Citizen Bill Frist: The Senator From Tennessee
Friday, June 29th, 2007By William Ferrall
Sitting in the living room of his Nantucket home early this summer, former U.S. Senator Bill Frist of Tennessee appeared upbeat and calm. His demeanor seemed far removed from the many tense moments in which he stood before the Capitol Hill press corps during his four years as U.S. Senate Majority Leader.
Frist moved into a Senate leadership role midway through his two-term, 12-year stint there, first overseeing the Republican takeover of that legislative body in the 2000 election as head of the Republican Senate Campaign Committee. He became Senate Majority Leader in late 2002, and soon stood at the center of contentious national debates on Medicare and social security, immigration, Supreme Court nominations, stem cell research and, notably, the case of comatose nursing home patient Terry Schiavo.
Frist is a fourth-generation Tennessean born into a prominent family noted for its philanthropy and with substantial holdings in Hospital Corporation of America. As an accomplished heart-lung surgeon trained at Princeton and Harvard, Frist won praise for his often coolheaded physician’s approach to problem solving in the public arena. His detractors accused him of putting the highly partisan goals of the White House and President Bush above mutual, bi-partisan solutions.
When he left the Senate in December of 2006, Frist noted that in the Senate “trust is… very rare,” a dynamic that he called “an adjustment for me.” Those on Nantucket who’ve known him and his family–he and his wife Karyn have three grown sons–speak fondly of his friendly, outgoing personality.
For many, the Frists’ more than two decade presence on Nantucket has gone largely unnoticed. According to the Senator, when producers of an opposition political campaign ad came to the island looking for his home, in an effort to anoint him as elitist, they were unable to find it and ended up photographing the nearby Sankaty lighthouse instead. “Nantucket has always been our anchor,” said Frist when recalling his peripatetic professional and political careers. “It’s the appeal of nature, of being out doors all the time, of having our kids grow up here.”
You’re one of the lead backers of One Vote ‘08 to enlist political candidates in the causes of poverty and HIV/AIDS. Please tell us about that.
I think the fact that Tom Daschle and Bill Frist are joined hand-in-hand will speak loudly to the American people. And I think it’ll speak loudly to the American people that Washington hasn’t lost its mind.We joined hands to support an initiative that is high-energy, high-tech, using new media to reach out and touch the presidential candidates on the issues of extreme poverty and issues such as malaria, tuberculosis and HIV. The goal is to connect the grass roots directly with what they see playing out in the race to be the next president. Last night we had eleven thousand people on a conference call, just to give you an idea of the power of the technology we’re using. Extreme poverty and HIV is not just a moral issue; it’s a national security issue. And in the strategic interest of the United States, you don’t go to war with somebody who has saved your child’s life.
When you last spoke publicly on Nantucket, you talked about the threat from “super viruses” or other medical pandemics. How do things stand today?
Well, it’s a very hot issue because of what’s called XDR tuberculosis, meaning “extremely drug-resistant” tuberculosis. We had all the media attention two weeks ago, but about a month ago, another individual with XDR tuberculosis had come to this country. It’s a disease that’s highly infectious. The fact that right now you can travel on an airplane and go to any major city in the world within twelve to fourteen hours shows how easy it is to transmit those viruses. Thomas Friedman’s book “The World is Flat“ demonstrated that you’ve got an inter-connected world and that we have viruses out there. Since the talk I did here, about five billion dollars have been spent in order to establish a global surveillance system by the United States to fight two potential threats. One is the natural emergence of a disease – it can be Ebola, it can be pandemic flu – and the second component is if terrorists use it on purpose. [Whether it's] accidental release or purposeful release, we’re much more prepared today. But again, it becomes a national security threat, and that’s why it becomes so important to be appropriately prepared. Bill Frist
In what ways did your training and work as a doctor influence your public life in the Senate?
I’m a heart-transplant surgeon and I have been at that for a very long period of time. I did one of the first heart-lung transplants in the country. When you do that, patients tend to get infections. My whole professional life–twenty years in medicine and politics the last twelve–has been related to infectious disease. That’s where the interest started. For the last eleven years, I’ve traveled to Africa every year to do medical mission work. As part of that medical mission work, I treat patients with HIV/AIDS, malaria and tuberculosis. I work with a group called World Medical Mission, which is a division of Samaritan’s Purse, which is a faith-based initiative with Billy Graham and Franklin Graham.
Now that you’re no longer in the Senate, what sorts of things are you doing?
