The White House Doctor My Patients Were Presidents: A Memoir

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  • Edition: 1st
  • Format: Hardcover
  • Copyright: 2010-06-22
  • Publisher: Thomas Dunne Books
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Dr. Mariano served as the White House physician for nine years under Presidents George H.W. Bush, Bill Clinton, and George W. Bush. Here, she offers readers a glimpse into life behind the White House doors.

Author Biography

DR. Connie Mariano is a board-certified general internist and a retired Navy Rear Admiral who served as White House physician from 1992 to 2001. When she retired after twenty-four years of active duty in the Navy in 2001, she joined the Mayo Clinic in Scottsdale, Arizona. In 2005 she established her own medical concierge practice, the Center for Executive Medicine, in Scottsdale, where she currently takes care of more than three hundred corporate presidents and their families. Dr. Mariano is a frequent speaker in the national media on executive/VIP medicine, the history of presidential medical care, and the Twenty-fifth Amendment

Table of Contents

Acknowledgmentsp. ix
Forewordp. xiii
Sweet Dreamsp. 1
Destined for Dutyp. 13
The Steward's Daughterp. 26
The President Will See You Nowp. 43
One of the Guysp. 60
The New Face of the White Housep. 72
Change Is Our Friendp. 85
The Presidential Road Showp. 103
Life in the Kill Zonep. 122
The King and Ip. 135
The White House Bag Ladyp. 156
The House of Sorrowp. 174
Rough Seas Aheadp. 191
Eye of the Stormp. 208
It Takes a Villagep. 223
My First Familyp. 244
A Star Is Wornp. 260
Doctor's Progress Notesp. 278
Table of Contents provided by Ingram. All Rights Reserved.


