The White House Doctor

Dr. Connie Mariano has cared for some of the most prominent patients in the world. She was the personal physician for three former U.S. presidents and their families — George H.W. Bush, Bill Clinton and George W. Bush. Mariano talks about her experiences in her new book, White House Doctor: My Patients were Presidents. Dr. Mariano was the first female to head up the White House Medical Unit, and the first Filipino-American to hold the post of top doc. She talks with host Michel Martin about life and interesting times in the White House.

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MICHEL MARTIN, host:

I'm Michel Martin, and this is TELL ME MORE from NPR News.

Now it's time for our Wisdom Watch. That's the part of the program where we talk to people who have made a different through their work, people who have wisdom to share.

Today we talk to a physician who had some of the most famous patients in the world under her care. Dr. Connie Mariano was the White House physician. In her nine years at the White House, she cared for Presidents George H.W. Bush, Bill Clinton and George W. Bush and members of their families, as well as visiting dignitaries from all parts of the world. While serving on overseas trips she cared for staff members and reporters and anybody else, just about, who became ill while in the White House orbit.

And while doing all that, Dr. Mariano was making history herself as the first woman to head the White House medical unit and the first Filipino-American to achieve the rank of Navy Rear Admiral. Now she's written a memoir about those experiences and more. It's called "White House Doctor." And she's with us now to tell us more about it. Welcome, Dr. Mariano. Thank you so much for joining...

Dr. CONNIE MARIANO (Author, "White House Doctor"): Thanks, Michel, my pleasure to be onboard.

MARTIN: Just to clarify, you're not the first woman physician to serve the president. That was President Kennedy's doctor.

Dr. MARIANO: That's correct. The first woman physician to the White House was Janet Travell, and she came onboard with Kennedy. She was a physiatrist from New York and was with him until shortly after the assassination.

MARTIN: Why did you want this job?

Dr. MARIANO: I wasn't going to do this. I had no idea this job existed. I was in San Diego in the 1990s and I was at the Navy hospital and I was thinking of getting out of the Navy when all of a sudden, my boss, who didn't know I was thinking of getting out, nominated me for the position of Navy White House doctor. And I went through the nomination process and was chosen to my surprise and everybody else's surprise.

MARTIN: You know, there are so many stories in this book of the behind the scenes detail of just how much choreography, how much planning goes into running the White House. I just want to ask you to tell one story about when you first you were first assigned there, when you were doing the drill about do you know what I'm talking about? If you'd tell that story.

Dr. MARIANO: Oh, the one at Kennebunkport?

MARTIN: Yeah.

Dr. MARIANO: Oh, my goodness. Part of it is, you know, when you show up at the White House with your medical bag, they train you because you have to realize in this job as a physician, not only do you take care of the first patient, but he's also the first target, as you will. And one of my initial training episodes was at Kennebunkport, where George Herbert Walker Bush used to go dashing around the water outside of Walker's Point.

And so Secret Service took me out in this water boat and they simulated throwing a dummy into the water as though it were the president. So they toss this mannequin into the cold water. They send the divers in after it, they pull him out of the water, they put him in my boat and they said, doctor, do your thing. So all these people are watching you go through the drills of A, B, C, D, resuscitation. And then the next step is disposition what do you do?

Well, gee, at this point, we need a helicopter. So I look up, and they're sending a Coast Guard helicopter out to our boat in the middle of the water. They load the dummy up into the helicopter, they fly away and everyone's patting me on the back, great job. And they said, now, stand by because this is the part where the helicopter above you is whipping around its rotors and the waves around us are coming into the boat and I was almost drowned. I was totally drenched by the end of that exercise.

MARTIN: Were you supposed to be or what that kind of a hazing thing?

Dr. MARIANO: It was the all-boys Secret Service club watching the young doctor get baptism at sea. I think they were hazing me.

MARTIN: Well, you know, to that point, though, first Filipino-American to become a Navy Rear Admiral. And this is no small thing. I think some people might not realize your father was a master chief steward and you described what I thought was a very moving scene where you first got to the White House and the other master chief steward invited you for a meal. If you would just talk a little bit about that and what that meant.

