New book by former vice president and his cardiologist chronicles his decades of health problems, resulting in a heart transplant last year.
WILSON, Wyo. —. Dick Cheney tools around town these days in his brand new Ford pickup, equipped with an extended cab and a hitch on the back bumper to pull his granddaughter's horse trailer.
Cheney himself comes equipped with a new heart.
Just three years ago, the former vice president was within hours of dying from heart failure, saved by urgent surgery to implant a left ventricular assist device with an external battery that kept him alive while he waited for a heart transplant. After 20 months, the call came late one night last year that he finally had reached the top of the organ list. There was a donor heart available for him.
Now, at age 72, he looks strikingly younger and more robust than he did when he left the White House and the public eye in 2009 — at that point struggling with more serious deterioration of his heart and health than was generally recognized at the time. "As I think about the future, I'm back where most people live their lives," he told USA TODAY in an extended interview about Heart: An American Medical Odyssey, a new book he co-authored with cardiologist Jonathan Reiner. "Which is death is not imminent, and that's different."
Cheney is many things to many people: The most powerful vice president in U.S. history. A hero for conservatives and villain for liberals. To this day and in this interview, a defender of the controversial "enhanced interrogation" of terror suspects and a critic of President Obama for policies he argues weaken the nation's security.
Add to that list medical phenom — and possibly the luckiest guy in the world.
He had the first of five heart attacks in 1978, when he was 37 and running in his first political campaign, for the Republican nomination for Wyoming's sole seat in the House of Representatives. Over the 35 years that followed, he has been saved from disability or death through a series of medical advancements in treating heart disease that often became widely available just at the time he needed them most.
"It's as though you got up in the morning at home and were late to work," Cheney says, quoting his doctor. "You jump in the car and head out for the office and every single stoplight is red. And he said, 'Cheney, when you got to it, they all turned green.' That's exactly what happened. When I needed an implantable defibrillator, I had it. When I needed stents, we had it. Cholesterol-lowering drugs, we had it."
He underwent quadruple bypass surgery in 1988 and, finally, the heart transplant in March 2012.
The intersection of Cheney's personal story with the history of cardiovascular medicine prompted Cheney and Reiner to collaborate on the book, being published Tuesday by Scribner. They have written alternating passages in which Cheney describes what was happening in his life while Reiner dissects the research that produced the medical breakthroughs.
"Whereas 30 years ago, 40 years ago, each of those red lights would have stopped somebody — either killed them or completely changed the arc of their lives — he was in the right place at the right time and maybe most important had the right temperament," Reiner said in an interview at his office, a few blocks down Pennsylvania Avenue from the White House. He is director of the cardiac catheterization lab at George Washington University Hospital and a professor at the medical school there. Cheney also benefited from the best of medical care, including constant monitoring by the White House medical office during his eight years as vice president.
Reiner describes the former vice president as a singular figure. "He has the longest history of heart disease of any of my patients," he says. "He has the most complex history in terms of how difficult his disease became, the most number of moving parts. And he happens to be Dick Cheney."
MELLOWED? NOT EXACTLY
Even in Wilson, 2,000 miles west of Washington, Cheney hasn't lost his interest in government and politics. He reads several national newspapers every day on his iPad and subscribes to print editions of The Economist and The Weekly Standard.
Ask him how President Obama is doing, and stand back.
Cheney was unsparing in his criticism of Obama early in the new president's tenure, and he says his assessment has only gotten worse since then — for his personal leadership, his political agenda and, especially, his handling of national security.
"His priorities are radically different from mine," Cheney says. "I'd put defense first and foremost. The Constitution and the oath of office, the first thing you need to be focused on is defending the nation. All the highway money, food stamps and education, and everything else we like having the government do, don't amount to a hill of beans compared to our inability to defend the nation."
Obama has defended the National Security Agency surveillance programs, expanded in the Bush-Cheney administration, that collect data about Americans' phone calls and e-mails. But, even with that, Cheney faults Obama for failing to quell the controversies about them.
