Consensus Builder to Take the Helm

As he prepares to become the next Senate majority leader, Bill Frist is on the cusp of another milestone in a second career that some believe may include a run for the White House in 2008.

“Fristy” to his ally President Bush, the heart-and-lung transplant surgeon-turned-senator from Tennessee had already been mentioned as a possible secretary of the new Department of Homeland Security, a future party leader in the Senate, even Bush’s running mate in 2004.

Not bad for a man who didn’t bother to vote until age 34.

The 51-seat Senate Republican majority will find in Frist a consensus builder. Like Bush, he presents himself as a “compassionate conservative.”

For years, this scion of a wealthy Tennessee family has spent portions of his congressional vacations performing free surgeries all over Africa, sometimes under flashlights.

But Frist’s unassuming, straight-arrow persona belies a sharply partisan streak that surfaces during election campaigns -- as Democratic Senate candidates discovered this fall.

As head of the National Republican Senatorial Committee, Frist, 50 years old and two years into his second term, engineered the party’s recapture of the Senate last month by raising more than $100 million and waging a hard-hitting ad campaign that exploited Southern Democrats’ opposition to the display of the Confederate flag.

William H. Frist is a fourth-generation Tennessean and the first physician to serve in the Senate since 1928.

He learned to pilot a plane as a teenager and soloed for the first time at age 16.

His father, Thomas Frist Sr., was a cardiologist who in 1968 founded the Hospital Corp. of America, now known as HCA, the nation’s largest chain of for-profit hospitals.

According to the congressional newspaper Roll Call, with personal wealth of about $20 million, the senator is in ninth place in the Senate’s roll of millionaires, just behind Edward M. Kennedy (D-Mass.).

As a source of wealth, HCA could prove politically nettlesome down the road as Frist comes under increased scrutiny.

After a lengthy federal investigation, the company pleaded guilty in 2000 to charges of large-scale Medicare fraud, and agreed to pay more than $880 million in fines and restitution.

Frist, who never worked at HCA, was untouched by the investigation. But his Senate financial disclosure forms indicate that he, his wife and their children hold millions of dollars in HCA stock.

Frist and his wife have also held smaller investments in other health-related companies, the disclosure forms show. And during his time in the Senate, he has accepted more than $1.8 million in campaign contributions from health-care and related industries, according to data compiled by campaign finance expert Dwight L. Morris.

Frist has rejected suggestions that because of his investments he recuse himself from health-care legislation. He has argued, instead, that the Senate benefits from his expertise. The Senate Ethics Committee ruled that he was not required to divest his health-related holdings.

But if Frist becomes majority leader, “he’s going to get a level of scrutiny that he’s not used to,” congressional scholar Norman Ornstein said.

And health issues could prove a minefield for him, Ornstein added. “Any large for-profit health-care company is going to have lots of things -- that cut costs, for example -- that people won’t like,” he said.

Frist, one of five children, earned his bachelor’s degree from Princeton.

“He was one of those students who would come up after class to discuss things you had mentioned,” recalled Uwe Reinhardt, a Princeton University economist.

“He always had a keen interest in policy and clearly was interested in becoming a policymaker even in those days,” Reinhardt recalled Friday.

Frist earned his medical degree from Harvard. As a student, he adopted stray cats from Boston-area shelters -- and then dissected them. He later confessed that it had been “a heinous and dishonest thing to do.”

Much of what is known about Frist’s life before his 1994 election to the Senate derives from his 1989 autobiography, “Transplant: A Heart Surgeon’s Account of the Life-and-Death Dramas of the New Medicine.”

After postgraduate training at Stanford University, at Massachusetts General Hospital in Boston, and in the United Kingdom, Frist returned to his native Tennessee.

There, he taught at Vanderbilt University and founded the school’s transplant center; he performed more than 200 organ transplants.

Frist told an interviewer for the Hospitals & Health Network that he had not voted earlier in life because “I didn’t realize ... how significant the impact of an individual could be.”

