There was an element of risk for former Vermont Gov. Howard Dean, M.D., in inviting reporters onto his chartered campaign jet, the Grass Roots Express, in August.
As it happened, turbulence trapped Dean in a cramped coach seat between reporters from Modern Physician and Rolling Stone.
Stuck there for 20 minutes, Dean was questioned about his medical training and experience and what influence they have on him as a candidate--and would have on him as president.
Dean admits one of the few bad influences his medical background has had on his political style is a tendency to be abrupt.
"Somebody in my staff said, 'You know, you've improved a lot over the last eight months, but you still start answering questions before they finish asking them,"' Dean says. "That comes from being a doctor, and it's accelerated by being a doctor."
He has a theory about why physicians do that, one he says doctors won't like.
"As governor, I had a problem because I had 30 senators and they all thought they should be governor," Dean says. "If I were the dean of the medical school, my problem would be I'd have 250 medical staff and they'd all think they should be God.
"We do have this extraordinary sense of the power we've been given, and sometimes that makes us a little more overbearing than we should be."
Physicians are trained to deal with facts, to value accurate information and to speak the truth, even if it is not what a patient wants to hear--all attributes Dean has carried with him into politics, says Dean Ornish, M.D., clinical professor of medicine at the University of California, San Francisco, and a former consultant to President Clinton.
"He is a great listener and asks a lot of appropriate questions," Ornish says. "He is able to integrate a lot of information and synthesize it and make it clear and compelling for people."
Stephen Goldstone, M.D., a general surgeon and associate clinical professor at Mount Sinai School of Medicine in New York, attended medical school with Dean at Albert Einstein College of Medicine in the Bronx. It's where Dean completed a four-year program in three years and met his wife, Judith Steinberg, M.D.
Goldstone defends Dean's manner as necessary for a physician and refreshing in a politician.
"We have to make split-second decisions," Goldstone says. "Your mind is always racing ahead . . . Often you jump in with a patient and ask, 'Is this what you're trying to say?' and help them through it. Politicians won't always give answers, but as a doctor, you have to give an answer."
Since Dean's entry into professional politics, he and Steinberg, who practiced medicine together in Burlington, Vt., have carved out autonomous careers and maintained a respectful support for one another's choices.
Dean is fiercely protective of his wife's desire to continue to practice medicine should he be elected president. The only evidence of brusqueness this reporter saw while observing Dean at close quarters during the four-day cross-country campaign swing was when Dean cut off a question about whether his wife would talk to the physician community about his health policy.
"She's not going to talk about that stuff," Dean says sharply. "That's not her job in life, to worry about health policy. She doesn't do health policy, she just takes care of patients. What she is, is a doctor and a mom. That's what she thinks of. There's only two things she really cares about, her family and her job. So, I mean, the kinds of interviews she's going to be doing are about what I'm like, what she's like, what our family's like. She's not going to touch healthcare policy, she's just not going to."
Their daughter, Anne, 19, is enrolled at Yale University, and son Paul, 17, is a high-school senior.
Goldstone remembers Dean as "just one of us, trying to get through medical school," but perhaps even more dedicated as a slightly older student who, at 26, made a life choice to quit being a stockbroker on Wall Street, like his father, and study medicine instead.
"He really wanted to be a doctor," Goldstone says. "He always knew what he wanted and wasn't afraid of tough choices. Like he had the guts to say, 'I can be president.' It's like being on Wall Street and saying, 'I want to be a doctor.' He makes it happen."
Glenn Englander, M.D., was a medical student on rotation when Dean was a resident at the University of Vermont 22 years ago. Englander recognized a similar toughness and sense of purpose.
"He was a decent guy with integrity who let a medical student take an old patient off the ventilator who looked miserable," says Englander, now a solo gastroenterologist in private practice in West Palm Beach, Fla. "Yes, the patient did fine," he adds.
One of Dean's favorite replies on the stump when a supporter shouts, "Give 'em hell, Howard!" is to quote Harry Truman.
"I don't give them hell," he says with a big grin. "I just tell the truth and the Republicans think it's hell."
