The Magazine

Bill Frist's New South

The revenge of the patricians.

Jan 27, 2003, Vol. 8, No. 19 • By DAVID BROOKS
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Nashville

PEOPLE IN TENNESSEE couldn't even agree which side to fight on in the Civil War, but today they are united around one proposition: Bill Frist is a wonderful guy. You meet diehard Democrats who think Bill Frist is a wonderful guy, alongside Confederate loyalists. Tobacco-spitting rednecks think Bill Frist is wonderful. So do liberal college professors, suburban rabbis, African-American preachers, society dames, and minivan moms. They really should put it on the license plate: "Tennessee--Home of Bill Frist, Who Is a Wonderful Guy."

They tell you stories. Aware that Bill Frist spent some summers on Nantucket, a school principal wrote him a letter asking what he should see on his upcoming visit. Senator Frist wrote back a 40-page letter describing the history and ecology of the island, and the sights that should not be missed. A weary mom was trying to lug some papers on an airplane. Frist noticed her plight and not only carried them on for her, he waited while the plane was unloading so he could carry them off for her as well. On one memorable day during a tour of Israel, Senator Frist stood on the spot where Jesus delivered the Sermon on the Mount and read the sermon to the tour group. He electrified them with his simple faith and devotion.

And this is not even to begin to recount the tales told by the heart patients whose lives Bill Frist has saved. An old acquaintance went on a local radio station and ventured some criticism of Dr. Frist. The next day he was snowed under with hostile mail from former Frist patients.

"Bill Frist is the finest political talent the Republican party has produced," says one veteran Democratic pol. "Bill Frist is the most capable man I have ever met," says a middle aged businessman. "There is still a mystique surrounding Bill Frist at Vanderbilt," says the university's chancellor, Gordon Gee. In a moderately long career of writing about politicians, I've never come across one whose character was so universally admired. I can't tell for sure whether this reflects Frist himself or the graciousness of Nashvillians, who say nice things about people with the same fervor that New Yorkers and journalists say the reverse.

Fortunately, I didn't come to Nashville to dig up dirt on the new majority leader. I came to investigate a cluster of questions. A few years ago, the Republican party was dominated by middle-class suburban and rural southerners like Newt Gingrich, Dick Armey, and Trent Lott. Now the Republican party is dominated by southerners of a different sort--a scion of the Bush family who went to Andover, Yale, and Harvard, and a scion of the Frist family who went to Montgomery Bell Academy, Princeton, and Harvard.

The former group fought the tough political battles of the 1970s and 80s, which Bush and Frist missed or avoided. After a few years in the hands of anti-government, middle-class strivers, is the GOP now in the hands of a modernized patrician class? How is Bill Frist's South different from Trent Lott's South? What are the cultural roots of the compassionate conservatism that Bush and Frist, among others, embody? What part of America produced the rising star Bill Frist?

AT FIRST GLANCE, the answer to that last question is easy: the rich part. Bill Frist was raised in Belle Meade, the old-money suburb of Nashville and the fifth richest town in the United States. You drive down the roads and boulevards looking at the homes, which were built in the early part of the 20th century, and it looks like the Executive Mansion Hall of Fame. There are several houses that look like the White House (Al Gore lives in one). There are several that look like the sort of palazzo a Venetian prince might settle in to escape a foreign invasion. And there are a few châteaus a French president might choose to inhabit on days when he was feeling particularly grand.

Although there are a few homes in the southern plantation style (including some modern-looking Tara ramblers), the dominant mode is more like Buckingham Palace, though less showy and arriviste.

But the houses are mere specks compared with the front yards, which stretch on forever. I began to measure the yards by what kind of golf club you would need to use from the street to send a ball through a front parlor window. Some of the homes have mere 3 iron yards, but many have 2 wood yards, and several have Tiger Woods-with-a-driver-and-the-wind-at-his-back yards.

