Wednesday, June 11, 2008

Regarding John McCain's age and health

Nate at posts comments by Will Carroll (subscription site) who analyses medical histories (baseball players, specifically, but I noticed a tickler comment at the link speculating why Big Brown missed the Triple Crown at Belmont) for a living.

I'm not worried about anyone's health (note what an impact Randy Pausch is having on his way to dying) as much as their character and political aims. My memory of the Sixties remains vivid enough to make me imagine the Civil Rights Act of 1964 may not have passed had JFK not been killed. The man and his whole family were widely reviled here in the South and only after his assassination did it become bad form to spew vitriol in that direction. Thankfully, there is provision for an orderly transition of power following the death of a president although disability (Wilson, FDR and Reagan are cases in point) is a more ambiguous issue. So the health of John McCain is way down the list of my concerns.

Unlike Bob Dole, a comparable that many have brought up due to war injuries and an advancing age at the time of their campaign, McCain never seems to wear down. Given his workload recently, made up of mostly fundraisers and media opportunities, he's had a chance to rest that his opponent has not. Sure, Obama's relative youth and athleticism should give him some recovery advantage, but the fall campaign is not going to be the same kind of long-term grind that could wear on McCain. Focused on a few big performances and keyed to his electoral needs, McCain will be able to pick his spots.

McCain's two most significant injuries are to his shoulders and his history of melanoma. The shoulders are a visible sign of his captivity in Viet Nam, leaving the Senator unable to raise either arm significantly above his head. While it prevents a vigorous Nixonian wave of victory, it isn't noticeable and without prompting, most voters don't notice a deficit. The signs of melanoma, a puffy cheek and a long, five-inch scar on his left cheek, are far more noticeable. His appearance on "Saturday Night Live" highlighted his need for careful control of the media environment. McCain needs to be seated head-on to his audience, lit from his right and does not like to turn his head to stage right, exposing his scar. While the signs of melanoma have not recurred, the data does raise some concerns.

There was, buried in his extensive medical records, one glaring warning sign. In an article in the New York Times, Elisabeth Bumiller found that McCain's physicians had noted not one, but two melanomas and suggested some spread. Doctors aggressively removed lymph nodes - hence the large scar - and halted the spread. McCain himself knows well that melanoma can recur. He's had two other instances of melanomas being removed, once from his shoulder in the early 1990s and another on his nose in 2002, two years after the more noted melanoma removal. McCain's health and vigor eight years after the most significant melanoma is a good sign. Patients with this type of cancer have a 65% survival rate, but this is more a curve than a line, trending back up after a period of time.

Finally, McCain claims a genetic advantage and does appear to have it. His mother is 96 years old but notably vigorous and mentally sharp. The rest of his family history is less notable. His father, a Navy Admiral, lived to age 70 while his grandfather died at 61, worn down by the stress of combat during World War II.

Overall, McCain is in good shape for a 71-year-old who has been through harrowing torture and multiple bouts with cancer. McCain's most obvious comparables, Bob Dole and Dick Cheney, offer interesting lessons. Both would have had far more negative Health Reports during their campaigns, but both are alive and well at the end of their terms (in Dole's case, the hypothetical). History is not destiny, but neither is destiny predictable. Age will surely be an issue, though health it appears, should not be.

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