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Margaret “Maggie” Williams’ Correspondence Files
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Withdrawal/Redaction Sheet
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001a. letter
To Sherry Lansing from Maggie Williams re: movie (1 page)
10/26/94
b(6)
001b. memo
To the First Lady from Ann Stock re: guest (1 page)
09/28/94
b(6)
001c. note
Handwritten note (1 page)
n.d.
b(6)
001d. memo
To Capricia Marshall from Jack Valenti re: draft (2 pages)
n.d.
b(6)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Maggie Williams (Correspondence)
OA/Box Number: 17604
FOLDER TITLE:
[Correspondence from 1994]: L
2013-0359-S
ry1325
RESTRICTION CODES
Presidential Records Act - |44 U.S.C. 2204(a)]
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRAJ
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office [(a)(2) of the PRAJ
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute |(a)(3) of the PRA]
an agency |(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute |(b)(3) of the FOIA]
financial information [(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information [(b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRAJ
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells [(b)(9) of the FOIA|
RR. Document will be reviewed upon request.
THE WHITE HOUSE
WASHINGTON
August 10, 1994
Ms. Peg Langhammer
Executive Director
Rhode Island Rape Crisis Center
Suite 205
300 Richmond Street
Providence, Rhode Island 02903-4222
Dear Ms. Langhammer:
Thank you for your kind letter asking the First Lady
to serve as the honorary chair for the Rhode Island Rape
Crisis Center's 1994 gala. Mrs. Clinton very much
appreciates your invitation.
Although the First Lady is grateful for the important
work that organizations like yours are doing, I regret that
her official commitments prevent her from serving as your
honorary chair at this time.
I know that Mrs. Clinton would want me to convey her
appreciation for your thoughtfulness, along with her best
wishes. Please do not hesitate to contact our office if we
can be of assistance to you.
Sincerely yours,
Margaret Margars Bille A. Williams
Chief of Staff
for the First Lady
rape crisis center, n., a place where
all Rhode Islanders can receive
confidential support, advocacy and
information about sexual assault.
July 21, 1994
alice Stacy
to Evelyn
Mrs. Hillary Rodham Clinton
First Lady
no per
The White House
when
Office of Scheduling and Advance
slalay
1600 Pennsylvania Avenue, N.W.
OEOB Room 185 1/2
Washington, DC 20500
Dear Madame First Lady:
On behalf of the Board of Directors of the Rhode Island Rape Crisis Center, I am
writing to invite you to join us at our annual gala fundraiser as Honorary Chairperson
this fall. We have tentatively reserved several dates for the event, as we know how
busy your schedule is. Those dates are Friday, October 21; Saturday, October 22;
and Saturday, October 29, 1994.
In past years, 250-300 individuals have attended the gala. All of the State general
officers, including the State Attorney General, will be invited and are expected to
attend. Your presence and participation would clearly be the highlight of the evening.
The Rhode Island Rape Crisis Center, Inc., is the sole agency in the state organized
specifically to deal with issues of sexual assault as a community concern. Its purpose
is to provide advocacy and counseling to victims of sexual assault and their families
through both crisis intervention and follow-up services, and to educate the community
in awareness so that the incidence of rape will decrease. The Center was established
in 1973 by a group of women concerned about the increasing problem of sexual
assault and the lack of services and information available to victims and the public.
In just twenty-one years, the RI Rape Crisis Center has grown from an agency with
three part-time staff, to one with over twenty staff members. Its budget has grown
from $42,000 to just under $1 million. The Center's scope of services has expanded
to include:
24-Hour, Statewide Hotline: The RI Rape Crisis Center offers a 24-hour, statewide
hotline. Collect calls are accepted. Local counselor/advocates are available to
provide confidential support, information, and advocacy on the phone, at the
police station, at the hospital, or in court to both adult and child victims of sexual
assault.
300 Richmond Street, Suite 205, Providence, Rhode Island 02903-4222
401 421-4100 Fax 401 454-5565
RI Rape Crisis Center
Page 2
Legal Advocacy: The Center provides a court advocacy program for adult and
child sexual assault survivors. Trained volunteers and staff are available to
accompany victims to court and related interviews, provide information about the
criminal justice process and ongoing emotional support, make referrals, and act
as liaisons with police and the Department of the Attorney General.
Individual and Group Counseling: The RI Rape Crisis Center provides counseling
services to survivors of sexual assault, child sexual abuse, and incest, and to their
significant others. Individual, group, and family counseling are available on a
sliding-scale fee basis. Services are available for both adults and children. In
addition, a referral network has been established for appropriate recommendations
to be made for clients.
Building Bridges: A Partnership Against Violence: In the fall of 1992, the RI Rape
Crisis Center, in collaboration with Women's Resource Center of South County,
and Sojourner House of Woonsocket, two of the state's shelters for battered
women, launched "Building Bridges: A Partnership Against Violence." This
unique program was designed to provide individual and group counseling to
victims of domestic violence who are also victims of childhood sexual abuse.
Funding for the program was provided by the United Way of Southeastern New
England, through its Critical Issues Fund, and by The Rhode Island Foundation.
Child Assault Prevention Program (CAPP): The RI Rape Crisis Center offers the
CAPP program to teach children how to recognize and protect themselves against
potentially dangerous or abusive situations. Age-appropriate CAPP workshops are
available for pre-school, elementary, junior high, and high school student. The
program also provides accompanying workshops for parents and school personnel.
Juvenile Offender and Victimization Prevention Program: A new component of the
Child Assault Prevention Program was offered this spring for students in grades
4 through 8, their teachers, and parents. Topics covered include the incidence of
sexual and physical abuse, assault prevention techniques, peer support against
violence, and the identification of, and intervention with juvenile offenders.
Public Education: The Center has trained speakers available to speak to any
community group on issues of sexual assault, child sexual abuse, and incest.
Topics for presentations and in-service trainings include myths and facts, date and
acquaintance rape, medical and legal issues, prevention, assertiveness training,
sexual harassment, and the politics of rape. The Speakers' Bureau adapts its
presentations to suit the needs of specific audiences.
The RI Children's Advocacy Center: Operating out of the RI Rape Crisis Center's
Providence location, the Children's Advocacy Center serves as a facility where
Extended Page
3.1
RI Rape Crisis Center
Page 3
children who are the victims of sexual and/or violent physical abuse, and their non-
offending family members, can go for the purpose of evaluation, evidence
gathering, and counseling.
The purpose of the program is to provide the child victim and non-offending
parent/guardian with interviewing, evaluation, and treatment services at a neutral
location in a comfortable environment; to prevent further trauma to the child
caused by multiple interviews and contacts with responding professionals; to
enhance interagency and case coordination, communication, and cooperation; to
hold more offenders accountable through improved prosecution of child abuse
cases; and to enhance and refine professional skills needed in responding to sexual
and physical abuse cases through training.
The formation of the Children's Advocacy Center is the result of several years of
work by the Attorney General's Task Force on Sexual and Violent Physical Abuse
of Children. Based on a national model, it has been a multidisciplinary team effort
involving prosecutors, police, medical personnel, mental health professionals, and
human service providers. Plans are in the works to expand the program throughout
the state during the next year.
In 1993, the RI Rape Crisis Center received 1,425 reports of sexual assault. Sixty-
nine percent of these assaults involved children under the age of 18; fifty-three
percent were under the age of 14.
As in the past, all funds generated by the gala help support the Center's many
programs. In addition, and perhaps even more important, the event increases public
awareness of the issue of sexual assault, and of the resources and services available
at the RI Rape Crisis Center.
Again, we would be honored if you could join us this year. If there are dates other
than those mentioned above which better fit your schedule, please let me know.
I look forward to hearing from you.
Sincerely,
Peg Langhammer
Executive Director
rape crisis center, n., a place where
all Rhode Islanders can receive
confidential support, advocacy and
information about sexual assault.
FACSIMILE COVER PAGE
TO:
NAME:
Wendy Towber
FIRM:
White House
CITY:
Washington, DC
FACSIMILE PHONE NO: 202-456-5199
FROM:
Peg Langhammer, Executive Director
RHODE ISLAND RAPE CRISIS CENTER
Date: July 21, 1994 Time: 1:55pm
Total Number of Pages 4 Including this Cover Page
If you do not receive all papers as transmitted, please advise by telephone
number (401) 421-4100 or by fax to our machine at the number below.
300 Richmond Street, Suite 205, Providence, Rhode Island 02903
401 421-4100 Fax 401 454-5565
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001a. letter
To Sherry Lansing from Maggie Williams re: movie (1 page)
10/26/94
b(6)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Maggie Williams (Correspondence)
OA/Box Number: 17604
FOLDER TITLE:
[Correspondence from 1994]: L
2013-0359-S
ry1325
RESTRICTION CODES
Presidential Records Act - |44 U.S.C. 2204(a)|
Freedom of Information Act - 15 U.S.C. 552(b)]
P1 National Security Classified Information [(a)(1) of the PRA]
b(1) National security classified information [(b)(1) of the FOIA|
P2 Relating to the appointment to Federal office |(a)(2) of the PRA
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute [(a)(3) of the PRAJ
an agency [(b)(2) of the FOIA]
P4. Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute |(b)(3) of the FOIA]
financial information |(a)(4) of the PRA|
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA]
and his advisors, or between such advisors |a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy |(b)(6) of the FOIA]
personal privacy [(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions |(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells |(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001b. memo
To the First Lady from Ann Stock re: guest (1 page)
09/28/94
b(6)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Maggie Williams (Correspondence)
OA/Box Number: 17604
FOLDER TITLE:
[Correspondence from 1994]: L
2013-0359-S
ry1325
RESTRICTION CODES
Presidential Records Act |44 U.S.C. 2204(a)]
Freedom of Information Act - [5 U.S.C. 552(b)]
PI National Security Classified Information |(a)(1) of the PRA]
b(1) National security classified information |(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office |(a)(2) of the PRA|
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute |(a)(3) of the PRA|
an agency |(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information |(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information [(b)(4) of the FOIA]
and his advisors, or between such advisors |a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy |(b)(6) of the FOIA]
personal privacy |(a)(6) of the PRA|
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions |(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells |(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001c. note
Handwritten note (1 page)
n.d.
b(6)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Maggie Williams (Correspondence)
OA/Box Number: 17604
FOLDER TITLE:
[Correspondence from 1994]: L
2013-0359-S
ry1325
RESTRICTION CODES
Presidential Records Act - [44 U.S.C. 2204(a)]
Freedom of Information Act - [5 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA|
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office |(a)(2) of the PRA]
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute [(a)(3) of the PRA]
an agency |(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information |(a)(4) of the PRA]
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA]
and his advisors, or between such advisors [a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy |(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA]
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions |(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
h(9) Release would disclose geological or geophysical information
2201(3).
concerning wells [(b)(9) of the FOIA]
RR. Document will be reviewed upon request.
