The mayor checked into Mercy Hospital a bit before 9:00 a.m. on Friday, November 8. He'd risen with the sun, as always, and dragged his wife Teresa (a self-described night person who can barely function before noon) with him to 8:00 a.m. mass and then to Room 6139 at Mercy, where a nurse attached to his left forearm a tube connected to a plastic bag filled with one liter of potassium chloride in water. The salt solution prepares the mayor's body for the dosage of chemicals that he must take every three weeks for the next year. "This is to dilate my veins," he says matter-of-factly, "so that they'll be ready to accept the poison."
Today Clark will undergo his third chemotherapy treatment since October, when he discovered that the stomach pains he was suffering portended something more serious than the ulcers he suspected. The treatment for the cancer, which started in his esophagus and has spread to his stomach, will last all day. The mayor brought his pajamas, as instructed, in case he gets woozy and must stay the night. But Clark is wearing his street clothes: charcoal-gray slacks. Black suspenders. The kind of green-and-blue short-sleeve silk shirt that can only be worn in the tropics, a pack of Salems in the left breast pocket. The pajamas remain tucked in a black leather bag in a corner of the Spartan room.
The sixth floor of Mercy's main building is devoted to cancer patients. The mayor's room faces Key Biscayne, and as he lies on his back with a blanket covering his legs, he can see the Cigarette boats skimming across the gold and blue ripples of the bay. Teresa, the mayor's long-time companion who he married in August, lounges on a recliner near the window, scanning Ann Landers's column and struggling to stay awake. Lael Schumacher, Clark's top political aide, sits in another chair by the window, watching The Price Is Right out of the corner of his eye and chatting about the rumors that the mayor is soon to resign.
Rumors are an accepted part of Miami politics. "I've always told my staff you don't listen to rumors, you listen to facts," says Willy Gort, who, as the chairman of the Downtown Development Authority, was called upon to open the Brickell bridge in the mayor's absence. The dominant rumor of the past few weeks has Clark resigning after the new year and Miriam Alonso winning the vacated post. (According to the city charter, if the mayor were to resign, or to die while in office, commissioners would have ten days to appoint a successor, by majority vote. Should they deadlock, a special election would be held.) Alonso, a former city commissioner, lost in the 1993 mayoral election that returned Clark to city government after twenty years spent serving Dade County. Another rumor scenario has the popular Gort ascending to the mayor's post while a politician handpicked by Alonso and newly elected commissioner Joe Carollo -- probably Humberto Hernandez -- assumes Gort's commission seat.
The common denominator of all the rumors is that the mayor is going to resign. His poor health is so widely accepted that Schumacher has been inundated with phone calls from friends expressing condolences. "Things were so bad rumorwise that our office received 60 calls in one day about the mayor's health," he mutters. "It was just outrageous."
Clark was perturbed enough by the rumors to address the matter at the December 7 city commission meeting. Looking fit, his slick hair dyed a new shade of copper, he spoke forcefully, lashing out at his detractors. "I would like to disprove and silence those comments that, without any known authority, are speculating about my health and political future," he declared. "I'll be your mayor until God and the people decide otherwise."
The remarks put Alonso on the defensive; she promptly scribbled a letter to Clark denying any involvement in the rumors: "I join you on the record in denouncing such despicable conduct and call for the absolute cessation of further comments on the state of your health and your ability to carry on your mayoral duties."
Lying on his narrow hospital bed, Clark expresses doubt about Alonso's sincerity. "Why would she send a letter unless she was behind it?" he asks. "That's an admission of guilt if I ever heard one." Teresa turns down the volume on the TV so her husband can better make his point. "It's jealousy. A lot of people want to be in the mayor's position."
Clark should know. He has been in the mayor's position, in one form or another, since 1968. The 72-year-old Kansas native, who arrived in Miami soon after the Depression forced his family to migrate in search of work, was elected to the Miami City Commission in 1963 and rose to the top office after then-mayor Robert King High died suddenly. He has held the title of mayor either at the city or county ever since, with the exception of two years in the early Seventies when he lost the Metro mayorship to Jack Orr. When Orr died in office, Clark became county mayor and served until the position was abolished in 1993.
Her husband, Teresa Clark explains, has enjoyed such longevity in office because he possesses an unrivaled ability to focus. In the months preceding an election, he stops reading the papers and watching TV, lest the media distract him from his objective. "That's a tip on how to win," she says with a sly smile. In his race against Alonso, such focus helped Clark overcome his reputation as the "marshmallow mayor," a man comfortable with the ceremonial functions of the office but incapable of leading Dade County into the future. And that same focus is what Clark is relying on now for a different sort of longevity: his own. "Ninety percent of sickness is in your head anyway," he said during the November 3 press conference at which he disclosed his illness. "This is not my first bout with this. I had prostate cancer five years ago and I beat that. I'll beat this, too."
