Mary Alice Cisneros pulled her Jeep Cherokee into a parking lot in downtown San Antonio and scanned the crowd of teenagers emerging from a school bus with unseasonably studious looks on their faces. Although it was a hot July day, the kids had just come from class: an eight-week college-level course meant to prepare them for distant careers in math, engineering, and science.
After a few moments, Mary Alice’s son, John Paul, crossed the lot and greeted her with good news. “I made 105 on the egg project,” he said. John Paul was supposed to build a box in which an egg could withstand being dropped four stories. And, amazingly, the box worked.
“But how could you get 105, not just 100?” Mary Alice asked.
“I don’t know, Mom,” he replied. “I suppose it’s rare for the egg to survive the drop. What can I say?”
Like the egg, John Paul is miraculously intact, and he’s busily planning his life with that knowledge. At fourteen, he is at that wonderful phase between childhood and adolescence, before boys begin to resist their mother’s fawning. He is of medium height and build and has dark eyes, an angular head with close-cropped hair, and fine features. But the thing you notice most about him is the matter-of-fact way he talks about his brushes with death.
“I can’t remember not knowing that I was born with a heart defect,” he tells me. “I’ve never really worried about it too much. Everybody dies at some point. I just knew that I might die early. But I didn’t die. And now my heart is well enough. I’m fixed.”
That said, the hole in the center of his body remains the primary window through which he and his family view the world. The night before, John Paul and his father, former San Antonio mayor Henry Cisneros, spent an hour sitting at the kitchen table of their home on the West Side, talking about Aldous Huxley’s Brave New World. To Henry, the message of the novel was that the notion of utopia—a place where crime, poverty, and disease are wiped out—is a nightmare. “In such a world, individuals outside the norm—in other words, people born with heart defects—are diminished,” he told John Paul. “In that kind of world, individuals don’t count.”
Not so, John Paul countered: “In such a world, my defect would have been corrected by scientists before I was even born. But the novel is about how stability crushes creativity.”
Yet as his parents have learned the hard way in the past fourteen years, stability is an illusion, and the world requires more bravery than they ever imagined.
A few hours after John Paul was born, on June 10, 1987, doctors informed his father that the five-pound, fourteen-ounce infant had four major birth defects. At that moment, he became a major character in the ever-evolving Cisneros drama.
Henry’s rise and fall has been likened to everything from Shakespearean drama to Greek tragedy. The more apt frame of reference, however, is Mexican American. In the map of his imagination, Henry is pulled in two directions: north to America, where intelligence and hard work are rewarded and there are no limits to success; and south to Mexico, a land of perpetual defeats and unfulfilled fantasies.
Part of the story unfolded in the public arena, as Henry struggled to deal with the fallout from a six-year, $15 million federal investigation into his now-infamous affair with his chief fundraiser, Linda Medlar, and whether he’d told the FBI the truth about it. (Although Henry paid a fine of $10,000 and pleaded guilty to one misdemeanor count of lying, and although Bill Clinton pardoned him, the special prosecutor has yet to close the case.) Offstage, however, is where the decisive elements of the plot played out: in hospital corridors in San Antonio, Washington, D.C., and Philadelphia, where he and Mary Alice were forced to rely on each other, and medical science, to save their son. “Everyone thought the great crisis in my life was the loss of my political standing,” Henry says. “The real crisis was always John Paul. He has been the centering force in my life and in Mary Alice’s life. Frankly, it took something as big as his problems to remind me of what’s really important.”
“It had been a very difficult pregnancy,” recalls Mary Alice, who was 37 at the time. The amniocentesis indicated she was carrying a healthy boy. But in the thirtieth week, she began to bleed, and her doctor sent her to bed. Six and a half weeks later, she started bleeding heavily and having contractions. She was taken by ambulance to Methodist Hospital, where her son was delivered by cesarean section one month early, on the day before his father turned 40. Henry and their daughters, Teresa and Mercedes, were in the delivery room. A few hours later, he addressed reporters and announced the boy’s name just in time for the ten o’clock news: John Paul Anthony Cisneros (“John Paul” for the pope, who was coming to San Antonio in a few months, and “Anthony” for the city’s namesake saint).