Withdrawal/Redaction Marker
Clinton Library
DOCUMENT NO.
SUBJECT/TITLE
DATE
RESTRICTION
AND TYPE
001d. memo
To Capricia Marshall from Jack Valenti re: draft (2 pages)
n.d.
b(6)
COLLECTION:
Clinton Presidential Records
First Lady's Office
Maggie Williams (Correspondence)
OA/Box Number: 17604
FOLDER TITLE:
[Correspondence from 1994]: L
2013-0359-S
ry1325
RESTRICTION CODES
Presidential Records Act.- |44 U.S.C. 2204(a)]
Freedom of Information Act - [5 U.S.C. 552(b)]
P1 National Security Classified Information |(a)(1) of the PRA|
b(1) National security classified information [(b)(1) of the FOIA]
P2 Relating to the appointment to Federal office ((a)(2) of the PRA|
b(2) Release would disclose internal personnel rules and practices of
P3 Release would violate a Federal statute [(a)(3) of the PRAJ
an agency [(b)(2) of the FOIA]
P4 Release would disclose trade secrets or confidential commercial or
b(3) Release would violate a Federal statute [(b)(3) of the FOIA]
financial information [(a)(4) of the PRA|
b(4) Release would disclose trade secrets or confidential or financial
P5 Release would disclose confidential advice between the President
information |(b)(4) of the FOIA|
and his advisors, or between such advisors [a)(5) of the PRA]
b(6) Release would constitute a clearly unwarranted invasion of
P6 Release would constitute a clearly unwarranted invasion of
personal privacy [(b)(6) of the FOIA]
personal privacy |(a)(6) of the PRA]
b(7) Release would disclose information compiled for law enforcement
purposes |(b)(7) of the FOIA].
C. Closed in accordance with restrictions contained in donor's deed
b(8) Release would disclose information concerning the regulation of
of gift.
financial institutions [(b)(8) of the FOIA]
PRM. Personal record misfile defined in accordance with 44 U.S.C.
b(9) Release would disclose geological or geophysical information
2201(3).
concerning wells [(b)(9) of the FOIA|
RR. Document will be reviewed upon request.
THE WHITE HOUSE
WASHINGTON
February 1, 1994
Mr. Mark B. Leeds
NVA Communications Chair
P.O. Box 23434
Waco, TX 76702
Dear Mr. Leeds:
Thank you very much for your letter requesting guidance on
health care and related issues, and expressing appreciation for
the First Lady's efforts. I apologize for the delay in sending
you a response. We have received thousands of wonderful,
constructive letters from concerned citizens. I appreciate your
taking the time to make your ideas heard.
At this point, the Health Care Task Force and the health
care reform working groups have terminated. I will forward your
correspondence to the Office of Domestic Policy, room 410, Old
Executive Office Building.
Thank you for your patience and support of the Clinton
Administration.
Sincerely,
Maggie Williams
Chief of Staff to the First Lady
LEEDS.
COMM
ASSOC
ASSOC.
P.01
Health
NVA
NATIONAL VIATICAL ASSOCIATION
P.O. BOX 23434 WACO, TEXAS 76702 (817) 772-3888 FAX (817) 772-6626
January 5, 1994
Ms. Maggie Williams, Chief of Staff to
Mrs. Hillary Rodham Clinton
THE WHITE HOUSE
1600 Pennsylvania Avenue
Washington, DC 20500
via FAX: 202-456-2461
Dear Ms. Williams,
We write to request your help and guidance on health care and
related issues, and to express our appreciation for Mrs. Rodham
Clinton's concern and leadership vis-a-vis health care reform.
Controlling runaway costs, providing security to every American
family, while maintaining quality medical care and preserving
basic choices is so vital to the American people.
We have parallel concerns for AIDS victims, cancer victims and
others that are terminally ill. In 1993 the viatical settlement
industry paid about $200 million in lump sums of cash to Persons
With AIDs (PWA) and other terminally ill individuals, to be used
as they saw fit for health care, medications, food, rent, etc.
over the remaining 12-24 months of life. Life insurance companies,
through accelerated/living benefits programs, paid under $50 million
to PWA in '93, to individuals with 3-6 months of remaining life.
Through policy cancellations by insurers of terminally 111 persons
that can no longer afford coverage and miss premiums, the major
life insurers save $3 billion (yes, billion!!) a year. Those PWA
become destitute and are then cared for at taxpayer expense, SO
what was once a personal benefit paid for by the individual and an
obligation of the life insurance company, is thusly transferred to
the public to fund. In most cases, and as can be documented by
The National Association of Persons With AIDS and other groups rep-
resenting minorities, women's interests, seniors and others, the
viatical option or choice is the only alternative for terminally-ill
persons, short of less generous offers (if any) from insurers and
the awful choice of exhausting a lifetime's savings and ultimate
poverty. As may be expected the life insurance lobbies at the fed-
eral and state levels are inclined to hamper or remove the compet-
itive threat posed by viatical firms, to protect that $3 billion
windfall.
We seek to alert Mrs. Rodham Clinton to this matter and enlist the
administration's support as part of the overall health care reform.
Relatedly, when PWA lose their jobs and group health coverages, the
problem is aggravated and the viatical option needlessly precluded.
We welcome discussing these concerns and pledge our support for reform.
Will Mark B. Leeds, NVA Communications Chair
MBL: mlf
212-819-0769
THE WHITE HOUSE
WASHINGTON
January 12, 1994
Martin B. Leon, M.D.
Washington Cardiology Center, P.C.
110 Irving Street, N.W.
Suite 4B1
Washington, DC 20010
Dear Dr. Leon:
Thank you for your letter welcoming Mrs.
Clinton to participate in the Transcatheter
Cardiovascular Therapeutics, Sixth Annual Symposium
in February. Your kind invitation is greatly
appreciated. I have forwarded your correspondence
to the Scheduling Office.
Again, thank you for your invitation.
Sincerely,
Maggie Williams(DL)
Margaret A. Williams
Chief of Staff to the First Lady
WASHINGTON CARDIOLOGY CENTER, P.C.
Kenneth M. Kent, M.D.
Chester E. Clark, M.D.
Martin B. Leon, M.D.
Mun. K. Hong, M.D.
Augusto D. Pichard, M.D.
Gary S. Mintz, M.D.
Lowell F. Satler, M.D.
Jeffery J. Popma, M.D.
S. Chiu Wong, M.D.
December 20, 1993
Ms. Maggie Williams
Chief of Staff
The White House
1600 Pennsylvania Avenue, N.W.
Washington, D.C. 20500
Dear Ms. Williams:
We have recently sent the attached letter to Ms. Clinton requesting her participation at
TCT-VI, the Transcatheter Cardiovascular Therapeutics, Sixth Annual Symposium, to
be held at the DC Convention Center in Washington, February 24-26, 1994.
We are currently planning to devote a portion of this year's meeting to the healthcare
reform policy and would be very honored if she would attend. This is currently the
largest teaching symposium in interventional cardiology in the world. Over the several
years, each symposium has been attended by more than 1,500 physician registrants,
key representatives from industry, academia, and the FDA.
I hope that you will strongly consider our invitation to Ms. Clinton to join us. Should her
schedule not permit her attending, we would be honored if another Administration
representative would join us. We will leave to your office's discretion, the length of the
discussion, its format, and the specific date and time of the meeting.
Thank you for your consideration and I am hopeful that her schedule might permit her
participation or that of a key administration spokesperson.
Sincerely,
MBR
Martin B. Leon, M.D.
Director
Cardiovascular Research
Main Office 110 Irving Street, N.W., Suite 4B1 Washington, DC 20010 (202) 877-5975 Fax: (202) 877-3339
Takoma Park Office 7620 Carroll Avenue, Suite 200 Takoma Park, MD 20912 (202) 877-5975
WASHINGTON CARDIOLOGY CENTER, P.C.
Kenneth M. Kent, M.D.
Chester E. Clark, M.D.
Martin B. Leon, M.D.
Mun. K. Hong, M.D.
Augusto D. Pichard, M.D.
Gary S. Mintz, M.D.
Lowell F. Satler, M.D.
Jeffery J. Popma, M.D.
S. Chiu Wong, M.D.
December 20, 1993
Mrs. Hillary Rodham Clinton
Reform Delivery Room
The White House
1600 Pennsylvania Avenue, N.W.
Washington, D.C. 20500
Dear Mrs. Clinton:
I represent a group of academic and clinical interventionalists in Washington, DC. We
currently direct the largest teaching symposium in interventional cardiology in the
world. Over the last several years, each symposium has been attended by more than
1,500 physician registrants, key representatives from industry, academia, and the FDA.
This year, we would like to cordially invite you to speak at TCT-VI, the Transcatheter
Cardiovascular Therapeutics, Sixth Annual Symposium, to be held in Washington,
February 24-26, 1994. We are currently planning to devote a portion of this year's
meeting to the healthcare reform policy and would be very honored if you would attend.
This would provide you with a wonderful forum to meet and interact with important
physician constituents who will be in the critical position of enacting many of your
innovative policies.
I hope that you will strongly consider our invitation and will help us to provide an
avenue for active discourse amongst our colleagues in the medical community, during
TCT-VI in February. We will leave to your discretion, the length of the discussion, its
format, and the specific date and time of the meeting.
Thank you for your interest and I am hopeful that your schedule might permit the active
participation of a key administration spokesperson.
Sincerely,
Mister
Martin B. Leon, M.D.
