فصل 16

CHAPTER 16

OUR FIRST SPRING IN THE WHITE HOUSE arrived early. By mid-March, the air had softened and the days grown longer. As the weather warmed, the South Lawn became almost like a private park to explore. There were acres of lush grass ringed by massive, shady oaks and elms and a tiny pond tucked behind the hedges, with the handprints of presidential children and grandchildren pressed into the paved pathway that led to it. There were nooks and crannies for games of tag and hide-and-go-seek, and there was even a bit of wildlife—not just squirrels and rabbits but a red-tailed hawk that a group of visiting fourth graders had named Lincoln and a slender, long-legged fox that could sometimes be spotted at a distance in the late afternoon and occasionally got bold enough to wander down the colonnade.

Cooped up as we’d been through the winter, we took full advantage of the new backyard. We had a swing set installed for Sasha and Malia, near the swimming pool and directly in front of the Oval Office. Looking up from a late afternoon meeting on this or that crisis, I might glimpse the girls playing outside, their faces set in bliss as they soared high on the swings. We also set up a couple of portable basketball hoops on either end of the tennis courts, so that I could sneak out with Reggie for a quick game of H-O-R-S-E and the staff could play interoffice games of five-on-five.

And with the help of Sam Kass, as well as the White House horticulturalist and a crew of enthusiastic fifth graders from a local elementary school, Michelle planted her garden. What we expected to be a meaningful but modest project to encourage healthy eating ended up becoming a genuine phenomenon, inspiring school and community gardens across the country, attracting worldwide attention, and generating so much produce by the end of that first summer—collards, carrots, peppers, fennel, onions, lettuce, broccoli, strawberries, blueberries, you name it—that the White House kitchen started donating crates of spare vegetables to the local food banks. As an unexpected bonus, a member of the groundskeeping crew turned out to be an amateur beekeeper, and we gave him the okay to set up a small hive. Not only did it end up producing more than a hundred pounds of honey a year, but an enterprising microbrewer in the Navy Mess suggested that we could use the honey in a beer recipe, which led to the purchase of a home brew kit and made me the first presidential brewmaster. (George Washington, I was told, made his own whiskey.) But of all the pleasures that first year in the White House would deliver, none quite compared to the mid-April arrival of Bo, a huggable, four-legged black bundle of fur, with a snowy-white chest and front paws. Malia and Sasha, who’d been lobbying for a puppy since before the campaign, squealed with delight upon seeing him for the first time, letting him lick their ears and faces as the three of them rolled around on the floor of the residence. It wasn’t just the girls who fell in love either. Michelle spent so much time with Bo—teaching him tricks, cradling him in her lap, sneaking him bacon—that Marian confessed to feeling like a bad parent for never having given in to Michelle’s girlhood wish for a family dog.

As for me, I got what someone once described as the only reliable friend a politician can have in Washington. Bo also gave me an added excuse to put off my evening paperwork and join my family on meandering after-dinner walks around the South Lawn. It was during those moments—with the light fading into streaks of purple and gold, Michelle smiling and squeezing my hand as the dog bounded in and out of the bushes with the girls giving chase, Malia eventually catching up to us to interrogate me about things like birds’ nests or cloud formations while Sasha wrapped herself around one of my legs to see how far I could carry her along—that I felt normal and whole and as lucky as any man has a right to expect.

Bo had come to us as a gift from Ted and Vicki Kennedy, part of a litter that was related to Teddy’s own beloved pair of Portuguese water dogs. It was an incredibly thoughtful gesture—not only because the breed was hypoallergenic (a necessity due to Malia’s allergies) but also because the Kennedys had made sure that Bo was housebroken before he came to us. When I called to thank them, though, it was only Vicki I could speak with. It had been almost a year since Teddy was diagnosed with a malignant brain tumor, and although he was still receiving treatment in Boston, it was clear to everyone—Teddy included—that the prognosis was not good.

I’d seen him in March, when he’d made a surprise appearance at a White House conference we held to get the ball rolling on universal-healthcare legislation. Vicki had worried about the trip, and I’d understood why. Teddy’s walk was unsteady that day; his suit barely fit after all the weight he’d lost, and despite his cheerful demeanor, his pinched, cloudy eyes showed the strain it took just to hold himself upright. And yet he’d insisted on coming anyway, because thirty-five years earlier the cause of getting everyone decent, affordable healthcare had become personal for him. His son Teddy Jr. had been diagnosed with a bone cancer that led to a leg amputation at the age of twelve. While at the hospital, Teddy had gotten to know other parents whose children were just as ill but who had no idea how they’d pay the mounting medical bills. Then and there, he had vowed to do something to change that.

Through seven presidents, Teddy had fought the good fight. During the Clinton administration, he helped secure passage of the Children’s Health Insurance Program. Over the objections of some in his own party, he worked with President Bush to get drug coverage for seniors. But for all his power and legislative skill, the dream of establishing universal healthcare—a system that delivered quality medical care to all people, regardless of their ability to pay—continued to elude him.

Which is why Ted Kennedy had forced himself out of bed to come to our conference, knowing that while he could no longer lead the fight, his brief but symbolic presence might have an effect. Sure enough, when he walked into the East Room, the hundred and fifty people who were present erupted into cheers and lengthy applause. After opening the conference, I called upon him to speak first, and some of his former staffers could be seen tearing up at the sight of their old boss rising to speak. His remarks were short; his baritone didn’t boom quite as loudly as it used to when he’d roared on the Senate floor. He looked forward, he said, to being “a foot soldier” in the upcoming effort. By the time we’d moved on to the third or fourth speaker, Vicki had quietly escorted him out the door.

I saw him only once more in person, a couple of weeks later, at a signing ceremony for a bill expanding national service programs, which Republicans and Democrats alike had named in his honor. But I would think of Teddy sometimes when Bo wandered into the Treaty Room, his head down, his tail wagging, before he curled up at my feet. And I’d recall what Teddy had told me that day, just before we walked into the East Room together.

“This is the time, Mr. President,” he had said. “Don’t let it slip away.”

—

THE QUEST FOR some form of universal healthcare in the United States dates back to 1912, when Theodore Roosevelt, who had previously served nearly eight years as a Republican president, decided to run again—this time on a progressive ticket and with a platform that called for the establishment of a centralized national health service. At the time, few people had or felt the need for private health insurance. Most Americans paid their doctors visit by visit, but the field of medicine was quickly growing more sophisticated, and as more diagnostic tests and surgeries became available, the attendant costs began to rise, tying health more explicitly to wealth. Both the United Kingdom and Germany had addressed similar issues by instituting national health insurance systems, and other European nations would eventually follow suit. While Roosevelt ultimately lost the 1912 election, his party’s progressive ideals planted a seed that accessible and affordable medical care might be viewed as a right more than a privilege. It wasn’t long, however, before doctors and southern politicians vocally opposed any type of government involvement in healthcare, branding it as a form of bolshevism.

