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Profiles of US Presidents in the : Merits and Maladies

Robert W. Schrier Professor of Medicine University of School of Medicine (1858-1919) Twenty-sixth President (1901-1909) Theodore Roosevelt, Conservationist National Treasures Created or Enlarged 1901-1909

• U.S. Forest Service • National Forests (150) • National Parks (6) • National Monuments (18) • Federal Bird Reservations (51) • National Game Preserves (4)

Theodore Roosevelt Sr., Father of Teddy Roosevelt

Teddy Roosevelt in his Rough Rider uniform Teddy Roosevelt as of New from 1899-1900 Teddy and with their children Quentin, Theodore III, Archie, Alice, Kermit, and Ethel Teddy’s bloody shirt from attempt (1857-1930) Twenty-seventh President (1909-1913) Mrs. William Howard Taft (Helen “Nellie” Herron Taft) William Howard Taft, the Governor of the , on a carabao Woodrow (1856-1924) Twenty-eighth President (1913-1921) President Taft and heading to Presidential Inauguration WOODROW WILSON

• 1896 - First stroke at age 40 while a Professor at • 1906 - Second stroke at age 50 while President of Princeton University • 1910 - Elected at age 54 • 1912 - Elected President of the at age 56 WOODROW WILSON’S MEDICAL ILLNESSES DURING HIS PRESIDENCY (1912-1920) • 1912 – Symptoms on left side compatible with right internal carotid ischemia • 1914 – Wife’s death led to severe depression with suicidal tendencies • 1914 – Medical records showed high blood pressure with hypertensive and atherosclerotic changes and exudates in fundi • 1918 – “Cerebral atherosclerosis with lapses in memory and judgment, diminished emotional control and increased suspiciousness” Wilson with his second wife, Edith AND THE VERSAILLES TREATY • – United States declares war against • 1918 – Versailles Treaty • ENTENTE POWERS – Severe reparations • Clemenceau – • Lloyd-George – Great Britain • Orlando –

• WILSON’S “” – humane WOODROW WILSON AT VERSAILLES

“He was beaten out that he could only remember with effort what the council had done in the afternoon.” Wilson Aide Versailles, France WILSON’S POST-VERSAILLES CROSS COUNTRY SPEAKING TOUR • September 25, 1919 – Third stroke at age 63 in Pueblo, Colorado

, 1919 – Fourth stroke with complete paralysis on the left side

– Finished second term bedridden Wilson early (above) and later (right) in his Presidency Warren G. Harding (1865-1923) Twenty-ninth President (1921-1923) Warren and The U.S. Senate investigation of the Teapot Dome (1872-1933) Thirtieth President (1923-1929) President and Mrs. Calvin Coolidge Silent Cal with Indian chiefs President and Mrs. Coolidge at their son’s funeral (1874-1964) Thirty-first President (1929-1933) The Herbert Hoover family Herbert Hoover’s support for starving children in World War I Vice President Curtis A “” during the A shanty in a Hooverville Franklin D. Roosevelt (1882-1945) Thirty-second President (1933-1945) , POLIO AND FDR • 1905 – Married Roosevelt • 1910 – Elected to State Senate • 1913 – Roosevelt appointed Assistant Secretary of Navy by Woodrow Wilson • 1920 – Lost election as Democratic candidate for Vice President • 1921 – Developed polio at Campobello, New Brunswick • 1922 – Returned to New York law practice and many other activities with increased vigor FDR’S PATH TO THE PRESIDENCY • 1924 – Nominated Governor for Presidency at Democratic Convention • 1928 – Al Smith asked FDR to run for ; FDR replied, “You’re asking me to run, Al, but I can’t even walk.” • 1928 – Elected Governor of New York • 1932 – Elected 32nd President of United States - 49 years old - major issue of campaign was FDR’s health (public release of medical exam; BP – 140/100 mm HG, LVH by EKG) FDR photo in wheelchair in support of polio victims President Roosevelt’s strong upper body and withered lower limbs President Roosevelt’s leg braces President Roosevelt being supported by Eleanor and his son President Roosevelt with his daughter Anna and Eleanor FDR AND POLIO

