James McManus

Every Saturday, James McManus’ poker column appears in the New York Times. An odd gig, if you can get it–and even ten years ago, McManus, a novelist and teacher, would have been completely unqualified. However, in 1999 Harper’s magazine hired him to write about the World Series of Poker, and thus began his obsession with the strange world of high-stakes cards. In fact, when we first phoned McManus, he had to make sure we knew that “the rake” is a poker term (um, we did know).

But when he’s not peering over the shoulder of a card sharp, McManus has bigger concerns. After his oldest daughter was diagnosed with juvenile diabetes, he become a keen observer of the American health care system; in 2003, Harper’s sent him to the medical mecca in Minnesota whose patients include politicians, dignitaries, CEOs, and oil magnates from around the world–that is, the Mayo Clinic. McManus signed up for what may be the most thorough physical examination available anywhere. In his book Physical: An American Checkup, he shares what the rest of us are missing.

You got what is called the “Executive Physical” at the Mayo. Is it superior to the treatment the average patient gets?
No. It’s the exact same physical. I was sitting next to a senator, but we were sitting amongst ordinary Minnesota citizens. But for an extra three hundred dollars, the executive patients get scheduled very efficiently. The waiting in line, the six- or seven-hour gaps between appointments disappears. The theory is that some people’s time is more valuable than other people’s time. It’s very important to note that the fees from the executive program bring in money for medical research that benefits everyone.

Outside of the clinic, what was your impression of Rochester?
You see a lot of sick children around town. It’s sobering to see them, especially if you’re up there with your own small children. It’s a big wake-up. I consider the Mayo one of the most beautiful things that humans have ever invented. Put aside the Mall of America and all the cathedrals; one of the most beautiful things that people can do is put together a great teaching hospital and help people who are sick.
Also, the Arab and Muslim presence was everywhere when I was there. I stayed at the Kahler Hotel, and they had a separate Middle Eastern menu and a huge number of Arab cable channels. But that’s changed; it’s no longer easy for Middle Eastern patients to come here for treatments. When the fact-checkers were going through my book, they called the hotel to verify the cable channels and menu, and they said they don’t have them anymore.

Although you write about how your family history of heart problems haunts you, you seem to be almost more concerned by the same issues when they affect celebrities, particularly David Letterman.
Yeah, Letterman and Bill Clinton. When guys around my age have open-heart surgery–especially guys like Letterman, who runs every day–that really gives you pause. When he talked about what he went through, he saved lots of lives. When celebrities talk about their health, people pay attention in a different way than when their family members experience the same things.

Did you make lasting changes in your lifestyle based on what your doctors told you?
I love these doctors and I deeply respect what they do, and I believed everything they told me about my health–but that doesn’t make it any easier if they tell you not to drink wine or eat pasta, or to get more exercise. I have managed to quit smoking; I haven’t had a cigarette since I was up there. But I still drink too much wine and eat too much dinner.

After your physical, your book turns to the larger issues surrounding American health care. You’re clearly incensed by Bush’s decision on stem-cell research, and say that you’re getting ready to do “something rash” about it. What do you think ordinary citizens can do?
People make jokes that writing letters to congresspeople is ineffective, but right now, this issue is before Congress, and I think many, many congresspeople are teetering between a “yes” and a “no” on America moving forward on this research. It varies state by state. California is very supportive of it. Kansas is very antagonistic; their Senator Sam Brownback is in favor of putting people in prison if they pursue this research.

And yet rapid progress is now being made in this area in South Korea. Do you think the administration is unnerved by the fact that stem cell research is moving forward where we can’t profit from it or be a part of any big cures?
If you base your policy on cynical, faith-based, narrow-minded constructions of the Bible, then it’s not going to make an impression. But enlightened people see that this research is actually advancing rapidly, that no one is cloning babies, and that new cell lines may give people brain or heart or nerve cells to repair damaged organs. That is astounding, and something everyone should want to help happen.