A Heart to Serve

by Bill Frist

  An important step I took during my initial days in Washington was to join the weekly Senate prayer breakfast in the Capitol. It was attended by twelve to twenty senators each Tuesday morning as well as by the distinguished and beloved chaplain of the Senate, Dr. Lloyd Ogilvie. The prayer breakfasts were a fifty-year tradition in the Senate and they offered a time of personal exchange, prayer, and fellowship among senators of both parties. I soon came to find it my favorite hour of the week, in part because of the intimacy of the discussion and in part because it was one of the few times you could find Republicans and Democrats in the same room, talking civilly with one another.

  I learned quickly not to take the Capitol Hill wrangling personally. Much of the public bombast by certain members is nothing more than that—bombast designed to get a sound bite on the evening news or to appeal to the voters back home. Nevertheless, it still hurt when we worked so hard trying to convince people across the aisle to vote for some measure that we truly believed would benefit the entire country only to see it go down to defeat due to a lot of hot air. Usually, I took either victory or defeat in stride; if we lost a vote, I refused to give up or get depressed, regardless of how much effort we’d put into trying to pass the legislation.

  At first, it was frustrating to realize how slow and tedious accomplishing anything in the Senate was going to be. Part of that, of course, is intentional, and was designed to be so by our Founding Fathers. The Senate is meant to be a place of debate, a place for the nation to slow down, stop, think, and make sure the government is not acting impetuously. But as a heart surgeon, I was accustomed to fixing things—not merely talking about them. I had said in my campaign that people in Washington tend to have a two-year outlook, worried more about the next round of elections, rather than a twenty-year plan; too many politicians seemed to be more intent on maintaining power than concerned about what was best for the country. The reality of that short-term thinking hit me hard during my first months in office.

  Nevertheless, I looked at the situation as a magnificent opportunity. Because I’d told my constituency in advance that I would serve two terms and then come home, Mark and I felt that we didn’t have to do business as usual; we could change things.

  ON SEPTEMBER 14, 1995, I WAS SUPPOSED TO FLY BACK TO NASHville for a midweek fundraising event and return to Washington the following day. I was running late, and I still had to go over to the Senate floor to vote. Perhaps it was providential.

  Just about that time, Graeme Sieber, the director of a home for troubled boys in Cleveland, Tennessee, was visiting my colleague Fred Thompson and the Tennessee House members, lobbying them to reconsider budget cuts that would affect charities like his. Sieber had just gotten off the elevator outside the Dirksen office of Rhode Island senator John Chafee when he keeled over with a heart attack, falling partially in the elevator doorway and partially in the hallway. A woman staffer from Senator Chafee’s office raced around the corner to my office and called in to Ramona, “Is your boss here? I think a man in the hall has had a heart attack!”

  Ramona burst into my office to inform me, and I grabbed an emergency medical kit I kept in my closet, rushed down the hall, and pushed through a small crowd in front of the elevator. I found a man ashen gray on the floor, his head in a pool of blood. Had he been shot? No, I found a gash in his scalp, resulting, I concluded, from his fall to the hard marble floor.

  Chafee’s office manager had been a Girl Scout leader, and she had already begun administering CPR before I arrived. I dropped to my knees, felt the patient’s neck for a pulse, and immediately cleared his airway and began mouth-to-mouth resuscitation. “Can someone else give her a hand in compressing the chest?” I said, looking up between breaths, knowing the woman would soon grow tired. “Has someone called 911?” I knew it’d be impossible to get him back without a defibrillator. I was worried because it had been several minutes since the man on the floor had passed out. I checked his carotid pulse again and felt nothing—a bad sign. I made a fist and delivered a strong thump to the chest—nothing. I had grabbed an airway tube from my emergency kit. I inserted the clear plastic tube down his windpipe to force air into his lungs, attached the big black air “ambu” bag, and instructed a bystander to squeeze it once every five seconds. I knew if we didn’t get him turned around quickly he would die.

  The on-call doctor from the Capitol Physician’s Office arrived with a heart defibrillator. I stripped open the man’s shirt, slapped on the sticky electrode pads, and read the wildly irregular electrical activity on the screen as ventricular fibrillation (which is incompatible with life). We shocked the patient once…his body jerked into the air. No pulse. Twice, nothing…I glanced up at the clock, thinking maybe it had taken too long to begin CPR. I thought for sure that he was gone. Then I turned up the power on the defibrillator and shocked him once again. Suddenly, his heart kicked back into a regular, normal sinus rhythm. The squiggles on the screen normalized into a repetitive, steady pattern. He was alive.

  “Stop CPR,” I said.

  We watched and he took a breath on his own. His color slowly began to return. As I looked up, the District of Columbia emergency response team was arriving on the scene. I filled them in on what had happened and turned the situation over to them.

  I stood up from the marble floor, my white shirt disheveled and soaked with sweat from all the activity. I hurried back to the office where Ramona greeted me with a “What in the world happened to you?” expression on her face. I looked a mess, blood still on my hands, but I still had to go over to the Senate floor to vote.

  I cast my vote in favor of an amendment to a bill and then raced off to the airport.