Yards like these require boulevard-sized driveways. It's not even fair to call them driveways. They have so many graceful curves, guest parking areas, and scenic view pullouts near the topiary highlights it's more accurate to call them Multi-Time-Zone Lexus Glideways. You expect to see signs halfway up--"Last Gas Station Before House"--and of course few of these autoroutes are made from a surface as mundane as blacktop. Instead the residents of Belle Meade seem to prefer cobblestones or a mahogany-colored gravel that looks like it's been individually chiseled and distressed by ancient Burmese craftsmen. If Corian made driveways, the Belle Meaders would lap them up and it would look as if they had turnpike-width kitchen counters stretching up through their front gates.

Not all that long ago, the old-money residents of Belle Meade dominated Nashville. Their institutions--the Belle Meade Country Club, the annual Swan Ball, the Vanderbilt University Board of Trust--were the city's power centers. From the 1960s through the early 1980s, a secret society called Watauga made many of the important decisions about city life. As it's since been described by Nashville journalist Bruce Dobie, Watauga comprised the CEOs of the town's banks and businesses, and a few selected others such as Jack Massey who built Kentucky Fried Chicken and then, with Bill's older brother Tommy, built the Hospital Corporation of America. They recruited mayoral candidates, gave them money, and organized the business community's efforts to recruit companies to the city and shape growth.

In most northern cities, the WASP aristocracy, if it exists, is basically irrelevant. New York and Philadelphia are no longer dominated by Episcopalian blue bloods with honking accents. But in Nashville the old Belle Meade elite is diminished but still cohesive and important. It is diminished because the old financial institutions have been bought up by national firms. Now health care is the booming sector in Nashville's economy, along with private prisons and music. No group like Watauga exists, nor could it.

But Bill Frist's neighborhood is not all that different from when he grew up there. The Belle Meade Country Club still has so many elitist connotations that politicians are wise to resign their memberships before running for office. The Swan Ball is still the highlight of the social season; even meetings to plan the event are listed in the local paper. Both of Tennessee's senators attend the neighborhood Presbyterian church. There's a local society magazine, NFocus, which every month carries party photos of members of the same families--Ingrams, Armisteads, and so on--at white tie galas and deb balls.

There is also still the community service ethos. What litigators are to billable hours, Belle Meade women are to charity. Every night, it seems, there is a profusion of charity balls, events, and fundraisers. There are events for AIDS sufferers, the homeless, ill children, and arts organizations beyond counting, which send great billowing gusts of noblesse oblige blowing through ballrooms, country clubs, and hotel conference rooms, leaving behind six-figure drifts.

Many mothers need to hire full-time nannies so as to free their hours for planning these events. Local school children collect pennies to give to the poor. As soon as Bill Frist's brother Tommy made the family fortune with HCA, he built a wildly successful arts center downtown. Nor does the neighborhood neglect political giving. Over the past two elections, more money has been donated to campaigns in Belle Meade and its adjoining zip code than in any other area of the country.

Most impressively, young Belle Meaders are still raised to be ladies and gentlemen--in this part of the country, the word gentleman still has a distinct meaning and is used unironically. The Frist family is not old money. Senator Frist's father, Thomas Frist Sr., came to Nashville as a good old-fashioned country doctor. He soon became doctor to the governors and the Belle Meade elite, while remaining a traveling doctor for the rural poor. In 1997, when he was 89 and approaching death, he wrote a letter to his great-grandchildren summarizing his philosophy of life. It's a straightforward, simple creed that captures the character-building ethos of the area:

"I believe that religion is so very important. I was raised in the Presbyterian church in Meridian, Mississippi, and I never missed a Sunday from when I was three to when I was eighteen. . . . I say something nice to people when they deserve it. When they don't deserve it, I say something nice about other people, so they know how to act and they always smile. . . . Tell your children how great they are. Encourage them in everything they do. I never punished my children, never ever raised my voice with them. If they know you expect them to do right, they will do right. . . . I loved being a doctor because it meant helping people, being with patients every minute. All my sons were doctors. It's a great thing to be a doctor. . . . I believe the free enterprise system can do a better job at most things than the government can. People should learn to be self-reliant; when they are self-reliant, they will have self-respect. I believe good people beget good people. . . . I believe life is made up of peaks and valleys. But the thing to remember is that the curve is always going up. . . . Finally, it is so terribly important in life to stay humble."

