April, 2016

Political Science

By Michael J. Katin, MD

It's that time again that comes around every four years, when the media tell us whom we should elect as the next President of the United States. This election is particularly critical, with the winner serving as the bridge between Obama 44 and Obama 46.

Every election time we in the oncology field need to assess which candidate would be most favorable to the cause of providing affordable and accessible cancer care. In 2008 there was only one candidate whose platform even once mentioned cancer: the Third Party, whose candidate was David Jon Sponheim. This column encouraged his support that year, , but, despite this endorsement, the groundswell did not materialize. It would seem nonproductive to again throw support to Mr. Sponheim (who is again a candidate ) but it still might be of interest to review any special relationships that certain of the candidates for 2016 have or had with the medical profession, including one with a very unexpected connection.

12. James S. Gilmore, III: former Governor of Virginia, and chair of the coincidentally named Gilmore Commission, otherwise known as the Congressional Advisory Panel to Assess Domestic Response Capabilities for Terrorism Involving Weapons of Mass Destruction: recommendations of this committee included the mechanism to reorganize medical resources in the event of a national emergency, presumably temporarily suspending Meaningful Use reporting requirements.

11. Mike Huckabee, former Governor of Arkansas: his wife, Janet Huckabee, as a newlywed 20-year-old, was diagnosed as having a tumor involving the spinal column and successfully treated with surgery and radiation therapy. He is also distinguished by the possibility that the nurse anesthetist present at his own birth might have been none other than Virginia Clinton Kelley, Bill Clinton's mother, who frequently worked with the obstetrician who delivered Governor Huckabee (clarification: he was not called Governor Huckabee at that time).

10. Bobby Jindal, Governor of Louisiana: was accepted to Harvard Medical School but turned it down in favor of becoming one of the least popular governors in Louisiana history (job approval rating of 20% ). However, he and his wife successfully delivered their third child at home while waiting for EMS to arrive.

9. Bernie Sanders, Senator from Vermont: noteworthy that his first wife, Deborah Shiling, is the daughter of the Chief of Pulmonary Disease at Sinai Hospital in Baltimore, Dr. Moses Shiling. To make things more complicated, she subsequently remarried and is now known as Deborah Messing and supports Senator Sanders for the nomination, unlike Debra Messing.

8. Rick Santorum, former Senator from Pennsylvania: he and his wife have been through innumerable medical interventions for their daughter, Isabella, , but it is less well known that his wife, Karen, sustained a spinal injury due to a "negligent chiropractic manipulation " and they diligently pursued a malpractice case against the chiropractor despite having been a major advocate for tort reform. It is to be noted that his mother was a nurse and his wife has worked as a neo-natal nurse.

7. Gary Johnson, former Governor of New Mexico: resigned as CEO of Cannabis Sativa, Inc. , a company dedicated to distributing medical marijuana products, when he began campaigning for the nomination of the Libertarian Party for President. He had used medical marijuana while recovering from severe injuries from a paragliding accident.

6. Rand Paul, MD, Senator from Kentucky: still practices ophthalmology, whereas it is not known whether Bashar al-Assad, President of Syria, had actually completed ophthalmology training and whether he maintains a medical practice. Dr. Paul had rebelled against the medical bureaucracy by setting up the National Board of Ophthalmology to compete with the American Board of Ophthalmology, although unsuccessfully. He is also distinguished by the fact that his father is a physician, and even more distinguished by the fact that both were in private practice! It could make one forget that Aqua Buddha thing.

5. Ben Carson, MD, retired Director of Pediatric Neurosurgery, author and Egyptologist: another physician who would have a different perspective on health care than would professional politicians. Extra points for having undergone treatment for carcinoma of the prostate, but deductions for having endorsed glyconutritional supplement Mannatech.

4. Martin O'Malley, former Governor of Maryland: promoted aggressive efforts to expand medical coverage in Maryland through the Maryland Health Care Reform Coordinating Council. He selected Anthony G. Brown as his running mate, and Lt. Governor Brown (highly decorated Iraq war veteran and Harvard Law School Graduate) was the co-chairman of that council as well as Maryland's Health Quality and Cost Council. Health Enterprise Zones were launched in 2013 to increase access to primary care providers in underserved areas. Despite all that, he gets more attention for being the founder and lead singer for the musical group, O'Malley's March

3. Hillary Rodham Clinton: former Secretary of State and Senator from New York: her father, Hugh Rodham, died following a stroke and her mother, Dorothy Howell Rodham, died from heart disease. Her mother-in-law, Virginia Clinton Kelley, a nurse anesthetist, passed away in 1994 from recurrent carcinoma of the breast. In 1999, her brothers, Hugh and Anthony, were involved in a company working to import hazelnuts from the Republic of Georgia. Despite that fact that hazelnuts are an excellent source of protein, fiber, thiamin, manganese, magnesium, calcium, iron, and vitamin E, this enterprise was unsuccessful. Mrs. Clinton's only medical problem has been a concussion in 2012, which occurred when she fainted due to dehydration related to a gastrointestinal virus acquired during a trip to Europe. This left her with a temporary period of decreased mental acuity, as opposed to the more chronic condition of most of the other candidates.

2. Carly Fiorina, former CEO of Hewlett-Packard: the most personally knowledgeable candidate regarding cancer treatment, as she is the only one who has undergone, surgery, chemotherapy, and radiation therapy. In addition, she and her husband were involved in multiple medical events involving her stepdaughter, who eventually succumbed from alcohol and drug addiction. She would probably be the best of all the candidates to be able to put things into perspective.

1. Donald J. Trump, businessman and university dean: the Donald, of all people, has two of the most remarkable medically-related pieces of information of all the candidates. A report of his health status included his having a PSA of 0.15 ng/ml, certainly a phenomenally low value for a 69-year-old male. The other amazing story involves his uncle, John J. Trump, Ph.D. Whenever we use a megavoltage unit to treat cancer with radiation therapy, we should remember that Dr. Trump was an engineer ahead of his time who worked with Robert J. Van de Graaff to create the first megavoltage accelerator, and who, while at MIT, was affiliated with the Radiology Department at the Lahey Clinic and Massachusetts General Hospital and was involved in the adaptation of megavoltage linear accelerators and electron beam for treatment of cancer and was even involved in the design of rotational techniques for radiation therapy. If he had acquired certain other characteristics of his distinguished family, we might all be treating patients on Trumpelators rather than linear accelerators.

BONUS: Paul Ryan declined to run for the Republican nomination or even to accept a draft, but it is to be noted that his grandfather, Adolph Hutter, was a distinguished cardiologist and his uncle, Adolph Matthew Hutter, is an equally distinguished cardiologist, practicing at Massachusetts General Hospital. This means that it might be worthwhile to check on uncles of politicians to determine if there is a trend, but also that when Speaker Ryan is accused of making decisions from the mind rather than from the heart, he can at least get a consultation within his family.

Emanuel Countdown: Dr. Ezekiel Emanuel's biographies list his birth year as 1957 but, interestingly, do not list a birth date. Giving him every benefit of the doubt, he will have his 75th birthday no later than December 31, 2032. Including April 1, 2016, this leaves 6,119 days to his goal.