Magazine | March 10, 2014, Issue

State of the Art

Heart: An American Medical Odyssey, by Dick Cheney and Jonathan Reiner, M.D., with Liz Cheney (Scribner, 352 pp, $28)

‘You’re not sure what is happening, but somehow, in a visceral way you can’t articulate, you know that it is not good. At first, the symptoms were subtle. Maybe you awoke not feeling right; you might have had some of these symptoms yesterday, but you’re not really sure when it began. You thought it might be indigestion because you’re a bit nauseated, and you took some antacid a little while ago, but the discomfort hasn’t eased. Now you’re feeling something in your shoulder and chest, and your left arm is tingling. Someone tells you that you look pale, and you realize that your shirt is drenched even though it is not warm in the room. You’re asked if you are having chest pain, and you say no, it’s not a pain, it’s more like a pressure or maybe a tightness. When you try to describe what you’re feeling, you subconsciously place a clenched fist over your chest. You have the sense that if you could manage to burp, you would feel better, but you can’t, and to make matters worse, you’re a little short of breath.

“You don’t know it yet, but a blood clot, smaller than a pencil’s eraser, is forming inside one of your coronary arteries, and if it is not dealt with quickly, it can kill you.”

This is about as good a description of a heart attack as can be imagined by anyone who has not, in fact, had one, the confusing, conflicting symptoms perfectly set forth. And no wonder: It’s written by Dr. Jonathan Reiner, director of the cardiac-catheterization laboratory at George Washington University Hospital in Washington, D.C., and one of the nation’s top cardiologists. He is the co-author of this riveting true-life medical thriller, in collaboration with the country’s most famous heart patient, former vice president Dick Cheney, and with Liz Cheney, the ex-veep’s daughter.

They say that if you survive your first heart attack, your long-term survival chances are good. Dick Cheney’s heart history proves that maxim five times over. Cheney will go into the books as either a political hero or a villain, depending on who’s writing the history; scholars and partisans can and will argue about that for decades. But it’s his history as a heart patient — he suffered his first heart attack in 1978, and had four more after that before his heart completely gave out — that deserves prolonged, nonpartisan scrutiny. For Cheney’s lethal coronary-artery disease and his perils-of-Pauline heart, perhaps uniquely in modern medical history, have been consistently outpaced by discoveries and improvements in medical technology, each one appearing just when he needed it most, right up to his successful and so far complication-free heart transplant in 2012.

#page#Heart is written in alternating sections, taking us through Cheney’s entire cardio history, as seen through the eyes of both the patient and the doctor. Much of Cheney’s personal story will be familiar to those who read his 2011 memoir, In My Time, a well-written, dispassionate, and fluent account of his many years in public service as a congressman from Wyoming, White House chief of staff under Gerald Ford, secretary of defense under George H. W. Bush, and vice president in the George W. Bush administration; were the man a Democrat, he’d be celebrated by the media as a selfless patriot with a “compelling personal narrative” of overcoming the worst kind of physical adversity. As Reiner notes of his controversial patient, “My father used to say that it’s one thing to have a disease, but quite another to let the disease have you. . . . [Cheney] managed to live an extraordinarily full life despite having had to live with an extraordinarily aggressive disease for a very long time.” Aside from one delightful shot at John McCain, however, this book is as apolitical as possible.

The real interest here is Reiner’s contribution, a lucid and jargon-free recounting of the history of heart surgery, from something once deemed impossible to a commonplace procedure today. The advances made in the treatment of cardiovascular disease, including bypass surgery, drugs, angioplasty, medicated stents, defibrillators, VADs (ventricular assist devices), and transplantation: Cheney’s had them all. It is astounding to think that, as recently as President Eisenhower’s 1955 heart attack at the age of 65, the standard course of treatment — assuming one survived the initial infarction — was essentially bed rest and prayer. Writes Reiner: “Eisenhower’s case illuminates the standard of care for a heart attack at midcentury. For the first eight decades of the 20th century, the standard therapy for a heart attack mostly involved bed rest and pain control, usually with morphine, palliative treatments intended to keep the patient quiet and comfortable in the hope that no further catastrophe would befall the damaged heart.”

Now, just over half a century later, hope is no longer the principal option, and a heart attack is not a sentence to prolonged invalidity and death. True, heart disease — an unsexy killer — is still the leading cause of death in the U.S. for both men and women, killing about 600,000 people annually; according to the Centers for Disease Control, one in every four deaths is attributable to coronary causes. And yet, as Cheney’s epic medical saga proves, one can live a long and productive life in spite of it all.

