A Political Surgeon for the Senate GOP

...Now, the announced retirement of Jesse Helms and speculation that other old lions may follow his lead make the prospect of regaining that majority next year look more complicated...

...Let's put it this way," says a veteran campaign strategist now with the Bush administration, "if he's successful, these candidates' supporters and activists—the grass-roots organizers, the political donors, the GOP establishment— they'll all become his supporters and activists...

...He didn't articulate it that way, but that's where he came down...

...He graduated from Princeton and Harvard medical school...

...And of the Senate seats in play next year, Republican and Democratic alike, most are in states Bush carried...

...The job, says Frist, uses "skill sets that are much more [like] an executive position in terms of decision-making, in terms of building something as a team...

...If Frist is able to parlay these factors into victories, the payoff for him is high...

...For two-and-a-half hours he sat there looking at numbers," recalls Ayres...

...This is nearly three times what the committee raised during the first six months of the last cycle...

...The family wasn't fabulously wealthy until his oldest brother Tommy got to thinking about applying economies of scale to the health care business in 1968, when Frist was 16...

...Once he started talking about public policy issues, where he always came down was on a limited form of government, on individual rights and responsibility, on limited taxes...

...I like to win," he says recalling the race...

...Everyone but Frist...

...That really does come down to self-worth...

...It comes down to integrity...

...Then again, Frist has only been at the game for seven years...

...After a shoo-fly reelection campaign last fall, Frist ran unopposed for the chairmanship of the NRSC...

...When you look to the future, people say, 'Oh, gosh, here's a guy who's doing okay, he'll stay here forever,'" says Frist...

...It comes down to the conservative values that George W. Bush captured in his campaign: character and integrity...

...Just embarked on his second term after arriving in the Senate as a political novice in 1995, Frist will have a direct hand in the effort to regain the majority, as head of the National Republican Senatorial Committee...

...Frist weighed in with ten "essential components" that should guide the federal government's support for stem cell research...

...After that, it was all medicine, all the time...

...For three and a half hours...

...Senate Republicans "got their clock cleaned last cycle, and [Kentucky senator Mitch] McConnell and his team were roundly criticized for not having a strategy or a focus to keeping the Senate and improving their majority," says a former national GOP official...

...The very traits that have made him a favorite of the GOP establish-ment—his deliberate intellect, his warmth and quiet reserve, his obvious marketability as an outsider—call to mind another Tennessee favorite son, Lamar Alexander, whose track record as a national candidate is not auspicious...

...Frist himself is coy about his future...

...This guy is near genius if he's not in fact genius...

...The turning point for Frist came in September, when, for the first time, an internal Ayres poll showed him ahead, 47 percent to 41 percent...

...The plan met with a resounding thud...

...Arguably, no one from the Republican Class of 1994 has risen faster...

...Bush ultimately came down to the right of Frist's approach to embryonic stem cell research, and pro-life groups grudgingly pronounced Bush's solution acceptable...

...His grandfather was a conductor who achieved near-martyrdom when he saved a woman and her child from an oncoming train—he lost a leg in the process and later died of complications...

...Of course, locking everything out may not always be politically advantageous...

...I have never ever had a substantive conversation with the president of the United States, with Josh Bolten, with Karl Rove, with Karen Hughes, or with anybody on their staff...

...George Mitchell as Senate Democratic leader and has rushed back to Tennessee to face a suddenly serious threat to his reelection...

...troops from NATO commitments, such as in Kosovo, and for the chemical weapons treaty...

...After all, "absolute right" and "absolute wrong" answers tend to go farther with voters than long-winded exegeses on core issues...

...With his victory over James Sasser that year, Frist became emblematic of the resurgent GOP—an honest-to-goodness outsider who rose from political obscurity to defeat a powerful incumbent many presumed unbeatable...

...A year later, "He came out in his scrubs and said, 'I'm thinking about running for the Senate,'" recalls Whit Ayres, his pollster in that year's race...

...Nonetheless, it's paying off...

...Colleagues and aides say they regularly receive e-mails from him in the wee hours of the morning...

...An hour later, Frist showed up...

...In his first six months, the NRSC has raked in $15.4 million, $11.7 of which is hard money, the most difficult to raise...

...Maybe he just doesn't have politics in his blood...

...Frist, though, never voted until 1988, when he was 36 years old...