Dr. Frist died a short time later and his wife died the night before his funeral. All of Dr. Frist's sons did become doctors, and all of his children are remarkably successful. In Nashville, Tom Frist is as well known as Bill is; he's less reserved and just as much admired. The senior Dr. Frist was the dominant influence on his son Bill's life.

Another important influence is Montgomery Bell Academy, the 136-year-old school where Belle Meaders send their boys to be educated. Comparable schools in the Northeast--Groton, Choate--went through progressive phases in the 1970s, but not MBA. The school is far more diverse than it was in Frist's day, and it has added a fine arts curriculum, but the ethos is the same. "Gentleman Scholar Athlete" is the omnipresent motto. In the hallway outside the headmaster's office there is a portrait of the Confederate hero Sam Davis, who gave his life rather than betray his friends. On the wall of the school's weight room, a sprawling room that would do credit to a Big Ten university, there is a quotation from John F. Kennedy that begins, "From those to whom much is given, much is required."

When you ask people around Nashville what it is like to go to MBA, you get a variation on: "They work their asses off." It's an academic and athletic powerhouse. Its debate team has a daunting national reputation. "Character is formed through those expectations," says headmaster Bradford Gioia. "We try to imbue students with a sense of humility," he is quick to add, so that they don't get too carried away with their own accomplishments, and understand that integrity and true civility are the highest virtues. Students stand when an adult enters the room.

The folks at MBA are characteristically understated about the man who is at present the school's most famous alum. Bill Frist was class of 1970. He was class president, a quarterback on the football team, editor of the yearbook, and a member of Totomoi, the elite honor society. He dated the school's head cheerleader (who attended the sister school). He was active in the Fellowship of Christian Athletes, the Forensic Club, the Service Club, the Photography Club. He won the math medal, the Outstanding Sophomore and Junior awards. His nicknames were "Mr. President," "Precious," and "Wilbur," and the saying he put under his yearbook photo was, "But I don't like to rest."

You look through the yearbook Frist edited (this is 1970, remember) for any sign that the sixties are happening--Woodstock, the peace movement, hippies. There is none. The yearbook looks like it was produced in 1962. In his introduction to the annual, Frist does pause to wonder whether it might have been better if he had been "allowed to make more of my own decisions while at MBA." He notes, "My friends at other schools are never reminded to get their hair cut." But he concludes the school is right to be the way it is: "MBA is not like other schools; it doesn't want to be. MBA is on a Hill. Its ideals are to produce the combined gentleman scholar athlete. And it does that."

WHAT BILL FRIST would have gotten from Belle Meade and MBA is an unspoken sense that he was born to the leadership class. He would have been taught gentlemanly behavior and gracious manners.

He also would have imbibed an aristocratic service ethic, both from his community and from his father, who writes about being a doctor as of a holy calling. Finally, and this is a bit unusual in privileged communities, he would have been instructed, both by his neighbors and by his family, in the need to work and strive.

In Transplant, his 1990 book about his early days as a surgeon, Frist recalled that his mother "worked hard to protect my sense of self-worth. If Woodmont Grammar school conducted a paper drive, she motored me about afternoon after afternoon, making sure I collected more newspapers than anyone else." (How many middle-class Americans use the word "motored" as a verb?) Frist's mother made sure he sold more raffle tickets, got better grades. "She wanted me never to know humiliation, never to suffer defeat, never to feel self-doubt. . . . Not surprisingly, with the family emphasis on self-worth, I longed to be first in everything, to be king of the hill, the grammar school capo di capo. I imagine I was quite insufferable."