After FDR imposed a nationwide wage freeze meant to stem inflation during World War II, many companies began offering private health insurance and pension benefits as a way to compete for the limited number of workers not deployed overseas. Once the war ended, this employer-based system continued, in no small part because labor unions liked the arrangement, since it enabled them to use the more generous benefit packages negotiated under collective bargaining agreements as a selling point to recruit new members. The downside was that it left those unions unmotivated to push for government-sponsored health programs that might help everybody else. Harry Truman proposed a national healthcare system twice, once in 1945 and again as part of his Fair Deal package in 1949, but his appeal for public support was no match for the well-financed PR efforts of the American Medical Association and other industry lobbyists. Opponents didn’t just kill Truman’s effort. They convinced a large swath of the public that “socialized medicine” would lead to rationing, the loss of your family doctor, and the freedoms Americans hold so dear.

Rather than challenging private insurance head-on, progressives shifted their energy to help those populations the marketplace had left behind. These efforts bore fruit during LBJ’s Great Society campaign, when a universal single-payer program partially funded by payroll tax revenue was introduced for seniors (Medicare) and a not-so-comprehensive program based on a combination of federal and state funding was set up for the poor (Medicaid). During the 1970s and early 1980s, this patchwork system functioned well enough, with roughly 80 percent of Americans covered through either their jobs or one of these two programs. Meanwhile, defenders of the status quo could point to the many innovations brought to market by the for-profit medical industry, from MRIs to lifesaving drugs.

Useful as they were, though, these innovations also further drove up healthcare costs. And with insurers footing the nation’s medical bills, patients had little incentive to question whether drug companies were overcharging or if doctors and hospitals were ordering redundant tests and unnecessary treatments in order to pad their bottom lines. Meanwhile, nearly a fifth of the country lived just an illness or accident away from potential financial ruin. Forgoing regular checkups and preventive care because they couldn’t afford it, the uninsured often waited until they were very sick before seeking care at hospital emergency rooms, where more advanced illnesses meant more expensive treatment. Hospitals made up for this uncompensated care by increasing prices for insured customers, which in turn further jacked up premiums.

All this explained why the United States spent a lot more money per person on healthcare than any other advanced economy (112 percent more than Canada, 109 percent more than France, 117 percent more than Japan) and for similar or worse results. The difference amounted to hundreds of billions of dollars per year—money that could have been used instead to provide quality childcare for American families, or to reduce college tuition, or to eliminate a good chunk of the federal deficit. Spiraling healthcare costs also burdened American businesses: Japanese and German automakers didn’t have to worry about the extra $1,500 in worker and retiree healthcare costs that Detroit had to build into the price of every car rolling off the assembly line.

In fact, it was in response to foreign competition that U.S. companies began off-loading rising insurance costs onto their employees in the late 1980s and ’90s, replacing traditional plans that had few, if any, out-of-pocket costs with cheaper versions that included higher deductibles, co-pays, lifetime limits, and other unpleasant surprises hidden in the fine print. Unions often found themselves able to preserve their traditional benefit plans only by agreeing to forgo increases in wages. Small businesses found it tough to provide their workers with health benefits at all. Meanwhile, insurance companies that operated in the individual market perfected the art of rejecting customers who, according to their actuarial data, were most likely to make use of the healthcare system, especially anyone with a “preexisting condition”—which they often defined to include anything from a previous bout of cancer to asthma and chronic allergies.

It’s no wonder, then, that by the time I took office there were very few people ready to defend the existing system. More than 43 million Americans were now uninsured, premiums for family coverage had risen 97 percent since 2000, and costs were only continuing to climb. And yet the prospect of trying to get a big healthcare-reform bill through Congress at the height of a historic recession made my team nervous. Even Axe—who’d experienced the challenges of getting specialized care for a daughter with severe epilepsy and had left journalism to become a political consultant in part to pay for her treatment—had his doubts.

“The data’s pretty clear,” Axe said when we discussed the topic early on. “People may hate the way things work in general, but most of them have insurance. They don’t really think about the flaws in the system until somebody in their own family gets sick. They like their doctor. They don’t trust Washington to fix anything. And even if they think you’re sincere, they worry that any changes you make will cost them money and help somebody else. Plus, when you ask them what changes they’d like to see to the healthcare system, they basically want every possible treatment, regardless of cost or effectiveness, from whatever provider they choose, whenever they want it—for free. Which, of course, we can’t deliver. And that’s before the insurance companies, the drug companies, the docs start running ads—” “What Axe is trying to say, Mr. President,” Rahm interrupted, his face screwed up in a frown, “is that this can blow up in our faces.”

Rahm went on to remind us that he’d had a front-row seat at the last push for universal healthcare, when Hillary Clinton’s legislative proposal crashed and burned, creating a backlash that contributed to Democrats losing control of the House in the 1994 midterms. “Republicans will say healthcare is a big new liberal spending binge, and that it’s a distraction from solving the economic crisis.” “Unless I’m missing something,” I said, “we’re doing everything we can do on the economy.”

“I know that, Mr. President. But the American people don’t know that.”

“So what are we saying here?” I asked. “That despite having the biggest Democratic majorities in decades, despite the promises we made during the campaign, we shouldn’t try to get healthcare done?”

Rahm looked to Axe for help.

“We all think we should try,” Axe said. “You just need to know that if we lose, your presidency will be badly weakened. And nobody understands that better than McConnell and Boehner.”

I stood up, signaling that the meeting was over.

“We better not lose, then,” I said.

—

WHEN I THINK back to those early conversations, it’s hard to deny my overconfidence. I was convinced that the logic of healthcare reform was so obvious that even in the face of well-organized opposition I could rally the American people’s support. Other big initiatives—like immigration reform and climate change legislation—would probably be even harder to get through Congress; I figured that scoring a victory on the item that most affected people’s day-to-day lives was our best shot at building momentum for the rest of my legislative agenda. As for the political hazards Axe and Rahm worried about, the recession virtually ensured that my poll numbers were going to take a hit anyway. Being timid wouldn’t change that reality. Even if it did, passing up a chance to help millions of people just because it might hurt my reelection prospects…well, that was exactly the kind of myopic, self-preserving behavior I’d vowed to reject.

