THE EX-PRESIDENT: Nixon: Surgery, Shock and Uncertainty

The ordeal, mental and physical, of Richard Nixon goes on and on, and so too does the nation’s involvement with him.

Last week, less than three months after he was forced to resign the presidency, Nixon lay in critical condition in Long Beach Memorial Hospital Medical Center. The cause was internal bleeding in the wake of sudden surgery for blood clots in his left leg and lower abdomen. It is thought that the anticoagulant drugs he had been taking had caused a tendency toward prolonged bleeding, and he went into shock. His family gathered round in vigil, their photographed faces masked by now familiar anguish. President Gerald Ford sent red roses to his predecessor and offered prayers on Nixon’s behalf.

Later the President, on a campaign swing through Southern California, paid the patient an eight-minute visit. Nixon’s voice was husky, but he showed no difficulty in talking. Propped up in bed, he discussed Ford’s upcoming visit to Japan and the diplomatic travels of Henry Kissinger. At one point, Ford asked Nixon: “Did you have a good night?” Nixon replied: “None of the nights are too good.” A sober Ford emerged from the visit to tell newsmen: “Obviously, he’s a very sick man. But I think he’s coming along well.”

Earlier, when told that Nixon was critically ill, California Governor Ronald Reagan gracelessly said: “Maybe that will satisfy the lynch mob.” In fact, the hospital switchboard was jammed with sympathetic calls, and its mailroom flooded with get-well messages from across the country. One room had to be set aside to contain the flowers.

Nixon’s trauma last week in Memorial inevitably brought to mind his initial, cryptic refusal two months ago to enter a hospital: “I’ll never come out alive.” He had finally, of course, yielded and spent twelve days in Memorial in late September and early October for treatment of phlebitis, the painful inflammation of the veins in his left leg that has bothered him off and on since 1964. It could at any time cause a fatal blood clot to travel upward in the bloodstream through his heart to the lungs.

New Tests. Doctors had discovered a clot in Nixon’s right lung during that first hospital stay. Fortunately, the small clot did no major damage, and supposedly adequate doses of anticoagulant drugs to prevent formation of new clots enabled Nixon to go home to his San Clemente villa.

But two weeks ago, Nixon’s physician of 22 years, Dr. John C. Lungren, ordered new tests, unconvinced that the anticoagulant drug Nixon was taking orally at home was keeping his patient’s phlebitis under control. Lungren admitted Nixon to the hospital a second time for further tests and treatment. A venogram, X rays of a vein injected with an iodine compound, revealed clots in Nixon’s left leg in areas other than the femoral vein above the knee, where some of his previous clots had formed. The additional clots (doctors could not be certain that they were new ones) were found higher in his leg. Dr. Scott H.M. Driscoll, the Memorial Hospital radiologist who did the venogram, described Nixon’s deep venous system as “99 and 44/100% clotted.”

A worried Lungren called in Dr. Wiley F. Barker, an expert in venous-systems diseases and professor of surgery at U.C.L.A., and Dr. Eldon B. Hickman, deputy chief of surgery at Memorial. After consultation and another venogram of their patient, the medicalmen agreed that immediate surgery was essential to keep the clots from breaking off and moving upward to Nixon’s heart and lungs. They showed Nixon the venogram, explaining that, as Hickman put it to reporters later, “it was a threat that the clot could become a pulmonary embolus.” After discussing his condition with Pat Nixon and, by telephone, with Daughters Julie Eisenhower and Tricia Cox, Nixon gave his consent to undergo surgery—the first he has ever had.

The surgical team, headed by Hickman, performed the relatively simple operation (see box) in 70 minutes, and Nixon was wheeled back to his seventh-floor room (for security reasons he is the only patient on the floor), where standard postoperative care got under way. The seventh floor, however, had an advantage beyond privacy that was soon to be needed. Only recently completed, this floor is about to become the hospital’s intensive-care unit, and all of the complex monitoring and life-preserving equipment for the unit was in place and functioning.

The first postoperative bulletins were reassuring: Hospital Spokesman Norman Nager told reporters that “the doctors are looking rather pleased,” and in a press conference, Dr. Hickman said: “Mr. Nixon is doing well post-op. He’s stable. He’s in his room undergoing a normal recovery period. It was an uneventful procedure.” Then, six hours after the operation, intensive bleeding, perhaps behind the abdominal cavity, sent Nixon into sudden vascular shock. For three hours doctors battled to restore his vital signs to normal. Said shaken Nixon Aide Ron Ziegler the next day: “We almost lost President Nixon yesterday.”

Nixon’s condition was still serious and remained so as the week wore on. Some bleeding continued, his hemoglobin dropped slightly, leading to more transfusions, and other intensive-care monitoring continued. Sparse, naggingly incomplete bulletins continued to be issued by Nixon’s doctors, and the hospital listed him in “critical” condition.

No Insurance. There was another, lesser, but still bothersome problem that faced Nixon, according to Ziegler: the ailing former President has no medical insurance. As Chief Executive, Nixon chose not to enroll in the Government’s health-insurance plan, which could have been transferred to a private insurer when he left office. He could have used a military hospital, but Lungren apparently insisted on admitting his patient to Long Beach Memorial, probably because it contains the elaborate technical equipment that Nixon’s case might require. The rate for Nixon’s room was $90 a day until Oct. 1, then went to $94; the intensive care he is now receiving costs $250 a day. His bill for those two items alone so far is well over $3,500, and to that must be added the cost of sophisticated monitoring equipment, doctors’ fees, blood transfusions and medication—all of which Nixon will have to pay out of his own pocket.

Pat Nixon has kept a grim watch at the hospital, leaving only for brief periods of rest. At the doctors’ suggestion, she has not returned to San Clemente, 50 miles away. Julie and Tricia flew in to comfort their mother and help answer the calls from old family friends, including Betty Ford. Other people phoned the hospital offering to donate blood, but all such offers were politely declined, since the hospital had a plentiful supply of the type A-positive blood that Nixon needs.

At week’s end doctors reported that Nixon was “alert to all that is going on around him.” But they also said that “the possibility for further complications still exists.”