E-Mail This Article to a Friend Key to the city (continued)
	Related stories Menino finally gets some love. By Adam Reilly. Frequent-flier Menino: Is Menino following in the third-term footsteps of Kevin White and Ray Flynn, or can his forays outside Boston help the city? By Seth Gitell.

IF HENNIGAN doesn’t wrest the mayor’s job from Menino, of course, he could still choose to give it up voluntarily. This scenario strikes both his fans and foes as improbable: the mayor seems genuinely to love his job, and it’s not exactly clear what he’d be able or willing to do if he decided to try something new. But one savvy observer of Boston politics thinks Menino’s mounting health problems — he had a small cancer removed from his back last year and has been hospitalized six times since taking office — may, despite being downplayed in the press, prompt some serious soul-searching by Menino and his wife, Angela. "Will Angela sit down with Tommy at the kitchen table and say, ‘Everything’s been great. It’s been 12 pretty good years. Nobody’s really gotten in trouble. The DNC’s behind us. You’ve got six grandchildren. And you’re sick’?" this observer asks. If so, he suggests, Menino might go ahead and seek re-election, then craft a deal to hand the office over to City Council president Michael Flaherty. Flaherty would promise to provide jobs for certain Menino-administration members, and Menino would step down after serving only part of his fourth term. "It’s unlikely, because that’s so contrary to what he wants to do," the same observer says of Menino. "But on the other hand, if he feels like shit all the time.... My gut instinct is, whatever happens, things aren’t going to get much better."

The party line, since the Crohn’s-disease diagnosis became public last week, has been that the condition won’t be a professional liability. "I think he thinks that if he’s careful, if he stays away from the peanuts and popcorn, that he’ll be just fine," one senior Menino staffer says. Seth Gitell, Menino’s press secretary, insists that Crohn’s won’t be a factor as Menino weighs whether to seek a fourth term. "Given that medical professionals have said this condition will have no impact on the mayor’s ability to be mayor, it will likewise have no effect on his decision to run for mayor in 2005," Gitell says. "Anybody interested in the mayor’s political future is invited to observe him at public events during the next six months, and they can make a judgment based on that."

Here’s the problem: Crohn’s isn’t just exacerbated by hard-to-digest foods like the popcorn and Cracker Jacks that Menino scarfed down at Fenway Park last week. While the disease isn’t caused by stress, many experts believe its symptoms can be exacerbated, in some patients, by stressful situations — and that these heightened symptoms, in turn, can make the disease more serious. "If you have stress, the symptoms may be worse," says Dr. Kenneth Falchuk, a gastroenterologist at Beth Israel Deaconess Medical Center and a past president of the Crohn’s & Colitis Foundation of America. "And if the symptoms are worse, then the disease itself becomes more prominent — and that is counterproductive to the goal of therapy, which is to try to reduce the inflammation and let things settle down." What advice would Falchuk give to a Crohn’s patient with a stressful job, e.g., a CEO or politician? "I would urge them to learn how to deal with stress," he says. "I have patients in that situation where stress doesn’t really affect them that much. And others don’t handle it well."

The potential problem Menino faces is that a certain type of stress — the resentment he obviously feels toward people who underestimate him or dwell on negatives in the city — seems to serve as a kind of emotional fuel. During the DNC, when the dust-up over Jesse Jackson’s comments about racial disparities in Boston was big news, Menino and Jackson appeared together for a photo-op in Grove Hall in what had to be an already-tense situation. At one point, a New England Cable News reporter asked the mayor about reports that small businesses were hurting because of the convention. Menino lost it. "You continually talk about how negative this convention is," he snapped. "Why don’t you look at the political impact? You want to continue to be negative about the city? Why don’t you go back where you came from!" The reporter, Mont Fennel, was baffled after Menino’s tirade. "I am a native," he said. "I don’t know what he’s talking about." Watching this scene unfold, one had the sense that Menino would harness his anger, go back to City Hall, and do his damnedest to prove the reporter wrong. Naming Merita Hopkins, his former corporation counsel and a trusted adviser, as his new chief of staff may help Menino curtail his admitted tendency to micromanage. But the mayor will find it harder to change his simultaneously aggressive and defensive political temperament. If he can’t — and if, in Menino’s case, stress exacerbates the symptoms of Crohn’s — he may be back in the hospital sooner rather than later. And if that happens, Hennigan might not be the only one to ponder a run against Menino next year.

THIS TUESDAY, Menino made his first public appearance since his discharge from Brigham and Women’s Hospital. After visiting a youth basketball camp at Boston University, he discussed the implications of his illness with the Phoenix. "I don’t think it’s going to change my lifestyle at all," Menino said. "I’ll have to watch some of the things I eat, which I should have done a long time ago.... I’ve been working since I got out of the hospital Friday. I might not work 18 hours — I might work 14 or 16 hours a day — but how many people work those many hours? I think I have an obligation to the people of Boston to be out there on a continual basis serving them." The mayor also made a point of noting that his Crohn’s flare-up last week stemmed from imprudent food choices, not from work-related tension. "Nobody had more stress than I did the last year," he said. "I had no problem until I ate some things I shouldn’t have eaten. That’s why I had the attack. I lived through the DNC; I lived through all the union negotiations, I didn’t have one problem at all. It’s not about stress. I know how to deal with stress."

Time will tell if he’s right.

Adam Reilly can be reached at areilly[a]phx.com