the observatory

How Are You Feeling?

Healthy candidates, tired reporters
June 9, 2008

Two weeks ago, Fox News asked me to fly out to Phoenix and join a group of nineteen journalists to review more than 1,100 pages of Senator John McCain’s medical records, stretching back over the past fifteen years.

It was supposed to be a tightly controlled process, with the pool of reporters given only three hours to make notes on the documents without Xeroxing or removing any of them. Yet by the time we arrived in Phoenix, they had already been leaked, and I knew that there were would be no major secrets. But after a night spent looking out over the miner-red hills, thriving cacti, and deep purple mountains in the Arizona distance, I joined the others at a long oval table in a room, just off the Copperwynd Resort restaurant at 7:30 a.m. the following morning.

To my left, two scribes from an unknown publication recorded every lab value from McCain’s records without seeming to comprehend what they signified. They sat scrunched over, staring red-eyed at the papers, seeming tired. But these medical reporters didn’t seem nearly as tired as the political reporters who were following the campaign and entered and exited the room at regular intervals. I suspected that some of these reporters might actually be in worse shape than the man whose medical life lay before us.

In my daily life as an internist, I am familiar with patient records, and I quickly learned here that McCain was close to his ideal weight at 74 kg, his blood pressure was normal, and he had had a recent stress test and echocardiogram of the heart in March that were entirely normal. He had had six skin cancers, including four melanomas, all superficial except for one in 2000. The initial biopsy report on that had suggested the possibility of local spread, but the surgical records that followed clearly showed that wasn’t the case. He had had thirty-five lymph nodes removed, all negative, extensive plastic surgery to rebuild his face after the two-by-two centimeter melanoma had been removed. Now, eight years later, his chance of no recurrence approached 95%. His dermatologist screened him carefully every few months.

McCain took frequent walks and though he is a former smoker, he hasn’t smoked in over twenty-five years. He was being treated for high cholesterol (his most recent total cholesterol was 192 with an LDL (“bad”) cholesterol of 123, and he could probably use a higher dose of his cholesterol-lowering medication (Simvastatin). Recently, McCain’s internist had raised the dose of his diuretic, ostensibly to prevent a recurrence of his kidney stones. His blood pressure on the diuretic was normal. He had occasional bouts of vertigo, and I could tell by his kidney numbers that the diuretic might be drying him out slightly.

This was no big story here. As with Senator Barack Obama, whose Illinois doctor recently released a letter attesting to his good health, there there were no major health problems. The reporters were the real story—the twenty of us journalistic scavengers poring over the inert documents stacked in neat piles for our review—our stress level and physical sacrifices made on behalf of “the story”

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McCain was essentially healthy. But as I walked out to the parking lot to watch one of my own network’s top reporters downing one Red Bull after another to go with his cigarettes and compensating for a lack of sleep that no amount of pancake make-up could cover, and as I returned again bleary-eyed to the piles of papers for one last half hour stint, I couldn’t help but wonder, were we half as healthy as McCain? I was more worried about my unshaven field producer who had arrived from the west coast at 4 a.m., had a drink but hadn’t eaten, had slept two hours and was now back at work, than I was about any of the candidates.

I am a physician but I routinely sleep less than six hours per night and I rarely eat my meals on time if at all. I often rise early in the morning to respond quickly to health stories and do my research. But compared to the reporters I often work with, who jet around the country without knowing where or if they will sleep and have drinks instead of dinner, I am the picture of a healthy lifestyle. What about you?

Marc Siegel is an internist and associate professor of medicine at the New York University School of Medicine. He also writes the Unreal World column for the Los Angeles Times health section and is a Fox News medical contributor.