The Magazine

Heavy Heart

The life and cardiac times of Dick Cheney.

Jan 27, 2014, Vol. 19, No. 19 • By TEVI TROY
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Those who follow politics know that Dick Cheney’s biography is an extraordinary one. His rapid ascension from Capitol Hill intern (and Yale dropout) in 1969 to White House chief of staff by 1974 is one of the fastest rises in American political annals. It was so fast, and he rose so high, that it comes second only to Theodore Roosevelt’s five-year ascent from New York City police commissioner to assistant secretary of the Navy to New York governor to vice president to president. And Cheney, unlike Roosevelt, was completely unknown when he started his climb.

Dick Cheney, Jonathan Reiner, M.D. (2013)

Dick Cheney, Jonathan Reiner, M.D. (2013)

alberto e. tamargo / sipa usa / newscom

But, as we learn here, Cheney’s medical history may be even more extraordinary. This engaging book is cowritten by Cheney and his cardiologist, Jonathan Reiner, with an assist from his daughter Liz Cheney. As the former vice president writes, Reiner once related to him that he is not aware of anyone else, besides Cheney, who suffered a heart attack in the 1970s and is still alive. 

Furthermore, and this is something even political junkies might not realize, Cheney came remarkably close to death on multiple occasions. In 2009, he had an episode of ventricular fibrillation, which he only survived because “eight years earlier, Dr. Reiner had had the judgment and foresight to recommend I get an implantable ICD.” In addition, he almost died on the night doctors implanted a left ventricular assist device (LVAD) in 2010. If they had not made the accelerated decision to have the surgery on that very night, before the doctors had planned on doing the operation, Cheney would not have survived. And when he received a heart transplant in 2012, doctors marveled at the swollen, diseased organ that had plagued Cheney for so long.

That Cheney did survive so long despite his chronic heart condition—he suffered his first heart attack in his 30s—is a tribute to extraordinary advances in the field of cardiology over the last four decades. Reiner tells this story for roughly half the book, using Cheney’s experiences as a patient to trace the improvements in cardiac medicine. The other half of the book, coming from Cheney himself, provides an incisive précis of his longer 2011 memoir, In My Time, with an especial focus on his medical travails.

Cheney’s heart issues were, in part, congenital, but they also stemmed from extremely unhealthy habits. Cheney was a heavy smoker during his first tour at the White House, and he was not alone in this. As he reminisces, “In those days, just about everyone smoked in meetings, at meals, at home. It was pervasive.” In fact, as Cheney notes, the White House itself encouraged his habit: Both President Gerald Ford and Donald Rumsfeld (Cheney’s direct superior) smoked pipes, and free cigarette packages with the White House seal on them were a perk for White House aides, as were matches from both the presidential plane and helicopter.  

“There was a certain cachet,” he writes, “to pulling out a box of presidential cigarettes and using a match from a pack labeled ‘Air Force One’ to light up.” 

Alas, the fun could not last forever, and Mother Nature caught up with him. By the time Cheney was in his 30s, he recalls, “I’d developed a heavy smoking habit, my diet was terrible, and I didn’t get nearly enough sleep or exercise.” Cheney is quite frank about the detrimental effect of his unhealthy habits, as well as the shortsightedness of his approach: “I operated as though I’d live forever. Bad habits and their long-term consequences frankly didn’t concern me much.” 

Cheney may not have known it at the time, but his cardiac odyssey was about to begin.  

When Ford lost a close election to Jimmy Carter in 1976, one of Cheney’s responsibilities as chief of staff was to read Ford’s concession telegram (yes, telegram) over the telephone to President-elect Carter.  

After leaving the White House, Cheney went for an overdue physical exam. The doctor warned Cheney that he was a “prime candidate for a heart attack.” Cheney, however, was having none of it, noting, “I didn’t believe him.” It would not be long, however, before Cheney was mugged by reality: He had his first heart attack soon after, and then decided to develop a long-term relationship with a cardiologist, which he calls one of the best decisions he ever made. After the first cardiologist retired, Dr. Reiner took over.  

This book intertwines the fascinating ups and downs (mostly ups) of Cheney’s political career with his heart incidents and his cardiologist’s recollections of Cheney’s condition and the development of cardiac medicine at the time. This is an important point, as 20th-century medical advances and the attendant increases in life expectancy meant that people were less likely to die of infections and more likely to die of cancer or heart disease. Consequently, doctors and scientists were putting more and more effort into cardiac treatment and technologies, and Cheney was a direct beneficiary of these advances.

One such technological marvel was the ICD, or implantable cardioverter defibrillator. In Cheney’s case, medical-device maker Medtronic had to create a special modification to his ICD to disable the device’s wireless-programming capabilities. This modification came at the insistence of Dr. Reiner. He was concerned about the possibility of outside interference, and he wanted to protect not just the vice president but also the patient he had been tending to for so long. Eleven years later, the fictional vice president on the television show Homeland would be assassinated by militant jihadists using just such a technique. Reiner also notes that a real-life computer hacker has demonstrated that such an attack could successfully sabotage an implanted ICD.

In writing a book like this, with his vulnerabilities and unhealthy habits acknowledged quite frankly, Dick Cheney reveals a new public side. Perhaps this Cheney 2.0 can help counter the unfair-but-prevalent Darth Vader image he has among ideological critics. At a time when partisanship rides high, it would be interesting to see Dick Cheney and Michelle Obama team up to lend their voices and reputations to an event that supports healthy eating and living. That may not happen, but Heart will remind readers of Dick Cheney’s humanity and his long service to the nation. 

Tevi Troy, a former deputy secretary of Health and Human Services and senior White House aide, is the author of What Jefferson Read, Ike Watched, and Obama Tweeted: 200 Years of Popular Culture in the White House.