  On the way, I called Ramona. She told me that Senator Chafee had gone to the Senate floor, proclaiming something like “Bill Frist has saved a person’s life, bringing him back from the dead, right outside my office door!”

  “No, he can’t say that!” I replied emphatically. I was horrified, first because of the senator from Rhode Island’s compliment, but second, because I wasn’t so sure the man was going to survive or not have brain damage. I called the hospital emergency room and relayed to them the details of the procedures we had used to resuscitate the patient. The hospital reported that Mr. Sieber was in the emergency room, stable, and that all signs were that he was going to make it.

  I arrived in Nashville just in time to clean up, change clothes, and make my speech. The following morning at five o’clock, I was back at the airport headed to Washington to make a 9:30 A.M. vote in the Senate. When I walked into the Senate chamber that morning, I received the surprise of my life. The members of the Senate broke out in spontaneous applause. I sheepishly acknowledged the senators’ congratulations. In truth, I had just done in public what hundreds of doctors all over the country do anonymously every single day in America. Here, among this collection of lawyers and politicians, it was an extraordinary feat.

  A day or so later, I visited Mr. Sieber and his wife in the hospital. They both thanked me profusely. We talked briefly about the surgery scheduled for the following day, when an automatic internal defibrillator device would be surgically inserted under the skin to prevent the life-threatening event from occurring again. If his heart went into fibrillation, the remarkable device would automatically give his heart a shock of electricity to normalize the rhythm.

  As I was leaving the room, Mr. Sieber called out, “And by the way, Dr. Frist, don’t forget why I came to Washington…to see that you support my boys back home. We need that money.” Despite his close call with death, Sieber was most concerned about those he’d come to Washington to serve. Indeed, constituents have passion. I smiled as I waved good-bye. Graeme was my kind of man.

  As an interesting byproduct of my newfound notoriety in the halls of Congress, Ramona began an entirely new file she labeled simply as “Referrals.” Everyone from my fellow senators to the Capitol Police to the catering people knew somebody with some sort of medical problem. “Do you know somebody who might be abl
e to help?” they’d discreetly pull me aside to ask. I tried my best to connect people to the best doctors around. But I began to realize how hard that is to do, even for a doctor. Which doctors in the Washington region are really the best? How do I know for sure? No objective, accurate measures of quality of doctors existed then (and little exists today). Yes, even senators have a hard time navigating our irrational and fragmented health-care system.

  Probably all this attention to my “medical side” reminded me of my roots. Having become acclimated to my new surroundings, I found myself longing to be able to help people as a doctor. I got my medical license to practice in Washington, D.C., and decided to do volunteer medical work in my off-hours in a traveling medical van in Southeast Washington—a notoriously dangerous section of town almost totally lacking in health resources. I was aware that a man in Southeast would on average live seventeen years less than a man five miles away in suburban Maryland—seventeen years less. Maybe I could make a difference there.

  A fellow Tennessean living in D.C. had befriended the Southeast community and saw the need. She scrounged up enough money to buy a secondhand van to provide free health screening on the streets; the problem was that she didn’t have a doctor. I heard about her plight through some friends back in Nashville and volunteered to join her on a regular basis. We’d park on the street, in what would seem to be the worst part of town. I knew for a fact that the adjacent block was the site of the most drug arrests in the city. People would line up outside the van, from which we saw and treated patients. The people we served were among the city’s poorest. This was life in the trenches with real hurting people. No money, little food, no home, no family—and no help with their diabetes or treatment for their high blood pressure. Being uninsured matters; you die sooner. Even those with Medicare could not get life-saving prescription drugs; maybe someday I can help change that. Maybe someday we can provide affordable coverage for the medical needs of these patients.

  I doubt the press was even aware that I was working with the free clinic, and frankly, that suited me just fine. The Washington media is much more interested in covering the partisan shouting matches on TV than in the plight of poor people.

  I often found myself in the right place at the right time. For example, after speaking on health-care issues and participating at the Republican National Convention in San Diego in August 1996, Karyn and the boys and I attended a barbecue in Montecito, California, where an eighty-four-year-old woman slumped to the floor, grabbing her neck with both hands as she fell. A shout went out for help. A quick sweep of her mouth with my finger followed by the standard Heimlich maneuver of upper abdomen compression and she was able to breathe again. Once she calmed down, she continued to enjoy the evening.

  On another occasion, I was returning home from Indonesia when my connecting flight got delayed in Los Angeles. When we finally got airborne and I had just settled back in my seat to do some reading, the announcement came over the plane’s public address system: “Is there a doctor on board?” I identified myself as a physician to the flight attendant, and she informed me that a man on board had passed out and seemed to be having trouble breathing. I quickly checked his vital signs, and while checking his heart, I felt a prescription pill bottle in the man’s pocket. Amazingly, I recognized the physician’s name on the prescription from my Stanford days. I had the pilot contact Ramona in our Washington office, and Ramona connected me to the doctor at Stanford, who explained why the medication had caused the adverse reaction and how to overcome it. We were able to revive the man, and he survived just fine.

  I was reminded once again that although I was now a United States senator, I was still a physician at heart.

