In last Saturday's Free for All, Edmund Morris inaccurately readressed comments made by Dr. Joseph M. Giordano and me regarding various aspects of President Ronald Reagan's medical care ["Re 'Dutch': A Few Clarifications," Oct. 23]. Morris's clarification, I fear, may have muddied further the waters surrounding the subject. In some areas Dr. Benjamin L. Aaron, the surgeon who stanched the massive bleeding and removed the bullet from President Reagan's left lung, has been misquoted badly. He will address these errors in a separate letter.
In a previous response [letters, Oct. 15] to remarks made by Morris in your newspaper [op-ed, Oct. 3], I stated that in spite of undergoing four surgical procedures during his two terms in office, Reagan's recovery after each surgical procedure was "extraordinarily rapid." Now Morris contends that rapid recovery is "somewhat belied by the fact that late in February 1987, seven weeks after his prostatectomy, aides were worried enough to again consider invoking the 25th Amendment" (the other instances related to his being under the influence of anesthesia).
The president had undergone a trans-urethral resection of the prostate--a considerably lesser procedure than prostatectomy. Morris insinuates that this worry might have been caused by a less than rapid recovery or an unanticipated complication from his January operation. Morris forgets his own description of President Reagan's rousing State of the Union Address on Jan. 20, in which he quotes Dr. Oliver Beahrs of the Mayo Clinic, who stated that the president "had presented the address in style, as he had all previous talks."
Whatever other state he attributes to the president had nothing to do with his totally uneventful recovery but was a reflection of the disarray of the departing staff and the impending termination of the Tower Commission's investigation. The departing chief of staff and his aides' last and weakest of salvos was to suggest that the competency of the president be questioned.
Morris has not demonstrated a complete grasp of President Reagan's health and medical problems, which he survived with ease and without disability. It would be better if Morris would assess accurately the word of the medical profession, especially those who related with the president on a daily basis.
We have now exhausted this subject. I hope we can move along without further damage to the truths that history must uphold.
--John E. Hutton Jr.
The writer is a former physician to President Reagan.
Edmund Morris, in his book "Dutch, A Memoir" and in two communications with your paper, has quoted me as a source for certain statements and conclusions he has written concerning the care and medical condition of President Reagan at the time of his attempted assassination in March 1981 and later. I would like to set the record straight.
In the emergency room, Dr. Joseph Giordano inserted one chest tube to drain the blood from the president's chest. In the operating room, following his left thoracotomy, I removed the blood-filled tube and inserted two fresh tubes for optimal drainage.
The medical layperson who states that a beating heart lowers blood pressure probably has not considered what would happen to the blood pressure if the heart stopped beating. No doubt, if the blood loss in the president's left chest had continued, his pressure would have dropped further, but attributing this to his beating heart in no way can be medically accepted as a "simple hydraulic fact."
Concerning my phone conversation with Morris in 1989, I have a good recollection of what I said and what I did not say. In stating that significant blood loss represented one of the major physiologic insults a body could sustain, I was quoting Prof. Francis Moore, one of the preeminent surgical physiologists of that decade. I have no recollection of comparing the physiologic insult with a beating, but I did compare it with a major burn in terms of magnitude, once again quoting Moore.
I have no recollection of discussing with Morris the physiologic qualities of the blood that was administered to the president, though I may have agreed with him that the blood was probably still somewhat cold at the time from storage in a refrigerator. In a healthy individual who needs only volume replacement, not warming the blood has little to do with the person's response, and to make so much of this is to show little in the way of medical insight.
Any effects from impurities and breakdown products in the bank blood would be inconsequential in this setting and be gone within a few days; certainly they would have no bearing on the president's blood picture years later.
Morris's statement that the president's eight-unit transfusion in 1981 was responsible for a lowered blood count in 1989 is neither supportable from our 1989 conversation nor medically accurate. I had no medical follow-up with the president after May 1981 nor knowledge of the quality or nature of his subsequent blood picture, so I clearly could not have given Morris any such information.
When I examined President Reagan at six weeks out from his injury and surgery, he was alert and cheerful, carried himself well and showed no problems with moving or breathing. Morris's penchant to attribute the status of the president's health in later years of his presidency to the injury and surgery in early 1981 is medically unsustainable. I would hope that the above discussion would induce further restraint from him in this regard.
--Benjamin L. Aaron
The writer was chief operating surgeon when President Reagan was shot in 1981.