[World, March 12, 1994]
It was "almost providential."
This is a cautious man speaking. Governor Bob Casey is not given to effusive pronouncements. His lengthy form is folded behind the ornate desk, but his long arms sometimes escape to chop the air in emphasis. White hair and black eyebrows lend him an intense appearance, but his manner is plain-spoken and unaffected, and always marked by caution.
For some of us the word "politician" brings to mind a beaming Senator Claghorn, glad-handing and declaiming ostentatiously saccharine sentiments. This office in the Pennsylvania state Capital would be the good Senator’s natural setting, a suite of vast high-ceilinged rooms brooding in heavily-carved dark English oak. The entry room is large enough for a cotillion; at one end, the receptionist sits framed in a huge yellow arch of Venetian marble, a walk-in fireplace. Around the wall march enormous murals depicting the struggle for freedom of religion in America. George Fox jostles up to William Penn, everyone posing in the storybook manner of illustrator N. C. Wyeth. This sort of grandeur typifies governmental building of the era (this specimen is from 1906)—a time of heady optimism and faith in human progress, before World War I effected its own brutal form of reality therapy.
An architect’s dilemma exists for such magnificent old piles, however. When seen from a distance, perched above a massive flight of stairs, they look impressive; but when the viewer approaches to actually enter the building his eyes are fixed down on those stairs. Objects at foot level steal attention from the magnificence. The last impression a pedestrian has before setting foot inside the huge stone building is a firm, practical message centered over the curbside drain: DO NOT DUMP.
In a world of Senator Longhorns, Governor Bob Casey is a DO NOT DUMP sign. He is direct and unaffected; nothing is done for dramatic effect. He is strong-willed and self-disciplined, and too busy to spend time in self-observation.
Just as he breaks the politician mold, he disrupts party lines. A committed Democrat, he is just as committed to the cause of defeating abortion. In the last election he ran against a female Republican, a woman who favored abortion and attacked him for his "no-exceptions" stand. One of her TV commercials showed a rapist’s face, backed by a woman’s screams; the face then dissolved into the likeness of Governor Casey.
It was in this overheated setting that the Governor approached his important televised debate with his opponent. His political advisor pleaded with him to modify his abortion stand and at least say, reluctantly, that abortion should be legal in cases of rape and incest. "If you don’t do this," the advice went, "you will lose this election."
"If I lose, I lose," responded Governor Casey. He won by a million votes.
Since then his name was carried to the Supreme Court in the case of Planned Parenthood vs. Casey; the court’s June 1992 decision affirmed most parts of Pennsylvania’s pro-life law, while declining to dismantle Roe vs. Wade. More recently, Governor Casey has challenged a Clinton administration directive (released, with appalling bad taste, on Christmas day) requiring that states use Medicaid funds to pay for abortions in cases of rape and incest. Where states have laws forbidding this use of public funds, those laws must be voided. Where states require women to report these crimes to the authorities, those requirements must be dropped.
Governor Casey is leading a charge against this ideologically-driven directive. He is fighting to keep his state’s reporting requirements, on the double grounds that they protect sexual abuse victims from being subjected to secret abortions by their tormentors, and that requiring women to make official their allegations of violence eliminates false claims: it cut the publicly-funded abortion rate in Pennsylvania by 90%.
A stealth directive from the White House, especially one promoting abortion, constitutes fighting words to this seasoned political combatant. The Scranton Times runs photos of President Clinton and Governor Casey side-by-side, with the brief caption, "At it again."
Courageous leadership in a battle like this is what pro-life citizens would hope from any governor. It’s a little different that this governor is a Democrat. It’s a lot different that, this time last year, the Governor was dying of a supposedly incurable disease.
This is the story he tells, one in which an overly-excitable person might claim the hand of Providence. It is his own story, and reaches its turning point with a dramatic heart and liver transplant just nine months ago.
"The fact that I was able to get to that point was incredible. I had a disease called familial amyloidosis; they call it an ‘inborn error of metabolism,’ where an organ in your body has a glitch that causes it to produce abnormal quantities of one substance or another. In my case the liver produced an abnormal protein that coats the organs, including the heart. So I had a disease for which there was no cure.
"Then I just happened to get a book from Dr. Thomas Starzl, who is one of the leading transplant surgeons in the world. Dr. Starzl did the first successful liver transplant in America, about 30 years ago, and he’s made the University of Pittsburgh probably the most prominent transplant center in the world.
