Cheney Doesn’t Have the Heart to Serve as VP

For the good of his heart, his family and a nation aware that heart disease is the major killer, Dick Cheney should resign before he is officially inaugurated as vice president.

Early in the morning of Nov. 22, Cheney awoke with chest pain and sensed that he was experiencing another “cardiac event.” Hours later, he underwent cardiac catheterization, coronary arteriography, angioplastic dilatation of the diagonal branch of the left anterior descending coronary artery and the placement of a metal tube, or stent, in his artery to help keep it open. His physician later announced that he had suffered a “mild” heart attack.

The stented branch, which supplies blood to the muscle of the main pumping chamber of the heart, was about 90% to 95% narrowed. Cheney was placed on blood-thinning medication to decrease the likelihood of clots in the stent.

Cheney now has had four heart attacks, with disease in five coronary branches. Even with bypass surgery, his outlook is significantly worse than that of a 59-year-old with no coronary heart disease. The likelihood of another heart attack, with or without a concurrent arrhythmia, is greater.

A number of questions have not been answered: Have Cheney’s bypass grafts narrowed since his 1988 operation? Has his blood pressure been elevated (an important risk factor)? How overweight is he? What prescription drugs does he take?

We do know that he has required cholesterol-lowering drugs; that his “ejection fraction”--the percentage of blood that leaves the heart during each contraction--is 20% to 30% lower than normal; that his heart muscle was damaged by the previous heart attacks, and that additional muscle tissue has been injured, as shown by his elevated blood enzymes. These medical problems are grounds for serious worry.

Cheney was under enormous pressure when his heart attack occurred. The vice presidency in the 21st century is an operationally intensive job. Stress can only accelerate coming cardiac events. Numerous studies have shown that heart disease and heart attacks are associated with varying degrees of depression and impaired thinking. Such changes may harm concentration, memory, analytic ability--qualities that make for good decision-making.

Cheney’s doctors have given him a “clean bill of health” and declared that he could resume “normal activities.” This has meant, in fact, joining the bitter battle in Florida over vote-counting and presenting the public voice of the Bush-Cheney team.

Far more important, Cheney has been pulled directly into what may be the most stressful part of a presidency, the transition. He is deeply involved in supervising the process for initiating policy, selecting the Cabinet, recruiting personnel, reviewing the budget and shaping the conduct of foreign affairs. Assuming Bush takes office, Cheney’s role will include overseeing selection for the nearly 100 positions at the deputy and undersecretary ranks and an equal number of positions at the assistant secretary level, not to mention the thousands of other positions needed to fill out the government. And all of this in a shortened time period.

If Cheney resigns before Dec. 18--the date the electoral college meets--the Republican National Committee, with the approval of George W. Bush, can choose a substitute without further delay.

Four presidents have been assassinated while in office. In the last 100 years, there have been at least 10 attempts on a president’s life. It is certainly within the realm of possibility that Cheney might be called upon to be president, or to act as president should the president become temporarily disabled by sudden illness, accident or attack. If Cheney were to assume these duties, only a “stent” might separate him from the most severe heart attack he has yet suffered.