True Compass (33 page)

Besides Dr. Farber, these included some giants of their times, people whose contributions, like those of Walter Reuther, have regrettably faded in the public memory. One of them was Mary Lasker. The wife of the wealthy Albert Lasker, a pioneer of modern advertising, Mary was herself a pioneer: she fought for higher health standards and for medical research in America for most of her long life, and received a Congressional Gold Medal before her death at ninety-four. Mary brought prestige and tactical wisdom to our efforts.

Another valuable partner was Benno Schmidt. The well-connected New York investment banker shared my belief that cancer research was a critical national duty. His financial expertise told him that the country could and would support our quest for as much as one and a half billion dollars, a fourfold increase in research funding. That estimate became our figure in the bill.

Our intention, expressed in the legislation's early drafts, was to bypass the then ineffectual National Cancer Institute, an appendage of the National Institutes of Health, by creating a new independent agency structured along the lines of NASA. Mary Lasker had long advocated for such an agency. In her early seventies then, she lent her distinguished reputation to a round of speeches and published essays advocating for our bill.

We faced a powerful competitor for our goal: the Nixon administration, anxious to put its own stamp on cancer research, but at a much lower price tag than ours. In January, the president proposed a bill with an increase of $100 million in spending for this purpose, thus capturing temporary cachet as the leader in the fight. "Temporary" could easily become "permanent" unless we outflanked him: he was hardly likely to cede the momentum, and the credit, to a liberal Democrat in Congress--especially one named Kennedy.

My allies and I were now in a fight for the initiative and, along with it, a truly adequate research budget. We needed a bipartisan thrust; this effort must not get tangled up in partisan politics. And so I formed a partnership with an eager Jacob Javits, the Republican senator from New York, to get our bill written and moving through Congress.

A final obstacle remained: Nixon could not bring himself to sign a landmark bill that had the Kennedy name attached. So I immediately said to take my name off the bill, though I felt badly that Jacob Javits was also being denied the credit he deserved because of Nixon's feelings about me.

Nixon had insisted that his own bill, not the one created by our team, be the one submitted. So we replaced the language of the Nixon bill with the language of ours, and kept it labeled as the Nixon bill. The measure passed by a vote of seventy-nine to one and was signed by Nixon in 1971. The new department created by the act, the Conquest of Cancer Agency, remained within the NIH, as the Republicans wished. But administratively it would report not to NIH but directly to the president. And it carried our budget figures. The important point was that cancer research had entered a new era of federal funding and productivity.

Many others, of course, have felt the same urgency as I about health care. Progressives' calls for some sort of federal health-cost protection for Americans had fitfully arisen and subsided since the days before World War I. President Roosevelt considered a health insurance provision in the Social Security Act of 1935, but omitted it out of concern that its projected costs would scuttle the act, a cornerstone of his New Deal. He later asked Congress to include adequate medical care as part of an "economic bill of rights," but was rebuffed. When President Truman proposed national health insurance to Congress in 1945, the American Medical Association mobilized a virulent opposition campaign, aimed at the heartland, portraying the idea as "socialized medicine." Senator Robert Taft of Ohio took up that charge, and a House subcommittee member went even further, labeling it "a communist plot." Medicare was passed in 1965 under Lyndon Johnson, with my strong support. Still, large disparities remained. With eighty million Americans uninsured and a national outlay of $60 billion in health-related costs,
Time
reported on May 11, 1970, that "there is a growing consensus that some national insurance blanket must be thrown over the ailing body of health care." True enough--and the scatter-quilt of federal programs was hardly a remedy.

In a December 1969 speech at the Boston University Medical Center, I declared that the time had come to begin phasing in such a program, despite its unarguably high costs. I expanded these views and enfolded them into a larger arraignment of the American health care system in my 1972 book
In Critical Condition
. As a member of the Labor Committee's health subcommittee, I had been in communication since the end of 1968 with Walter Reuther. Reuther is remembered as the progressive president of the United Auto Workers union, but his larger legacy, all but forgotten to history, is that of a social visionary whose humanitarian concerns included but extended well beyond the members of his union. When Reuther himself called for national health insurance in November 1968, I'd sensed an alignment of forces that could produce a new opportunity for action. In January 1969, when he invited me to join his new Committee of One Hundred for National Health Insurance, I did not hesitate. Reuther was killed in a small-airplane crash in May 1970, but the committee's work went forward, and in August 1970, drawing on its contributions, I introduced the first bill of my career for national health insurance. It was defeated: the first setback in a long, long struggle.

