in their book "heart" former vice president dick cheney and his longtime cardiologist jonathan reiner talk about his long history with heart disease and advances in cardiology in the past decades. he had a heart transplant in 2012. the two discuss their book for about an hour next on book tv. >> tonight's program will consist of an interview conducted by margaret cochran president of the national press club journalist institute and the hurley chair in public affairs journalism at the missouri school of journalism. with mr. cheney and dr. reiner

followed by a brief q&a. we invite you to purchase a book if you haven't already done so. each of the books have been pre-signed, have the pre-signed plate so you get a signed copy. there won't be a book signing tonight. as long as he has served at the highest levels of business and government vice president cheney cheney -- dick cheney has been one of the world's most prominent for the first time ever cheney together with his longtime cardiologist jonathan reiner m.d. chairs -- shares a personal story of this 35 year battle with heart disease from his first heart attack in 1978 and a heart transplant he received in 2012. part of the book has been described as riveting, singular memoir with doctor impatient. like no u.s. politician has before him cheney opens up about

his health troubles sharing never before told stories about the challenges he faced during the perilous time in our nations history. dr. reiner provides his perspective on cheney's case and also gives readers a glimpse into his own education is a doctor in the history of our understanding of the human heart. the book "heart" stances on optimistic book that will give you hope and millions of americans affected by hard disease. ladies and gentlemen please join me in welcoming mr. cheney and dr. reiner. [applause] >> welcome gentlemen and as joe said you have written a fascinating book. the method you chose is a little unusual. you each right part of every air mr. vice president you describe

your personal experience and a are reiner you give your perspective as dr. cheney's cardiologist and also the history of change innovation and part of that care. this is the formula that works so well in the book i thought we would use it for this evening. mr. vice president your heart health history is amazing and i'm sure everyone is so pleased to see you here and looking so well tonight and after they learned everything that you had been through felt even more amazed. you have had five heart attacks, numerous catheterizations quadruple bypass surgery, implantation of stems and a defibrillator and a heart pump and then 20 months ago you received a heart transplant. through it all you held some of the most high-powered jobs and dealt with some of the most stressful situations imaginable. so going back to your first heart attack which happened to

you at the age of 37 during your first campaign for congress, what are the lessons you have learned from your experience that you would like to share with others? >> well, it's sort of what the book is about in the sense of what we try to do is to use my case to talk about those developments most of which had occurred when i had a heart attack. so it's a hope -- a message of hope and optimism and the phenomenal innovative capabilities of american medicine. the treatment i had in 1978 when i had my first heart attack wasn't much different than what dwight eisenhower had gotten 20 years before when he had a major heart attack. i guess to mention lessons a couple of things come to mind from a personal stamp point. one is when i had the first heart attack in the first

campaign i asked my doctor a man named rick davis and in turn asked, i said does this mean i have to give up the campaign in his response was a little hard work won't kill anybody. that is not exactly conventional wisdom and i say that next to john here but he also said that stress comes from spending your life doing something you don't want to do and he said if you feel up to it and something you want to do, do it. i sort of lived by that and i think that was an important lesson. i also very early on realized that you never hesitate great if you think you might be having a heart attack if you don't get your fanny to that emergency room -- and unfortunately a lot of people put it off and say well maybe tomorrow or maybe it's indigestion or i will check it next week. when i had the first heart attack the only sensation i had

was numbness in these two fingers and the only reason i checked into the hospital that night was my first cousin had had it that heart attack a few weeks before. the lesson i took away from that one second of the hospital and sat down on the examining table and passed out. if when in doubt check it out. if you don't you are a fool. that's his lenses i can be about it but that saved my life on more than one occasion. and i had a series of small attacks over period of years. i never had what i would call a major attack. the problem of course were cumulative and the damage was significant. finally the lesson that the book is about, but he wonders of modern american medicine in spite of all the debate we are having over obama carried everything else and it's not a political look. the fact of the matter is we have the best health care system in the world.

