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Carrying out a presidential campaign in the shadow of 9/11, the war in Iraq and a troubled economy can't help but ratchet up the candidates' stress to levels that would test even the fittest among us. Yet so far, none has visibly wilted under the pressure.
Most notably, Vice President Cheney, who had a heart attack during the Florida vote recount four years ago, appeared energetic during Tuesday night's debate. Despite his 26-year history of heart disease, he has weathered the storms of his office seemingly without additional health crises, and doctors say Cheney is most likely physically fit to serve four more years -- but they can't say for certain because the vice president and his doctors haven't revealed key details of his case.
Cheney, 63, had the first of his four heart attacks at age 37. Since then, he has had a quadruple bypass; angioplasty to clear a clogged artery and prop it open with a stent; and an operation to implant a state-of-the-art pacemaker-defibrillator to regulate his heartbeat and jump-start it if necessary.
''I predicted he could do two terms because heart disease is so eminently treatable,'' says Cleveland Clinic cardiologist Eric Topol, who has served as an informal medical adviser to doctors treating both the president and vice president. ''He'll probably do well for several years, despite the emotional stress and heavy workload.''
Cheney has denied that stress played a role in his most recent heart attack four years ago, noting his heart fared well during the Persian Gulf War when he was secretary of defense.
But Cheney hasn't spoken in detail about the state of his heart before or after those crises. His doctors have repeatedly denied requests for interviews. They now say federal regulations on patient privacy prevent them from speaking publicly about the man who's a heartbeat away from the presidency without written permission from him. Cheney aides did not respond to two written requests from USA TODAY for permission to interview his physicians.
Topol, who advised Cheney's cardiologist, Jonathan Reiner at George Washington University, at Reiner's request the morning after the vice president's fourth heart attack, says, ''It's legitimate to ask a man who's had four heart attacks and a bypass operation about his fitness to serve four more years.''
Just a week ago, Sen. John Kerry and his physicians offered a candid account in The New York Times of surgery to remove the candidate's cancerous prostate in February 2003. The surgery was successful and the cancer is unlikely to recur, Kerry's doctors said.
William Catalona, director of Northwestern University's prostate program, concurs, though he notes that he can never offer patients a ''100% guarantee that there will never be a recurrence.'' But doctors classified the tumor as grade 6, he says, which is ''not one of the scary, high-grade tumors. . . . The great majority of patients who had this finding would not have a recurrence of prostate cancer.''
Even if they did, he said, ''there would still be other curative options, including salvage radiation therapy.''
Apart from the cancer, Vietnam-era shrapnel in one leg and surgery in March to fix an injured shoulder, Kerry is physically active and in excellent health, his doctors say.
An avid jogger, President Bush is in excellent health, marred only by minor injuries from jogging and a famous fainting spell. The president, 58, a football fan, had been watching a Ravens-Dolphins playoff game in January 2002 and fainted briefly after choking on a pretzel.
Kerry's running mate, John Edwards, 51, hasn't had any reported health problems.
John Bumgarner, a retired Greensboro, N.C., cardiologist and author of The Health of the Presidents, says politicians now are more open about their health than in the past. He notes that President Franklin Roosevelt did his best to hide his near paralysis and the fact that he was ''very, very sick'' during his last year in office, and President Kennedy hid the fact that he was taking painkillers and stimulants for several chronic health problems.
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