A Heart to Serve

by Bill Frist

  These trips have a huge personal impact. Not only do they remind me of how lucky I am to be an American, with the opportunity to live a rewarding life in which I can develop my skills and interests to their fullest potential, they also keep me grounded in the nitty-gritty realities of life, including the oppressive challenges with which hundreds of millions of people have to grapple every day. Too often, well-intentioned policy makers and academic experts develop programs in isolation from the people they’re intended to serve. The result is wasted resources, problems that remain unsolved, and deepening cynicism about the inability of government or nonprofit organizations to make any real headway in coping with such issues as global poverty. Perhaps it would help matters if those charged with devising solutions had to spend a week or two every year working in a concrete-walled clinic in a remote region of Africa, without electricity, running water, or basic medical supplies. It helped give me perspective. At the very least, it would reinforce the urgency of the challenges we have to meet. It might also inject a much-needed note of realism into the plans and programs they create.

  My medical missions have helped me to see that a commitment to meeting the health-care needs of the world can be a vital part of American foreign diplomacy in the twenty-first century—for reasons both altruistic and selfish. We know all about hard power when it comes to international relations; it’s time we spend a lot more time and focus on soft power, including health diplomacy. Here’s a bit of what I wrote about the subject of health diplomacy in a 2008 article in the Yale Law and Policy Review:

  Why is health such a powerful and universal message of peace and goodwill? The answer lies in large part with the intimacy of one’s health, which touches everyone in a personal way.

  Health is a basic need, and the desire for good health is universal. Health holds a unique place in human relationships. The most important and powerful times in family relationships are those of failing health. And the most moving and seminal moments are those of healing and relief from affliction and pain. Healthcare delivery, whether vaccination or treatment for tuberculosis, is closely associated with trust.

  Health is the source of the most potent of forces in each human: the fear of death and the desire to preserve our own lives and the lives of those we love. Because health is so fundamental to all humans—of all nations, religions, races, and situations—healthcare communicates a remarkable message of understanding and human connection across all boundaries and thus provides a unique, heretofore under-applied, tool of diplomacy.

  Healing is an unmistakable and universal message of goodwill. It is the direct opposite of aggression and harm. The message and gestures of health and healing do not require explanation. The message is not encumbered by differences in language. And it does not rely on an abstract political concept of educated people to touch the lives of the poor and oppressed.

  Healing a sick person typically does not take years. I am reminded of the simple hernia repairs I completed at Lui Hospital in Sudan, procedures that take only an hour but are lifesaving in that particular region because of the high risk of fatal obstruction. The simple act builds trust.

  Moreover, sickness can be prevented. Twenty-eight thousand children die every day in the world, but two-thirds of those deaths are preventable with tools that today are proven and inexpensive. And that is fundamentally why public health diplomacy is today, more so than anytime in the past, ripe for use as a currency for peace. Curing the diseases of the world is not just about charity, it is about increasing cooperation and harmony in a global society.

  Using healthcare enlivens the diplomacy of inspiration rather than simply intimidation. You do not go to war with someone who has saved the life of your child. What a difference it would make if more people in the world found themselves saying, “The Americans helped heal our children.”

  The trust established through healing and the delivery of medicine and the understanding that comes from the one-to-one connections and person-to-person intimacy of medicine set the backdrop for peace and understanding. If we remove disease from our neighbor’s struggles, then our own security is bolstered. And through medicine, health, and saving lives, we secure a future with potentially fewer enemies with whom to struggle.

  Health diplomacy—built upon the compassion and generosity of those who employ it—helps undermine the support of the extremism and radicalism that is spreading so insidiously around the world. Medicine is a currency that overpowers division and hatred. It can foster peace and, as a by-product, radically change America’s position, credibility, and respect throughout the world.