"It has been, I think, poorly defended by the president because he doesn't have credibility on this issue, especially after controversies like the IRS and Benghazi," a reference to firestorms over Internal Revenue Service missteps and the administration's misleading explanation of a deadly attack in Libya. "People don't believe him and don't trust him. He's seen as a very weak reed to lean on in terms of defending that program."
Many of the disclosures have come through leaks by Edward Snowden, the former NSA contractor who has been granted asylum in Russia. "It's a serious, serious breach, certainly the most serious breach in my memory," Cheney says, calling Snowden "a traitor of the worst sort and I hope we're successful in capturing him."
And charge him with treason? "Absolutely."
Still, in some ways, the famously combative Cheney has mellowed.
He shows off with pride the spectacular view from windows that stretch two stories high in the great room of his home, located in a gated community near Jackson Hole, Wyo. He pads into the kitchen to brew a cup of coffee for a visitor.
In his cozy office, a fire crackling in the fireplace, he is more relaxed and at ease than he was in an interview two years earlier in his home in suburban Virginia pegged to the publication of his 2011 memoir, In My Time, a book that settled any number of political scores.
Over the previous weekend, he says, he had taken his 13-year-old granddaughter, Grace, and her horse, Cherokee, to compete in a barrel-riding contest in Rock Springs. She won her age division and a $55 prize, he brags.
And in August, when he and House Speaker John Boehner got together to fish, "we didn't talk politics," he says. "We just fished all day. No politics at all. Just two friends having a great time out on the river, and there's something to be said for that."
NO SPECIAL TREATMENT
Cheney bristles a bit at the suggestion that, as a wealthy and well-connected man, he might have sought or received preferential treatment in getting a new heart. "It's not true," he says.
Reiner concurs. "When he told me he had made the final decision he wanted the transplant, he said to me, 'I don't want any special accommodation; I'm going to wait my turn here,'" the doctor recalls. "I told him I completely agree and, by the way, there's no other way." Under the highly structured system that allocates organs, he says, "You can't get to the dean of admissions and say, 'Hey, how about it?'"
Cheney dedicates the book "to my family, my medical team, and the donor of my heart." He says he doesn't know who the donor was and hasn't sought to reach out to his family. He notes that he has long listed himself as an organ donor, pulling from his wallet a new Wyoming driver's license he had picked up just that morning to show the donor red-heart symbol in one corner.
On only one occasion did Cheney get special treatment.
In 2007, Reiner wanted to replace the implantable cardioverter defibrillator in Cheney's chest. The updated version could detect the onset of congestive heart failure, a feature that in an incident two years later would help save his life. But it also had a Wi-Fi feature that allowed the defibrillator to be reprogrammed remotely, without a device being placed directly on the patient's chest.
Reiner worried about hackers and terrorists. "I thought it didn't make a lot of sense for the vice president of the United States ... to have a device that someone in the next hotel room, someone downstairs, someone on the rope line, might get into and kill him." After confidential consultations, the manufacturer, Medtronic, agreed to produce a single special version of the defibrillator with the Wi-Fi feature deactivated.
Last year, Lynne Cheney phoned Reiner. "Did you see Homeland last night?" she asked, referring to Showtime's TV drama series. "The terrorists just killed the vice president by reprogramming his defibrillator!"
After the transplant, of course, Cheney no longer has the defibrillator or any of the other gear that had helped keep him alive for decades. With that surgery, the health problems that plagued his adulthood nearly vanished. Just about the only medical complaint he's left with is a bum knee.
"It's the only disease I'm aware of that you live with it for 35 years and it gets progressively worse; you get weaker and weaker, and the day comes that you do a transplant, and all that stuff goes away: the old heart, the LVAD, the pump that kept me going for 20 months, the stent, the implantable defibrillator, all that stuff," he says. "And all that's left to show that I was a heart patient was that scar on my chest."
What happened to his battered first heart, swollen to twice normal size by the time it was removed?
In the interview, Cheney said he didn't know. Reiner promised to find out. It was sent to the pathology department, he reported back later, where it was examined and sliced into sections. Slides were made for analysis. The heart had been labeled with an alias, to protect Cheney's privacy, and the pathologist probably didn't realize whose heart it was. Then, as is routine, it was destroyed and discarded.
After all, Cheney didn't need it any more.