"THE PRESIDENT IS FINE"
AND OTHER HISTORICAL LIES

BY RICHARD NORTON SMITH

These days the health of politicians -- remember Bill Bradley's irregular heartbeat and John McCain's recurring skin cancer? -- inspires more press coverage than the politics of health. As viewers of NBC's West Wing can attest, when the president catches a cold, much less multiple sclerosis, it's news. When a real vice president suffers from "chronic coronary artery disease" -- to quote Dick Cheney's cardiologist -- reporters are bound to pursue the patient's medical records and current medications.

Or are they? For most of our history, journalists have covered up White House illnesses as much as they have covered them. The first president to practice the politics of self-denial was George Washington. Barely a year into his first term, he fell victim to influenza. Fearing the consequences of public disclosure, Major William Jackson of the executive staff secretly summoned Philadelphia's leading physician, John Jones. Exactly what course of treatment Jones and his colleagues prescribed for their illustrious patient is unknown; one favorite eighteenth-century remedy for congestion of the lung was turnip broth. Inevitably, rumors leaked out, sparking something close to panic among the young nation's ruling elite. "You cannot conceive the public alarm on this occasion," wrote Thomas Jefferson, himself bedridden with one of his periodic crippling migraines. When after four anxious days Washington's fever broke, no one was more relieved than the slavishly pro-administration Gazette of the United States. "From all let grateful incense rise," intoned its editors.

In the autumn of 1863, amid still graver peril, Abraham Lincoln contracted an apparent case of smallpox. Saying "No one is supposed to know," those around the president's bedside labeled Lincoln's complaint "a mild attack of varioloid" or "mild smallpox," with complete recovery expected soon. Characteristically, Lincoln found humor in his predicament. If nothing else, enforced bedrest provided a welcome alternative to the plague of office-seekers who haunted Lincoln's days. At last, said the infectious president, he had something he could give to everyone.

Next to prolonged mourning, Victorian Americans loved nothing better than a wasting illness. James Garfield and Ulysses Grant gratified both desires, in highly publicized deathwatches conducted by a press corps that relished such gruesome details as Garfield's diet, which included limewater and oatmeal.

Garfield's successor, Chester Arthur, proved less amenable to sickroom journalism. Through a friend, Arthur denied an Associated Press report that he was suffering from Bright's disease, a usually fatal kidney ailment. "Pure fiction," chimed in a friendly newspaper. As indolent in his official duties as he was lethargic in seeking a second term in 1884, Arthur finally succumbed to the condition in November 1886.

It was during the race to succeed Arthur that Grover Cleveland developed his own abiding distaste for keyhole journalism. Embarrassing enough was the revelation of an illegitimate child fathered by Cleveland ten years before, and instantly dubbed Little Tom Tid by an enterprising songwriter. Still more offensive were telescope-wielding reporters who shadowed Cleveland and his young bride, Frances Folsom, in the Maryland mountains after their White House wedding in 1886. Newspapermen made a celebrity out of the Clevelands' infant daughter Ruth. For good measure, they reported, on no credible evidence, that the president beat his wife.

Cleveland got his revenge in 1893, the year a financial panic coincided with Frances Cleveland's second pregnancy. That June doctors confirmed the presence of a quarter-sized growth near the presidential palate. Like U.S. Grant, who had smoked up to twenty cigars a day, Cleveland was paying the price for his tobacco habit. The reluctant patient agreed to early surgery -- on one condition: not a syllable would be allowed to reach the press. Cleveland said he was expected to lead the nation out of its financial crisis, and if the public learned of his condition, business failures and foreclosures would multiply.

On June 30, appearing for all the world like any other busy executive enjoying a nautical holiday, Cleveland strode down the gangway of New York's Pier A and on to the yacht Oneida. The next morning, as the vessel plied the waters of the East River, a Philadelphia surgeon named W.W. Keen removed the malignant tumor, along with the left half of the president's upper jaw, replacing the latter with a rubber prosthetic.

Tipped off to the procedure by a resentful dental surgeon, E.J. Edwards of the Philadelphia Press wrote a dramatic account of the shipboard operation, only to have his own editor denounce the story as "an infamous exploitation of a toothache." The White House undertook what a recent Cleveland biographer calls "arguably the greatest instance of stonewalling in pre-Watergate American presidential history." Incredibly, the secret held until 1917, when Dr. Keen finally shared it with readers of The Saturday Evening Post.

