Dick Cheney’s Tell Tale Heart

It’s no secret that Dick Cheney has battled heart disease for most of his life. But in his new book, Heart: An American Medical Odyssey, the former Vice-President gives an honest account of just how tenuous his heart condition has been, and how he benefited from each new advance in the treatment of heart disease.

Written with his cardiologist, Dr. Jonathan Reiner, the pair chronicle the thirty-five year course of Cheney’s heart disease. Cheney provides the personal and historical context, while Dr. Reiner discusses the research that produced the medical breakthroughs that allowed Cheney to remain alive as long as he has.

Cheney underwent the first of five heart attacks in 1978, at the age of 37. It was his first political campaign, and he was running for Wyoming’s only seat in the House of Representative. After subsequent heart attacks in 1984 and 1988, he underwent a four-vessel coronary artery bypass grafting.

When George Bush asked Cheney to be his running mate in 2000, there was enough of a question about his health that the Bush campaign consulted world renowned Texas heart surgeon Denton Cooley. After discussing Cheney’s health with Dr. Reiner, Dr. Cooley wrote a statement that Cheney’s “heart function was normal”.

In an interview with VP Cheney on CBS’s 60 Minutes (October 20, 2013), Dr. Sanjay Gupta took Cheney to task on this:

Sanjay Gupta: The normal cardiac function wasn’t true.

Dick Cheney: I’m not responsible for that. I didn’t know what took place between the doctors.

Sanjay Gupta: This idea that you have this respected heart surgeon from Texas who didn’t see you, didn’t examine you, and then writes something saying that you have normal cardiac function. That just wasn’t true, Mr. Vice President.

Dick Cheney: Listen to me, I think the bottom line is: was I up to the task of being vice president? And there’s no question. I think based upon the fact that I did it for eight years that they were right.

Cheney underwent coronary artery stenting in November 2000 (during the presidential election recount), had a fourth heart attack requiring an urgent coronary balloon angioplasty in March 2001, and had an implantable cardioverter-defibrillator placed in June, 2001.

Sixty-seven days after being sworn in as Vice President, Cheney did something unprecedented- he handed George W. Bush a letter stating his resignation. Cheney said he did this when he learned there was no other mechanism to replace a living VP who was incapacitated. Bush never acted on the letter, and Cheney joked that an action is still “pending.”

In 2007, Cheney needed to have his cardioverter-defibrillator replaced. When a new one was inserted, Dr. Reiner made one special request- that the Wi-Fi feature that allowed the defibrillator to be reprogrammed remotely be disabled. Concerned about terrorists or hackers, Reiner thought:

… it didn’t make a lot of sense for the vice president of the United States … to have a device that someone in the next hotel room, someone downstairs, someone on the rope line, might get into and kill him.

Little did Reiner know that the producers of the Showtime’s drama Homeland were thinking the same thing, when they killed their fictional Vice President by remotely disabling his defibrillator. Reiner apparently got a phone call from Lynne Cheney saying:

Did you see Homeland last night? The terrorists just killed the vice president by reprogramming his defibrillator!

Cheney’s heart functioned continued to deteriorate until July 2010 when he received another new innovation: a ventricular assist device to help his heart pump better. This was a stop-gap measure taken to keep him alive while waiting for a match on the heart transplant list. Pictures taken of Cheney at this time showed a gaunt, fragile appearing man.

Cheney did receive a heart transplant in March 2012. Since that time, he has is back to his normal weight and is feeling great and reports that he is taking good care of his new heart:

You wake up every morning with a smile on your face because you’ve got a new day you never expected to have. And there’s a sense of wonderment. Nothing short of magical.

Despite concerns about Cheney getting preferential treatment in obtaining a heart transplant, just as with Steve Jobs, there is no way to jump to the head of the line if you are rich or famous. The only way to get an organ is to be the sickest patient with whom the organ is a match.