Candidates’ Medical Records Lack Transparency

NYT’s Altman makes the most out of scant information

The New York Times’s Lawrence K. Altman, one of the few reporters in the this country who holds an M.D., has a long breakdown on the front page today of what is known about the four presidential and vice-presidential candidates’ current health. Actually, it’s more about what is unknown:

Fifteen days before the election, serious gaps remain in the public’s knowledge about the health of the presidential and vice-presidential nominees. The limited information provided by the candidates is a striking departure from recent campaigns, in which many candidates and their doctors were more forthcoming.

In past elections, the decisions of some candidates for the nation’s top elected offices to withhold health information turned out to have a significant impact after the information came to light. This year, the health issue carries extraordinary significance because two of the four nominees have survived potentially fatal medical problems that could recur.

I interviewed Altman in June, shortly after John McCain allowed a limited group of reporters—from which Altman was notably excluded—to view (but not photocopy or otherwise digitally record) over 1,000 pages of his medical records. Altman was allowed to take part in a teleconference with McCain’s doctors at the Mayo Clinic in Scottsdale, Arizona following the release, but New York Times reporters were prohibited from asking questions, and the call lasted only forty-five minutes rather than the promised two hours. When I asked Altman about the stonewalling, he replied, “They did not like the editorial that ran in early May—which I had nothing to do with—pointing out that [McCain] had passed his April deadline for issuing his medical records; we’d been trying to get them for over a year.”

Nonetheless, McCain seems to have been more forthcoming with information than the other candidates in the race and, appropriately, he received most of the attention in Altman’s piece today. Most importantly, Altman explains some conflicting opinion about the melanoma McCain had removed in 2000. Mayo Clinic doctors had reported that it was a primary, or new, melanoma and that none of four detected melanomas had spread. But two pathologists at the Armed Forces Institute of Pathology in Washington, after examining a biopsy of the melanoma, suggested that it had spread, or metastasized, from another melanoma—a much more worrisome opinion. Unfortunately, according to Altman’s article:

The Armed Forces pathologists did not speak in the teleconference in May 2008, and questions raised by their report have remained unanswered. The selected reporters did not ask about that report, and the Mayo Clinic doctors did not discuss it. A complete Mayo pathology report was apparently not included in the pool summary.

Obama’s lack of transparency about his medical is second only to that of Republican vice-presidential nominee Sarah Palin, who has refused to release any medical information or grant any interviews (personally or from her doctors). Last May, Obama’s campaign released an undated, single-page letter from his doctor in Chicago stating vaguely that he is in “excellent health.” According to Altman’s article:

Mr. Obama has had a notable medical problem: a difficulty in stopping smoking. It is not known how heavily he smoked. Dr. Scheiner wrote that Mr. Obama began smoking at least two decades ago and had made several efforts to stop. Mr. Obama has used Nicorette gum “with success,” Dr. Scheiner wrote, without defining success.

… Dr. Scheiner did not say when Mr. Obama had started using Nicorette, how much he had used or for how long he had used it. Reporters have often observed him chewing it.

Mr. Obama said he quit smoking in 2007 when he began his presidential campaign. But he has “bummed” cigarettes since then, he has said.

… Information about Mr. Obama’s smoking is relevant because studies show that the risk of cancer and other tobacco-related serious diseases declines after an individual stops smoking, but not until then.

Delaware Senator and Democratic vice-presidential nominee Joe Biden’s record on medical transparency seems to be somewhat similar to McCain’s insofar as he has released some troubling information and a complete, up-to-date picture is still missing. According the Altman’s article, “[He] had emergency surgery in 1988 for an aneurysm in an artery in his brain and elective surgery for a second one. His campaign released 49 pages of medical records to The New York Times late last week showing that he was healthy, but the documents did not indicate whether he had had a test in recent years to detect any new aneurysm.”

The first aneurysms kept Biden away from the Senate for seven months, according to Altman: “Now, a question arises: Has Mr. Biden developed a new aneurysm over the last two decades that could burst?” While Altman reports that Biden’s type of aneurysm was once thought to be a “once-in-a-lifetime event,” doctors now think it can recur. Although the likelihood of recurrence might still be low, Altman wrote:

Four leading neurosurgeons interviewed separately in this country and Europe said that as a vice-presidential nominee, Mr. Biden should have had recent brain imaging studies to detect any new aneurysm, because if one is found he might face more neurosurgery and be out of work for weeks or longer.

At any rate, the lack of transparency among all four candidates for the nation’s two highest offices is disturbing. Thankfully, Altman was undeterred and, perhaps coincidentally , his story was cast into even higher relief by one that appeared next to it on the Times’s front page. It was by Amy Harmon, who won the 2008 Pulitzer Prize for explanatory reporting for her stories about the privacy dilemmas surrounding DNA testing. Her story today focuses on the first ten volunteers in the “Personal Genome Project, a study at Harvard University Medical School aimed at challenging the conventional wisdom that the secrets of our genes are best kept to ourselves.”

Alas, our candidates are not so bold.

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Curtis Brainard writes on science and environment reporting. Follow him on Twitter @cbrainard.