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Doctor on Call

In an Independent exclusive, Senate Majority Leader Bill Frist talks about war, AIDS, the presidency and the man he knows better than anybody

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Here is a short story that Dr. Bill Frist, currently Washington's closest version of prime-time television's Martin Sheen, tells about his good friend, Dr. Ted Eastburn, who is currently running for mayor of Colorado Springs:

"I'm probably the only person in the world who has sat with him night after night from midnight until 5 in the morning at the bedside of patients, watching him hold the hand of a 16-year-old boy, scared to death because I was going to cut the fellow's heart out the next day and put a new one in, and to have Ted sit there next to his bed and hold his hand the whole night, and talk about the great life that he is going to be able to live once he goes through this operation ...

"I'm not sure how much of this Ted has stressed in his literature and that sort of thing."

Beginning in 1987, Frist, then a heart surgeon, and Eastburn, currently a city councilman and cardiologist, spent a profound four years of constant days and nights together, heading the creation of Vanderbilt University's heart transplant center in Nashville.

Eight years ago, after a lifetime of admittedly voting only sporadically, Frist's own heart turned to politics. Running for public office for the first time, he captivated voters in his home state of Tennessee, becoming the first doctor in the United States Senate in more than 50 years. His re-election two years ago was the biggest landslide Tennessee has seen in recent memory.

Last fall, Frist coordinated the Republican takeover of the Senate. Right after that, Trent Lott embarrassed the party, reminiscing at Sen. Strom Thurmond's 100th birthday party over the "good old days" of segregation, opining that "we wouldn't be in the mess we're in now" if things had only gone differently in 1948.

Frist moved right in. The fellow southerner masterminded Lott's ouster as Senate Majority Leader and seemingly eased into place as George W. Bush's go-to man, the person most trusted to guide the president's agenda in Congress.

Now, power players talk about Bill Frist as though he is some kind of Republican Supernova, the man that could, with surgical precision, carve his way right into the White House in 2008.

Frist's ascendancy is the stuff that could just as well be a Hollywood screenplay. Though he is as conservative as they come, he is respected across party lines, if for nothing simpler than being a nice guy, a gentleman.

He has hooked up with rock star Bono in a mutual obsession with obliterating the AIDS epidemic in Africa. At his 50th birthday party last year, Eastburn and 199 other friends gathered to represent and celebrate eras from Frist's five decades of life. Democratic Sen. Ted Kennedy sent along a videotape wishing Frist the very best.

The esteemed investigative reporter Willy Stern, of the Nashville Scene, reports that since Frist's ascendancy, journalists have descended on Tennessee, scouring the state for past missteps. The most they've found are Frist's self-admission of long-ago medical school experiments on cats (from his 1989 autobiography Transplant), a last-minute cancelled wedding in his youth, and his family connections to the for-profit Hospital Corporation of America.

In a recent exclusive Independent interview, the Senate Majority Leader took time amid a frenzied schedule -- "Washington last night, Florida this morning, New Jersey today, I'm in the middle of a lot of snow!" -- to talk about Iraq, terrorist cells, AIDS in Africa, the presidency, local control and the man he knows better than anyone.

Indy: You strongly supported the Senate resolution for war against Iraq last October, indicating that you saw Saddam Hussein and particularly the buildup of biological weapons as "a direct and deadly threat to the American people." As a former U.S. delegate to the United Nations, how can we improve our foreign policy in an effort to not alienate our allies in our plans for war against Iraq?

Frist: We have now the support of 18 nations in terms of our current action and current course in our war on terrorism, specifically with Iraq. We do have both Germany and France who are dragging their feet and it's not to be unexpected. I do not think we will win them over.

In terms of the [anti-war] protests around the world, that is not unusual. If you look at before World War II and you look at support even in America as late as 1940, the polls only had 17 percent of Americans saying "Lets go to war." [Now], people who don't want to go to war [are] people who don't understand the unprecedented nexus of weapons of mass destruction in the hands of a mass serial killer who is supporting terrorists both in his country and around the world. I expect that unless Saddam Hussein falls some way over the next three to four weeks, that military action will be taken. I don't want to go to war, the president does not want to go to war but ... Saddam Hussein [needs to be] disarmed and the American people at rest.

Indy: And what about the threat of the al Qaeda network and Osama bin Laden?

