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Office of the Press Secretary

For Immediate Release March 16, 1997
                           PRESS BRIEFING
                           BY MIKE MCCURRY

The Briefing Room

12:37 P.M. EST

MR. MCCURRY: Good morning, everyone. I've got reinforcements here with me today, if you've got any questions. I think you all know Dr. Connie Mariano, the President's personal physician and head of the White House Medical Unit; and Dr. Marlene de Maio, who did such a great job, the orthopedic surgeon who was on the team at the National Naval Medical Center at Bethesda, who treated the President.

Let me tell you a little bit about how the President spent the evening since we saw you late yesterday afternoon. He had a very vigorous and successful physical therapy session last night, shortly before dinner time, rested comfortably, has had a good night's sleep. The doctors woke him up at 8:45 this morning and he rubbed the sleep out of his eyes and said, I want to go home.

And they spent the rest of the morning evaluating that desire on the part of the President and the doctors concluded, after a physical therapy session this morning and consulting further, examining the President's wound, looking at the mobility of his leg and knee, that he was good to go. So the President, as you know, arrived here at the White House a short while ago, happy to be home, anxious to spend some time with Mrs. Clinton and Chelsea before they depart later this afternoon for their trip to Africa.

The doctors are continuing to treat the discomfort that the President is experiencing as a result of the surgery. He's been taking a combination of non-narcotic, analgesic pain killers, including Motrin and Ultran and also just good old Extra Strength Tylenol. He also continues to take Robaxin, which is a muscle relaxant that helps deal with a little bit of the stiffness that he's had in his thigh area.

I'll tell you a little bit -- if you want to know about the physical therapy he's doing. He's working on parallel bars and crutches, just to kind of practice building up his upper body strength, since he'll need that to work the crutches. I told some of you earlier he's gotten pretty good at doing the 60-foot sprint on his crutches now and the doctors were -- they can tell you themselves -- they were pretty surprised at how well he was doing with the physical therapy.

The ride down from Bethesda was uneventful. The President jabbered away and did a little sightseeing tour -- I guess you came down by way of Georgetown, so he pointed out where he used to live and ate some breakfast on the way down. And I think you saw him a short while ago as he arrived here and took a few questions from all of you.

That's about all there is to report -- except let me give a little bit on schedule. I think you noticed that we announced that we were moving the Helsinki Summit schedule ahead one day. That will give the President an additional day here in Washington before we depart from Helsinki. We had to drop Denmark off the schedule, but we'll add that back on in July when the President goes to Spain for the NATO summit.

The only real event on his schedule at this point is his meeting with Foreign Minister Primakov tomorrow, which he intends to go ahead with. Foreign Minister Primakov has been here in Washington meeting with the Secretary of State and I believe, Eric, he had seen Secretary Cohen today, too, correct. So he'll be over at -- are they doing that at the Pentagon? They'll be at the Pentagon today. We might also take a picture with former Vice President Mondale and with former Senator Kassebaum-Baker in connection with the event that the Vice President will do.

The Vice President will fill in and, based on his performance at the Gridiron last night, that's not bad news for us. We'll have our campaign finance reform event that had been scheduled at 9:00 a.m. tomorrow. He will meet with Prime Minister Bruton and accept the customary bowl of shamrocks on St. Patrick's Day. And he'll also do a meeting with members of the Council of Chief State School Officers at 1:30, there's a reception. And then tomorrow night is the annual St. Patrick's Day reception here at the White House, and the Vice President will preside at that. We'll try to keep the noise level down so we don't disturb our patient upstairs.

I guess beyond that, not a whole lot else to tell. Yes.

Q Has the President expressed any concern about the strenuous travel and meetings ahead with the summit -- we all know how tough that travel is -- considering the fact of the pain of his leg and the medicine he'll be on?

MR. MCCURRY: Not concerned about it. I think he's anticipating it with a fair amount of relish. He wants to see President Yeltsin. There are a number of very important issues on the bilateral agenda that we have with the Russian Federation, especially with respect to the future of NATO. And, as I told some of you last week, this is really a meeting in which the two Presidents are going to look ahead to the 21st century and think about the role the United States and Russia will play in the post-Cold War era of the 21st century.

Key to that, of course, is continuing to have an undivided, democratic Europe, and Russia's role in that continent and in the institutional architecture of a peaceful Europe is very much the key point that will be discussed at the Summit.

Q Mike, any thought that the delay in the trip is a quid pro quo for coming home early today?