My transitions are different than most politicians. Totally different. You won’t find anybody, at least at the leadership level, who says they’re going to voluntarily step down years and years in advance. So I came to the Senate in 1994, and I told the people of Tennessee I’d serve twelve years as a citizen legislator and after my term, I was going to come back home and live under the laws that we passed. As a citizen legislator, I did exactly what I said, something that a lot of politicians don’t do. And then I came back home, began rebuilding the house that I grew up in. [I'm also working] on the global issues of health, oneness of mankind, extreme poverty, those sorts of issues. In medicine, I was treating one-on-one. I did heart transplants to save one life at a time. In politics, I went to Washington to look at the health of the state, Tennessee, and then when I became majority leader, helping the nation. Now that I’m out of the political arena, I’m looking at global health issues.
For example, I was in Russia two weeks ago working with Saint Petersburg State University, and in this country [at] a think-tank in Washington, the Center for Strategic and International Strategic Studies. There I chaired a conference on global health between Russia and the United States. That’s timely in that President Putin will be meeting with President Bush. As you know, they’ve been politically way apart, and this illustrates the idea of using medicine as a currency for peace. Next year, I’ll be a professor at the Woodrow Wilson School of Public and International Affairs at Princeton University. Then I’ll be finishing a book that I’m writing on public service.
The book will show the comparisons and contrasts of public service doing medicine serving one-on-one and being in the public arena as aUnited States Senator, hoping to show that they’re really one and the same. The goal is to heal, to address problems that otherwise might not be addressed, whether it’s through a heart transplant or passing Medicare legislation. Before that, I spent about four weeks in Africa doing surgery, everything from a spear shot in the back of somebody’s head to treating a young twelve-year-old boy with tuberculosis. I did surgery in Darfur region of Sudan, which you hear a lot about, my second trip there. What I do when I look at global health is not what a politician would do. I go, and yes, Isee President Kagame of Rwanda and address the Bill Fristbig issues there, but for the three days before meeting him, I’m on the ground working in clinics, hospitals, taking care of patients.
What are the lessons people back here can get from places like those over in Africa?
Microbes and bacteria know no borders. The HIV in this country that has killed thousands and thousands and thousands of people is the same one as over there, the only difference is that it’s killed twenty-three million people in Africa. That sort of oneness of disease is very important, because you look at the potential for pandemics. If you have decimation of a society by a virus or a bacteria, which goes on all the time in Africa, that leads to loss of hope. That leads to desperation, and that leads to instability in communities. That leads to the potential for terrorist activities. People realize there is this potential out there for not just disease in one’s community,but also instability elsewhere. When people see what’s going in Iraq and potentially in Iran and North Korea, people make that connection. Why someone in Soddy-Daisy, Tennessee, would care about Africa is the moral imperative. A child less than five has about hundred-and-twenty times higher chance of dying just because they happen to be born in Africa compared to the United States. To some, that’s powerful. To others, that’s charity. Very quickly, you move to the larger strategic and security interests of the United States of America. The 9/11 Commission – smart people – basically had that as a major finding in their report. It’s a breeding ground for terrorism if you haveinstability in a community that is being hollowed-out by disease and famine. The solution to all of this is really inexpensive. For things like childhood deaths, vitamins cost about five cents, and a life-saving treatment for diarrhea, which kills most of these kids, is about twenty cents. A vaccine is about twelve dollars. There are about sixty-five billion people in the world today, and only about four billion have access to any health care at all. That’s more powerful today because it used to be that all the money was thrown away with foreign aid. Especially on my side of the aisle they used to say, “You’re just throwing money down a rat hole.” Because in the past, that money – your taxpayer dollars – never got down to buying the vaccines or the vitamin A or the oral hydration. Now, over the last five or six years, we’ve got structures that are set up and now it gets down to the local level. And now, we don’t give it unless there’saccountability and there’s transparency built into the system.We established this Millennium Challenge Corporation, so this money flows only to people who we know are going to use it and use it locally. And the US has taken a leadership role. Back six years ago, when the president in the State of the Union message came out and said we’re going to give fifteen billion dollars to HIV/AIDS, a lot of people threw up their hands and said why are you spending money over there? But in retrospect, in looking at it, the money has been very well spent. As just one example, today there are about two million people on anti-retrovirals, which are the medicines we use to treat it, and the United States is paying for about 1.5 million of them. So we know the money is getting down to the ground.
Looking back on your twelve years in the Senate, which accomplishments are you most pleased about? What are your biggest disappointments?
I’d say overseeing in a very efficient way getting Sam Alito and John Roberts, two of the Supreme Court justices, through in a period of twelve months – carefully, easily, avoiding filibusters and that sort of thing. Before that, I’d put Medicare – making prescription drugs available to seniors, which just didn’t occur before. That was a major piece of legislation. Forty million seniors today have affordable access to prescription drugs, and that’s working very well right now. Third, I’d put the tax cut-two trillion dollars in tax cuts that have at least contributed to making our economy grow twenty-four consecutive quarters now and [has put] home ownership at an all-time high, and six million jobs created.