My interest in healthcare went beyond policy or politics; it was personal, just as it was for Teddy. Each time I met a parent struggling to come up with the money to get treatment for a sick child, I thought back to the night Michelle and I had to take a three-month-old Sasha to the emergency room for what turned out to be viral meningitis—the terror and helplessness we felt as the nurses whisked her away for a spinal tap, and the realization that we might never have caught the infection in time had the girls not had a regular pediatrician we felt comfortable calling in the middle of the night. When, on the campaign trail, I met farmworkers or supermarket cashiers suffering from a bum knee or bad back because they couldn’t afford a doctor’s visit, I thought about one of my best friends, Bobby Titcomb, a commercial fisherman in Hawaii who resorted to professional medical help only for life-threatening injuries (like the time a diving accident resulted in a spear puncturing his lung) because the monthly cost of insurance would have wiped out what he earned from an entire week’s catch.

Most of all, I thought about my mom. In mid-June, I headed to Green Bay, Wisconsin, for the first of a series of healthcare town hall meetings we would hold around the country, hoping to solicit citizen input and educate people on the possibilities for reform. Introducing me that day was Laura Klitzka, who was thirty-five years old and had been diagnosed with aggressive breast cancer that had spread to her bones. Even though she was on her husband’s insurance plan, repeated rounds of surgery, radiation, and chemo had bumped her up against the policy’s lifetime limits, leaving them with $12,000 in unpaid medical bills. Over her husband Peter’s objections, she was now pondering whether more treatment was worth it. Sitting in their living room before we headed for the event, she smiled wanly as we watched Peter doing his best to keep track of the two young kids playing on the floor.

“I want as much time with them as I can get,” Laura said to me, “but I don’t want to leave them with a mountain of debt. It feels selfish.” Her eyes started misting, and I held her hand, remembering my mom wasting away in those final months: the times she’d put off checkups that might have caught her disease because she was in between consulting contracts and didn’t have coverage; the stress she carried to her hospital bed when her insurer refused to pay her disability claim, arguing that she had failed to disclose a preexisting condition despite the fact that she hadn’t even been diagnosed when her policy started. The unspoken regrets.

Passing a healthcare bill wouldn’t bring my mom back. It wouldn’t douse the guilt I still felt for not having been at her side when she took her last breath. It would probably come too late to help Laura Klitzka and her family.

But it would save somebody’s mom out there, somewhere down the line. And that was worth fighting for.

—

THE QUESTION WAS whether we could get it done. As tough as it had been to pass the Recovery Act, the concept behind the stimulus legislation was pretty simple: enable the government to pump out money as fast as it could in order to keep the economy afloat and people employed. The law didn’t take cash out of anyone’s pockets, or force a change in how businesses operated, or discontinue old programs in order to pay for new ones. In the immediate term, there were no losers in the deal.

By contrast, any major healthcare bill meant rejiggering one-sixth of the American economy. Legislation of this scope was guaranteed to involve hundreds of pages of endlessly fussed-over amendments and regulations, some of them new, some of them rewrites to previous law, all of them with their own high stakes. A single provision tucked inside the bill could translate to billions of dollars in gains or losses for some sector of the healthcare industry. A shift in one number, a zero here or a decimal point there, could mean a million more families getting coverage—or not. Across the country, insurance companies like Aetna and UnitedHealthcare were major employers, and local hospitals served as the economic anchor for many small towns and counties. People had good reasons—life-and-death reasons—to worry about how any change would affect them.

There was also the question of how to pay for the law. To cover more people, I had argued, America didn’t need to spend more money on healthcare; we just needed to use that money more wisely. In theory, that was true. But one person’s waste and inefficiency was another person’s profit or convenience; spending on coverage would show up on the federal books much sooner than the savings from reform; and unlike the insurance companies or Big Pharma, whose shareholders expected them to be on guard against any change that might cost them a dime, most of the potential beneficiaries of reform—the waitress, the family farmer, the independent contractor, the cancer survivor—didn’t have gaggles of well-paid and experienced lobbyists roaming the halls of Congress on their behalf.

In other words, both the politics and the substance of healthcare were mind-numbingly complicated. I was going to have to explain to the American people, including those with quality health insurance, why and how reform could work. For this reason, I thought we’d use as open and transparent a process as possible when it came to developing the necessary legislation. “Everyone will have a seat at the table,” I’d told voters during the campaign. “Not negotiating behind closed doors, but bringing all parties together, and broadcasting those negotiations on C-SPAN, so that the American people can see what the choices are.” When I later brought this idea up with Rahm, he looked like he wished I weren’t the president, just so he could more vividly explain the stupidity of my plan. If we were going to get a bill passed, he told me, the process would involve dozens of deals and compromises along the way—and it wasn’t going to be conducted like a civics seminar.

“Making sausage isn’t pretty, Mr. President,” he said. “And you’re asking for a really big piece of sausage.”

—

ONE THING RAHM and I did agree on was that we had months of work ahead of us, parsing the cost and outcome of each piece of possible legislation, coordinating every effort across different federal agencies and both houses of Congress, and all the while looking for leverage with major players in the healthcare world, from medical providers and hospital administrators to insurers and pharmaceutical companies. To do all this, we needed a top-notch healthcare team to keep us on track.

Luckily we were able to recruit a remarkable trio of women to help run the show. Kathleen Sebelius, the two-term Democratic governor from Republican-leaning Kansas, came on as secretary of health and human services (HHS). A former state insurance commissioner, she knew both the politics and the economics of healthcare and was a gifted enough politician—smart, funny, outgoing, tough, and media savvy—to serve as the public face of health reform, someone we could put on TV or send to town halls around the country to explain what we were doing. Jeanne Lambrew, a professor at the University of Texas and an expert on Medicare and Medicaid, became the director of the HHS Office of Health Reform, basically our chief policy advisor. Tall, earnest, and often oblivious to political constraints, she had every fact and nuance of every healthcare proposal at her fingertips—and could be counted on to keep the room honest if we veered too far in the direction of political expediency.

But it was Nancy-Ann DeParle whom I would come to rely on most as our campaign took shape. A Tennessee lawyer who’d run that state’s health programs before serving as the Medicare administrator in the Clinton administration, Nancy-Ann carried herself with the crisp professionalism of someone accustomed to seeing hard work translate into success. How much of that drive could be traced to her experiences growing up Chinese American in a tiny Tennessee town, I couldn’t say. Nancy-Ann didn’t talk much about herself—at least not with me. I do know that when she was seventeen, her mom died of lung cancer, which might have had something to do with her willingness to give up a lucrative position at a private equity firm to work in a job that required even more time away from a loving husband and two young sons.

It seems I wasn’t the only one for whom getting healthcare passed was personal.