MR. MCCURRY: I don't think that was part of your decision-making, doctors, was it? I mean, it was really -- it gives the President an additional day to convalesce, which is a good thing. It gives him an additional day to get used to how to be mobile. I mean, there's a lot of learning that will go into adjusting to the President's somewhat less than mobile status right now. He's got to learn how to navigate his way around the residence. He'll have to get more familiar, more accustomed to using the crutches. And I think the Doctors -- chime in if you want -- I think they're going to feel more comfortable if he's got that extra time just to practice being ambulatory in his new condition.

Q What changes have been made in the White House to accommodate him?

MR. MCCURRY: The physical therapist who came down here to the White House yesterday and surveyed the scene with Mrs. Clinton looked at things like, you know, there are lots of places where we have furniture that was too close together. And if the President is in a wheelchair or if he's on crutches, it will be hard for him to navigate. So they had to move some furniture around. They had to tape some carpets down. They discovered when the President arrived here that that's a pretty small elevator that he uses to get upstairs, so he's got to go into it sideways. So there will be some things that we'll do around here to adjust.

But part of the discharge planning that was done with the President's medical team at Bethesda was to really examine those issues and make sure that people here were prepared and that the White House Medical Unit staff was prepared to have the President arrive here. And people are very comfortable with the President's desire to come home.

Q Walk me through the decision to delay for a day. Yesterday, at the hospital, you said you knew of no plans to do that.

MR. MCCURRY: Well, they were talking about it in a very tentative way late last night and really firmed it up, I think, as they thought about what the President would be doing Monday and Tuesday here. They had some conversations --

Q Who was involved in this?

MR. MCCURRY: Well, the NSC staff, Mr. Bowles, some of the Chief of Staff folks.

Q Mike, at what point did the President decide that he was willing to delay it, because he had been the one saying that he wanted to leave on time.

MR. MCCURRY: They actually did not -- they went ahead and made the change in the schedule and alerted him to it today. He was fine with it. But we had begun putting it in motion prior to asking him. The only thing they wanted to check with him was whether he was okay with postponing Denmark until July, and he said that was fine.

Q Mike, did doctors push for more of a delay than one day?

MR. MCCURRY: Connie, why don't you --

DR. MARIANO: Actually, let me refer you to Dr. de Maio, because she does a lot of this surgery. And, again, it depends on a combination of what the patient's progress is like. In his case, he had very good progress. He had very good pain control on the regimen. You know, the first day is always going to be the most painful and he was aware of that. But he really responded well to the physical therapy. He got some well-deserved rest and I think rest is very important. He got to sleep more than he normally gets to sleep. He'd wake up from sleep and have a lot of energy and work out. And I think we felt comfortable saying you are now graduated out of the hospital.

Also, the other thing we wanted to make sure of, was that he was ready to be received at home. And, again, that's vital to any type of discharge planning for patients -- that the family, the house, everything is conducive to a safe transition to living at home. And it meant training Secret Service on how to move him. And it meant looking at the residence to make sure everything is safe, all the trip hazards are taken care of.

And, again, back to the clinical opinion among the surgeons, that he was healing well, progressing as expected. It was safe. It was safe to do that. But maybe Dr. De Maio can comment about what normally orthopedic surgeons see for a length of stay in cases such as this.

DR. DE MAIO: Sure. When you review the national records for this diagnosis, most people stay in about 48 hours to three days. So the President actually was on the shorter end for a hospital stay. And, as Dr. Adkison had mentioned earlier on Friday, our patients have to meet certain goals before they can leave the hospital. And when the President met them there was really very little reason to keep him in. So we sent him back here with the idea that he would do his therapy and convalesce at home. And, again, we really have to emphasize that he's got to protect that right leg and do his rigorous physical therapy. And his Secret Service and the people here at the White House have to also be instructed on that.

Q Doctor, from a purely medical standpoint, would it be your preference that he did not make this trip?

DR. DE MAIO: Well, I think Dr. Adkison really put it very well and succinctly, but he is the President. And he said that he's going to go. And right now, orthopedically, there's really no reason to hold him back. His wounds look great. He's doing well. He's fully alert, chipper. No reason to hold him back.

Q How is his pain medication any different than the average person who doesn't have to worry about being alert all the time because he might have to make some terribly important decision? Would the medication be a little bit different for an average guy who could take a couple weeks off from work?

DR. DE MAIO: Yes, actually, that's an excellent question. We -- again, there's been a team concept here working with the President. And our anesthesiologists, who are specialists in pain control, particularly Dr. Petty, mentioned that in his 25 years or so of taking care of recon Marines and Green Berets, et cetera, that pretty much all those people have needed some type of narcotics. And the President has not really required any. He's had some tough times with some spasms, et cetera, but he's done remarkably well. In my period of time as being an orthopedic surgeon, I've never had a patient that was able to go through this without narcotics of some sort. And he's doing great.