it may not be perfect and there are things people can find that they would like to fix but do not underestimate the enormous talent and creativity encourages john says and persistence of those people who have given us the kind of system to save my life and allowed me to go forward to have a full and complete career by anybody's standards even though i was for 35 years a hard patient. >> thank you and that leads perfectly to the question i want to ask dr. reiner which is the right in the book that for many years the new developments in cardiac care seems to arrive just in the ninth of time to help mr. cheney. can you talk a little bit about what some of those advances were? >> i told the vice president at the beginning of this project that it's like you are driving down the road early in the morning, maybe early on a sunday morning and there's very little traffic on the road. the lights ahead if you stretch out red but just as you reach the lights each light turns

green. it struck me that was really a perfect metaphor for the vice president's medical history. seemingly every time he had a medical event that might turn his light read and stop his career or stop his life medicine had an answer for it and when you look at the vice presidents life, the vice president did and just survived these events. seemingly every time he had an event he took on the job of responsibility. he had his first heart attack in 1978 and became a member of congress and had another heart attack in eight -- 1984 and ascended leadership in the republican party. he had another art attack and bypass surgery in the late 80s and became secretary of defense obviously 12 years ago became the vice president of the united states so there was a medical answer and the vice president

use that medical advances to not just survive but to thrive. when we were writing the book we wanted to write it look which was less medical memoir but really a book that offered people with heart disease hope and impart to understand what we can do. i had a phonecall last week with a patient i hadn't seen in 10 years and this was the best call from anyone i have had about the look. i had known this man for a long time. he moved out of town and called and said hey john i read your book, i am dick cheney. he had multiple heart attacks than he had heart failure and he thanked us for writing the book because it helps them understand where he was and what it did and

they gave him hope and that was her goal for this project. >> we are going to go through the dramatic story that you tell mr. vice president when you had from 1988 when you had ipath surgery until 2000 you experienced no heart related crises of any kind and then in 2000 george w. bush asked you to vet possible vice presidentpresident ial candidates and offered me the job. what were your concerns as related to your health and how did you address them? >> in addition to the quadruple bypass the other thing that was magical in terms of my case in the summer of 1988 was the cholesterol lowering drugs statins. late 1988 was one i won on them. between those two things cholesterol lowering drugs and

bypass when i was nominated to be secretary of rensin was asked questions dr. john's predecessor originally referred me to john was able to write to the armed services committee that we have dealt with my cholesterol problem and also the blockage of the arteries and so forth. there wasn't any reason i couldn't take on the most significant responsibilities and that was true for the next 12 years. when we got to 2000 the first time i was approached about the vice president i said no way. i had a great job in 25 years in public life. i thought about running for president myself in the 90s and decided not to do that. i was going to go off and enjoy business. the vice president was not a job i aspire to in my political career was over.

>> you were a dubious man about the job. >> i'm going to -- being too definitive but i'd didn't want to be vice president so i said no and he asked me if i would find someone. i figured out eventually he never except that anyone. he knew what he wanted and eventually got it and i'm glad he asked and was proud to serve in glad i did serve trade it was unique experience from my perspective and the opportunity to be vice president of the united states, health did enter into it. once he said look you are the solution to my problem i said i'm going to set myself to you because i have been fed a everybody else. you have to look at my situation front and center. i said look, a twinge in the middle of the vice president to debate i am out of there. i went to the emergency room to get it checked out.

i made it clear that was a potential. he needed to satisfy himself that there was no reason why couldn't serve. that in turn led to consultations between john who is that in my dock and then who was advising then governor bush. they talk to each other and the governor talks talked to dr. coolly and concluded that there was no reason why i couldn't serve. i didn't make it through the eight years. >> three you actually figured out that he was going to become vice president or the vice president nominee before was announced. how did that happen and what are your thoughts because you had been his chief cardiologist for only two years.

>> i'm at the vice president initially when i was a fellow. my mentor alan ross had been the vice president's doctor for many years and i met the vice president when i was still a trainee and when al ross retired was in the vice president's care. in late june 2000 the vice president called our office and wanted an appointment to be seen but wanted a stress test. you know, the vice president, the vice presidential sweepstakes is as they say in the book and obsession in this town. at the time i think the smart money was on tom ridge. i went to talk to the vice president in turn is then asked him is if cheney okay? he goes yeah his heart looks great. i said he wants a stress test. i think he's going to run for vice president.

