The Medical Ordeals of JFK

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? …

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 …

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 20 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 1955–63. 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 difficulties of chronic illness …

Kennedy’s collective health problems were not enough to deter him from running for president. Though they were a considerable burden, no one of them impressed him as life-threatening. Nor did he believe that the many medications he took would reduce his ability to work effectively; on the contrary, he saw them as ensuring his competence to deal with the demands of the office. And apparently none of his many doctors told him that were he elevated to the presidency, his health problems (or the treatments for them) could pose a danger to the country.

After reaching the White House, Kennedy believed it was more essential than ever to hide his afflictions. The day after his election, in response to a reporter’s question, he declared himself in “excellent” shape and dismissed the rumors of Addison’s disease as false …

A Thousand Days of Suffering

During his time in the White House, despite public indications of continuing back difficulties, Kennedy enjoyed an image of robust good health. But according to the Travell records, medical attention was a fixed part of his routine. He was under the care of an allergist, an endocrinologist, a gastroenterologist, an orthopedist, and a urologist, along with that of Janet Travell, Admiral George Burkley, and Max Jacobson, an émigré doctor from Germany who now lived in New York and had made a reputation by treating celebrities with “pep pills,” or amphetamines, that helped to combat depression and fatigue. Jacobson, whom patients called “Dr. Feelgood,” administered amphetamines and back injections of painkillers that JFK believed made him less dependent on crutches …

The Travell records reveal that during the first six months of his term, Kennedy suffered stomach, colon, and prostate problems, high fevers, occasional dehydration, abscesses, sleeplessness, and high cholesterol, in addition to his ongoing back and adrenal ailments. His physicians administered large doses of so many drugs that Travell kept a “Medicine Administration Record,” cataloguing injected and ingested corticosteroids for his adrenal insufficiency; procaine shots and ultrasound treatments and hot packs for his back; Lomotil, Metamucil, paregoric, phenobarbital, testosterone, and trasentine to control his diarrhea, abdominal discomfort, and weight loss; penicillin and other antibiotics for his urinary-tract infections and an abscess; and Tuinal to help him sleep. Before press conferences and nationally televised speeches his doctors increased his cortisone dose to deal with tensions harmful to someone unable to produce his own corticosteroids in response to stress. Though the medications occasionally made Kennedy groggy and tired, he did not see them as a problem. He dismissed questions about Jacobson’s injections, saying, “I don’t care if it’s horse piss. It works” …

Kennedy continued to need extensive medication. His condition at the time of the Cuban missile crisis is a case in point. The Travell records show that during the 13 days in October of 1962 when Moscow and Washington brought the world to the brink of a nuclear war, Kennedy took his usual doses of anti-spasmodics to control his colitis, antibiotics for a flare-up of his urinary-tract problem and a bout of sinusitis, and increased amounts of hydrocortisone and testosterone, along with salt tablets, to control his Addison’s disease and boost his energy. Judging from the tape recordings made of conversations during this time, the medications were no impediment to lucid thought during these long days; on the contrary, Kennedy would have been significantly less effective without them, and might even have been unable to function. But these medications were only one element in helping Kennedy to focus on the crisis; his extraordinary strength of will cannot be underestimated.

This is not to suggest that Kennedy was superhuman, or to exaggerate his ability to endure physical and emotional ills. On November 2, 1962, he took 10 additional milligrams of hydrocortisone and 10 grains of salt to boost himself before giving a brief report to the American people on the dismantling of the Soviet missile bases in Cuba. In December, Jackie complained to the president’s gastroenterologist, Russell Boles, that the antihistamines for food allergies had a “depressing action” on the president. She asked Boles to prescribe something that would assure “mood elevation without irritation to the gastrointestinal tract.” The Travell records reveal that Boles prescribed one milligram twice a day of Stelazine, an anti-psychotic that was also used as a treatment for anxiety. In two days, Kennedy showed marked improvement, and he apparently never needed the drug again …

Lee Harvey Oswald killed Kennedy before the president’s medical ailments could. But the evidence suggests that Kennedy’s physical condition contributed to his demise. On November 22, 1963, Kennedy was, as always, wearing a corsetlike back brace as he rode through Dallas. Oswald’s first bullet struck him in the back of the neck. Were it not for the back brace, which held him erect, the second, fatal shot to the head might not have found its mark.

Read the full article in the Atlantic archives.