Q But doesn't that make it easier for him? I mean, relieve some of the pain.

DR. DE MAIO: Well, no, he's actually quite comfortable. He's just -- we took it minute by minute, hour by hour, and, you know, when he was having some spasms yesterday, we talked about what the contingency would be if he had more difficulty. But he weathered the storm, so to speak, and he didn't need anything further, so we didn't prescribe it. There was no need.

Q Doctor, just to be clear, was it the doctors' recommendation that this trip be delayed by a day, or was it purely a White House decision?

DR. DE MAIO: No, we told him what we needed orthopedically, in terms of control of the limb and the wound, post-operatively, and how his therapy needed to go. And then we made sure that that would fit in with what was demanded of him, of the trip and what his goals were.

And he's doing great medically. So from an orthopedic standpoint there's no reason to hold him back. And Dr. Mariano has been in charge of his medical condition and he's just soared right through the surgery and that.

DR. MARIANO: But it does help in the recovery that we have an extra day to observe him and let him rest up for this trip. It's going to be strenuous on him and he's aware of that. We're going to be moving, lifting him, doing a lot of things, but we're going to have to enforce as much rest, so he's fairly comfortable with that.

Q Doctor, physically that's tough on him, but does that mean there's any mental effects, as well, that the pain or the medicine or the travel could have on the President as he's making these --

DR. MARIANO: Not really. I mean, his pain is well controlled right now. I think that the tough thing is for him, knowing him after almost five years now, he's so determined to do a lot of things. He's so energetic, and I think he wants to do everything at once. And I told him privately, I said, this is going to be the hardest thing, is to slow down, and you'll have to learn to deal with that and use a little bit of that rest -- definitely rest and the rehab that we're going to be working with.

Q How long are the physical therapy sessions every day? How many physical therapists are there? And can you tell us a little more about what the routine consists of?

DR. DE MAIO: Sure. Once again, in the early post-operative period, it depends on the individual patient. Some people can't tolerate long periods of time doing therapy, and this is true with Mr. Clinton. Early on he could only tolerate shorter periods of time. But right now, for example, last night he had a very strenuous session that lasted approximately 45 minutes, in which he did some range of motion, muscle strengthening and stretching. He got up and successfully ambulated on parallel bars without much difficulty.

And with respect to your question about how many therapists, right now he's got one-on-one therapy with LTJG Paco, who's one of the team of excellent therapists that we have at Bethesda. And she has jumped right in and done a great job. And he's following her instructions with some reticence. You know, it's hard to tell him what to do, but he's doing great.

Q Who is in charge of telling him what to do? Who's going to say, go slow?

DR. DE MAIO: Medically, it's Dr. Mariano. She is the person in control and in charge of all medical decisions. And we, as orthopedic surgeons and physical therapists, are consultants.

MR. MCCURRY: Although, there's probably a different way to answer that question, too. (Laughter.)

Q Let's hear it. (Laughter.)

Q Mike, a political question rather than a medical one --

MR. MCCURRY: He's very determined to do what he wants to do. But I think it's fair to say, Connie, he has been following the advice of doctors pretty carefully.

DR. MARIANO: You know, he's a good patient, actually. He really is. He really is. A lot of people are amazed. But he will listen to you, he'll understand, he'll think about it, and he will do it. Part of what we do in the Medical Unit is make sure that you give him good quality of care. And a lot of people -- I know a lot of physicians don't normally work with the President of the United States and order him around and say, you will do this, and inflict pain.

And part of what we do is say, listen, he's going to be complaining, it's going to hurt. And you do what you would do for him, like you would do for any other patient. Don't deny him the right to be a patient. And that's really my emphasis.

On rounds this morning with all the consultants of the team, as we concluded I went around the group and said, I want you to tell me honestly if the care we provided to this patient is consistent with the care you would provide to anybody at this hospital, that you made no exceptions, that you didn't deviate because of who he was in terms of the type of treatment, therapy modalities. And they say the care is consistent. And I said, that's what I want, consistent care like you would do for anybody.

Q Mike, back in the '60s, John Kennedy sprained his back, or strained his back, prior to a summit with a Russian leader. And the pain he suffered from that has since -- historians have since concluded that that was part of the reason why the summit ended as a disaster. (Laughter.) Why take a chance -- why can't the summit be postponed a couple of weeks.

MR. MCCURRY: If this summit ends in disaster, I'm sure future historians will go back and make the same careful analysis of what happened.