In his bid for political office, Frist upset James R. Sasser, a three-term Democratic incumbent, by a 14-percentage-point margin. Frist spent $3.7 million of his own fortune campaigning.

He arrived in Congress as a citizen-legislator, having vowed to serve only two terms. That pledge now looms as a big question mark over his political future because his second term ends in January 2007.

“His pledge was unequivocal,” said William Lyons, a political science professor at the University of Tennessee.

But given his impending ascension to Senate majority leader, Frist could probably get away with changing his mind without serious consequences, Lyons said. “I think the people of Tennessee would not hold him to that,” he said.

In the Senate, Frist quickly became a leader on health issues, from prescription drug coverage and legislation protecting patients’ rights to anthrax and smallpox vaccinations.

“He has proven to be very adept personally and a quick study,” Lyons said. “He’s somebody who’s exceeded just about everybody’s expectations, and he continues to surprise people.”

But AIDS activists have criticized Frist for not fighting for more funding to combat the disease. Consumer groups have chided him for siding with a Bush-backed version of a patient’s bill of rights that would limit consumers’ ability to sue providers.

Although the Senate’s moderate Republicans on Friday hailed Frist’s impending ascension, his voting record is quite consistently conservative.

For instance, Frist -- like Sen. Trent Lott of Mississippi -- received a failing record from the National Assn. for the Advancement of Colored People on 37 key votes during the congressional session that ended last month. He also voted against an amendment to make it easier to investigate and prosecute hate crimes.

His record is generally antiabortion, though he has made exceptions for rape, incest and protecting the mother’s life. But some antiabortion activists say he does not go far enough.

“Frist projects a moderate image, but he’s very conservative,” one top Democratic Senate aide said.

Frist also was criticized from the right on Friday. Paul M. Weyrich, head of the Free Congress Foundation, described him as “not somebody conservatives would be comfortable with.”

Frist, who keeps a white lab coat and an emergency doctor’s bag in his office, also has put his medical expertise to more immediate use. On numerous occasions, he has provided emergency treatment to colleagues and tourists alike.

In 1995, Frist helped a heart attack victim who had collapsed in the Dirksen Senate Office Building. Performing CPR, Frist was able to restore the man’s normal heart rhythm. The patient -- who turned out to be a Tennessee voter -- survived.

Frist is known for often getting by on just four or five hours of sleep. Aides can recall countless e-mails from him that were composed in the dead of night.

Frist was quite chubby when he arrived in Washington. But he quickly regained his fitness and in recent years has run half a dozen marathons.

“He’s not fast, but he runs a long way,” said Rep. Zach Wamp (R-Tenn.). Wamp said Friday he will never forget a Frist speech at the 2001 National Prayer Breakfast in which Frist spoke of holding in his hands a beating heart and “the gift of life.”

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(BEGIN TEXT OF INFOBOX)

William H. Frist

Background

Born: Feb. 22, 1952, in Nashville

Education: Graduated from Princeton, 1974; graduated from Harvard Medical School, 1978.

Occupation: Heart and lung transplant surgeon 1978-94; started heart and lung transplant program, Vanderbilt University Medical Center, in 1986

Political experience: Elected as a Republican to the U.S. Senate in 1994; reelected in 2000; chairman, National Republican Senatorial Committee (2001-). Serves on the Budget, Foreign Relations, and Health, Education, Labor and Pensions committees.

Family: Wife and three children

Key votes

How Frist voted in 2002:

Farm Bill -- N

Fuel Economy Standards -- Y

Campaign Finance -- N

Federal Election Standards -- Y

Energy Plan/ANWR -- Y

Fast Track Trade Procedures -- Y

Extending the 2001 Tax Cut -- Y

Terrorism Insurance -- Y

Corporate Regulation -- Y

Medicare Prescription Coverage -- N

Independent Sept. 11 Comm. -- Y

Homeland Security -- N

Use of Force against Iraq -- Y

Sources: U.S. Senate; Congressional Quarterly

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Times staff writers Lisa Getter and Judy Pasternak, and researcher Robert Patrick contributed to this report.