Director
Cardiovascular Research
Main Office 110 Irving Street, N.W., Suite 4B1 Washington, DC 20010 (202) 877-5975 Fax: (202) 877-3339
Takoma Park Office 7620 Carroll Avenue, Suite 200 Takoma Park, MD 20912 (202) 877-5975
WASHINGTON CARDIOLOGY CENTER, P.C.
Kenneth M. Kent, M.D.
Chester E. Clark, M.D.
Martin B. Leon, M.D.
Mun. K. Hong, M.D.
Augusto D. Pichard, M.D.
Gary S. Mintz, M.D.
Lowell F. Satler, M.D.
Jeffery J. Popma, M.D.
S. Chiu Wong, M.D.
December 20, 1993
Ms. Maggie Williams
Chief of Staff
The White House
1600 Pennsylvania Avenue, N.W.
Washington, D.C. 20500
Dear Ms. Williams:
We have recently sent the attached letter to Ms. Clinton requesting her participation at
TCT-VI, the Transcatheter Cardiovascular Therapeutics, Sixth Annual Symposium, to
be held at the DC Convention Center in Washington, February 24-26, 1994.
We are currently planning to devote a portion of this year's meeting to the healthcare
reform policy and would be very honored if she would attend. This is currently the
largest teaching symposium in interventional cardiology in the world. Over the several
years, each symposium has been attended by more than 1,500 physician registrants,
key representatives from industry, academia, and the FDA.
I hope that you will strongly consider our invitation to Ms. Clinton to join us. Should her
schedule not permit her attending, we would be honored if another Administration
representative would join us. We will leave to your office's discretion, the length of the
discussion, its format, and the specific date and time of the meeting.
Thank you for your consideration and I am hopeful that her schedule might permit her
participation or that of a key administration spokesperson.
Sincerely,
MBRe
Martin B. Leon, M.D.
Director
Cardiovascular Research
Main Office 110 Irving Street, N.W., Suite 4B1 Washington, DC 20010 (202) 877-5975 Fax: (202) 877-3339
Takoma Park Office 7620 Carroll Avenue, Suite 200 Takoma Park, MD 20912 (202) 877-5975
WASHINGTON CARDIOLOGY CENTER, P.C.
Kenneth M. Kent, M.D.
Chester E. Clark, M.D.
Martin B. Leon, M.D.
Mun. K. Hong, M.D.
Augusto D. Pichard, M.D.
Gary S. Mintz, M.D.
Lowell F. Satler, M.D.
Jeffery J. Popma, M.D.
S. Chiu Wong, M.D.
December 20, 1993
Mrs. Hillary Rodham Clinton
Reform Delivery Room
The White House
1600 Pennsylvania Avenue, N.W.
Washington, D.C. 20500
Dear Mrs. Clinton:
I represent a group of academic and clinical interventionalists in Washington, DC. We
currently direct the largest teaching symposium in interventional cardiology in the
world. Over the last several years, each symposium has been attended by more than
1,500 physician registrants, key representatives from industry, academia, and the FDA.
This year, we would like to cordially invite you to speak at TCT-VI, the Transcatheter
Cardiovascular Therapeutics, Sixth Annual Symposium, to be held in Washington,
February 24-26, 1994. We are currently planning to devote a portion of this year's
meeting to the healthcare reform policy and would be very honored if you would attend.
This would provide you with a wonderful forum to meet and interact with important
physician constituents who will be in the critical position of enacting many of your
innovative policies.
I hope that you will strongly consider our invitation and will help us to provide an
avenue for active discourse amongst our colleagues in the medical community, during
TCT-VI in February. We will leave to your discretion, the length of the discussion, its
format, and the specific date and time of the meeting.
Thank you for your interest and I am hopeful that your schedule might permit the active
participation of a key administration spokesperson.
Sincerely,
Master
Martin B. Leon, M.D.
Director
Cardiovascular Research
Main Office 110 Irving Street, N.W., Suite 4B1 Washington, DC 20010 (202) 877-5975 Fax: (202) 877-3339
Takoma Park Office 7620 Carroll Avenue, Suite 200 Takoma Park, MD 20912 (202) 877-5975
DOCTORS HAVE USED A BALLOON, A DRILL,
AND A LASER TO CLEAR JULIUS WALKER'S ARTERIES.
HERE'S THE LATEST ON HOW DOCTORS
ARE TREATING HEART DISEASE.
Mending
Heart
ULIUS WALKER WAS IN LIB-
eria and finding it one of his
hardest postings with the State
Department. He was spending
much of his time as charge d af-
faires, running the embassy in
lieu of an ambassador. This in-
cluded maintaining the US pres-
ence during a military coup in
1980. Through that particularly
tense period, soldiers repeatedly threat-
ened Walker's life as he tried to cross
blockades to attend meetings demanded by the renegade government.
One year later, a few weeks away from leaving Liberia-he would return to
Washington briefly, on his way to becoming ambassador in Upper Volta-Walker
was finding a few moments to relax. That's when he first felt the pain.
"I was lying in bed, reading, when this pain came in my chest and ran out my
elbows," he remembers. "It wasn't strong but was terribly annoying.'
His wife called the embassy's doctor. After several electrocardiograms. the doctor
told him it was merely indigestion. But just to be sure, he suggested that Walker see a
cardiologist when stateside.
Back in DC, Walker failed a treadmill test, much to his surprise. Dr. William Battle
then sent him to Georgetown University Hospital for an arteriogram. The X-ray
revealed massive heart disease.
All three of Walker's coronary arteries were critically clogged by fatty blockages.
Starved for the oxygen and nutrients brought by blood coming from the lungs, his heart
was swollen to twice its natural size.
At age 54, with hardly any warning, Walker was primed for a fatal heart attack or
stroke.
By Laura Elliott
68
THE WASHINGTONIAN
PHOTOGRAPHS BY STEPHEN SPARTANA
in those history lessons, his efforts to
sometimes without stopping to think. Remember when he de-
Ington bureaucrat to the hills of West
clared the Clinton administration DOA before it had even taken
e playing, and his pale-blue suits, and
over?
is zeroing in on the Annoying Hall of
JOHN BANZHAF. This George Washington University law pro-
fessor was going to be the next Ralph Nader, as if one weren't
crime-wracked society we live in, but if
enough. Instead he turned into Nader-Lite.
al "and here's where the body lay'' one
news, we could be driven to criminal
JONATHAN YARDLEY. Technically a Baltimoron, the one-time
the first victim.
Pulitzer recipient qualifies by virtue of his self-righteous ramblings
in the Post. Yardley knows what he likes-and likes what he
without this veteran amendment-pro-
knows.
r-not to mention relentless courtside
unty politics would be unbearably ra-
TOM CLANCY. Even before the Cold War ended. robbing him of
his best material, Clancy's techno-thrillers had become formula
fiction-and the great man himself had become a clear and present
OLLIE NORTH. If
bore.
you thought the
distinguished US
THE BOX. No doubt about it, Jack Kent Cooke's box at RFK is the
Naval Academy
place to watch the Skins. But the obligatory TV shots of this
graduate was smug
collection of hangers-on and celebrities can make you yearn for
testifying before a
another Bud Lite commercial.
congressional
committee on the
DON & MIKE. In the Land of the Incredibly Obnoxious, all roads
Iran-contra affair,
lead to WJFK-FM's afternoon hosts, Don Geronimo and Mike
just wait until he's
O'Meara, whose humor makes the Three Stooges seem like a trio
a United States
of Noel Cowards.
senator.
METER MAIDS. Last, a group prize to those intrepid DC parking-
HERBERT "THE
ticket writers. Basic services may go undelivered in the District,
to
HAIR" HAFT. One
children may go hungry, potholes unfilled. But let your car sit a
could argue that
minute too long and these DC public servants will be over it like a
Herb Haft needs
cheap suit. Congratulations.
ego, but he'd better beware of small
mergency landings.
her a "shareholder activist" or a
she's a woman who can make an
eting seem like a forced march through
cuddly, and leopards do change their
bostle of Reaganism to an apologist for
it takes Herb Haft to spray his hair is
abiding opportunism.
ith his Poindexter glasses and quiet
leader likes to present himself as a
annoying enough, but what's worse
chell is the most fiercely partisan Senate
irnalists have to make their way in the
Am Corporation
Newsweek and Washington Week in
But if he could just be less obvious
swamis have to make their way in
equires lots of exposure. But Hess, of
seems to be everywhere at once,
Evelyn Y. Davis: She's a CEO's worst nightmare.
TOM
WOLFF
DECEMBER 1993 67
Kept alive by the latest in cardiac care, Julius Walker exercises by taking brisk walks with
his dogs, Toto and Boccie. Doctors used monitors like the ones at left to watch their work
as they cleared Walker's clogged bypass grafts.
DECEMBER 1993 69
quires a continuum of care: medication,
surgery. or catheter-based procedures to
open individual blockages. CVD remains
the number-one killer of American men
and women, despite an overall decline and
increased awareness of the preventive ben-
efits of exercise, low-fat diets, and lower-
ing cholesterol counts and blood pressure.
Medicine continues to improve the treat-
While doctors work on the conscious patient inside the lab, a nurse outside keeps track of
The doctor inflates the balloon catheter,
vital signs and records each step of the procedure.
threaded from the groin to the heart.
(Top) An artery is pinched closed by a one-
third-inch blockage that could cause a
heart attack. After treatment, blood flows
After extraction atherectomy, in which fatty deposits in blood vessels are broken up with a tiny
evenly through the opened vessel.
drill and sucked out, doctors often use a balloon catheter to flatten remaining plaque.
