6.10.2008

Candidate Health Report: John McCain

Will Carroll is my colleague at Baseball Prospectus and analyzes baseball player's medical histories for a living. So naturally, when he heard about FiveThirtyEight.com, he wanted to do the same thing for John McCain. Here, then, is Will's take on McCain, which presents an essentially optimistic picture.

Let's get right past the age issue. Simple chronological age isn't a good gauge for what we're trying to look at here. McCain has kept up a normal, active Senate calendar and held his own on the campaign trail, a grueling march that never seemed to get to McCain.

Unlike Bob Dole, a comparable that many have brought up due to war injuries and an advancing age at the time of their campaign, McCain never seems to wear down. Given his workload recently, made up of mostly fundraisers and media opportunities, he's had a chance to rest that his opponent has not. Sure, Obama's relative youth and athleticism should give him some recovery advantage, but the fall campaign is not going to be the same kind of long-term grind that could wear on McCain. Focused on a few big performances and keyed to his electoral needs, McCain will be able to pick his spots.

McCain's two most significant injuries are to his shoulders and his history of melanoma. The shoulders are a visible sign of his captivity in Viet Nam, leaving the Senator unable to raise either arm significantly above his head. While it prevents a vigorous Nixonian wave of victory, it isn't noticeable and without prompting, most voters don't notice a deficit. The signs of melanoma, a puffy cheek and a long, five-inch scar on his left cheek, are far more noticeable. His appearance on "Saturday Night Live" highlighted his need for careful control of the media environment. McCain needs to be seated head-on to his audience, lit from his right and does not like to turn his head to stage right, exposing his scar. While the signs of melanoma have not recurred, the data does raise some concerns.

There was, buried in his extensive medical records, one glaring warning sign. In an article in the New York Times, Elisabeth Bumiller found that McCain's physicians had noted not one, but two melanomas and suggested some spread. Doctors aggressively removed lymph nodes - hence the large scar - and halted the spread. McCain himself knows well that melanoma can recur. He's had two other instances of melanomas being removed, once from his shoulder in the early 1990s and another on his nose in 2002, two years after the more noted melanoma removal. McCain's health and vigor eight years after the most significant melanoma is a good sign. Patients with this type of cancer have a 65% survival rate, but this is more a curve than a line, trending back up after a period of time.

Finally, McCain claims a genetic advantage and does appear to have it. His mother is 96 years old but notably vigorous and mentally sharp. The rest of his family history is less notable. His father, a Navy Admiral, lived to age 70 while his grandfather died at 61, worn down by the stress of combat during World War II.

Overall, McCain is in good shape for a 71-year-old who has been through harrowing torture and multiple bouts with cancer. McCain's most obvious comparables, Bob Dole and Dick Cheney, offer interesting lessons. Both would have had far more negative Health Reports during their campaigns, but both are alive and well at the end of their terms (in Dole's case, the hypothetical). History is not destiny, but neither is destiny predictable. Age will surely be an issue, though health it appears, should not be.

21 comments

Anna said...

Yes, but what I think we all need to see is a thorough psychiatric report!

Naomi said...

I think McCain's age would be less of an issue if he was more naturally energetic. He's not by nature a spry, lively person, and his speaking style is ponderous. Many septugenarians these days look and act about 55. McCain looks and sounds a lot older than that.

Anonymous said...

The problem, Will, is that the Presidency comes with a guaranteed four year contract. McCain may be ready to go in 2009, but by 211, he'll be shot. I'm surprised you didn't bring up the most obvious comparable, Ronald Reagan. Reagan was younger and in much better health when he got elected, and look what being President did to him. By the time he left office, his brain was fried forever, and we had his wife making foreign policy decisions based on astrology.

The key issue is not whether McCain can live past Election Day, but whether he is up to four years of the most grueling job on earth.

To use your system, he gets a big, honking RED light from me. :)

Love your work, Will.

Oliver said...