Dr. MARIANO: Oh, they did. They were sort of like my godfathers. The president has a number of valets. And under George Herbert Walker Bush he had five valets who were career servicemen who were all Filipino. And it was my first week at the White House. And they met me at the clinic and they said the master chiefs want to meet you. And we chatted and we got to know each other. And it was sort of coming down to your roots. And we decided then that we would look out for each other.

MARTIN: Well, what do you think that says, though? I mean one of the things that one of the valets said to you, which I thought was charming and very moving, which is: How come you're not stuck up like some of the other officers? I mean because there are people who would not want to connect with the stewards, the valets, thinking that, well, I'm a big time doctor here and I don't necessarily want to hang with you or be seen hanging with you.

Dr. MARIANO: Oh, yeah.

MARTIN: And I'm just wondering whether, was it that you were you thinking about your dad or you think that's just common sense? Or tell me about that.

Dr. MARIANO: You know, I think one of the reasons I've been able to do what I've done in the military is I never forgot my roots, and also growing up in the type of family that really stressed humility, and also being an overachiever, what is the mantra that a lot of us overachievers hear? It's you're not good enough. So, really, you've got to constantly prove yourself, but it doesn't help to be stuck up.

You know, there is sort of an unwritten caste system. You have enlisted personnel, you have officer personnel in the military. You don't mingle, but you can also respect your enlisted personnel for their knowledge and experience. And as a naval officer, I always did that.

When I - on board ship as a young naval lieutenant, I worked with senior chiefs, master chiefs who'd been in almost 30 years. They had more experience at sea than I did. And I would say, listen, you're my advisers. And the same as the valets at the White House, some of them had already served five presidents. I mean they'd been for almost 30 there. So I relied on them a lot.

MARTIN: Did you ever feel, though, sometimes people were not giving you the respect of your position because you're a woman - attractive woman, Filipina, you know, brown.

Dr. MARIANO: Oh, yeah. It would happen often, because you would look and say oh, you don't fit the stereotype of a White House doctor. You know, they would think, you know, are you one of the valets?

There was one of the White House staffers assumed that I was a valet because I wore the same type of hard pin that everyone in the White House military office wore and she assumed, you know, go get me the water. I said, well, is this a medical emergency? And then one of the valet said she doesn't know you're the doc. She thinks you're one of us.

But you're always being questioned. Even in the medical community when I invited a group of surgeons over to present some information to them, they would always look at my tall Caucasian assistant and think he was the doctor and he would say, no, no, no. This is the doctor and point to me.

So, you know, one of my theories is if you're going to stand out, which we often do in a situation, now is your opportunity to be outstanding, to educate people, and to be gracious about it. You know, I've learned that it's better to fight fire with water. And if you're a nice person, they get to know you, they're not threatened, then you just educate people about what you're about.

MARTIN: If you're just joining us, you're listening to TELL ME MORE from NPR News. I'm talking to Dr. Connie Mariano. She's the author of a new book called "The White House Doctor: My Patients Were Presidents," and it's a memoir of her time as White House doctor. She served there nine years taking care of three different presidents and their families.

Why did you want to write this book? It's of particular interest to me, as a former White House correspondent, I'm curious why you wanted to write this book and why now? It's been 10 years since you left the White House.

Dr. MARIANO: Well, when I was at the White House for the first year and a half, I would keep a little journal just for my kid's purposes, so that they would see what happened and just sort of what life was like because I was gone so much. And then when I left the White House in 2001, I was approached by a lot of authors who would write magazine articles as well as books about what it was like behind the scenes.

And one of the authors, Dr. Michael Palmer, who wrote a lot of best-selling medical thrillers, approached me in 2006 and said he was going to write a novel, a medical thriller called "The First Patient." And it had to deal with the president's doctor and issues regarding the president's mental capacity. And at first I said no. I don't want to do this. And then finally he was so charming I said yeah, I'll go ahead and help you.

And so I got to see how he wrote his book in the span of a year and in the process of emailing each other back and forth vignettes of what I had done or seen, he emailed me and said, you know, you write really well. You really should write your memoir.

And I said well, how do you even do that? And he says I'll get you an agent. And then from there I got an agent and we talked about the book proposal and St. Martin's Press decided to take the book. And I think the true story in my sense hasn't really been told yet until I wrote this.