Sweet Dreams
I never slept with the president. I did sleep with the former president. In fact, I slept with three of them, all at once, on Air Force One. Actually, it was more like a slumber party, which sounds even more bizarre. This all started on a very typical White House day that ended up as anything but typical.
“Hey, Doc, we’ve got a tourist down in the State Dining Room.”
I looked up from my computer on the mahogany desk in my office on the ground floor of the White House. The tall dark-haired man standing in my doorway was a Uniformed Division officer of the Secret Ser vice. I recognized the guard’s face, but his first name escaped me. Even after seven years at the White House, I couldn’t remember the names of all the guards who sat in a post outside my office, the doctor’s office, across the hallway from the president’s private elevator.
“Do you want me to call over to the clinic for the duty nurse to respond?” he asked tentatively.
I stood up, clipped my Secret Ser vice radio to my belt, and inserted my earpiece as I walked around the desk, grabbing the AED, the automated external defibrillator, and my medical bag along the way. “He can back me up, but presidents, visiting dignitaries, kitchen help, and . . . tourists get the same treatment.”
Taking care of an ill or injured tourist is one of the first duties a White House physician assumes, even before meeting the first patient, the president of the United States. It was one of the first things I learned to do after arriving at the White House in 1992 as the Navy physician to the White House. It wasn’t the first time I had taken care of someone who had passed out. Years of working as a Navy doctor in emergency rooms, clinics, teaching hospitals, and onboard a destroyer tender in the Pacific made me an expert in critical care. What was special this time was the setting: the grandeur and elegance of the State Dining Room of the White House.
Please don’t let anyone die on my watch, I prayed as we rapidly ascended the marble staircase to the State Floor. The medical bag and defibrillator I was carrying were quite heavy. This was going to be my workout for the day: stair climbing and lifting medical bags. No chance for a run on the Mall. I was scheduled to leave in one hour with the president and first lady for an overseas trip.
I entered the State Dining Room where the line of tourists weaves its way from one end of the room to the other. A gold cordon separates them from the formal dining table in the center of the room, resplendent with a large floral centerpiece, with the chandeliers glittering overhead. The fallen tourist was an elderly, frail woman sitting in a chair in the corner of the room. A woman guard stood beside her. The Secret Ser vice first-aid and trauma—FAT—kit was already on the scene, and the guard was waiting for my cue to administer oxygen. I squatted down beside the woman, looking at her eye to eye. She was approximately eighty years old, wearing glasses, hearing aids, and was sweating profusely. I took her hand in mine and squeezed it gently. It was cold and clammy. My index and third fingers planted themselves on her radial pulse, which was rapid and strong, not thready. I began my routine.
“Hello, ma’am. I’m the White House doctor. How are you feeling?”
She looked at me and blinked. “Are you the nurse?” she drawled. Her voice was soft, sweet, and fresh from West Virginia.
I smiled. “No, ma’am. I’m the doctor, and I’m here to help you. Are you having any chest pain?”
She squinted behind her glasses. “You’re not the nurse?” She examined me closely, trying to comprehend how someone who looks like Connie Chung could be a White House doctor. I suppressed the urge to tell her, “Welcome to the Clinton White House,” as I wrapped a blood pressure cuff around her arm.
“Ma’am, are you a diabetic?” I asked as I pumped the blood pressure cuff.
“No, no diabetes.”
Her blood pressure was 110/60 and her pulse was 80 and regular. Respirations were 20, unlabored. I looked up to a woman in her fifties standing behind the chair, who had identified herself as the daughter of the elderly tourist. “Does your mother take any medications for blood pressure, diabetes, or heart disease?”
She shook her head. “No. No medications at all.”
“What happened to her this morning?” I asked.
“She was so excited about coming to see the White House that she skipped breakfast. Then we waited in line for an hour. By the time we got upstairs, she said she was sleepy and then she broke out in a sweat.”
I looked at the guard and before I could say “OJ please,” a White House usher had brought a glass of fresh orange juice on a silver tray.
“Ma’am, we’re going to give you a sip of orange juice, okay?”
She nodded, accepting the glass and drinking it quickly. She patted her lips with a napkin the usher had handed her. She then noticed the embossed gold presidential seal on the napkin, and placed it surreptitiously in her pocket.
By now the White House nurse on duty had arrived. It was tall, brown-haired, all-American Jim Hosack carrying his medical bag. He hunched down beside me, looking guilty, and confessed in a hushed tone, “Sorry, Captain, I was delayed. We were swamped in the clinic.”
“I think our patient is going to be okay,” I reassured him. “She’s a little hypoglycemic. Blood pressure and pulse are stable. I’m going to turn her over to you.”
Suddenly, my radio blared—I had taken out my earpiece to attend to my patient. “All points on Oscar . . . Eagle moving . . .” Eagle was the Secret Ser vice code name for President Bill Clinton. Oscar was the name of the Secret Ser vice frequency. The voice was one of the president’s agents reporting Bill Clinton’s movements on the White House compound.
Jim looked up at me. “The funeral?”
I nodded. Jim tentatively asked, “With all the presidents?” I smiled. I could see intimidation in his eyes. That was why I was taking Vince Starks, the senior White House nurse, with me. He understood: they were just patients. As I walked away, I could hear Jim introduce himself to our elderly patient.
“Oh, so you’re the doctor?”
As I hurried back to my office, I checked my watch. It was twenty minutes before we were to lift from the South Lawn on Marine One. The helicopter had not even arrived. Then I heard over my radio, “Eagle moving.” “Eagle moving” meant Eagle was on the move, going somewhere. But where? “Eagle moving to the residence,” someone said over the radio, as though he had heard my question.