  Yes, health can be a currency for peace. In the years to come, whatever else I do in my life, continuing to participate in and promote health diplomacy will certainly be high on my personal agenda. Even as it provides hope and comfort to others, it enriches my life and the lives of Karyn and the boys in ways that are difficult to quantify or explain—but that I know my own father with his simple and basic values would have understood and appreciated.

  SO AS I TURN THE PAGE ON MEDICINE AND POLITICS, I DO SO WITH a few final reflections. I continue to believe that our country needs citizen legislators, people who will come out of the private sector to serve for a season, bringing their particular expertise to bear on our problems, and then returning to everyday life to serve as ordinary citizens. I believe our government could be greatly strengthened by more citizen legislators and fewer career politicians, more people who understand what it takes to earn a dollar in the real world, and less who have lived off the public payroll for most of their careers. I believe we need more people who will refuse to accept the status quo as normative, whether it is in health care or K–12 education, and will aspirationally seek innovative solutions.

  My communications director Amy Call came into my Capitol office one day, upset and fretting over a computer problem we were experiencing in our communications office. The computer tech said that what we wanted to do was impossible. When Amy relayed his message to me, I replied, “Amy, don’t tell me it can’t be done. It can be done. Go tell them to figure out how.”

  Amy looked at me for a moment, turned on her heel, and went to find the computer guy. She relayed the message forcefully and with assurance: “Don’t say it can’t be done. It can be done. Figure out how.” And he did!

  That is a message for our nation. In every field, barriers exist where experts say, “It can’t be done.” It’s what I heard when I wanted to do heart transplants in Boston, and when I first decided to run as a doctor for the Senate. But from what I’ve witnessed, I’ve come to believe that in America almost anything can be done. We just need to figure out how to do it. We all need to find our Shumways, our Tommy Frists, our Howard Bakers, to inspire us to take on the next challenge.

  Holding office in America is not an end in itself—or at least it shouldn’t be. But it is one means of helping, an opportunity to serve. Helping people and giving hope, finding solutions to seemingly insurmountable problems, and making a real difference in the world brings an incredible amount of significance and value. It can be by working in a lab, donating a kidney, volunteering with the poor in Southeast Washington, or spending time reading to your daughter. It’s the passion to serve that counts. I’m so glad that I don’t need the U.S. Senate or any other office to bring meaning to my life. I’ve found an inexhaustible source of meaning in my love for Karyn, that woman I fell in love with the moment I first saw her in a clinics building at the MGH, my three boys who leave me proud each and every day, my faith in God, my friends, and hopefully in some of the things I’ve been able to accomplish along the way that makes others’ lives a little more fulfilling.

  For twelve years, I was defined by Washington standards, and during the last two years of my term, I was defined by some of my fellow senators and the press as a potential candidate for president. They tried to analyze everything I did by how that might play as a candidate. It was beyond the pale of their imaginations that anyone could do something in Washing
ton without political calculations.

  I understand that, but I choose to have a different formula. One of the unwritten rules of being majority leader is that you never take a piece of legislation to the Senate floor that you can’t pass, that you don’t know that you have the votes to win. But to me, it was worth it to bring certain issues to the floor whether we could win or not. I preferred to push something out there and bring some attention to the issue, even if we lost the vote. We did that with medical tort reform, which we lost time and time again, but it set the stage for state reform around the country. We did it with expanded school choice for children living in the District of Columbia. It pays to lead on principle even if you don’t always win.

  I’m often asked these days if a good man or woman can actually make a difference in government. While acknowledging the difficulties and all the negatives of public life, I always respond affirmatively. Good men and women must get involved with government; they must risk the humiliation and insults of running for public office, they must risk the potential of baseless investigations that strike at their integrity, they must risk public ridicule when they act to protect those with disability. It is vital that they do so.

