Chapter 1
Does stress cause cancer? A November 2005 New York Times article considered the connection between stress and cancer an open question but noted “a tenuous connection between stress, the immune system and cancer with a surprising new insight that is changing the direction of research: it now appears that cancer cells make proteins that actually tell the immune system to let them alone and even to help them grow.” Women reportedly seemed convinced that stress caused their breast cancer while the “male ego” caused men to view stress as a “sign of weakness” better kept inside.1 I do not believe in keeping such concerns bottled up, but I also do not believe a challenge should be avoided because it is stressful.
One of my congressional colleagues, former Representative Billy Tauzin, who filled a vacant seat in the House of Representatives in 1980, the same year I was elected to the Senate, is sure that stress and tension caused his cancer. In the summer of 2003, Tauzin relates, he took excessive quantities of Motrin, which caused a bleeding ulcer and inflamed his immune system. He explained his situation to me, saying that stress creates the inflammation of the immune system, which then impedes it from functioning. When the immune system is, in effect, worn out, cancer sets in. He said the bleeding ulcer was diagnosed in December 2003, and a rare intestinal cancer was diagnosed in March 2004. That February he had an operation that removed portions of his stomach, intestines, and pancreas; the cancer had come within a half centimeter of his pancreas. Had the cancer invaded that organ, it most likely would have been fatal, since pancreatic cancer is virtually incurable. Tauzin noted that the operation took out twelve lymph nodes, three of which had dead cancer cells, which indicated that the immune system had successfully fought off some of the cancer attack. His operation, conducted at a very prestigious hospital, did not remove all the cancer, and when he then went to the MD Anderson Cancer Center at the University of Texas, he was told he had a 5 percent chance to survive. He was prescribed a drug known as Avastin, which was off label, meaning it was not designed for his kind of cancer. Miraculously, as he put it, the Avastin normalized his situation and eliminated the need for another operation.
After his treatment, the congressman was advised by his doctor that he would have to give up his seat in Congress if he was to have any chance of beating the cancer. Following that advice, he did not run for reelection in 2004.
When I met him for lunch in February 2007, he was robust and healthy and working for Pharmaceutical Research and Manufacturers of America (PhRMA). He said he had selected that job because he could help the pharmaceutical industry develop drugs to save other people’s lives. Tauzin said that he was diagnosed with a bleeding ulcer in the intestines at the same time that Representative John Dingell, his predecessor as chairman of the Energy and Commerce Committee, who later became chairman after the Democrats gained control in 2006, was diagnosed with a bleeding ulcer in his stomach. Tauzin asserted that beyond any question, both illnesses were the result of stress. After Tauzin had the operation, he was treated with massive doses of chemotherapy. He said his capacity to endure the chemotherapy was considered very surprising by the doctors.
He then disregarded his doctors’ advice: He was counseled against exercise, but he drove a tractor or bulldozer on his Louisiana ranch in his effort to regain his physical strength after losing forty-five pounds in his fight with cancer. He undertook that course because he felt that he could beat the cancer only if he regained his strength and stopped losing muscle. He recounted his “fear” every time he would take a CT scan: When he started to feel good, he thought the good cells were returning and was worried that maybe the bad cells were returning as well. When he took a CT scan and got a favorable report, he characterized himself as being euphoric. On one occasion, the doctor was otherwise engaged and took an hour and a half to tell him the favorable results, during which time he was very worried, thinking that the news would be bad. He was much relieved to find the news was good and expressed surprise that the doctor would keep him waiting so long before giving him the news, leading to additional stress. This resembled several of my own experiences with insensitive doctors. During our lunch, however, the former congressman was in his characteristic jovial mood, his health challenge largely behind him and a promising future still ahead.
My own story began in 2004, which promised to be an eventful—and stressful—year. The people of Pennsylvania had never elected anyone to a fifth term in the Senate, and the approaching election promised to add to a list of political challenges I had faced during my public career. With the challenges invariably came excitement, but not always success. Apart from my days in the Air Force (1951–53), my government service dated all the way back to 1959, when I served as an assistant district attorney in Philadelphia. From there, I was elected as district attorney, a Republican in a heavily Democratic city, though not before participating in a dark chapter of history, serving as a member of the staff of the Warren Commission that investigated the assassination of President John F. Kennedy.
