WASHINGTON – As he exited the stairs of his “Straight Talk Express” campaign bus on a chilly March day in Iowa, Sen. John McCain carefully took one step at a time, his left hand gripping a rail and his right knee looking stiff.
A bum knee isn’t surprising in a 70-year-old man – particularly one whose right leg was shattered about four decades ago when his jet fighter was shot down over North Vietnam.
But his wooden movements, along with his age and appearance, are creating an impression about McCain’s health that could be a liability for the Arizona Republican as he tries to persuade Americans to elect him president.
McCain brings to the campaign a body and mind with some heavy wear and tear, including a couple of bouts of cancer and the effects of years of torture. If elected, he would be the oldest person in history to enter the White House, and if he served two terms he would leave office an octogenarian.
Other presidential contenders have health issues, including Sen. Joseph R. Biden’s two brain aneurysms in 1988, Rudolph W. Giuliani’s 2000 prostate cancer and former Sen. Fred Thompson’s lymphoma. But they are all younger and haven’t experienced McCain’s physical and mental agonies.
Voters should not worry, the senator’s staff says. He passed a recent health exam with flying colors, they say, the results of which will be publicly released in coming weeks.
“We all have trouble keeping up with him,” said Eileen McMenamin, communications director in McCain’s Senate office.
Indeed, when life spans are lengthening and people in their 80s are running companies and marathons, McCain’s age in itself shouldn’t be an issue, some experts say.
“Don’t give me that age business,” said Dr. James E. Birren, a prolific medical author known as the father of gerontology who still lectures at the University of Southern California at age 89. “If the task requires speed, then you want the younger person. But if it requires wisdom, you want somebody old.”
But McCain’s health, much like his politics, is a complex matter.
McCain has twice developed melanoma, a potentially deadly form of skin cancer. He had four surgeries between 1993 and 2002: two to remove melanomas, one to remove skin lesions and one to treat an enlarged prostate.
When doctors removed a melanoma from his left temple in 2000, they did exploratory surgery to look for cancer in his lymph nodes, leaving a buildup of scar tissue – a big lump – on his left jaw. So far, McCain has rejected his staff’s suggestions to have it removed by cosmetic surgery. To prevent a recurrence of the melanoma, McCain slathers himself with sunscreen whenever he ventures out.
“John looks pale, but he has to stay out of the sun,” said James McGovern, a longtime friend and a campaign fundraiser, who asserts McCain has more than enough stamina to be president.
McCain, who was not made available by his staff to be interviewed for this article, described his health as excellent last Sunday on NBC’s “Meet the Press.”
Critics have a tougher assessment of how the public perceives him.
“What does in McCain is the fact that he looks old,” said Loren Thompson, an expert on military affairs at the Lexington Institute, a public policy think tank in Arlington, Va. “Looks count, and McCain looks terrible.”
A recent Roper poll found that 30 percent of registered voters had “some reservations” or were “very uncomfortable” about the fact that McCain would be the oldest president elected to a first term. McCain does not regularly run, lift weights or go to a gym, and he smoked cigarettes until age 45, his staff said. But he is not a couch potato. McCain, who regularly hikes near his home in northern Arizona, marched across the Grand Canyon last year from rim to rim.
McCain can also point to good genes, at least on his mother’s side. Roberta McCain is 95. With her twin sister, she traveled around Europe last year about the time McCain was slogging across the Grand Canyon. On the other hand, McCain’s father, a Navy admiral, died of a heart attack at 70, and his grandfather, another Navy admiral, died at 61.
The melanoma that McCain suffered was probably related to a genetic predisposition and sunburns he may have sustained as a young man, medical experts say.
The cancer has no implications for his general health, and the fact that it did not spread into his lymph nodes is a good sign, said Dr. Jeffrey Weber, associate director at the USC Norris Comprehensive Cancer Center.
Like others with his condition, McCain is checked every three months for new signs of problems.
McCain’s war experience sets him apart. No president has endured the tribulations McCain faced in 5 1/2 years as a prisoner of war, said Georgetown University historian Michael Kazin. Judging from interviews with medical experts and with fellow prisoners in North Vietnam, and from McCain’s own writings, those dark days left many scars.
George “Bud” Day, a Medal of Honor recipient, vividly remembers the day McCain’s broken body was brought by guards through the door of Hoa Lo prison, the infamous Hanoi Hilton.
“He had been starved,” Day said. “He was emaciated and weighed around 100 pounds. He had lost a third of his body weight. He had a fracture of his right knee that had been unskillfully repaired, as well as multiple fractures of his right arm. His left shoulder was dislocated, and he had been bayoneted in the left leg. And he was filthy. You could smell him a quarter block away.
“I expected he would die before morning,” Day continued. “I thought the Vietnamese had dropped him off with us so he would die with us and they would be able to blame his death on us.”
To this day, McCain can barely lift his arms above his head. At the 2000 Republican convention, President Bush tried to hoist joined hands with McCain over their heads, leaving the senator grimacing, recalls Mark Salter, a senior adviser to his campaign: “He is stiff.”
Of his leg injury, McCain acknowledged years later in his acclaimed autobiography, “When I am tired or when the weather is inclement, my knee stiffens in pain and I pick up a trace of my old limp.”
The incarceration, the broken bones, the beatings and years of starvation have left little lasting damage, McCain’s staff says.
McCain released extensive medical records when he sought the presidency in 2000, including reports of his periodic examinations at the Robert E. Mitchell Center for Prisoner of War Studies at the Naval Operational Medicine Institute in Pensacola, Fla. Those reports indicated that McCain was in generally good health and did not suffer any psychological illness.
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