Frist continues, "Local rich kids, scions of socially prominent families, have few crosses to bear in life, but one of them is that they can never fail, not really, not the way others can." So Frist had to work extra hard to prove his merit. Going to Princeton rather than Vanderbilt was a mildly unusual step, which displeased his parents. His career at Princeton mirrored his career at MBA. "Later, I would worry I had spread myself too thin," he would write, "cheated myself of a more emotionally fulfilling college career. At the time, only the ticking off of accomplishments seemed to matter."

Medical school made matters worse. It stripped human beings, he later realized, "of everything but the raw, almost insane ambition you must have simply to get through." His diaries from his med school years were filled with minute calculations of how long he could afford to sleep and still master his studies. It was during that period that he adopted pets from animal shelters and then killed them so he could experiment on their hearts. "In short," he writes, "I was going a little crazy."

He was also having some troubles with his love life. "Imagining myself as a leader, a Ulysses out on his travels to conquer the world, I possibly wanted a Penelope back home waiting for me and managing the home I so treasured," he wrote in Transplant. For ten years he had been dating a Nashville girl, Katie, assuming that marriage was at the end of the road. While Frist was finishing his medical training in Boston, they did get engaged, and were to return to Nashville for the ceremony. But a few weeks before the wedding he met a woman from West Texas, Karyn, and they had a dinner and a night together.

Two days before the wedding, Frist flew back to Nashville from Massachusetts General, where he was doing his internship. He called off his marriage to Katie. "Everyone listened carefully to what I said, all the lame explanations I had that were and were not the truth," he wrote, "and they nodded and dealt with it and I went on my way." Think of that: two days before a Belle Meade wedding. You can imagine the string of parties that would have been planned, the cascades of gifts that would have been bought. You can imagine the social uproar Frist's decision must have caused.

You don't call off a wedding to a woman you've known for ten years in circumstances like that unless you have a steely determination, to say the least, at the core of your being. And as Frist notes in his book, despite all the trauma, he "did not miss a minute of work at Mass General."

THE PROBLEM for a person born into this culture is obvious. Raised in such rarefied air, how to talk to normal people? How can Bill Frist possibly relate to rural rednecks, urban blacks, or even middle-class suburbanites? His background is nothing like theirs.

Some in Nashville say that being a doctor helps. The people he treats come from all walks of life. But that doesn't explain much. In your experience with normal doctors, let alone superstar transplant surgeons, would you say that their life paths have bred in them a simple egalitarian ethos? Of course not. Many doctors, and especially the surgical superstars, see themselves as inhabiting a Mount Olympus of the mind. And yet Bill Frist obviously does relate to people. Like Bush, he does not alienate or cast himself as superior to normal, middle-class Americans. Frist was reelected to the Senate with a wider margin than any other candidate for statewide election in recent Tennessee history, which, given some of the senators the state has produced, is saying something.

Moreover, he has been elected majority leader by his fellow Republican senators, a group not known for their deference to upper-class toffs.

Tennessee may have something to do with it.

If you went into a lab and tried to create a state that would be perfectly suited for producing successful national politicians, you would create Tennessee. It is southern, which is important because the South is both the largest and the fastest growing region of the country. But it is not too southern. It is rich, and has that huge fundraising base, but it is not culturally elitist, like New York and California. Most important, it is heterodox. If you are going to live in Tennessee and thrive there, you cannot live in an insular cultural enclave, the way Trent Lott can in Mississippi, or the way Nancy Pelosi can in the Bay Area. In Tennessee you have to travel to the eastern part of the state, where they supported the Union, you have to travel to the western part, where they supported the Confederacy, and you have to travel to West Nashville, where they support Cadillac dealerships. If you travel and campaign throughout Tennessee, you are apt to acquire an instinctive feel for how different types of people think and react.

