No, Paul Tsongas was not like Hillary Clinton
I can’t say I ever expected to be writing a post in 2016 defending Paul Tsongas. But here it is.
Tsongas was one of the very few politicians I’ve ever really liked. Here’s a post I wrote about him in 2011 that included a video I’m going to reproduce here because it displays both his unusual personality (for a politician, that is) and his politics:
No, he wasn’t perfect. And yes, as many have pointed out recently, had he won the Democratic nomination in 1992 instead of Bill Clinton and been elected president, he would not have served out his term because unfortunately he died a few days before the term would have been over, and was quite ill during it.
The context in which Tsongas’ name has come up in recent days is Hillary’s coverup of her health status, which has been compared to his. Jim Geraghty wrote a National Review article yesterday making such a comparison:
In 1992, Massachusetts senator Paul Tsongas was one of the leading candidates for the Democratic nomination. He had been treated for a form of lymph-node cancer, or lymphoma, from 1983 to 1986, but when he ran in 1992, he declared himself “cured.” Tak Takvorian, Tsongas’s doctor at Harvard’s Dana-Farber Cancer Institute, told reporters, “I’m very confident that he’s fine.”…
In December 1992, he announced that a new growth in his abdomen was cancerous, and he underwent chemotherapy and radiation treatment. He spent a good portion of the next four years in hospitals, dealing with complications from the treatment. Had Tsongas been elected in 1992, he would not have lived to the end of his first term: He died on January 18, 1997, two days before Clinton’s second inauguration.
It’s scary to contemplate an alternative history where Tsongas won the White House, aided by doctors who misled the public about his condition.
I have to correct the record, because although Geraghty ends his piece by saying that Tsongas has been forgotten, he’s not been forgotten by me nor by many others who supported him in 1992. Nor has the story of his health problems been forgotten.
There is no question that in retrospect his health problems would have made a Tsongas presidency very difficult or perhaps impossible. However, here are the details, which indicate the complexity of what happened [emphasis mine]:
In September 1983, while serving as a freshman senator, Tsongas was diagnosed with lymphoma, a form of cancer that affects the lymph system. Citing his desire to be with his family, the young Democrat chose not to seek re-election to a second term in 1984.
Instead, he returned to Boston and underwent a then-experimental form of treatment known as “autologous bone marrow transplant.” Under the care of Drs. George Canellos and Tak Takvorian, Tsongas had marrow removed from his hip and purified. With his marrow out, he was treated with whole-body radiation in an effort to kill all the cancerous cells in his body.
Later, the marrow was reinjected, and Tsongas made an impressive recovery. As a presidential candidate, he made a point of demonstrating his good health by walking and swimming. Tsongas also he spoke at length about his illness and treatment and asked his doctors to do the same.
In an interview with The Washington Post in November 1991, Tsongas said he considered himself “cured,” because he had been cancer-free for more than five years. In separate interviews, his doctors declined to use the term “cured,” but they said Tsongas had been disease-free since he was discharged in October 1986 and that they could find no medical problems.
In the 1991 Post interview, Tsongas noted that in 1987 “they found a node in my armpit, and to this day they disagree on what it was but they pulled me in for a mass of radiation.” Some Boston news media described the node as a recurrence of cancer.
In April, 12 days after Tsongas suspended his Democratic presidential campaign, The New York Times depicted the 1987 node as a “recurrence” of Tsongas’ cancer and suggested that the candidate and his doctors had been less than fully candid.
Tsongas’ doctors said in April that it was unclear whether the node, which was treated with radiation, was a recurrence or a batch of residual malignant cells from the original case that had escaped treatment. In any case, they said he remained healthy.
Tsongas had used the word “cured,” which usually isn’t quite appropriate for cancer patients but was often used at that time if a person had survived for five years and seemed cancer-free. He explained that, his doctors explained it, and even the 1987 node was explained by Tsongas in 1991 as ambiguous (which it apparently was). People can nitpick over every detail in an arena of medicine that is not crystal clear anyway, but I would not call what Tsongas and his doctors said a coverup—in fact, there was quite a bit of disclosure.
