Man of the World: The Further Endeavors of Bill Clinton (31 page)

While Clinton had confessed to being “a little scared” of the impending operation, he felt a sense of relief when he was finally prepped for surgery shortly before 8 a.m. on Monday, September 6. He later told ABC
correspondent Diane Sawyer that as the anesthesia put him to sleep, he had “an amazing experience,” with dark visions of “death masks being crushed,” and then images of Hillary, Chelsea, and others appearing in circles of light before flying away.

As he was wheeled into the operating theater, Band and Cooper followed, with two Secret Service agents. The hospital staff taped paper over the windows of the room to block any attempt to photograph the surgery. As the operation proceeded, Hillary waited outside. Band went in and out of the operating room to brief her at each stage.

Once Dr. Smith had sawed Clinton’s chest open, he removed arteries from either side of the breastbone to create three grafts or shunts around the blocked blood vessels leading to his heart; he made a fourth from an artery taken from the left thigh. At first, everything proceeded smoothly and without incident.

But suddenly, after a couple of hours, the mood in the operating room changed.

The original plan had been to operate on Clinton without actually stopping his heart and putting him on a heart-lung machine—to perform what is called “beating heart” or “off pump” surgery, in which a device is used to limit the motion of a portion of the heart while the surgeon sews on a grafted artery. When surgeons elect to use this method, their aim is to limit the likelihood of future strokes, memory loss, and other potential problems that are believed to arise from completely stopping and then restarting the heart.

Midway through, Dr. Smith shifted Clinton to the heart-lung machine already set up for emergency use in the operating room. This change required very rapid and efficient movement by the surgeon—and all the other hospital personnel in the room—to ensure that the blood supply to Clinton’s brain and other organs wasn’t interrupted too long.

At a post-operative press conference, Dr. Smith would acknowledge that there had been “a few anxious moments” during the procedure. While he didn’t explain further, he probably meant the unexpected shift to the heart-lung machine. For well over an hour, Clinton’s heart was stopped completely while a machine took over the work of pumping oxygenated blood through his body.

Just before 1:30 p.m., Dr. Smith finished stitching up Clinton’s
chest. Still unconscious, strapped to a gurney, and breathing through a tube, the former president was wheeled into an intensive-care recovery room. Within minutes, Jim Kennedy began to call and email reporters with the news: The operation had been successful. The former president was expected to recover fully. The doctors would appear on the hospital steps to speak with the press around 4 p.m.

Tall, thin, dry, and deliberate in manner, Dr. Allan Schwartz loomed over the bouquet of microphones as he recounted again the timeline of Clinton’s illness. The cardiologist confirmed that the surgery had been successful, that the patient was “in good spirits,” and that had the former president not gotten effective medical attention when he did, he would have been in very deep trouble.

With characteristic understatement, Schwartz explained, “There was a substantial likelihood that he would have had a substantial heart attack.” He went on to explain that once Clinton left the hospital, the former president would commence a daily regimen that included low-dose aspirin, a statin drug to lower cholesterol, a beta-blocker to prevent irregular heartbeats, and another medication to maintain lower blood pressure. Just as important would be strict adherence to a diet low in saturated fats and sodium—and, when he was sufficiently recovered, a course of rehabilitative exercise. Dr. Smith reported that aside from those few fretful moments, the surgery had been completed without incident.

By late Monday evening, nurses removed the breathing tube that had left Clinton uncomfortable and unable to speak for several hours. He began to take some liquid nourishment the next morning. Over the following three days, he underwent the same painful ritual endured by countless other bypass patients: sitting up in bed, putting his legs over the side, standing up, walking around his room, and then circling the hospital ward, slowly and exhaustingly. But his progress was steady. On Friday, September 10, he returned to Chappaqua.

When Clinton awoke from his surgery, he felt happy and elated to be alive, he later recalled—and that feeling lasted. While most heart patients awake with similar joy, many soon confront a sense of mortality, often for the first time, and suffer from sadness or even depression fol
lowing surgery. One of Hillary’s Senate colleagues had warned her that after his bypass, he had sat and wept for four days straight.