After talking to the press, Henry met with a group of doctors in a conference room. They told him that there was something seriously wrong with John Paul’s heart, that he did not have a spleen, that his stomach was inverted, and that other organs were out of place. “All I remember is that their language was so oblique,” Henry says. Finally he came to understand that at some age, John Paul’s heart would be unable to meet the demands of his body. It was long after midnight when he left the hospital. The night was as dark as any in his memory.
The next morning Henry returned to the hospital and told Mary Alice about John Paul’s heart defect. She turned her face to her pillow and began to cry. “Let me rest,” she said. Later that day they went to the neonatal unit, where John Paul’s slightly jaundiced body lay under a warmer and an oxygen tent. He was connected to various machines, including a device that monitored his heart, and he was being fed through an intravenous tube. Still, when Henry placed his index finger near John Paul’s tiny hand, the infant grabbed hold of it. “He has a nice firm grip,” Henry told Mary Alice.
“My God,” she thought. “We need a miracle.”
John paul stayed in the hospital for ten days, long enough for his doctors to define his condition. Instead of the normal four chambers, it turned out his heart had only two. “Let’s go to Houston and get him a heart transplant,” Mary Alice said. But John Paul’s circulatory system was also damaged. The left ventricle had the internal configuration of the right, which decreased its ability to pump all the blood back through his body.
On June 21, the day John Paul left the hospital, Henry and Mary Alice stopped at Sacred Heart Church to have him baptized. They were afraid to delay the service for fear he might not live. Afterward, Henry, Mary Alice, John Paul, the girls, and a pack of reporters walked the short block to the Cisneros house. “May health, happiness, and holiness happen in the house,” said Archbishop Patrick Flores, of San Antonio, during a blessing that took place in the doorway and was later shown on the news.
Even in the hothouse that is San Antonio, where politicians are routinely elevated to folk heroes, the media coverage of John Paul’s health crisis seems, in retrospect, a little much. But Henry had so thoroughly blurred the line between private and public that it seemed perfectly natural at the time. It came off as not at all strange, for instance, when Henry allowed lighting equipment and stylists to be brought into his home for an afternoon so that photographer James McGoon could shoot him and his ailing four-week-old son for the cover of the September 1987 Texas Monthly.
By late summer Henry had become an authority on John Paul’s condition. He had telephoned cardiologists all over the world, studied medical textbooks, and learned to sketch the peculiarities of John Paul’s heart. Through letters from parents of children with similar problems, Henry found out about two specialists in Philadelphia who had experience in treating children with complex heart defects. He arranged to take John Paul there in October.
The intervening months were grim. Henry sought comfort and support from Linda Medlar, Mary Alice from a small group of Christian friends who rallied around her. “I was terrified of losing John Paul,” she says. “Henry and I were like Jack and Jill, rolling down the hill as fast as we could.” Everything seemed to be coming apart. In August, when Lieutenant Governor Bill Hobby announced he would not run for governor, Henry told reporters he wouldn’t be a candidate either, and he began to reconcile himself to the fact that he wouldn’t seek a fifth term as mayor. On September 13 Pope John Paul II made his long-awaited visit to San Antonio. Henry, wracked with guilt about his affair, and Mary Alice, draped in a black veil, took John Paul for a private blessing from the Holy Father.
In October, for the first time, there was finally cause for optimism. Henry and Mary Alice took John Paul to Philadelphia for two days of extensive tests, then met with John Murphy, a pediatric cardiologist, and William Norwood, a surgeon who had invented a number of procedures for congenital heart defects, including the one that afflicted John Paul. “We can fix this,” Norwood told them. “What do you mean?” asked Henry, who was flabbergasted but instantly buoyed. The doctors explained two possible approaches: One was to reconstruct the heart from the inside and create four working chambers that would perform the functions of a normal heart; the other was to repair the heart’s routing system, a simpler procedure. “We told them we might be able to restore the heart function,” Murphy recalls. “It helped that John Paul had all the components and two well-preserved ventricles.” They added that while the operation could be done at any time, allowing John Paul to grow a little older and stronger would make him a better candidate for surgery. Henry and Mary Alice were told to take John Paul home and watch for signs of trouble: clubby toes and fingers, blue lips and nail beds, fatigue and coughing.