Asked if her husband’s polio had affected his mental ability, replied, “Yes, any person who has gone through great suffering is bound to have a greater sympathy for and understanding of the problems of mankind.” Changing of the guard: Hitler and Hindenburg In Potsdam, WORLD WAR II AND FDR

• 1937 – Hitler annexed • 1938 – falls • 1939 – invaded • 1940 – France surrendered • 1940 – FDR elected for third term • December 7, 1941 – Pearl Harbor FDR’S FOURTH PRESIDENTIAL TERM • 1944 – Normandy invasion

• 1944 – Democratic convention – FDR did not attend; Harry replaced Henry Wallace as Vice Presidential candidate

• 1944 – FDR elected for fourth term in spite of congestive heart failure, anorexia and cardiac cachexia

• 1944 – Admiral Ross McIntire stated that FDR was “in better condition than the average man of his age;” FDR’s health was “very good,” he was in “splendid shape.”

• 1944 – – campaign “was Father’s Death Warrant” Natural of Essential (?) Hypertension (Franklin D. Roosevelt) FRANKLIN D. ROOSEVELT’S HYPERTENSION

• 1935-1941 – Blood pressure (BP) rose from 140/100 to 188/105 mm Hg

• March 1944 – Digitalis started; lungs cleared; decreased heart size; BP was 220/118 mm Hg

• May 1944 – BP was 240/130 mm Hg

• November 1944 – Reelected to fourth term

• February 1945 – conference with Stalin and Churchill

, 1945 – Died of massive cerebral hemorrhage The question about whether Roosevelt’s fatal brain hemorrhage was due to a melanoma OF THE

• FDR’s trip to Yalta – A total of 12 days. FDR was accompanied by who had terminal and new Stettinius had replaced moribund

• Resulted in the division of

• Did FDR’s illnesses (28 hospitalizations from 1942-45) contribute to the failure to coordinate military and throughout the war and thus the imbalance at Yalta and the ultimate division of Europe?

Roosevelt making a point to Churchill at Yalta President Roosevelt at his Warm Springs Polio Retreat The deadly hiatus in American leadership – from the point when Roosevelt’s health and judgment began to fail to the point when Truman woke up to the reality of Soviet intentions – led to Yalta and Potsdam, the betrayal of the Poles, the imposition of Communist governments in Eastern Europe, the Czechoslovak coup, and, on the other side of the world, the loss of and the invasion of South Korea.

(, , , 1989) Ochsner Harry S. Truman (1884-1972) Thirty-third President (1945-1953) Truman in his National Guard uniform Truman and Bess on their wedding day Tribune gets it wrong Margaret Truman was a vocalist, pianist and novelist Dwight D. Eisenhower (1890-1969) Thirty-fourth President (1953-1961)

The MacArthur years - Douglas MacArthur and Dwight Eisenhower George Patton, Ike and Bernard Montgomery Ike at time of Fitzsimons Hospital for heart attack Ike’s room at Fitzsimons Army Hospital Ike and Mamie on his discharge from Fitzsimons Army Hospital “ … But three illnesses in three successive years, any one of which could have been completely disabling if not fatal, convinced me that I should make some specific arrangements for the Vice President to succeed to my office if I should incur a disability that precluded proper performance of duty over any period of significant length.”

Dwight D. Eisenhower, 1964 President Eisenhower with Vice President Richard John F. (1917-1963) Thirty-fifth President (1961-1963) He and his aides had created the image of a young, heroic , full of vital energy, an image which both the public and the media accepted, and which carried the patient, with his back troubles, three episodes of near deaths with the last rites, and Addison’s disease, into the . JOHN F. KENNEDY’S ILLNESSES

• 1942 – After P.T. boat school – “out of commission for several weeks” – fatigue, back pain

• 1943 – PT 109 wreck – stranded with crew for 6 days on an island

• 1943 – Assigned to PT 59 but “back ache, mental and physical exhaustion” kept him from assuming command and ended his military career Kennedy after PT 109 episode JOHN F. KENNEDY’S ILLNESSES

• 1944 – First back surgery in

• 1947 – Post-election trip to Europe; admitted to clinic where Addison‘s Disease first diagnosed by Sir Daniel Davis – “Young American friend of yours hasn’t got a year to live.”