However, Tsongas had a recurrence that was first diagnosed in August of 1992 months after he had dropped out of the race (he had dropped out in March), and it was successfully treated. There is some disagreement about how sick Tsongas was for the next few years; this article indicates he was sick enough that he probably would have had to resign the presidency had he won it, while this article indicates he continued to be active and involved:
Mr. Tsongas practiced law and, with former Senator Warren Rudman of New Hampshire, a Republican, helped start the Concord Coalition, a nonprofit group that focused attention on the budget deficit and other economic problems.
He also remained active in public affairs in his home state.
But all of that is irrelevant to the question of whether he was too secretive or even deceptive during the 1992 campaign about his health history. Neither he nor his doctors could not see the future, and he really had been healthy and active for many years at the time. Neither he nor they had reason to think that would not continue, and my strong recollection is that everyone knew he was more at risk of a recurrence than someone who had never had lymphoma.
In retrospect, it’s probably best that he wasn’t elected because I think he could not have withstood the rigors of the presidency. But that’s hindsight.
Geraghty’s article doesn’t mention exactly what Tsongas died from, but it was not cancer; it was a complication of treatment:
Mr. Tsongas, who was hospitalized on Jan. 3 [1997] with a liver problem related to his treatments for non-Hodgkin’s lymphoma, a slow-growing cancer of the lymph system, and later developed pneumonia, died at Brigham and Women’s Hospital.
Mr. Tsongas made his survival from cancer an issue in his Presidential campaign when he and two of his doctors, Dr. Tak Takvorian and Dr. George P. Canellos, said he had been cancer-free since a bone-marrow transplant in 1986.
In May 1996, he underwent another transplant, getting bone marrow from his twin sister, Thaleia Schlesinger, to correct myelodysplasia, a bone-marrow disorder that can occur in people who have recovered from lymph cancer.
When Tsongas died, he was entirely cancer-free.
You may think I’m nit-picking over this, but I still have enough respect for Tsongas that I don’t like to see him portrayed as a Hillary-esque liar. It is impossible to see the future, and my sense is that he and his doctors truly thought he would be healthy, and disclosed quite a bit about his illness without giving a worst-case scenario. Unfortunately, that worst-case scenario played out.
RIP, Paul Tsongas.
In 2005, I think it was, my best friend came down with cancer. She underwent a course of chemotherapy, at the end of which the doctors said she was likely cancer-free; but just to be on the safe side, would she want to go for a course of radiation therapy.
She decided she would. As a result, she contracted pneumonia and died of it in early 2006.
I can well believe that Mr. Tsongas’ cancer cells had been killed, and that he died of pneumonia.
I think that’s a fair distinction. Tsongas was putting the best spin on an ambiguous situation, and seems to have believed what he said. In retrospect, it wasn’t that far off the mark, though it was over-optimistic. I find that different than the Clinton camp saying “nothing to see here. Move along.”
“… I don’t like to see him portrayed as a Hillary-esque liar.”
Hear hear. I’m hard pressed to think of another American president as devoid of decency or morality as Obama and the Clintons.
Tsongas’ onetime chief of staff was my landlord (and housemate too, briefly) in D.C. for a time — from ’79-’84. He had been hard at work fundraising for the ’84 Senate campaign when news came from Paul that he had been diagnosed. Difficult, hard, sad days, those, for thems that were close to the Senator. He was well loved by many.
I remember Tsongas as an honorable politician. It yanks my chain whenever some wishy washy republican is compared to Reagan. And, comparing anyone in American politics in any manner whatsoever to hrc is an insult; so I understand your desire to set the record straight.
I’d still give Tsongas the benefit of the doubt, as I did then. It seems that back then there were still democrat politicians who placed the nation’s welfare ahead of an ideological agenda. Still understood that “politics stops at the water’s edge”.
I do not believe that to be the case today.
No way does the DNC and democrat elite not suspect/know that Hillary is suffering from a debilitating illness that disqualifies her from the Presidency. As a party, the leadership and, much of the base, places ideology far above our national security. And of course, there are many other indications that this is the case.