Along with Rahm, Phil Schiliro, and deputy chief of staff Jim Messina, who had served as Plouffe’s right hand in the campaign and was one of our shrewdest political operators, our healthcare team began to map out what a legislative strategy might look like. Based on our experiences with the Recovery Act, we had no doubt that Mitch McConnell would do everything he could to torpedo our efforts, and that the chances of getting Republican votes in the Senate for something as big and as controversial as a healthcare bill were slim. We could take heart from the fact that instead of the fifty-eight senators who were caucusing with the Democrats when we passed the stimulus bill, we were likely to have sixty by the time any healthcare bill actually came to a vote. Al Franken had finally taken his seat after a contentious election recount in Minnesota, and Arlen Specter had decided to switch parties after being effectively driven out of the GOP—just like Charlie Crist—for supporting the Recovery Act.

Still, our filibuster-proof head count was tenuous, for it included a terminally ill Ted Kennedy and the frail and ailing Robert Byrd of West Virginia, not to mention conservative Dems like Nebraska’s Ben Nelson (a former insurance company executive) who could go sideways on us at any minute. Beyond wanting some margin for error, I also knew that passing something as monumental as healthcare reform on a purely party-line vote would make the law politically more vulnerable down the road. Consequently we thought it made sense to shape our legislative proposal in such a way that it at least had a chance of winning over a handful of Republicans.

Fortunately we had a model to work with, one that, ironically, had grown out of a partnership between Ted Kennedy and former Massachusetts governor Mitt Romney, one of John McCain’s opponents in the Republican primary for president. Confronting budget shortfalls and the prospect of losing Medicaid funding a few years earlier, Romney had become fixated on finding a way to get more Massachusetts residents properly insured, which would then reduce state spending on emergency care for the uninsured and, ideally, lead to a healthier population in general.

He and his staff came up with a multipronged approach in which every person would be required to purchase health insurance (an “individual mandate”), the same way every car owner was required to carry auto insurance. Middle-income people who couldn’t access insurance through their job, didn’t qualify for Medicare or Medicaid, and were unable to afford insurance on their own would get a government subsidy to buy coverage. Subsidies would be determined on a sliding scale according to each person’s income, and a central online marketplace—an “exchange”—would be set up so that consumers could shop for the best insurance deal. Insurers, meanwhile, would no longer be able to deny people coverage based on preexisting conditions.

These two ideas—the individual mandate and protecting people with preexisting conditions—went hand in hand. With a huge new pool of government-subsidized customers, insurers no longer had an excuse for trying to cherry-pick only the young and healthy for coverage to protect their profits. Meanwhile, the mandate ensured that people couldn’t game the system by waiting until they got sick to purchase insurance. Touting the plan to reporters, Romney called the individual mandate “the ultimate conservative idea” because it promoted personal responsibility.

Not surprisingly, Massachusetts’s Democratic-controlled state legislature had initially been suspicious of the Romney plan, and not just because a Republican had proposed it; among many progressives, the need to replace private insurance and for-profit healthcare with a single-payer system like Canada’s was an article of faith. Had we been starting from scratch, I would have agreed with them; the evidence from other countries showed that a single, national system—basically Medicare for All—was a cost-effective way to deliver quality healthcare. But neither Massachusetts nor the United States was starting from scratch. Teddy, who despite his reputation as a wide-eyed liberal was ever practical, understood that trying to dismantle the existing system and replace it with an entirely new one would be not only a political nonstarter but hugely disruptive economically. Instead, he’d embraced the Romney proposal with enthusiasm and helped the governor line up the Democratic votes in the state legislature required to get it passed into law.

“Romneycare,” as it eventually became known, was now two years old and had been a clear success, driving the uninsured rate in Massachusetts down to just under 4 percent, the lowest in the country. Teddy had used it as the basis for draft legislation he’d started preparing many months ahead of the election in his role as chair of the Senate Health and Education Committee. And though Plouffe and Axe had persuaded me to hold off on endorsing the Massachusetts approach during the campaign—the idea of requiring people to buy insurance was extremely unpopular with voters, and I’d instead focused my plan on lowering costs—I was now convinced, as were most healthcare advocates, that Romney’s model offered us the best chance of achieving our goal of universal coverage.

People still differed on the details of what a national version of the Massachusetts plan might look like, and as my team and I mapped out our strategy, a number of advocates urged us to settle these issues early by putting out a specific White House proposal for Congress to follow. We decided against that. One of the lessons from the Clintons’ failed effort was the need to involve key Democrats in the process, so they’d feel a sense of ownership of the bill. Insufficient coordination, we knew, could result in legislative death by a thousand cuts.

On the House side, this meant working with old-school liberals like Henry Waxman, the wily, pugnacious congressman from California. In the Senate, the landscape was different: With Teddy convalescing, the main player was Max Baucus, a conservative Democrat from Montana who chaired the powerful Finance Committee. When it came to the tax issues that occupied most of the committee’s time, Baucus often aligned himself with business lobbies, which I found worrying, and in three decades as a senator he had yet to spearhead the passage of any major legislation. Still, he appeared to be genuinely invested in the issue, having organized a congressional healthcare summit the previous June and having spent months working with Ted Kennedy and his staff on early drafts of a reform bill. Baucus also had a close friendship with Iowa senator Chuck Grassley, the Finance Committee’s ranking Republican, and was optimistic that he could win Grassley’s support for a bill.

Rahm and Phil Schiliro were skeptical that Grassley was gettable—after all, we’d been down that rabbit hole during the Recovery Act debate. But we decided it was best to let Baucus’s process play itself out. He’d already outlined some of his ideas in the press and would soon pull together a healthcare-reform working group that included Grassley and two other Republicans. During an Oval Office meeting, though, I made a point of warning him not to let Grassley string him along.

“Trust me, Mr. President,” Baucus said. “Chuck and I have already discussed it. We’re going to have this thing done by July.”

—

EVERY JOB HAS its share of surprises. A key piece of equipment breaks down. A traffic accident forces a change in delivery routes. A client calls to say you’ve won the contract—but they need the order filled three months earlier than planned. If it’s the kind of thing that’s happened before, the place where you work may have systems and procedures to handle the situation. But even the best organizations can’t anticipate everything, in which case you learn to improvise to meet your objectives—or at least to cut your losses.

The presidency was no different. Except that the surprises came daily, often in waves. And over the course of the spring and summer of that first year, as we wrestled with the financial crisis, two wars, and the push for healthcare reform, several unexpected items got added to our already overloaded plate.

The first carried the possibility of a genuine catastrophe. In April, reports surfaced of a worrying flu outbreak in Mexico. The flu virus usually hits vulnerable populations like the elderly, infants, and asthma sufferers hardest, but this strain appeared to strike young, healthy people—and was killing them at a higher-than-usual rate. Within weeks, people in the United States were falling ill with the virus: one in Ohio, two in Kansas, eight in a single high school in New York City. By the end of the month, both our own Centers for Disease Control (CDC) and the World Health Organization (WHO) had confirmed that we were dealing with a variation of the H1N1 virus. In June, the WHO officially declared the first global pandemic in forty years.