>> a lot of political reporters needed to be talking to you then. >> someone asked me for a stress test who is otherwise feeling well at that time in the political history of this country just stood out. the vice president had a stress test and a week later, he said it looks like i'm going to be asked to run for vice president. it's one of those moments where you have to suppress what's happening inside of your head and say oh really? [laughter] you are the third person today that has said that to me. but he happened to be right. >> fast-forward to the election, the famous elections that seem to go on forever while the votes were being counted. on november 22, you began experiencing some difficulty following your own rule you said

i need to go check this out. that turned out to be your third heart attack. it was the fourth by then. a couple of other things happened in the intervening couple of months right after the inoculation and so on. you made a decision in march. tell us about that decision and what you did and why you did it. >> i was concerned. the genesis of that was -- i asked david to review all of the statutes of the constitution and any provision that i needed to know about in order to get ready to become president and do the transition. that was my main job to be ready i wanted to make certain i knew absolutely every single

possibility. what david pointed out was while the 25th amendment makes it impossible to replace a president who is still alive but maybe -- maybe had a stroke in his second term the vice president under the 25th amendment by a majority vote the cabinet and the vice president can set aside president and the vice president comes the president. there is no provision and we were concerned for example if i were to have a stroke or a serious heart attack and i'm still alive and still in the office but unable to function that creates problems. it becomes almost impossible to execute the 25th amendment because the vice president is not capable of making that kind of decision. if something should happen to the president and you have a

very weak president that succeeds to the top office and there's simply no way to remove in the capacity of the 25th amendment provides a way to replace it once it's gone. what i did with david was i wrote a letter of resignation in the same form that any president or vice president for constitutional officer would write to resign the post and address the secretary of state like when nixon said when he resigned the presidency. i hereby resign the vice presidency today effective and then gave it to david and told him to hang onto it. if the need ever arose and i was no longer able to function as vice president i wanted him to present that to the president and the president would have the ability. all he would have to do is submit it to the date.

if he didn't want to do that fine but he had the choice. nobody else would. they were the only two knowledgeable. the other sideline was david didn't keep it in the office. he was worried something would happen and he wouldn't be able to get back into the white house for some reason. >> you didn't know this was in the book. >> he got his wife and kids out of many went back in and got the family papers in my letter of resignation. i never had to execute it but i felt it was something i needed to do. >> dr. an american medical odyssey review all of a sudden found herself working with something called the white house medical unit and i found this to be one of the more fascinating things that you really went into.

first of all it's very unusual for mr. cheney as vice president to continue to see you as a cardiologist. can you talk a little bit about that arrangement and how you worked with the white house medical unit and what they do? >> i think that is one of the lessons. i think there's a lot of value in the continuity of care. regardless of how one feels about current issues with the affordable care act. there is tremendous value in having a physician follow you for many years and with a vice president with 35 years of heart disease he is only had to cardiologist take care of him, a very important longitudinal relationship. the white house has a full-time now quite large and in fact i was just over there today group

of doc ayers and nurses and assistance whose primary mission is to take care of the president and the vice president and the families. it's grown in size and it takes on more than just the urgent care family doctor role which we talk about in the book in the aftermath of 9/11. the white house was concerned about bioterrorism and a lot of concerns for the safety of the president and vice president not just from natural hazards that man-made weaponized pathogens. so there are a group of fabulous full-time military docs from all the branches who are with the president and vice president 24/7. my great friend and colleague colonel hoffman was the vice president's full-time medical

doc for eight years. i don't know how many hundreds of thousands of miles we traveled over the course of eight years. a tremendous personal sacrifice and away from home for so much time. there is a group of tremendously dedicated incredibly capable people who look after the president and the vice president and they do a tremendous job. i wanted to talk in the book about them because they were really unsung heroes. i say in the look. [inaudible] >> there also was a time you mentioned concerns about terrorism. there was a time when you are replacing the i call it a defibrillator. there was a much fancier name for itself i'm saying the wrong name, please. they were replacing the vice president's defibrillator but