Again, a lot of interviews here and there, but people wanted something a little bit more substantial where what it was like in my shoes or high heels chasing around the president of the United States all over the globe, taking care of him and his family, especially at a time that we look back in the Clinton years, where there was so much going on. And I thought it was worthy of writing that behind the scenes story. But it was also an American story of somebody like myself, who starts off as an underdog. And I thought it would give hope to people who always underestimated themselves that they can make it in this country.

MARTIN: Well, you do talk about that. It's such an important job. But in part, your job was to be as invisible as possible. In fact, you tell the scene of where you're on the QE II or on Queen Elizabeth's yacht, for example. The Queen of England...

Dr. MARIANO: Oh, the Juan Carlos - Juan Carlos yacht. Yeah.

MARTIN: Juan Carlos yacht. Yeah. And you are below deck and you had these very complicated feelings. Do you mind sharing - well, you wrote about it in the book, so why wouldnt you mind sharing it. But...

Dr. MARIANO: Oh, absolutely. You know, there's a lot of scenes where you observe people and you have to be invisible. I think the one scene; there were several yachts we were on, Queen Elizabeth II. There was also a yacht Don Kluge's(ph) yacht in Miami. And then the Juan Carlos yacht, the King of Spain, we were off Palma de Mallorca and it was always the only people out on the yacht were myself, the White House photographer and the secret service agents. So we hid up in the wheelhouse out of sight while the President and Mrs. Clinton and Chelsea were entertained by the King and Queen of Spain.

And all of a sudden we hear voices coming up to the wheelhouse, and it's the president and first lady and king and queen. And we sort of pulled to the side so they can get their door, and the Queen of Spain is actually carrying a silver tray of hors'devours and she's offering them to us and she approaches me, and for a second there I thought maybe she wanted me to serve them - who knows - but she was trying to graciously offer them.

And then as I pulled away even further, Bill Clinton caught me doing that, trying to disappear. And he nudged the King of Spain and said, have you met my doctor? And the King of Spain looks up very charming and says oh, this beautiful thing is your doctor? And as he approaches me to shake my hand, I reach over, he fanes like he's faints, so I instinctively reach over, grab him and he starts laughing.

MARTIN: Oh.

Dr. MARIANO: Like oh, I fooled you. See, you caught me. And all I could say was it's a pleasure to meet you, so charming. And I said well, thank you, your majesty, you have a very strong pulse.

(Soundbite of laughter)

MARTIN: Well, I don't know, I found it very moving, that you didn't quite know what to do. It's like your brain could not accommodate the idea that she was actually bringing you something to eat.

Dr. MARIANO: It's a sort of mentality.

MARTIN: Yeah.

Dr. MARIANO: And one of the biggest piece of advice, it was given to me by my predecessor is, the best way to survive this job is to approach this with a servant mentality. You're behind the scenes. You're the potted plant, so to speak, you're invisible. And that's probably the best way to look at it.

MARTIN: Why break that invisible shield now? Why talk about all that now? In fact, there was some stuff in here that's kind of detailed, like you describe having to give one world leader a shot in his butt.

Dr. MARIANO: Mm-hmm. Mm-hmm.

MARTIN: Well, that's where people get shots, but still, there's a scene.

(Soundbite of laughter)

MARTIN: I just can't bring myself to go into the details. But suffice it to say, they're in the men's room and another world leader, the president comes he because he...

Dr. MARIANO: Mm-hmm. Walks in. You know, you got to use the bathroom.

MARTIN: ...walks in while you're trying to give him a shot in his butt and I don't think we need to tell any more that. People can...

Dr. MARIANO: They can read the book.

MARTIN: Yeah. They can read the book. But why talk about all that now?

Dr. MARIANO: I think people have asked me so many times what is it like? What is it like? And I think it gives a different perspective. People always wonder. They think it's such a glamorous job. It's not. It's actually a frightening job in some ways because you can get killed.

When you're at the White House you can't write a book. You can write it when you're a private citizen as long as you don't divulge any secrets. You can talk about issues that have been common knowledge in the press. The issue about Hillary Rodham Clinton's blood clot in her leg, actually she revealed it in her memoirs, you can touch on that.