"Overall, McCain is in good shape for a 71-year-old who has been through harrowing torture and multiple bouts with cancer" - well, yes. Exactly. The problem is, simply being ambulatory qualifies as good shape for a 71-year-old who has been through harrowing torture and multiple bouts with cancer! It certainly doesn't convince me he'll be fit in 2012, even without the incredible stresses of a presidential campaign and of actually being president.

I expect Goldstein up in this piece giving us profiles of up-and-coming mayors and state representatives next, Nate!

Anonymous said...

I'd like to know the reasoning behind the assertion that chronological age is not important here. I'm less concerned about his energy level on the campaign trail than I am about the drastically rising incidence rates for serious diseases at his age. Rates of Alzheimer's disease, heart disease, and especially cancer follow an exponential curve.

Anonymous said...

For me, the big issue regarding McCain's age isn't health (the president will get the best medical care in the country, after all), it's worldview. McCain was born in 1936. That is a long time ago. When McCain came of age, Joe McCarthy was still a respected figure. Computers used vacuum tubes and took up an entire room. The transistor radio and color television had just barely been invented. The national civil rights movement had not yet begun.

I think that kind of thing could have a serious effect on how a president confronts the problems facing the nation today.

Anonymous said...

I want Sheehan to rank the VP hopefuls!

liforcerenewal said...

I am very concerned with the drug usage...Studies have shown that cholesterol meds don't discriminate~they eat ALL the cholesterol in the body~including the brain!
Isn't it of any concern that the man has been chemically-lebotomized(sp?)???

Anonymous said...

We also need Goldstein here to assess Obama's comparative youth and "athleticism". While certainly a tantalizing prospect, Obama's bowling fiasco certainly signifies a hole in his game. Still a 5-tool prospect? Still lots of upside, sure, but his versatility must be called into question until I hear different from BP's KG.

Anonymous said...

Yes, but how do McCain's shoulder injuries affect his ability to throw out the first pitch of the Nationals opener?

RedsManRick said...

If Goldstein is going to come over, I expect an analysis on music choices of the campaigns, both review of what they've used and suggestions.

Regarding the health of any potential president, I think it's completely fair to examine the odds that they will be physically incapacitated during their time in office. As nervous as a "a 71-year-old who has been through harrowing torture and multiple bouts with cancer" makes me, a 74 or 75 year old with the same profile and his finger on the launch button makes me even more nervous.

As was said in an earlier comment, the presidency is a 4 year contract. Sure, that 38 year old might have some juice left in his arm, but do you really want to be locked in to his salary when he's 42? And unfortunately, you can't bench the president, and cutting him is pretty hard to do as well.

Mikey said...

Can McCain conduct a town hall on three days rest or does he really need full rest?

hosertohoosier said...

Somebody gives an essentially favourable health evaluation of McCain, and you guys all leap on it as evidence that McCain will probably die in office. Are you just reading what you want to read?

Also, why is it taboo to consider the possibility of assassination (especially within earshot of Olberpuke... my god how I hate that man), but not death by natural causes? After all, each has claimed an equal number of presidents (I actually think it is a legitimate topic - 18% of presidents have died in office).

Moreover, Obama is a former cocaine user who has also been a heavy smoker for about 30 years. His risk of developing lung cancer is surely far from negligible - and the risk only decreases by 20% within 5 years of quitting.

His mother died of cancer at age 52, his father died at 46. I think a stones in glass houses remark is in order.

Anonymous said...

A regional metastasis of melanoma is bad news - the rate of survival drops significantly. Patients tend to have late recurrences that show up in the lungs, bones, or brain. He would have a significant chance of having a metastasis develop during his presidency. Just thinking out loud.

Anonymous said...

Isn't it actually a bit concerning that on his paternal side, everybody was dead before their 71st birthday?

Anonymous said...

I am going to have to disagree about the Fall Campaign - with Obama expanding the electoral map McCain will be running all over the country and now that the Dem race is over the spotlight with the questions, interviews etc... it is going to wear him down--
the guy is already miscueing every day at some point people will start to connect his miscues to his age

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