Lying in her hospital bed late one Friday night last April, Tamera Luzzatto knew she was somewhat lucky — in that what-if kind of way.

What if her husband hadn’t returned home early to discover Luzzatto in the midst of a seizure? What if she hadn’t been rushed that morning to Sibley Memorial Hospital? What if the “mass” on the right side of her brain that doctors found was deadly?

Semi-conscious, she knew one thing for certain: Her boss, Sen. Hillary Rodham Clinton (D-N.Y.), was about to appear on the “Late Show with David Letterman.” So, needing something to take her mind off of her plight, Clinton’s chief of staff directed her nurse to turn on the television to CBS and angle it so Luzzatto could watch. “The nurse thought I was crazy,” she recalled, laughing.

Nine months later, Luzzatto has gone through more MRIs and CAT scans than she’d wish on her worst enemy, but her doctors were able to perform successful brain surgery in June to remove a tumor that one doctor told her was the “best kind of tumor to have.” Slowly returning to normal activity with as clean a bill of health as possible, Luzzatto has fully reassumed control of managing Clinton’s Senate office.

Faced with her own mortality, Luzzatto went through a grueling experience in which she learned how much her family cares for her, how many friends and supporters she has both on and off Capitol Hill and how much she cares for her boss. “Very good things can happen when very bad things happen,” she said last week in an extensive interview with Roll Call.

For Luzzatto, this was not a new lesson, having been forced to deal with another life-or-death situation more than five years ago. She thinks of that time as the first truly difficult experience that reminded her of the importance of “stopping and smelling the roses.”

“But somebody decided to teach it to me again,” she said.

Tackling a Big Task

Three days after the 2000 elections, Luzzatto got a call at home from the office of the first lady. Newly elected to the Senate, Clinton did not want one of her longtime political hands to oversee her transition to Capitol Hill; she wanted an insider, someone who knew the institution. Luzzatto was that person.

Already a 15-year veteran of the Senate, Luzzatto helped Clinton hit the ground running. While she knew some of Clinton’s closest advisers, she was new to the Senator, but the two quickly hit it off.

“I was mesmerized by her,” Luzzatto remembered. “We meshed or melded, we worked well together.” And by the end of December, Clinton told Luzzatto she wanted her to be chief of staff.

Amid a sea of inside and outside advisers to Clinton — not the least of which is former President Bill Clinton — Luzzatto is the person charged with overseeing the day-to-day operations relating to internal Senate matters and making sure there are no slip-ups in a chamber in which Clinton is a relative newcomer.

Luzzatto is “the best possible guide that Hillary could have for the Senate,” said Howard Wolfson, an outside political adviser to Clinton who was communications director in her 2000 campaign.

Karen Dunn, who worked on the campaign and came to the Senate with Clinton in 2001, said the office’s early days were filled with aides from New York and the White House who had no knowledge of the Senate, making Luzzatto indispensible. “Almost every sentence would start out ‘in the Senate,’ so we started calling them ‘in the Senate’ moments,” said Dunn, who left the office in July 2003 to attend Yale Law School.

Luzzatto compares her job to being an orchestra conductor or air-traffic controller.

“It’s kind of like three-dimensional prioritizing,” she said.

Rebounding from Tragedy

That she even returned to the Senate came as a huge surprise to Luzzatto herself, because she left the office of Sen. Jay Rockefeller (D-W.Va.) in June 2000, emotionally and physically exhausted, taking a six-month sabbatical from work and expecting to enter the non-profit world in 2001. In October 1999, Luzzatto’s first husband, Frances Luzzatto, lost a three-year battle with heart disease, a draining experience from which she decided she needed to take time off and recuperate.

But she never got the full six-month sabbatical and instead dove head-first into the Clinton world, a process that was both therapeutic and nearly overwhelming.

The daughter of a Presbyterian minister who led a prominent East Side church in Manhattan, Luzzatto had been active in politics since her early teens. She went on to become the first female president of the Harvard Democrats in the mid-1970s, and by 1979 she was working at the ACTION agency overseeing the Peace Corps and VISTA. By 1985 she took a job as legislative assistant for Rockefeller and worked her way through the ranks, becoming his top health care adviser and overseeing commissions he ran on the issue. “I had to have one of the most interesting job experiences on Capitol Hill,” she said, admitting it was absorbing. “It felt like 24 hours a day.”

By the mid-1990s she became Rockefeller’s chief of staff and was in charge of the totality of operations for a very senior Democrat.

But even that didn’t compare to running Clinton’s office. The media spotlight throughout New York state is intense, with three major daily newspapers in the Big Apple alone. West Virginia has 1.9 million people, New York has 19 million.

Rockefeller likes to tease Luzzatto about her job. “I guess the difference between working for her and me is a decimal point,” he said.

Early on, Clinton gave Luzzatto sound advice about some of the clutter she’d be facing. “We can’t let it paralyze us,” Clinton said.

“That’s what I had to learn in my first year,” Luzzatto said. “I’d never done any of that work with two tornadoes and three hurricanes swirling around me.”

Seeing Senate’s ‘Heart and Soul’

A devout fan of the composer Bach, Luzzatto has been known to give out Bach compact discs to staffers for birthday gifts.

Dunn said Luzzatto has a calming presence in some of the office’s most chaotic times, something she likely learned through her own personal travails. “Tamera combines being brass-tacks capable with a tremendous amount of empathy,” Dunn said. “She manages to do both.”

On the morning of April 30, 2004, Luzzatto went to the gym and worked out, returned home to get ready for her weekend trip with her husband, David Leiter, the former chief of staff to Sen. John Kerry (D-Mass.), whom she married 11 days after Sept. 11, 2001, with her father officiating the ceremony.

Shortly before 9 a.m., she called her old boss, Rockefeller, and they quickly began talking about Bach, one of their favorite topics. But she soon realized something awful was happening and let the phone drop.

She was quivering and unable to speak. Luckily, Leiter came home from work and realized something terrible was happening and called for an ambulance. She was taken to Sibley Hospital in Northwest D.C., where after a couple hours of CAT scans and MRIs, they told her only that there was a mass on the right side of her brain, unsure what it was and whether it was cancerous.

By Wednesday, after a litany of tests, her doctors told her it was a brain tumor, “like a balled-up piece of paper,” folding up her fist to demonstrate the size and shape.

She settled on a renowned brain surgeon, Henry Brem of Johns Hopkins Hospital, and scheduled the procedure for June 16.

In addition to an outpouring of support from friends and colleagues, she got an unexpected phone call the day before her surgery: Senate Majority Leader Bill Frist (R-Tenn.) was a classmate of Brem’s at Harvard’s medical school and he’d spoken to Brem about the surgery. Frist reassured her she was in good hands and that things sounded positive.

Several days after the six-hour surgery, Brem gave her the news that she had a tumor known as glioma, which was non-cancerous. Her doctors then warned her about rushing back to work and told her three things she had to do: “Minimize your stress, get plenty of sleep and no caffeine.”

She slowly but surely started going back to work in September and October, starting her days much later than normal. Wolfson recalled the moving e-mails Luzzatto sent out to her friends and fellow staffers, keeping them apprised of her recovery.

“They were eloquent and passionate and dignified and moving,” he said.

Her doctors have told her things are looking good. “So far, I’ve gotten the A-plus report,” she said.

Recalling the support of those on the Hill who’ve helped her through her ordeals, Luzzatto said the Senate isn’t just a place of partisan wrangling these days.

“I’ve also experienced the heart and soul of the place,” she said.