The other thing I did, just so that I don't violate doctor-patient confidentiality was I sent the manuscript to President Clinton's people. So they did see the manuscript. They had some things they didn't want to put in which I agreed and accepted and respected, and the book moved on in its form and it didn't detract from taking those issues out.

MARTIN: What about that whole question of you were caring for the Clintons during the whole Monica Lewinsky crisis and you do touch on that.

Dr. MARIANO: Mm-hmm.

MARTIN: I think a lot of people still wonder how they got through that period -on the other side of it.

Dr. MARIANO: It was a tough time. It was for me as a physician. As somebody who traveled with him everywhere, you sort of felt, gee, I should have known this. I should've, maybe could I help? Could I have helped? But you're only as effective as what your patient allows. And as a private practitioner, there's a lot of things our patients don't tell us.

And, you know, you would think that the White House, when you actually follow your patient around, you're with him most of the time you would know. But I didn't know. I found out about Lewinsky when President Clinton made that announcement in the Map Room. I was right next door when that happened. I had to draw his blood for the DNA before then. So it was a disappointment. But then you have to realize I'm not here to judge him. I'm here to take care of him and I'm not going to leave him because of that.

MARTIN: You also were candid about the effect on your own family of that long stint at the White House. You said when you initially took the position you thought you'd only be there for two years. And you were very candid about the effect you think it had on your own marriage. Why do you think that is? Is it a cautionary tale for other ambitious people?

I mean your husband; you mentioned your husband had to give up his law practice in San Diego. He basically adjusted his work life to accommodate your schedule.

Dr. MARIANO: He did. The reason I share that, because people think oh, you've got it made. Youve got this great career. You know, you do all these great things with the president. But something has to give. You know, you're gone a lot. And it's like a lot of active duty members who are deployed in Afghanistan, Iraq, anywhere in the world; you're away from your family. Meanwhile, your family carries on without you and you really, it's hard to keep up with that.

And one of the things that young ambitious women who want a career and they want marriage, they want it all. And I say well, I wish you the best. I mean I wanted it all too but I couldn't have it all at once. The focus was on my job at the White House and my husband, he stayed home as Mr. Mom, and it really didn't help the marriage. In fact, we ultimately divorced a few years ago. But the happy ending was he's remarried. I've remarried. We stayed good friends. The kids have done okay.

There is a toll that happens when you have your career that takes priority. It's a very difficult balance.

MARTIN: Do you think that the same would be the case if you were the man and he were the woman?

Dr. MARIANO: Yes. I have seen it among my colleagues at the White House, where the men are gone as a well and the wife carries on life without them. And unless you can do creative ways to keep in touch and grow together as a couple, you grow apart and it's very difficult to maintain that. You know, to be married and have a relationship, you've got to be there a lot of the time. And if youre gone most of the time it's hard. Especially like we were doing, I was home but I wasn't really there. My mind was going on back at the White House.

MARTIN: What would you do differently if you could do it over?

Dr. MARIANO: Probably have not stayed so long. Maybe done two to four years and then moved on to another job in the Navy. But again, you know, it depends on your basic relationship with your marriage. I think prior to the White House, there were issues in our marriage that were already sort of a warning sign when we see it as a couple as you look back on it.

So again, you have to have the initial - your foundation for a marriage is very strong. You both have to know what youre getting into, especially for a job like this, where you, as the member at the White House, are going to be gone so much that the one at home will have to carry on without you and that they have to buy into it completely.

MARTIN: Before we let you go, we like to end these conversations this way, do you have any wisdom to share? Particularly, if you were talking to a younger you, however you define that, what's your wisdom?

Dr. MARIANO: I would say don't be afraid. I would find out what your voice is and what you are passionate about and go with it. Don't let anyone say no to you and don't underestimate yourself.

MARTIN: Dr. Connie Mariano treated former presidents George H.W. Bush, Bill Clinton and President George W. Bush, along with their families. Her new book, "The White House Doctor: My Patients were Presidents: A Memoir," is available now. And Dr. Mariano joined us from Phoenix. Thank you so much for joining us.

Dr. MARIANO: Thank you, Michel.

(Soundbite of music)

MARTIN: And that's our program for today.

(Soundbite of credits)

MARTIN: I'm Michel Martin and you've been listening to TELL ME MORE from NPR News and the African-American Public Radio Consortium. Let's talk more tomorrow.

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