CHAPTER FIFTEEN
Autumn of a President
President Yeltsin’s fourth proven heart attack, on June 26, 1996, was the most invasive to date and came on the heels of indication after indication that he was at the end of his rope.1 The consilium of ten physicians watching over him during the campaign had sent a letter to Aleksandr Korzhakov on May 20 warning of “changes of a negative character” in his state of health, the result of “the mounting burdens on him, physically and emotionally,” and of his sleep allotment dwindling to three or four hours a night. “Such a work regimen poses a real threat to the health
The second inauguration, on August 9, was low-key, in contrast to July 1991. Plans for another inaugural address went by the boards. The event was moved indoors into the Kremlin Palace of Congresses instead of Cathedral Square, in the sunlight. Onstage, looking pudgy but frail, Yeltsin swore the oath in forty-five seconds, his hand on a bound copy of the constitution and his eyes on a teleprompter primed to help him notice the pauses. The speaker of the upper house of parliament, Yegor Stroyev, slipped the presidential chain of office around his neck.4 It was done within sixteen minutes:
Knowing his condition, Boris Yeltsin was extremely nervous. But once awareness set in that it was all behind him, that he been installed in office again, it was as if he had gotten a second wind. After the official ceremony, attendees at the state reception were surprised to see quite a different person. He entered the hall briskly, made a brief but animated toast, and even chatted up several guests. After about a half hour, he left. It was obvious to everyone who witnessed the official start to Yeltsin’s second presidential term that the ill-health of the leader was now a basic factor in Russian politics.5
On July 16 Yeltsin appointed Anatolii Chubais, his campaign mastermind, as presidential chief of staff, sending Nikolai Yegorov, a political soulmate of the demoted Korzhakov, back to Krasnodar as governor.6 The press dubbed Chubais Russia’s “regent.” For prime minister, Yeltsin stayed with the old pro Viktor Chernomyrdin, whom the State Duma confirmed uncomplainingly on August 10.
The theme of the next half year was apolitical—Yeltsin’s fight for elementary survival and recovery. Injections of a clot-dissolving drug eased unstable angina in July. After the induction, a battery of tests, beginning with the coronary angiogram he had refused in 1995 (an X-ray of the heart arteries, using iodized liquid), was done at the Moscow Cardiology Center. German surgeons tapped by Helmut Kohl advised from afar that the Russians consider an arterial bypass and have it done abroad. The conferences with the family were awkward, as Yevgenii Chazov, the director of the Moscow center, was the one who, as USSR health minister, had supervised Yeltsin’s care on behalf of the Politburo after the 1987 secret speech. Some of the medicos feared Yeltsin would not withstand a multiple bypass operation and were hopeful he could get away with balloon angioplasty. Chazov thought the risk was “colossal” but Yeltsin had to chance it.7 The blood ejection fraction from the left ventricle, a standard index of operating efficiency, was 22 percent; a healthy person’s is 55 to 75 percent. Without an intervention, Chazov and his deputies gauged the life expectancy of someone with these symptoms to be one and a half to two years. The choice, they told the family, was either bypass surgery or curtailment of Yeltsin’s activities to several hours a day and an end to most exertion and travel—diminution from governing president to a figurehead.
Yeltsin was apprehensive of the dangers of open-heart surgery and the loss of control it would entail. His daughter Tatyana took Sergei Parkhomenko, the editor of the newsmagazine