  John Adams expressed it so well when his son showed an interest in seeking public office:

  Public business, my son, must always be done by somebody. It will be done by somebody or other. If wise men decline it, others will not; if honest men refuse it, others will not. A young man should weigh well his plans. Integrity should be preserved in all events, as essential to his happiness, through every stage of his existence. His first maxim then should be to place his honor out of reach of all men. In order to do this he must make it a rule never to become dependent on public employments for subsistence. Let him have a trade, a profession, a farm, a shop, something where he can honestly live, and then he may engage in public affairs, if invited, upon independent principles. My advice to my children is to maintain an independent character. 1

  I’d say something similar to Jonathan or Bryan or Harrison, my own sons, if they chose to enter public service. No, it is not easy; it is not lucrative—or at least, it should not be. But it is essential that good people get involved. As Dad so often said, “Good people beget good people.”

  Yes, of course, some men and women in American politics are more self-serving than they are public servants, but their isolated, poor examples should not denigrate all, nor impugn the entire system. Certainly these abominably selfish people bring disgrace on a noble and honorable means of serving our country, and demoralize many young men and women from wanting to become involved in pursuing public office, but we must not allow the improprieties or insincerities of some to tarnish the many truly great men and women who have given themselves tirelessly, often at great cost to themselves and to their families, to help improve our nation. And you mustn’t shirk the responsibility or shy away from the opportunity to serve your country in whatever way you can. Kid Rock shows you don’t have to be a politician to serve and celebrate the greatness of America. As Dr. Martin Luther King, Jr., put it: “Everyone can be great…because anyone can serve. You only need a heart full of grace, a soul generated by love.” America is worth working hard to maintain; our nation has always been and will always be a risky venture; but it is worth it.

  America desperately needs innovative solutions to seemingly insurmountable problems; we can find them and we can implement them. In my life and yours, let’s commit to serve others—in healing, in politics, in faith, in education, and in charitable work. We all have a duty to do so. God will help us, as we each manifest a heart to serve.

  ACKNOWLEDGMENTS

  A Heart to Serve has been a long time in the making. The initial concept was to tell a story of service. It evolved into a call to action for each of us to discover our own passions and channel them toward service. The one constant from the outset has been fellow Nashvillian, writer and friend, Ken Abraham, who has traveled with our family literally around the world and interviewed hundreds of individuals to accurately capture and depict the nuances of serving others. To him I am deeply indebted.

  “I promise this is the last draft.” The words ring hollow to Karyn who lovingly tolerated not only my time spent writing this work but the thousands of nights away doing transplants, doing surgery in Africa, or addressing the interests of Tennesseans while in the Senate.

  Many people gave generously of their time, energy, and advice to make this volume possible. Dad’s “good people beget good people” philosophy leads me to begin with my selfless Senate and political staff, whose interviews and conversations enriched this work: Emily Reynolds, Mark Tipps, Linus Catignani, Bart VerHulst, Amy Call, Dean Rosen, Mitch Bainwol, Dawn Perkerson, Liz Hall, David Schiappa, Sue Ramthun, Marty Gold, Allen Hicks, Brandi White, Alex Vogel, Lee Rawls, Eric Ueland, Gus Puryear, Ken Bernard, Nick Smith, Mark Esper, Michael Miller, Andy Olson, Allen Moore, Meredith (Medley) and David Broome, Graham Wells, Ginny Wolfe, Rob Hoppin, and Kate Linkous, and so many more to whom I will be eternally grateful.

  Special heartfelt thanks goes to Matt Lehigh, my former press aid then executive assistant as we transitioned from Senate life back to Nashville. And, of course, not a day went by in the Senate that I wasn’t given marching orders by my right-hand assistant and longest serving staffer Ramona Lessen, the glue to the Senate Frist team. To all the other staff who made it all happen, thank you for your service to America.

  The Sudan chapter and all of my subsequent work in HIV globally rests principally on the shoulders of my African traveling companions: the remarkable surgeon whose Christian faith and commitment to healing continues to inspire me daily, Dr. Dick Furman; his best friend and leader of Samaritans Purse, Franklin Graham; and on the ground and in the bush, Kenny Isaacs and Scott Hughett, who taught me safety and survival—and how to give anonymously. And I thank, for her contributions to the book but also for her commitment to the underserved around the world, Jenny Dyer, who brings hope around the world by overseeing our foundation, Hope Through Healing Hands.