Tsongas was astute and personable; I liked him too. When he died there was some concern to the effect: “Was he hiding something?” But our minds expect hindsight to find causal connections to everything. Neo, how did Clinton try to exploit concerns on Paul’s fitness to serve in 1992? I’m not sure the 1992 electorate would consider attacks of that nature to be in good taste. Of course the 2016 electorate is expecting campaigns to be reality shows dishing out rumors, insults and scandals at regular intervals.
The really ironic thing about this attempt to make Clinton look better by comparing to Tsongas is the fact that he died from pneumonia.
Tsongas’ history:
1983-initial diagnosis, large cell lymphoma. Rx Total Body Irradiation (TBI). 1987-recurrence, armpit, irradiated. 1992-intra-abdominal relapse, treated with chemotherapy. Died in 1997 of myelodyplasia (profound bone marrow derangement), said to have been ‘free” of lymphoma at death.
I was an MD member of one of the early autologous bone marrow transfusion/TBI teams circa 1980.
The treatment was extraordinarily hard on the patients, many of whom did not survive the therapy. Supportive care was less able than today, and marrow stimulating factors to speed marrow repopulation (Epogen and Neupogen were the first) had not yet been developed.
TBI is a supra-lethal radiation dose, wiping out the marrow. The patient’s own marrow is re-infused as rescue. But since lymphoma often contaminates the marrow, the re-infusion then returns lymphoma cells to the patient. Which probably happened to Tsongas.
Myelodysplastic Syndrome (MDS) is profound derangement of bone marrow, inevitably fatal. In Tsongas’ case, the TBI may have been causative. In the absence of a thorough autopsy, his being free of lymphoma at death is less than certain. Lymphomas sometimes burn out as (fatal) MDS.
With large cell lymphoma treated with TBI, Tsongas should never have run for president. It was vanity, as he himself later admitted. He was a nice enough guy, but mentally and biologically unfit for that office.
Frog:
The issue here isn’t whether he should have run for office; it is probably the case that he shouldn’t have. The issue is whether he and his doctors thought he could and thought that he would probably be okay.
No one ever said he didn’t have cancer, or covered up the type of cancer he had, or the fact that he’d undergone the transplant. This was all in the public domain at the time.
No. But we can only hope, R.I.P., Hillary Clinton.
Neo, you have your issue and I have mine. You don’t understand lymphoma. I do. It is a very complicated set of ailments.
“In the 1991 Post interview, Tsongas noted that in 1987 “they found a node in my armpit, and to this day they disagree on what it was but they pulled me in for a mass of radiation.” That is fairly Hillaryesque, a vague partial truth.
I guarantee he had normal tissue consequences of his TBI therapy.
You cited his docs, who were were false and misleading: “his doctors declined to use the term “cured,” but they said (in 1991) Tsongas had been disease-free since he was discharged in October 1986 and that they could find no medical problems.” What happened to the 1987 lymph node mass that got irradiated? They could not find problems? How hard did they look?
Frog:
As I said before, the issue is not whether they put the best spin on it; they did. The issue is whether there is any analogy to Hillary’s lying about her situation; there is not. Tsongas was very upfront about the exact disease he had had. The only really controversial part was that lymph node, which was probably treated just a couple of months after the initial treatment ended in 1986 and was considered (as far as I can tell) to probably have been part of that initial presentation that they had somehow missed, and which was treated very very shortly after. So it would not technically have been a “recurrence” if they actually believed that, it would have been part of the original presentation. He was running for president in 1992, and it was approximately five years later.
I am fairly sure that if they had been entirely upfront they would have said something like: his chances of a recurrence are (some sort of percentage), and his chances of filling out his term in decent health was (some sort of percentage). They didn’t do that.Full disclosure would definitely have indicated they say more than they did, with more exact figures (which are only general estimates for a general population, anyway). But they certainly said a lot about his illness that was accurate, and there was nothing like a coverup where they said he had one thing and he really had another.
