On January 20, 2021, the oldest U.S. president in history was sworn into office. That plain fact should be a cause for concern, as American presidents have a long history of suffering from serious health issues while in office. Including when they took office at much younger ages than the current president!
So, today, on President’s Day, let’s take a closer look at the long, checkered history of presidential health and what it means for our country…
Many U.S. presidents suffered from poor health
About half of all the U.S. presidents struggled with serious illness while fulfilling the duties of the highest office in the land.
Of course, the earliest American presidents lived in the era before the advent of antibiotics. So, even just common infections had the potential to turn deadly.
Plus, they often came to office following successful service as military leaders, so they also tended to suffer from longstanding complications related to old battlefield illnesses and/or injuries.
By comparison, our more modern presidents often suffered from illnesses we now associate with the nation’s growing prosperity, such as heart disease, stroke, and obesity.
Either way, U.S. presidents haven’t always been a particularly healthy lot, and they often received substandard medical care. (I’ll explain why in just a moment.) And what is perhaps even more alarming is that on many occasions, a sitting president’s ill-heath was kept a secret!
Let’s start by taking a look at the health of our nation’s first president…
Washington suffered from several illnesses
George Washington suffered from several serious bacterial infections during and following his presidency. In 1789, shortly after taking office, he developed a “tumor,” as they called it, which probably represented a staph infection. (Historians think it may have arisen from a sore he developed while riding horseback.)
A prominent, local physician drained the abscess—which likely saved Washington’s life (since, as I mentioned earlier, it occurred before the advent of antibiotics).
Then, a year later, in 1790, Washington almost died yet again while in office—this time of pneumonia. The illness prompted great concerns from Thomas Jefferson and others. But once again, Washington eventually overcame the infection without the use of antibiotics. (A reminder that your body can overcome many common infections, without the use of antibiotics. And you should only agree to take one to avoid a more serious, life-threatening infection.)
As you probably recall, after Washington finished his two terms in office, he returned home to Mount Vernon—his estate in northern Virginia. But in December 1799, after taking a tour of his property on horseback in raw, icy weather, he suddenly developed a severe cold and sore throat and started to have difficulty breathing. Historians now think he probably had a severe infection of the larynx (voice box), which caused inflammation and swelling in the throat.
Several different physicians came to Washington’s bedside to “bleed” him. And Washington actually reported feeling better after the bleedings were administered.
(While “bloodletting” may sound medieval, it was actually an accepted and somewhat effective treatment option for this type of infection. To perform it, a physician would typically make a small incision and suction out moderate amounts of blood, which generally reduced congestion. And, contrary to a popular myth, Washington didn’t bleed to death. The bloodletting probably helped to relieve some of the systemic congestion and inflammation.)
Again, since antibiotics hadn’t been discovered yet, performing an emergency tracheotomy would have been the newly available treatment that could have saved Washington’s life. For this procedure, a doctor makes a surgical opening in the neck, below the swelling in the throat, to allow unobstructed breathing to occur.
A younger physician in attendance at Washington’s bedside actually knew about and suggested performing this “new” procedure. But elderly, more prominent physicians on the scene refused to allow it for fear that someone would accuse them of “experimenting” on the ill, former president.
Thus emerged a long-standing pattern whereby more politically connected and powerful physicians end up controlling a president’s medical destiny—and perform substandard medical care. In Washington’s case, they denied him care that could have saved his life. (The same thing happens with the general population.)
Secrecy about presidential health has always been a huge problem
As I mentioned earlier, since the beginning of our democracy, the political power structure in Washington, D.C., has often taken great pains to hide a sitting president’s ill-health.
For example, in 1919, President Woodrow Wilson suffered a stroke that incapacitated him until he left office in 1921. He couldn’t perform his constitutional duties. However, the President’s wife and doctors kept it a secret for 18 months. And even if Wilson’s disability had been widely known, there was no legislation in place to guide a sensible transfer of power.
White House physicians also covered up serious illnesses and disabilities of many other presidents over the years, including Presidents William McKinley, Warren Harding, Franklin D. Roosevelt, Dwight D. Eisenhower, John F. Kennedy, Lyndon B. Johnson, Richard Nixon, and even Vice President Dick Cheney.
Due to insistence on secrecy, cover-ups, and failure to follow modern medical protocols, these seriously ill presidents often ended up receiving substandard care…which ultimately meant the nation was ill-served as well.
Eventually, after the assassination death of President John F. Kennedy in 1963, congress passed the 25th Amendment, which clearly laid out an orderly process of succession in the event of the death of the president, vice president, etc.
But, it still left a large loophole—rife with conflicts of interest—when it comes to sitting presidents who become medically disabled or incapacitated…as President Wilson did.
So, while directing the College of Physicians in Philadelphia, before the contested 2000 election, I worked with Sen. Arlen Specter (R-PA), Chair of the Senate Judiciary Committee, and Rep. Henry Hyde (R-IL), Chair of the House Judiciary Committee, to create medical guidelines for implementing the 25th Amendment when a president becomes incapacitated.
Unfortunately, congress never implemented the guidelines. And here we are with a 78-year-old man who has already suffered two brain “events,” sitting in the White House.
We should have plans in place in the event that he (or any subsequent president) does get sick, requires treatment, or becomes fully incapacitated.
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