A
FEW DAYS LATER, DOCTORS PER-
Burkina Faso), he watched his blood pres-
formed open-heart surgery. Three
sure. Escorted by embassy marines, he
vein grafts were "harvested" from Walk-
took brisk 5 AM walks. He remained a
er's leg. They were attached to the aorta at
robust, enthusiastic man who didn't worry
his heart, then curved down like tiny hoses
much about his health. Like most bypass
to the heart's lower half, providing new
patients, he hoped he was fixed for life.
channels that bypassed the plugs in his
Then, one day in 1989, Walker couldn't
arteries.
catch his breath while walking his minia-
Because doctors created these detours
ture Scottie dogs. He headed back to the
before a heart attack, Walker did not sus-
cardiologist. The vein grafts implanted
tain the muscle damage that would have
during the 1981 bypass were beginning to
Tiny metallic devices called stents are
weakened his heart's ability to contract.
shut down.
implanted in collapsing vessels and work
Refueled, his heart quickly came down to a
like scaffolding to prop them open.
healthy size and vigorously pumped blood
N:
REPAIR TO THE HEART LASTS FOREV-
to the rest of his body.
er. Most bypass vein grafts like Walk-
ment of heart disease. And much of the
For eight years Walker lived on this
er's develop problems of their own within
research into the latest coronary proce-
manmade coronary system without any
ten years. Cardiovascular disease (CVD)
dure, called atherectomy--in which a min-
chest pain. While in Upper Volta (it's now
is a progressive illness that typically re-
uscule, Fantastic Voyage-like device
70
THE WASHINGTONIAN
PHOTOGRAPHS BY SIEPHEN SPARTANA
snakes through arteries to obliterate block-
blood to almost half the heart's muscle and
Hospital Center. "To have to go through
ages-is taking place here, at cardiac facil-
to the walls separating its right and left
the invasion and convalescence of a four-to-
ities such'as the one at Washington Hospi-
chambers. LAD blockages are nicknamed
six-hour bypass surgery for that is excessive.
tal Center.
"widow-makers" by medical personnel.
Our job with catheter-based procedures is to
Julius Walker's medical odyssey is not
This blockage had to be opened.
intervene before there is so much disease that
unusual. It parallels cardiology's stepping-
Dr. Kenneth Kent, a former NIH car-
bypass surgery is necessary. It's far easier on
stone advancements. After his bypass
diologist who was the third person to per-
the patient.`
grafts began their predictable degenera-
form a balloon angioplasty in this country,
Still, balloons are not perfect. Of the
tion, he would need six sometimes highly
used the technique on Walker at George-
blockages they do fix, one out of three
experimental procedures within four years
town University Hospital, where he was
recur within six months. Inflating the bal-
to stay alive. His vessels would be blown,
then director of the catheterization lab.
loon can sometimes bruise or crack a ves-
burned, and drilled open, and propped up
During angioplasty. a spaghetti-thin plas-
sel's inner walls, weakening it. And there
with tiny scaffolds. His cardiovascular sys-
tic catheter is threaded through a patient's
are certain conditions for which balloons
tem became a roadmap to science's search
femoral artery in the groin to the heart.
have proven ineffective.
for a way to keep a broken heart beating.
Through that catheter passes a smaller cath-
Plaque, it turns out, is rarely like soft,
eter with a deflated, miniature balloon on its
new-fallen snow. "We're coming to un-
W
ALKER'S PROBLEMS BEGAN WITH
tip. When the balloon reaches the blockage,
derstand that it's more like slush or ice,
atherosclerosis, a buildup of plaque
it is inflated, flattening the plaque against the
with rocks hidden in says Dr. Gus
in the circulatory system, which, to some
vessel wall to create a larger opening or
Pichard, director of the Washington Hos-
extent, happens to everyone. The process
"lumen." Cardiologists liked to think of the
pital Center's "cath lab." Instead, it's
begins in our youth with the emergence of
balloon as having the effect of a snowplow
generally calcified, mottled with clots, and
"fatty streaks," thin layers of cholesterol
flattening soft, new-fallen snow.
jagged or lopsided.
clinging to the interior walls of veins and
Angioplasty was devised in the late
Balloons can't squish bone-hard cal-
arteries. As the years pass, more fat and
1970s to help less-severe cases of coronary
cium. They might shove clots down-
minerals may build up on these streaks,
disease. After bypass surgery had been
stream, causing a heart attack, and they
accumulating layer upon layer like scales
introduced in 1967 at the Cleveland Clinic
can't exert even pressure in blockages that
in household plumbing.
by Dr. Rene Favaloro, thousands of pa-
are thicker on one side of the vessel. They
Like most heart patients, Walker had
tients who would have died slow, house-
also don't fare well in vein grafts, which
are wider than coronary arteries, have a
different molecular makeup, and produce a
WALKER'S PROBLEMS BEGAN WITH
more gelatinous plaque. These are all con-
ditions probably better attacked by atherec-
ATHEROSCLEROSIS, A BUILDUP OF PLAQUE IN
tomy drills, shavers, and lasers.
Julius Walker was not an ideal candidate
THE CIRCULATORY SYSTEM, WHICH TO
for balloon angioplasty, since his block-
ages were in fat-filled vein grafts. But in
SOME EXTENT HAPPENS TO EVERYONE.
July 1989, he was dependent on a science
still defining itself. His only other options
were another bypass or a regimen of medi-
three unchangeable risk factors-a family
bound deaths were able to lead productive,
cine that would treat his symptoms but not
history of heart disease, male gender, and
pain-free lives. Bypass surgery remains a
their cause.
increasing age-which sped up this inevita-
lifesaving procedure for people with clo-
In his post-angioplasty writeup of Walk-
ble process.
sures in all three coronary vessels. Almost
er's case, Dr. Kenneth Kent rued the fact
He also had a lifestyle that increased his
400,000 such operations are performed
that he couldn't use a stent, a tiny metallic
potential for trouble: a sedentary, high-
each year in the United States.
tubing implanted to hold open collapsing
stress job with a regular diet of reception
But bypasses are expensive-averaging
vessels, or any of the new atherectomy
buffets and state dinners.
$40,000-and painful. Surgeons must cut
devices designed to cut away plaque. It
"It was very difficult for my father to have
open a patient's chest and split and pull
would be three months before the FDA
a fat-free diet even after his bypass," says
apart his ribs to reach the heart. Saphenous
would allow their use even for limited clin-
Julius Walker's son, New York actor Stew-
veins must be taken from the legs, or inter-
ical trials in vein grafts such as Walker's.
art Walker. "Life as a diplomat required
nal mammary arteries from the chest-
going to parties, often two or three functions
which statistically seem to last longer than
O
NE YEAR LATER, IN JULY 1990,
a night, where there was nothing but rich
veins-to make the grafts. Recuperation
Kent's fears-that Walker's angio-
food. Those parties were just as much a part
takes weeks. And the risks and complica-
plasty would be only a temporary fix-
of his work as going to the office-and eating
tions increase with each repeat bypass.
came true. This time his symptoms were
what's there is a sign of respect for the
With angioplasty, patients are up and
far worse. The stitch in his chest became a
people you're dealing with."
about within days, even hours, of the pro-
crushing soreness within a few days. He
cedure. The cost averages $14,000.
could barely breathe.
J
ULY 1989: TESTS REVEALED THAT ONE
"Most narrowings are less than one third
By the time Walker was admitted to Wash-
of Julius Walker's 1981 bypass grafts
of an inch in length in vessels that are only
ington Hospital Center, where Kent had
was totally closed; another was open and
three millimeters in diameter," says Dr.
teamed with Leon, Pichard, and Dr. Lowell
flowing well; and the third had a substantial
Marty Leon. He is director of cardiovascular
Satler, another research cardiologist, the
narrowing at its aortic origin. This final graft
research at Washington Cardiology Center,
same LAD-bypass graft that had been
supplied the left anterior descending artery
a private practice that performs most of the
opened by balloon the previous summer had
(LAD), an all-important vessel that funnels
cutting-edge atherectomies at Washington
collapsed. The front half of Walker's heart
DECEMBER 1993 71
was receiving virtually no blood. A mas-
sive coronary could occur any moment.
Leon, Pichard, and Satler injected Urok-
inase, a $386-a-dose enzyme that dissolves
clots, directly into Walker's graft. Then
they dilated it with another balloon to force
open a small, temporary channel. "It was a
nondefinitive solution,' says Leon, "to
stabilize an unstable situation."
They sent Walker home with a blood-
thinning medication, Coumadin, and told
him to come back in a few weeks. Then
his body would be ready to undergo one
of the newer atherectomies the team had
begun testing for the Food and Drug
Administration.
S
ITTING IN HIS ANTIQUE-FILLED HOME IN
DC's Friendship Heights, Walker
doesn't like talking about his heart condition.
After a bypass and six other lab procedures.
the details have become blurred. He'd rather
discuss children, his Scottie dogs, the Afri-
can trinkets on the tables, and the needle-
point pillows he makes to keep from feeling
idle while he watches television.
A soft-spoken, 66-year-old man with
courtly manners, Walker still gently flirts
with Savannah, his wife of 37 years. They
met in Washington, when he came from
Texas to join the foreign service. He pro-
posed to her on their second date, married
her three months later.
"Yes, only three months,' she says.
"Seemed like a long time to me," he
replies, making her laugh shyly.
Being able to make up his mind quickly
kept him from fearing the experimental
techniques recommended by Dr. Leon,
Walker says. Perhaps his time as a diplo-
mat in unstable countries helped prepare
him, too. 'You do have to keep loose and
adjust to changing situations.'
He fiddles with his Mickey Mouse watch
before adding that a sense of humor helps.
Walker liked that about the cardiology team
that treated him. "They're a bunch of kids,
and act like it, too, he says. "They perform
The team that performs most of the atherectomies at the Washington Hospital Center:
terribly serious, stressful work on you, but
Drs. Lowell Satler, Gus Pichard, Kenny Kent, and Marty Leon (seated).
without any feeling of impending doom."
day. That comes to about 3,500 angioplas-
tors watched by a nurse. One screen dis-
E
VEN so, THE ATMOSPHERE IN WASH-
ties/atherectomies a year, one of the high-
plays details of a patient's medical history.
ington Hospital Center's five cath labs
est volumes of any hospital in the world.
