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Jewish World Review March 6, 2001 / 12 Adar 5761

Philip Terzian

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Take it easy, Mr. C -- I AM not a physician, and am no better informed about the private life of Richard Cheney than any newspaper reader. But there is something distinctly unsettling about this latest episode of coronary disease, which has put the vice president in the hospital for the second time in six months.

His doctor's words were reassuring. Mr. Cheney did not suffer a coronary, as he had last November; and the angioplasty, performed under mild sedation, successfully reopened a blood vessel that had been filling with scar tissue. This was, said Mr. Cheney's physician, a routine "nonemergency ... uncomplicated" procedure, requiring no more than a day or two spent in the hospital.

Asked for a long-term prognosis, Dr. Jonathan Reiner lapsed into the sort of lawyerly construction that physicians sometimes employ. "There is a very high likelihood that [Cheney] can finish out his term in his extremely vigorous capacity," he declared. Then the inevitable qualifier: "His chance of an adverse outcome is certainly higher than someone without heart disease. But unfortunately, I cannot quantify that."

This is, of course, explaining the obvious. No physician can predict an "adverse outcome" -- translate that as you will -- with absolute certainty; and somebody with heart disease has a better chance of suffering an "adverse outcome" than somebody without heart disease. You needn't be board certified to come to such conclusions.

Yet even the cheeriest pronouncements raise more questions than they answer. Mr. Cheney has a long history of heart disease, beginning with a coronary at the premature age of 37, and including bypass surgery a dozen years ago. He has suffered four heart attacks in the past quarter-century, and is evidently subject to"nonemergency ... routine" complications, with symptoms that prompt him to repair to emergency rooms.

Is this cause for concern? In an earlier era, Mr. Cheney might not have survived that initial coronary. He certainly would not have enjoyed the benefit of a bypass procedure, or any of the latter-day medications and procedures that reduce the risks of heart disease. If Mr. Cheney had been fortunate enough to survive to his present age (60), his physician would have advised him to cease working, and retire to a quiet, contemplative life, free of aggravating stress and tension.

But that was then. Today, Mr. Cheney is the number-two constitutional officer in the United States, and the vice presidency has grown more, not less, onerous in recent times. The culture of political Washington -- long hours, frantic paces, tense confrontations, hard decisions -- is an ideal breeding ground for coronary strain. It is fair to say that, all things being equal, Dick Cheney is not in the best of circumstances.

His circumstances, however, are not without precedent. In the past half-century we have had three presidents with serious heart problems, and only one proved problematical. Lyndon Johnson suffered a massive coronary at the age of 47, before he entered the White House, and died of a heart attack four years after he left it. Dwight Eisenhower suffered his first coronary at the age of 65, toward the end of his first term, and died of heart disease 14 years later. In neither instance did heart trouble seriously affect their tenure in office.

Ike's coronary led to some brief speculation that he might not run for a second term in 1956; but he did run, the country prospered, and his heart was the least of his worries. Johnson's health was a natural concern when he first took office in 1963, but for six years LBJ conducted a frenzied presidency. You could argue that the stress of forced retirement, more than the strain of the White House, led to Johnson's demise. The exception was Franklin Roosevelt FDR developed all the major symptoms of coronary disease in his early sixties, at the height of World War II. But effective weapons to fight hypertension scarcely existed in the early 1940s, and Roosevelt suffered a swift decline. He probably suffered two heart attacks between the summer of 1944 and his death from a stroke the following spring.

Dick Cheney lives in a different world. We now have a better understanding of the importance of exercise and a healthy diet, and a range of treatments exist for all coronary problems. Certainly nobody will begrudge Mr. Cheney any weight loss, or time spent on the treadmill instead of on TV. But let us also ascribe some common sense to Mr. Cheney. It is not necessary to bounce out of the hospital before necessary, or overdo the demonstrations of business-as-usual. It is more important for the vice president to preserve his health, and do what is best for his long-term survival, than to pretend things are perfect when we know they are not.

JWR contributor Philip Terzian is associate editor of The Providence Journal. Comment by clicking here.


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© 2001, The Providence Journal