you had a security concern. tell us about that. >> wanted the innovations we talk about in the book is the development of technology implantable technology to prevent what would otherwise be a fatal heart rhythm. these are plentiful heart that it for later's and we talk about how these devices were developed. the innovator was a holocaust survivor, the only survivor in his family and he went on to develop divisive ultimate save the vice president's life. a few years ago. that we replace his original device and the new device came along with the feature that i wanted which was the ability of an early warning system for heart failure. going forward i wanted able to understand the vice president called me and said he was a little bit short of breath and i want to know if was heart failure or just a cold. it also came with the ability which was not customizable to

basically talk to the device and interrogate the device wirelessly. it just seemed the threat environment of the last decade but that might not be smart and i didn't know was possible to hack into the device but the fact that they device had wireless capability gave me enough laws to ask the company and my colleagues in the tracy who left the company to disable that feature and got approval from the fda to do that. about a year ago on a sunday night mrs. cheney e-mails me and says oh my god they just hacked into the vice president's defibrillator and killed him. [laughter] i didn't get any royalty on that. but it highlights the unusual environment that this patient lived in and a lot of the folks

in dozens of people who provide care for the vice president had to react to it. it wasn't just a complicated patient. he was a complicated patient living and working in essentially the most complicated environment and the most complicated time of most of our lives. it was interesting. >> there's just one additional thought because john ever gets himself enough credit. because of the dash overtime john shortly after decided i was a candidate possibly for sub cardiac arrest. and that is when we put in the icd, the defibrillator and eight years later as i'm packing my jeep out of the grudge in jackson wyoming and 79. >> you had already left the

white house, a private citizen. >> a private citizen and the secret service was still with me. i went into sudden cardiac arrest and just blacked out ming came back. i had a vague not on my head. the jeep was on a rock at the end of the driveway. john's foresight in having me do that saved my life. 16 seconds from the time my heart went into defib until i was back and the device measured the situation, executed the preprogrammed shock to my heart and i was back in 16 seconds but that was one of the most crucial decisions that saved my life. and a very important one. >> you talked about 2009 and even beginning in 2007.or reiner you were noticing a decline in the vice president's health or

his status i guess. you said now we were beginning to see a not-so-subtle decline in his cardiovascular status. it was becoming abundantly clear that dick cheney had been congestive heart failure. we observing what steps did you take? e. the vice president was becoming more short of breath and what we were really watching was the degree of over 30 years of heart disease involving the arteries that lead to the heart muscle. the vice president had them so well compensatcompensat ed for so many years and had been asymptomatic with this vigorous incredibly had the life and really an amazingly stressful environment. you know about a year from the end of the vice president's term

in office i noticed that he was becoming more short of breath and starting to develop the early signs of heart failure which is part of the natural history of this disease. it was subtle and the vice president could still function and put in a full day of work and still exercise area it was becoming clear that we were going to enter into a phase of the disease. >> so you left the white house in 2009 and he told us about the incident in the driveway. a 2010 things have deteriorated further, and i guess maybe doctors everywhere that you you describe the state of the men i will ask the vice president about how you were feeling about it. >> there were a series of events in the last days of the administration the vice

president had incapacitating back injury which ultimately required back surgery in the summer of 2010 and a few months after that the vice president had out of congestive heart failure and a month or two after that in 2009 at the device went off. then there were a series of events that followed that. there is a term i describe in the book which i call circling the drain. in medicine we have ways of describing things which sometimes seem cold but you get a world will forming of this accelerating torrent of events in the vice president is starting to have them. he developed a drill to elation which was not tolerated well with rapid irregular heartbeat which required blood thinner's.