Another has colored lines charting the pa-
is businesslike. Three are divided in half,
The lab design is the work of Dr. Gus
tient's vital signs: green for the heartbeat,
so that a million-dollar X-ray machine
Pichard, the Chilean-born cardiologist
orange for blood pressure.
needed for the shadowy angiograms that
who has been director of the cath labs since
Next to them are screens that look into the
locate blockages can swing from one pa-
1983. Upbeat and gregarious. he delights
workings of the patient's heart. One is fro-
tient to another. While the first patient is
in giving visitors a tour of the labs and the
zen, the initial shot of a nasty blockage,
being worked on, the second is behind a
supply room, where there are hundreds of
showing a shriveled artery that looks like a
sliding wall being prepped. The giant
catheters ranging in price from $350 to
dead grapevine. The adjacent screen's pic-
X-ray machine swings, and the team of
$1,000, and in diameter from .66 milli-
ture undulates with the heart's contractions.
nurses and technicians enters quickly.
meter to 3.3 millimeters. They have names
The doctor shoots an iodine-based dye
Such clockwork transitions allow the
like Road Runner, Sherpa, Edge, Hockey
through the catheter to get another look. A
unit to perform up to 50 catheterizations-
Stick, and Shadow.
little puff of smoky film starts at the aorta
half diagnostic and half therapeutic-a
Just outside each lab sits a bank of moni-
and then shoots through, illuminating the
72 THE WASHINGTONIAN
"HOTOGRAPH BY STEPHEN SPARTANA
lacework of coronary arteries on the moni-
my. The FDA approved its general use just
higher success rate in keeping arteries
tor as suddenly as a lightning bolt across a
this summer. The front-end cutting device
clear, it also had a higher rate of complica-
night sky, from origin to tiniest fingers.
rotates relatively slowly, at 750 rpm, and
tions and cost, on average, $1,300 more.
Inside the lab, the medical team watches
has a vacuum to suck the cut-up plaque
"They're wrong," says Kent, who was
a similar row of screens. It was these moni-
back down the catheter. "The problem
involved in the study. "It wasn't a good
tors that most fascinated Walker as he was
with other devices that are not front-end
test, because we weren't doing atherecto-
rolled in on a narrow table for his atherec-
cutting is that they must first go through the
mies very well then.` He explains that
tomy in October 1990. As all patients are,
blockage to scrape," says Leon. "If you
medical trials typically take about three
Walker was awake throughout.
have soft, friable debris, you may break off
years to complete. "During that time,
"That big camera looks right through you,
large pieces of it."
technology and our skills improve, yet the
so you see the wires snake around inside,"
Having such a diverse toolbox available
test is still gauging earlier methods.'
says Walker. "You can feel down here at
was lucky for Walker. "That's what is really
"I've been in medicine long enough to
your groin, up through your leg, their twist-
unique about our group," says Satler, 39.
remember when bypass surgery and those
ing and pushing things. Then you hear the
"Most institutions may have one or two
who performed it were wildly controver-
doctors say, 'No, it needs to go more into the
devices and use them on all patients because
sial," says cardiologist Sander Mendel-
mmmmmm,' so then the wire backs up and
that's the best they have. We have a variety,
son, who also serves on Washington Hos-
makes another run, showing up over there.
so we can really target the treatment to suit
pital Center's bioethics committee. "Now
It's great fun to watch."
the need. It's like screwdrivers. If what you
bypass is universally accepted. This kind
Noticing his listener's grimace, Walker
really need is a Phillips head, you can still
of debate is entirely healthy and traditional
smiles and says, "Oh, they give you happy
take a regular screwdriver and eventually
in medicine.
pills. It's much more interesting than look-
unscrew the screws. But it's hard and clum-
"Cardiac care is an area where definitive
ing at the ceiling."
sy, and you strip the screws."
knowledge is not there yet. We must treat
Being involved in so many FDA trials
on the basis of incomplete knowledge.
O
CTOBER 1990: WALKER'S LAD-BYPASS
and advising manufacturers on the design
That's life. You can't freeze patients for a
graft had renarrowed by 95 percent.
of fledgling technologies has earned the
few years until all the data are in. You have
The blockage was unusually long, several
team of Leon, Kent, Pichard, and Satler a
to do something for real human beings who
centimeters in length, and filled with a
high-visibility profile. Three out of four of
are sitting in front of you today."
cottage-cheese-like plaque. It looked on
their patients are referred from other car-
J
ULIUS WALKER DIDN'T WORRY
that the extraction atherectomy was ex-
"THEN YOU HEAR THE DOCTORS SAY, 'NO, IT NEEDS
perimental. He knew he couldn't breathe
easily or walk far, and he didn't want his
TO GO MORE INTO THE MMMMMM,' SO THEN THE
chest split open for another bypass if he
could help it. He was calm as he was
WIRE BACKS UP AND MAKES ANOTHER RUN, SHOWING
wheeled into the lab for his third catheter-
based treatment.
UP OVER THERE. IT'S GREAT FUN TO WATCH."
Leon numbed Walker's groin area and
inserted a catheter, slipping it up through
his femoral vein and the right side of his
the angiogram to contain residual blood
diologists who do interventional proce-
heart, into his pulmonary artery. That was
clots, despite Walker's taking the blood-
sures as well, Pichard says. Each winter
for a pacemaker monitor to give instant
thinning medication for several weeks.
they teach a symposium with live proce-
readings on changes in his heart pressure
That information told Dr. Leon that
dures that is beamed by satellite to coun-
and fluid levels. It also had a tiny contact
trying to compress the material with a bal-
tries as far away as Japan.
electrode in case Walker's heartbeat
loon again would be useless, perhaps even
They also get some criticism from a still-
slowed or stopped.
dangerous; it might knock a clot down-
skeptical medical community. Across the na-
Then Leon threaded another guide cath-
stream, leading to a heart attack or emer-
tion, probably as few as 35,000 atherecto-
eter up the femoral artery. leaving it
gency surgery. Instead, Leon would need
mies are done a year, compared with
perched in the aorta where it connected
to use an atherectomy device that could
300,000 balloon angioplasties. That's large-
with the clogged bypass graft. Through it
cut, drill, or suction out the material.
ly because half of the devices weren't FDA-
would pass the tiny extraction drill.
He had several to choose from. Wash-
approved or available to most cardiologists
An intense 43-year-old man who spent
ington Hospital Center was then one of
until this summer. The fact that the Washing-
seven years overseeing NIH's research
only ten sites selected by the FDA to test
ton Cardiology Center performs almost
into stents, lasers, and atherectomies,
these tiny drills in vein grafts as well as in
1,000 atherectomies and stent procedures a
Leon still has a warm manner with pa-
"native," or original, coronary arteries.
year has caused a few area doctors, with less
tients. He explained to Walker that he was
The directional atherectomy device shaves
experience in atherectomy, to wonder if the
going to slip a Teflon-coated wire, thinner
plaque with a motorized blade in a tiny stain-
team might too often choose the newer tech-
than a cat's whisker, through the catheter
less-steel capsule. The rotational atherecto-
nology over other treatments, such as medi-
to serve as a support and guide for the
my uses a diamond-chip tip that spins at
cation or surgery.
extraction cutter. Asked how he could see
200,000 rpm to drill through hard calcium.
The first conclusive comparison of ath-
to do it, Leon pointed to the angiogram
The excimer laser shoots ultraviolet light to
erectomy and balloon angioplasty was pub-
monitor. "Don't worry," he joked. "I'll
vaporize plaque in tight closures.
lished in the New England Journal of Medi-
try to keep it from coming out your ear."
Leon decided that the safest approach for
cine in July. The 1988-91 study found that
Walker watched the screen as he saw the
Walker's situation, given the blood clots,
while directional atherectomy did produce
tiny wire snake its way down through the
was a fourth tool, the extraction atherecto-
larger artery openings and had a 9-percent
Continued on page 93
DECEMBER 1993 73
T
HE PONTIAC FIREBIRD HAS JUMPED THE CURB,
EVERY MORNING,
its front end resting against a telephone pole, windshield wipers still
moving in the predawn drizzle. The driver is dead, a gunshot wound
WASHINGTON WAKES
to the head. Chip Forte takes out his camera and starts shooting.
When the police open the car door, revealing the body sprawled across the
UP TO NEWS OF
seat, Forte puts down his camera.
"They don't need to see that,' he says, referring to TV viewers who will be
MORE CRIMES AND
watching this over breakfast.
Welcome to the graveyard shift, a beat that Forte, an independent news
TRAGEDIES. EVERY
cameraman, has staked out as his own.
Forte has been chasing shootings, stabbings, fires, and traffic accidents
NIGHT, CHIP FORTE
from midnight to dawn for more than ten years, providing footage for local
stations and national networks that don't employ overnight camera crews.
GETS IT ALL ON FILM.
WAIT UNTIL
D
L
Unlike competitors, most of whom have come and gone, Forte doesn't show
much gore. "You don't have to show a body close up," he says. "A body
under a blood-soaked sheet is enough."
This discretion has earned Forte a kind of insider status with police and fire
officials, as well as with news editors.
"One freelancer used to send us really gruesome stuff,' WJLA assignment
editor Diane Boozer recalls, describing footage of a man decapitated in a
Beltway accident. "Chip would never do that.'
One night in 1992, Forte was listening to his bank of police, fire, and
ambulance scanners when he heard a dispatcher report a mugging on Capitol
Hill. Using what colleagues call "an uncanny sense for the big story,' he
raced to the scene to discover Michigan Congressman Bob Traxler lying dazed
and bloody on the sidewalk.
Forte sold that footage to the networks. Although he could get more money
from a single buyer looking for an exclusive, he prefers to make his work
available at a standard rate to all of his Teleforte Communications subscribers.
One station puts the price at $200.
A bachelor who works seven nights a week, he drives around in a four-
wheel-drive truck that's a mobile newsroom, including video monitor and
editing equipment.
He says the competition was more cutthroat when he started, but now a new
threat looms. "People are coming out of the woodwork with their home video
cameras-everybody's a newsman," says US Park Police Lieutenant John
Harasek, who keeps them at bay while investigating crime scenes.
Forte has an edge here. "Everybody knows 'Chip the TV guy, and he gets
away with more than anybody else does," says the Post's Brian Mooar, who is
Forte's partner in crime-watching, although the two compete for scoops.
The police give Forte many of his tips, but he also gets them from tow-truck
operators, doughnut makers, and newspaper-delivery drivers, who don't
seem to think of taking the story back to their own newsrooms.
This camaraderie gives Forte as much satisfaction as a good scoop, even if
it's Marlene Cooke in a paddy wagon. "That's just another story,' he says,
unimpressed with the excitement over Mrs. Cooke's wild night in September
on the streets of Georgetown.
