Personal Loss Changes Business as Usual

He did not know if he could carry on. "It is hard to work with an anchor on your heart," he says.

"Garrett was always proud of me; we had a beautiful relationship," Smith says. "But I missed lots of ball games. I wasn't present at camping trips when he was trying to become an Eagle Scout. Those are things you can't take back."

To his surprise, however, he was not alone in his sadness and guilt. Many fellow senators flew to Garrett's funeral to comfort their colleague. And they began to tell their own stories. Sen. Mike DeWine (R-Ohio) lost his 22-year-old daughter in a car crash. The brother of Democrat Ron Wyden, the other senator from Oregon, had schizophrenia and died the year before. Another senator had a daughter who committed suicide, though he won't say so publicly.

With help from them and others, Smith converted his tragedy into a movement. He decided to devote himself to finding ways to help young people with mental illnesses avoid Garrett's fate. In March 2004, Smith testified at a Senate subcommittee hearing chaired by DeWine. "It's time to start trying to find more meaning in Garrett's life and help others who suffer like he did," Smith said.

Smith had good reason beyond his own mourning to bolster government assistance. More than 3,000 people ages 10 to 24 take their lives each year, which makes suicide the third-leading cause of death in that age group. And every time Congress cuts Medicaid, people with mental illnesses are among the first to lose their benefits.

So Smith launched a two-pronged effort. As a start, he became the moving force behind a three-year, $82 million program that offers suicide-prevention counseling to vulnerable students and others.

The measure, which DeWine named the Garrett Lee Smith Memorial Act, passed unanimously on what would have been Garrett's birthday in 2004. (Before that happened, Sen. Harry M. Reid (D-Nev.) and Sen. Don Nickles (R-Okla.) revealed to a hushed chamber that their fathers had killed themselves.)

Smith has also transformed himself into the leading Republican champion for Medicaid. As hard as Republicans have tried to trim the program, he has fought back harder. As a swing member of the Senate Finance Committee, which has jurisdiction over Medicaid, he also has had the clout to make his wishes stick.

"There's nobody we've worked with more closely on this than Sen. Smith," says Ronald F. Pollack, executive director of Families USA, a leading advocacy group for Medicaid. "He has been an extraordinarily tenacious advocate for expanding and retaining health care coverage. It's very evident that this is something that he believes in intellectually and emotionally."

Lots of legislation has become law because of to the personal histories of senators. The best-known recent example was the Americans with Disabilities Act of 1990, which Robert J. Dole (R-Kan.), who was Senate majority leader at the time, spearheaded in large part because of the physical infirmities he has had since he was wounded in World War II.

The current debate on expanding federal funding for stem-cell research is another example. Lawmakers have lined up in the Senate and the House to tell about relatives who might have been saved had stem-cell research been given a looser rein.

Smith credits this congressional "fraternity of sorrow" for the progress he's made on his issues. He also understands that those policies have done far more than advance the public good. The legislative battles, he says, "in a lot of ways have saved my own life; it has given me a purpose for being here."

Jeffrey Birnbaum writes about the intersection of government and business every other Monday. E-mail him atkstreetconfidential@washpost.com.