I had more than a passing knowledge of H1N1 after working on U.S. pandemic preparedness when I was in the Senate. What I knew scared the hell out of me. In 1918, a strain of H1N1 that came to be known as “the Spanish flu” had infected an estimated half a billion people and killed somewhere between 50 and 100 million—roughly 4 percent of the world’s population. In Philadelphia alone, more than 12,000 died in the span of a few weeks. The effects of the pandemic went beyond the stunning death tolls and shutdown of economic activity; later research would reveal that those who were in utero during the pandemic grew up to have lower incomes, poorer educational outcomes, and higher rates of physical disability.

It was too early to tell how deadly this new virus would be. But I wasn’t interested in taking any chances. On the same day that Kathleen Sebelius was confirmed as HHS secretary, we sent a plane to pick her up from Kansas, flew her to the Capitol to be sworn in at a makeshift ceremony, and immediately asked her to spearhead a two-hour conference call with WHO officials and health ministers from Mexico and Canada. A few days later, we pulled together an interagency team to evaluate how ready the United States was for a worst-case scenario.

The answer was, we weren’t at all ready. Annual flu shots didn’t provide protection against H1N1, it turned out, and because vaccines generally weren’t a moneymaker for drug companies, the few U.S. vaccine makers that existed had a limited capacity to ramp up production of a new one. Then we faced questions of how to distribute antiviral medicines, what guidelines hospitals used in treating cases of the flu, and even how we’d handle the possibility of closing schools and imposing quarantines if things got significantly worse. Several veterans of the Ford administration’s 1976 swine flu response team warned us of the difficulties involved in getting out in front of an outbreak without overreacting or triggering a panic: Apparently President Ford, wanting to act decisively in the middle of a reelection campaign, had fast-tracked mandatory vaccinations before the severity of the pandemic had been determined, with the result that more Americans developed a neurological disorder connected to the vaccine than died from the flu.

“You need to be involved, Mr. President,” one of Ford’s staffers advised, “but you need to let the experts run the process.”

I put my arm around Sebelius’s shoulders. “You see this?” I said, nodding her way. “This…is the face of the virus. Congratulations, Kathleen.”

“Happy to serve, Mr. President,” she said brightly. “Happy to serve.”

My instructions to Kathleen and the public health team were simple: Decisions would be made based on the best available science, and we were going to explain each step of our response to the public—including detailing what we did and didn’t know. Over the course of the next six months, we did exactly that. A summertime dip in H1N1 cases gave the team time to work with drugmakers and incentivize new processes for quicker vaccine production. They pre-positioned medical supplies across regions and gave hospitals increased flexibility to manage a surge in flu cases. They evaluated—and ultimately rejected—the idea of closing schools for the rest of the year, but worked with school districts, businesses, and state and local officials to make sure that everyone had the resources they needed to respond in the event of an outbreak.

Although the United States did not escape unscathed—more than 12,000 Americans lost their lives—we were fortunate that this particular strain of H1N1 turned out to be less deadly than the experts had feared, and news that the pandemic had abated by mid-2010 didn’t generate headlines. Still, I took great pride in how well our team had performed. Without fanfare or fuss, not only had they helped keep the virus contained, but they’d strengthened our readiness for any future public health emergency—which would make all the difference several years later, when the Ebola outbreak in West Africa would trigger a full-blown panic.

This, I was coming to realize, was the nature of the presidency: Sometimes your most important work involved the stuff nobody noticed.

—

THE SECOND TURN of events was an opportunity rather than a crisis. At the end of April, Supreme Court justice David Souter called to tell me he was retiring from the bench, giving me my first chance to fill a seat on the highest court in the land.

Getting somebody confirmed to the Supreme Court has never been a slam dunk, in part because the Court’s role in American government has always been controversial. After all, the idea of giving nine unelected, tenured-for-life lawyers in black robes the power to strike down laws passed by a majority of the people’s representatives doesn’t sound very democratic. But since Marbury v. Madison, the 1803 Supreme Court case that gave the Court final say on the meaning of the U.S. Constitution and established the principle of judicial review over the actions of the Congress and the president, that’s how our system of checks and balances has worked. In theory, Supreme Court justices don’t “make law” when exercising these powers; instead, they’re supposed to merely “interpret” the Constitution, helping to bridge how its provisions were understood by the framers and how they apply to the world we live in today.

For the bulk of constitutional cases coming before the Court, the theory holds up pretty well. Justices have for the most part felt bound by the text of the Constitution and precedents set by earlier courts, even when doing so results in an outcome they don’t personally agree with. Throughout American history, though, the most important cases have involved deciphering the meaning of phrases like “due process,” “privileges and immunities,” “equal protection,” or “establishment of religion”—terms so vague that it’s doubtful any two Founding Fathers agreed on exactly what they meant. This ambiguity gives individual justices all kinds of room to “interpret” in ways that reflect their moral judgments, political preferences, biases, and fears. That’s why in the 1930s a mostly conservative Court could rule that FDR’s New Deal policies violated the Constitution, while forty years later a mostly liberal Court could rule that the Constitution grants Congress almost unlimited power to regulate the economy. It’s how one set of justices, in Plessy v. Ferguson, could read the Equal Protection Clause to permit “separate but equal,” and another set of justices, in Brown v. Board of Education, could rely on the exact same language to unanimously arrive at the opposite conclusion.

It turned out that Supreme Court justices made law all the time.

Over the years, the press and the public started paying more attention to Court decisions and, by extension, to the process of confirming justices. In 1955, southern Democrats—in a fit of pique over the Brown decision—institutionalized the practice of having Supreme Court nominees appear before the Senate Judiciary Committee to be grilled on their legal views. The 1973 Roe v. Wade decision focused further attention on Court appointments, with every nomination from that point on triggering a pitched battle between pro-choice and anti-abortion forces. The high-profile rejection of Robert Bork’s nomination in the late 1980s and the Clarence Thomas–Anita Hill hearings in the early 1990s—in which the nominee was accused of sexual harassment—proved to be irresistible TV drama. All of which meant that when it came time for me to replace Justice Souter, identifying a well-qualified candidate was the easy part. The hard part would be getting that person confirmed while avoiding a political circus that could sidetrack our other business.

