His medical issues, and his tendency not to look after them, dated back decades. The tonsil infection and rheumatic fever at UPI, when Yeltsin refused the bed rest prescribed, foretold a tendency to slight doctor’s orders, on the assumption that exercise and self-command would see him through. “I take risks with my health,” he said in one of his books, “because I rely heavily on my body’s [strength]. I do not always take special care of myself.”90 In June 1992 he had his first comprehensive physical examination since 1987. A bulletin signed by a consilium of five doctors pronounced his health good and noted “the staying power of the patient.”91 Yeltsin’s complaints over the next several years were mostly minor, in particular, backache (for which he had an arthroscopic procedure in September 1993), sciatic inflammation of nerves in the legs, and the nasal condition. But his haggard visage and no-shows fueled often scurrilous speculation. The movie director El’dar Ryazanov, who interviewed him in April 1993 and in two sessions in November, found him changed over the seven months. Courtly in April, Yeltsin was perspiring, puffy-eyed, and “programmed” in November and lugged “an enormous burden of guilt” over political developments. Midway through the first November session, he had to interrupt it for a catnap, informing Ryazanov that he was now in the habit of sleeping in the daytime.92 By 1994 Moscow insiders were using the alias Dedushka— Grandpa, or the Old Man—in chitchat about him.
It emerged that the principal problem was cardiovascular illness. Yeltsin is known to have experienced angina pectoris, ascribable to ischemic deterioration of blood flow to the heart, in September–October 1991, January 1992, and September 1994. On the last occasion, on September 30, 1994, he ruffled diplomatic feathers when he was a no-show for a meeting with the Irish prime minister, Albert Reynolds, at an airport layover in Shannon. After Berlin, one month before, the world press ascribed it to drinking, which had indeed triggered the incident. First Deputy Premier Oleg Soskovets greeted Reynolds in Yeltsin’s place. Yeltsin apologized to Reynolds on October 6, saying he had overslept. He was sensitive to those who made fun of his excuse.93 In 1995 his symptoms reached life-threatening dimensions in a rapid-fire sequence of three heart attacks in six months: the first two (on July 10 and October 26) reported in the Russian media, the third (in late December) unreported.94 He was laid up after each in the TsKB, the government’s premier hospital, in southwest Moscow, spending a total of six weeks there and seven in the sanatorium at Barvikha. At the TsKB in October–November, he for the first time did government business out of a hospital bed for a considerable period. From now on, there would be an ambulance in his motorcade.
Aging, the wear and tear of a lifetime, the high-fat diet common in Russia and the former Soviet Union, and the acute pressures of governing in a decade of troubles made Yeltsin an excellent candidate for the disease. His burning of the candle at both ends made him even more vulnerable. Although he cut back his alcohol intake after Berlin, he was not consistently abstinent. The day of his first coronary, says Korzhakov, he had marked Mikhail Barsukov’s appointment as chief of the Federal Security Service, part of the post-Budënnovsk purge, by sharing two liters of sugary Cointreau liqueur with Barsukov.95 Yevgenii Chazov, the former health minister and head of Russia’s best cardiology hospital, and a consultant on the Yeltsin case, says the patient’s willfulness helped bring on the next crisis. “He decided to show that all the prattle about the state of his health was groundless and took to his previous way of life. He went to Sochi, played tennis, and did some drinking. Of course, it all ended sadly.” The October attack came right after Yeltsin deplaned in Moscow from a trip to the United States. Only following it did he behave more carefully, writes Chazov, although he would not agree to the diagnostic angiogram urged by the Kremlin doctors. The circumstances of the December coronary seem to have been similar to those of the first two.96 In 1996, as he ran to defend his presidential position against the communists, he was more careful.97
Much as he might have wanted it under wraps, Yeltsin, not so different from the Samson Agonistes pushing the grain mill in John Milton’s verse, played out his torments in public view. This was because Russia’s press was freer and livelier in the 1990s than in any other period of the nation’s history. Censorship had been abolished by Soviet legislation in June 1990. Two of the three authors of that law, Yurii Baturin and Mikhail Fedotov, were to hold senior positions after 1991. The constitution of 1993 affirmed the ban on censorship, and in the drafting sessions Yeltsin agreed to language that strengthened it.98
The media frankness about Yeltsin’s derelictions and peccadillos was unprecedented for a Russian leader. Yeltsin did not cotton to criticism of his person, or of his policies, and had no shortage of opportunities to throttle it. His refusal to take them is traceable to principle, psychology, and realism. After communism, he accepted the need for a modern country to have an inquisitive and contentious press. “Criticism is a necessary thing,” he declaimed in 1992. “If we do not take part in criticism today, we will fall into the same swamp in which we wallowed for decades.” Suppression of it would also be a confession of pusillanimity: “If a statesman or leader or president goes about squeezing the press, this means he is weak-kneed. A strong leader will not squeeze the press, even if it criticizes him.”99 Once in a great while, he had to be reminded this was so. He asked press secretary Kostikov in 1994 if he could not do something about the withering stories carried by Kostikov’s friend Igor Golembiovskii, the editor of Izvestiya. Kostikov replied that he could take care of the problem if Yeltsin arranged to give him “the powers of Suslov”—Mikhail Suslov, the intransigent overseer of ideology in Leonid Brezhnev’s Politburo. Yeltsin left it at that and based his press strategy on carrots more than sticks.100 His first-term press secretaries, all of them professional journalists, helped him cajole political reporters and commentators; Gorbachev had talked only to the editors-in-chief. Yeltsin could name the anchors on the national television news programs (although he watched only excerpts from the evening news spliced together by staff), the main correspondents for the several Russian wire services, and half of the roughly twenty print journalists in the “Kremlin pool” started by Kostikov in 1994. While formal press conferences were rare, he made himself available to reporters for weekly off-the-record briefings and conversed quietly with them at proforma events, such as the accreditation of ambassadors.
In the television market, the population’s primary source of political information, Yeltsin inherited two state-owned national networks, Ostankino (Channel 1) from the Soviet government, and Russian Television or RTR (Channel 2), created in 1991. He did not shrink from using the personnel weapon, firing Ostankino director Yegor Yakovlev in November 1992 and the chairman of Channel 2, Oleg Poptsov, in February 1996.101 Editorial autonomy on state television was greater than in the Soviet era, by virtue of drift and division in the executive branch as well as legal guarantees and ethical scruples.102 Yeltsin’s biggest gift to pluralism on television was his agreement to the establishment of a full-service private network, NTV. Headed by Igor Malashenko, a former Central Committee deskman, and owned by Vladimir Gusinskii, one of the first of the oligarchs, it aimed for white-collar, urban viewers and soon distinguished itself by hard-hitting reportage of Moscow political scandals and the war in Chechnya. It went on the air October 10, 1993, the week after the shelling of parliament.103