Clinton suffered no such bouts of melancholy. Having learned of his father’s death at an early age, and then seeing several friends die young, he had contemplated death for many years—not obsessively, but as a simple and inevitable fact of existence. “I’ve never been under any illusion that I would live forever. I knew that sooner or later, my time would be up.”

Physically, he was very sore, especially across his chest, where the rib cage had been cut down the middle, pulled apart, and then stapled back together. He had to work every day at restoring his own mobility, taking long walks through local parks with Band and Cooper (and a couple of Secret Service agents), and that required no small effort. Emotionally, he felt “grateful for every day of life I had.” He was “more conscious of people,” wanting to see and talk with friends even more than before.

Awakening to every new day at home, with no pressing responsibilities, Clinton also felt a refreshing sense of relaxation.

For the first time in decades, he was left to do more or less whatever he wanted—to read, watch movies or television, talk with friends on the phone, take a walk or a nap. Aside from brief vacations, which had almost always involved some kind of work, his life had included very little downtime since he first ran for an Arkansas congressional seat in 1974.

“By 2004, I had been working like crazy for more than thirty years. I’d had vacations, but I’d had thirty years of sleep deprivation, thirty years of exhausting work. I enjoyed the time off. I enjoyed the recovery process. I enjoyed learning how to walk and how to climb a hill again.” Although recuperating his strength made him want to accomplish more, he was also learning to enjoy more—to shrug off feelings of guilt if he chose to take time off rather than work constantly.

Not all the changes in his personality were positive, as he conceded readily. He was more impatient, no longer quite so able to hide his “intolerance for dreck,” a skill he had developed as a politician. He was more irritable when he grew tired, which happened more, and less able “to control my emotional and psychological responses to fatigue than I was before it happened.” And he wasn’t thrilled to notice these aspects of his recovery. “I didn’t like becoming more of a whiner.” He tried to
notice when he was getting tired, so he could rest before he started to become irritable.

And for all his talk of learning to unwind, the enforced relaxation and isolation ultimately left him bored and frustrated. Sitting on the couch, watching movies and reading, even taking longer and longer walks every day, inevitably left him restless. “Those weeks felt like forever,” he said years later. “It felt like we weren’t doing anything, for the longest time.”

At first the doctors had thought Clinton was joking when he told them that he planned to go out on the road for the Democratic ticket of John Kerry and John Edwards. When they realized he wasn’t kidding, their reaction was roughly the same as if he’d announced a new interest in skydiving. The rigors of campaign travel were not advised for a heart patient who had not even begun, let alone completed, the slow march toward rehabilitation.

A month after surgery, he was still “pretty frail,” by his own estimation, suffering pain from the chest incision and feeling quite exhausted after walking a mile. But he assured the doctors and his equally skeptical staff that he would be going, sooner or later. He appreciated Kerry—“I thought he was underrated”—and felt profoundly angered by the Republican attacks on the Democratic war hero.

But there was another consideration, as he acknowledged later. “I didn’t want there to be any doubt that I was using this as an excuse not to weigh in”—so that Kerry would lose and leave the Democratic nomination open for Hillary in 2008. Besides, he had made a personal promise to the candidate that he would campaign, when Kerry called him in the hospital over the Labor Day weekend before his surgery.

The question was not whether to appear with Kerry, but where and when. Communication with the Kerry campaign was eased by the presence of several former Clinton White House staffers there, including former press secretaries Mike McCurry and Joe Lockhart, who maintained a close relationship with his old boss. If Clinton couldn’t travel yet, he could still send out fundraising letters and record “robocalls,” the taped messages, tailored to particular states and constituencies, that reached voters on their home telephones.

But the robocalls weren’t enough for a Democratic campaign still struggling by mid-October to overtake Bush even in reliably blue states like Pennsylvania. At his own campaign appearances, Kerry started quoting his phone conversations with the former president (“Bill Clinton and I were talking, and he said . . .”); then on October 19, he told reporters in Wilkes-Barre, “I think it’s possible in the next days former President Clinton may be here, working.” McCurry quickly added that Kerry was only “expressing a hope.”

