In the Oval Room—thirty-five minutes late

Travels with the Government: Page Four

I invaded the U.S. government only once more. About two months into President Nixon’s second term, I made one more try. I called Rose Mary Woods and told her the PHT matter was just too important to hang in limbo any longer. I had done the best I could with government for the last four years and now I needed presidential advice. Rose Mary understood, and a few days later called back to say a date had been set up for lunch with the President—I should come at 11:30 so we would have more time to talk about PHT. Perfect.

I couldn’t be late for such an appointment and planned to go to Washington the day before. But when I found the chance for rain approached zero, I made a reservation for a flight scheduled to get to Washington at 9:15, which gave me almost two hours leeway. That darn plane (“Doing What We Do Best”) managed to be two-and-a-half hours late, and I was thirty-five minutes late for my appointment. If that wasn’t embarrassing. But no one other than I appeared ruffled. The President set me at ease and listened closely to my experiences with the government. I told him the situation was incredible. Everyone had tried to be helpful, but they were so busy with problems they didn’t have time for a solution. I said I couldn’t get it out of my head that if someone with authority had the facts he’d see to it that something got done in this matter so urgent to public health.

The PHT story was not new to the President, having heard it from me on three occasions. He agreed that something should be done and asked for my suggestion. I had anticipated the possibility that he might ask. I told him that political jokes for at least a century suggested that vice-presidents of the United States were not overworked. I said that if this applied to Vice President Agnew, he might be able to help. This suggestion got a prompt presidential veto (I lacked the two-thirds majority to overrule).

The President said he thought Secretary of Health Caspar Weinberger would be the man for me to see. I told him I had already seen two Secretaries of HEW and found them pretty busy; on average I’d spent an hour apiece with them. This time I had to have enough time to tell the whole story. He asked how long this would take. I said at least two days, at a quiet place away from the telephone. I thought this was shooting for the moon, but the President saw the sense in it. He said he’d make arrangements, that at the moment the Secretary was up to his elbows in some matter, but I would hear from him within thirty days. I thanked the President and took a plane back to New York. Of course it got there two minutes early.

Back home I waited for Secretary Weinberger’s call. After four weeks had gone by I began to have Finch flashbacks. But, on the twenty-ninth day, Secretary Weinberger called and made a date to spend the following weekend at Hobeau Farm. Mrs. Weinberger came to the farm with the Secretary and Dr. Bogoch was with me. Over the two days we had four long sessions, during which Dr. Bogoch and I poured information about PHT into the Secretary. Mrs. Weinberger was an interested listener. Late Sunday we went our separate ways, the Weinbergers to Washington, Dr. Bogoch and I to New York. Caspar said he wanted to cogitate on the matter and would get in touch with me soon. Time went by, more than I’d expected, and I was afraid I had struck a black hole (a semi-anachronism—they were around in those days but who knew). But after two months Secretary Weinberger called and invited me to come to Washington to meet the newly appointed Commissioner of the FDA, Dr. Alexander Mackay Schmidt.

Our meeting was in the office of our friend, Charlie Edwards, who had become assistant head of HEW. Secretary Weinberger was present, but I got the feeling that, not being a physician, he was reluctant to make suggestions of a medical nature to the FDA, and he had asked Dr. Edwards, who knew the subject well, to introduce Dr. Bogoch and me to Dr. Schmidt.

After the introductions we all chatted for a few minutes in Dr. Edwards’ office about nothing I can remember. Then Dr. Schmidt and Dr. Bogoch and I went off to another room to have a talk. I assumed, of course, that Dr. Edwards or the Secretary had given Dr. Schmidt the bibliography of the Dreyfus Medical Foundation and a thorough briefing on the nature of our interest in PHT. I was totally unprepared for Dr. Schmidt’s opening words, “My number one objective in my new position is to see that the FDA is run in an honest and honorable fashion.”

Son-of-a-gun!

After all the years of work with the government it was apparent Dr. Schmidt hadn’t even been briefed. I was back at the starting line, with a new Commissioner of the FDA, and the baton hadn’t even been passed on. I considered getting up and going home. But I wasn’t delighted with the implications of Dr. Schmidt’s opening remark, and I wanted to get that straightened out. I told Dr. Schmidt we were a charitable medical foundation, had no private interest of any sort, but a damned important public one, and that trying to be helpful with our government was getting to be a tiresome job. Dr. Schmidt’s response was a lot nicer than I expected. He said, “Take your time and tell me about it.” For the umpteenth time I started telling the story of PHT.

After about an hour Dr. Schmidt said he had an appointment that he couldn’t get out of, but he saw how important this was and he intended to pursue it personally. He said of course he knew PHT was more than an anticonvulsant. In fact he had been teaching its use in cardiac arrhythmia since 1969. I said that’s just one example of what I’m talking about. “As you know, PHT does not have a listed indication-of-use for arrhythmias.” Dr. Schmidt said, “You’re mistaken. I’m sure PHT has such a listing.” I didn’t argue, this not being an opinion but a fact that could be checked. But I said I thought I was right. (A week later Dr. Schmidt called to say that it was hard to believe, but PHT did not have a listed indication-of-use for arrhythmias. The head of the Heart and Lung Institute, Dr. Theodore Cooper, had made the same mistake. At our medical conference, he had said, “There is no question of the usefulness of PHT as an antiarrhythmic, and this is an approved indication-of-use in the package insert.”)

Just before we left, Dr. Schmidt mentioned that he was a specialist in communication. I said, “I’ve come to believe that communication is just a word in the dictionary, but if there is such a thing, you sure have a good spot to use your specialty.”

Well, it turned out that Commissioner Schmidt was a gentleman of the old school (an endangered species). Even with the pressures of his new office he kept his promise to look into PHT himself and visited the Foundation twice in the following month. The second time, he spent a full day getting the facts about PHT from Dr. Bogoch and me and even stayed into the evening so we could finish our discussion at dinner. By that time I had a feeling of empathy with Mack, and with the help of a glass of wine, I emptied myself of my feelings on the subject of the great sin of neglect of PHT. Dr. Schmidt understood. Then he said something I’d been hoping to hear from a government official but had given up on. “You’ve done what you can. Now the ball is in our court.”

Well, that was it; there was no more to do. I had been trying to turn the responsibility for PHT over to the U.S. government for ten years. Finally a Commissioner of the FDA had accepted it.

Epilogue: Of course I should have figured that a man as sensitive as Mack Schmidt wouldn’t last long in government. Five months later he was back at the University of Illinois, and there was a new Commissioner of the FDA. I have not visited the government since and have no ambition to. That’s one reason this book is written. It’s for members of the staff and government officials in health, all at the same time. I hope it will make it easier for them to do whatever they think is right.

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