We are taking great care to work through the agenda. I want to remind you of something I said even before the President's accident. I told you last week that this summit is, by design, not supposed to be extraordinary. That was a time of extraordinary conflict between the United States and Russia, then the Soviet Union -- a time of a Cold War in which there were really serious issues that confronted two superpower adversaries. The relationship with the Russian Federation is much different now. We have a working relationship. We have two Presidents that are engaged and two governments that are engaged at a variety of levels, unlike the 1960s. And the ability to work through the agenda and make this as routine as possible a working meeting is what the two Presidents intend.

We, at the same time, we are not -- had not looked for a dramatic breakthrough at this summit. This is a working meeting that sets up a lot of issues that are going to be on the agenda that we have for the coming months, working up to the July NATO summit in Madrid. There was no anticipation on our part that we were going to have major agreements to negotiate or anything of that nature. It's one of what is now a fairly commonplace exchange of high level meetings between the two governments.

Q Well, if it is so ordinary and commonplace, why can't it be delayed for a week or two?

MR. MCCURRY: Well, because it's a very important chronology now that comes through setting up some of the meetings that are going to happen. I can walk you through those real quickly.

Remember, we've got, later on in March, a summit meeting with the European Union that the President certainly -- I'm sorry, in May -- that he intends to go ahead with. We will see President Yeltsin again in June at the time of the Denver Summit of Industrialized Nations. And then we need to work up to what is going to be a very historic meeting of the North Atlantic Alliance in Madrid in July.

So working through each of those things in a sequence made it very important to go ahead and do this meeting, kind of keep things moving on track. Some of you saw that President Yeltsin has had some things to say about the strong feelings that the Russian Federation has towards the concept of NATO enlargement, and we are aware of that. We've been working these issues hard. Secretary Albright yesterday had a session that was, you know, very textured -- a meeting with Foreign Minister Primakov that went deeply into some of the issues and anxieties that exist on both sides.

Q Mike, you mentioned that the decision to delay was made by NSC and Erskine and among the group that decided that --

MR. MCCURRY: Well, I think that everyone consulting together agreed that it would be good if we could give the President an extra day to convalesce and to rest, and that we had some flexibility in the schedule because we could obviously move the Denmark portion of it to later on this year.

Q But from the beginning, he was the one that said, I am going. Allegedly he told the doctors, I'm going to go on this whether you like it or not, in essence. How come he was not consulted as to whether or not to delay?

MR. MCCURRY: Well, look, we gave him an extra day so he could rest. I don't think he -- no one thought he would object too much to that.

Q Mike, the doctor is talking about the need to slow down. Is there going to be any change in the day-to-day schedule of the delayed summit, scaling it back at all?

MR. MCCURRY: Yes, that's where I went through earlier the events the Vice President will pick up on the President's part tomorrow, is to show you that he'll be subbing in for a lot of the schedule that the President would normally carry forward on. And we obviously will not be bringing him over here to the West Wing that much. He'll be doing a lot of his work in the residence, where he will be more comfortable.

Q What about the summit, itself, though, Mike? Is anything going to change at the summit? Will there be fewer meetings, shorter meetings?

MR. MCCURRY: My guess is they will probably stick with the schedule that had already been designed. And, remember, the schedule had been designed to accommodate everyone's health needs. So it was a schedule that I think will work and continue to work as it was designed.

Q Could one of the doctors describe, and spell, the painkillers. and tell us if this combination has any side effects, if it results in drowsiness, sleepiness, wooziness and does it in any way degrade performance.

MR. MCCURRY: I'll do the spelling and let the doctors comment on the regimen itself. Motrin is just M-o-t-r-i-n. Ultran is U-l-t-r-a-n. Those are the two painkillers, and I guess he's taking some Tylenol, as well.

DR. MARIANO: Yes. Motrin is like Extra Strength Advil. It's like super strength Advil.

MR. MCCURRY: Super strength Advil is what you would compare it to.

DR. MARIANO: It doesn't affect your thinking.

MR. MCCURRY: And then the muscle relaxant is Robaxin, R-o-b-a-x-i-n. Let me have the doctors comment on the side effects. Are there any side effects from using this combination?

DR. DE MAIO: Well, first let me say that any time you take any kind of medication, even vitamins, there are side effects, of course there are. But the important thing to remember is that we picked medications that are commonly used and very safe and effective. So there are side effects and most people are -- the type of side effects and the number of side effects are quite small.

So, you know, can there be side effects? Absolutely. Is he being watched closely for side effects? You bet. That's one of the reasons why Dr. Mariano and the nurses and doctors are all watching him.

