The Vice President’s Internist Is Missing!

Who cares?

Reporters insinuate. When a newspaper runs a story that says a bank is missing $10 million dollars and that one of that bank’s employees has disappeared with no explanation, that newspaper is insinuating that the employee stole the money. Why doesn’t the newspaper just say, “The employee stole the money” or “We think the employee may have stolen the money”? Because it doesn’t feel the evidence is strong enough to air an accusation that it can’t put into someone else’s mouth. Or because it wants to sustain the venerable fiction that newspapers recite facts but never draw conclusions. Or because it doesn’t want to get sued. Nearly always, when reporters insinuate, their insinuation is no more difficult to grasp than the example of the bank employee. But every now and then, the insinuation can be difficult to tease out.

Case in point: Cheney Doc Is Drug Addict. Jane Mayer broke the story (“The Vice President’s Doctor“) in the “Talk of the Town” section of the July 12/19 New Yorker. The gist was that Dr. Gary Malakoff, Cheney’s personal physician, had a history of obtaining prescription drugs, often under false pretenses, to sustain his addiction to narcotics. After initially receiving what in hindsight was overly indulgent treatment by his colleagues at George Washington University Medical Center, Malakoff was stripped of an important position—chief of internal medicine—and placed on leave. End of story.

It’s well known that the medical profession does a poor job of policing itself. Malakoff’s case seems a reasonably good illustration of this societal problem. But his story wouldn’t likely interest Mayer, a political reporter, if it lacked a political angle, and it certainly wouldn’t make the cut for “Talk of the Town.” Somehow, we are supposed to believe, Malakoff’s story is rendered more significant because Malakoff is Cheney’s doctor. But how?

Chatterbox’s best guess is that for Mayer, and for Sheryl Gay Stolberg, who did a follow-up inside the July 5 New York Times, the story derives significance by casting doubt on Malakoff’s public statement four years ago that Cheney was “up to the task of the most sensitive office,” even though Cheney had suffered three heart attacks and subsequently had a fourth. The insinuation would therefore be that the public was defrauded because it never knew that the person making this statement was a junkie, and therefore unreliable. But it’s far from clear that Malakoff’s drug addiction compromised his assessment of Cheney’s physical health. If Malakoff’s judgment was clouded by anything, more likely it was his powerful patient’s strong desire for an upbeat public endorsement. A clean bill of health announced in the presence of microphones is always taken with a grain of salt because it’s ridiculously speculative and because no doctor is ever going to tell the press, “My patient, the president/vice-president/senator/governor/CEO/whatever, can’t handle his very important job and he won’t listen to me. Please urge him to resign.” Moreover, for Cheney, the ridiculously speculative pronouncement turned out to be correct. Four years later, he hasn’t dropped dead.

The fraud insinuation is so weak that Chatterbox harbors doubts that Mayer, a smart and resourceful journalist, intended it. But Chatterbox can’t think of anything more plausible that Mayer might be trying to telegraph.

The July 5 Washington Post put the Malakoff story on Page 2, with no apparent rationale other than that anything the vice president does (in this case, finding himself a new doctor) constitutes news. On July 6, Malakoff landed on Page 1 of the Post with the local angle that the District of Columbia’s Board of Medicine didn’t know about Malakoff’s drug addiction because the Medical Society of the District of Columbia, a physician’s group that did know, kept that information secret (per usual, accepted, and demonstrably unwise practice). Decent story for the Metro section. But its prominent placement suggested that Cheney’s involvement had some unarticulated significance.

On July 8, Internistgate landed on Page 1 again, this time with some fairly shocking details about the “deferential treatment” George Washington Medical Center granted Malakoff after it learned about his addiction. (For instance, a neurologist overseeing Malakoff’s rehab wrote Malakoff prescriptions for two of the very drugs he abused.) But reporter Rick Weiss still didn’t know how to handle the Cheney angle. Cheney had known about Malakoff’s drug addiction “for years,” according to Jonathan Reiner, director of GWU’s cardiac catheterization laboratory. This suggests one counterintuitive insinuation: Dick Cheney Nice Guy. Or, more plausibly: Dick Cheney Takes Lousy Care of Self. But Weiss bore down on the tried-and-true: What Did Veep Know and When Did He Know It? Cheney’s press secretary “would not comment on when the vice president learned about Malakoff’s problems.” Why does this chronology matter?

Are we supposed to worry that Cheney might have been killed by his junkie doctor? That’s pretty far-fetched. Are we supposed to think that Cheney was in on a cover-up? Oh, please. Maybe we’re meant to accept a pro-health-insurers’ argument that patients shouldn’t be granted the liberty to choose their own doctor, because look how badly a smart and powerful guy like Dick Cheney chose! Wait, I’ve got it! Cheney wanted his doctor to be a junkie, because … because … Oh, I give up. I don’t know why we should care about Dick Cheney’s doctor’s sad story.