A Heart to Serve

by Bill Frist

  Amidst the sounds of multiple sirens and the roaring noise of a helicopter overhead, an emergency team arrived, and we lifted the fallen officer onto a stretcher. A member of the Capitol Physicians team inserted a breathing tube to keep his airway open. “You’ve got to get air into the lungs,” I called to the medic above the din of the sirens and an approaching “lifeflight” helicopter. “I can barely feel his pulse. About thirty and thready. Let’s compress his chest and get an IV in to get his pressure up.” We hurriedly carried the stretcher out the door and then rolled it across the hot pavement to the waiting ambulance. I held the man’s wrist the whole way, monitoring his still weak pulse, knowing that his only chance would be to keep his heart and lungs going until we could get him to the emergency room for a full assessment of his likely fatal head injury. I climbed into the back of the ambulance, continuing my resuscitative efforts. He was unresponsive, but his heart rate had stabilized, his blood pressure was slowly coming up, and we had control of his airway. Another doctor showed up, introduced himself as an emergency physician who had just started working with the District, and offered to travel with the injured patient to the hospital. Someone rushed up to the ambulance and through the back door of the ambulance called to me, “Dr. Frist, can you come back inside the Capitol immediately? We have other victims still inside who need help!” I jumped out the back of the ambulance and paused for a brief moment. How surreal, I thought, as I looked up at the massive dome of the Capitol, silhouetted by a bright blue sky, with the American flag waving so proudly. How could this human tragedy be unfolding here, now?

  Satisfied that the first patient was stabilized and in excellent hands, I sent them off to the hospital and ran back inside. As I was re-entering the hallway, I saw another emergency team carrying a second gravely wounded man from the Capitol to a helicopter with rotor whirling thirty yards from the building in the east parking lot, waiting to transport the man to a hospital. I’d walked peacefully through that parking area a thousand times on the way to voting.

  An officer led me to the DeLay office suite, where I discovered yet another man lying sprawled near the back entry door. The man on the floor had been shot several times by the looks of it. The walls and floor all around him were spattered with blood, and he had severe injuries to his extremities and chest. I immediately dropped to my knees to begin resuscitation in an attempt to save the man’s life. I focused on his airways, making sure the man could breathe, stabilizing him until the paramedics arrived. We lifted him to the stretcher; by then my white shirt was covered with blood. Unlike the other two patients, he was still spontaneously moving and would wince when we moved him. Having taken care of scores of people with injuries like this in trauma rooms, I knew that if we could stop the bleeding, control his airway, and keep him out of shock, we could keep him alive. We got him into the back of the ambulance, and with sirens wailing we headed to the district’s General Hospital.

  Since I had been so involved in the emergency response from a medical standpoint, it was still unclear to me what had actually happened. The only thing I knew was that there were three people seriously injured, all with gunshot wounds. As we made the bumpy ride in the back of the ambulance, I asked the paramedic riding in the back with me if he had heard what happened. He looked up and said he didn’t know the details, but from what he understood, nodding down toward the man whose femoral artery I was at that moment compressing to stop the bleeding, this individual was the shooter, the man who had perpetrated the deadly acts inside the Capitol.

  Back in our offices in Dirksen, rumors ran rampant. By now nearly everyone knew there had been a shooting—the sound of sirens below and helicopters above attested to the seriousness of the situation—but no one knew how many shooters might be on the loose. There was a real scare that armed gunmen might be running through the tunnels of the Capitol complex. Ramona and other staff locked the office doors to the outside hallways.

  When we arrived at D.C. General Hospital, I systematically reviewed with the doctors in charge the history, physical findings, and current status of the patient. The emergency room doctors and nurses took over. My job as doctor was complete. I waited until they no longer needed any information from me, spoke briefly with the police, and then called Ramona to have Gus come pick me up at the hospital. Gus was new to Washington and another staffer, Meredith Medley, rode with him to give directions.

  As I got into the car, the press waiting outside the hospital rushed forward and asked for details of the events over the past hour. I politely said “No comment” and that the police and hospital would be issuing statements. On the way to the airport, Meredith noticed blood on my white shirt and was full of questions, wanting to know all the specifics of what had happened. Many of those details were too graphic to share, and even attempting to describe clinically what had transpired was difficult, especially since I had no idea what was behind the shooting.

  At Reagan Airport, we met Karyn and the boys, who had been following the live news as it unfolded; they had spotted me in the background in the news coverage carrying one of the patients out to the ambulance and got a glimpse of me moments before at the hospital as we were departing. They were, of course, accustomed to my responding daily to trauma in my “real life” at Vanderbilt Hospital before the Senate, but even they were a little taken aback by my being in the middle of all this at the nation’s Capitol. We hopped into the small plane and took off for the tranquility of a brief family getaway to Nantucket.

  I leaned back and reflected on the nightmarish scenes I had just witnessed. Already our office was being bombarded with interview requests from major media. I had told Gus and Meredith to refuse all interviews for the next several days out of respect for the families.