But really these things are able to control pain -- and/or spasm, for example, in the case of Robaxin -- with very little side effects in terms of your mental abilities, state of consciousness, clouding your thoughts, et cetera. And, you know, he's surrounded by medical people, and part of our training is to determine one's state of alertness, how well you're thinking, are you competent -- that sort of thing. And he seems to be very much himself. Dr. Mariano knows him for quite a while and he's bounced right back.

Q What happened to the Toradol?

DR. DE MAIO: Well, Toradol is used quite commonly in orthopedic procedures in the U.S. And we like it early on because it's very effective when you can give it by vein or by a shot in the muscle. And it works more rapidly when you give it by vein. And now he doesn't have a Hep-Lock or a little I.V. in, and he's taking food and drink very well. So we've moved on to meds by mouth. And in many patients Toradol is not quite as effective when you take it by mouth.

Q You mentioned goals that you wanted him to meet before discharge. What were those goals?

DR. DE MAIO: Well, they're the same pretty much for any orthopedic patient, which is he's got to be able to get up and around safely, to be able to transfer from his bed to a wheelchair and to crutches. He's got to be able to eat and drink okay, got to be able to use the bathroom well, and breathe and cough, have no temperature and his wound needed to look healthy. And he accomplished all those goals. He wanted to go home. We let him go.

Q You mentioned there are side effects in this group of drugs from its treatment. To what degree might there be additional side effects, or conflicting side effects to the medication he already takes for his allergies?

DR. DE MAIO: Oh, would you like to --

DR. MARIANO: We looked at that closely to make sure that you don't have any -- you know, every time you add an extra drug you always have the risk of getting drug interactions, and we looked at it closely. And it was actually pretty minimal, in terms of all the other medications he takes for the allergies or his reflux.

And again, I think the beauty of what we have here is we're able to watch him closely. We're going to have an attendant with him 24 hours a day, just keeping an eye on him and his symptoms and how he's doing.

Q Mike, will the President be briefed today on Albania, and do you have an update on the situation there?

MR. MCCURRY: I don't have an update beyond the one that -- I think they gave one at the State Department earlier today. The evacuation was proceeding. They evacuated, last I saw, in the neighborhood of 89 or 90 people yesterday from Tirana. Ambassador Lino was reporting in that things were continuing to go smoothly.

The President did get a national security update. Routinely, he did -- I think he did either at Bethesda or shortly after arriving here. He typically on weekends gets a written update from the National Security Council staff.

Q You mentioned a wheelchair. Will he be using one in the residence a lot?

DR. DE MAIO: Yes, he will. And that's also not too uncommon after an injury like this. What we want him to do is to be able to safely ambulate unassisted with crutches. And also, he is in a recovery period, and rather than have him staying in his bed, we'd rather have him up and around in a wheelchair and intersperse that with supervised and unsupervised P.T.

Q What about a hospital bed? Is that being used in the residence?

DR. DE MAIO: No hospital bed is really necessary, and I do believe that Mr. Clinton is probably going to be more comfortable in his usual surroundings. And I don't really think he needs that. He's really getting around quite well, so he's safely getting in and out of bed.

Q One more question, what about any kind of electronic monitoring at night or anything like that? Will he be --

DR. DE MAIO: Oh, no. Oh, no. He's a healthy man. And when we do this kind of orthopedic surgery and people go home, they don't go home with monitors. And there is absolutely no reason for him to have one.

Q Will the President be in a wheelchair when we see him tomorrow? I mean, how will he situate it with Prime Minister Primakov?

MR. MCCURRY: I don't know that they've really figured that out yet. I think it's more comfortable for him if they can keep the leg elevated and in the -- you know, confined in the brace and on the wheelchair. But I assume that's probably the way he'll see -- we'll let you know more tomorrow.

Q What time is Primakov?

MR. MCCURRY: Primakov is -- I think we're pushing it in the afternoon.

Q Mike, how long will he need the wheelchair?

DR. DE MAIO: Probably not that long. I imagine just -- I'd be surprised if he's using it by the end of the week, because he's really making excellent progress. It's really so he can get around and get upstairs and get to know his surroundings. But he's not going to need it very long.

Q Will it go to Helsinki with him? And is it a motorized wheelchair?

DR. DE MAIO: Oh, it is not a motorized wheelchair. He absolutely doesn't need that. That's usually for people who have lung or heart problems where they can't get up the steam, so to speak, or they have a problem with the muscles in their upper extremities. And he's perfectly healthy. He just has a disability right now with the healing leg, so he doesn't need motor --

Q Will it go to Helsinki, the wheelchair?