• 1948 – Collapsed after 5 mile Bunker Hill Day Parade walk during campaign for Congress Sickly-looking Kennedy five months after the diagnosis of Addison’s disease JOHN F. KENNEDY’S ILLNESSES • 1952 – During round-the-world trip with Kennedy, JFK developed high fever and became seriously ill • Given last rites by the • Treated with increased corticosteroids and antibiotics • 1954 – Second back operation in Boston - Given last rites by the Catholic Church - Developed severe infection - 5 months of hospitalization and treatment with antibiotics and larger doses of cortisone President Kennedy and Jackie after back surgery KENNEDY’S ILLNESSES BECAME A PRESIDENTIAL CAMPAIGN ISSUE IN 1960 “John F. Kennedy does not now nor has he ever had an ailment described classically as Addison’s disease, which is a tuberculous destruction of the adrenal gland. Any statement to the contrary is malicious and false … in the post war period (he had) some mild adrenal insufficiency. This is not in any way a condition and it is possible that even this ACTH stimulation test for adrenal function was considered normal in 1958.”

JFK spokesperson Medical History of John F. Kennedy “Autoimmune Polyendocrine Syndrome Type 2” (Ann Int Med, Sept 2009)

Family History Younger sister, Eunice, had Addison’s disease John F. Kennedy, Jr., had Graves disease

Dr. Janet Travell’s listing of Kennedy's medications hydrocortisone, 10 mg daily prednisone, 2.5 mg twice daily methyltestosterone, 10 mg/d liothyronine sodium, 25 μg twice daily fludrocortisone, 0.1 mg/d

President Kennedy and Jackie in just prior to his assassination Bobby, Jackie and Teddy Kennedy at President Kennedy’s funeral Lyndon B. Johnson (1908-1973) Thirty-sixth President (1963-1969) Johnson being sworn in as President after Kennedy’s assassination President Johnson chatting with the first recipient, former President Truman The “Johnson treatment” on New York Governor Nelson Johnson said, “If I’ve lost , I’ve lost Middle .” President and on the of the White House Richard M. Nixon (1913-1994) Thirty-seventh President (1969-1974) The Nixon family and Nixon in their Nixon and the Vietnam troops and Nixon and Leaving the White House permanently after the Quotes about Nixon

Biographer “Nixon was a smart, talented man, but the most peculiar and haunted of all presidents.”

Author Richard Reeves “Nixon was a strange man of uncomfortable shyness who functioned best alone with his thoughts.”

Dr. Hutschnecker (Nixon’s psychotherapist) “Nixon’s mental status was fragile and like a rumbling volcano.” “He was racked with fears and desperate to be loved.” Nixon had problems with depression and alcoholism. (Secretary of State) When shot down a U.S. spy plane, a drunken Nixon said, “Henry, we’ve got to nuke them.”

James Reston (journalist) With the against the invasion of , Nixon made 51 telephone calls from 9:22 p.m. May 8th to 4:22 a.m. on May 9th to reporters, cabinet members, Foreign Service officers, and magazine editors.

Alexander Haig The end of the Nixon Presidency was “one of the most dangerous periods in American history.”

Gerald R. Ford (born 1913) Thirty-eighth President (1974-1977) , All-American at the University of Gerald Ford in his Navy uniform Watergate Crisis

• Vice President Agnew Resigns

• Gerald Ford APPOINTED Vice President

• President Nixon Resigns and Ford APPOINTED President

• President Ford APPOINTED Vice President

President Ford announcing the Nixon “full, free, and absolute ” President Ford discussing the end of the with Nelson Rockefeller and Henry Kissinger President Ford immediately after assassination attempt 1976 Debates between Ford and Carter Jerry and dancing in the White House

Jimmy Carter (born 1924) Thirty-ninth President (1977-1981) Jimmy and Rosalyn Carter on their wedding day Governor of President Carter with Anwar and at the Accords President Carter receiving the in 2002 Carter and Rosalyn with Founders of the (1911–2004) Fortieth President (1981-1989) Ronald Reagan, “The Gipper” Ronald Reagan in his Air Force uniform Ronald Reagan as host of the General Electric Theater The bullet

