Presidents As Patients: An Interview With Dr. Connie Mariano
Eleanor Concepcion “Connie” Mariano has quite an impressive resume — even for a doctor. Not only was Dr. Mariano — or, Dr. Connie, as she’s more intimately known by a few — the first Filipino-American to become a Rear Admiral in the United States Navy, but she was also the first American woman to be appointed the Director of the White House Medical Unit.
In June 2010, Dr. Mariano released The White House Doctor: My Patients Were Presidents: A Memoir (Thomas Dune Books, 2010).
I was able to speak with her recently about the psychology behind spending nine years caring for three Presidents of the United States through everything from surprisingly panic-inducing blisters to that sex scandal heard ’round the world.
Alicia Sparks: Whether you were headed to a local golf course or an overseas event, so much “just in case” medical planning went into preparing for trips. In the beginning, there was even a point during which you were afraid you didn’t have a simple Band-Aid. How nerve-wracking was it to plan these trips?
Dr. Connie Mariano: It was very nerve-wracking in the beginning because when I started out in the White House Medical Unit there was no standardized list of items to pack in your medical bag. So, had to go by what the other doctors kept. We were focused on life-threatening events like cardiac arrest, trauma, and assassination that somehow a blister on the back of the president’s heel wasn’t on the list of potential threats to his health. So since that episode, I stocked the medical bag with lots of Band-Aids.
Sparks: How long before it became “normal,” sort of “second nature” – or did it ever?
Mariano: After about 2 – 3 years. But even though you knew what to do, your adrenaline was always up because any time, any place, something threatening could happen to the president be it a heart attack or attempt on his life.
Sparks: During the beginning of your White House tour, you were new, wide-eyed – nervous even – and by the end you were completely in command. Was there any one incident that was the pivotal point for that transformation?
Mariano: When I realized that my boss wasn’t a good leader and that the Medical Unit needed to change to do its job better. And I had the experience, but most important, the trust of the President and First Lady, to make those changes happen.
Sparks: We all know humans are humans — whether they’re grocery store clerks or United States presidents. We all sleep, we all get sick, we all shower, we all use the bathroom. Still, US presidents are US presidents. How did you come to acclimate to seeing the POTUS in very real “human situations,” such as when President Bush threw up in the Japanese Emperor’s lap?
Mariano: As a physician, you are very focused on the human condition of your patients. As the physician to the president of the United States, you are acutely aware of his humanity but respectful of his power and position. Through daily contact with him by seeing him at the White House or traveling with him on Air Force One, on Marine One, or on all his events where you are only a few feet away, you become accustomed to knowing him and understanding him better.
Sparks: In Dublin, when you were juggling suicide staffer “Mary” and presidential care, how did you manage this incident, and incidents like it, when you had to take care of serious staff cases, be watchful of the president, and make sure nothing interfered with the trip? What kind of frame of mind did you have to put yourself in?
Mariano: You have to prioritize and balance at the same time. Fortunately, I had another doctor with me in Dublin along with a nurse who accompanied the president to dinner that night to keep on eye on him and the First Lady while I was able to search for Mary with the White House staffer. Having the right assistants makes a huge difference.
Sparks: When President Clinton’s uncle and then mother died, how did you comfort one of the world’s most powerful leaders? How did it feel to see that person go from “large and in charge” to just a grieving nephew and son?
Mariano: You offer words of condolence and by the very fact that you say those words and are present for him, the President is grateful and comforted. It is very hard for Presidents to share those private moments of grief because part of the persona of the president is to project power and strength.
Sparks: During the Monica Lewinsky scandal, you seemed very sure of Clinton’s innocence. You were very supportive, and the way you described how it felt to be forced to be the one to draw his blood made it sound as if you almost thought of yourself as a traitor. Later, when the truth came out, you were hurt and angry. How did that affect your relationship with Bill? How did you reconcile your feelings toward him?
Mariano: It made my relationship difficult because I was very disappointed in him. But I realized I couldn’t give up on him and that I had a job to do. I was not sent to the White House to judge him. I was sent to take care of him. And by focusing on why I was there, I overcame my disappointment.
Sparks: In the book, you mentioned Hillary Clinton’s mantra must have been “Don’t let them see the pain.” That she just “got back on the horse and rode it to victory.” Were you ever afraid Hillary wasn’t dealing with the pain in a healthy way? That all the work wasn’t just to keep the ball rolling, but a way to avoid dealing with the hurt? Did you ever hope there was a time she was letting it out?
Mariano: I admired the way she handled the pain privately. Truly, this woman is not a victim. I think she kept busy on the projects she believed were important and in her own private way, forgave him as well. I observed she was able to have the support of her close friends, her minister, her own personal faith and strength to get her through the tough times.
Sparks: And on that note, what about you? There’s not a whole lot of mention of you taking care of YOU in your memoir, though there’s definitely mention of the consequences (feeling disconnected from your family – your husband and sons – eventual divorce, etc.). At one point in the book you admitted to fantasizing about being dressed up when you were at work events. Were there any times when you focused on yourself, spending time with family and friends and getting to wear something other than “duty attire”?
Mariano: I was a lousy patient in the White House. Never slept, ate poorly. I tried to compensate by jogging and exercising, and going for my annual exams at Bethesda. When my hands got clumsy, I finally surrendered and got the neurosurgeon to see me at Bethesda where they discovered I had compression on my spinal cord that led to my surgery. It was very difficult to get away from work. The one vacation I tried to go on was to Puerto Rico with my family for a few days and I was called the first day about a press statement about Buddy the dog being neutered. I’ve gotten much better since I left the White House and got out of the “kill zone.”
Sparks: The term “servant voice” pops up a lot throughout the book, yet you were clearly well liked and treated by each of the presidents and their families. How long did it take for this voice to disappear? Did it ever? At what point? Did being promoted to captain make a difference?
Mariano: I think the servant voice never has gone away. Instead, it’s more like being plain humble which I think is a good thing. I’ve seen too many people in Washington DC getting into trouble because their egos got too big for them. Being promoted to Captain and Admiral meant I did a good job. But even now, I still think, it’s “never enough.” What more can I do in my life?
Sparks: You took a lot of your Navy training and work experience and applied it to working with the POTUS. What kinds of experiences working with the POTUS have you applied in your current practice, the Center for Executive Medicine?
Mariano: The logo for my practice is a silver star, which symbolizes the one star I wore as a Rear Admiral when I retired from the Navy. Also the letters in the word “STAR” stand for the factors I learned that were important from the White House that would be important for my patients in my current practice:
- S: Service
In the end, between doctor and patient: it’s all about the relationship.
To learn more about The White House Doctor — the book and the woman behind it — visit www.whitehousedoctor.com.
Sparks, A. (2018). Presidents As Patients: An Interview With Dr. Connie Mariano. Psych Central. Retrieved on February 26, 2020, from https://psychcentral.com/blog/presidents-as-patients-an-interview-with-dr-connie-mariano/