Dr. Frist makes change in a political prescription
WASHINGTON -- Last week, the medical establishment welcomed home a long-lost friend, Bill Frist, the Senate majority leader and a noted heart-transplant surgeon. The occasion was Frist's surprise endorsement of a bill that would approve federal funds for new lines of stem cells using frozen embryos discarded by fertility clinics. Frist's backing was especially noteworthy because it represented a very rare break with the White House.
The Juvenile Diabetes Research Foundation, like many other medical groups, thanked ''Dr. Frist" for his ''critically important support of a bill that could benefit science and, more importantly, the millions of Americans fighting life-threatening diseases."
For Frist, almost certain to be a candidate for president in 2008, it was a return to his natural medical constituency after a long, strange trip to the heart of the religious right. Frist's journey has included a politically disastrous intervention in the Terri Schiavo right-to-die case and a dramatic attempt to change Senate filibuster rules to clear the way for more socially conservative judges. The filibuster imbroglio ended with one of Frist's 2008 rivals, Senator John McCain, Republican of Arizona, announcing a statesmanlike compromise, while Frist stood flummoxed on the Senate floor.
Presidential ambitions have driven many candidates to seek strange bedfellows, but the most awkward dances usually occur in the months leading up to elections. With three years to go, Frist's attempt to become the favored candidate of the religious right seemed especially cynical. And the miscasting was obvious to everyone: It was like Tom Hanks donning a kilt and trying to play the lead in ''Braveheart."
The scion of a wealthy Tennessee family whose holdings included the for-profit Hospital Corporation of America, now Columbia/HCA, Frist was trained as a surgeon at Harvard Medical School, Massachusetts General Hospital, Southampton General Hospital in England, and Stanford University Medical Center, before going home to Tennessee's Vanderbilt Medical Center.
Frist has presented this elite trajectory as his version of George H. W. Bush's move from stuffy Connecticut to the free-wheeling oil industry in Texas: Frist has said he fled Harvard because its approach to medicine was too cautious and he could do more challenging work at Vanderbilt.
Frist certainly has a yen for medical research. Like many sons of privileged families, Frist sees few boundaries to his possibilities. Unlike many sons of the privileged, he is a hard worker who burns as hot as any self-made man.
Sometimes he is too hot. In 1989, before launching his political career, he acknowledged in a book that he had regularly adopted cats from a Boston animal shelter, pretending to make them his pets, and then used them for medical experiments that killed them.
Frist's experimentation on cats, for which he has apologized, is not going to help him with any voters. But his zealous commitment to medical research, combined with his expertise in health policy (which he studied at Princeton University's Woodrow Wilson School), and his demonstrated concern for public health around the world, put him at the vanguard of one of the most important issues of this era: healthcare.
His knowledge of life-and-death issues made his efforts to prevent Schiavo's husband from removing her feeding tube stand out. When an autopsy found that court-appointed doctors were correct in saying Schiavo was in a persistent vegetative state, Frist came in for the harshest criticism of any of the politicians who had questioned that diagnosis.
Such Republican Schiavo interventionists as the House majority leader, Tom DeLay of Texas, Senator Rick Santorum of Pennsylvania, and Governor Jeb Bush of Florida have each made passionate, religious fervor about the right to life a part of their political personas. Frist came to Washington under a different flag. His intervention in the Schiavo case was so out of character that it drew suspicion from the religious right and fury from the medical establishment.
When Frist broke with the president over stem-cell research last week, Washington political observers began buzzing for an explanation. At one time, Frist had hoped to inherit the Bush political machine if Jeb Bush did not run for president.
Perhaps Frist's failure to break the Senate logjam blocking some of the president's agenda had soured his relationship with the White House. Perhaps Bush's advisers were looking too fondly at another potential presidential aspirant, Senator George Allen of Virginia, the son of a football coach who reliably follows the White House line, without any of Frist's complications.
Most likely, Frist realized that if he is going to move to the next level, he will have to do it his own way. It is an important lesson for anyone in public life.
Peter S. Canellos is the Globe's Washington bureau chief. National Perspective is his weekly analysis of events in the capital and beyond. 