Although their marriage had been damaged by the Medlar affair, Henry and Mary Alice were unified over John Paul. “I found that when it came right down to it, I couldn’t leave her to deal with such a big problem,” Henry says. Separately, Mary Alice tells me, “Our problems were difficult but compared to the situation John Paul faced, they were secondary. We pulled together to give him the best chance. Ultimately, we saw a lot of good in each other.”
When John Paul was old enough to talk, he often asked why he had to take so much medicine. “Because you’re special,” his mother said. “Because this is what you have to do to stay healthy,” his father said. He also asked if he was going to die. “Not if we can help it,” his father said. “We all live in God’s hands, John Paul,” his mother said.
In January 1993, after Bill Clinton nominated Henry to be the Secretary of Housing and Urban Development, the family moved to Washington, D.C. Mary Alice enrolled John Paul in kindergarten at a public bilingual elementary school. Some of Mary Alice’s happiest memories are of the Easter egg hunts at Hickory Hill, Ethel Kennedy’s compound. The Cisneros family was always invited, and one year she sat on a hill and watched Attorney General Janet Reno go down a rope swing with Henry and John Paul not far behind.
The heart surgery was scheduled for late July 1993. When they arrived at the Children’s Hospital of Philadelphia, Mary Alice and Henry were beginning to feel at peace. He carried John Paul in his arms to the door of the operating suite and handed him over to the eight doctors and nurses who would rebuild his heart over the next two and a half hours. To hear John Paul describe the procedure, you’d think it was as simple as building a drainage project on the West Side. “Dr. Norwood built a septum, which is like a wall that made my two-chamber heart into a regular four-chamber heart,” he says. “Then he had to create some valves for pumping and do a little more rerouting.” As Norwood himself told Henry and Mary Alice, the surgery stabilized John Paul’s heart and its circulatory system. “None of us knows the future, of course,” he said, “but the basic fix is in.” Ten days later John Paul left the hospital and came home to Washington. Except for being more susceptible to colds while he was regaining his strength after surgery, John Paul was soon back in school, playing soccer and baseball.
In 1996 the Cisneros family moved to Los Angeles, where Henry had taken a job as the president of Univision, the nation’s largest Spanish-language television network. They bought a large house in Bel-Air Crest, and John Paul lived the kid version of the California dream. He played on a baseball team with the children of movie stars, skateboarded on the Santa Monica Pier, went to beach parties. At St. Paul the Apostle Catholic School, on L.A.’s West Side, he studied hard but was a real cutup in class and made many friends.
Then, in April 1999, he developed a complication. When he exercised too much, his lips and nail beds turned blue. By then Norwood and Murphy had moved to the Alfred I. DuPont Hospital for Children in Wilmington, Delaware. Soon Henry, Mary Alice, and John Paul were on their way there. As it turned out, a large anomalous vein was draining into the pulmonary venous atrium of his heart, reducing his oxygen efficiency. The surgery took place on a Friday and was performed by a doctor named John W. Moore. The plan had been to close off the large vein by inserting two small metal devices, but the procedure was only partially successful. The doctors told Henry and Mary Alice to come back in six weeks and try again. “There’s another option,” John Paul chimed in. “Let’s just stay here now and try again.” The following Tuesday, Murphy operated for a second time—and it worked. John Paul has been free of health problems ever since.
John paul loved living in L.A., so he was sorry when his parents announced last August that the family was relocating back to San Antonio. “How can you do this to me?” he asked his father. “I don’t want to leave.” By then, however, Mary Alice was ready to come home. She wanted her son to grow up and go to school on the West Side, where she and Henry had grown up. And, sure enough, John Paul adjusted to the move quickly. He has just finished the seventh grade at St. Anthony’s Catholic School, where he made the honor roll. In the evenings he and his father play basketball at Sacred Heart Church. He’s learning to drive. Next up—well, down the road—is medical school. “I want to train as a pediatric cardiologist,” he tells me. “I saw other kids die in the hospital. I figure there’s a reason I lived.”
What he doesn’t want is for his father to go into politics again, although he knows the pressure is intense. “I don’t want my dad to get hurt,” he says. “He’s been hurt enough.”
“Well, we’ll cross that bridge when we come to it,” Mary Alice says, sounding very much like a woman who has seen her share of unlikely comebacks.
