Tick, Tick, Tick...
  By Bryan Zepp Jamieson   6/30/01
 
When Dick Cheney stood up in front of the media on Friday the 29th of
June, 2001, to disclose that he was going in the hospital the following day
for testing with an eye to installing a “pacemaker plus” as an “insurance policy”,
he was being courageous, but he wasn’t being particularly straightforward.

 Cheney is going to have a device called an implantable cardioverter
defibrillator.  For the sake of your eyes and my fingers, let’s just
call it an ICD.  It is NOT a pacemaker, which is nothing more than a
device to maintain a steady beat.  An ICD is a device to START a beat,
which is obviously a much more serious situation.  As the “defibrillator” part
of the name suggests, it’s a high-tech, internal version of the electroshock
paddles used in every other episode of ER­the ones used when someone
shouts “clear!” and a large electrical jolt is thrown into someone who is still
and glassy-eyed and presumably seeing bright lights and dead relatives.

 There’s two types of heart conditions that can call for implantation of this device.
The first is ventricular tachycardia, which is described by the Boston Medical
Publishing Corporation in this manner:

 “No absolute ECG criteria exist for establishing the presence of VT.
   Several features, however, suggest VT:
    1.Rate greater than 100 beats per minute (usually 150-200)
    2.Wide QRS complexes (>120 ms)
    3.Presence of atrioventricular dissociation
    4.Fusion beats

Ventricular tachycardia may develop without hemodynamic deterioration,
yet it often causes severe hemodynamic compromise and may deteriorate
rapidly into ventricular fibrillation. This tachydysrhythmia must be
addressed swiftly to avoid morbidity or mortality.”

If that sounds dire, it’s probably because it is. The heart is still beating, but it is
doing so at a rate double or even triple the rate it’s supposed to, and the large lower
chambers (the ventricles) are beating out of synch with the upper chambers, with the
result that for all the hammering going on, little or no blood is being moved around.
Untreated, it can quickly cause irreparable heart damage (morbidity) and death (mortality).

The second condition, and one often caused by the first, is ventricular fibrillation.
The American Heart Association defines this as

 “a condition in which disordered electrical activity causes the
ventricles to contract in a rapid, unsynchronized, uncoordinated
fashion. When this occurs, little or no blood is pumped from the heart.”

When this occurs, the patient is almost certainly going to die without
medical intervention.  It is the death spiral of the heart, and about
the only way to bring the heart back is to shock it, or (sometimes,
rarely) give it a mighty whack by pounding on the chest of the victim..

Inserting such a device isn’t such a big deal.  Most hospitals can do it as a matter of routine.
However, it isn’t done on a patient who is sixty years old and has had four heart attacks
already unless the attitude is, “Oh, hell, we’re out of options.  Maybe this will buy him a
little bit more time.”  It means the heart is so damaged that drugs are no longer effective.

In Cheney’s case, the reason he is having ventricular tachycardia, or V-Tach, is because
the muscles in the upper part of the heart, where the beat is supposed to originate, are too
damaged to sustain a beat.  At this point, they still can beat for a while, but tire far too
greatly and far too easily, and when they are spent, they stop beating and the neural pulse
is rerouted to the ventricles to try and keep the organism­in this case, the Vice President ­ alive.

The damage is irreversible, and rapidly worsening, since the exertion and overstress of
beating is accelerating the area of damage and dead tissue.  The upper part of the heart
will tire more easily, sustaining more damage as it does, and stop more often, and for
longer periods of times.

The ICD emits shocks, and while they are hardly the vast jolts administered by the
electroshock paddles, they are reportedly quite painful to the patient ­ people wearing
such devices have been known to emit apparently random screams when they fire off ­
and they do add to the damage, although given that the alternative is immediate death,
that’s regarded as a fair trade-off.

Cheney’s condition is not sustainable, and all the implantation of this device does is
(maybe) buy him a little time.  How much time, no one can say, but he’s certainly not
in any position to function as the de facto President of the United States for another 1329 days.

Vice Presidents have died in office*, and usually nobody gives a wet shit.  Normally, it’s
an utter sinecure of a job, and all they do is sit around and wait to see if the President
walks into a propeller or annoys too many of the wrong people and is either shot
or impeached.  They’re like the fact checker at the Rush Limbaugh show ­ they just
don’t matter.  In no American history text do the words, “The crisis was precipitated
by the death of Vice President...” appear.

But this isn’t a normal situation.  Most Americans realize that George W. is just a
figurehead, a puppet President, and that Dick Cheney is the power behind the throne.
If he were to die, the administration would flutter weakly and ineffectively, and essentially
be at an end.   In fact, the White House would be a good reflection of what Dick Cheney’s
heart is like now.  Administrative V-Tach.

Granted, the idea that the malevolent and inimical forces that put Putsch where he is would
be thus nullified fills me with unalloyed joy. I have no good wishes for the Putsch administration.

But whether Cheney resigns or keels over, Putsch’s Presidency is effectively finished.
He’ll wallow around in the White House, get hammered in the off year elections,
and spend his last two years cutting ribbons and greeting girl scouts, and the country
will muddle through, better off than it would be with this administration actually doing things.

So with nothing to gain or lose, my own feeling is that Cheney should resign the Vice Presidency,
and the sooner, the better.  He should go home, be with his family, do some writing, do some
reading, enjoy some sunsets.  As much as I despise the man’s politics, I found myself
admiring his courage as he faced the media yesterday, and noticed he has the same
off-center grin I have.  I bet he caught hell for it when he was younger, too, from insecure
authoritarian types who mistook the smile for a smirk.
I bet, like me, a lot of the time it WAS a smirk, too.

Cheney got the brass ring ­ control of America ­ and it’s not his fault that his heart failed him.
But both he and the country can only benefit by him leaving now, and if it hurts Putsch, well,
that’s hardly a big deal, is it?

It’s over, Cheney.  Go home.
Spend your last remaining time at home, let your family love you, and spare the country.

*George Clinton ­ yes, we had a vice president named Clinton ­ in 1812.
Another one, Elbridge  Gerry ­ I’m not making these names up ­ died just
two years later.  William R. King died in 1853.  Henry Wilson died in
1875.  Thomas A. Hendricks died in 1885.  Garrett A. Hobart ­ really ­
died in 1899.  James Sherman died in 1912.  Three others quit in mid
term, one to run for the Senate, and quite a few quit or were asked not
to run again after the first term.  FDR used up a couple of Veeps before
running out of steam himself.


"I had a firm policy that we wouldn't do anything in Iraq, even arrangements that were
supposedly legal," he said.  "We've not done any business in Iraq since U.N. sanctions
were imposed on Iraq in 1990, and I had a standing policy that I wouldn't do that."
--Dick Cheney, lying to the American people.

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