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Vice President Cheney's health has long been a source of concern, given his heart problems. And now there are suggestions that the condition of President Bush's heart might be a cause for concern. We are not dabbling in hypotheticals here or metaphors about his initial stinted response to the tsunami disaster. I draw your attention to a riveting report by C.L. Hallmark, run just before Christmas by Indymedia, Houston (http://houston.indymedia.org/
news/2004/12/35839.php
).

Using file photos, Hallmark demonstrates, convincingly, in my view, that George W. Bush "is wearing a medical device for 'persons at risk of cardiac arrest.' It is a LifeVest wearable defibrillator. He started using it sometime after his January 2002 fainting spell, which was attributed to choking." This was the notorious pretzel incident, when said pretzel lodged in Bush's throat, thus stimulating the vagus nerve to send a signal to his heart, slowing it down and reducing blood flow so much he passed out, according to White House physician Col. Richard J. Tubb, M.D.

"Based on photos showing him wearing the device," Hallmark goes on, "one can conclude the fainting was due to atrial fibrillation, which his father also had. His father's AF was caused by Graves' hyperthyroidism, which Barbara Bush also has. Bush Jr. likely has AF and, less likely, Graves', based on his family history and symptoms. The AF may have caused a stroke or TIA (mini-stroke), of which physicians watching the debates detected symptoms. Observers have noted psychological symptoms consistent with this and with Wernicke-Korsakoff disease ."

When the monitor detects a life-threatening heart arrhythmia, it sends a signal to a small module on Bush's belt that can activate a sequence whereby the defibrillator connected to the monitor sends an electrical pulse to the large "shocking electrode" on the Bush's back between his shoulder blades (visible in outline in photos of the president in the second and third debates, and thought by some to be a W/T interface with Karl Rove) and a smaller one on the chest. The pulse can be repeated until the heart starts pumping blood effectively, up to five pulses.

Hallmark explains that "in the January 2002 pretzel-choking episode, according to President Bush, the period of unconsciousness was brief -- a few seconds. When fainting begins and ends suddenly, the cause of fainting usually is not what his doctors reported (vaso-vagal syncope) but instead is an abnormal heart rhythm such as atrial fibrillation (AF). Chronic AF is consistent with Mr. Bush's requirement for constant monitoring and immediate access to defibrillation. Atrial fibrillation can lead to disastrous consequences The LifeVest the president wears terminates ventricular fibrillation or ventricular tachycardia (overspeed) to prevent sudden cardiac death. This may be the reason the president wore the device during the debates, even though he risked exposing his vulnerability, especially if the device alarm sounded."

President Bush's father had the same problem. Jogging at Camp David on a Saturday afternoon (May 4, 1991), Bush Sr. developed shortness of breath, chest tightness and a general feeling of fatigue. A White House physician discovered Bush had a rapid irregular heartbeat, ultimately diagnosed as atrial fibrillation caused by Graves' disease, a form of hyperthyroidism (overactive thyroid).

The earliest photo of President Bush wearing the LifeVest, Hallmark says, was one taken in August 2002. He probably started wearing the LifeVest between the January 2002 pretzel incident and this. The most likely time would seem to be after his June 28, 2002 colonoscopy, for which he was put under anesthesia at Camp David, Md. -- that is, sometime in July 2002.

Has Bush had a stroke? Hallmark says carefully, "The evidence of a stroke or TIA (transient ischemic attack) is less strong. It is symptomatic and based on observation-at-a-distance -- TV appearances and news reports -- but it is there."

After watching the third presidential debate, Dr. W. Kendall Tongier, an anesthesiologist for 15 years, posted on the Dallas Morning News Web site a note about his concerns that the president may have had a stroke. His post said:

"As a physician and a professor, I tend to pick up on signs and symptoms of physical problems better than most other people. I am highly concerned with what I saw. The drooping left side of the president's face, his mouth and nasolabial fold (the crease in the face running from the nostril to the side of mouth) may be indicative of a recent stroke, TIA (transient ischemic attack) or, possibly, Botox injections.

But I'd like to see the Bush campaign at least give an explanation."

There was no explanation, and the president delayed his annual medical examination until after the election. "The president remains in superb physical condition," said Adam M. Robinson Jr., commander of the National Naval Medical Center in Bethesda, Md., after the president's fourth annual physical at the center on Dec. 11. These days, Bush bicycles most days and nearly brained himself last July after a tremendous toss off his custom $3,000 Trek Fuel 98 mountain bike while careening down a trail at his Crawford, Texas, spread.

So here's the president strapped into his shock harness. And if he's a health risk, what about Dick Cheney? Given the state of the veep's heart, he's probably hard-wired into a local generating station. They both go down, and we have Hastert, the former wrestling coach who weighs in these days at 275 pounds. Hastert? Here is the sequence of presidential succession. If both Bush and Cheney were incapable of fulfilling the president's duties, the nation's affairs would be guided by Dennis Hastert, speaker of the House of Representatives. And if Hastert also was incapacitated, Ted Stevens would follow, the current president pro tem of the U.S. Senate and, as such, fourth in line to succeed W. Bush, as designated by Title 3, Chapter 1, Section 19 of the United States Code, also known as the Presidential Succession Act. Stevens is one ahead of Condoleezza Rice, two ahead of John Snow and three ahead of Rumsfeld.

Who says the universe isn't full of surprises? Ask the people on the shores of the Indian Ocean. We could lose Bush, Cheney, Hastert and the choleric Stevens all on the same day, and then Condoleezza will be running the show.

Alexander Cockburn is coeditor with Jeffrey St. Clair of the muckraking newsletter CounterPunch. He is also co-author of the new book "Dime's Worth of Difference: Beyond the Lesser of Two Evils," available through www.counterpunch.com. To find out more about Alexander Cockburn and read features by other columnists and cartoonists, visit the Creators Syndicate Web page at www.creators.com. COPYRIGHT 2004 CREATORS SYNDICATE, INC.