Bourne knew he didn't have to convince Carter of the virtues of curing disease. The former president had grown up in rural South Georgia, one of the most backward regions of the United States, where it was routine to see sores on the skin of pellagra-stricken sharecroppers; Carter understood the relationship between stigma and sickness, the circular way one keeps leading to the other. But there are a lot of illnesses in the world that bedevil poor people, and unlike Guinea worm, some of them afflict Americans. So Bourne sold Carter on fighting the Guinea worm by pointing out that only one disease in history has ever been completely eradicated: smallpox. That coup had been less a matter of science than a massive engineering enterprise, a medical Manhattan Project. Guinea worm, Bourne said, could be the world's second eradicated disease. All that would be required for Carter to achieve such a rare and glorious victory was a sustained organizational effort — the kind of undertaking certain to appeal to an engineering graduate, U.S. Naval Academy, Class of '47. With that, Bourne had his man.
The first personal trait most people would think to describe in Carter is motivation, how much stamina he can summon of himself to defeat a problem over a sustained period. His college sport at the Naval Academy was cross-country, and until his knees failed him in his seventies, he continued to run long distances. "I was a fanatic runner," he tells me. "Forty miles a week for a long time." What made Carter well suited to the sport also explains his aptitude for long-term projects, the way patience and impatience play at useful tension in him. He is always thinking about the distant finish. As a politician, Carter seemed to thrive on being underestimated. He was inevitably the long-shot candidate who campaigned so tenaciously that he simply wore down his better-known opponents. (In his 1970 run for Georgia governor, he shook 600,000 hands and visited, he claimed, every factory gate in Georgia.) During his presidency, his greatest achievement was the Camp David Accords, the historic framework for peaceful relations between Israel and Egypt that was negotiated over 12 days in September 1978, and which succeeded only because Carter shuttled back and forth between the Egyptian president Anwar Sadat and the Israeli prime minister Menachem Begin, staying up deep into the night, refusing to allow them to quit, singing Israeli folk songs with Begin's delegation, refereeing moments of stalemate and outrage, inexorably coaxing them toward an agreement. In the end, when Sadat and Begin raised their arms in joint accomplishment, it was Carter's unexpected victory.
It has been the same way with Guinea worm. Today, a quarter-century after Carter took up the cause and began deploying platoons of volunteers across the world, only 1,700 cases of Guinea worm are thought to still exist, most of them somewhere out in the vast Southern Sudan bush. "Village by village, like chewing on a rock, we make progress," is how Carter describes the process. Once I hear him use this phrase, it seems so perfectly to express Carter himself that for a long time afterward, whenever I think of him, I imagine a man with a chunk of shale in his mouth, biting down hard.
Before heading out into the bush to visit a remote village, Carter meets with a group of health officials and volunteers at the U.S. consulate in Juba. Nothing energizes Carter more than a good Guinea-worm meeting, and this one is full of PowerPoint presentations and meticulous reports from in-country. Carter sits at the head of the table, listening to health workers who have emerged from the field, taken long showers and put on their best clothes to meet the former president and describe what they need from him to finish the job. They look like campaign volunteers, and they have the same all-in passion for the cause — they are sure that Guinea worm will be totally eradicated by 2012, if there is no more war in the region. "We will get there!" one of them declares.
The torrent of infrastructure data and case-reduction figures Carter is absorbing brings to mind the president whose appetite for briefing-book minutiae was such that his CIA director Stansfield Turner says he once approached Carter to bring him up to speed on world food supplies, only to discover that his boss had already memorized the figures for wheat production per hectare in places like Afghanistan and India. Donald Hopkins, a leading epidemiologist who helped eliminate smallpox and now directs health programs at the Carter Center, compares the former president to Jack Webb, the relentless detective from the old TV show Dragnet. "Just the facts," Hopkins says. "He wants the bottom line, and you can't bluff him."
Listening to the health workers in Juba, Carter offers praise and encouragement, although in limited doses. He has never been much for approbation. "Every sort of compliment you get from him is hard not to take," is the delicate way that Bert Lance, his closest White House adviser, puts it. Carter's two great mentors in life were his father, a businessman and land owner, and the Navy admiral Hyman Rickover, who created the country's nuclear submarine program and chose Carter to take part in it. Their mutual way of nurturing Carter was not to say anything about his performance unless they found it lacking. Carter's response, according to Rafshoon, was to become a person who is "always wanting to prove it to somebody."
The conference room at the consulate has cold soft drinks and dishes full of fresh macadamia nuts, and the surrounding compound includes a swimming pool where Carter can complete his daily regimen of at least 40 lengths. But atop the exterior walls are spikes of barbed wire, and a sign on the exit gate warns those heading out to vary their transit routes and never to travel without a cellphone. Encountering Carter in such a setting, it is difficult not to think of the Iranian hostage crisis of 1979, the event that abruptly alerted Americans that they were now as vulnerable as everyone else. That November, Islamic students stormed the U.S. Embassy compound in Tehran, holding 52 hostages captive for the final 444 days of Carter's presidency. Carter himself became a prisoner of the predicament, growing so obsessed with the hostages that for months on end he remained in the Oval Office, refusing to light the national Christmas tree or campaign for re-election. His inability to make a band of flag-burning militants in a small nation bend to our will enraged an electorate whose desire to see America as an indefatigable force in the world prevented them from finding virtue in a dogged president whose determination to wait the situation out, in the end, brought every hostage back alive.
At home, Americans were also becoming increasingly familiar with an economic indicator known as the Misery Index. Oil shortages led to an "energy crisis," double-digit inflation and high unemployment. Carter responded by appointing Paul Volcker to lead the Federal Reserve. Volcker, he knew, would raise interest rates, creating a counterbalancing recession. There would be many months of economic pain, and then, well after the presidential election in November 1980, there would be relief. Stuart Eizenstat, who served as Carter's chief domestic policy adviser, remembers him making the Volcker decision. "He said, 'Inflation can't be my legacy. We must choke inflation out. I've tried everything else.' If that's weak and ineffectual, I don't understand the definition. He took the worst medicine. It was like chemotherapy. He hoped it would work. Otherwise comes death. It worked. Volcker rightly gets the economic credit. But Carter should get the political credit."
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