...A lot of times," says Frist, "the people who sort of get through it and are successful are the hard-driving, cutthroat, pin 'em down, wipe 'em out of the way, squish 'em and move on" guys...

...Just one Senate cycle later, he was off and running...

...My intention is to stay in the Senate for 12 years," he says...

...In 1985, at age 33, he returned to Nashville to cut the ribbon as director of Vanderbilt University Medical Center's new heart and lung transplant center...

...With the Republican majority so precarious, fund-raising would be virtually a full-time job...

...The youngest of five children, Frist was born into a dignified family with deep roots in Tennessee...

...When his term is up in 2006, he says he plans to move home to Nashville, where his political idyll began...

...In the early 1970s, when he was still a Princeton undergrad, he interned for a summer in Congress...

...If the Senate GOP is hurting, is a surgeon the answer...

...He'd snipped the heart out, thrown it—carefully—into an iced red and white Igloo cooler, and choppered back to the plane, whose engines were already whining on the tarmac...

...Frist is a cat's best friend"—a reference to Frist's admission in his 1989 autobiography Transplant that during medical school, he had regularly picked up strays from the pound, befriended them for a few days, and then carved them up...

...His brother Tommy, as president of HCA, had even held a fund-raiser for Jim Sasser...

...Truth be told, not all the odds are against Frist...

...As a national candidate, "Frist would be actively opposed by pro-life conservatives in this country," speculates Terry Jeffrey, a long-time conservative activist now with Human Events...

...He voted for funding the National Endowment for the Arts...

...He doesn't come across as a pol's pol...

...The Frists' HCA had merged with Columbia that same year, and many of the candidate's positions were portrayed as a windfall for the family dynasty...

...But raising money is only half the job...

...In a broader sense, it's not clear how Frist would fare as a national candidate...

...then came the defection of Jim Jeffords, when they did lose it...

...He needs to win some seats in 2002," says a senior GOP Senate aide...

...In a city where limelighting is considered a good day's work and aides are tasked with doing the heavy lifting, Frist's hands-on approach is legendary...

...Sasser's spokesman dismissed the numbers, calling Ayres a charlatan and a conjurer...

...There are no tales of Frist slapping an aide, hurling pens and plants, or dallying...

...Primarily this consisted of juxtaposing Sasser's liberal votes in Congress with what he had been telling the folks back home...

...What's more, should Frist's ambitions aim higher, there are Senate races next year in Iowa and New Hampshire, states with the first presidential caucuses and primary respectively, and South Carolina, the Gateway to the South, with its primary the Saturday before Super Tuesday...

...There are no . . . absolute right, absolute wrong answers.'" Frist may have the mechanics of politics down pat: He may help deliver the Senate back into Republican hands next year, and perhaps even become majority leader in the process...

...This is the only position in the United States Senate that [requires] what I did good in medicine...

...The debate is similar to the one that raged 30 years ago over heart transplantation, where the donor isn't dead: The heart's still beating and the lungs are still pumping, but the brain has stopped functioning...

...His political convictions were so obscure that many thought he was a Democrat, if anything at all...

...Frist is often called a conservative, but his record in Congress suggests he's more patrician than anything else...

...It really does come back to making peoples' lives more fulfilling," he says of his credo...

...Perhaps...

...Bright, hard working, and quietly genial, he rose to the occasion...

...During the previous 12 hours—since he'd first received a call that a donor heart was available for a patient—Frist had been caught up in a whirlwind...

...Both deny it up and down...

...On September 22, a cartoon appeared in the Chattanooga Times of Garfield the cat, looking typically blasé, holding up a sign that read "Not For Frist...

...He had gone from surgeon to senator virtually overnight...

...Then he'd come home to meet with his handlers...

...First there was the disappointing showing in last fall's elections, when they almost lost their majority...

...His father was a doctor, as are his two brothers...

...Frist won 56 percent to 42 percent, and took his place in the Senate...

...It translates to Medical Savings Accounts, individual responsibility, education, self-sufficiency...

...Even more unusual for a senator, he has a computer that appears used, and his office desk is a mess...

...To be the very best heart surgeon that I could possibly be, and transplant lung surgeon, and to run a large research lab, and to be productive—it took constant focus...