  Sadly, Officer Jacob Chestnut never regained consciousness and was pronounced dead at George Washington University Hospital. Officer John Gibson died during emergency surgery at Washington Hospital Center later that afternoon. They had sacrificed their lives in the line of duty of service to others, dying to protect my congressional colleagues and their staff, as well as innocent bystanders. Flowers and wreaths began showing up at the Capitol almost immediately, sent by a shocked public as well as congressmen, staff members, Capitol employees, and fellow law enforcement families. Both Jacob Chestnut and John Gibson were popular men in the Capitol; both left behind wives and children. The officers received the high tribute of lying in honor in the Capitol Rotunda as hundreds of mourners passed by to pay their respects. I sat alone in the back of the Rotunda during the service to honor these men and their families, reflecting on these men’s sacrifice for our country. Afterward I introduced myself to their children and told them how much I respected their dads. I told them their dads had hearts to serve, and that our country is a better place because of their service. That brief conversation inspired me to contribute for the next five years to a fund established to support their education and well-being.

  Early in the week after returning to Washington, as the most controlled and efficient way to respond to all the media requests, I held a short press briefing on the east lawn of the Capitol in an area designated as “the press swamp.” I believed it important to clarify what had happened in a way that would be sensitive to the families involved. Afterward, as I was walking underneath the huge maple tree back to Dirksen, a young Capitol police officer approached me, carrying a baby girl, his daughter. He thanked me for trying to help his friends, the fallen officers inside the Capitol, and we talked briefly about his daughter. “She is so lovely. How old is your daughter?” I asked.

  “Six months,” he said proudly.

  I nodded. “I once did a heart transplant on a little girl who was only six months old,” I said. “You are a very lucky man to have a beautiful baby girl in good health. Thank you for your service and sacrifice of being away from her so much to keep all of us safe and secure.” The officer nodded appreciatively. Somehow, in the midst of all the Capitol chaos, everything reminded me of medicine and healing.


  In an unusual twist, Russell Weston recovered but was deemed incompetent to stand trial due to mental illness. No plausible motive explained Weston’s deranged attack, other than his mental instability. He was not part of a terrorist group, or even on the Secret Service’s “watch list.”

  The vivid memories of the event and questions about whether Weston was a product of a health system that underinvested in treating mental illness and failed to ensure access for the disadvantaged surfaced regularly over the ensuing years as I worked with my colleagues Pete Domenici, to ensure better access for those with mental illness; Ted Kennedy, as we addressed health-care disparities that lead to unpardonable gaps in health-care delivery; and House Speaker Denny Hastert, as we worked to get affordable and necessary prescription drugs to millions of seniors in need. Such efforts don’t solve all problems for the Russell Westons of the world, but they do make all of our lives more promising.

  Weston was remanded to the psychiatric center at Butner Federal Correctional Facility for treatment. He was a diagnosed paranoid schizophrenic who apparently had stopped taking his medicine before the murders, and his case took another bizarre turn when a judge ruled that he could be forced to take his medicine, especially if it allowed him to be mentally competent enough to stand trial. In 2004, the court determined that Weston was still not competent to be tried, despite treatment. The judge suspended but did not dismiss the criminal charges against him. Russell Weston has yet to stand trial for shooting to death two noble and courageous law officers.

  Some people saw my actions that fateful day as ironic—the man who gunned down two Capitol police officers was himself saved by a U.S. Senator. A few, to my surprise, were even critical of my actions. Of course, I merely did what any doctor would have done. Let judges be judges; but let doctors be doctors. Our focus is to treat and heal, regardless of the circumstances. And that’s as it should be.

  ALTHOUGH I STARTED MY POLITICAL CAREER AS A NOVICE, I FOUND myself quickly climbing the political ladder and becoming better known to the American people through a series of events that were, for the most part, not of my making. For example, in 1997 and 1998, I worked with several fellow legislators and outstanding health-care experts to more fully understand the federal Medicare health program for seniors: its strengths, its shortcomings, and options for its reform. Many of the people I worked with through this process were influential players in federal health-care policy, and while the Clinton administration veered away from the more consumer-directed and patient-centered types of ideas we explored, these people and their progressive ideas would resurface a few years later in future health-care battles.

  On January 27, 2000, Senate Majority Leader Trent Lott asked me to present the Republican response to President Clinton’s 2000 State of the Union Address, along with Senator Susan Collins of Maine. Susan spoke about education and the economy; my job was to talk about health care, and in particular, to rebut the Clinton plan that at the time was strongly proposing much more government control of health care through thousands of new mandates and weighty new bureaucracies. The State of the Union responses by the party not in power are notable mostly for the criticisms the speakers receive from commentators afterward. Relatively few people want to watch a response by two Congress people taped hours before in a sterile office setting after an hour-long, choreographed speech by the president of the United States presented in the majestic House Chamber live before an adoring, enthusiastic audience of seven hundred cheering political figures. But I had fun putting my thoughts together, working with Susan, and going through the process.

  In Washington, success in the Senate meant not just success in policy. You also needed to be successful in politics.

