Dr. Michael DeBakey, surgeon to the former shah of Iran, said yesterday he advised both White House chief of staff Hamilton Jordan and the shah that the deposed ruler's cancer operation could not be performed safely in Panama.
He also disputed the statements of U.S. officials that satisfactory arrangements had been made for an operation in Panama with DeBakey in charge, and that he had been fully ready to operate there so Shah Mohammad Reza Pahlavi need not have left for Egypt.
The Panamanian medical arrangements were "definitely" far from satisfactory, the famed Houston surgeon said in a telephone interview.
"What I said to Hamilton Jordan," said DeBakey, "was that in my opinion, performing the surgery there would increase the risk considerably -- several-fold.
"Therefore, I said, I could not recommend that it be done there. However, if the situation reached a point that there was no other way out -- like operating in an emergency situation on a battleship -- and there was nothing else to do, I would do my best to be of service."'
He told Jordan these things, DeBakey said, when the White House aide visited him in Houston on March 20, on his way to Panama to try to patch up arrangements there, and again later, when the surgeon was told by phone that any disputes had been cleared up and he could operate.
"I pointed out," he said, "that I still didn't have confidence" in the medical equipment or back-up staff at Paitilla Hospital, the expected operation site in Panama, and "there still wasn't a clear understanding of what role" or "how much control I would have."
For safe surgery, he said, "you can't have more than one captain of the ship."
White House assistant Claudia Townsend said yesterday that "we have never tried to speak for Dr. DeBakey," but "the view of three doctors representing our government" -- our trio headed by Dr. Benjamin Kean of New York and not including DeBakey -- "was that satisfactory conditions had been arranged for an operation in Panama."
DeBakey said he told the shah the same things he told Powell and others. According to the shah's American representative, Robert Armao, the shah decided in large part on this basis to leave Panama.
He went to Cairo, where DeBakey operated on him Friday, removing his swollen spleen and learning, after tests were done, that the former monarch's lymph gland cancer had spread to both his spleen and his liver.
DeBakey told yesterday how, at Kean's request, he went to Panama in mid-March, expecting to oeperate at Paitilla Hospital.
"This is what the shah wanted," DeBakey said. And "I looked at him" not politically, he said, but "absolutely" the way "I would look at any patient in a very serious situation." It is true, said DeBakey, that removing a spleen is usually not very risky, but with the debilitated, possibly cancer-ridden shah, "we were dealing with a very ticklish situation."
Paitilla was not a bad hospital for its size, he said, but it is only "a 94-bed community hospital. You would want to be in a large hospital, with experts of every kind." Then, he said, he and other American doctors were met with an "antagonistic" attitude, then a "vacillating" one, so "I had no confidence" there.
"I didn't know how much I could trust the laboratory," he added, "and the nearest cell separator" -- a machine to give the shah the kind of blood transfusions he needed -- "was at Gorgas Hospital, 35 to 40 miles away. I didn't like that."
As to the possibility of operating at Gorgas, a modest-sized U.S. mlitary and Canal Zone facility, "I didn't even see Gorgas," said DeBakey, because the shah, once in Gorgas, might not be allowed to return to Panama proper.
At any rate, DeBakey maintained, the Cairo military hospital where he and a full team of assistants operated is a "large, 600-bed hospital" with a good staff and eqiupment, far superior to Paitilla.
As to the shah, DeBakey said, "I just heard" by phone he is making a "beautiful" recovery and will begin getting a battery of anticancer drugs Wednesday.
DeBakey said the Eygptian government paid only expenses for him and his team, and no fee was charged.
Most American experts in histiocytic lymphoma, the shah's affliciton, say that while a cure is not impossible, since vigorous drug treatment may produce a 30 to 50 percent cure rate even when the disease is advanced, the shah's chances of living more than a year or two are poor.
However, DeBakey said, "I'm very hopeful, I'm reasonably hopeful" he can be treated successfully.