The Medical Ordeals of JFK

Recent assessments of Kennedy's presidency have tended to raise "questions of character"—to view his Administration in the context of his sometimes wayward personal behavior. Such assessments are incomplete. Newly uncovered medical records reveal that the scope and intensity of his physical suffering were beyond what we had previously imagined. What Kennedy endured—and what he hid from the public—both complicates and enlarges our understanding of his character
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Concealing one's true medical condition from the voting public is a time-honored tradition of the American presidency. William Henry Harrison, who died of pneumonia in April of 1841, after only one month in office, was the first Chief Executive to hide his physical frailties. Nine years later Zachary Taylor's handlers refused to acknowledge that cholera had put the President's life in jeopardy; they denied rumors of illness until he was near death, in July of 1850, sixteen months into his presidency. During Grover Cleveland's second term, in the 1890s, the White House deceived the public by dismissing allegations that surgeons had removed a cancerous growth from the President's mouth; a vulcanized-rubber prosthesis disguised the absence of much of Cleveland's upper left jaw and part of his palate. The public knew nothing about the implant until one of the President's physicians revealed it in 1917, nine years after Cleveland's death.

In the twentieth century Woodrow Wilson, Calvin Coolidge, Franklin Delano Roosevelt, and Dwight D. Eisenhower all, to one degree or another, held back the full truth about medical difficulties that could have jeopardized their hold on the Oval Office. Wilson suffered a paralyzing stroke in 1919 that made him merely a figurehead during the last year and a half of his term. After Coolidge's sixteen-year-old son died of blood poisoning, in the summer of 1924, Coolidge himself struggled with a clinical depression that made inactivity and passivity the principal features of his Administration. It has been well known for some time that Roosevelt went to great lengths to conceal how physically incapacitated he had been rendered by polio. If voters had known the truth about his generally deteriorating health in 1944, it is unlikely that they would have re-elected him a third time—but they did not know, and FDR died just three months into his fourth term, in April of 1945. Though Eisenhower was much more open about his health than any of his predecessors, the full disclosure of his maladies (including heart disease) in 1956, when he was sixty-six, might have discouraged the country from electing him President again; he had a heart attack during his first term and suffered a number of other medical problems, including a minor stroke, during his second.

The lifelong health problems of John F. Kennedy constitute one of the best-kept secrets of recent U.S. history—no surprise, because if the extent of those problems had been revealed while he was alive, his presidential ambitions would likely have been dashed. Kennedy, like so many of his predecessors, was more intent on winning the presidency than on revealing himself to the public. On one level this secrecy can be taken as another stain on his oft-criticized character, a deception maintained at the potential expense of the citizens he was elected to lead. Yet there is another way of viewing the silence regarding his health—as the quiet stoicism of a man struggling to endure extraordinary pain and distress and performing his presidential (and pre-presidential) duties largely undeterred by his physical suffering. Does this not also speak to his character, but in a more complex way?

Not only the extent of Kennedy's medical problems but the lengths to which he and his family went to conceal them were significant. According to Bill Walton, a Kennedy family friend, JFK was followed everywhere during the 1960 presidential campaign by an aide with a special bag containing the "medical support" that was needed all the time. When the bag was misplaced during a trip to Connecticut, Kennedy telephoned Governor Abe Ribicoff and said, "There's a medical bag floating around and it can't get in anybody's hands ... You have to find that bag." If the wrong people got hold of it, he said, "it would be murder." (The bag was recovered.)

In 1983 the Kennedy biographer Herbert Parmet observed that "dealing with the Kennedy medical history is in some ways like trying to uncover aspects of vital national-security operations." In 1995, when executors of Joseph P. Kennedy's estate made additional family papers available in the JFK Library, reports to Joe about Jack's medical condition remained closed. Before, during, and since his presidency, the Kennedys have guarded JFK's medical records from public view, apparently worrying that even posthumous revelations about his health would hurt his reputation for honest dealings with the public.

Of course, evidence of Kennedy's medical problems has been trickling out for years. In 1960, during the fight for the Democratic nomination, John Connally and India Edwards, aides to Lyndon B. Johnson, told the press—correctly—that Kennedy suffered from Addison's disease, a condition of the adrenal glands characterized by a deficiency of the hormones needed to regulate blood sugar, sodium and potassium, and the response to stress. They described the problem as life-threatening and requiring regular doses of cortisone. The Kennedys publicly denied the allegation. They released a letter from two of JFK's doctors describing his health as "excellent" and Kennedy as fully capable of serving as President. During his Administration, according to Admiral George Burkley, a physician on the White House staff, Kennedy was so determined not to give the impression that he was "physically impaired ... and require[d] the constant supervision of a physician" that he shunned having "a medical man in the near proximity to him" in public.

It appears that Richard Nixon may have tried at one point to gain access to Kennedy's medical history. In the fall of 1960, as he and JFK battled in what turned out to be one of the closest presidential elections ever, thieves ransacked the office of Eugene J. Cohen, a New York endocrinologist who had been treating Kennedy for Addison's disease. When they failed to find Kennedy's records, which were filed under a code name, they tried unsuccessfully to break into the office of Janet Travell, an internist and pharmacologist who had been relieving Kennedy's back pain with injections of procaine (an agent similar to lidocaine). Although the thieves remain unidentified, it is reasonable to speculate that they were Nixon operatives; the failed robberies have the aura of Watergate and of the break-in at the Beverly Hills office of Daniel Ellsberg's psychiatrist.

Using personal letters, Navy records, and oral histories, biographers and historians over the past twenty years have begun to fill in a picture of Jack Kennedy as ill and ailment-ridden for his entire life—a far cry from the paragon of vigor (or "vigah," in the family's distinctive Massachusetts accent) that the Kennedys presented. After a sickly childhood he spent significant periods during his prep school and college years in the hospital for severe intestinal ailments, infections, and what doctors thought for a time was leukemia. He suffered from ulcers and colitis as well as Addison's disease, which necessitated the administration of regular steroid treatments. And it has been known for some time that Kennedy endured terrible back trouble. He wrote his book Profiles in Courage while recovering from back surgery in 1954 that almost killed him.

But the full extent of Kennedy's medical ordeals has not been known until now. Earlier this year a small committee of Kennedy Administration friends and associates agreed to open a collection of his papers for the years 1955-1963. I was given access to these newly released materials, which included x-rays and prescription records from Janet Travell's files. Together with recent research and a growing understanding of medical science, the newly available records allow us to construct an authoritative account of JFK's medical tribulations. And they add telling detail to a story of lifelong suffering, revealing that many of the various treatments doctors gave Kennedy, starting when he was a boy, did far more harm than good. In particular, steroid treatments that he may have received as a young man for his intestinal ailments could have compounded—and perhaps even caused—both the Addison's disease and the degenerative back trouble that plagued him later in life. Travell's prescription records also confirm that during his presidency—and in particular during times of stress, such as the Bay of Pigs fiasco, in April of 1961, and the Cuban Missile Crisis, in October of 1962—Kennedy was taking an extraordinary variety of medications: steroids for his Addison's disease; painkillers for his back; anti-spasmodics for his colitis; antibiotics for urinary-tract infections; antihistamines for allergies; and, on at least one occasion, an anti-psychotic (though only for two days) for a severe mood change that Jackie Kennedy believed had been brought on by the antihistamines.

Kennedy's charismatic appeal rested heavily on the image of youthful energy and good health he projected. This image was a myth. The real story, disconcerting though it would have been to contemplate at the time, is actually more heroic. It is a story of iron-willed fortitude in mastering the diffi-culties of chronic illness.

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