"He sent me a copy of his autobiography through our state treasurer, but it was here for six weeks before I knew I had it, because gifts have to be tagged and valued. But twice when our treasurer called me on other matters she asked if I’d seen the book yet. The second time that happened I said, ‘I still haven’t seen it, but I’m going to call right now and get it.’
"When I got the book I saw there was a dedication on the flyleaf, so I called Dr. Starzl simply to thank him for thinking of me—I didn’t have any other purpose than that. In the course of the discussion I said, ‘By the way, what do you know about amyloidosis?’ He said, ‘I’ll call you back in 5 minutes.’
"He called me back in five minutes and said ‘I can cure amyloidosis with a liver transplant.’"
An amazed smile breaks over the Governor’s face. This story is ever new to him.
"There I was thinking there was no cure, and all of a sudden from nowhere appears my savior. I was three feet off the ground. I just couldn’t believe it."
What the Governor fails to tell is the extent to which he is responsible for his own healing. He had spent long hours researching the disease, reading medical journals and interviewing doctors, before encountering the famed transplant specialist. In fact, information Governor Casey had gathered and passed on to Dr. Starzl was essential to his cure.
This determination and self-mastery has Dr. Starzl, a world-renowned physician who has seen it all, obviously puzzled. "He was like a guy in a tiny prison, and all by himself, with no help from anyone, he figured a way to get out," says the surgeon. "It was remarkable how he grabbed onto the last rung of life on his way down the chute and pulled himself back to the top."
Governor Casey resumes the story. "So we’re into May by now. Quickly I got together with Dr. Starzl and my other doctors. A surgeon in Boston told me he had had five similar cases with good results, and that they had done six cases in Sweden in 1990, and all these people were doing well. If you have amyloidosis of the kind I had, the disease is confined to the liver. If you replace the liver with a new one, the disease is cured."
Then it turned out that a liver transplant was only half the story.
"But with a liver transplant, there’s tremendous strain put on the heart. When they reconnect the liver after transplant, that surge of blood through your system creates what they call an ‘insult to the heart.’ Unless your heart is sound, you can’t stand it. So I needed both."
The series of coincidences didn’t stop at the point of finding the right doctor. Part of the story weaves in and out of a town named Monessen.
"Monessen is right near Pittsburgh. When you drive into town there’s a big steel mill for block after block, and of course all that’s down now.
"Monessen was to me a symbol of our commitment to the towns of western Pennsylvania that had been bypassed by the loss of the steel industry. It was not only an economic problem but a human problem. You had families broken up, alcoholism went up, domestic abuse, suicide, depression, the dreams of a lifetime dashed overnight. The day after I was sworn in as Governor I kept my pledge to go to Monessen, to symbolize my committment to western Pennsylvania.
"Monessen is where the donor of my heart and liver came from. Michael Lucas was 34 when he was beaten to death, and his mother and sister made the decision to donate his organs. Michael Lucas was also a participant in our jobs program. Last April—just before the surgery in June—I visited Monessen again, to give awards to some women who were making a transition from welfare to work. In the very building where I was that day, Michael Lucas had gone to enroll in a job training program."
The relationship between these two men, who never met, is complex. It is not unusual for transplant recipients to have a desire to finish the work of their donors. In this case, Governor Casey is hoping to establish a Michael Lucas scholarship; the money would go to a black medical student with an interest in becoming a transplant surgeon.
After news of the surgery broke, there was some grumbling that the Governor must have been given preference in the selection process; his prestigious position must have moved him to the top of the recipient list. Not so.
"The rules that govern the allocation of organs operated two ways in my favor. One, I was close to death, according to the surgeons. Secondly, if you’re going for a double organ transplant you move to the top of the list; a lot of people have benefitted from that rule."
Governor Casey doesn’t look like a man who was on the doorstep of death less than a year ago. Though lanky, he appears reasonably filled out, with good color and no trace of gauntness. Yet Dr. Starzl says that, before the surgery, "His heart was not functioning at a rate compatible with human life. His legs were all blue and he had no circulation to speak of in his hands. I was taken aback, but his brain was still working like a computer."
The Governor’s assistant Karen Walsh confirms that keeping up with him in those weeks before the surgery was trying, even for a healthy woman half his age. "I think he put out an announcement of some sort, or was on the road, every day in the month of May. Two weeks to the day before the announcement that he was seeking a transplant, he was made an out-of-town trip. Those days started at 7:00 in the morning and went till midnight, doing things like walking around strip-mining land, and looking at options to bring the community back. Then the budget was passed that day, so he came back to Harrisburg and signed the budget at 11:30 Friday night. That same month he launched his children’s health insurance program.