Start with Nashville. The city is hard to figure out because, though it isn't very big, it exists on many different planes. Beyond the Belle Meade elite, there are the music people, who live in the exurbs or in rural mansions. When Bill Frist was growing up, he would not necessarily have had any contact with the country music community, who would have been regarded as rednecks. Even today, when the music industry is just another successful business sector, the visitor is surprised to find that country music has a relatively low profile in Nashville. Country music doesn't dominate the radio dial. It doesn't color local conversation the way the movies color chatter in Los Angeles. As Lamar Alexander, a successful governor and newly elected senator, notes, "Country music still sits uncomfortably in Nashville, like McDonald's in Japan."

Then, outside of Nashville, there are collar counties, such as Williamson County, with McMansions, mega-churches, G. Gordon Liddy fans, and new money. These fast-growing places are extremely Republican, anti-tax and anti-government, and are looked upon with bewilderment and suspicion by many people in Bill Frist's neighborhood. There are also the religious elites. Nashville is home to several denominations, including the conservative Church of Christ. The city hosts the largest publisher of Bibles in the world.

Then of course there are less affluent areas, in East Nashville, in the African-American neighborhoods and elsewhere. I received an e-mail from someone who works in Belle Meade serving the elite. Speaking from a working-class perspective, he is offended by the Versailles-like grandeur of Tommy Frist's new house, which is reputed to be over 40,000 square feet--eight times the size of your normal obscenely large McMansion--and is appraised at over $20 million. He rails against the Belle Meade Country Club, "which, I believe, actually has one black member, but he lives in Birmingham, and has the decency to never show up. This club is so (I shudder to use the word) liberal, it even has a couple of Jewish members." He is offended by the size of the trust funds passed down to the children of Belle Meade, while people in his town, a few miles away, lose their jobs when local plants move to Mexico.

Plainly, Tennessee is a state, as the travel writers say, of contrasts. Lamar Alexander grew up in East Tennessee. His ancestors fought for the Union in the Civil War. While campaigning, he walked across the state, and he "could almost feel the air change," he wrote, as he crossed from east to west. Upscale political candidates tend to adopt not-too-subtle cultural signifiers to prove their solidarity with the good ol' boys. Former Senator Fred Thompson drove a pick-up truck while campaigning. Alexander wore that red plaid shirt. Frist wore an American flag tie constantly during his first campaign.

If you want to start an argument, ask Tennesseans whether their state is more like Mississippi or Illinois. In the Vanderbilt triangle, with its huge influx of New Yorkers and Californians, people tend to say Illinois. If you live in Nashville, your mayor, congressman, governor, and both senators all went to Ivy League or other northeastern universities. If you ask people there to list the features that form the state's identity, the fact that it is part of the South comes far down the list.

In other parts of the state, the verdict is more mixed. "Of course it's the South," says Lamar Alexander. "We go to church, hunt, and fish. We have certain views on abortion. We're suspicious of federal intervention into our lives. We're against people who make fun of religion or who deprecate the values of rural life. We're suspicious of people who talk too fast and who aren't neighborly." At the same time Alexander, like everyone else I spoke to, distinguishes between Tennessee and the Deep South. I must have heard it a hundred times: The things Trent Lott said would never have come from the mouth of a Tennessee politician. "There's none of that chip-on-your-shoulder inferiority complex," says John Egerton, the author of The Americanization of Dixie and many other books. "We're pretty reasonable."

Nathan Bedford Forrest Shoaf, an investment banker and former Army Ranger and congressional candidate, was one of the more colorfully southern and perceptive people I met down here. An avid student of the Civil War, he points out that the state of Tennessee contributed more troops to the Confederacy than any other state and that the ground Bill Frist grew up on would have been trod by soldiers during the battle of Nashville. He believes the South is permanently distinguished by its experience of defeat in that war. But he does not believe that Confederate flags should fly on public property, and he points out that someone like Bill Frist would have grown up entirely without Confederate consciousness.