Each day for 35 straight days back in 1990, Clark's lower torso was bombarded with radiation. "I had no problems with that. I came through that fine," he boasts now. He came through the political repercussions just as well. "The last time I was running they also said I was sick. It's in poor taste," the mayor grumbles.
At a few minutes before noon a nurse enters, carrying a brown plastic bag emblazoned with red radioactive-waste symbols. She removes from the IV stand a small pouch that had contained dextrose but is now flattened and wrinkled. She pulls a rattan chair over to the bed and retrieves from the plastic bag a fluid-filled syringe the size of a turkey baster and attaches the syringe tip to a tube connected to the IV needle. Gradually depressing the plunger, she takes exactly ten minutes to drain the syringe, which is filled with Decadron, a steroid that will ease the pain of the upcoming poisons.
"How are we doing?" the mayor asks in a strong voice.
"We're doing just fine," the nurse replies, not looking up from her watch. She drops the empty syringe into the hazardous-waste bag and pulls out a second, smaller container of a clear liquid called #5 Fluorouracil, which she attaches to the IV and again slowly administers. Figuratively speaking, the body needs four types of bricks to build DNA, the nucleic acid by which cells reproduce. Fluorouracil denies the body one type of brick. Cell growth stops altogether, thereby, presumably, preventing the spread of cancer.
Ten minutes later, the nurse repeats the process with mitomycin, an antibiotic anti-cancer drug and the final toxin in Clark's cocktail. "How are we doing?" the mayor repeats as the nurse puts away the final vial. It is not a question filled with anxiety. Assuring him that everything is fine, she leaves so the doctor can have a look. Dr. Jim Hirschman, who has been Clark's physician since 1974, is so comfortable with his patient that he spends the first five minutes of the visit talking about the boat trip he took over the weekend. A sturdy and handsome man with a lively interest in disaster mitigation, the doctor pulls from a folder a few engraved illustrations that ran in a London newspaper back in the 1850s. A hurricane had struck the Bahamas, and these old pictures were what England saw of the destruction. Clark admires the pictures and notes that Miami was not even a city at this point. Dr. Hirschman takes back the drawings and smiles.
"I'm rattling on and on about the pictures because how can we talk about an illness that is hardly there?" Hirschman muses. "How are you feeling?"
"Fine. I feel fine," replies Clark. "I am eating again. Plenty of Manhattan clam chowder. I go down to Monty's. I have fish sticks or fried grouper. And cheeses, milk. Lots of protein."
"So things are pretty normal. That's wonderful," the doctor beams. He rubs his hands across Clark's belly the way a baker might massage bread dough. "I see that your cholesterol level is up to 269. That's not a dangerous level but it lets me know that you are eating." He pauses, then runs his hand through his buzz-cut white hair. "You look good, man," he says, smiling broadly. "You look good."
Later, outside the room, the doctor explains that the chemotherapy will probably spoil Clark's appetite for the next two or three days, but that is about all Clark should expect in the way of side effects. Some people lose their hair because of the treatment, but the mayor hasn't lost his. "To those of us who know him, he seems even more magnificent," Dr. Hirschman comments. "I know I can't really use that word, but he remains completely focused on conquering the disease. He's doing well. Even better than some might have expected." The doctor adds that after the one-year course of treatment, surgery might still be necessary to remove any cancerous growth that persists.
The stomach is one of the deadliest places that cancer can strike. From there, cancer cells can move with relative ease into the rest of the body. Though Clark says his cancer has not spread to his lungs or liver, the chances of long-term survival aren't great, according to Dr. William Ganz, an associate professor of clinical radiology at the University of Miami School of Medicine. "Basically stomach cancer has a poor prognosis. It would be surprising to me if he lasted more than one year."
At 6:00 p.m., Clark receives a final small bag of intravenous dextrose. When the bag shrivels, the IV is removed. The mayor is discharged at 7:30 p.m. As anticipated, the pajama precaution has proven unnecessary. Later, Schumacher reports that the mayor felt good all weekend, though some side effects kicked in on Monday, making him tired and cranky. Schumacher expects the sluggishness to pass. "He's coming through in good colors," the aide announces. "He's still eating. Everything is just fine.