I now heard the muffled sound of Marine One’s rotors as it touched down on the South Lawn. My ride had arrived. The he licop ter would shortly take the president to Andrews Air Force Base. He was preparing to depart the White House and I, his physician, was to accompany him. As I approached my office, I asked the Secret Ser vice agents across the hallway near the president’s elevator, “What gives? Are we going early?” They smiled and shrugged their shoulders; so much for Secret Ser vice intelligence.
I stepped into my office, wondering how soon before we would depart to Andrews. The president could be upstairs for a minute or he could decide to leave in an hour. The Secret Ser vice doesn’t know. How could I have not predicted that President Clinton would be true to form: predictably unpredictable!
But I had my own spy network: the president’s Filipino valets. I went to my computer and text-paged Master Chief Joe Fama, one of the president’s valets, with the message, “When is departure? Doc M.”
No sooner had I struck the send key when my phone rang. I picked it up and it was Joe: “Doc, POTUS wants to leave in ten minutes,” he announced, from POTUS’s (President of the United States) lips to Joe’s ears. The president’s valet was among the most trusted and reliable of sources. Everyone at the White House knew it. Even Ken Starr knew it.
I walked out into the hallway, grinning like Socks the cat because I now had something that everyone on the eighteen acres of the White House coveted: the scoop. The military aide on duty had just arrived in the hallway now. We called him (or her) the “mil aide.” One is assigned each day to follow the president and carries the black briefcase called the “football” that contains the nuclear codes.
The mil aide on duty today would also be accompanying the president on our overseas trip. He was in full dress uniform, perspiring and breathing rapidly. The military aide was not cool; he didn’t have the scoop. I walked over to him. He greeted me formally, “Hello, Captain Mariano.”
I smiled back and tested him. “Any word about departure?”
He wiped his brow with a white handkerchief and then answered, “No, ma’am.”
“Oh,” I remarked. “The president’s valet just called me and said that POTUS wants to leave in ten minutes.” The mil aide’s mood brightened when he realized that I had just given him the scoop. You’ve got to have the scoop to be in the loop. And being in the loop is something military aides crave.
“Per the valet, POTUS wants to depart in ten minutes,” he announced into his radio with an air of authority. The Secret Ser vice, White House communications, Marine One pi lots, and military personnel who monitor the Secret Ser vice frequency heard the announcement. The Secret Ser vice agents standing in the hallway beside us gave the mil aide the thumbs-up. The approval went to his sweaty head, and he began to strut around like he was the man. Then he caught himself as he saw me observing him. He whispered to me, avoiding eye contact, “Uh, thanks, ma’am.”
“Don’t mention it, Major,” I whispered back to him knowingly.
“Eagle and Evergreen. South Lawn,” reported the SAIC, the president’s special agent in charge, into his sleeve microphone as President and Mrs. Clinton stepped from the Diplomatic Reception Room onto the South Lawn. They were greeted by a thousand points of light from the camera crews positioned on the west side of the South Portico. I trailed behind them, trying to be invisible as I gingerly stepped onto the moist green lawn. Stay out of the shot and don’t trip, I reminded myself. Stay out of the picture is what we are told on day one of our arrival at the White House. The commandment handed down from the White House Military Office is: Thou shalt be invisible. It was an easy edict for me to follow. Growing up as the Filipino daughter of a Navy steward, invisibility was embedded in my DNA.
The rear hatch of Marine One closed with a loud thump. I took my seat on the cushioned bench opposite the hatch, wrapping my woolen navy blue coat around me, shivering. The SAIC sat in the jump seat across from me. He slid on the headphones that allowed him to talk with the Marine One pi lots in the cockpit. Looking in my direction, the SAIC must’ve noticed me bundled up in my coat. “Doc’s cold back here. Can you turn up the heat?” he asked the pi lots. In a minute, the compartment began to heat up as we lifted from the South Lawn.
I looked toward the front of the helicopter at the president and first lady. They sat facing each other in royal blue cloth seats each bearing the presidential seal, reading their respective briefing materials. The president’s personal aide and the national security advisor were on the opposite bench, each reviewing the trip books that outline the president’s itinerary. I gazed out the window as Marine One lifted from the South Lawn. It was twilight now, and the red lights from the top of the Washington Monument blinked in a pulselike beat. As Marine One banked south, we flew close enough that I could almost touch it. I realized how very few people had the privilege of seeing this structure so close in the air and from the presidential helicopter no less. A sense of awe and appreciation overcame me as the helicopter made its way across the Tidal Basin.
I gazed out onto the Potomac as we flew toward Andrews Air Force Base. I thought about how quickly this trip had been scheduled and arranged. King Hussein of Jordan had just died and as it’s often said at the White House: you die, we fly. This meant Air Force One was prepared to fly the president to the state funeral in Amman, Jordan. Onboard the presidential aircraft would be President and Mrs. Clinton, senior White House staff, State Department officers, Secret Ser vice, White House press, and members of my White House Medical Unit. This journey was particularly special because of three additional passengers: the former presidents George H. W. Bush, Jimmy Carter, and Gerald Ford. I was looking forward to seeing President George Bush, who had been my first “first patient” when I arrived at the White House in 1992. I had also previously met President Carter during one of President Clinton’s trips. And I had dined with President Ford at a symposium at Wake Forest University a few years ago.
