy officer who had served as White House physician during both of his terms, had located her post-government practice.

And it was also true that the assessment of his overall health by the Mayo specialists had been encouraging—in fact, his blood lipid tests were good enough that the doctors had told him to stop taking Zocor, the cholesterol-lowering statin drug he had used since leaving the White House, when his numbers had been frighteningly bad.

Having pushed him to seek medical attention, Hillary had felt a sense of relief when he went out to Arizona. She had grown increasingly concerned about her husband’s health during their long walks on hiking paths in the Westchester countryside near their home. His difficulty climbing hills, his frequent shortness of breath, even on terrain that wasn’t very challenging, had disturbed her.

More than once she had urged him to get himself “checked out,” but usually he had brushed her off, saying he was “just tired” from his taxing schedule of travel, meetings, and long days working on his book. Yet for months he had often felt what he would later describe as “tightness” in his chest after exercising.

Returning home from the Vineyard, he had taken a speaking trip to Iceland and Ireland, then signed books in Pittsburgh, St. Louis, and Cleveland before flying down to New Orleans on September 1 for an event at the city’s Barnes & Noble that had attracted more than three thousand people. That evening he had dined well in the Crescent City, but in Chappaqua the next morning his breathing problem worsened.

Seated comfortably at home while reading, without exerting himself at all, Clinton suddenly felt that same painful constriction around his rib cage. He mentioned the discomfort to Oscar Flores, who immediately told him to call Dr. Lisa Bardack, a Westchester physician who was among the doctors providing care for him and Hillary. After Flores prodded him once or twice, he placed the call. When he reached Bardack, she instructed him to proceed without delay to the nearest medical facility, Northern Westchester Hospital in Mount Kisco, just three miles north.

Hillary was in Syracuse that morning, waiting for him to join her at the annual state fair. He called her cell phone as he climbed into the black Suburban with two Secret Service agents to head for the hospital. Dr. Bardack met him at the emergency room, where tests swiftly established that he hadn’t suffered a heart attack. Walking on a treadmill, he passed a stress test, but still felt “something was wrong.”

Listening to Clinton and consulting with other doctors at the hospital, Bardack made an appointment for him to undergo an angiogram the next morning at Westchester Medical Center, a larger facility several miles south in the town of Valhalla.

He returned to Chappaqua wearing a heart monitor around his neck, with instructions to get some rest. By then, Doug Band and Justin Cooper had showed up at the hospital, having rushed there after hearing the news from Flores. The doctors directed the two aides to spend the night with Clinton in Chappaqua, and to remain awake to monitor his condition. Exhausted, they eventually fell asleep on couches in the living room, only to be awakened by Clinton standing over them at around 4 a.m., waiting to head to the hospital.

In the operating room, Clinton lay prone and strapped down on a special X-ray table. His chest was blanketed with electrodes; an intravenous tube snaked from one arm, and a blood-pressure cuff tethered the other. Through an incision in his groin, the surgeon threaded a cathe
ter tube upward through his arteries toward his heart, where an injection of dye would reveal any blockage instantly on the X-ray screen.

Through a glass window, Band and Cooper could easily observe the doctors standing around Clinton—and saw their faces turn pale with horror as the imaging appeared. With two of his main arteries almost totally blocked, the former president was teetering on the edge of a serious and perhaps deadly heart attack.

CHAPTER NINE

The almost complete occlusion of Bill Clinton’s arteries required immediate surgical correction to avoid a heart attack, but the discovery of that potentially fatal problem on the Friday before Labor Day weekend was inconvenient, to say the least.

The former president’s family and many of his staff were scattered. Hillary Clinton was in upstate Syracuse, almost 250 miles north of Chappaqua, waiting for her husband to join her in a senatorial visit to the annual state fair, where he liked to say he “played the token redneck.” Chelsea Clinton, then working for McKinsey & Company, was away in Paris on business. Doug Band was headed to Paris as well. Yet the people closest to Clinton could be summoned quickly in an emergency and all would return at top speed. On a holiday weekend, finding the best surgeon was a much greater challenge.

Within an hour after the angiogram revealed his dangerous condition—including two major blood vessels that were more than 90 percent blocked—Clinton, his physician Dr. Bardack, and some of her colleagues at Westchester Medical Center began to seek a top surgeon. Not long after 6 a.m., one of the Westchester physicians reached out to Wayne Isom, a renowned cardiac surgeon at Manhattan’s Cornell Medical Center, who had performed successful operations over the years on TV host Larry King, former CBS news anchor Walter Cronkite, violinist Isaac Stern, and former treasury secretary William Simon—and had become something of a celebrity himself after a highly publicized surgical rescue of late-night host David Letterman in January 2000.

Unsurprisingly, Dr. Isom was not on duty. He took the call at his summer home in East Hampton where—perhaps even less surprisingly—he was looking forward to an early tee time at the exclusive Maidstone Club. According to him, the caller said that he was needed to operate on “an important person.”

“Well, they’re
all
important,”
drawled Isom, a blunt-spoken Texan. “Who is it?”

“I can’t tell you.”

“If you can’t tell me,” he said, “then I’m going to play golf.” Before he hung up, however, the other doctor quickly asked whom he might recommend instead.