President Reagan’s chest x-ray after assassination attempt March 1981

• President Reagan Shot

• President’s physician not consulted about his condition until the morning after surgery

• White House and staff dismissed 25th Amendment

Alexander Haig, Secretary of Defense, stated, “I’m in charge.” Succession Act of 1947 of Powers and Duties of the President Vice President Speaker of the House President Pro Tempore of Senate Secretary of State Secretary of Treasury Secretary of Defense Attorney General Secretary of Labor Secretary of Health and Human Service Secretary of House and Urban Development Secretary of Transportation July 13, 1985 • President Reagan’s Colon Surgery

• Written declaration to Congress that Vice President Bush would assume power i.e. Acting President.

• Surgery began at 11:48 am; Reagan reasserted his authority as President at 7:22 pm President Reagan, after colon surgery, with Regan and MacFarland at his bedside President Reagan and Reagan riding off into the sunset George Bush (born 1924) Forty-first President (1989-1993)

Naval aviator, three days before his 19th birthday Captain of his Yale team President Bush with soldiers when he had hyperthyroidism All three, including the dog, had hyperthyroidism Bush debate with Clinton and when he was euthyroid William J. Clinton (born 1946) Forty-second President (1993-2001) on the saxophone

Young Bill Clinton meeting President Kennedy A bearded Bill Clinton with roommates Bill and Hillary Rodham dating during law school 32 year old Bill Clinton being sworn in as Governor of President and dancing at the Inaugural , January 20, 1993 President Clinton signing the North America Treaty Agreement (NAFTA)

Monica Lewinsky and President Clinton share a moment

President Clinton denies the accusation President Clinton, Prime Minister , and Palestine Chairman

Former Presidents Bush and Clinton work together to raise funds after the tsunami in Asia Summary of 20th Century Presidents’ Illnesses

Theodore Roosevelt Jr. Disabling as a child Episodes of depression Probable bipolar personality

William Howard Taft Hypertension Morbid obesity Probable obstructive sleep apnea

Thomas Woodrow Wilson Tobacco addiction Hypertension Atherosclerosis Four strokes Terminal left sided paralysis and disability during last 14 months of presidency Summary of 20th Century Presidents’ Illnesses

Warren Gamaliel Harding Tobacco addiction Atherosclerosis Fatal heart attack

John Calvin Coolidge Jr. Debilitating depression over death of son

Herbert Clark Hoover Orphan Total commitment to Quaker during early phase of depression

Franklin Delano Roosevelt Polio related lower extremity paralysis Tobacco addiction Atherosclerosis Accelerated hypertension Congestive heart failure Summary of 20th Century Presidents’ Illnesses

Harry S. Truman Diphtheria related partial paralysis as child Poverty limited his formal

David Dwight Eisenhower Tobacco addiction Atherosclerosis and heart attack Hypertension Bowel obstruction secondary to Crohn’s disease Left ventricular aneurysm and probably embolic stroke Multiple heart attacks, cardiac arrests and terminal congestive heart failure

John Fitzgerald Kennedy Autoimmune Polyendocrine Syndrome Type 2 with adrenal insufficiency and hypothyroidism Chronic back pain with vertebral fusion Probable addiction to prescription drugs Sexual addiction Summary of 20th Century Presidents’ Illnesses

Lyndon Baines Johnson Tobacco addiction Atherosclerosis Hypertension Gall bladder disease Episodes of depression and probable bipolar personality

Richard Milhaus Nixon Severe insecurity and paranoid personality Alcoholism

Gerald Rudolph Ford Jr. Two assassination attempts on his life Wife with breast cancer and drug addiction

James Earl Carter Jr. Probable obsessive-compulsive personality

Summary of 20th Century Presidents’ Illnesses

Ronald Wilson Reagan Gun shot to chest Alzheimer’s disease

George Herbert Walker Bush Graves disease (hyperthyroidism)

William Jefferson Blythe III Clinton Sexual addiction