the blood thinners cause life-threatening bleeding but the blood thinners were necessary to prevent stroke. you can see one event to lead to aid and other events like a series of dominos. that led to end-stage heart disease and now in the late spring and early summer of 2010 when the vice president essentially was dying of congestive heart failure. >> how are you approaching things at that point? what did you think ben? >> i was in the period, 17 months after he left the white house until i reached the real crisis. as john said it was sort of one thing after another and a complex set of developments through the spring.

when i got down to the point, this would have been july 2010, i remember going to the hospital i think it was the fourth of july. i had these bleeding problems at one point and i had arterial nosebleeds that involves bleeding in the leg and so forth i went down and went back home and i heard the fireworks going off driving down river road for the park great canaveral rd.. this was impossible during normal circumstances. i had had a fantastic life, a great family and done everything i could conceivably think of doing and i have known for many years that, assumed for many years that eventually i would die of a heart attack. it happened to my dad and

happened to my mother's father and i had reached the point where i was 69 years old and i was at peace. as i contemplated the end of my days, it was not nearly as difficult for me as it was for my family. so it was a time that i had come to grips with the fact that my time was up and i had run out of technology. there weren't any more green lights that i focused on her thought much about. that is the shape i was in when we went into the hospital on the sixth of july expecting to try one more thing which was a binge regular device. >> what was the next possible greenlight that you had? >> the natural history of heart disease is the heart function deteriorates to the point where the heart can no longer

compensate and the heart can no longer function. until recently the next thing that would happen is that person would die. in the spring of 2010. >> this spring? and we are now in july. >> a month or two before that the vice president's daughter liz called me and she said and it was very sad to hear this. she said my dad is gone. and is it true that there is nothing that can be done in? i said no, there is more that can be done. we can put a left ventricular assist device and we can transplant him. liz said he's not too old for for for that and i said he's not too old for that. that began this process of moving the vice president

towards mechanical assist so now in 2013 instead of watching the inexorablinexorabl e decline of the patient we can support the function of a heart with a really wonderful elegant technology with one moving part that spends about 10,000 revolutions per minute and can take over for essentially ape pumping chamber heart. that is what we offered the vice president. although the vice president appeared to be somebody who was at the end of his days, what we thought all of these problems would have a single cause which was the bad heart and if we could make the heart that are all these other problems ,-com,-com ma bleeding and the arrhythmias everything would go away. so we set out to expat and our colleagues across the river at

fairfax hospital, a wonderful display of surgical skill and dedication, perseverance. the whole operation implanting in assist device on the night of july 6. the vice president that night was --. >> so did you think about not doing it or as soon as you heard about this you are willing to do this? >> it wasn't really a close call. i had not thought about transplant and partly it never occurred to me that it was a possibility. i had never really spent a lot of time oppressing on it and john set up a meeting with the

nova team and actually brought in a wheel honest-to-goodness working -- and they briefed me on the operation. when it was time for going to operate on thursday night to try to rebuild my strength. my numbers were collapsing so fast. the docs came into my family was there and a basic he said we have to do this. i said let's do it. it was the toughest surgery by far and texts 20 some units of blood. i came out and i was so weak when i went to the surgery, was a very sick puppy. i have five weeks in the icu and part of that on a respirator sedated and 35 weeks afterwards contracting pneumonia while i was recovering from it so it is a rough patch but it worked. once i came out from under the

anesthetic i had lost 40 pounds and i was unable to control wadleigh functions except that i could breathe and i had to practice that that i was alive. with the prospect that if i could get the transplant i would would -- [inaudible] >> okay, let's move ahead than to wind you let believe it was march 232012. he both received calls. tell your experience. >> i won't be able to forget the date he a cassette of wood had been my dad's 90th birthday. my wife charisse and i were going to take our children the next day to colorado for a speech trip but the phone rang as i was getting into bed and it was my colleague today looked at the phone and before you even

press the green button on the phone i saw the caller i.d.. it would have been no other reason for him to call me at that time at midnight. i just picked up the phone and without even saying hello i just said and the head of the heart failure at fairfax said john, we have a heart and it's perfect. i had known in some ways ever since i had met the vice president that one day we might be getting a phonecall like that but it was a very dramatic moment. i called the vice president. he had gotten the news from one of the prep is nurse at fairfax and i called the vice president and i said sir this is going to be a great day. i realized i was probably trying