We already had a team of lawyers in place to manage the process of filling scores of lower court vacancies, and they immediately began compiling an exhaustive list of possible Supreme Court candidates. In less than a week, we’d narrowed it down to a few finalists, who would be asked to submit to an FBI background check and come to the White House for an interview. The short list included former Harvard Law School dean and current solicitor general Elena Kagan and Seventh Circuit appellate judge Diane Wood, both first-rate legal scholars whom I knew from my time teaching constitutional law at the University of Chicago. But as I read through the fat briefing books my team had prepared on each candidate, it was someone I’d never met, Second Circuit appellate judge Sonia Sotomayor, who most piqued my interest. A Puerto Rican from the Bronx, she’d been raised mostly by her mom, a telephone operator who eventually earned her nurse’s license, after her father—a tradesman with a third-grade education—died when Sonia was just nine years old. Despite speaking mostly Spanish at home, Sonia had excelled in parochial school and won a scholarship to Princeton. There, her experiences echoed what Michelle would encounter at the university a decade later: an initial sense of uncertainty and displacement that came with being just one of a handful of women of color on campus; the need to sometimes put in extra work to compensate for the gaps in knowledge that more privileged kids took for granted; the comfort of finding community among other Black students and supportive professors; and the realization over time that she was as smart as any of her peers.

Sotomayor graduated from Yale Law School and went on to do standout work as a prosecutor in the Manhattan district attorney’s office, which helped catapult her to the federal bench. Over the course of nearly seventeen years as a judge, she’d developed a reputation for thoroughness, fairness, and restraint, ultimately leading the American Bar Association to give her its highest rating. Still, when word leaked that Sotomayor was among the finalists I was considering, some in the legal priesthood suggested that her credentials were inferior to those of Kagan or Wood, and a number of left-leaning interest groups questioned whether she had the intellectual heft to go toe-to-toe with conservative ideologues like Justice Antonin Scalia.

Maybe because of my own background in legal and academic circles—where I’d met my share of highly credentialed, high-IQ morons and had witnessed firsthand the tendency to move the goalposts when it came to promoting women and people of color—I was quick to dismiss such concerns. Not only were Judge Sotomayor’s academic credentials outstanding, but I understood the kind of intelligence, grit, and adaptability required of someone of her background to get to where she was. A breadth of experience, familiarity with the vagaries of life, the combination of brains and heart—that, I thought, was where wisdom came from. When asked during the campaign what qualities I’d look for in a Supreme Court nominee, I had talked not only about legal qualifications but also about empathy. Conservative commentators had scoffed at my answer, citing it as evidence that I planned to load up the Court with woolly-headed, social-engineering liberals who cared nothing about the “objective” application of the law. But as far as I was concerned, they had it upside down: It was precisely the ability of a judge to understand the context of his or her decisions, to know what life was like for a pregnant teen as well as for a Catholic priest, a self-made tycoon as well as an assembly-line worker, the minority as well as the majority, that was the wellspring of objectivity.

There were other considerations that made Sotomayor a compelling choice. She’d be the first Latina—and only the third woman—to serve on the Supreme Court. And she’d already been confirmed twice by the Senate, once unanimously, making it harder for Republicans to argue that she was an unacceptable choice.

Given my high regard for Kagan and Wood, I was still undecided when Judge Sotomayor came to the Oval Office for a get-to-know-you session. She had a broad, kind face and a ready smile. Her manner was formal and she chose her words carefully, though her years at Ivy League schools and on the federal bench hadn’t sanded away the Bronx accent. I’d been warned by my team not to ask candidates their positions on specific legal controversies like abortion (Republicans on the committee were sure to ask about any conversation between me and a nominee to see if I had applied a “litmus test” in making my choice). Instead, the judge and I talked about her family, her work as a prosecutor, and her broad judicial philosophy. By the end of the interview, I was convinced that Sotomayor had what I was looking for, although I didn’t say so on the spot. I did mention that there was one aspect of her résumé that I found troubling.

“What’s that, Mr. President?” she asked.

“You’re a Yankees fan,” I said. “But since you grew up in the Bronx and were brainwashed early in life, I’m inclined to overlook it.”

A few days later, I announced my selection of Sonia Sotomayor as a Supreme Court nominee. The news was positively received, and in the run-up to her appearance before the Senate Judiciary Committee, I was happy to see that Republicans had trouble identifying anything in the judge’s written opinions or conduct on the bench that might derail her confirmation. Instead, they fastened on two race-related issues to justify their opposition. The first involved a 2008 case in New Haven, Connecticut, in which Sotomayor joined the majority in ruling against a group of primarily white firefighters who’d filed a “reverse discrimination” claim. The second issue concerned a 2001 speech Sotomayor had delivered at the University of California, Berkeley, in which she’d argued that female and minority judges added a much-needed perspective to the federal courts, triggering charges from conservatives that she was incapable of impartiality on the bench.

Despite the temporary dustup, the confirmation hearings proved anticlimactic. Justice Sotomayor was confirmed by a Senate vote of 68–31, with nine Republicans joining all the Democrats except for Teddy Kennedy, who was undergoing treatment for his cancer—about as much support as any nominee was likely to get, given the polarized environment we were operating in.

Michelle and I hosted a reception for Justice Sotomayor and her family at the White House in August, after she was sworn in. The new justice’s mother was there, and I was moved to think what must be going through the mind of this elderly woman who’d grown up on a distant island, who’d barely spoken English when she had signed up for the Women’s Army Corps during World War II, and who, despite the odds stacked against her, had insisted that somehow her kids would count for something. It made me think of my own mother, and Toot and Gramps, and I felt a flash of sorrow that none of them had ever had a day like this, that they were gone before they’d seen what their dreams for me had come to.

Tamping down my emotions as the justice spoke to the audience, I looked over at a pair of handsome young Korean American boys—Sotomayor’s adopted nephews—squirming in their Sunday best. They would take for granted that their aunt was on the U.S. Supreme Court, shaping the life of a nation—as would kids across the country.

Which was fine. That’s what progress looks like.

—

THE SLOW MARCH toward healthcare reform consumed much of the summer. As the legislation lumbered through Congress, we looked for any opportunity to help keep the process on track. Since the White House summit in March, members of my healthcare and legislative teams had participated in countless meetings on the subject up on Capitol Hill, trudging into the Oval at the end of the day like weary field commanders back from the front, offering me reports on the ebb and flow of battle. The good news was that the key Democratic chairs—especially Baucus and Waxman—were working hard to craft bills they could pass out of their respective committees before the traditional August recess. The bad news was that the more everyone dug into the details of reform, the more differences in substance and strategy emerged—not just between Democrats and Republicans but between House and Senate Democrats, between us and congressional Democrats, and even between members of my own team.