Mediating the negotiation between Clinton and his doctors, Doug Band broached an idea that proved helpful. His older brother Roger, an emergency-care doctor at the Hospital of the University of Pennsylvania in Philadelphia, could travel with the Clinton entourage to keep an eye on the former president and administer immediate care, if necessary. He would be an unobtrusive and trusted presence—looking almost enough like Doug to be mistaken for him—with the skill to handle any medical incident. With the doctors’ assent, Roger Band, MD, became the former president’s traveling physician. Intended as a stopgap measure for a few 2004 campaign stops, “Doc” Band would join Clinton on many trips for more than a decade, charging no fees and flying around the world with him several times over.

“If this isn’t a good idea for my heart, I don’t know what is,” Clinton told a wildly cheering rally as colorful confetti fell around him in downtown Philadelphia on October 25, with only a week left until Election Day. Standing beside him onstage at Love Park, overlooking a huge lunchtime crowd estimated at 100,000 or more, was a beaming Kerry—who embraced him not once but twice, and held up their clasped hands repeatedly. “Isn’t it great to have Bill Clinton back on the trail?” he exulted. He was determined not to repeat the errors of Al Gore, who had coldly distanced himself from the president he served.

Looking pinched and pale, Clinton spoke for less than ten minutes—possibly a personal record for brevity on the stump. But his appearance made national headlines and thrilled the Kerry campaign. Later that same day, he flew down to Florida, another battleground state where he remained highly popular. He appeared for Kerry in New Mexico a few days later and then, on the final Sunday before Election Day, went home to Arkansas to mobilize black voters behind the Democrat.

On November 2, Bush defeated Kerry by only three million votes,
with a margin of 35 votes in the Electoral College. It was a narrow victory that only looked impressive in contrast with the deadlocked contest against Al Gore. Of the states where Clinton campaigned, only Pennsylvania went for Kerry. But nobody would ever be able to deny he had risen from his sickbed to try.

“It was wet.”

That is how Clinton would always remember November 18, a day he had awaited for nearly six years, when he returned to Little Rock just two weeks after the election for the official opening of his $200 million library, the William J. Clinton Presidential Center and Park. Thousands of friends and supporters were expected to attend the grand event, including three other presidents—George W. Bush, his father, George Herbert Walker Bush, and Jimmy Carter, all of whom were to deliver speeches to mark the occasion. And with President Bush coming, the entire White House press corps and national media would cover the event, starting with live broadcasts from Little Rock days before the actual ceremony.

All over town, officials and residents prepared for a week of worldwide attention. Republican governor Mike Huckabee ordered a swift renovation of the state capitol grounds. The municipal airport commission, chaired by a Clinton friend, already had spent as much as a million dollars refurbishing its facilities, with fresh landscaping and even a new fountain to impress the influx of distinguished visitors from both coasts and beyond.

The city was excited, but the weather forecasts leading up to November 18 did not look promising; in fact, the ominous predictions had inspired Stephanie Streett, the center’s executive director, to procure tens of thousands of umbrellas and plastic ponchos in advance. On the day before, only a slight drizzle had fallen on the city. Doug Band had kept checking the forecast with the crew of Air Force One, old friends whose access to the latest meteorological data was unrivaled in government.

At about 2 a.m. the night before, following a lavish pre-opening party at the library, Band had checked with them again to determine whether he should order a special tent for the dais where Clinton and
his presidential guests were to sit during the ceremony. According to the Air Force One forecast, rainfall was expected to stop in Little Rock before dawn. He didn’t order a tent for the dais. Even if the rain continued, he thought, providing shelter for the presidents and their spouses would look wrong while everyone else in the audience endured the weather. It was a choice he would question hours later.

With almost biblical intensity, the pitiless rainstorm drenched everyone, from presidents to ordinary citizens, as Marine guards struggled to hold umbrellas over the distinguished guests on the dais. For the most significant day since he had left the White House—indeed, one of the most important days in his life—to be drowned in that deluge was a devastating disappointment to Clinton.