Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, April 3, 1990 TAG: 9004030466
SECTION: NATIONAL/INTERNATIONAL PAGE: A1 EDITION: METRO
SOURCE: MICHAEL ORESKES THE NEW YORK TIMES
DATELINE: WASHINGTON LENGTH: Long
Atwater, the Republican national chairman, entered the Montefiore Medical Center in the Bronx on Monday for a specialized radiation procedure to reduce the potential growth of the tumor, his office said.
For the past few weeks Atwater has been undergoing daily radiation treatments as an outpatient, but Monday it was decided to launch a new medical offensive.
Being on the offensive is what most of Atwater's life has been about.
He brought a relentless, win-at-all-cost aggressiveness to national politics that thrilled his Republican followers and infuriated his Democratic opponents.
But for the first time in his adult life, Atwater's central preoccupation is no longer politics.
His enemy is not some Democrat he can slash away at, but a small cluster of errant cells, about a quarter of an inch in diameter, in the right forward part of his brain.
There is something about Atwater's situation that is almost like a novel.
At the age of 39 he had become the dark prince of politics, admired and perhaps feared by Republican colleagues; disliked and feared by many Democrats.
He is one of the youngest Republican national chairmen in the party's history and a confidant of the president of the United States, a president he helped elect.
Then, by his own description, Atwater came suddenly "this close to your Maker" when the tumor announced its presence 26 days ago by causing a seizure as he was delivering a fund-raising speech.
Atwater's schedule used to include barnstorming tours to Republican events around the country.
He used to rise at dawn, run six miles a day and often wind up after midnight playing rhythm and blues at a ribs eatery in Virginia in which he is an investor.
"I fooled myself into thinking I was indestructible," he told his hometown newspaper, The State, in Columbia, S.C.
His aides have shielded him from any further interviews with the press.
A man whose thoughts used to sweep forward toward the turn of the century, when he envisioned a new Republican majority led by voters of his own baby boom generation, now finds his focus circumscribed to the day when he will complete his therapy.
Just when that day might come appears uncertain. Leslie Goodman, Atwater's press secretary at Republican National Headquarters, said the tumor is in the right frontal lobe and is a "benign" astrocytoma, a tumor that afflicts star-shaped, supporting brain cells.
Neurologists and neurosurgeons not involved in Atwater's care said the distinction between benign and malignant brain tumors could be a matter of semantics. However, the experts said that the type of treatment that Atwater is now undergoing is unusual for a benign astrocytoma.
The treatment to be undertaken at Montefiore Medical Center involves implanting a tube containing radioactive isotopes at the tip of the tumor, leaving it in place to provide a high dose of radiation aimed at the tumor, and removing it after five days.
The procedure is carried out under local anesthesia and under guidance by CAT scan X-rays.
Doctors classify astrocytomas according to two different scales. In one of those classifications, a classic system, the growths are graded one through four, according to the rate of growth and degree of malignancy. Grade one is least harmful and grade four is most malignant.
But that classifying system is yielding to another that rates astrocytomas in three groups. One is astrocytoma, which correlates to grades one and two in the old, classic scale. The two other categories in the newer system are called anaplastic astrocytoma and glioblastoma.
While some doctors call the lowest-graded astrocytomas benign, others call them malignant, the experts said.
Atwater's office did not disclose the grade of the Republican leader's astrocytoma. Goodman said, "The purpose of the therapy is to end the possibility of the tumor growing and taking on a more aggressive nature."
Such therapy is now available in leading medical centers in the country, the experts said. But Dr. William R. Shapiro of the Barrow Clinic in Phoenix, an expert on brain tumors, said, "With few exceptions, low grade astrocytomas are not treated with interstitial radiation."
"Doctors are . . . optimistic," said Charles Black, Atwater's friend and business partner.
"If the treatment is successful," Black said, "after a couple of months he'll be able to get back in the normal swing of things."
Black and Mary Matalin, Atwater's chief of staff, said that if Atwater had to get sick it was just as well it happened now.
The plans for this year's political campaigns and for the political travels of President Bush and Vice President Dan Quayle are already drawn, Matalin said.
Matalin has taken on much of the day-to-day load at Republican headquarters, keeping up with state chairmen, consultants and candidates.
She and the rest of the staff have been presenting Atwater with crucial decisions, visiting him at his house early in the morning or at the end of the day, or holding meetings in the late morning when he visited the office, Matalin said.
The president and his wife, Barbara, have visited Atwater and talk with him on the telephone, aides said.
They report that Bush, who lost a daughter to leukemia, has been shaken by Atwater's illness.
At times the president is a bit at a loss on how to handle it, the aides said, and refuses to dwell on the subject in conversations.
In a meeting last Friday with a group of Republicans who are reviewing sites for the 1992 presidential nominating convention, Atwater said his illness had given him a different perspective on life.
Summarizing what he said, Matalin said:
"The normal pettiness that accompanies politics isn't, under normal circumstances, worthy of very much. In this case it's pretty clearly blown off the radar."
Some of Atwater's friends say this reassessment is only natural for a man with a serious illness and whose wife, Sally, is about to give birth to their third daughter.
Even before his illness he had been talking more about the political importance of family and friends to baby-boom voters.
Indeed, some friends say Atwater's introspective remarks did not show a new Atwater, but rather the old Atwater adjusting to a new political landscape.
After Atwater said he could not imagine he would ever feel like being mean again, Black wryly suggested that Atwater should not be taken literally.
"I've decided to reserve judgment about whether he was serious about that," Black said.
by CNB