to reassure myself. the vice president was saying incredible spirits and it was a very emotional evening for me. >> you described the surgery and when you came out of it he describes the heart refilling with blood and starting to beat again. when you woke up tell us what you felt then. >> well i can remember john was at the bedside as well as the surgeon at fairfax and they told me everything had gone very well in the transplant had gone very smooth and it looked like a good hard. once it was hooked up with the blood supply and given a touch electric glee it had taken off

and it was perfect. at that point my immediate reaction was one of joy. at the same time as you go through this you are very much aware and i always emphasize as they do tonight i wouldn't be here without it. people often ask who don't understand it. early on partly because my sense of almost being ripped one, thought it was dying and all of a sudden i got an extension of my life. on the other hand the family had just been through a terrible tragedy and had lost someone and there was a mismatch emotionally in terms of where you are at that particular time. it was the easiest surgery i ever had. i had done it three times, the same scar. the only thing i have left to

show for 35 years of heart disease is that i've got a scar open three times for open heart procedures. the stents are gone and defibrillators are gone, everything that was the part of the 35 years of coronary artery disease. a new heart and arteries and it are absolutely clean from the standpoint of luggage and backend a year or words after catheterization. i hadn't had arteries like that since i was much younger. as john said it was at the center of my illness and once i got a new heart everything else went away and the problems i had been living with for so long. >> in 2010 you were unable to fish or hunt, two of your favorite activities and you

could need up the stairs. what is your tiffany like today? what is life like for you today? we can see you look very well. >> i spent heart of the year in wyoming. i got a diesel that i called the horse trailer with. it's a -- my granddaughters force. she is a barrel racer. this year i shot pheasant and tailed grouse in montana and south dakota and last week i was on the eastern shore for use. i fished probably one day a week all summer long. from the standpoint of physical limitations i work out on exercise goal bike every day. i have got a bad knee but that's because i have played too much ice -- football when i was in high

school. john told me a long time ago he said this whole operation in everything we are going through will be a success when you tell me you are more worried about your game then you are your heart. [laughter] speech.tercel three some people have suggested that mr. cheney got special treatment because he is a vip. is that true? >> obviously not. every innovation, every drug, every device that the vice president received is commercially available technology. there are no experimental therapies offered to the vice president that the vice president wasn't unusual patient. he was the vice was the vice president of united states although we delivered i think state-of-the-art complex medical medical -- to complex patient the most

complex patient of my career actually what was different was how he had it delivered and i talk about in the book how we have to tailor the care of somebody who has very singular security requirements who requires very efficient care. i can't impose on the vice president if you come in tomorrow and maybe later in the week and next week and try to create an efficient model of care. we talk about how we do that in the book. the way we deliver the care is unusual. the care he got his standard state-of-the-art cardiovascular care 2500 years in the making. sure, when you have to find a place for the military aide carrying the football that is not usual care. and that g. w. were almost all

the vice president's care has been for the last three decades we knew how to do that so we configured this standard care to a standard patient and i admit that absolutely. >> but you do say in the woke that sometimes celebrities can get worse care. there is the famous celebrity syndrome and then better care. there can be a downside. >> we tried not to do that in very early on the early morning when the vice president was admitted with a small heart attack i told him that i didn't want to negatively diocese care by not doing what i would normally do for the average joe who came in with those symptoms. i think throughout the course of his care with me and with us and

my many colleagues that g. w. we tried very hard to do that. early on when we were thinking about the defibrillator in 20011 of my colleagues said why look for trouble? that is the kind of thinking that we really wanted to avoid. so vip care usually doesn't mean good care. it usually means the converse of that but we try to divide usual care in an unusual way. >> thank you. mr. vice president you wrote in the book about how important your family was to your recovery and you also wrote about how your political campaigns were always a family affair. i'm sure it's painful right now for you to be experiencing the rifts between your daughters.