Forte's idea of a "real story" unfolded one night when he spotted plumes of
smoke and thought he had a fire of major proportions. When he reached the
scene, he found a group of off-duty police officers preparing a big barbecue to
raise charity funds-at 5 AM.
Forte asked the department to issue a statement on the barbecue-as an
example of the unsung devotion of the local police-and he delivered the
package to TV stations in time for the morning broadcasts.
-GRETCHEN Cook
74
THE WASHINGTONIAN
stainless-steel tube, at the time of the ex-
in other locations, like the groin. Patients
Mending a Heart
traction procedure. The stent would have
have to stay in the hospital for five days,
Continued from page 73
braced open the walls of the vessel. But
on average, to ensure there are no
because of the presence of blood clots in
complications."
web of his coronary arteries. Torquing it
Walker's plaque, it would have been dan-
But why would plaque regrow within six
from Walker's groin, almost three feet
gerous to do so.
months in the graft, when it took years to
away from the target, Leon wiggled the
"One of the drawbacks to stents,"
accumulate in the first place?
wire through the microscopic hole left by
says Leon, "is that they sometimes cause
Cardiologists don't know the whole an-
the blockage. Walker's steady heartbeat
blood clots to grow around them. They
swer. Part of the buildup is scar tissue in
made the job as hard as threading a needle
are foreign objects, and the body-reactes
response to jostlings caused by the treatment.
in a rowboat at high tide.
against them. So you cannot put a stent in
Part of it might be what they call "recoil."
Leon pressed the X-ray machine's foot
if you detect already existing clotting.
With balloon angioplasty, the artery or vein
pedal and flushed in dye to make sure he
Stents also require patients to be on blood
is forced farther open than it would be in its
had the wire where he wanted it. Walker
thinners, which can precipitate bleeding
natural state, like a small bubble in a glass
felt heat rip through his chest and out
tube. Perhaps the flattened plaque
his fingertips.
simply plumps up again while the nat-
Now it was time for the extraction
Getting Good Heart Care
urally elastic vessel walls shrink back
device. This was where the skill of
Hospitals Where You Can Go for Help
in on themselves.
the support team was vital. "This
Leon and his colleagues believe
device needs to be set up and moni-
MOST HOSPITALS OFFER cardiac care, but their ca-
that stents, regardless of their draw-
tored very carefully," says Satler,
pabilities vary. Some have specialties within cardiac
backs, are particularly effective
"because the flush system can clog
medicine. For instance, Georgetown University Hos-
against recoil. Because Walker had
up without the operator knowing it.
pital offers a broad range of treatment in pediatric
remained on Coumadin and been
It continues to spin, but it's not as-
cardiology, and George Washington University Hospi-
taking an aspirin a day since his ex-
pirating. The debris might be going
tal has launched a program dedicated to research and
traction atherectomy six months ear-
downstream-into the heart-in-
treatment of women's cardiovascular problems. To be
lier, his blood was free of clots. Now
stead of out."
considered among the "centers of excellence" by the
a $1,200 stent could be implanted
Walker heard the device churn. It
National Cardiovascular Network, a hospital must:
safely. In April 1991, Leon put one
sounded like a mouse-sized dental
perform more than 500 open-heart surgeries a year;
into Walker's graft.
drill. After a few minutes, Leon
perform more than 500 coronary angioplasties a year;
For nearly two years, Walker
withdrew it. He pumped in more dye
have an operative mortality rate of less than 5
lived, walked, taught at the Foreign
to see the results. Because Walker's
percent for open-heart procedures;
Service Institute, and traveled with-
vein graft was 4 millimeters wide
have an operative mortality rate of less than 1.5
out any breathing or heart problems
and the device only 2.5 millimeters
percent for balloon angioplasties;
at all.
wide, Leon needed to complement it
have on staff at least two heart surgeons who per-
with a balloon to compress the thin
form 150 or more open-heart surgeries a year;
J
ANUARY 1993: WALKER
sheath of plaque that remained.
have at least one physician who performs 150 or
had new troubles. The bypass
Walker watched the extraction
more angioplasties a year;
graft that had been open when Leon
drill disappear from the screen and
have additional physicians on staff who perform at
began treating Walker in 1990 was
come out his groin. A balloon cath-
least 75 open-heart surgeries or angioplasties a year.
developing problems of its own.
eter was slipped in over the wire and
Fewer than 100 centers across the nation qualify.
This second graft, connecting the
went up and into place. Inflated, the
They include:
aorta to the heart's left circumflex
balloon looked like a tiny stringbean
Washington Heart at Washington Hospital Center
artery, had a 90-percent narrowing.
in his heart. Leon pumped it open
(202/877-7321);
A stent seemed the logical treat-
with dye several times and then
Virginia Heart Center, Fairfax Hospital (703/698-3691);
ment, since Walker had had such
withdrew it. The graft was wide
Washington Adventist Hospital (301/891-7600).
success with it before, but FDA re-
open, and blood rushed through.
Other area cardiac-care centers also can handle
strictions prevented Leon from
Walker took a deep breath. "I felt
coronary angioplasty, atherectomy, and angiograms,
using it. "We had done our quota of
the difference immediately,'
as well as surgical procedures including pacemaker
600 patients in the FDA's vein-graft
he says.
implants, valve replacements, coronary bypasses,
stent study, so the trial use had been
In a little over an hour, Walker
and open-heart procedures. For more information
stopped," says Leon. "Here's the
was on his way to a recovery room.
about them, contact:
only technique that has allowed this
The most frustrating thing for him
George Washington University Hospital, Division of
man a long, symptom-free period,
was to lie still for six hours with a
Cardiology (202/994-1000);
but the FDA says we're not allowed
lead weight on his groin to prevent
Georgetown University Hospital, Division of Car-
to put it in."
hemorrhaging from the catheter en-
diology (202/687-5050);
Leon decided to get creative. He
try holes. He felt so good he wanted
Howard University Hospital, Cardiovascular Center
did have access to a larger stent that
to get up and take a walk.
(202/865-6100);
the FDA had approved for use in leg
Arlington Hospital, Heart Center (703/558-5000);
arteries. "This was a vessel origi-
A
S IT DOES IN A THIRD OF SUCH
Alexandria Hospital, Cardiovascular Services (703/
nally from the leg," he says with a
cases, Walker's LAD graft re-
379-3000);
shrug and a laugh, "so we decided to
closed again six months later. Leon
Johns Hopkins Medical Institutions, Division of Car-
use it in an off-label, nonapproved
felt he could have prevented the
diology and Cardiac Surgery (410/955-5000);
indication. The FDA can't restrict
"restenosis" had he been able to
St. Joseph's Hospital, Keelty Heart Center (410/
off-label use if a physician's judg-
insert a stent, a tiny, honeycombed,
337-1000).
-SARA SWITZER
ment indicates it.
DECEMBER 1993 93
Leon inserted a "biliary" stent, .004
former Soviet republics, Kazakhstan and
from scratch, has sworn off red meat, and
inches thick, to shore up this newly col-
Belarus, advising new diplomats on how
still is not discouraged by his troubles of
lapsing graft. It was Walker's fifth inter-
Washington works. Each day he takes an
the heart.
ventional treatment, but he wasn't discour-
aspirin, Coumadin, a calcium-channel
Walker and Leon have discussed his
aged. "What's the alternative?" he says
blocker, and a Beta-blocker to lower his
needing another bypass operation if his
with a smile that seems to add, "I'm still
heart rate and blood pressure and to keep
grafts continue to degenerate. As to why
here, aren't I?"
his blood slick. He makes bran muffins
Walker's LAD graft has repeatedly nar-
rowed at the same spot, car-
T
HIS PAST SUMMER, WALKER
diology doesn't have a good
again felt pressure in his
How to Save Your Heart
answer. Walker may have a
chest. In the angiogram, Leon
What to Do If You Feel That Dull Pain
hyperactive internal scarring
could see that the second stent
response, akin to that of some
was clean, but that the first
CARDIOVASCULAR DISEASE CLAIMS nearly a million American
people who produce keloids,
one, placed in the LAD graft in
lives each year-and a fifth of those victims are younger than 65.
abnormally large scars, when
April 1991, was badly nar-
The major warning sign is a dull pain or tightness that may spread
their skin is cut.
rowed. But he couldn't see
from the center of the chest into the upper left arm or jaw. Some
Or it may have to do with a
how or with what. For that
people mistake it for indigestion. Rarely is the pain severe. If the
biological function that some-
knowledge he would need a
discomfort recurs regularly after exercise, during cold weather, fol-
how keeps cardiovascular dis-
new diagnostic tool: an intra-
lowing a heavy meal, or in times of stress, see your doctor quickly.
ease very focal in its attacks on
vascular ultrasound.
Coronary disease brought on by fatty build-up in blood vessels is
vessels. "Mechanical engi-
Leon threaded a very small
usually well advanced by the time the first symptoms appear.
neers will tell you that in tor-
catheter into Walker's heart
Three risk factors-a family history of heart disease; male gen-
tuous conduits, there are cer-
and its LAD bypass. Emitting
der; and advancing age-increase the chances of cardiovascular
tain stresses and angle points
ultrasonic waves, the device
disease. But even women as young as 35 can be at risk. Your doctor
that are more prone to develop-
gave Leon a three-dimensional
can determine your risk level-and can suggest preventive steps-
ing narrowing," says Leon.
picture of the graft's inside
with the help of a blood-cholesterol reading; a lipid profile (it
"But those are engineering ex-
wall. From that, Leon could
measures low-density lipoprotein, the "bad" cholesterol most like-
planations for a biologic
see that the obstruction was not
ly to cause problems); a treadmill test, to measure heart rate under
process. It's like asking why
a result of recoil, but of a de-
stress; and an electrocardiogram. Cardiologists suggest that peo-
someone gets cancer in a cer-
layed growth of new tissue on
ple-even as young as 40-with a family history of cardiovascular
tain spot. Someday we may
the stent's edges and within the
disease have these tests done before developing any symptoms.
know, but now it's conjecture.
slots of its honeycomb, some-
While such factors as gender and heredity can't be controlled,
"We'd like to increase our
thing he had hoped wouldn't
you can do something about other risks, such as lack of exercise,
knowledge in home runs, but
happen. Leon couldn't use a
high cholesterol level, high blood pressure, obesity, and smoking.
it's more incremental than
cutting device for fear of dam-
Changing the way you cook and eat can lower both cholesterol
that. You take a treatment or
aging the stent itself. He would
level and blood pressure. Don't eat fried foods. Trim off fat from
device and refine, refine, re-
need a laser instead.
meats. Choose pasta, very lean meat, poultry, or fish as a main
fine, so that over the years the
The excimer laser has a co-
course, and choose dairy products, like skim milk, that contain a
differences made are large.
bra-head design, with 220 fi-
low percentage of fat.
