The doctor is in--or out? The case of Sen. Tom Coburn, (would-be) citizen-legislator.

Tom Coburn, the obstetrician and Republican senator from Oklahoma, is still in the beginning of his first term. But he has already launched an unprecedented attack on his colleagues' pet pork projects, and is preparing to mount a challenge to an Ethics Committee that, rejecting the idea of the citizen-legislator, has forbidden him to continue treating some of his patients. In fighting these battles, the good doctor is tackling a chronic condition. His campaign against pork, privilege, and preening is a threat to the established order, and the chamber's old bulls are determined to tame the maverick in their midst before he can cure the Senate's sclerosis.

In late October, Coburn mounted an assault on the Senate's most highly prized prerogative: the allocation of pork spending. This year's transportation bill, with some 6,300 "earmarks" for pet projects at a cost of $22 billion, presented plenty of targets for the cost-cutting crusader. Most prominent among them was Alaska's infamous "bridge to nowhere," meant to replace a ferry connecting Ketchikan (pop. 8,000) with Gravina Island (pop. 50). (On Alaska's pork spending, see Stephen Spruiell's "No One Beats Alaska" in the November 7, 2005, issue of NR.) If built, it would be longer than the Golden Gate bridge and cost some $223 million--enough, Coburn has noted, to buy every resident of Gravina Island a Lear jet. Coburn proposed an amendment that would have instead used those funds to cover the costs of repairing the Twin Spans bridge in New Orleans.

In what the Washington Post called "the senatorial version of a hissy fit," Alaska senator Ted Stevens angrily vowed to become a "wounded bull on the floor of this Senate," and warned his colleagues that he would "be taken out of here on a stretcher" if they backed Coburn's proposal. He even threatened to resign from the Senate if the boondoggle bridge were defunded. Apparently believing that he was bolstering his case by repeatedly noting the decades he has spent in the Senate, Stevens declared: "This is not the Senate I devoted 37 years to"; and, "That is not equality, and is not treating my state the way I have seen it treated for 37 years"; and, "I made a statement earlier today that in my 37 years I have never seen this." In the end, the Senate deferred to Stevens's longevity--and to his reputation as an Appropriations Committee chairman with a very long memory. The Coburn amendment tailed on an 82-15 vote.

But even if Coburn lost the amendment, he won the argument. Stevens's tirade focused attention on the Senate's self-interested spending habits: The showdown was front-page news, and Coburn won accolades from editorialists across the country. The "bridge to nowhere" became the most famous bridge in America.

By insisting that the senators' right to tap the Treasury for political gain be treated as sacrosanct, Ted Stevens has defended the ultimate conflict of interest among political officials. But, ironically, it's Senator Coburn who stands accused of a conflict of interest by the Senate Ethics Committee. Here too he threatens the established order.

"Dr. Tom Coburn's office" is the phone greeting you hear if you call the senator's staff in Washington. Most Mondays, when votes aren't scheduled, Coburn can be found back home in Muskogee, Okla., seeing his patients. You'd think that, given Coburn's habit of spotting and condemning wasteful spending, his colleagues wouldn't want him to spend any more time in the Capitol than necessary. But the Senate's ethics watchdogs have demanded that he stop practicing medicine in order to devote his full attention to Senate business.

When Coburn served in the House of Representatives, the House Ethics Committee granted him a waiver that allowed him to continue practicing medicine part-time. He was permitted to earn just enough income as a doctor to cover his expenses, including medical-malpractice insurance. During his six years in the House, he delivered more than 400 babies. The self-described citizen-legislator kept his promise to serve only three terms, and went back to practicing medicine for four years before running for the Senate in 2004. In that race, he promised to serve only two terms, and to keep in touch with the people of his state by continuing his medical practice. Before he was sworn in, however, the Senate Ethics Committee informed him that this would not be allowed.

Under chairman George Voinovich, the Ethics Committee has decided that Senator Coburn's request to treat patients runs afoul of a Senate rule holding that members shall not "receive compensation for practicing a profession which involves a fiduciary relationship." Is the senator "receiving compensation" from his reduced practice even if it brings no net income? The committee says yes. Reasonable people can disagree with that answer, and a large number of reasonable senators do.

Coburn hopes there are enough such senators to support a resolution giving an alternative "sense of the Senate" concerning his practice. Should 67 senators support this challenge to the Ethics Committee's turf, the Senate rules will be formally interpreted to permit Coburn to maintain his practice. Coburn's spokesman notes that the senator ran and won as a citizen-legislator, and asks, "Will the Senate criminalize our Founders' intent?"

In a letter to Coburn, Ethics Committee members harrumphed that their interpretation of the rules was meant to ensure that their colleagues "undertake their official duties as, and understand them to be, a full-time responsibility." But there is no obvious reason that Coburn should be forbidden to practice medicine when other senators engage in less worthy commercial endeavors. Senators have been allowed, in their spare time, to write bad poetry, bad song lyrics, and bad fiction, and to keep all the proceeds from their scribblings. The committee allows payment for "works of fiction (including poetry, lyrics, or scripts), where the payment is not offered because of the author's Senate status." Here the Ethics Committee engages in a little fiction writing of its own, pretending that Barbara Mikulski and Barbara Boxer would be hot publishing properties without their "Senate status."

Senators can also be compensated for the expenses they incur when giving speeches. Shouldn't that practice count as "receiving compensation" if Coburn's medical activities--which generate no net income--do? Some senators spend more time fundraising or playing golf than Coburn does seeing patients. One of Coburn's allies, Sen. Jim DeMint, characterizes as "ludicrous" the claim that Coburn is neglecting his public duties, and points out that Coburn, in his first nine months in Washington, presided over more than a dozen committee hearings and authored ten bills and 72 amendments.

Coburn is shaking up an institution that sees a conflict of interest in occasionally delivering babies, but views the conflict of interest that delivers billions in pork to boost reelection prospects as a senator's inviolable privilege. Call it the Hypocritical Oath.