Instead Tennessee has a moderate political tradition that included Estes Kefauver, Al Gore Sr., Howard Baker, and Jim Sasser. Because of its ties to the Union cause, the Republican party in Tennessee is older and better established than the Republican party in other southern states. During the furious period of the civil rights struggles, Kefauver and Gore didn't sign the Southern Manifesto. The Tennessee GOP was less powerfully influenced by Pat Robertson's 1988 presidential campaign and the rallying of Christian conservatives than other parties in the South. And though Tennessee politicians might have hidden the fact at the height of the Gingrich/Armey era, now they are once again proud to walk in Howard Baker's footsteps. "We're all out of that tradition," Alexander says of himself, Frist, and Fred Thompson. Baker was one of the first people Frist called when considering a run for the majority leader's job, and Baker appeared with him on his first day in office.

Exactly what the guiding principles of that Tennessee brand of politics are is harder to say. Part of it is simply being gracious and non-confrontational. "I understand and appreciate what Newt did, but I'm a lot more comfortable with Bush's presentation," says Lamar Alexander. Part of it is seeing oneself as a fixer and a doer, rather than an arguer and a point-maker. "I've been put off by people who say 'I'm a better conservative than you are,'" he continues. "I believe in the restraint of government, but I'm going to fix the schools at home. I'm going to fix things. . . . Some conservatives start with being pro-life and pro-gun and anti-homosexual. I'm with them on those things but I don't start there. I'm going to start with education and clean water and creating new jobs. That's a different emphasis."

ONE OF THE REFRAINS you hear from transplanted northerners and westerners is that discussion in Tennessee is more open. Gordon Gee, the Vanderbilt chancellor, observes that on Vanderbilt's campus it is not necessary to subscribe to the rigid "political catechism" one finds at most northeastern schools. The city's outstanding alternative weekly, the Nashville Scene, is not cut from the same multicultural/futon ad/knee-jerk left political and cultural cloth as just about every other alternative weekly in the country.

As you struggle to understand Frist and his upper-class Tennessee roots, you are forced to wrestle with paradoxes. He does have an aristocratic background, yet right now that background and the soft-spoken caution it implies seem more in tune with the middle-class public than the more radical aspirations of the Gingrich revolutionaries. He is relentlessly ambitious, yet he is also a sincere do-gooder. He is a meritocratic striver, yet he also has a service mentality that transcends narrow self-interest. He has an ego, but he also performs unpublicized acts of charity. He is a member of genteel society, but he is not cowardly--or obsessed with the opinions of the parlor set, as the crack-up of his near-marriage proves. He is political, but for much of his life had no interest in anything but medicine and still defines himself as a doctor first.

The Tennessee Republican party is conservative, but it has the sort of pragmatic and establishmentarian leanings that alarm many conservatives. It is southern, but it is not parochial. It is hard to pin down ideologically, yet it is easy to define temperamentally. It is moderate, low-volume, compassionate. It represents the upper crust, but somehow it doesn't seem snobbish. "People don't engage in class arrogance here," says Gordon Gee, who headed Ohio State and Brown before coming to Vanderbilt. "I see that class arrogance more in the North than in the South. There people limit who they will meet, and there are always the questions, Where did you go to school, and What do you do? There's not a lot of giving out your résumé down here."

Bill Frist has term-limited himself and is scheduled to leave the Senate in 2006. It's hard to see him breaking that pledge. It would violate his sense of rectitude, and so damage any dreams he might have of being president someday. The more likely route is that he would leave the Senate in 2006 and begin campaigning for the White House in 2008. Some of his intimates believe he feels himself predestined for the job.

If he won in 2008, we might have one southern patrician succeeding another in the White House. Some of us thought we'd had a cultural revolution in this country that had destroyed the WASP establishment. But maybe that was only in the North. Maybe the cultural revolution of the 1960s was a temporary phenomenon, and it's the country club Republicans of the New South, with all their virtues and sins, who will have the last laugh.

David Brooks is a senior editor at The Weekly Standard.