Were there disappointments?
Social security for this next generation. Medical liability. Right now, I have too many friends and colleagues who are leaving the practice of medicine because of the high cost of their malpractice insurance. I have obstetrician friends in Florida who, for everybaby they deliver, are paying a thousand dollars in malpractice expense even if they’ve never had a claim against them. And that cost just gets passed on to the mother. But eventually it means that there is going to be a crisis in doctors delivering babies in the future unless we act. I took it to the floor on four different occasions and could not get it through, so that’s a huge disappointment. If you look over the past, it has cost about seventy-seven billion dollars, and thirty billion of that, instead of going to the people that were injured, went to the pockets of the system, the trial lawyers. That system needs to be reformed. You have to have leadership somewhere that can overcome huge, huge lobbying. Most of what killed those legal reforms is the handful of trial lawyers who are making money. Not the overall legal profession, but probably eight or nine companies, and they throw millions and millions and millions of dollars to lobby. It’s easier to resist that at the state level than it is at the federal level.
President Bush recently vetoed a stem cell research bill again. You were in favor of a similar bill when you were in the Senate. What’s your reaction?
Two years ago I made a long speech on the floor of the Senate outlining ten principles of ethical human stem cell research, and I’ve been a strong advocate of it. I supported almost the same bill. I’m pro-life-and that’s what so astounded people–that someone who’s pro-life would support it. As a doctor, I take a heart from a body that will be discarded, so why not take human stem cells that might be similarly thrown away? The President and I don’t agree on that.
The Massachusetts legislature recently gave a green light, in a manner of speaking, to same-sex marriages. As a lawmaker, you have spoken out against that.
I’ve been opposed to it, and have continually held that marriage – not necessarily civil unions – should be restricted to between a man and a woman.
So, you’re not opposed to civil unions for same sex couples?
I’ll leave that up to the states. It is the twenty-first century, you know.
How do you feel about the Terry Schiavo situation in retrospect?
Politically, it was probably not wise because people don’t want you to get involved in those sorts of decisions. Morally, it was absolutely the right thing. I deal with brain death all the time as a transplant surgeon. For every heart that I put into somebody, somebody has died or is brain dead. That’s clear to me. What is not clear, and what the ethicists have a hard time with, is when you take somebody whose parents say, ‘Don’t kill her, she’s not dead. She doesn’t have a terminal illness. She’s not on artificial life support.’ But a third party comes in and says, ‘Kill her.’ That’s tough. As a physician who has to protect life, I said, ‘Let’s make sure of what the law really says.’ We said, ‘Judges, you decide.’ They decided to uphold the law, and the law said even if your parents want you to live and they’re willing to pay for it and your brothers and sisters want you to live, you can still kill her because the next of kin by law is the husband.
That’s loaded language to say her husband wanted to “kill her.” He might say that he wanted to see if she could survive on her own or not.
But, that’s exactly what he said. Usually, when you have someone who’s brain dead, they’re on a ventilator. She didn’t have a terminal illness. She had a huge disability. I was talking about the moral issue. The problem was they never had a husband-and-wife conversation about it. The parents said, ‘We’ll take care of her. If you don’t want her, just get divorced.’ That’s why it was so hard. People don’t want their government, especially their federal government, to get involved in intimate things. I’m a physician who protects life, which is what I took an oath to do. But you have to actively intervene for her to die. If your parents and brothers and sisters say, ‘Don’t actively kill him,’ is that right? Probably not.
The U.S. Congress has deadlocked on many issues, with immigration foremost among them. What are your thoughts on the current proposal supported by President Bush and possible solutions to a legislative deadlock?
We were unsuccessful last term. That was a disappointment. People are saying this is too big of a problem and we can’t solve it. The centrist group, of which I was a part, is not quite big enough to overcome the polar groups: the group that says let’s just have full amnesty and move on, and the other that says let’s just build a fence. It’s more than just the fact that an election is looming. There are three basic elements. First is border security and border enforcement, and most people agree on that. Some say you don’t need a fence, some say you do. Second is the employer workplace element – that sort of issue here on the island is very big, because people can’t get workers. It’s a huge problem that has to be addressed and a very complicated problem. Third, the only one that cannot be resolved today, though I think it can be in the next several months, is the twelve million people who are here illegally. What is our responsibility to them? Most are working very hard and contributing to our society. Right now, people think it’s dead, but I think it’s going to come back.