...It raises his profile, puts him in contact with big-stakes donors nationwide, and racks up chits with political players of all stripes—the president, Senate colleagues, and of course those up for reelection...

...The new Senate leadership touted him at every turn...

...That's pretty convoluted, if standard Frist boilerplate...

...For Ayres, it's the morning during the '94 campaign when he went to Frist's home in Nashville to deliver the first poll results...

...on that same day, Robert Novak reported that Sasser had "put on hold his campaign to succeed retiring Sen...

...As far as official Washington was concerned, Frist might as well have been in Hyde Park, shouting to the pigeons...

...But of course he wasn't...

...Of the 34 seats up for reelection next year, 20 are Republican— and mid-term elections have tended to go against the sitting president's party...

...Sam Dealey is a writer in Washington, D.C...

...He seems uncomfortable with ideological discussion of specific issues...

...It's also hard to tell where his ultimate interests lie...

...I don't think he comes out of the right-wing, fundamentalist, Christian Right, moral majority...

...This June, Frist was aboard Air Force 2, ripping through the skies from Washington to an American Enterprise Institute conference in Colorado...

...He'd made calls mobilizing the patient and his medical team...

...Maybe, maybe not...

...Norm Shumway, the godfather of heart transplantation...

...In the end, the race wasn't even close...

...And that's just where it was," Frist now says...

...And never once did he give any indication of being distracted or tired or anything of the sort...

...My first question was 'Why?' He was a god in his own world, and I couldn't figure out why he'd want to leave that exalted position to enter the world of politics...

...That's when the family empire, a mega-mall of health care operations known as the Hospital Corporation of America, was born...

...Mild-mannered Bill Frist regularly railed against his opponent as a "bleeding heart liberal" and a "tax-and-spender...

...A quick trip back to Vanderbilt Hospital and Frist was sawing through the sedated patient's chest, discarding the failing heart, and quickly—but carefully—stitching in the new one...

...Those are the more conservative values...

...Frist was given plum committee assignments in the areas of banking, the budget, and labor, health, and education...

...When Sasser could be bothered with the race at all, he picked up on the themes hurled at Frist during the primary—that he was a country-club Republican and a smooth-talking patsy for the evil HMOs...

...But politically, Frist again found himself on the wrong side of social conservatives, as he had with Clinton's surgeon generals...

...Five years from now I have no earthly idea what I'll be doing...

...The multi-candidate Republican primary had been bloody, and public polling showed Sasser holding a commanding lead The race was relegated to "second-tier" status...

...The two didn't add up...

...Leveraging his medical background, he has been in the thick of the big political debates of the summer, from stem cells and cloning to the patients' bill of rights...

...For liberals it pandered too much to the pro-life caucus...

...Frist's most tangible area of success has been at the helm of the NRSC...

...I've got two years to take on a challenge which other people say is almost undoable...

...Nor is Frist cut from the same cloth as his predecessors—campaign chairmen such as Phil Gramm, Al D'Am-ato, and Mitch McConnell...

...He would be defeated on that issue alone...

...Frist's political genesis is unclear...

...Says Tom Perdue, his 1994 campaign manager: "I think Bill has the potential to be anything he wants to be...

...If he doesn't, that's a bit of a smudge...

...It's hard to tell where he is on the learning curve...

...David Satcher and Henry Foster, both adamantly pro-choice and the latter of whom acknowledged once performing abortions...

...Evidently Garfield was in the minority...

...Following the death of Georgia's Paul Coverdell last summer, he was tapped by the Bush campaign as its Senate liaison...

...Republicans are hoping they're not too broad...

...My interests are broad...

...It was "my family and my work, and that's it...

...He and his team had raced to a Lear jet, which in turn had raced them to a helicopter that would ferry them to the hospital where the brain-dead donor lay...

...On an airplane, in an airport, in a crowded place—this guy can lock everything out...

...So I didn't pay any attention" to politics...

...I like to win...

...But as for higher office, it's fair to wonder if he could survive the primary process...

...After last fall, chairing the Senate GOP's campaign committee wasn't exactly a job people were gunning for—and with good reason...

...In fact, those are terms I don't even think he knew existed" before 1994...

...In explaining his support for Foster, who was rejected by the Senate and by most of Frist's Republican colleagues, Frist told a reporter his background gave him special insight into the moral and ethical ambiguities of medicine...