Most of the arguments revolved around the issue of how to generate a mix of savings and new revenue to pay for expanding coverage to millions of uninsured Americans. Because of his own inclinations and his interest in producing a bipartisan bill, Baucus hoped to avoid anything that could be characterized as a tax increase. Instead, he and his staff had calculated the windfall profits that a new flood of insured customers would bring to hospitals, drug companies, and insurers and had used those figures as a basis for negotiating billions of dollars in up-front contributions through fees or Medicare payment reductions from each industry. To sweeten the deal, Baucus was also prepared to make certain policy concessions. For example, he promised the pharmaceutical lobbyists that his bill wouldn’t include provisions allowing the reimportation of drugs from Canada—a popular Democratic proposal that highlighted the way Canadian and European government-run healthcare systems used their massive bargaining power to negotiate much cheaper prices than Big Pharma charged inside the United States.

Politically and emotionally, I would’ve found it a lot more satisfying to just go after the drug and insurance companies and see if we could beat them into submission. They were wildly unpopular with voters—and for good reason. But as a practical matter, it was hard to argue with Baucus’s more conciliatory approach. We had no way to get to sixty votes in the Senate for a major healthcare bill without at least the tacit agreement of the big industry players. Drug reimportation was a great political issue, but at the end of the day, we didn’t have the votes for it, partly because plenty of Democrats had major pharmaceutical companies headquartered or operating in their states.

With these realities in mind, I signed off on having Rahm, Nancy-Ann, and Jim Messina (who had once been on Baucus’s staff) sit in on Baucus’s negotiations with healthcare industry representatives. By the end of June, they’d hashed out a deal, securing hundreds of billions of dollars in givebacks and broader drug discounts for seniors using Medicare. Just as important, they’d gotten a commitment from the hospitals, insurers, and drug companies to support—or at least not oppose—the emerging bill.

It was a big hurdle to clear, a case of politics as the art of the possible. But for some of the more liberal Democrats in the House, where no one had to worry about a filibuster, and among progressive advocacy groups that were still hoping to lay the groundwork for a single-payer healthcare system, our compromises smacked of capitulation, a deal with the devil. It didn’t help that, as Rahm had predicted, none of the negotiations with the industry had been broadcast on C-SPAN. The press started reporting on details of what they called “backroom deals.” More than a few constituents wrote in to ask whether I’d gone over to the dark side. And Chairman Waxman made a point of saying he didn’t consider his work bound by whatever concessions Baucus or the White House had made to industry lobbyists.

Quick as they were to mount their high horse, House Dems were also more than willing to protect the status quo when it threatened their prerogatives or benefited politically influential constituencies. For example, more or less every healthcare economist agreed that it wasn’t enough just to pry money out of insurance and drug company profits and use it to cover more people—in order for reform to work, we also had to do something about the skyrocketing costs charged by doctors and hospitals. Otherwise, any new money put into the system would yield less and less care for fewer and fewer people over time. One of the best ways to “bend the cost curve” was to establish an independent board, shielded from politics and special-interest lobbying, that would set reimbursement rates for Medicare based on the comparative effectiveness of particular treatments.

House Democrats hated the idea. It would mean giving away their power to determine what Medicare did and didn’t cover (along with the potential campaign fundraising opportunities that came with that power). They also worried that they’d get blamed by cranky seniors who found themselves unable to get the latest drug or diagnostic test advertised on TV, even if an expert could prove that it was actually a waste of money.

They were similarly skeptical of the other big proposal to control costs: a cap on the tax deductibility of so-called Cadillac insurance plans—high-cost, employer-provided policies that paid for all sorts of premium services but didn’t improve health outcomes. Other than corporate managers and well-paid professionals, the main group covered by such plans were union members, and the unions were adamantly opposed to what would come to be known as “the Cadillac tax.” It didn’t matter to labor leaders that their members might be willing to trade a deluxe hospital suite or a second, unnecessary MRI for a chance at higher take-home pay. They didn’t trust that any savings from reform would accrue to their members, and they were absolutely certain they’d catch flak for any changes to their existing healthcare plans. Unfortunately, so long as the unions were opposed to the Cadillac tax, most House Democrats were going to be too.

The squabbles quickly found their way into the press, making the whole process appear messy and convoluted. By late July, polls showed that more Americans disapproved than approved of the way I was handling healthcare reform, prompting me to complain to Axe about our communications strategy. “We’re on the right side of this stuff,” I insisted. “We just have to explain it better to voters.” Axe was irritated that his shop was seemingly getting blamed for the very problem he’d warned me about from the start. “You can explain it till you’re blue in the face,” he told me. “But people who already have healthcare are skeptical that reform will benefit them, and a whole bunch of facts and figures won’t change that.” Unconvinced, I decided I needed to be more public in selling our agenda. Which is how I found myself in a prime-time press conference devoted to healthcare, facing an East Room full of White House reporters, many of whom were already writing the obituary on my number one legislative initiative.

—

IN GENERAL, I enjoyed the unscripted nature of live press conferences. And unlike the first healthcare forum during the campaign, in which I’d laid an egg as Hillary and John Edwards shined, I now knew my subject cold. In fact, I probably knew it too well. During the press conference, I succumbed to an old pattern, giving exhaustive explanations of each facet of the issue under debate. It was as if, having failed to get the various negotiations involving the bill on C-SPAN, I was going to make up for it by offering the public a one-hour, highly detailed crash course on U.S. healthcare policy.

The press corps didn’t much appreciate the thoroughness. One news story made a point of noting that at times I adopted a “professorial” tone. Perhaps that was why, when the time came for the last question, Lynn Sweet, a veteran Chicago Sun-Times reporter I’d known for years, decided to ask me something entirely off the topic.

“Recently,” Lynn said, “Professor Henry Louis Gates, Jr., was arrested at his home in Cambridge. What does that incident say to you, and what does it say about race relations in America?”

Where to start? Henry Louis Gates, Jr., was a professor of English and Afro-American studies at Harvard and one of the country’s most prominent Black scholars. He was also a casual friend, someone I’d occasionally run into at social gatherings. Earlier that week, Gates had returned to his home in Cambridge after a trip to China and found his front door jammed shut. A neighbor—having witnessed Gates trying to force the door open—called the police to report a possible break-in. When the responding officer, Sergeant James Crowley, arrived, he asked Gates for identification. Gates refused at first and—according to Crowley—called him racist. Eventually Gates produced his identification but allegedly continued to berate the departing officer from his porch. When a warning failed to quiet Gates down, Crowley and two other officers that he’d called for backup handcuffed him, took him to the police station, and booked him for disorderly conduct. (The charges were quickly dropped.) Predictably the incident had become a national story. For a big swath of white America, Gates’s arrest was entirely deserved, a simple case of someone not showing the proper respect for a routine law enforcement procedure. For Blacks, it was just one more example of the humiliations and inequities, large and small, suffered at the hands of the police specifically and white authority in general.