I know. Four years ago, while I was on business in Washington, D.C., a heart attack hit me at 3 a.m. in my hotel room near Dupont Circle. At first, I had no idea what was happening: Pressure in the chest, check; tingling in the left arm, check; nausea, check. Heart attack? Impossible. It had to be indigestion, or an old ulcer acting up. I suffered with it for six hours before finally calling a doctor, who advised me to get to the hospital as fast as possible. A short time later, I was on the gurney, being rushed into the catheterization lab at G. W. University Hospital. As I was being prepped, one of the medical staff told me I was a lucky man, that the doctor on call was Dick Cheney’s personal heart doctor. Five minutes later, Dr. Jon Reiner introduced himself to me and went to work.

Take it from one who knows: If you have a heart, then Heart is for you.

– Mr. Walsh is a journalist, novelist, and screenwriter, and a regular contributor to National Review Online. Writing as “David Kahane,” he is the author of Rules for Radical Conservatives: Beating the Left at Its Own Game to Take Back America.

In This Issue


Politics & Policy

A Campus Apart

Hillsdale, Mich. — ‘There are some closet liberals here,” a student tells me. The phrase makes my blood run a little cold. I have known lots of closet conservatives, on ...


Books, Arts & Manners

Politics & Policy

Roots of Hatred

In Islamic societies, Jews are still widely thought of as people of bad character who cannot help engaging in criminal conspiracy. Muslims are advised several times in their canonical writings ...
Politics & Policy

The Force of Law

American conservatives are split into two main camps on the issue of judicial enforcement of the Constitution. One, exemplified by the work of the late Robert Bork, believes our system ...
Politics & Policy

Save the Next Generation

Everyone — certainly every reader of National Review — knows America’s public schools are a disgrace. He or she also knows that, barring a few elite institutions such as Harvard, ...


Politics & Policy


¿Cómo se dice ‘homonym’? I assure you that I share your contempt for the Affordable Care Act, but one of your criticisms of the Spanish-language site is undeserved (The Week, February ...
Politics & Policy

The Week

‐ John Kerry says that climate change is a weapon of mass destruction. We assume that means that he will support a war against it, then bug out after a ...

Bridge to Nowhere

Imagine a progressively inclined cable-news consumer running through the channels, sneering at the offerings. Fox: a massacre of Venezuelan protesters — damned CIA, up to their old tricks. CNN: An ...
The Long View

A Professional Correspondence

Wilson & Sterling A professional corporation IN RE: CLINTON/CLINTON CONTINUATION-OF-MARRIAGE AGREEMENT 2000, AND ADDENDA, UPDATED JUNE 2012, CODICIL AND FURTHER ITEMS FOR DISCUSSION Dear Steve: Many thanks for the phone call yesterday. It clarified ...
Politics & Policy


THE SCENT OF APPLES As one comes upon the last days of autumn, after the long rain that brings down the old leaves, the sky dark, and brooding, the harvest in, and its moon, ...
Happy Warrior

Where the Action Is

People keep asking me whom I favor for the 2016 Republican nomination. I politely demur — and not just because it’s almost three years till Election Day, and at this ...

Most Popular


If Amy Wax Is Wrong, Let’s See the Data

Regarding the kerfuffle Jason Richwine addressed here earlier, the economist Glenn Loury has posted an impassioned plea to his Facebook page. Loury, you may recall, hosts the video blog where Wax made her controversial claim that black students at Penn Law School rarely graduate in the top half of the ... Read More
Politics & Policy

San Francisco Bans Fur Sales

San Francisco has banned the sale of fur. From the CBS-SF story: San Francisco has become the first major U.S. city to ban the sale of fur clothing and products. Tuesday, the Board of Supervisors unanimously approved a measure that prohibits the sale of fur clothes, accessories, even souvenirs in stores and ... Read More

For the First Time in Weeks, Relief Sweeps over Austin

Making the click-through worthwhile: The Austin bomber is done in by one of his own devices; some new numbers suggest that a small but significant portion of Trump voters are tiring of the chaos and aren’t showing up to support other Republicans in 2018; and the mixed news for conservatives coming out of the ... Read More

The Baleful Effect of #MeToo on Campus

Remember the series of hurricanes that pounded the Caribbean last summer? Something like that has been occurring on college campuses, as they're hit by one destructive mania after another: diversity, Title IX, anti-speech protests. Now it's the #MeToo Movement. In this Martin Center article, British academic ... Read More
Politics & Policy

A Time for Choosing

This year’s Conservative Political Action Conference was controversial. Invitations to European nationalist populists such as Nigel Farage and Marion Maréchal-Le Pen (the niece of Marine Le Pen) caused many longtime conservatives to question whether they still belong to the conservative movement. Vocal critics ... Read More