“I’d select Craig Smith,” he answered, naming the head of cardiothoracic surgery at New York Presbyterian, the hospital associated with Columbia University, which was affiliated with Cornell Medical Center.

The doctors reached Smith’s secretary, who rang him on his cell phone. He was in a car with his wife, speeding up the New York State Thruway toward their summer place in the Adirondacks, where they had planned to celebrate their thirty-fourth wedding anniversary that weekend. She answered the call and urged him to find the next exit, turn around, and head back to the city. Told that he was wanted to operate on Clinton, the bluff fifty-five-year-old surgeon mused, “This will be interesting.”

On Smith’s instructions, Band—with the assistance of four Secret Service agents—moved Clinton in an ambulance to New York Presbyterian, an imposing complex of buildings in northern Manhattan, about half a mile from the George Washington Bridge. In the meantime Band had alerted Herbert Pardes, the distinguished physician who served as the hospital’s president and CEO, to Clinton’s impending arrival. Cooper had gone ahead to prepare the way with Pardes so that Clinton’s arrival would occur as discreetly as possible. When they showed up, hospital staff escorted them to an entire floor of VIP rooms, with stunning views of the Hudson River—and highly restricted access. Word of the former president’s illness had somehow leaked to the press already, and reporters were beginning to swarm around the hospital. To contain them and hundreds of curious hospital employees who might be tempted to peek, special passes were issued to those permitted access to Clinton’s floor.

Directly overseeing his care were Dr. Allan Schwartz, the hospital’s forthright, laconic chief of cardiology, who also chaired that department at Columbia’s medical school, and Robert Kelly, a physician and administrator who served as the hospital’s chief operating officer.

Even with several top-ranked doctors and a world-class hospital on
highest alert, Clinton could do little but sit and wait for another two days. The Westchester doctors, understandably frightened by the angiogram images, had pumped blood thinners into his system to prevent the seemingly imminent medical catastrophe. But the Presbyterian team had to wait for those drugs to wear off before opening up his chest for a quadruple bypass operation.

By all accounts, Clinton remained calm, even as tension built around him in the hours before his surgery. When Smith came by to see him, the surgeon found his patient “engaging” and “easy to talk to.” Having escaped the worst, Clinton said later, he felt a certain sense of relief, understanding that his chances of survival had in fact improved enormously over the previous forty-eight hours. Coronary artery bypass grafting—colloquially known as a “cabbage” from its acronym—is a procedure so ordinary and so reliable that doctors as skilled as Smith could do two or even three a day, with a fatality rate below one percent.

The odds of death from an unexpected heart attack were far higher, particularly if it occurred while Clinton happened to be on an airplane. And not long after Labor Day, he had been scheduled for a three-week trip to promote his book overseas—beginning with a long, transcontinental flight to Asia.

While he waited, Clinton played cards with Band and Cooper, read books, watched television, chatted with the surgeons, and spent time talking with Hillary and Chelsea, who arrived late in the evening. Both Band and Cooper had their own rooms on the hospital floor to stay near their boss. When Hillary walked in and saw that the two young aides had ordered burgers and fries from a nearby Wendy’s for dinner, she practically exploded.

“What are you
eating
?” cried the senator. Then she turned to the young doctors standing around. “Please get check-ups for these boys, as soon as possible!” They did.

Not too long after she arrived at the hospital, a tense but smiling Hillary went outside to deliver a brief statement to the press corps on the hospital steps.

“I want to report to you that my husband is doing very well. He’s in great humor. He’s beating us all at cards and the rest of the games we’re playing.”

Praising the “excellent care” provided by the hospital’s doctors,
nurses, and staff, she said, “We’re delighted that we have good health insurance. That makes a big difference. And I hope someday everybody will be able to say the same thing.” The Clinton Foundation posted a similar but longer statement online, in response to tens of thousands of email messages received from around the world.

During those two long days, which felt like weeks, an outpouring of goodwill messages swamped not only the foundation’s website but Clinton’s personal staff and Hillary’s Senate office. Hundreds of telephone calls poured in from friends and strangers expressing concern—including Vice President Dick Cheney, who had undergone quadruple bypass surgery in 1988—as well as a stream of carefully vetted visitors, notably U2’s Bono and Al Gore.

Renowned cardiologist and author Dean Ornish, a Clinton friend who had admonished him for years to adopt a low-fat vegan diet, tried to call several times, and finally got through. Hours before his surgery, Ornish tried to persuade Clinton to heal himself with dietary changes and exercise instead. At some point, a hospital employee who went into the computer system foolishly trying to look up “Clinton” was traced and swiftly fired. He was registered under an assumed name.

Outside the hospital, a sizable press contingent camped out, waiting for occasional word from the doctors and family. An enterprising photographer with a powerful telephoto lens set up on the elevated West Side Highway, and captured Clinton in his hospital room. After the
New York Post
published the grainy image on its front page, he quipped, “At least I wasn’t wearing one of those open-backed hospital gowns.”

Indeed, Clinton was deeply touched by the level of public interest in his condition—and the outpouring of sympathy symbolized by the thousands of messages and prayers posted to the foundation’s website and the truckloads of flowers sent to his Harlem office. Contrary to the expectations of his critics, dismal memories of the final hours of his presidency seemed to be fading, in an atmosphere of renewed affection.