i wonder if tonight you have anything you want to add to the statement that you and your wife made a few weeks ago about that situation? >> no. [laughter] i knew you were going to ask. it is obviously a difficult thing for a family to deal with but when i put out a statement a few days ago, a week or two ago and we were surprised when there was an attack launched against lives on facebook and wished it hadn't happened and do believe we lived with his situation and have dealt with it for many years. it's always been dealt with within the context of the family and that is their preference. that's the proper place to do with it. >> you can't publicly say that

you are supportive -- the that's as far as i'm going to go on the subject barbour said don't waste your time. >> okay. >> you taught me a lot. john is sitting over here. [laughter] >> one last question and we will take some questions from the audience on the affordable care act in the opening here. do you think if the affordable care acted and in place with your health care have been any different? you are covered bye bye insurance the whole time. >> insurance i had, there was a time when i was 23 when i got second hospitalized and had no health insurance. i spent our honeymoon money on medical. later on i learned i needed health insurance and i got the regular who crossed lou shield program and i've had that throughout my life. that basically finance the care

and i believe when i left the white house at that point, i think that was the way it worked in terms of my concerns, there are a lot of them. i talk about for example the importance of continuity and doctors. i had my second heart attack in 1984. i was in the congress and the semito bethesda at that time. the care was perfect. i had been in the hospitals and this was my second heart attack. one of the things that concerned me was i never knew who might doctor was. that is when i made the decision that i needed to find a first-rate cardiologist in the washington area so i embarked on a political career and to follow it over time. that is how i was put onto alan ross and that led to john. the continuity of those two

doctors over time is absolutely crucial. i wouldn't be here today without it. i worry when i hear all this talk about you can keep the same doctor if you want. i'm sorry, but i think that's a very bad sign. i worry very much about the device tax. we talk about in the book in one of the great things john does is he writes about stents. two guys had a good idea and no money. i happen to know and i didn't know he was doing it at the time a guy named -- invested $250,000 and that gave him enough to get a patent and he sold it to johnson & johnson johnson & johnson. it saved millions of lives. the initiative and incentive for them to do that and make it happen didn't come from the government. they put it together themselves

and now under obamacare is we are going to tax the makings of devices. they pay taxes on every profit they make like everybody else but this is a new tax imposed on medical devices. i think that is one of the dumbest ideas i have heard and i feel very strongly about it. literally i'm mocking proof of how great and how innovative our health care system has been. i can't imagine anything worse. i'm sure i can but i think it's an example of how ill-conceived parts of this program are. >> thank you. we will go now to the audience for questions. we have people with microphones and shelby go here? you have someone there who wants to ask a question? >> mr. vice president there are countless people waiting for hearts in the united states. had you not been the vice president do you believe he

would have received a heart when he needed one? >> i went through the process that everybody else has to go through. john can speak to it with greater resort than i did. the normal waiting time was 12 months and i waited 20 months. >> dr. reiner? >> i can answer that. there is no way to game the system. there was certainly never any intent to try to game the system and even if there was it can't be done. transplants are managed in the united states by the united network for organ sharing which has highly codified rules and regulations to allocate in the united states. so, the answer to your question is yes, we absolutely would have received a heart if he you were not the vice president. feeding -- being vice president in a state suffered no advantage and in

fact he waited 20 months for a hard. but the vice president hasn't said or what we say in the book is when he finally made the decision to go for the transplant he privately said i'm going to wait my turn for this. i said i understand that sir of course and he did. >> the 20 months was twice as long as the average weight. another question. >> thank you. mr. vice president, during your tenure in office do you feel that enough information was disseminated about your health to the public and more pertinent

i think do you have any thoughts about the way such information should be handled in the future for the president and vice president? i believe, i can't think of another instance where as much information is provided on a regular basis for each and every one of the incidents. i can go into gw for a calf and no one would know about it. tv cameras outside. it was not like it was a secret. when i had heart attacks i was always in the hometown newspaper. i got ready to have quadruple bypass and we announced it so there was anything that was kept secret in my mind and the book itself a think is the