The rise of the mass media did little to pierce the veil of White House secrecy regarding a president's physical or mental health. Hailed at the time as a new prince of peace, in retrospect, Woodrow Wilson displayed unmistakable signs of obsessive paranoia at the Versailles Conference in the spring of 1919. After a severe bout of flu, the mercurial president complained that his French allies were spying on him. Declaring that "the greens and the reds are mixed up here and there's no harmony," Wilson ordered the furniture in his room rearranged. He was less fortunate in arranging the map of Europe.

A cross-country speaking tour on behalf of the League of Nations ended in a crippling stroke. Edith Wilson joined forces with the White House physician Cary Grayson to conceal her husband's desperate condition. The press maintained a discreet, if not always respectful, silence. After a February 1920 newspaper interview with another member of Wilson's medical team ("The president walks sturdily now, without assistance and without fatigue . . . as to his mental vigor, it is simply prodigious"), The New York Times described this blatant falsehood as "a service to common sense and truth."

As with a dying Franklin Roosevelt at Yalta, or the refusal of Richard Nixon, while hospitalized for viral pneumonia, to burn incriminating tapes, the historical consequences of Wilson's illness are still being debated. Which is only appropriate given the fact that until recently, journalists have told us less than historians about presidential incapacity. Only in recent years have we belatedly learned that the famously inactive Coolidge was in the grip of depression following the death of his sixteen-year-old son and namesake in the summer of 1924. Of far graver significance was the deteriorating heart of Franklin Roosevelt during the closing days of World War II. Not content to keep their patient's condition from the press and public, doctors attending the president hid it from their patient as well. While the UP's Merriman Smith chased down rumors that FDR was in a Boston hospital, Roosevelt displayed far less curiosity about his persistent cough and lack of appetite, not to mention the digitalis pills and frequent chest exams ordered by a young naval cardiologist named Howard Bruenn.

Fencing with reporters, Roosevelt attributed his condition to "flaring sinuses" and a stubborn cold. The truth became depressingly apparent to his running mate, Harry Truman, when he joined FDR for lunch two months after D-Day. Beneath a magnolia tree planted by Andrew Jackson, the aging commander-in-chief urged Truman to avoid air travel when campaigning, adding that "this time we may need you." Understandably, Truman revealed none of this when talking for attribution. "The president looked fine and ate a bigger meal than I did," he gushed.

If today's Americans have become familiar with Dick Cheney's enzyme tests, they can thank, or blame, Dwight Eisenhower. Ike's September 1955 heart attack was the first presidential health crisis of the nuclear age. It was also the first to play out before television's omniscient eye. Determined to avoid a Wilsonian cover-up, Eisenhower instructed the White House press secretary, Jim Hagerty, "Tell the truth, the whole truth; don't try to conceal anything." Taking him at his word, Hagerty unleashed a flood of intimate details. Daily briefings before a hundred reporters in Denver ranged from the president's diet and sleeping habits to the color of his pajamas.

More than a turning point in journalistic history, Eisenhower's frankness transformed public attitudes toward illnesses once seen as debilitating. The fact that the government went on in orderly fashion soothed popular anxieties. So did the president's return to the White House that fall. Of course, there were limits to official candor. On learning of a hospital bulletin describing his bodily functions in graphic language, Ike remarked snappishly that perhaps they were carrying "realism" a bit far. Eisenhower's November 1957 stroke caused even Hagerty to fear the consequences should reporters discover that the leader of the free world took a few minutes of oxygen each day and relied on Seconal to sleep at night. To intimates, the president confessed that he was putting off a prostate operation to avoid distasteful publicity. At times, he fantasized about having the procedure done on a cruiser in the middle of a "vacation" -- exactly as Grover Cleveland had misled his journalistic tormentors nearly seventy years earlier.

Meanwhile, Ike's political opponents showed scant inclination to emulate his example. In the weeks leading up to the 1960 Democratic convention, each of the party's leading contenders spread rumors about the other's health. John F. Kennedy alluded to four out of seven presidents during his lifetime who had suffered from heart disease -- a none-too-veiled reference to Lyndon Johnson's massive coronary in 1955. In retaliation, Johnson's supporters raised questions about Kennedy's long-rumored, and publicly denied, bout with Addison's disease, a failure of the adrenal glands for which the youthful Massachusetts senator received frequent injections of cortisone and other medications.