My own guess as to what had happened was more particular, more human, than the simple black-and-white morality tale being portrayed. Having lived in Cambridge, I knew that its police department didn’t have a reputation for harboring a whole bunch of Bull Connor types. Meanwhile, Skip—as Gates was known to his friends—was brilliant and loud, one part W.E.B. Du Bois, one part Mars Blackmon, and cocky enough that I could easily picture him cussing out a cop to the point where even a relatively restrained officer might feel his testosterone kick in.

Still, while no one had been hurt, I found the episode depressing—a vivid reminder that not even the highest level of Black achievement and the most accommodating of white settings could escape the cloud of our racial history. Hearing about what had happened to Gates, I had found myself almost involuntarily conducting a quick inventory of my own experiences. The multiple occasions when I’d been asked for my student ID while walking to the library on Columbia’s campus, something that never seemed to happen to my white classmates. The unmerited traffic stops while visiting certain “nice” Chicago neighborhoods. Being followed around by department store security guards while doing my Christmas shopping. The sound of car locks clicking as I walked across a street, dressed in a suit and tie, in the middle of the day.

Moments like these were routine among Black friends, acquaintances, guys in the barbershop. If you were poor, or working-class, or lived in a rough neighborhood, or didn’t properly signify being a respectable Negro, the stories were usually worse. For just about every Black man in the country, and every woman who loved a Black man, and every parent of a Black boy, it was not a matter of paranoia or “playing the race card” or disrespecting law enforcement to conclude that whatever else had happened that day in Cambridge, this much was almost certainly true: A wealthy, famous, five-foot-six, 140-pound, fifty-eight-year-old white Harvard professor who walked with a cane because of a childhood leg injury would not have been handcuffed and taken down to the station merely for being rude to a cop who’d forced him to produce some form of identification while standing on his own damn property.

Of course, I didn’t say all that. Maybe I should have. Instead, I made what I thought were some pretty unremarkable observations, beginning with the acknowledgment that the police had responded appropriately to the 911 call and also that Gates was a friend, which meant I might be biased. “I don’t know, not having been there and not seeing all the facts, what role race played in that,” I said. “But I think it’s fair to say, number one, any of us would be pretty angry; number two, that the Cambridge police acted stupidly in arresting somebody when there was already proof that they were in their own home; and number three, what I think we know separate and apart from this incident is that there is a long history in this country of African Americans and Latinos being stopped by law enforcement disproportionately.” That was it. I left the evening press conference assuming that my four minutes on the Gates affair would be a brief sidebar to the hour I’d spent on healthcare.

Boy, was I wrong. The next morning, my suggestion that the police had acted “stupidly” led every news broadcast. Police union representatives suggested that I had vilified Officer Crowley and law enforcement in general and were demanding an apology. Anonymous sources claimed that strings had been pulled to get Gates’s charges dropped without a court appearance. Conservative media outlets barely hid their glee, portraying my comments as a case of an elitist (professorial, uppity) Black president siding with his well-connected (mouthy, race-card-wielding) Harvard friend over a white, working-class cop who was just doing his job. In the daily White House press briefing, Gibbs fielded questions on little else. Afterward, he asked whether I’d consider issuing a clarification.

“What am I clarifying?” I asked. “I thought I was pretty clear the first time.”

“The way it’s being consumed, people think you called the police stupid.”

“I didn’t say they were stupid. I said they acted stupidly. There’s a difference.”

“I get it. But…”

“We’re not doing a clarification,” I said. “It’ll blow over.”

The next day, though, it hadn’t blown over. Instead, the story had completely swamped everything else, including our healthcare message. Fielding nervous calls from Democrats on the Hill, Rahm looked like he was ready to jump off a bridge. You would have thought that in the press conference I had donned a dashiki and cussed out the police myself.

Eventually I agreed to a damage-control plan. I began by calling Sergeant Crowley to let him know I was sorry for having used the word “stupidly.” He was gracious and good-humored, and at some point I suggested that he and Gates come visit the White House. The three of us could have a beer, I said, and show the country that good people could get past misunderstandings. Both Crowley and Gates, whom I called immediately afterward, were enthusiastic about the idea. In a press briefing later that day, I told reporters that I continued to believe that the police had overreacted in arresting Gates, just as the professor had overreacted to their arrival at his home. I acknowledged that I could have calibrated my original comments more carefully. Much later I’d learn through David Simas, our in-house polling guru and Axe’s deputy, that the Gates affair caused a huge drop in my support among white voters, bigger than would come from any single event during the eight years of my presidency. It was support that I’d never completely get back.

Six days later, Joe Biden and I sat down with Sergeant Crowley and Skip Gates at the White House for what came to be known as the “Beer Summit.” It was a low-key, friendly, and slightly stilted affair. As I’d expected based on our phone conversation, Crowley came across as a thoughtful, decent man, while Skip was on his best behavior. For an hour or so, the four of us talked about our upbringings, our work, and ways to improve trust and communication between police officers and the African American community. When our time was up, both Crowley and Gates expressed appreciation for the tours my staff had given their families, though I joked that next time they could probably find easier ways to score an invitation.

After they were gone, I sat alone in the Oval Office, reflecting on it all. Michelle, friends like Valerie and Marty, Black senior officials like Attorney General Eric Holder, ambassador to the U.N. Susan Rice, and U.S. trade representative Ron Kirk—we were all accustomed to running the obstacle course necessary to be effective inside of predominantly white institutions. We’d grown skilled at suppressing our reactions to minor slights, ever ready to give white colleagues the benefit of the doubt, remaining mindful that all but the most careful discussions of race risked triggering in them a mild panic. Still, the reaction to my comments on Gates surprised us all. It was my first indicator of how the issue of Black folks and the police was more polarizing than just about any other subject in American life. It seemed to tap into some of the deepest undercurrents of our nation’s psyche, touching on the rawest of nerves, perhaps because it reminded all of us, Black and white alike, that the basis of our nation’s social order had never been simply about consent; that it was also about centuries of state-sponsored violence by whites against Black and brown people, and that who controlled legally sanctioned violence, how it was wielded and against whom, still mattered in the recesses of our tribal minds much more than we cared to admit.

My thoughts were interrupted by Valerie, who poked her head in to check on me. She said that the coverage of the “Beer Summit” had been generally positive, although she admitted to having received a bunch of calls from Black supporters who weren’t happy. “They don’t understand why we’d bend over backward to make Crowley feel welcome,” she said.

“What’d you tell them?” I asked.

“I said the whole thing has become a distraction, and you’re focused on governing and getting healthcare passed.”

I nodded. “And our Black folks on staff…how are they doing?”

Valerie shrugged. “The younger ones are a little discouraged. But they get it. With all you’ve got on your plate, they just don’t like seeing you being put in this position.”

“Which position?” I said. “Being Black, or being president?”

We both got a good laugh out of that.