Consider it the first foreign trip of Rand Paul’s presidential campaign. That’s not how the Kentucky senator characterized the six days he spent in Guatemala this week, most of them performing free eye surgeries in the small, impoverished city of Salama, but he didn’t need to.
The trip was marked by all of the trappings of a politician on the ascent. Paul was accompanied by his top political advisers, personal friends, his ad men, several reporters, and even by cameras from the conservative activist group Citizens United, which is in the process of filming a documentary about him. The senator and his aides were ferried from one location to another by an armored caravan and accompanied at all times by an armed security detail. Media reports were embargoed until he left the country mid-day Thursday.
Paul, who practiced ophthalmology in Bowling Green, Ky., before mounting his senatorial bid in 2010, has always cast himself as a doctor first and a politician second. Over the past four years, that calculation has clearly shifted, though Paul is loath to admit it.
“I don’t think it’s either or, that I do one or the other,” he says.
Americans have never elected a president with a medical degree, and Paul, who is fashioning himself as a new type of Republican, isn’t shy about the qualities he thinks a doctor would bring to the Oval Office. “I personally think that if we got rid of all the lawyers and replaced them with all the doctors our country would be much better off,” he says, sitting on an examination table and clad in medical scrubs, “because doctors are “problem-solvers who don’t get caught up in partisanship.”
Throughout the trip, the humanitarian work of skilled medical professionals intermingled with one doctor’s presidential ambitions. Paul spent most of his time Monday, Tuesday, and Wednesday at Salama’s Hospital de Ojos, or Hospital for Eyes, working with a team of eye surgeons — some of them world-renowned — affiliated with the University of Utah’s John A. Moran Eye Center. It’s not every day Moran receives a big check from Donald Trump, but a five-figure donation from the real-estate magnate, solicited by Paul, helped to cover the cost of the trip. A Trump spokeswoman says it was “an honor” for Trump to lend his support.
While performing surgeries, Paul popped in and out of the operating room to sit for media interviews. At one point, he joined five doctors outside the clinic as an unmanned drone hired by Citizens United for its documentary filmed them from above (see image below). The senator, who mounted a 13-hour filibuster in March over the Obama administration’s use of drones to target American citizens, didn’t protest this time.
As eye patches were removed from patients in the clinic’s waiting room, Wesley Kimbell, who is engaged to Paul’s niece, Lisa, nudged me to say, “Hey, I came up with a great slogan. Rand Paul 2016: A clear vision.”
Paul is consistently polling near the top of an amorphous field of potential GOP presidential nominees. Many consider him the front-runner for the party’s 2016 nomination, and while he spent this week doing charity work in a poor town and bunking in a less than luxurious setting, the likely Democratic nominee, Hillary Clinton, was vacationing in the glistening Hamptons. The Las Vegas Review Journal recently reported she demands transportation in a Gulfstream jet and accommodation in a presidential suite when she travels.
Paul’s focus in recent months has been on staking out his ground as a different sort of Republican — not a full-fledged libertarian like his father, former Texas representative and three-time presidential candidate Ron Paul, but certainly an alternative to the square, establishment choices who have gone down to electoral defeat in the past two presidential elections. Traveling to Guatemala to do humanitarian work in the midst of an immigration crisis in which tens of thousands of people, many of them Guatemalan, are flooding the U.S. border is one way to do that. As is the call he made, in a recent op-ed in Time magazine in response to the escalating violence in Ferguson, Mo., for the demilitarization of the police.
Over the three days Paul joined the Moran team at the hospital, patients and their families packed the small, dilapidated waiting room. Many had traveled hours for treatment. In Guatemala, blindness-inducing cataracts rarely seen in the United States and the rest of the developed world are common, the result of sun exposure, malnutrition, and limited access to medical care. These were difficult surgeries and, at times, the doctors themselves even seemed astonished by what they saw. On Monday afternoon, David Chang, a Palo Alto–based ophthalmologist and a world-renowned eye surgeon, emerged from the operating room holding a dark cataract on a swab of cotton. He’d just removed it from a patient’s eye in a single piece. About the size of a button on a dress shirt, it was easy even for a layperson to see how this could cause blindness.
“It’s been there for more than ten years,” he said, noting that in the U.S. he rarely sees a condition so far advanced but that, in Guatemala, 90 percent of the cases are “that bad.”
Many of the patients told stories like that of Maria Alvarez, 81, who had reached the clinic by bus with her daughter. A cataract in her left eye had left her almost blind. She complained that her eye was perpetually watery. Twenty four hours later, as a nurse removed the patch that was placed over her eye after surgery, her vision was restored. “May God in heaven bless you all,” she said, barely audible. “Thank God because we don’t have any money and we’re poor.” Her daughter held her hand.
There were also moments staged for reporters that went less smoothly. At Salama’s central hospital on Monday, where windows were barred, paint peeled off the walls, and around one corner a wheelchair fashioned out of a plastic deck chair sat empty, Paul examined patients in front of about a dozen cameras. A two-year-old suffering from a club foot, Kelvin David, was propped on the examination table for what may have been the world’s most uncomfortable doctor’s appointment.