The state of the Congress is not good, and that’s the reason I’m working so hard to pull bipartisan things together. People outside of Washington think we’ve lost our minds. Extreme partisanship, the lack of governing, of pulling people together with real solutions to problems that are out there – high energy, high health care costs, the war in Iraq – is real frustrating to people. To fix that, you’re going to have to bring people back together. In an election year, that’s hard to do. But you’ve got to start. Two years ago, when I was leading the Senate, the [public's] favorable opinion was way down at about thirty-percent. Today, with Harry Reed leading the United States Senate, it’s right at thirtypercent. That’s a reflection on the state of affairs in Washington today. I’m optimistic, though. It is going to take a series of elections-the first of which was last year, in which people called for change that will be fully reflected, I think, in the [next] presidential election.
You visited the detainee camp at Guantanamo Bay and were at the center of congressional debates on the current war in Iraq. What do you think will be the eventual outcome in Iraq?
About fifteen years ago, I got a telephone call at home, to come in quickly because we had a helicopter coming in. Somebody had been shot, which is not that unusual if you’re a trauma surgeon. He’d been shot in the chest and it nicked his heart. He was bleeding out. So I went to the hospital, and down the stretcher came and out of the helicopter, and it was somebody I didn’t know. The guy who had been shot was in shock, low blood pressure.We took him straight up to the operating room, opened his chest and fixed him up. Ironically, that’s Dave Petraeus. As a trauma surgeon, I had repaired his heart. That was 1991. He was at Fort Campbell in Kentucky. [He] was a battalion commander there and had been accidentally shot by one of his soldiers during a live-fire drill. I tell you that because he’s a very good friend. I visited him in Iraq multiple times. I’ve gotten to know his family, and I’m going to trust his judgment in September. Likely it’ll be longer than that. I think our troop level is going to stay up fairly high for a period of months. At some point, it’ll pull back to certain phases across Iraq, and the goal will be to fully train Iraqis. That’s the goal right now, but it will continue to be accelerated.We’ll be pulled out of the front lines. There’ll be some diminution of those troops–[from the current] 130,000, it’ll probably go down to about 80,000, hopefully beneath that at some point. Our goal will be security for the government itself.
We will not cut and run, we will not leave. It’s going to take real leadership. When you’re sitting around with a Democrat or a Republican and you’re really talking seriously, not with CSPAN and the press, everybody realizes that for us to pull out leaves chaos. And chaos in the Middle East where the oil is – you’ve got Iran and you’ve got Afghanistan and you’ve got the Taliban and terrorismwould be devastating to the world. So I don’t worry that much about a cut-andrun approach really becoming a reality.
What were the factors that went into your deciding not to run as a presidential candidate? What do you think of the current field of candidates in both parties?
I thought a lot about it. I made a pledge to the people of Tennessee that I’d serve twelve years and then come home. My passion will continue, in my one-on-one work in medicine as I’m doing in Africa now. As I’m doing with think-tanks, I continue to do it globally by working with presidents. But the passion to both run and serve as president of the United States just isn’t there right now. You were so under the microscope and at the center of several controversial issues.
Did you feel that you were getting a fair shake from the public and the press?
No, but as majority leader, that’s part of it. You are leading the upper legislative branch of our government, so whatever happens there, that’s your job. That’s going to be under the microscope. If anything goes wrong or if there’s a call for change, you’re a part of the establishment and that’s all reflected on you. If you don’t want that, then you shouldn’t be majority leader. But the call to leadership and to lead the legislative body was my primary purpose.
My goal was never to be president of the United States. Otherwise, I’d be in there right now. As you know, it’s wide open right now. I’ve been working hard to get (fellow Tennessean) Fred Thompson in [the race]. Now he is, and he’ll be running. He is that outside voice for that call to change that has become so important. He can speak directly to the American people. He’s not a part of the Republican establishment, which I am. That’s another reason for me not to run.
Who will the two candidates be next year?
I think on the Democratic side it will be a Clinton-Obama ticket. People say [it won't happen because] they’re both Senators, but Obama is so new that he doesn’t have any identity in the Senate. I think that his call to aspirations of hope is a powerful one, very appealing to most people. Our side is just wide open. I’m supporting Fred because I know him as a person. I know of his ability to communicate, I know his thought processes. He’s a team player. He’s a straight talker and he’s untarnished. He can run as an outsider.
Do you think this country’s ready to elect a woman or an African-American?
I think it could. Things are so radically different. I think because of the interconnectedness that we have today, our ability to communicate, to blog, to get information out. Things are happening so quickly.