"The important thing to re-
bers on its 2.2-millimeter
Half of all heart-disease deaths result from heart attacks. Studies
member about Ambassador
crown. Each fiber emits a
show that one of every five heart-attack deaths could have been
Walker," Leon concludes, "is
beam that melts fatty mole-
prevented if victims had dialed 911 at the first sign of trouble. The
that his native coronaries are all
cules into gas and water. Leon
major symptom of a heart attack is often a pressure, squeezing, or
closed near their origins. If he
would fire it only briefly be-
pain in the center of the chest that lasts longer than a few mo-
didn't have access to bypass sur-
cause of the mass of gas bub-
ments. The pain may spread to the shoulders, neck, or arms, and
gery or these interventional
bles generated by the fat dis-
be accompanied by fainting, dizziness, sweating, nausea, or short-
techniques of ours, he would
solving. Shooting 60 ultravi-
ness of breath. This can mean that blood flow to the heart has been
have been dead several times
olet pulses over 3 seconds, the
seriously reduced, which begins to damage heart muscle within
over. Yet his heart muscle has
laser sounded like a tiny Ga-
minutes.
been preserved. He has excel-
tling gun firing in Walker's
Fast attention usually enables doctors to head off permanent
lent heart function. For the past
heart.
damage to the heart. But clot-dissolving drugs, such as streptoki-
twelve years, he's lived a nor-
Leon withdrew the laser and
nase, must be administered quickly to be effective. If they are
mal life, being very productive
again inserted the ultrasound.
received within an hour of the first symptoms, the risk of dying is
in his work, with almost no cor-
Noticing a dangling fragment in
cut in half.
onary arteries of his own."
the ultrasound image, he again
If you think you might be having a heart attack, call 911 and the
Julius Walker smiles at the
used the laser. Then he forced
nearest hospital emergency room immediately. And chew an aspi-
suggestion that he's a kind of
the stent farther open with one
rin tablet, unless another medical condition prevents it. The anti-
bionic man. He prefers to liken
of his largest balloons. Finally,
clotting factor in aspirin aids blood flow.
himself to an old car. "You
he rechecked all his work with
Cardiovascular disease is the number-one killer of women as
repair it. You can't make it
ultrasound. "Clean as a whistle
well as men. Post-menopausal women are at the greatest risk,
new again, or really get it back
in there," he told Walker.
although studies show that women smokers who use oral contra-
to the condition it once was.
ceptives are up to 39 times more likely to have a heart attack than
But you do the best you can.'
T
HAT WAS SIX MONTHS AGO,
those who do neither.
Right now, if you ask him,
and so far Walker feels
For more information, call the American Heart Association, 800/
the mechanics are doing a pret-
fine. He spent the fall in two
242-8721.
-SARA SWITZER
ty good job.
94 THE WASHINGTONIAN
Clinton Presidential Records
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This is not a presidential record. This is used as an administrative
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This marker identifies the place of a publication.
Publications have not been scanned in their entirety for the purpose
of digitization. To see the full publication please search online or
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TRANSCATHETER
CARDIOVASCULAR
THERAPEUTICS
A Multi-Device, Lesion Specific Approach. Featuring Daily
Live Televised Case Demonstrations From Washington. D.C.,
Rotterdam. The Netherlands, and Toulouse, France.
SINTHAND
SAMPSUM
THURSDAY.
FEBRUARY 24
TCT
SUNDAY,
FEBRUARY 27, 1994
mann
PRESENTEDING
Washington Cardiology Center
and Washington Hospital Center
COURSEDIRECTORS:
Martin B. Leon, M.D.
pum print units HITTIN ######## name
Kenneth M. Kent M.D.
Augusto D. Pichard, M.D.
Lowell F. Satler, M.D
COURSECO:DIRECTORS
Jeffrey Popma. M.D.
Gary s Mintz, M.D.
EATURED QUESTMODERATORS
Donald S. Baim, M.D.
David R. Holmes, M.D.
Eric J. Topol. M.D.
they
New Location:
WASHINGTON CONVENTION CENTER
Washington, D.C
Gala Reception
NATIONAL AIR AND SPACE MUSEUM
Washington, D.C
THE WHITE HOUSE
WASHINGTON
April 8, 1994
Dr. Tobe Levin Freifrau von Gleichen
Martin-Luther StraBe 35
60389 Frankfurt am Main
Germany
Dear Dr. Levin Freifrau von Gleichen:
Thank you for your letter of March 22, 1994.
Your Kind invitation for Mrs. Clinton to be the
guest of honor at a dinner sponsored by the
Hessischer Kreis is greatly appreciated.
I have forwarded your correspondence to the
First Lady's Scheduling Office.
Sincerely,
Margaret A. Williams
Chief of Staff to the
First Lady
Diane hom me arento and Dr.
Tobe Levin Freifrau von Gleichen
c/o University of Maryland University College European Division
Patti
FKT BSB Abrams Education Center
Unit 25754 Box 3
APO AE 09242
Tel: +49 69 45 96 60
Fax: +49 69 46 40 69
22 March 1994
Ms. Maggie Williams
Assistant to the President and Chief Aide to Hillary Rodham Clinton
The White House
1600 Pennsylvania Ave. NW
Washington, DC 20500
Dear Ms. Williams,
At your earliest convenience, would you please give the enclosed invitation to Hillary Rodham
Clinton?
Aware that she will soon be spending some time in Germany, I am writing to ask if she would
be our guest of honor at a dinner sponsored by the Hessischer Kreis (Hessian Circle), a group
of business and professional leaders described on the second of the following two pages.
Among Americans who have addressed us are Edward Kennedy and Henry Kissinger; I would
more than welcome the vibrant, progressive voice of Hillary Rodham Clinton.
I appreciate your help.
Sincerely,
Jobe Levin
The Hessischer Kreis
c/o Dr. Tobe Levin Freifrau von Gleichen
Martin-Luther Straße 35
60389 Frankfurt am Main
Germany
Tel: +49 69 45 96 60
Fax: +49 69 46 40 69
21 March 1994
Dear Hillary Rodham Clinton,
Your advocacy for health and educational reform has won you an enthusiastic following in
Germany.
On your forthcoming visit to this country, would you consider addressing the Hessischer Kreis
(Hessian Circle) in Frankfurt? If your schedule permits, let us welcome you into our forum for
discussion and debate on pressing contemporary issues.
Sponsored by the top German political and social institutions and corporations, the Hessischer
Kreis, now in its fourth decade, has developed into a diverse forum for leaders from all strata
of German society, gathering together CEOs, trade union and student representatives,
ambassadors, generals, television producers, authors, intellectuals, and editors who invite
speakers of international renown. Recent guests have included Helmut Kohl, Shimon Peres,
Henry Kissinger and even the Dalai Lama. A speech usually lasts about forty minutes and is
followed by discussion after dinner, moderated by the group's founder, the Baron Gleichen,
who draws the members into lively debate. The enclosed documentation gives you a more
detailed picture.
Normally, we propose a general theme. For instance, based on your extensive advocacy for
health care reform, you might want to address aspects of the campaign to extend coverage to
all US citizens. Having studied the situation in France, you might also enjoy discussion
comparing the French with the German systems. After dinner, our guests, among them many
CEOs of US and German firms, will be happy to explore with you our corporate contribution
to a successful German health care partnership. But of course we would be equally receptive
should you prefer another topic closer to your heart.
As an American lecturing for the University of Maryland University College, European
Division, and an activist in the international women's studies movement, I would feel more
than privileged to hear you speak in Frankfurt. Since you would also be only the third female
to address the Hessischer Kreis, you would be pioneering women's access to that level of
influence represented by its members. A sponsor of our gathering will be University of
Maryland University College, European Division, which annually offers courses to 40,000 US
service personnel and family members overseas. If you wish media coverage, you would
therefore touch not only a German but also an American audience.
As Germany undergoes dramatic transformations, the Hessischer Kreis would like to present
clear progressive voices. Your work, both public and private, demonstrates an inspiring ideal.
Please join our movers and shakers for dinner, and include us in your itinerary during a
forthcoming visit to Germany.
Sincerely,
Tobe Levin
Hessischer Kreis
Known throughout Germany, the Hessischer Kreis (Hessian Circle) offers a
forum to opinion-makers from all strata of society. Launched in the 1950s,
the circle initiates gatherings by inviting two hundred members to enjoy
dinner while listening to a speaker of national or international standing. A
forty minute talk precedes the meal; lively discussion follows it. Although
meetings are private, the press will be invited if both guest and host desire
their attendance. The director, Kurt Freiherr (Baron) von Gleichen, serves as
moderator. Gisela Leicher takes charge of coordination and planning.
Guests have included
Norbert Blüm (German Labor Minister)
Birgit Breuel (CEO, Treuhand)
Edgar Bronfman (CEO, Seagram's)
Mangosuthu Buthelezi (Zulu Chieftain)
Jacques Calvet (CEO, Peugeot)
Dalai Lama (Tibetan Religious Leader)
Hans-Dietrich Genscher (Foreign Minister)
Günther Grass (Author)
Otto von Habsburg (European Parliament)
Edward Heath (Prime Minister)
Kenneth D. Kuanda (President, Zambia)
Edward Kennedy (Senator)
Henry Kissinger (Secretary of State)
Helmut Kohl (Chancellor)
Shimon Peres (Foreign Minister)
Edzard Reuter (CEO, Mercedes Benz)
Helmut Schmidt (Chancellor)
Léopold Senghor (President, Sénégal)
Rita Süßmuth (Bundestag President)
Edward Teller (Nuclear Physicist)
Franz Vranitzky (Chancellor)
Hosts have included Adam Opel, AEG, American Express, Allianz, Bundesbank, Citibank,
Commerzbank, Degussa, Deutsche Bank, Dresdner Bank, Dyckerhoff, the European Business
School, Fina, Frankfurter Allgemeine Zeitung, Flughafen (Airport) Frankfurt, Henkell,
Heraeus, Hessische Landesregierung (Government, State of Hesse), Hoechst, Holtzmann,
Lufthansa, Lurgi, M.A.N. Roland, Mercedes, E. Merck, Metallgesellschaft, Nestlé, Pirelli,
Quandt, Siemens, Stadt Frankfurt/Main (Municipal Government), Telenorma, Teves, Tishman
Speyer, VDO, Wella, ZDF (German Television).