  In the spring of 2000, I became cochairman of the Republican National Convention platform committee, a group of about 110 Republican activists from around the country charged with developing the official platform for the 2000 presidential campaign, describing our positions on the major issues of the day. Paul Coverdell, the junior senator from Georgia, had become Trent’s right-hand man in day-to-day Senate floor operations. He had also become the formal liaison between the Senate Republicans and the presidential campaign of Texas governor George W. Bush. Early on, the Bush people, all from Texas, weren’t comfortable with many of the Washington regulars. Surprising to most, in those days very few people in the Senate (or in all of Washington for that matter) had had much contact with Governor Bush. He had not been involved in affairs at a national level. Paul, not officially in elected Senate leadership, had become acquainted with the young George Bush years earlier when Paul had worked for President George H. W. Bush at an event at the Bush compound in Kennebunkport. When the campaign said they needed a point person in the Senate, Governor Bush said to go with Coverdell. In that capacity Paul each week in his office would pull together senators to meet with representatives of the campaign, making sure each senator had the opportunity to access them. Paul was the ultimate team player and was trusted by all. Paul tapped me to be his assistant in his capacity as Senate liaison for the Bush campaign.

  My selection to be platform cochair created a stir. The typical pattern over the years had been for the Senate Republican Policy Committee Chairman to fill this slot. But serving in that capacity at the time was Idaho senator Larry Craig, a well-liked senator viewed by many as rigidly conservative and seemingly dominated by the National Rifle Association, imagery the Bush folks were anxious to avoid in those early days. That I was selected effectively broke protocol.

  But then in mid-July, we were still on the Senate floor late one night when Paul mentioned to some of his staff that he had a splitting headache. Nobody thought much of it, since it had been a long, tension-filled day on the floor. Paul’s doctor resided in Atlanta and he would see him the next day. The following day Paul flew home, where shortly after arrival he suffered a massive cerebral hemorrhage, a type of bleeding brain aneurysm that threw him into a coma.

  He had been in the cath lab for diagnostic studies for several hours and was about to go into a second procedure when the family called me in Nashville for advice. Hours later I flew down to Georgia. I went straight to the hospital and was met by the hospital administrator, who walked me through a side door to avoid the press parked outside the front. After meeting with the family the neurologist took me down the hall to review the angiographic studies and the CT scans. The X-rays told the story: Paul had suffered irreversible brain injury from an abnormality that there was no way to prevent. Modern medicine had nothing more to offer.

  Lloyd Ogilvie, the Senate Chaplain and a close friend to Paul, arrived later that morning to be with the family. Lloyd played a powerful role in the spiritual and personal lives of so many in the Senate family. Later that night I returned to Washington knowing, as did Paul’s family, what the inevitable outcome would be. Paul clung to life for another two days, dying Tuesday evening, July 18, 2000. Word of his death came to many of my colleagues early the next morning as they were arriving for the weekly Senate prayer breakfast in the Capitol, which Paul had so loyally attended in his years in the Senate. The hour was spent memorializing the truly great man and friend to all, the individual who worked tirelessly behind the scenes to make sure that the legislative trains ran on time; the chair he had occupied in that small room on the ground floor of the Capitol for the past eight years of weekly fellowship gatherings would remain empty.

  When I received the news of his death on Tuesday night, I was on my way to the Washington Metropolitan Club for an organizational meeting of the Republican platform subcommittee chairs. As I stood in front of the fireplace in the dark paneled room on the second floor, I announced that Paul Coverdell had died the hour before. The audience, who knew of his commitment to the principles of the party and the platform being put together, was in shock. I remember explaining that his death reminded me of a transplant, the loss felt in one family and the hope felt by another, and that Coverdell’s vision and commitment to freedom and truth woul
d be incorporated in the platform document, like a beating heart.

  The fundamental challenge in working as a platform chairman was to give the delegates confidence that they owned the platform content and were controlling it, yet ensure that the candidate’s voice was given great weight. The most important element of the platform was to make sure no bad stories flowed out of the process, since the committee proceedings peaked just days before the kickoff of the convention. That was a first, second, and third objective. Bush advisor Karl Rove and campaign policy director Josh Bolten basically told platform executive director Mitch Bainwol, an experienced and highly respected political operative, that his job working with the platform cochairs was to make sure everything stayed under control, out of the media limelight, and in the background. In some ways, putting together the party’s platform can be an exercise in containment. For example, in San Diego, at the 1996 Republican National Convention, the prolife plank had become a sore spot with many people and created division among our own members that the media tried to use, with some success, to further divide us. We were intent on preventing a repeat performance.

  Under Mitch’s astute leadership, one of the most critical things we did in managing the platform process was to call every one of the delegates just after their appointments simply to listen to their ideas, to hear them out, and to pick their brains. Mitch assigned a third of the delegates to each of the cochairs. I took careful notes of each conversation. Through strategic exercises like this, day after day, Mitch and I really got to know and respect each other. We shared a focus on demanding an incredibly granular sense of the schedule, the strategy, the process, and the personalities.