In January 2018, Ronny Jackson, the former physician to the president, accompanied Trump to the Walter Reed National Military Medical Center.Chip Somodevilla / Getty

The public may have a right to know about their president’s health, but a president’s physicians are beholden only to their patient, not to the American people. Historical examples suggest that Americans have had reason to be skeptical of what a president’s physician reported, especially when the news seemed to be suspiciously positive or selectively vague.

In the summer of 1893, Grover Cleveland was obviously not well. He had gone to Gray Gables, his summer home on Buzzards Bay in Massachusetts, in early July, ostensibly for a vacation. But he’d barely left the house, even to sit on the porch.

Rumors began to spread that Cleveland was suffering from cancer—specifically oral cancer, a disease similar to the one that had killed Ulysses S. Grant eight years earlier. On the evening of July 6, a reporter for United Press managed to corner Cleveland’s personal physician, Joseph Bryant, on the porch of Gray Gables.

“From what is he suffering?” the unidentified reporter asked.

“He is suffering from rheumatism, just as it was reported this afternoon,” Bryant answered. “Those reports were correct.”

“Then, doctor, the report that he is suffering from a malignant or cancerous growth in the mouth and that an operation was necessary and had been performed to relieve it is not correct.”

“He is suffering from the teeth,” Bryant said. “That is all.”

Bryant was the president of the New York Academy of Medicine and would later serve as the president of the American Medical Association. His credentials were unimpeachable.

And so the next day, the papers dutifully reported that Cleveland was suffering from nothing worse than a toothache, and the nation was reassured.

But Bryant had lied. Cleveland was in fact very ill.

In late June, Bryant had examined a lesion on the roof of Cleveland’s mouth and declared it a “bad-looking tenant.” The doctor recommended it be removed immediately. But Cleveland didn’t want the public to know he was ill, so the operation was performed on a yacht owned by one of the president’s friends.

In a 90-minute operation, a hastily assembled surgical team, sworn to secrecy, removed the tumor, along with five teeth and much of Cleveland’s upper-left palate and jawbone. The procedure took place entirely within the patient’s mouth, so that no external scars would betray the operation.

Cleveland eventually recovered, and the truth would not be known until long after he died, in 1908.

Cleveland insisted on keeping his condition secret, because he didn’t want to alarm the public. At the time, the nation was mired in an economic depression now known as the Panic of 1893. If the public knew he had cancer, Cleveland believed, the stock market would crash.

Cleveland, like all presidents, was also loath to appear weak in any way. (This is especially true of the incumbent, of course.) Presidents have an almost pathological need to appear vigorous, regardless of any infirmities. And if they can’t appear vigorous, then they try not to appear at all.

That was the case with Woodrow Wilson. On October 2, 1919, he suffered a massive stroke at the White House. The left side of his body was paralyzed. It was a pivotal time for the country: The Senate was debating whether the United States would join the League of Nations. According to the historian Robert Ferrell, “The president should have resigned immediately.” But rather than resign, Wilson went into hiding inside the White House, even concealing his ailment from his own Cabinet. His physician, Cary T. Grayson, announced that the president was merely suffering from “nervous exhaustion.” For the next four months, Wilson conducted virtually no official business. The United States never joined the League of Nations.

Donald Trump has been less transparent than most presidents about his health. His trip to Walter Reed National Military Medical Center last November remains shrouded in mystery. He is also prone to exaggeration. Harold Bornstein, the doctor who attended Trump before he became president, wrote in a 2015 letter that the then-candidate was in “astonishingly excellent” health and would be the “healthiest individual ever elected to the presidency.” Bornstein later insisted that Trump himself had dictated the letter.

The current White House physician is a naval officer named Sean Conley. His credentials, like those of Cleveland’s doctor, are unimpeachable. When Trump took hydroxychloroquine as a preventive measure against COVID-19 in May, Conley supervised the regimen—despite the fact that little evidence showed its effectiveness, and that some doctors even warned against it. This, perhaps, is a case of the president, not the physician, guiding the course of treatment.

Just as people in 1893 heard that Cleveland’s condition was “only a toothache,” the American people may not hear the full story about Trump’s condition. We experienced that vagueness yesterday, as his “mild symptoms” morphed into a helicopter trip to Walter Reed for a hospital stay. No law requires a president (or a presidential candidate) to release private medical records. And in the competing interests of maintaining a president’s privacy and informing the public, the doctor is obligated to be completely transparent with only one person.

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