Still, with the help of others, I was able to gain some important early victories. In 1965, two physicians on the faculty of Tufts University, Jack Geiger and Count Gibson, came to one of the semi-regular policy dinners that I held, this time in Boston. The discussion that evening involved health care, and in the course of it the two doctors began to focus on the need to eradicate the barrier of distance that often discouraged poor and working people from visiting their doctors. From our conversation was born a plan for community health centers, modeled on experimental centers in the third world, notably Africa. The idea was not only to redress illnesses and injury, but to educate the community in prevention and healthy living. Excited by their concept, and aware of funding possibilities through the new Office of Economic Opportunity, I introduced an appropriation bill in 1966 that would expand upon their concept, providing $38 million to make it a reality. The original plan was for two neighborhood health centers, one at Columbia Point in Boston and the other in Mount Bayou, Mississippi.

In searching for allies, I approached Adam Clayton Powell Jr., the charismatic congressman and social activist from New York's 18th District, which included Harlem. As chairman of the House Education and Labor Committee, Powell had championed Jack's New Frontier programs, and helped steer many of them into law. He'd done the same for Lyndon Johnson's Great Society initiatives.

In 1966, Powell was fifty-seven, still handsome with his neatly trimmed mustache, and still very much the master of his congressional domain. When I visited his committee to make my pitch, he obliged me to wait for several hours as they went through their other business. Yet when he finally turned to me, I received the full force of his famous spark and dazzle. "Teddy Kennedy!" he began. "You want these neighborhood health centers?" I said that I did. "How many are you going to have for thirty-eight million?" he asked. I said that it would cover two and (quickly anticipating Powell's own interests in backing me) perhaps four. Powell shot back, "You write in there that one of them is going to be in my district, and you've got it!" I told him that that would be fine with me. I wrote it in; Powell steered the bill through the House; the Senate passed it; and that was the beginning of neighborhood health centers across the United States.

My battle against cancer first struck home in 1973.

Teddy was a seventh grader at the St. Albans School in Washington that fall. He'd turned twelve on September 26 and was proud to be a member of the Bulldogs' football team despite his slight build. Thinner and smaller than I had been at the same age, he was nevertheless a good athlete in the style of Bobby, whom he'd adored--a good runner especially.

He was an even better student, thanks in part to his own perseverance. He'd determined to keep up academically in this highly demanding school. He was exceptional at memorization. This was something he and I worked on when he was a small boy, and I remember almost to the moment when he dazzled us with his first big breakthrough. It was during a ski weekend with Bobby and his family at Stowe, Vermont, one spring. After a hearty dinner, I reminded my son that it was time for him to go and learn his next assignment: "Casey at the Bat." Triumphantly, Teddy announced that he'd already memorized it--then recited it at the table, to everyone's applause.

At St. Albans, he and the other students were required to memorize one poem each week. I remember listening enchanted as Teddy mastered Yeats's "The Second Coming": "Turning and turning in the widening gyre / The falcon cannot hear the falconer..."

On November 6, Teddy came down with a cold and remained home from school at our McLean house, where he padded about in a bathrobe. I was in the library, just winding up a briefing session with staff. As I walked out, I spotted my son and noticed that the area just below his right kneecap was discolored by an ugly reddish lump. He grudgingly admitted that it hurt a little--which meant, in Kennedy lexicon, that it hurt a lot. I assumed that it was nothing more than just a football bruise. (Teddy himself said later that he'd thought it was Osgood-Schlatter disease, a common affliction to fast-growing young knees that several of his classmates had experienced.) I asked our governess, Teresa Fitzpatrick, to telephone Dr. S. Philip Caper, who had been affiliated with Harvard Medical School, but was then in Washington as a staff member for my Senate health subcommittee.