Frist: Well, we got six* of the top nine operatives in the al Qaeda network -- that's pretty impressive. They're either dead or in jail. I think Osama bin Laden's important, but we've got about 80 percent of the organization. We have shut down 150 phony charitable organizations. We have locked up the transfer of finances of the al Qaeda network and we've got 'em on the run. And as long as we've got 'em on the run and no money coming in, it's going to be hard for them to plan major terrorist attacks, so we've made huge progress there. We've got two more people to go, plus Osama bin Laden and then al Qaeda's dead.

*Note: Since this interview, Pakistani and CIA agents arrested Khalid Shaikh Mohammed, said to be a top al Qaeda leader and the alleged mastermind of the Sept. 11 attacks.

Indy: So the focus is still on al Qaeda as well as turning our attention to Iraq.

Frist: Oh yeah. And the resources are being prepared. The war on terrorism is a much bigger war then the war against Iraq. People focus on Iraq because we have to build up so many troops, but the war on terrorism is not geographically based. Success depends on what does not happen rather than [what] does happen.

It's not a decisive battle, it's going to be here with us for years and you approach [it threefold]: Number one, you disrupt them at work; number two, you lock up their finances; and number three, you protect our homeland here.

We've got terrorist groups and terrorist cells -- most of which are classified -- in our communities around the country that are terrorists trained to kill and to kill with weapons of mass destruction. They are in the United States and they take their cue from out of Iraq right now, but there could be other places as well.

As politicians, both Frist and Eastburn routinely evoke medical metaphors, often describing their turning to public service almost in Hippocratic terms. As the Senate Majority Leader, following Trent Lott's embarrassing comments as well as an extraordinary flexing by the far right within the Republican Party in recent years, Frist acknowledges the challenges to reclaim the middle.

Indy: How do you find those common bonds with people with whom you sometimes vigorously disagree with ideologically?

Frist: It really comes back to what we were talking about in the transplant world: It is cutting through most of the politics, cutting through the extreme partisanship, cutting through the rhetoric and going to the sort of conversation that one would have doctor to patient, or patient to doctor.

Therefore you'll see me working on HIV/AIDS in Africa much more so than the biggest bleeding-heart liberal out there. I'm the one who goes to Africa and I'm the one who works with the president to move in that direction and I deliver the money and I link prevention care and treatment, instead of just talking about it. So the team approach ... is to really look at a range of people, to recognize you're not going to agree with everybody, but to pull the very best out of them so the sum of the whole is much greater than the sum of the parts.

Indy: I'm in Colorado and not in Washington, but what I've observed at both the local level and the national level for the last several years is a pull by the far right within the Republican Party and a retreat from the big tent of the past. Obviously it's going to lie on your shoulders to help pull people of color and more moderates back into the party and convince them that this is still the party of the big tent.

Frist: Yeah, that's right. That's exactly right. There aren't many politicians who have taken the heart out of a young white guy and put it in a young black woman. You start by talking about racial issues and sort of think about the things in medicine, the objectivity of medicine and the compassion.

Indy: So just what is the role of a national political player in local politics?

Frist: Ninety percent of what I can do is not fulfilled in Washington, D.C., but it's fulfilled at the local level. The entire federal budget has my signature on it -- that's important.

But ultimately it has to reflect into what a Ted Eastburn, [for example], will do for quality of life issues there. It doesn't matter how much money I throw at the problem in Washington D.C. I'm going to pass the welfare bill and I'll write the welfare bill. But it can't be carried out without the appropriate partnerships at the local level. That's where the engine of public service actually is. The reality of what I do in Washington means almost nothing if it's not carried out by people of integrity, honesty and compassion at the local level.

I talked to Ted a few weeks ago, and I know that water is a huge issue out there. Can Bill Frist in Washington solve the whole drought issue? No. Yet I can set in place a large structure that will encourage and facilitate how it is solved at the local level. How things are carried out all depends on local officials.

Indy: The previous mayor of the city, Bob Isaac -- who has also been an inspiration to Dr. Eastburn -- was one of the original voices in raising hell, if you will, over federal mandates.

Frist: It really is killing people and health care. Mandates, if you translate it down into micromanagement, ties the hands of the local officials where they can't carry out even basic services and it goes all the way across the board.

Indy: Dr. Eastburn describes standing in your kitchen at 1 a.m. several years ago, pumping you about your decision to exit medicine at the peak of your medical career for public service. He indicates that in many ways his own foray into politics was inspired by you.