DR. DE MAIO: Yes, we just -- you know, he's going to this meeting and we want him to move safely. And there are certain transfer points that are just more safely accomplished in a wheelchair. And when he can be fully independent with crutches in Helsinki, he will be. For example, I'm sure in the hotel environment where some of these meetings are, there is really no reason for a wheelchair and I doubt very much he's going to want to use it.

Q Mike, yesterday you said you didn't know yet about scheduling after that, for the California trip and Mexico. Is that still the case? Can you give us any sense of the likelihood or unlikelihood of that?

MR. MCCURRY: My sense is we will probably postpone the California trip. I don't know that we've decided that a hundred percent yet, but most of the --

Q What about generally on the road? He's got a lot of travel coming up over the next couple of months. This is probably going to crimp his style somewhat, even on the way through to Latin America?

MR. MCCURRY: I think that's safe to say -- safe to say we are going to be -- we will not be able to do nearly the number and types of things that he would want to do in Mexico or in Latin America or when he goes back to Europe or --

Q Did he have recreational activities that were planned as part of that --

MR. MCCURRY: Well, he always enjoys his jog in the morning and I think that we had tried to work out a way that he could do some sightseeing, too. And I think some of that will be circumscribed, but we'll have to let you know more as we plan the schedule. And, of course, one of the things we'll have to do as White House staff is to conduct the proper kind of advance and take into account whatever the President's physical needs are.

Q Is he still planning to go?

Q How large will the medical staff be that's going on this trip? How many physical therapists and how --

MR. MCCURRY: It will be our standard size, augmented by two, right?

DR. MARIANO: Augmented by -- Dr. De Maio is going to go and then our physical therapist.

MR. MCCURRY: There will be an additional physical therapist and Dr. De Maio will also go as a member of the team to sort of supplement the standard complement we would have from the White House Medical Unit for an oversees trip.

Q So that's three or four -- three, four?

MR. MCCURRY: It depends, because it changes from site to site sometimes. But it's a point to make. I think you need to remind your readers and viewers that the President does, by law, have access to very good, quality health care all the time. That's one of the things that we, the American people, provide our President. And he's in a fortunate circumstance because his plane is equipped with a good medical facility and he has access to good, immediate medical attention wherever he is.

Q Mike, President Yeltsin, who apparently is in fine fettle, gave an interview to a Finnish newspaper -- apparently it came out today -- in which he said that moving of NATO to the borders of Russia is "absolutely unacceptable." Does the White House have a position on that and how will you respond to that when he tells you that?

MR. MCCURRY: The President is aware of that report. The Russian Federation has for some time made it clear that they have concern and anxieties about the enlargement of NATO. That has been a chief feature of our dialogue between our countries. We have continued to say that our interest in an expanded NATO is in the interests of an undivided, peaceful European continent that we believe is also in the interests of the Russian Federation.

But President Clinton is well prepared to deal directly with President Yeltsin on this issue, as he has already in the past, as they have in their exchanges of correspondence and in the diplomatic dialogue we've had at other levels. This was a chief subject of the conversations yesterday between Foreign Minister Primakov and Secretary Albright. And the whole concept that we have of our discussions between NATO and the Russian Federation, as we go through this historic period of enlargement, is to make that process of expansion nonthreatening in the eyes of the Russian people. It has to be seen, we believe, in the eyes of the Russian people as something that will increase their security, not threaten their existence.

Q Mike, where did the van come from that the President rode from the hospital back to the White House?

MR. MCCURRY: I think we hustled up one on the side. I'm actually not sure. They were hunting around trying to find that.

DR. MARIANO: I think it's Brady's.

MR. MCCURRY: Really?

DR. MARIANO: Yes, Brady. We borrowed it from Brady. He lent his van to us.

MR. MCCURRY: I think, according to Dr. Mariano, we borrowed it from James Brady. Another useful contribution made by press secretaries past. (Laughter.) Maybe erase some of the other contributions made by press secretaries past.

Q Mike, two questions. One, can the President, with his wheelchair, fit into the usual bulletproof limousine? Or what are they going to do about that?

MR. MCCURRY: Will you guys check that? That's an interesting point.

We'll check and see. I don't really want to comment on -- we routinely do not comment on what type of security arrangements we have for the President. But I'm sure the Secret Service will look carefully at it and make sure that he travels in well-protected circumstances.

