Pubdate: Mon, 5 Jul 2004 Source: New York Times (NY) Copyright: 2004 The New York Times Company Contact: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Author: Sheryl Gay Stolberg DOCTOR WHO TREATED CHENEY HAS HAD AN ADDICTION PROBLEM WASHINGTON, July 4 - Vice President Dick Cheney's personal doctor, who four years ago declared Mr. Cheney "up to the task of the most sensitive public office" despite a history of heart disease, was battling an addiction to prescription drugs at the time and has recently been dropped from the vice president's medical team, according to officials at the hospital where he practiced. The doctor, Gary Malakoff of George Washington University Medical Center, had treated Mr. Cheney since 1995 and been a prominent spokesman on the vice president's health. He also reviewed the medical records of Vice President Al Gore during the 2000 campaign, but did not see Mr. Gore as a patient. Hospital officials said Sunday that they had known since 1999 of Dr. Malakoff's problem, and that Dr. Malakoff informed the vice president at that time or in 2000. But he was permitted to continue working, they said, while undergoing treatment and monitoring, including urine tests, by an independent board. But in May, when the board concluded that Dr. Malakoff was too impaired to care for patients, he was relieved of his position as director of the medical center's general internal medicine division, they said. He is on leave until September, and could not be reached Sunday for comment. "He's been in a program from very early on, a monitored program," Mr. Cheney's cardiologist, Dr. Jonathan Reiner, said of Dr. Malakoff. "He has not treated the vice president at any time - or any patient - when the committee monitoring him has felt that he should not be working. And he has not withheld this information from the vice president." Mr. Cheney's spokesman, Kevin Kellems, confirmed in a statement on Sunday that Dr. Malakoff was no longer treating the vice president. Mr. Cheney has suffered four heart attacks, most recently in November 2000, just months after Dr. Malakoff pronounced him "in excellent health.'' It was Mr. Cheney's first heart attack since 1988. Mr. Kellems said on Sunday: "The results of the vice president's most recent routine comprehensive checkup were very good. He was advised by his physicians that there is no health issue that would interfere with his running for re-election or holding office for a second term." The news of Dr. Malakoff's problem with addiction was first reported on Sunday in The New Yorker. On Sunday, the provost of the medical center, Dr. John Williams - himself a patient of Dr. Malakoff's - said that he believed Dr. Malakoff's addiction problem had been resolved several years ago and that he did not know there was a continuing problem. He said he was "having a dialogue with my colleagues'' to learn how it had been handled. "I was completely unaware,'' Dr. Williams said. "As far as I knew he was under treatment, he was being monitored and things were fine.'' But Dr. Williams said he was "out of the loop,'' in part because federal patient confidentiality rules protected the privacy of Dr. Malakoff, who was considered a patient while undergoing treatment. At the same time, he said, he never raised the issue directly with Dr. Malakoff. "It was a conversation I was not going to open up with him," Dr. Williams said, "mainly because I didn't know if he knew that I knew." According to The New Yorker, which reviewed sealed records of Dr. Malakoff's 2002 divorce, including pharmacy records, Dr. Malakoff spent at least $46,238 on Internet purchases of a narcotic nasal spray, Stadol, and other medications during a two-and-a-half-year period that ended in December 2001. A person close to the divorce proceedings said hospital officials were presented with the information in 2001. But Dr. Alan Wasserman, who is Dr. Malakoff's immediate supervisor and had the most direct responsibility for monitoring his care, said he was unaware of the Internet purchases. Dr. Wasserman said that in 1999, either a pharmacist or another doctor informed him that Dr. Malakoff had been writing prescriptions under the name of one of his colleagues. He said he referred Dr. Malakoff to two psychiatrists for evaluation, and that they in turn suggested he be enrolled in a program run by the Medical Society of the District of Columbia. The society helped Dr. Malakoff get treatment, Dr. Wasserman said, and required him to submit to urine tests on a continuing basis. When the society determined that Dr. Malakoff was not fit to see patients, he took leave from work, Dr. Wasserman said. He, Dr. Reiner and Dr. Williams all said they saw no evidence that Dr. Malakoff's judgment was impaired while he was caring for patients. "No one has undergone as much scrutiny as Dr. Malakoff by the D.C. Medical Society," Dr. Wasserman said. - --- MAP posted-by: Larry Seguin