I have no idea how hard they looked after 1987, but that node was successfully treated and until August of 1992 there is no indication he had any health problems or any recurrences. Do you not think they would have been monitoring him all that time, according to the standards of the day? Of course they were.
By the way, this letter to the Times from his wife makes a reference to the fact that the 1987 node was not kept a secret; it had been discussed openly by Tsongas in Boston some years earlier.
See also this and this. And here’s some information that documents what Tsongas’ wife wrote to the Times, the fact that the 1987 biopsy had indeed been disclosed considerably earlier and was considered minor.
Neo, you overlook my points. His only anti-lymphoma treatment in 1983 was TBI, so from then through 1986 his lymphoma was in remission.
The docs in 1991 did not in their statement reference the 1987 relapse. An untruth.
I have seen very bad medicine practiced then and today at Mass General and the big name academic centers where I once worked. VIPs get less good care, very often, than mere grunts. Who are we to assume he got great care?
Frog:
If you read my links I think a great deal of that is explained. You don’t have to accept their explanations, of course.
Of course it’s possible he got care that wasn’t very good. I certainly don’t know his doctors, and I’ve had my own bad experiences with doctors, even once with a doctor at Mass General. But he went to a place with a very good reputation and supposedly got cutting edge care. More than that I cannot say, nor can you, since I’m assuming you don’t know his doctors personally, nor have I noticed you have any specific complaint about his actual treatment at the time.
OK, Neo. I was addressing other issues in earlier comments, so here goes:
The TBI treatment he got when first diagnosed with “large cell lymphoma”, of which there were/are several types, was totally inappropriate as frontline therapy in 1983.
Totally inappropriate, as a matter of fact and of opinion.
Certain types of “nodular” lymphomas run smoldering courses, and prudent practice then would have been multidrug chemotherapy for a “diffuse” large cell lymphoma, vs. observation if “nodular”. Whether he had nodular or diffuse was never stated. I presume it was diffuse.
That’s what we do today, too. No one with lymphoma gets TBI going out the gate, not even in the earliest days of TBI, which is a scary, toxic treatment. Kills some, cures none.
Frog:
If I’m reading your comment correctly, it seems you think that Tsongas had TBI and a transplant shortly after diagnosis—am I understanding you correctly? Actually, he was diagnosed in 1983, and received the TBI and transplant in 1986. See this as well as this. From the latter source (according to which, his original diagnosis was small-cell rather than large-cell lymphoma):
It was the later recurrence (late in 1992) that was described as large-cell lymphoma. The initial manifestation of lymphoma in Tsongas was the small-cell variety.
Here’s another article that states the history fairly clearly:
Apparently the 1992 treatment for the large-cell growth was successful in terms of the cancer recurrence, but it was after that (I don’t have an exact date) that he developed myelodysplasia. It was the myelodysplasia and treatments for that (and complications from that treatment, too) that led to his death.
Neo, the dates I used were from your prior reference (The Tech-online ed.), which stated,
“In September 1983, while serving as a freshman senator, Tsongas was diagnosed with lymphoma, a form of cancer that affects the lymph system. Citing his desire to be with his family, the young Democrat chose not to seek re-election to a second term in 1984.
“Instead, he returned to Boston and underwent a then-experimental form of treatment known as “autologous bone marrow transplant.” Under the care of Drs. George Canellos and Tak Takvorian, Tsongas had marrow removed from his hip and purified. With his marrow out, he was treated with whole-body radiation in an effort to kill all the cancerous cells in his body.”
Now you cite a new reference, with different dates and somewhat different story. Ah, well.
My remarks about Tsongas, TBI and lymphomas will stand.
Frog:
No, it’s not a new reference. It’s two new references that clarify something that was left unstated in the old reference.
The facts are that he was diagnosed with small-cell lymphoma in 1983, and had the transplant in 1986, and had a recurrence of lymphoma in late 1992 but this time it was of large cell lymphoma in the abdomen. There is no source I could find that says otherwise. The one you quote—the first one I offered—is merely less detailed.