Q Mike, in taking his national security briefing --about the deteriorating situation, not just in Albania, but also in Zaire and the towns that are falling, seemingly --

MR. MCCURRY: Our government has been following very carefully the fighting in and around Kisangani -- continue to urge the rebel factions to implement a cease-fire and to begin discussions with Mobutu's government that could restore some calm to that region in Eastern Zaire. It has been very difficult to get the factions to agree to discussions that would implement a cease-fire, even though there have been strenuous international efforts led by the government of South Africa, assisted by the United Nations, assisted by the United States government and by others -- the French and other central African republics.

We will continue to work this problem diplomatically because it is quite dire. The refugee flows in and around eastern Zaire have accelerated in recent weeks and we're quite concerned.

Q Mike, some of your republican interlocutors around the Sunday talk shows today, talking about campaign financing and other issues --

MR. MCCURRY: -- say anything that made sense? (Laughter.)

Q Orrin Hatch says the White House knew in 1995 about alleged Chinese funneling of contributions.

MR. MCCURRY: Well, if he is certain of that, his information is contrary to what has been communicated to me and contrary to what I've briefed you. I've made it quite clear to you that the circumstances under which we received a briefing in June of 1996, where that information went and where it did not go. And I suspect that this is another case of a senator hyperventilating on a Sunday talk show.

But if he has information or knowledge, factual knowledge of that, he should come forth and produce it.

Q Arlen Specter wants an investigation of the delinking of MFN from human rights considerations in 1994.

MR. MCCURRY: I don't know that you'd need to investigate something that was about as transparent a process as has existed in our government. The circumstances under which MFN was reviewed and was a subject of public dialogue and discourse, a constant feature of our diplomacy raised in just about every meeting we had with the Chinese side throughout 1993 and '94 and '95. It continues to be a subject of our bilateral discussions. And the strong concern that business and private sector interests have in the United States on that has been well documented because they speak quite openly and publicly about it.

So that sounds like a case of investigating something that's already public knowledge, which is a questionable use of resources.

Q Mike, Senator Daniel Patrick Moynihan, not a Republican --

MR. MCCURRY: Happy birthday, Senator Moynihan, 70 years old today.

Q -- was also on the Sunday talk shows today and said flat out that he, who has also been briefed by the FBI on the China question, did not believe the claim that the NSC people were told not to brief higher-ups. And when asked to explain how this could happen, he said maybe they just weren't doing their job well. Is there any thought of disciplinary action against --

MR. MCCURRY: I don't have anything to add to what I've told you in the past on this. The Attorney General has said what she has said. We've said here at the White House that we are looking at exactly the circumstances of that briefing and we are. And as soon as I have something to report on the review that Mr. Ruff and Mr. Berger are conducting, I can report back to you.

Q Mike, the 30-day arbitration report is due on the American Airlines dispute, I believe, in the morning. Is that something that will go to the President, or will the Vice President be handling that now?

MR. MCCURRY: Mr. Lindsey has been following the deliberations very carefully and I'll have to check and see. He will either -- I'm sure he will give an update here to other White House staffers, including Mr. Bowles, who also inquired about it last week. But I'm sure the President and the Vice President will at least want to know where they are and how the presidential board has been doing with the parties.

Q Is the report in house now or is it due tomorrow?

MR. MCCURRY: Not to my knowledge is it here yet, but we will check and see. It would be conveyed through Mr. Lindsey, no doubt.

Q I wonder if I could ask Dr. Mariano a question. The President is well known to have a healthy appetite and to rely on things like jogging and golf to keep his weight under control. Is he going to have to change his diet?

DR. MARIANO: He's very concerned about that, because he did not want to gain weight. I think I had read somewhere -- correct me if -- you take a healthy runner who runs routinely and you break their legs, they gain, what, 27 pounds in one year. And we do not want that to happen and he does not want that to happen.

So we're really going to look at closely what he eats, what people give him to eat -- (laughter) -- because they like to give him nice things to eat because they like him so much. And we're going to really -- he said, we need to limit what I take in. So I'm going to have a really bad reputation. I will be the enforcer in the White House. You're all going to hate me, but I'm just going to say no.

And we're also going to supplement with some exercise. They've got an exercise program set up for him. You probably have a couple of suggestions.

MR. MCCURRY: Yes, do you want to do that?

DR. MARIANO: We talked about the exercise with him.

MR. MCCURRY: I just want to say, let's put it this way, breakfast on the way down consisted of granola, strawberries, bananas and skim milk. (Laughter.)

DR. DE MAIO: I didn't pick that. He liked it.

