OMED 2011: Behind the scenes with a former chief White House physician
Former White House physician Eleanor “Connie” Mariano, MD, signs a copy of her memoir for Lino S. Dial Jr., DO, a fellow Filipino-American, during OMED 2011. (Photo by Patrick Sinco)
A tourist who fainted in the White House could not believe that Eleanor “Connie” Mariano, MD, was the White House physician. She kept asking if Dr. Mariano was the nurse, and when the male White House nurse came, the woman thought he was the doctor.
Dr. Mariano, who was the first woman in the military appointed chief White House physician, recounts this story in her memoir, The White House Doctor: My Patients Were Presidents.
As OMED’s final keynote speaker, Dr. Mariano described her remarkable career on Wednesday. For nine years, she was the personal physician to three presidents—George H.W. Bush, Bill Clinton and George W. Bush—as well as to their families and staffs.
“People always looked at me as not being mainstream, and it made me strive harder,” said Dr. Mariano, who also was the first Filipino-American to reach the rank of rear admiral in the U.S. Navy.
Job interview in the White House
Dr. Mariano told the audience in Orlando, Fla,. that she had considered leaving the military after eight years in the Navy, until her boss asked her to apply for the job of White House Navy physician in the White House Medical Unit. All other candidates who interviewed for the position were men, which led her to think, “I’m their token female minority,” Dr. Mariano said.
She described her intimidating interview at 1600 Pennsylvania Ave., in which a top-ranking physician started by “gruffly” asking her, “Why do you want this job?” She said she replied, “It’s payback time. My father came here from the Philippines, and I went to medical school here [Uniformed Services University of the Health Sciences School of Medicine in Bethesda, Md.]. If I can repay my debt to this country by serving the commander in chief, I want to do that.”
Answering the second interview question about what she could do in the job, Dr. Mariano recalls saying, “I’m a trench doctor. Put me anywhere in the world, and I can take care of anyone.” When the interviewer abruptly got up, she thought she had lost her chances at getting the position.
Then her interviewer said, “As far as I’m concerned, you got the job. I’m going to tell Barbara Bush.”
Not a glamorous job
In the six-physician medical unit of the White House, Dr. Mariano later became the chief physician. In that role, she instituted 24/7 on-site medical coverage and made the all-specialists medical team include primary care physicians.
The White House physician job is not as glamorous as it may appear, she said, apparently not just because she had to draw President Clinton’s blood for DNA analysis in the Monica Lewinsky scandal.
She listed several nonglamorous aspects of the job: “The car we ride in is called the decoy limo. It’s very humbling as a doctor to get a call, ‘The president is ready to see you now.’ And the patient is tough in many ways.”
The president is a VIP, a “Very Intimidating Patient,” said Dr. Mariano, who now is a physician in a concierge medical service she founded in Scottsdale, Ariz. From the sound of laughter, the audience enjoyed her definition of a VIP as “any patient who induces tachycardia in the physician.”
The presidential VIP, Dr. Mariano said, is “at huge risk for RIP—rest in peace” because of the demands of the job and attitudes to medical care. She explained that presidents “feel entitled to special care, tend to be noncompliant and believe the natural principles of medicine and healing do not apply to them. They want you to fix [their health problem] right away.”
Don’t compromise standards
If the physician complies with VIP patients’ requests for unhelpful care, this teaches them how to be a poor patient, Dr. Mariano believes.
When a request is medically inappropriate, Dr. Mariano said a physician must have “a lot of guts.” She recommended telling a VIP, ‘I’m not doing that. That’s not how I practice medicine. It’s not fair to give you substandard care.’ You have to reinforce that you are [acting] in their best interests.”
Dr. Mariano reportedly had to be forceful with President Clinton. On one occasion, she said the president initially refused her advice to take a day off to rest because of illness. “I told him if he didn’t rest, I’d have to tell his wife,” she commented, which drew laughs from the audience.
Bill Clinton must have forgiven Dr. Mariano for that threat because he wrote the foreword to her book, in which he calls “Dr. Connie” an American success story.
A physician in the audience was similarly impressed with Dr. Mariano. “She was amazing,” Jennifer Kendall, DO, the intern`and resident representative to the AOA Board of Trustees, told The DO. “She doesn’t compromise her own high personal standards. That was really motivational to me.”
During the question-and-answer session, Dr. Kendall asked the keynote speaker how she was able to balance her demanding career with being a wife and mother. Dr. Mariano said her time in the White House took a toll on her marriage, which later ended in divorce.
She offered these words of wisdom: “Someone once said to me, ‘You’ve had it all,’ I said, ‘You can have it all, but not all at the same time.’ ”