  I KNEW THAT BOB DOLE WAS GOING TO BE DISAPPOINTED IN ME. IT was 1996, and Dole was fulfilling his longtime dream of running for president. Now he’d asked me to introduce him in my hometown of Nashville at a major Tennessee fundraising event at our close friend Alynne Massey’s magnificent home on Belle Meade Boulevard—in the same zip code that for years was the highest per-capita Republican fundraising area in the nation. Although Senator Dole had been to Nashville many times, this was to be his formal introduction as a presidential candidate to the Middle Tennessee community. It was only appropriate the home-state senator welcome and introduce his good friend and Senate colleague, especially at such a prestigious event.

  Months ago I had told Bob that I’d love to host him in Nashville. But now I had a serious conflict. I knew that I had to tell Senator Dole no…again.

  For the past few months, whenever I could get home before the boys had gone to bed, our youngest son Bryan and I had been carving a Pinewood Derby car for the big Cub Scout race. Although I had little to add to nine-year-old Bryan’s work, every night for two weeks he and I had worked with the slowly changing block of wood and the chisel, weights, and sandpaper so we could together plan and accomplish the next step. Finally, we were ready for the trials for our troop.

  Unfortunately, because of the Senate’s haphazard and random schedule, when the night came, a vote was called for on the Senate floor. Having been in the Senate just a couple of years, it was important for me not to miss a Senate vote. I had to call and tell Bryan I couldn’t make the trials. Karyn would have to take him instead. Bryan didn’t say much, but I could tell he was disappointed.

  Bryan finished in the top third, I learned from Karyn as I sat in one of the Senate cloakroom phone booths. As I walked around the Senate chamber, still waiting for the Senate vote, I thought, I should have just skipped this vote to be with him. At home later that night, I told Bryan, “I’ll make the finals for sure,” remembering how my dad had always showed up for my Little League baseball games no matter how busy he was at the hospital.

  Now, as I checked the calendar for the date that Senator Dole was requesting, my schedule was clear except for one appointment—Bryan’s final Pinewood Derby race.

  I looked up at Mark, my chief of staff, who was standing in the doorway, waiting for my answer. “I can’t do it,” I said, as much to myself as to Mark.

  “What do you mean, you can’t do it?” Mark asked.

  “The Dole kickoff event is now the same day as Bryan’s Pine-wood Derby race,” I said. “I promised Bryan that I would be there. I am simply not going to break that promise.”

  Mark stared back at me with an incredulous look for just a second. Then he nodded and returned to his office without even attempting to talk me out of my decision. He understood. I set about the task of writing an apology to Senator Dole. Dole, the political pro, also understood—and even had the letter I’d written read at the event in Tennessee. Meanwhile, I went to Bryan’s Pinewood Derby race over at St. Patrick’s School. We finished in the middle of the pack, but our wheels didn’t fall off and Bryan had a blast, celebrating with his friends, their dads, and a number of moms, the many weeks of father-son work in friendly competition.

  It comes back to priorities. I had seen too many politicians, preachers, doctors, and businessmen spend their lives trying to win the accolades of the world, while losing in their relationships with their own family members. I didn’t always do it perfectly (far from it!), and if I had it to do all over I would have done much better than I did, but finding the right priorities was constantly on my mind.

  * * *

  ANY TIME I RETURNED TO NASHVILLE, I TRIED TO SPEND SOME extra time with my parents, then in their late eighties. Both remained sharp mentally, but neither was in good health. By then, Dad had suffered a heart attack, two heart operations, a stroke following his second heart procedure that had left him with the frustrating stutter, a broken neck from an automobile accident that required a metal “halo” brace screwed into his skull for six months, colon cancer that required a surgical resection, and progressive loss of hearing, but he remained active and he was always his usual upbeat self. With each health insult, he would bounce back and waste no time in getting back to counseling others and giving inspirational talks to people in medicine and in hea
lth care the country over. In every talk, he would open with a joke about all his past maladies to put his audience at ease.

  On every visit, my siblings and I gently urged Dad and Dodie—as the family had taken to calling Mother after the first grandchild arrived—to put down on paper some of the things that we could pass on to the great-grandchildren who would never have the opportunity to be in their presence. By now, there were fourteen grandchildren and five great-grandchildren who hung on every word Mother and Dad said. Every Christmas, Thanksgiving, and Easter, all of the next several generations, most of whom lived in Nashville, would gather in the living room on Bowling where we’d all grown up and listen to the family stories, most related to the enduring lessons of life, that Mom and Dad would share. Harry Hollis, an author and a close friend of the family, had observed the personal and powerful impact that Dad had had over the years on so many thousands of people, both in his large medical practice in the community, and globally through his work with HCA. To capture and preserve Dad’s simple philosophies for future generations, he began a tape-recorded oral history project with Dad.

  As we approached the Christmas season in 1997, I pushed Dad to put some of his philosophy on paper. Karyn’s and my grandchildren would never know him. He hesitated, saying humbly that he really didn’t have any profound philosophy worth sharing. But on December 15, Dad finally took time to write some of the things about which he felt strongly. In a letter headed, “For my family and for future generations, with great love,” he wrote: