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Office of the Press Secretary

(Ottawa, Canada)

For Immediate Release February 23, 1995
                               IN OTTAWA

                             Civic Hospital
                             Ottawa, Canada

9:30 p.m. EST

MR. JOHNSON: Good evening. My name is David Johnson. I know from things we've said before you all know that -- or perhaps you don't -- I'll take it from the top. The Secretary was feeling a little ill this afternoon when he got back from his bilateral meeting with the Canadian Foreign Minister. He consulted with his physician in Los Angeles, and based on the description of his symptoms, the Secretary was advised to consult with a physician here in Ottawa. He came to Civic Hospital here to do that. The Secretary is resting comfortably, and if things go as we expect they will, he will be released tomorrow.

But we thought that the best way for you to understand what went on and to have the most comfort and to get your questions answered was to have his physicians speak to you, which is the reason we invited you out here; this is where they are. And they are Dr. Chris Carruthers, the vice president of the hospital for medical affairs; Dr. Gunnar Kragg, the chief of staff; Dr. Andreas Laupacis; and Dr. Paul Deneault, the gastroenterologist, at the end of the table.

I'm going to hand the microphone to Dr. Carruthers now and he will pass the mike back and forth among the physicians as they describe the secretary's condition for you.

DR. CARRUTHERS: Thank you very much. I'm Dr. Carruthers, the vice president of medical affairs at the Ottawa Civic Hospital. The first statement I'd like to make is Mr. Warren Christopher is stable. He's in no harm, and he is doing quite well in the emergency department of the Ottawa Civic Hospital.

The Ottawa Civic Hospital was first forewarned about 6 p.m. that Mr. Christopher was having some difficulties and would like to see an internist with the Ottawa Civic Hospital. Shortly thereafter, he was brought to the hospital. Prior to that time we did call an internist, Dr. Andreas Laupacis, who is on my right, to see him.

When he arrived in emergency at the Ottawa Civic Hospital, he was walking, he was talking, he was quite alert and appeared in no difficulty. At that time he was examined by our emergency physician, Dr. Pat Stewart, who went over him thoroughly. And then Dr. Andreas Laupacis examined him, and I'll have Dr. Laupacis talk to you now.

DR. LAUPACIS: My name is Dr. Andreas Laupacis. I'm the internist who was asked to see Mr. Christopher tonight. When I first saw him he was entirely stable. His blood pressure and heart rate were entirely normal.

From talking to him and examining him it was apparent that he was bleeding into his bowel and it seemed that the most likely source of his bleed was from his stomach, probably from an ulcer. And because we consider it important to make that diagnosis, we asked Dr. Deneault, the gastroenterologist, to see him. And I'll let Dr. Deneault describe to you the findings of the endoscopy which he performed, which is a procedure whereby he used a tube to look down into Mr. Christopher's stomach.

DR. DENEAULT: My name is Dr. Paul Deneault. I'm a gastroenterologist here at the hospital. I was in to -- called into see the patient tonight, and as Dr. Laupacis said, he was really quite stable and in good medical condition, but I felt an endoscopy was indicated, which is a test where we pass a fiberoptic tube in through the throat, look at the stomach to see where the source of bleeding is. He had a very, very small ulcer which was oozing a little bit of blood at the far end of the stomach. We injected a little bit of medicine into it to stop the bleeding and it stopped very promptly.

He really did remarkably well. After the procedure we talked to him and he looked in good spirits and excellent medical condition.

Q: Why is he being held overnight if he's in excellent medical condition?

DR. DENEAULT: It's more of a precaution at this stage of the game, just to make sure that there's no further bleeding from his ulcer. That's all.

Q: Has the Secretary had any symptoms or anything like this before in his medical history?

DR. DENEAULT: Not at all.

Q: Was he aware that he had an ulcer?

DR. DENEAULT: No, he wasn't. That's not often the case when people are on anti-inflammatory drugs; but 50 percent of people have an ulcer without any symptoms whatsoever. So this was quite typical and the things we see most nights on call.

Q: Would you describe -- the Secretary was having difficulty. What difficulty was he having? What did he tell his own doctor? What did he tell you about this difficulty?

DR. CARRUTHERS: The Secretary had had some symptoms, very minor symptoms, and he had talked to his internist back in the States who, after he described the symptoms to him, recommended that he come into the emergency department.

Q: Was he feeling ill, or was it just blood in the stool?

DR. CARRUTHERS: He had some dark-colored stools, and they had just occurred. So with that conversation with his physicians back home, it was advised that he come into the emergency department and see someone.

Q: What will be the recommended course of treatment from his release?

DR. DENEAULT: I think the first and foremost thing is to stop the anti-inflammatory drugs he's on. The other thing we'll do is we'll put him on some medication that cuts out the acid production of the stomach and will help heal the ulcer. The ulcer should be healed within four to six weeks.

Q: I'm sorry, stop the anti-inflammatory drugs he's on? I'm sorry.

DR. DENEAULT: He's taking an anti-inflammatory drug for arthritis.

Q: Oh, okay, and does that contribute to an ulcer?

DR. DENEAULT: Yes, it does.

Q: What's it called -- the drug?


Q: Does the White House know whether he will continue with his normal schedule tomorrow? Is that --

MR. JOHNSON: We wouldn't expect him to be able to do that. We would expect him to return home tomorrow and based on the advice of his physicians.

Q: Is the President going to return home?

MR. JOHNSON: I think we'll wait and see in the morning. But that's certainly not unlikely.

Q: Is there a period of convalescence required with a condition like this? And will it require some kind of prolonged treatment?

DR. CARRUTHERS: It's likely that he'll be back to work well within a few days. He will be on a medication to heal the ulcer probably for anywhere from six to 12 weeks.

Q: Had the ulcer been previously diagnosed?


Q: Who will be filling in for the Secretary at this point, in terms of protocol and also decisions that must be made, et cetera?

MR. JOHNSON: Well, in terms of decisions, the acting Secretary of State, Strobe Talbott, I suppose, if it came to that. We really don't anticipate that being an issue. There's only one additional bilateral meeting scheduled that he would be the principal at tomorrow, so I don't really think that that's an issue in this case.

Q: Dr. Carruthers, can you give us a general statement about the Secretary's condition at this point?

DR. CARRUTHERS: The Secretary is stable; he's in no danger. And we're keeping him overnight just as a precaution. I should say that when he came into the hospital and his general health, he's fit as a fiddle; he's a very healthy man. And at the present time he's doing quite well and we're just observing him.

This was not a major health event. It's not uncommon to occur. And he's responded well to the routine treatment.

Q: Would you describe in more detail how you stopped the bleeding?

DR. DENEAULT: First, once we identified the ulcer site, we take a small catheter that has a tiny needle and through that we inject some medication. The medication is epinephrine.

Q: I'm sorry, sir, your name again was --

DR. DENEAULT: Deneault.

Q: Okay, thank you very much.

DR. CARRUTHERS: Someone asked me about the room he would be going into.

Q: Yes.

DR. CARRUTHERS: He will be, from a medical point of view, going into a normal room. Now, we are trying to find out which is the best room from a security point of view. That is possibly -- could be the intensive care unit because of a security reason. It is not because of his health. I repeat, it is not because of his health.

Q: Doctor, where is he right now?

DR. CARRUTHERS: Right now, we just left him in the emergency department. He was talking to all of us, and quite alert.

Q: Has the President spoken with him since this began?

MR. JOHNSON: I do not believe the President has spoken with him, but we are making arrangements and he wishes to do so.

Q: Dave, could you tell us again when you expect him to be able to resume his job -- his normal occupation?

DR. DENAULT: I would think if all goes well, as we can expect, he'll be back within a handful of days.

MR. JOHNSON: There's one more point I'd like to make to try to avoid any confusion. If I'm repeating this correctly, from what you all told me beforehand, it's likely that when the Secretary returns to Washington, he may be admitted to the hospital for another day. But I wouldn't want you to draw any strange conclusions from that if he does end up going to the hospital for one more day in Washington.

But we would expect, if he continues to behave as he has, from a medical point of view, that he would be released in about another day or so from a hospital in Washington.

Q: Could you spell the names one more time?

MR. JOHNSON: We tried to just pass out a list of the names. We'll get more copies of that for everyone. I think that's probably the most efficient way to do it.

Q: Is he on medication now? Have you prescribed any medication?

DR. CARRUTHERS: Yes, he's going to start the medication that he takes by mouth tonight.

Q: And what is that?

DR. CARRUTHERS: It's called Losec.

Q: Are there any side effects with that?

DR. CARRUTHERS: There are no side effects, no.

Q: And what does that do?

DR. DENEAULT: What Losec does is just cuts out the ability to make acid, and that just makes it easier for the ulcer to heal.

THE PRESS: Thank you.

END 9:43 p.m. EST