Director and Moderator: Kurt Freiherr (Baron) von Gleichen.
Organization and Planning: Gisela Leicher.
Rüsterstraße 1, 60325 Frankfurt am Main, Germany
Telephone and Fax + 49 69 72 09 17.
THE WHITE HOUSE
WASHINGTON
May 13, 1994
Ms. Natanya Levioff
2410 North 53rd Street
Philadelphia, PA 19131
Dear Ms. Levioff:
Thank you for your letter of February 15, expressing
personal interest in working with the Clinton Administration and
serving the public.
My apologies for the delay in responding. I am sure you can
imagine the large volume of mail received at the First Lady's
Office. We are trying to answer each and every letter.
I have forwarded your resume to the White House Personnel
Office.
Sincerely,
Diane G. Lino
Diane G. Limo
Special Assistant/Office Manager
Office of the First Lady
705 Walnut Avenue
Syracuse, NY 13210
February 15, 1994
Ms. Margaret Williams
17th and Pennsylvania Avenue
Washington D.C., 20500
Dear Ms. Williams:
As a current intern in a congressional district office, I am seeking further opportunities to
work on Capitol Hill. Since attending The Presidential Classroom in January, 1990 when
I was a senior in high school, I knew the Hill was where I wanted to build my career.
I have worked effectively in many different capacities and at many different levels. I am
a quick learner, versatile in my abilities, and creative in solving problems. I am also
dependable, and I see a job through to its completion. My job experiences have drawn
on these characteristics. Here are some examples: finding research articles and sending
them to a doctor overseas in time to write his/her article for a medical journal;
coordinating a wrestling tournament of 160 competitors; and being responsible for
peoples' safety as a lifeguard this past summer.
Politics is people oriented, and I am interested in a job where I will be working both for
and with people. I believe one person can make a difference, and if I could help solve a
problem that a constituent might have, or help with a piece of legislation that could make
the difference to a large amount of people, I would find that most satisfying.
I am planning to be in Washington during the week of March 7-11, 1994. I would like
the opportunity to meet with you, and would appreciate any help or advice you could
give me. I look forward to hearing from you. Thank you.
Sincerely,
Natanya Levioff
Natanya Levioff
705 Walnut Avenue
2410 N. 53rd Street
Syracuse, NY 13210,
Philadelphia, PA 19131
(315) 423-0903
(215) 473-9013
EDUCATION:
Syracuse University, Syracuse, NY
Major: Political Science, Minor: History
GPA: 3.1
Bachelor of Arts May, 1994
HONORS:
Moot Court, Best Advocate, Spring 1993
Dean's List, Spring 1993
Academic and Athletic Scholarships
EXPERIENCE:
Syracuse, NY
U.S. Congressman James Walsh
Spring 1994
Local Internship
-
Aid staff in expediting constituent casework
-
Miscellaneous office responsibilities including; answering
phones, clipping news articles and mailings
Syracuse, NY
Syracuse University
1990 - 1994
Varsity Wrestling Team 1/91 - 4/94: Senior Manager
- Coordinated 1993 'Cuse Classic Tournament
-
Ongoing responsibilities include; maintaining statistics,
videotaping and photography
Recreational Services 9/91-4/92, 1/93-4/93: Supervisor
London Centre, England 8/92-12/92: Office Responsibilities
Carrier Dome 9/90-4/91: Catering, Concessions and Novelties
Philadelphia, PA
Current Science
1989 - 1991
-
Researched medical articles for international clientele
-
Maintained computer records, mailing lists for marketing
and subscriptions departments
-
Miscellaneous office responsibilities included receptionist
duties, proof reading and mailings
COMPUTER:
MS Word, Lotus 1-2-3, Word Perfect, Word Star and Paradox
ACTIVITIES:
Student Government Association: Recorder of the Assembly
Syracuse University Equestrian Team: Treasurer
WJPZ Radio: Newscaster, member of the Morning Crew
Alpha Chi Omega Sorority: Recording Secretary, Co-
Chairperson for National Philanthropy
Summer Employment: Lifeguard and Riding Camp Counselor
Study Abroad: London, Fall 1992; traveled to France, Italy,
Wales, Belgium, Scotland and throughout England
THE WHITE HOUSE
WASHINGTON
September 23, 1994
Mr. Larry Dan Lewis
Glennon Park Apartments
Apt. 75A
124 North Hardesty
Kansas city, MO 64123
Dear Mr. Lewis,
Thank you for your thoughtful and
warm comments. Words of spiritual
encouragement are always welcomed by the
Clinton Administration.
Enclosed are the photos and
biographies of the Clintons, that you
requested.
Sincerely,
Margaret A. Williams
Chief of Staff to the
First Lady
Mr. Larry Dan Lewis
Glennon Park Apartments
Apt. 75A
124 North Hardesty
Kansas City, MO 64123
Send Kyou
d for ofcenton
July 29, 1994
Dear Margaret Williams (Wonderful Chief of Staff to First Lady,
Mrs. Clinton, Assistant to the President Bill Clinton)
Watch you on hearings in apt-tv channel 19 and many other
congressman and
and their RTC hearings. to very thankful
for chief of staff to First Lady Hillary Clinton and Assistant to
President Bill Clinton. Your doing an wonderful and excellent
job as always. Would you please wonderful Margaret Williams--
send me biography about the Clintons and picture of you.
(Request for biography about Clintons and a picture of the
Clintons and you)
Thanks.
Love,
Larry
note/Letter
THE WHITE HOUSE
WASHINGTON
February 1, 1994
Mr. David S. Liederman
Executive Director
Child Welfare League of America, Inc.
440 First Street, NW, Suite 310
Washington, DC 20001-2085
Dear Mr. Liederman:
Thank you for your letter of December 6, 1993.
Your kind invitation to Mrs. Clinton to speak at
your conference in Washington on April 13 is greatly
appreciated. I have forwarded your correspondence
to the Scheduling Office.
Again, thank you for your invitation.
Sincerely,
Margaret A. Williams
Chief of Staff to the First Lady
CHILD WELFARE LEAGUE OF AMERICA
Dear Ms. Williams,
I understand that Ann Jordan spoke to you about the
First Lady speaking briefly at our national conference in
April. She asked me to follow-up with a formal request
to you (attached).
I realize the demand on the First Lady's time is
enormous but as you know first-hand the people who attend
the League conference are on the "front lines" and would
be greatly uplifted by hearing from Hillary.
I appreciate your help on this one.
all the Bed
Daniel
CWIA
Child Welfare League of America, Inc.
440 First Street, NW, Suite 310, Washington, DC 20001-2085
202/638-2952
FAX 202/638-4004
PRESIDENT
John F. Merchant
VICE PRESIDENTS
Anne Duncan
December 6, 1993
Judith Sherman
Ruthann S. Yamanaka
SECRETARY
Marilyn Cox
Hillary Rodham Clinton
ASSISTANT SECRETARY
Norman W. Powell, Jr.
The First Lady
TREASURER
The White House
Richard H. Fleming
1600 Pennsylvania Avenue, N.W.
ASSISTANT TREASURER
Raymond P. Carpenter
Washington, D.C. 20500
BOARD OF DIRECTORS
Carol Armstrong
Dear Mrs. Clinton:
Charles L. Baker
Judith S. Block
Sheryl Brissett-Chapman
Sarah Bryant
We would be very grateful if you could spend a few minutes with over 1,000
Nan Dale
Charles A. DeGrandpre
other friends of children at the Child Welfare League of America's annual
Jeanelle Dunckel
conference on Wednesday morning, April 13, 1994, as they prepare to go to the Hill
Charles A. Haas
Kent Henderson
to discuss critical issues affecting children and families with their Members of
George T. Hubbard
Mai Bell Hurley
Congress. The conference is being held at the Grand Hyatt Hotel.
Ann D. Jordan
James M. Karet
Glynn D. Key
During our morning plenary we will also be presenting ten $10,000
Karl G. King
Suzanne S. Megathlin
scholarships to outstanding child welfare workers from around the country to enable
Elba Montalvo
Rob Mosbacher, Jr.
them to earn their M.S.W. degree. I know the winners would be thrilled if you
Timothy F. Noelker
Michael R. Ostrowski
could present the scholarship awards to them.
Jane K. Paine
Richard G. Plufka
Stephanie G. Robinson
The theme of this year's conference is "Children '94: Ensuring Health and
Marilyn R. Seymann
P. Stanley Shavers
Security for America's Children." Surgeon General Joycelyn Elders will open the
S. Norman Sherry
Faith Smith
conference on Tuesday which will feature a day-long symposium on health care
Pamela K. Steele
reform and its impact on the child welfare system. The conference will also
Martha Stennis
Susan S. Stepleton
highlight model programs and practices that will help child welfare workers and
George W. Swan III
John G. Theban
administrators meet the needs of over two million children and their families served
Mary Y. Tull
by our member agencies.
Cheryle Wills-Matthews
HONORARY MEMBER
Mrs. Ben W. Heineman
I do hope that you will be able to join us and share your vision and spirit.
EXECUTIVE DIRECTOR
David S Liederman
Sincerely,
DEPUTY DIRECTOR
Shirley E. Marcus
WESTERN OFFICE
Don't
762 W. Cypress Avenue
San Dimas, CA 91773
Warm Regned + March for
909/599-4565
David S. Liederman
FAX 909/599-7281
Jean McIntosh
Executive Director
Director
are you ore doing
CWLA/CANADA
180 Argyle Avenue
Suite 312
Ottawa. ON K2P 1B7
613/235-4412
FAX 613/788-5075
Sandra G. Scarth
Director