12.14.11

Examining Rick Perry's Medical Alibi

Back surgery made him blow the debates? Dr. Kent Sepkowitz on the Texas governor’s sorry explanation for his stumbles—and why we need to know more about candidates’ health.

That didn’t take long—it’s not even 2012, and we just got our first “the dog ate my rational brain” alibi from a charter member of the omnipresent Republican presidential candidates. Texas Gov. Rick Perry, still looking to regain his traction after a series of mind-numbing debate performances (oh, and an awful job as governor), has let the world and Iowa know that he “wasn’t on his game” recently (make that the last four months) because of a serious back surgery he had undergone over the summer. The surgery had by his report wiped him out. “But no excuses,” he added, making as forceful an excuse as he could.

Governor Rick, he of the prayer rally (held—it is worth noting—mere weeks after his back surgery), is not the first politician to say that something, and not the Devil, made him do it. We have seen Congressman Wilbur Mills cavorting in the Tidal Basin in Washington, D.C., with his escort, the Argentine burlesque interpreter Fanne Foxe, then checking in for alcohol rehab. A few years ago, Congressman Patrick Kennedy claimed that a mixture of zolpidem (Ambien) and promethazine (Phenergan) led to his serious car crash in the middle of D.C.

Perry, though, is trying to thread a slightly different needle than the rest of the guys. He has made no mention of pain meds, famous for their dulling effect, or perhaps muscle relaxants (often prescribed for people with back ailments) like diazepam (Valium) or nonaddictive medications such as cyclobenzaprine (Flexeril) or methocarbamol (Robaxin), which can and do often cause drowsiness or worse. That’s a bunch of sissy stuff—pills and tonics, the type of crap for wimps and losers.

No, he is letting us know he has a manly problem, the sort of situation one might expect from an outdoorsy guy who used to hunt at Niggerhead, the Texas ranch popular among a certain type. He has pain; just like a football player or a soldier, he had his spine fused, he had a nerve decompressed. These are tough-guy issues, Duke Wayne issues (and the Duke, not Reagan, seems to be the idol of this crop of wannabes), not the namby-pamby noise you get from some Ambien-addled addiction or alcohol-fueled romp, or worst of all, one of those introspective sorts of self-explorations like accepting personal responsibility for a decision that affects others (such as executing 234 Texans).

With this disclosure, Perry has introduced something actually serious into the Republican campaign, a first for him. He has raised that old, extremely prickly issue—the public’s need to know about candidates’ health and well-being. Assuming he is on the level, shouldn’t we have been told at a less-personally-convenient time that we weren’t seeing the A-plus version of the governor? We receive reports on an ongoing basis about an athlete’s sore ankle, about whether he will play this Sunday, but nothing (actually, less than nothing) about the doings of people racing to run the country and influence much of the free world.

The la-de-da approach at each election cycle toward the personal-health issue continues to shock me. We feel nervous, as we should, invading a person’s medical world, but the information may be critical.

It is true that in a world of too much information, hearing reports about candidates’ medications and surgeries might seem overwhelming, but the issue is an extremely serious one. Accuracy would be nice, too; I imagine Perry might be on medications for pain and maybe for muscle spasms and who knows what else. His picked-over “confession” admits no new information about him, about the Republican primary, or about how the public receives relevant information. As an alibi, let’s be honest, this one really blows.

Perry is not the only one with possibly important medical information kept from public consideration. During the Bush 43 years, rumors circulated that he was on antidepressants. No evidence ever emerged to support the whispering. But the side-effect profile of these agents is vast—and the underlying condition that might cause one to take them could have a potentially significant effect on job performance. And I, for one, have worried during the Obama years that the country is being led by someone who was trying, then finally succeeded, to stop a lifelong cigarette habit. Admittedly, Obama seems to have preserved his famously cool demeanor, but anyone who has ever lived with a smoker who is quitting knows this is not a mood-neutral event.

The la-de-da approach at each election cycle toward the personal health of the candidates continues to shock me. We feel nervous, as we should, invading a person’s medical world, but the information may be critical.

For those who adopt the please-don’t-tell-me approach, consider this—a recent chief justice of the United States Supreme Court was a drug addict whose judgment was surely affected by his drug use. The story was mostly ignored until late in his life; never was his fitness to serve questioned, though he once, while in office, ran out of the hospital in his gown, harboring fears that the CIA was scheming against him. Who was it, you may ask? None other than that paragon of right-wing virtue, the Honorable William Rehnquist, according to FBI records released after his death in 2005.

Chief Justice Rehnquist, who oversaw the Clinton impeachment, was, like Perry, a lower-back-pain sufferer. His pain, it turns out, was so intense that he became addicted to a medication, ethchlorvynol (Placidyl), a sleeping pill that is no longer made in the U.S. due to its bad street rep. I took care of many Placidyl addicts during my stint as an emergency-room physician in the early 1980s—we called them “placidonians.” I would say that they were the most addled, confused, stoned, and addicted people I have seen, at least at the ER level. When they showed up with an overdose we would pump their stomach, leaving the entire ER with a very acrid burning-plastic smell and a lingering concern about the effect such a harsh medication might be having on a person’s brain.

Rehnquist’s addiction and Perry’s spinal fusion point to the need for the public to know the less-than-savory goods about our leaders. Besides the windfall it would supply Comedy Central, such disclosure is absolutely necessary and much more relevant to how they might perform in office than the usual trail of documents the public insists upon: tax records, Selective Service embrace or avoidance, any oddball letters or written exchanges they might have had through the years. In our longstanding debate between the need to preserve privacy versus the need to know, this one is easy: give us the goods. All of them. We can handle the truth.