The doctor rang our doorbell scarcely half an hour later. He was en route to a formal event and was dressed for the occasion, yet he examined my son with fully professional concentration. It was probably nothing to worry about, Phil said, but we should keep an eye on it. He'd check back in a couple of days.

I flew to Boston on Thursday, November 8, to complete some work out of my office there and had planned to fly down to Florida the next day for a brief visit with my mother in Palm Beach. But when Teresa called me to say that Teddy's leg was not better, I really became concerned. I told Teresa to call Dr. Caper, and I made plans to return to Washington the next day when my Boston events were finished, instead of visiting my mother. Phil arranged for Teddy to see the chairman of orthopedic surgery at Georgetown University Hospital, Dr. George Hyatt. Dr. Hyatt examined my son and had X-rays taken.

As I flew back to Washington the next day, I began to have an almost overwhelming sense of dread, but I willed myself not to think of the possibilities. In truth, they
were
unthinkable. Phil Caper met me at the airport, and the expression on his face made me brace myself. He told me the situation was serious: that Dr. George Hyatt at Georgetown felt certain that we were looking at a bone tumor. We immediately went to Georgetown, where Phil and I met personally with Dr. Hyatt, and he repeated the same devastating news. He added that if we were indeed looking at bone cancer, then Teddy's leg would most likely have to be amputated. He wanted to bring Teddy into the hospital for more tests and to consult with a broader group of experts from other institutions as well. I readily agreed.

Later that day, my good-natured twelve-year-old son checked into the hospital for more X-rays and blood tests and examinations. He was so innocent and trusting. I could barely absorb the realities of the situation, and I didn't feel that it was the time to discuss it with him. Joan was traveling in Europe, and I hadn't even been able to talk to her yet.

After two days of tests, the news was no better, but the doctors let me take him home for the rest of the weekend. We wanted his life to be as normal as possible for as long as possible. When we got back to our home in the Washington suburbs, I grabbed a football, went out to the lawn, and threw passes to my son. As he ran to catch them, I was fighting not to be crushed by emotion, knowing that this was probably the last time that Teddy would be able to run on two legs. I didn't tell him what the future held. There would be time enough for that. I just played ball with my son and savored every moment and prayed that he was going to survive. There had been so much loss. But please God. Not Teddy.

I called Joan. She needed to come home from Europe. We were facing a life-and-death situation for our son.

Teddy returned to the hospital after the weekend and on Tuesday, November 13, the doctors operated on his leg to remove a small slice of the tissue believed to be malignant. The tissue was analyzed immediately by Dr. Lent Johnson of the Armed Forces Institute of Pathology, the country's leading expert in analyzing this kind of tumor.

I did not leave the hospital. Dr. Hyatt delivered news both devastating and hopeful: Teddy's right leg would have to be amputated above the knee, and quickly, in an attempt to overtake the cancer that was probably spreading. The hopeful news was that the type of cancer seemed to be chondrosarcoma, which attacked the ligaments and was a good deal less deadly than osteosarcoma, cancer of the bone, which took the lives of 80 percent of its victims within five years. Still, no one was sure.

The surgeons made plans to amputate Teddy's leg on Friday, November 16. Only Teddy's persistent cold prevented them from operating the next day, as they'd have preferred.

As of Thursday, I still had not told Teddy of what lay ahead. I'd consulted a child psychiatrist to get help on how to break the news. He said that we shouldn't tell Teddy too far in advance, to minimize his level of anxiety, and we had to tell him in the right way. On the day before Teddy was to have surgery, I went with Phil Caper and Dr. Robert Coles, the renowned child psychiatrist from Harvard, to deliver the news to my son. I'd heard and delivered more than my share of bad news in my life, but this was the worst of the worst. My twelve-year-old son started crying, and I was fighting back emotion with every ounce of my being. I held Teddy in my arms and told him that I'd be there with him, that we'd face this problem together, that surgery would take care of the problem so he could be well, that we would have many happy days still ahead. I needed to believe those words as much as he did. In the end, he accepted the news bravely, but I'm not sure that his young mind could truly absorb what it really would mean to lose his leg above the knee.