...Could they wait around for a bit...

...He didn't have instant opinions because he wasn't living and breathing politics," recalls Perdue, his '94 handler...

...At the Republican National Convention, he was tasked with the unpopular job of co-refereeing the platform committee (it went off without a hitch), and he delivered the much-coveted four-minute speech just prior to George W.'s appearance...

...My case is a little different...

...Add to that the fact that the issues Frist clearly enjoys most— the minutiae of health care, for example—don't lend themselves to soundbites or direct mail...

...No," says Frist...

...He runs his office like his operating room—"calm, efficient, congenial"—and never screams...

...Sasser was an 18-year incumbent who was more concerned with his race for Senate majority leader than his reelection back home...

...And here's Jeff Clark, Frist's Democratic opponent last fall: "I don't think he's a bad guy or anything like that...

...Almost in inverse proportion to the fortunes of his party, the stock of Tennessee's Bill Frist, a transplant surgeon by trade, has been soaring...

...He also wanted to further embryonic stem cell research by using for research excess embryos from in vitro fertilization procedures that would otherwise be discarded...

...He has the ability to focus like nobody I've seen on one single thing, on one word even...

...Karyn Frist told the group of aides that her husband had been called out for a heart transplant the night before but was expected back shortly...

...He spent his residencies at Massachusetts General in Boston, Southampton General in England, and Stanford University Medical Center, where he studied under Dr...

...After eight years of Clinton, Bush has created an enormous amount of enthusiasm among donors...

...Many suspected Frist's proposal was a trial balloon sent up at the behest of the White House, which was publicly agonizing over the issue and taking a good deal of heat...

...In fact, Frist's position could only have been his own...

...The Beltway penchant for speculation notwithstanding, one thing is clear: A lot of Republicans have a lot of hope invested in Frist...

...Frist attacked his first career with trademark single-mindedness...

...That's why I'm in the United States Senate and, hopefully, people will see that and say, 'Gosh, they are tough issues...

...In 1992, Tennessee's Democratic governor, Ned Ray McWherter, tapped Frist to chair a state task force on Medicaid...

...But Frist ran an aggressive campaign...

...The defection of Jeffords seems to have had a galvanizing effect on Republicans...

...Frist brought on Haley Barbour to chair fund-raising, and stacked the committee with able staffers...

...For a lesson in the practical effects of all of these, look no further than the recent stem cell debate...

...for conservatives, it came too close to treating human embryos as Frist once treated stray cats...

...His great-great grandfather was a Tennessee pioneer...

...He is a favorite with the White House and is increasingly mentioned in the press as a possible successor to GOP Senate leader Trent Lott in 2002, as a replacement for Dick Cheney on the Republican ticket in 2004, and even as a potential GOP presidential candidate in 2008...

...In his autobiography, Frist makes it clear that he believes there is a moral imperative to use one unsalvageable life to save another...

...If you believe their poll numbers," he said, "you believe that Dr...

...As you would expect of the owners of a large public health corporation, Frist's family had often contributed to political campaigns, Democrats and Republicans alike...

...He voted in favor of Clinton's controversial surgeon general nominees, Drs...

...These included banning human cloning, increasing adult stem cell research funding, and other fairly non-contentious parameters...

...In January 2000, Frist gave the GOP response to Bill Clinton's State of the Union address...

...He's an internationalist, by congressional GOP standards—against setting deadlines on withdrawing U.S...

...Frist is a conservative when it comes to issues like taxes and gun control and school vouchers, but he also supports a federal government whose role extends beyond the delivery of the mail...

...He was studying the instruction manual for his new BlackBerry, a two-way wireless e-mail gadget...

...Everyone who's ever dealt with Frist at close quarters has a story about his focus...

...What's more, the '02 cycle looked particularly bleak...

...Says a senior Bush aide, "We're not that smart...

...My style is just different...

...He churned out papers, pricked the public's conscience regarding organ donation, and turned Vanderbilt's program into a first-rate operation...

...The plane was packed with heavy hitters—the vice president, commerce secretary Don Evans, Fed chairman Alan Greenspan and his wife Andrea Mitchell, and a host of A-list senators—and everyone was chatting each other up, milking the opportunity for face time...

...The NRSC wasn't optimistic...

...But 1994 was a bad year for incumbents and a bad year for Democrats...