Cameras flashed incessantly to capture the moment, and the boy cried. He and his mother are soon headed to Bowling Green for a year, where he will receive thorough treatment, though not from Paul. In the room in Salama, Paul couldn’t complete a basic medical examination, which would have required partially undressing the boy, and had to continue with a tour of the hospital.
Paul was also reunited with a pair of brothers, Juan and Andres Hernandez, now 29 and 22, respectively, whom he operated on as children. The brothers came to Bowling Green for treatment in 1999 through neurosurgeon Bill Schwank, who is based in the city but was born in Guatemala and, with his wife Judy, has for years helped to shuttle patients between the two countries for treatment. Though cataracts are rare in young people, both Hernandez boys suffered from them. To survive in their small village with limited vision, they’d memorized the number of steps it took them to reach a town well from their home. When Paul saw them this week in Salama, the cameras that filled the exam room crowded out their mother, who was pushed out the door.
Both brothers complained their vision was still limited. They were fitted for glasses, which did not alleviate the problem, and Paul concluded that, though operated on as children, their blindness had retarded the development of their brains and permanently impaired their vision despite the removal of their cataracts. There was nothing to be done.
As Paul gears up for a presidential bid, the trip offered a window into his political operation. It’s infused with a streak of libertarian outrageousness that reflects the senator’s own political beliefs. Reporters covering the trip received no itinerary, and each day’s events were something of a free-for-all. A Paul aide announced, at one point, “We’re small-government people, you know, to each his own.”
New Jersey governor Chris Christie, by contrast, who is leading a trade delegation to Mexico in early September, has a staffer carefully coordinating logistics, RSVPs, transportation, and hotel accommodations. There are already strict requirements in place for press attendees.
At one point on the Paul trip, a handful of reporters were left behind at a venue, unsure how they’d reach the next destination as Paul and his staff pulled away in an armored car. Some staffers seemed particularly to enjoy the tight security they were afforded in what is perhaps Central America’s most dangerous country.
The rambunctiousness has its charm. Paul has a small and tightknit inner circle, and they were by his side in Guatemala. In the eye hospital, his communications director, former Michele Bachmann aide Sergio Gor, donned full surgical gear and administered antibiotics to patients as their eye patches were removed, post surgery, with a cotton swab. His press secretary, Eleanor May, scrubbed in to assist with surgeries and removed bandages from patient’s eyes. When a four-month-old baby appeared with an infection in his left eye, Paul’s chief of staff, Doug Stafford, ventured a guess: A blocked tear duct was the cause of the problem. He was right. “Sergio’s dropping stuff in people’s eyes, I diagnosed the baby, we’re doing great,” he said as he looked on. The feel on the team is far more like that of the Obama campaign in 2007 and 2008, which was comprised of a small group of loyal aides, than of Clintonworld, which, made up of dozens of high-level strategists, was torn apart by infighting.
Paul’s media guru, Rex Elsass, was rarely without his trademark cigar. The senator calmly sipped bourbon and beer in the hotel’s open-air courtyard after hours and chatted freely with doctors, reporters, and friends. He took in traditional Mayan dancing one night and, on one morning, broke into an impromptu dance with his fellow surgeons at the hospital. “We gotta warm up the operating room,” said Roger Furlong, a Montana-based ophthalmologist.
“People want to be around him, they like being around him,” says Paul’s longtime friend Rob Porter, who accompanied him on the trip. Most members of the group, which reached 60 people at some points, seemed to share the sentiment.
Dr. Paul got strong medical reviews, too. Chang, the Palo Alto–based ophthalmologist, and Alan Crandall, a cataract and glaucoma expert based in Salt Lake City told me on separate occasions they were impressed by his performance in the operating room, particularly given the difficultly of the cases they saw this week.
The senator is already planning his next foreign trip: He says he’s looking to visit China next summer with the Moran team. “I’ve not been to Asia,” he says. While “a lot of politicians travel to meet the local dignitaries,” he says, “I can actually travel and do something beneficial and meet the government as well.”
The message resonates with David Bossie, the president and chairman of Citizens United, a significant financial force on the right. He says Paul’s trajectory, from M.D. to the Senate and now, almost certainly, to the presidential campaign trail in 2016, is reminiscent of the sort of citizen-politicians who founded the country. “It’s a little refreshing to find someone who doesn’t need to be in politics but wants to serve, and isn’t going to go through the Washington turnstile and become a lobbyist when he’s done because he has real skills and a real job,” Bossie says. (Nobody will mistake Paul for Mitt Romney, but, of course, the same could’ve been said of the GOP’s 2012 nominee.)
Between now and his trip to China next summer, Paul will continue to try to differentiate himself from his Republican rivals. The time in Guatemala certainly revealed another side of Rand Paul, and the senator seemed pleased with how it went. He fist-bumped this reporter on his way out of the country.
— Eliana Johnson is a national reporter for National Review Online.