Fifteen minutes after leaving the White House, Marine One touched down at Andrews. President and Mrs. Clinton departed the helicopter from the front steps. The camera crew on the tarmac filmed the arrival and the president’s dignified stroll to the 747’s steps. Meanwhile, at the back of the helicopter, two Filipino valets, Fred Sanchez and Lito Bautista, were off-loading the president’s and first lady’s luggage. As I lugged my medical bag, defibrillator, and briefcase off the chopper, I patted Fred and Lito on the back. They smiled at me. I evaded the camera lens as I briskly walked toward the rear steps of the plane.
I loved Air Force One, which had become my home away from the White House. As I moved forward toward the medical compartment at the front of the plane, I passed the press section and waved to the seated White House press corps reporters; several waved back. One reporter asked, “Hey, Doc, can we drink the water over there?”
“Bottled water and plenty of it,” I advised him.
I walked past the compartment where the Secret Ser vice detail sat and noticed an agent had fallen asleep in his chair even before we had taken off. This hastily arranged overseas trip had everybody working late hours, especially the Secret Ser vice. But once we were airborne, they would at least get a ten-hour break. Some sooner than others.
In the next compartment that manifested the White House staff, one of the advance office staffers asked me for a sleeping pill. I advised her to see me in the medical compartment during the flight. As I passed each compartment, I reviewed the passenger manifest in my mind. All the people onboard were also potential patients for me.
When I reached the medical compartment, Timmy Kerwin, the chief flight attendant, stepped over. Cheerful in his blue vest with flight wings insignia and his name engraved in gold on the front, he was youthful in appearance despite his twenty-five-plus years in the Air Force.
“Hello, Doc. We got everybody onboard, including the three presidents. They’re in the senior staff compartment.” He nodded to the next compartment down from us.
“Where are they going to sleep?” I asked. I knew that beds were at a premium on Air Force One. There were two beds in the president’s cabin in the forward compartment. The only other decent beds were here in medical, two single-mattress bunk racks folded into the wall. These were designed to fold out for a patient who needed to be monitored or treated. If there were no patients, I would usually sleep in one of them on long trips. But I was willing to surrender my bunk bed to a former leader of the free world.
Timmy responded, “I’ve manifested the three presidents in the senior staff compartment.”
This space held three large-size reclining passenger seats. These leather chairs were comfortable but did not allow the passenger to lie flat. As I tried to visualize our distinguished guests trying to sleep in these seats, Timmy proudly added, “I also got three brand-new sleeping bags from Wal mart just in case.”
The image of a presidential slumber party on the floor of the senior staff compartment jarred me. “Timmy, I can’t imagine them lying on the floor in sleeping bags. Say I’m offering them the two bunk racks and the reclining chair in the medical compartment.”
Timmy smiled and ran off to inform the presidents of this invitation.
As I stepped inside, I was met by a tall, handsome African American man in scrubs. Navy Lieutenant Vince Starks greeted me with a tired “Good evening, ma’am. I got the blood in the belly of the plane.” For overseas trips, the White House Medical Unit carried several units of blood reserved for the president and first lady in the case of a medical emergency. This was stored in portable containers in the belly of the aircraft during flight.
Vince Starks, the senior White House nurse out of six, was the most experienced in terms of training and length of White House duty. Because of the short notice and our special passengers, I wanted Vince to assist me in case of an emergency in the air or in Amman.
“Get ready for some overnight visitors,” I announced, as I put away my medical bag and sat down in the seat across from him.
“Let me guess,” he said, smiling, his pearly white teeth contrasted against his ebony skin. “They all respond to the same first name: Mr. President.”
“You got it.” I nodded. “So let’s make it special.”
Vince leaped into action, folding out the two racks from the wall, and getting pillows and sheets to cover the thin mattresses. As an added touch, we prepared three place cards, each labeled “Mr. President” under the presidential seal. Like a five-star hotel concierge, Vince placed the name cards, along with a mint, on each of the pillows and in the seat across from mine. As an intensive care nurse prior to his assignment at the White House, I’m sure that Vince never imagined his duties would one day include bed preparation.
As we readied the compartment for our evening guests, Timmy had visited the three former presidents, telling them of the “doc’s offer” to sleep on bunks in the medical space. The offer was greeted enthusiastically by all. The first president to enter was Jimmy Carter. He arrived smiling, his bright eyes twinkling, looking relaxed in a jogging suit. A former naval officer, he greeted me by requesting to “come aboard” the compartment. I offered him the first pick of the two racks or the reclining chair. President Carter went directly to the bottom rack and sat on the edge. He grinned and proclaimed, “Just like onboard a submarine.”
“Sweet dreams, Mr. President,” I said. I caught myself using the same bedtime “nighty-night” tone reserved for my children on those rare occasions when I was home to put them to bed.
Excerpted from The White House Doctor by Dr. Connie Mariano.
Copyright © 2010 by Dr. Connie Mariano.
Published in 2010 by Thomas Dunne Books St. Martin’s Press.
All rights reserved. This work is protected under copyright laws and reproduction is strictly prohibited. Permission to reproduce the material in any manner or medium must be secured from the Publisher.

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