"Just speaking as someone who was traveling with him, I know I would be in tears from exhaustion at the end of the day." She gives him a look both maternal and respectful, an attitude typical of his staff. How do you protect someone who has no concept of needing protection?
Mrs. Walsh goes on, "The doctor described the Governor’s heart as being as hard as a telephone. Two of the chambers were shut down. Yet he never took a day off. He walked into the hospital on his own, no wheelchair or crutches. He just walked in with a smile on his face, and when they took a look at him they said, ‘Holy cow!’"
The Governor admits, "My cardiac index was so low they couldn’t understand how I could get around. People with that index are flat on their back. But they took a look at me and said ‘You’re staying right here, you’re not going to leave this hospital.’ At that point I was glad to hear that, because I knew that I was winding down."
This story is one of amazing strength and determination, yet articulating the source of that strength is beyond the Governor’s ability or interest. Self-reflection is not his strong suit.
Q. "How did you keep going at such a rate until then?"
"You just put it out of your mind. You don’t have to sit around thinking about it."
Q. "Where, in your background or upbringing, does this stamina and strength come from? "
"It’s just yourself, I don’t know. I can’t explain it."
Q. "Were there heroes of your childhood that showed similar determination?"
"Well, let’s see. I didn’t have many."
Mrs. Walsh reminds him that he’s talked before about his father’s influence.
"Yes, one the most powerful influences was my father’s life. He started out at 10 years old, working as a mule boy in a coal mine. He finished high school when he was 15 and never got a college degree. Still he was able eventually to go to Fordham Law School, and was admitted to the bar when he was forty years old. So he had a lot of determination, and I always took strength from his example.
"But I don’t think much about it, to tell you the truth, I really don’t. People always say to me, ‘How did you do that?’—the surgery and everything. I just say, ‘You have to have had the disease.’ Because if you’ve had the disease, when they say ‘I have an operation to cure you,’ you say ‘Where do I sign?’ If they say, ‘When do you want the operation,’ you say ‘Yesterday.’ If you’re not sick, then the thought of doing that is unthinkable."
After recounting the whole medical adventure for what must be the millionth time, the Governor looks satisfied to have wrapped the tale up neatly. He says, "So. That’s my story."
Q. "In everything you seem so steady and sure of yourself. Did you feel shaken up by any of this?"
"After going through all those experiences—the very improbability of my getting to the point where I was eligible for this procedure, the odds on my getting a book from a doctor I didn’t know, the odds on my calling him in return, the odds against him knowing something about the disease that a lot of other doctors didn’t know—that’s got to be a million to one shot.
"When that happened, I said to myself, the Lord’s carried me this far, he’s not going to drop me. He’s going to carry me the rest of the way. So I went into that surgery absolutely convinced in my own mind that I was going to make it. Don’t get me wrong; there’s a lot of fear and trepidation when you focus on what’s happening. But I just had a very strong feeling that He was going to carry me the rest of the way."
Q. "Do you have a sense that God has miraculously saved you for some purpose?"
This question prompts a frown of dismissal. "Oh no, I wouldn’t be so presumptuous as to get into that. I do think He certainly made it happen."
But questions about the future are inevitable. The Governor’s term will expire in January of 1995, and he is not eligible for re-election. There aren’t too many positions to follow an act like that.
Q. "To lot of people out there, you would be a dream candidate for President. Does that ever sound appealing to you?"
The Governor chuckles at this. "I get letters from people who say they wrote me in last time; that’s kind of fun—interesting. I don’t have any plans to run, but then again, who knows? I didn’t have any plans to be around this year either, but here I am. I’ve got a good pump and a good liver, and I’m ready to go."
Princeton professor Robert George, the Governor’s friend and speechwriter, concurs. "By all the usual indications, there is no political future for Bob Casey. But with Governor Casey, over and over we’ve seen that the ordinary rules don’t apply."
Ordinary rules don’t apply when you have an outspoken, no-compromise pro-life Governor, and he’s a Democrat; when you have a consummate politician, and he doesn’t know how to blather; when you have a dying man, and he shapes his own cure with both hands; when you have a heart-liver recipient that won’t rule out a run for the White House. Governor Bob Casey has made a career out of doing what couldn’t be done. It wouldn’t be out of the ordinary to expect more extraordinary doings up ahead.