You know, like a lot of things that happen to people in life, they'll take kind of a bad opportunity or an accident to make something good happen out of it. You know, when life gives you lemons, make lemonade. And we and his medical team are going to take this opportunity to help him out and get a different type of training regimen for him. We'd like to see him do some cross training and add some things besides these impact activities, like running. And I know he's a real basketball fan.

So when he's able, we're going to get him in the pool and get him swimming and doing some water aerobics. His therapist, LTJG Paco, is an expert in hydrotherapy and we are going to rely heavily on her. I have a particular interest in rehabilitation and so we will be employing state of the art rehab kinds of exercises. People out there will know what I mean, but closed-chain type exercises, leg presses, squatting, biking, Nordic Track, Stairmaster. So he's got that to look forward to.

Before then, we're going to use upper extremity strengthening and training and upper extremity cycle and weights and rubber bands. So when he's not answering questions from you all about affairs of state, he'll be working out.

MR. MCCURRY: Dr. De Maio, maybe if you want to comment on this -- right underneath the seats here in the press room there's a perfectly lovely swimming pool that used to be used by President John F. Kennedy, who did the backstroke as he read speech drafts, and President Roosevelt used it for his own hydrotherapy.

Would you comment on the utility of maybe removing the reporters from the room -- (laughter) -- since they will quickly shoot back at us that we already behave sometimes like we're under water as it is.

Q Mike, I don't mean to be too redundant on this, but just to go back to Jerry's question --

MR. MCCURRY: Redundancy is the norm of the day here.

Q Exactly. You can say that again. (Laughter.)

MR. MCCURRY: You can say that again. You can say that again. (Laughter.)

Q But it did seem a little weird -- your version that Erskine and the NSC presented this to him as a done deal -- look, we've made this decision. Are you really saying that he --

MR. MCCURRY: No, I had said that -- I mean, they began putting in motion the changes this morning. Of course they checked --

Q But he ultimately approved it. We've got this idea of the delay; he said fine.

MR. MCCURRY: If they had told him this morning that, by the way, we're going to do this, and he had said, no, I don't want to do that, I want to go on Tuesday, I insist on going Tuesday, we would have had to revisit that session and then we would have spent this entire briefing saying, why did the President overrule everyone that advised him to postpone it a day. I mean, let's use a little common sense here.

Q Mike, can you tell us how much -- or maybe one of the doctors -- how much of the equipment is already in place or what of the things that you mentioned do you have to bring in and where are you getting it from?

MR. MCCURRY: Some of it's already here.

DR. MARIANO: He's got a weight room already upstairs, third floor.

DR. DE MAIO: The White House is really well equipped. I was over here yesterday with LTJG Paco, and the only thing that we're really going to bring in is an upper extremity cycle. And the weights and most of the other equipment is already here. And so we really don't have to augment that much.

Q Where will he do water activities?

DR. DE MAIO: There's a hydropool and then, of course, there's the outdoor pool. So we're hoping that the weather changes. If it doesn't, we'll look into a pool somewhere else or, as Mr. McCurry says, just take the floor up.

MR. MCCURRY: Just kidding. We won't do that. (Laughter.)

DR. DE MAIO: I'm sorry.

MR. MCCURRY: Let's close it out.

Q Just by way of budget, Pete Domenici and others are ratcheting up the rhetoric in budget season again. Do you think it's really going to -- the comity is breaking down on good will on budget talks?

MR. MCCURRY: No, to the contrary. We've had good discussions with Senator Domenici. He indicated today that he intends to put forward a Republican alternative budget. And I think that takes a certain amount of courage on his part because it means that he has to address all the same budget issues the President addressed when the President submitted his balanced budget proposal.

And we said all along that rather than just sitting there and sniping at the President's budget, if the Republicans have different ideas they should come forward, put them together, lay it before the American people so that we can debate the preferences the American people might have as it comes to addressing budget questions. So in that sense, Senator Domenici's step is a good one and we will engage with him, talk further with him about his ideas, compare his proposed budget to that of the President, encourage other members of Congress to engage fully with us on the budget.

We're interested in talking to anyone in the Congress that wants to balance the budget by 2002. That's the President's goal. The President, I think, has some of the same frustrations that Senator Domenici has -- that we haven't made more progress more quickly in achieving what is one of the President's primary goals for this year.

So we will look forward to working with Senator Domenici and see if we can't move the budget debate forward.

Q When do you think you might cut a deal?

MR. MCCURRY: It depends. If more people want to engage directly with the President and begin to address the serious issues that have to be resolved before we get a balanced budget agreement, we believe it could be sooner rather than later.

Q Thank you.

MR. MCCURRY: He said optimistically, ending a long, long briefing.

END 1:20 P.M. EST