Frist: Ted and I have talked about public service and his participation at length and personally, because it's a huge major decision for him, as it was for me. I worked with Ted when he was doing transplant cardiology, which is dealing with life-or-death decisions on a daily basis. To do both well requires compassion. Both require careful listening; both require venturing into the unknown; both require accountability; both require boldness and courage; and both require a deep sense of humility that our own lives are governed not by coincidence but by our past experiences, and to some extent by providence.

Indy: Have you endorsed him formally?

Frist: No, you know, I don't even know who's running against him. He knows, with our friendship and my relationship with him, that I'm going to support him 100 percent with everything that I can possibly do in his efforts to be a great public servant. It's safe to say there [won't be] an endorsement in the political sense. [I haven't] studied all the issues and all of the candidates. It's an absolute endorsement of Ted in terms of his integrity, his compassion, his ability to lead, his ability to put together a team, his discipline and focus.

Indy: What are you planning to do to help Dr. Eastburn in his bid?

Frist: I thought I might be able to get out there, but I've not been able to, so we'll probably just talk to people and my involvement will really be a reflection on, 'I know this fella' better than anybody.'

Indy: This is supposed to be a nonpartisan race and in Colorado Springs that's always a bit of a joke because nearly every single elected office holder at all levels of government are avowed Republicans...

Frist: ... I wish it was that way in Tennessee ...

Indy: This year, all four Council members who are running for mayor of Colorado Springs term themselves as devoted Republicans. Some local Republican activists are backing another candidate in the race. What is the likelihood that you'll send them a message to back off from actively pushing one Republican over another?

Frist: Oh, not likely. I'm smart enough to know that in local politics its best to let the [candidates] make the best case and let the local politics determine outcomes.

Indy: Some have suggested that Dr. Eastburn would use this position as mayor as a steppingstone to higher office. Would you like to see him serving alongside you, or in the House of Representatives?

Frist: I have not talked to him about that. People, after serving in office -- if they're sensitive -- establish certain comfort levels. There are a number of people who are very comfortable in being mayor and that is it. Other people do that and do it well and after a period of four to eight years feel comfortable and say 'Well, now let's move to a different level.'

I'm not one who started with one office and then moved to the next office then the next one and then the next one.

Indy: Well yes, you jumped right to the top, to the United States Senate.

Frist: Yeah, well, I guess it's to the top, but to the top in people's minds. But this sort of steppingstone mentality is not one that I buy into initially.

Indy: Your own comfort level appears to be fairly solid. What are the chances that you are actually going to run for president yourself?

Frist: It's not a goal.

Indy: Are you ruling it out?

Frist: If you had asked me five years ago, 'Was my goal to be majority leader?' I'd say 'No'. If you'd asked me five years before that, 'Was my goal to even be in the United States Senate?' I would have said 'No, I'm a lung transplant surgeon.' If you'd asked me five years before that, 'Would you ever be a lung transplant surgeon?' I'd say 'No, lung transplants have not even been invented yet.' If you'd asked me five years before that, 'Would you ever want to be a heart surgeon?' I'd say 'No, I don't like the sight of blood,' and then I'd be back in medical school.

So I say all that because I have no earthly idea.

Indy: So I should call you back in five years and ask you where you're at?

Frist: Yeah. And seriously, most United States senators, in the back of their minds, would love to be president; it's just not a goal of mine, and I'm not sure I would love it. I love what I'm doing right now but I've got huge challenges right now. I'll probably be on a medical mission in Southern Sudan in eight years.

Indy: You have the reputation of being fairly to extremely conservative, depending on whom one talks to. Dr. Eastburn has positioned himself as more of a moderate. Do you agree on ideology and policy issues, or are you backing him because he's a friend?

Frist: There's a broad range both in the Republican Party and Democratic Party and [among] Independents in terms of the range of ideas that are a reflection of certain basic values. It's the values that I can speak to with Ted.

I'm pretty conservative. I'm a capitalist; I believe in individual self-worth and dignity; I'm not real big on dropping checks out of an airplane to benefit people to [hold] themselves up and I vote accordingly.

Indy: Amid the intensity of being at the center of national Republican Party leadership, at war with al Qaeda and at the brink of war with Iraq, do you know what happened to that 16-year-old boy, that former Vanderbilt patient whose heart you cut out and replaced 14 years ago?

Frist: Oh, yeah. He is still alive. Doing fine, by the way.

-- To read more about Sen. Frist's past, check out David Brooks' detailed Jan. 27 report in the Weekly Standard online at www.weeklystandard.com

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