Constant tension with the doctor taking care of the US president

Being the US president's physician is a very important position, not everyone can achieve it. However, besides the prestige, this job also brings terrible stress.

Dr. Connie Mariano served for nine years as presidential physician to Bill Clinton and the Bushes. According toNew York Times, Connie Mariano is the first Filipino-American to become a rear admiral, and the first woman in the military to become a White House physician.

In the autobiographyThe White House Doctor: My Patients Were Presidents - a Memoir, Ms. Mariano revealed that most of the White House medical staff comes from the military. The doctors come from many different specialties and are personally selected by the president.

Explaining this, Dr. Mariano said that few civilian doctors can suddenly quit their jobs for four years. Moreover, the medical team is the first responders in emergency situations, so "it's like practicing military medicine."

In addition to the head of state, the White House medical team of 24 staff, led by Dr. Mariano, also cares for the vice president and his family, and sometimes White House staff and guests. But the president is the number one priority. If the president or a family member needs help, everyone else is ignored, no matter how serious the condition.

Working with the president - the commander-in-chief of the US military, doctors at the White House cannot avoid pressure because their military rank is lower than that of their patients, which makes the doctor-patient relationship tense.

“Whenever the president overreacts, the image of a military tribunal comes to mind,” Dr. Mariano admitted.

In 1997, Dr. Mariano gave in to President Bill Clinton when he insisted on going to Helsinki, Finland, to meet with Russian President Boris N. Yeltsin, just four days after quadriceps surgery. When Clinton continued to work with gastritis, Dr. Mariano "toughly decided" that she would inform First Lady Hillary Clinton. "Okay, I'll listen to you," Clinton finally agreed.

In 1998, Mrs. Clinton had health problems. The First Lady suffered from phlebitis and a blood clot, but she refused to be hospitalized. The medical team treated Mrs. Clinton as an outpatient and used a new blood-thinning medication.

Apart from the above incidents, Dr. Mariano has not had any other conflicts with her "high-profile patients." If she had, she said she would resign. Other White House doctors have made similar commitments.

To ensure the health of the head of state, the Secret Service and White House medical staff must be on high alert even if the president feels fine. Rich Miller, a former senior agent for President Bush Sr., was so worried that he told Dr. Mariano: "The question is not if the president will be assassinated, but when."

Before every presidential trip, like Secret Service agents, the White House medical team must survey the destination, assess medical facilities, and talk to a select number of local doctors. "The Secret Service agents look for bombs, we look for pathogens," Mariano said.

The medical team is trained to stay away from the "assassination zone" around the president to reduce the risk of being caught in a stray bullet. They also wear civilian clothes because their uniforms make them easy targets.

"You can't treat a president if he's dead," Dr. Mariano explained.

Illustrating the harsh realities of the job, Dr. Mariano said that civilian doctors work up to 80 hours a week, military doctors are on call for up to 18 hours at a time, but the White House doctor must always be on call. On one occasion, Dr. Mariano worked 50 hours straight.

White House doctors carry heavy medical bags at all times. They often suffer from jet lag due to the change in time zones, but they must avoid sleeping pills. To avoid exhaustion, Dr. Mariano has a rule of "no more than 24 hours without a break." In addition, when traveling abroad, she arranges a rotating schedule so that doctors on the flight can go to the hotel to sleep while colleagues on the ground take over.

In addition to the chronic fatigue, the White House physician faced numerous personal challenges. Dr. Mariano put off seeing a doctor for a neck problem until the pain worsened and her arm went numb. Her marriage also suffered because her husband felt she was absent so much that he felt as if she didn’t exist.

If a White House physician makes a mistake, it can cost him his career. In 1994, when President Clinton was planning a trip abroad, Colonel Bob Ramsey, a White House hematologist, was fired for sending the wrong blood type to the host country's hospital.

By contrast, the heroics of the White House medical team are rarely recognized. At President Bush Sr.’s last Christmas party before leaving office, Mariano witnessed a man standing nearby suddenly wheeze and then clutch his throat. She realized he was choking and performed the Heimlich maneuver, helping the man cough up a piece of shrimp. Once he was stabilized, he left without a word of thanks.

In 2001, Dr. Mariano retired from the Navy and the White House. She continues to practice medicine in private practice.

In charge of President Donald Trump's health care is currently Dr. Sean Conley.

Minh Nguyen