  The book would not have been possible without the indirect participation of my brothers and sisters who indelibly colored the pages on family and values. Cole and Corinne Barfield both traveled to Lui, Sudan, and both today dedicate their professional lives to service through healing; Dad would be proud.

  I remain deeply grateful for the support over the years by Tom Nesbitt and John Gibson, both of whom I have known since the first grade, both of whom are doctors, and both of whom provided fond recollections that I had long forgotten. I want to thank Dr. Karl VanDevender and Dr. David Charles for their input and joining me on medical trips to Africa and Russia, and my former collaborator Charlie Phillips for his notes from the transplant years. To jog my memory along the way were Jean Ann and Barry Banker, Denise and Steve Smith., Ed O’Lear, and Tracy Frazier.

  I owe a deep debt of gratitude to photographer Farris Poole who shot the cover transplant shot; over a five-year period Farris dramatically documented my seemingly whimsical journey from transplant surgeon to Senator. Photographers John Howser from Vanderbilt and Steve Starr with Samaritans Purse dramatically captured the emotions of the moment of transplantation and humanitarian work in Africa.

  It all began with the incomparable advisor, agent, and friend to all, attorney Bob Barnett, who introduced me to the dynamic publishing team at the Hachette Book Group’s Center Street imprint, led by Rolf Zettersten. I have deep appreciation for the diligence and enthusiasm of his colleagues, including Whitney Luken, Katie Schaber, David Palmer, Shanon Stowe, Chris Murphy, and Pamela Clements. To the entire team at Center Street/ Hachette Book Group, your professionalism is deeply appreciated. I owe a deep debt of gratitude for preparation of the manuscript to Chris Walker, Christi Gibbs, Ellen Williams, and Lee Barfield, and to Karl Weber who made valuable editorial contributions that helped shape the final draft. And especially to Jane Lynch Crain, who has done it all for me: policy, politics, fundraising, charity work, expert writing—
and now masterful assistance in editing a manuscript that had to be artistically shaped and condensed from a work originally four times longer in length.

  That’s the tip of the iceberg. To all the others I have not mentioned but who have participated invaluably with your stories, your experiences, and your generosity, a big thanks from me.

  And most importantly, Karyn and the boys. My family has been the inspiration for service; they have given me unwavering support for all of the days away in medicine, in politics, and in humanitarian work. To Karyn, Bryan, Jonathan, and Harrison, I dedicate this book.

  NOTES

  11. Unexpected Storm

  1. Washington Week with Gwen Ifill & National Journal, December 6, 2002; http://www.pbs.org/weta/washingtonweek/transcripts/transcript021206.html.

  2. National Journal magazine; www.nationaljournal.com/pubs/almanac/2006/people/tn/tns1.htm.

  3. Transcripts, The White House, Office of the Press Secretary, December 12, 2002; www.whitehouse.gov/new/releases/2002/12/20021212-3.html.

  4. Ibid.

  5. Senator John Warner, interviewed by Margaret Warner, News Hour Special Report: Weekly Political Wrap Archive; December 20, 2002. Online News Hour: Stepping Aside; December 20, 2002; www.pbs.org/newshour/bb/politics/j.

  12. Getting It Done

  1. Reported by Jonathan Karl, CNN, Inside Politics, January 7, 2002, reported at 4:00 P.M. EST. Cable News Network; CNN.com; http://Transcripts.CNN.com/TRANSCRIPTS/0301/07/ip.00.html.

  13. When Push Comes to Shove

  1. Jonathan M. Katz, “Senator Sold Stock Before Price Dropped; Shares Fell Two Weeks Later,” Associated Press, September 21, 2005, p. A 03.