The truth lay buried for decades in official archives. For the moment, The New York Times seemed to accept claims from the Kennedy camp that its candidate could meet "any obligation of the presidency without the need for special medical treatment, unusual rest periods, or other limitations." Other journalists echoed this assessment. (Paradoxically, the perpetual tan caused by Addison's belied any appearance of weakness.)

A similar reticence obscured the war waged over their patient by Kennedy's White House physicians Janet Travell and Admiral George Burkley. Fearing possible narcotic addiction, Burkley objected to Travell's frequent injections of novocaine to ease the president's back pain. But when Burkley recruited the New York orthopedic surgeon Dr. Hans Kraus to prescribe regular stretching exercises and lengthy therapy sessions for the ailing chief executive, JFK fretted that Kraus's frequent White House visits might lead reporters to question his trademark vitality. (Years later, historians discovered one source of his vigor -- amphetamine cocktails served up by Dr. Max Jacobson, the notorious Dr. Feel-good whose potions led Kennedy's brother Robert to demand they be tested by the Food and Drug Administration. JFK demurred. "I don't care if it's horse piss," he told his brother. "It works.")

Little had changed by October 1965. Lyndon Johnson, facing gallbladder surgery, and mindful of the political stir caused by his earlier heart attack, arranged for a secret meeting with Eisenhower at Andrews Air Force Base outside Washington. Eisenhower advised LBJ to emulate his own openness with the press; the president should gain credit for candor, a trait infrequently associated with the Johnson White House. Once persuaded, Johnson relished the theatricality of the situation. Following a successful operation, he greeted reporters by lifting his sport shirt to display a foot-long surgical incision. The resulting photograph became an indelible piece of sixties culture. Adapted by the cartoonist David Levine to mock the president's Vietnam policies, it came to symbolize an administration that showed too much and told too little.

In the years since, other, equally memorable images -- Jimmy Carter collapsing while running a strenuous race, or the first George Bush depositing his state dinner in the lap of Japan's prime minister -- have provided a kind of medical shorthand for the television audience. In the summer of 1985, the president of the United States entered Bethesda Naval Hospital, where surgeons successfully operated after discovering an intestinal malignancy. When communicating this news to the public, doctors made only one mistake: they apparently didn't confer with their patient. According to Ronald Reagan, he didn't have cancer. Something inside of him had cancer, and they removed it, Reagan said.

In tailoring the facts of his health to fit the sunny contours of his temperament, Reagan deceived no one but himself. Ironically, it was in Bethesda that a recuperating Reagan authorized his national security adviser, Bud McFarlane, to embark upon the shadowy trail that led to the Iran-Contra affair. More recently, Reagan's post-White House diagnosis of Alzheimer's disease has prompted speculation, by journalists and others, about the final years of the Reagan presidency. Hugh Sidey, Time's former White House correspondent, recalls a disturbing encounter following Reagan's triumphant stroll through Red Square with Mikhail Gorbachev in 1988. "It was just like talking to protoplasm. He had nothing to say, no observations to make," says Sidey, who could hardly reconcile the monosyllabic Reagan of Moscow with the chatty raconteur whose vivid accounts of his early radio career were, literally, unforgettable. The incident went unreported, and would doubtless be forgotten but for Reagan's subsequent illness.

The Moscow trip ushered in a new era, and a different kind of presidency. With the post-cold-war downsizing of the office, much of the melodrama surrounding earlier presidential illnesses has dissipated -- an unintended consequence of the saturation coverage afforded a White House ringed by satellite dishes. In part, this reflects changes in the popular culture. When Adlai Stevenson used his closing television address of the 1956 campaign to sow seeds of doubt about Dwight Eisenhower's chances to survive a second term, he was roundly criticized for a shocking lapse of taste. Forty-five years later, Saturday Night Live regularly spoofs Cheney's condition.

If today's journalists are more reluctant to be co-conspirators in a guileful tradition as old as the republic, one thing, at least, has not changed. According to Sidey -- not to mention C.J., Leo, and Josh -- the White House staff remains as jealous of information as presidential doctors are possessive of their patient. That it took years for the public to learn how close John Hinckley came to assassinating Ronald Reagan only confirms Sidey's observation. No one would be prouder than Grover Cleveland.
 
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Richard Norton Smith, a presidential historian, is currently working on a biography of Nelson A. Rockefeller.