Take a look at that first source. It says he was diagnosed in 1983 (does not specify small or large cell, so that part is ambiguous). It says he quit Washington in 1984. It says that some unspecified time later he had the transplant. In fact it was in 1986, and you can find source after source that specifies that. In fact, it’s an undisputed fact. Nor does that first source contradict it; it merely leaves it out.
I have no idea why you are having trouble assimilating this. I offered this facts to you because, with your background, I’m curious—now that the facts have been clarified and detailed for you—what you think.
You were basing you old opinion on assumptions about Tsongas’ medical history that turned out to be incorrect, based on an ambiguous account. Now you have new facts that clarify things for you.
Your first source read, “Instead [of running for re-election], he returned to Boston and underwent a then-experimental form of treatment known as “autologous bone marrow transplant.” Why should I have looked into it further when I responded to your essay? That’s a pretty clear statement.
I considered him a (medical) fool back then for reasons I think I have made clear. That opinion stands. He was a Mr. Rogers kind of fellow. Maybe likable, but not presidential in fiber.
Frog:
No one’s saying you should have looked into it.
However, you had misconstrued that quote as meaning that Tsongas’ transplant had happened more quickly after his diagnosis than it actually did, although the quote didn’t give a date. You seemed to have based your opinion of his medical treatment on the fact that you thought he had the transplant quickly, and also on a misunderstanding of what his diagnosis back then was (large vs. small-cell?). At least, that’s how I interpret your earlier remarks.
I then offered some more information that should have clarified both points for you—the fact that the transplant was in 1996 and that his diagnosis at the time was small-cell lymphoma. How on earth do you interpret that as meaning you should have done your own extra research? I neither said that nor implied it. I merely did the research for you, later, and asked for your opinion based on the added information. Instead, all you say about it is you considered him a (medical) fool back then for reasons you think you have made clear, and that that opinion stands. But why do you say that? If he had small-cell lymphoma and all other treatments were unsuccessful for three years, do you still think a transplant was stupid? I’m curious why you say that. One of the articles I quoted in this comment of mine had stated:
If his condition had worsened despite conventional treatment, why was it stupid to take that option?
One did not do autologous marrow transplant and total body irradiation (TBI) for progressive lymphoma. The “body burden” of disease is too high for any honest hope of success. One did it for consolidation of a good response to chemo.
This is the first I’ve heard his conditioned worsened in 1986.
Lymphoma, as I said earlier, is a complex spectrum of complex diseases.
Large cell v. small cell? Who knows? Very different diseases. Lymphomas can morph from bad to worse over time, and morph in biopsy appearance also.
As a result of our tete-a-tete re Tsongas and his illness, I now think we do not know enough about the actual medical facts, since they come from non-medical sources. But I do know as a medical expert that electing Tsongas to the presidency after TBI was a bad idea. As I said, the bad normal tissue consequences of TBI are many and some quite slow in developing. Never mind the disease recurring in office. Tsongas’ remarks and those of his docs are reminiscent of Hillary and her doc’s BS, putting a good spin on stuff.
Tsongas was a hard guy not to like, or so I remember him. But that was in my squishy semi-liberal days, when I was more gullible politically. I now remember him as a Mr. Rogers for adults. “It’s a beautiful day in the neighborhood. Will you be my neighbor?” Part of our national emasculation.
Frog:
Then I think we are finally in agreement on Tsongas’ medical situation—we just don’t know enough. I think he acted in good faith, though. And I agree that it would have been a bad idea for him to have been president, because his health declined after the campaign and he would have been ill a great deal of the time.
However, on Tsongas’ personality—we very much disagree on that. I remember him as a highly unusual combination of extremely likeable and also quite tough. Did you watch the video? He doesn’t seem the least bit squishy or sanguine to me—no Polyanna there. He was a straight talker, actually. Nor do I see anything unmasculine. He’s not a blusterer, but he’s straightforward.
Neo-
Haven’t watched the vid. Was just remembering my impression of long ago! I thought he was likable enough.
Frog:
Why not watch it, then, to refresh your memory? You may or may not change your mind. I’d be curious to know what you think.
The video is rather short.