In 1967, while serving as district attorney, I ran for mayor of Philadelphia and narrowly lost. Six years later, in 1973, within weeks after the Saturday Night Massacre that cast a cloud over Republican candidates everywhere, I found myself unseated as district attorney in a devastating loss that many thought marked my political demise. Those who would have bet against me for the next five years would have ended up ahead. I made an unsuccessful run for the U.S. Senate in 1976 and for governor in 1978.
But the tide turned in 1980 when I won my first term to the Senate. The three reelection campaigns that followed were successful, but always with an effort—particularly my 1992 general election campaign against Lynn Yeakel. She capitalized on the controversy surrounding my questioning of Professor Anita Hill during the Supreme Court nomination hearings for Clarence Thomas the year before, and polled less than three percentage points behind me. It had been said that I alienated the entire electorate, half by voting against Judge Robert Bork, whose Supreme Court nomination was defeated in 1987 after I led the Judiciary Committee questioning, and the other half by questioning Hill and voting to confirm Thomas.2 It may be that a senator cannot do his job without angering everyone sometime.
Surviving so many potentially career-ending challenges left me confident I could win tough battles. Nowadays, getting renominated by one’s party is usually not a tremendous struggle for senators, and incumbents routinely win primary election contests. To be sure, there have been and will continue to be exceptions. In 2002, Representative John Sununu defeated incumbent Bob Smith of New Hampshire in that state’s Republican primary, but Smith had alienated many Republicans by bolting the party to run for president, only to return to it soon after. In 2006, incumbent Joe Lieberman of Connecticut would be defeated in a bitter Democratic primary based on his support for the war in Iraq.
In 2004, I was the only sitting senator to face a primary. In retrospect, after the Hodgkin’s diagnosis, I wonder if the stressful, intense primary campaign caused or contributed to the cancer. The reelection campaign was challenging because of my long track record as a centrist Republican in an increasingly polarized environment—one in which power has seemingly shifted to the extreme ideological base of each party, with potentially dire consequences for the elected official who does not meet the criteria of activists on the far ends of the political spectrum. This polarization created a stressful environment for the primary.
This situation was something of a break from the past. Among Republican incumbents, I was perhaps the last of a group of centrists that once included Mark Hatfield and Bob Packwood of Oregon, Bob Stafford of Vermont, Lowell Weicker of Connecticut, Bill Cohen of Maine, John Chafee of Rhode Island, Warren Rudman of New Hampshire, Alan Simpson of Wyoming, Jack Danforth of Missouri, Charles Percy of Illinois, Charles Mathias of Maryland, and my colleague from Pennsylvania, John Heinz.3 Others had since taken their place—Lincoln Chafee of Rhode Island, Gordon Smith of Oregon, and Maine senators Olympia Snowe and Susan Collins readily come to mind—but there is no doubt the ranks of the centrists have been diminishing. Linc, as we called the younger Chafee, would be defeated in the November 2006 election.
What was true in so much of the country was reflected in Pennsylvania. In April 2004, the Los Angeles Times observed, “Though Pennsylvania has a history of electing centrist Republicans, such as former Governor Tom Ridge and the late Senator John Heinz, that is changing.”4 As a Wall Street Journal column noted, “Republican primaries used to hinge heavily on the four big suburban Philadelphia counties.” This had changed as the party’s growth occurred “west and north of that region—Lancaster and York and Lehigh Counties.”5 My first Senate victory began with a successful challenge to Harold “Bud” Haabestad, the state Republican chairman and Princeton basketball star who was the choice of the statewide Republican leadership, in the 1980 primary. Nearly a quarter century later, a parallel challenge would be launched, only this time I was the organization’s choice.
Like modern races for the presidency, the 2004 primary campaign b...
