Former Vice President Cheney, cardiologist describe health crisis journey at Book Rap

Former Vice President Richard Cheney and Dr. Jonathan Reiner presented their book on Cheney’s health, Heart: An American Medical Odyssey, to a packed audience at the National Press Club on Dec 3.

Reiner described how “seemingly, every time (Cheney) had a medical event that … might stop his career or stop his life, medicine had an answer for it.” In each case, there was a medical answer and “the vice president used that medical event to not just survive the event but to thrive,” he emphasized.

“The vice president didn't just survive these events, every time he had an event, he took a job of increasing responsibility,” Reiner said.

Cheney had his first of five heart attacks when he was 37 and running for Congress in 1978.

"He had another heart attack and bypass surgery in the late '80s and became Secretary of Defense,” Reiner said.

"When we were writing the book we wanted … more of a book that would offer people with heart disease … hope … to understand what we can do," Reiner said.

When Cheney was approached about being vice president the first time, Cheney remembers he said “no way,” he “had a great job, 25 years in public life” and he enjoyed business.

“I didn’t want to be vice president, so I said no,” Cheney said. “I figured out eventually that [George W. Bush] he’d never accept the first ‘no’ … I’m glad he asked and was proud to serve.”

Barbara Cochran, chairman of the NPC's National Journalism Institute who interviewed the two men at the event, asked how he addressed his concerns related to his health. The doctors, after a stress test, agreed “there was no reason why I could not serve,” Cheney said.

Cochran described how after the election, Cheney had a third heart attack. She asked him to relate what he did. He responded that he wanted to make sure he knew every possibility of what would happen if he had a medical event while serving as vice president. His attorney told him that the 25th amendment to the Constitution has a provision with respect to an incapacitated president, “but there is no provision if something happens to the vice president” Cheney said.

Cheney's concern was if while in office he would be unable to function, “it creates problems.” It would make it “almost impossible to execute the 25th amendment” if he could not convene the cabinet in the event something happened to the president. He described how he wrote a letter of resignation - ahead of time - and gave it to his attorney so that if anything should happen and he was incapacitated, the president could decide whether to send it to the Secretary of State. Cheney's attorney, anticipating problems with access to the White House if anything should happen to the then vice president, decided to keep the letter in his house - which subsequently caught fire. The lawyer saved his family and went back into the dwelling to rescue the letter. It never had to be executed.

Cochran, Curtis B. Hurley Chair in Public Affairs Journalism, the University of Missouri School of Journalism, asked Reiner to describe how he remained the vice president’s cardiologist after he took office, unusual given the existing White House medical staff. “There is a lot of value in continuity of care,” Reiner replied. “There is tremendous value in having a physician follow you.”

“In the vice president’s 35 years of heart disease, he’s had only two cardiologists take care of him,” Reiner said.

Cheney stressed that among his concerns is “the importance of continuity in doctors.” He said that the continuity of his two cardiologists over time was “absolutely…crucial. I wouldn't have been here without it.”

Referring to the Affordable Care Act, also known as Obamacare, Cheney said: “I worry when I hear all this talk of whether you can keep the same doctor over time.”

“I worry very much about the device tax” said Cheney. “This is a new tax that’s going to be imposed on medical devices. I think it’s one of the dumbest ideas I've heard.... I’m walking around proof of how innovative our system has been....It’s just an example of how ill-conceived parts of this program are.”

Discussing Cheney’s implanted defibrillator, he and Reiner graphically told how the device saved his life in 2009, within 16 seconds after a heart attack in his pick-up truck. The capacity to wirelessly communicate with these devices was considered a potential threat and had been addressed with a new defibrillator.

“It highlights the unusual environment that this patient lived in,” Reiner said. "He was a complicated patient living and working in essentially the most complicated environment … of most of our lives.”

A torrent of events, including a back injury leading to surgery and another heart failure led Reiner to believe in the summer of 2010 that Cheney “essentially was dying of congestive heart failure.”

Asked what he was thinking at the time, Cheney responded: On July 4th, 2010, “I remember going to the hospital … I believed I reached the end of my days. I’d had a fantastic life, great family and done everything I could conceivably think of doing. I assumed for many years that eventually I’d die of heart failure.” He had heart problems on both sides of his parents’ families. “I was at peace. As I contemplated the end of my days, it was not nearly as difficult for me as it was for my family.”

”Now, we can support the function of the heart with a really wonderful … technology … that can take over for a dead left ventricle, it’s called a left ventricular assist device," Reiner said. "That’s what we offered the vice president.”

Reiner and colleagues thought many of Cheney’s health problems had a single cause, his heart. They believed that if they could make the heart better, all those issues including bleeding and the arrhythmia, "would go away.”

On March 23, 2012, after Cheney’s waiting twice as long as the average heart recipient for a heart donor, Reiner received the call notifying him with the news that they had “a heart and it is perfect.”

Cochran prompted the authors to tell the audience about the results of the surgery. Cheney said that after he woke up from the heart transplant surgery, his "immediate reaction was one of joy."

"At the same time, as you go through this, you are very much aware - I always emphasize this - I wouldn't be here without the donor … the donor’s family has just been through a terrible tragedy, lost someone … an almost sort of mismatch emotionally,” Cheney said.

Cheney now hauls his granddaughter’s horse to her rodeo barrel races with his pick-up truck. He’s back to hunting pheasant and goose. He says he “fished probably one day a week … all summer long.” He works out on an exercycle every day.

The former vice president described how Reiner told him the heart transplant "will have been a success when you are more worried about your knee than you are about your artery.” He then pronounced, "we’re there."

The former vice president also commented for the first time in public on the recent disclosure of a dispute between his daughter Mary, who is gay and married, and his daughter Liz, who is running for Senate from Wyoming and opposes same-sex marriage.

"We were surprised when there was an attack launched against Liz on Facebook and wished it hadn't happened," Cheney said. "It's always been dealt with within the context of the family and frankly that's our preference."

The authors and Cochran were introduced by Joe Motheral, chair of the NPC's Book and Author Committee, which sponsored the Book Rap.