The President Is a Sick Man

by Matthew Algeo

  The Cleveland family in 1893: Grover, Ruth, and Frances. LIBRARY OF CONGRESS

  At the Democratic convention in Chicago in June 1892, Cleveland, as expected, faced fierce opposition from pro-silver delegates, as well as his old nemesis Tammany Hall. But he still won the nomination on the first ballot, mainly because he was the only candidate with a realistic chance of actually winning the election. The silverites, however, won a consolation prize: Cleveland’s running mate would be former Illinois congressman Adlai Stevenson, whose stance on the money question was precisely the opposite of Cleveland’s. Stevenson favored the free coinage of silver. Cleveland wasn’t happy, but it was hardly an unusual situation. Presidential candidates did not begin choosing their own running mates until the 1940s. Before then, the vice presidential nominee was chosen at the party’s convention—usually with little input from the man at the top of the ticket. This inevitably led to some uncomfortable arranged marriages. Garfield and Arthur, for instance, were barely on speaking terms. It was, however, highly unusual for a president and vice president to be on opposite sides of the most fractious political issue of the day, as were Cleveland and Stevenson on the money question.

  Stevenson’s nomination balanced the ticket and mollified the silverites somewhat, but it would come back to haunt Cleveland.

  The 1892 campaign was even more tranquil than the campaign four years earlier had been. According to one historian, it was “the cleanest, quietest, and most creditable” since the Civil War. Truth was, the candidates hardly campaigned at all. Benjamin Harrison’s wife, Caroline, had contracted tuberculosis, and Harrison barely left her side. Cleveland refused to campaign as well, citing what he called the “afflictive dispensation of Providence.”*

  Mostly Cleveland whiled away the 1892 campaign at Gray Gables, his summer home on Cape Cod, fishing in Buzzards Bay and nursing his gout. Caroline Harrison died in the White House on October 25. Exactly two weeks later, Cleveland trounced Harrison in the most lopsided presidential election since Lincoln’s second victory in 1864. Cleveland carried twenty-three states, Harrison sixteen. James B. Weaver, the candidate of the pro-silver Populist Party, won four states. Cleveland won the popular vote by 3 percent, and he is still the only president besides FDR to have won the popular vote in more than two elections. The Democrats also captured both houses of Congress.

  Harrison’s undoing was the federal budget. He was the first president to sign a billion-dollar budget, and the Democrats made government spending a campaign issue. Not that Harrison minded losing. In fact, he seemed relieved. “For me there is no sting in it,” he said. “Indeed after the heavy blow the death of my wife dealt me, I do not think I could have stood the strain a reelection would have brought.”

  On March 4, 1893, the Clevelands returned to the White House, exactly as Frances had predicted four years earlier. As she’d requested, everything was just as the Clevelands had left it, with one notable exception: the Harrisons had replaced the gas lights with electric lights.

  Less than four months later, on the morning of Friday, June 23, Dr. Joseph Bryant examined the rough spot on the roof of Grover’s mouth and pronounced it a “bad looking tenant” that should be evicted posthaste. Fortunately, Bryant said, the tumor had been detected early. It could be removed surgically, though, as Bryant well knew, the procedure would be risky. Just three years earlier, Bryant had authored a paper on the removal of oral tumors. He reported a mortality rate of 14 percent.

  That afternoon, Bryant and White House physician Robert O’Reilly consulted with the president in his office above the East Room. Joining them was Dan Lamont, Cleveland’s close friend and former private secretary, who was now his secretary of war. The four men discussed, as Bryant later wrote, “the final removal of the disease, and the time and place of the operative procedure.” The tone was grave. Grover, sitting behind his massive Resolute desk, stroked his moustache compulsively, as was his habit when deep in thought. The discussion lasted into the evening, and the men made decisions that had the potential to alter the course of American history.

  The first decision: keep everything secret. “During the discussion,” Bryant recalled, “the president would not under any circumstances consent to the operative removal of the disease at a time or place that would not give the best opportunity of avoiding disclosures and even a suspicion that anything of significance had happened to him.” But there was a catch: secrecy was possible only if the surgery left no visible scars. It was possible, Bryant assured Cleveland, to perform the operation entirely within Cleveland’s mouth, without an external incision. But only if the cancer had not spread too far.

  Cleveland had two reasons for keeping his cancer secret. The first was political. If it came to be known he had the dread disease, he believed public confidence in the economy, already badly shaken, would be utterly shattered. Republican Wall Street, always suspicious of the Democratic president, would abandon him. The silverites would seize the opportunity to save the Silver Purchase Act. And, in the words of Dr. Bryant, the panic would “become a rout.” Cleveland was not being vain. It was widely believed that his health and the nation’s health were inextricably linked. In an editorial published before the full extent of his illness was even known, the Commercial and Financial Chronicle wrote, “Mr. Cleveland is about all that stands between this country and absolute disaster, and his death would be a great calamity.” Apart from Dan Lamont, not even his cabinet was to know. Cleveland was especially adamant that the truth be concealed from Adlai Stevenson, his pro-silver vice president. Cleveland’s failure to inform even his potential successor of the operation was uncharacteristically reckless. If the president died in surgery or was otherwise disabled, Stevenson would be wholly unprepared to assume power.*

  The second reason for secrecy was personal. As mentioned, Cleveland was by nature intensely private. He had witnessed firsthand the ghoulish hoopla surrounding Ulysses Grant’s illness, and he had no intention of becoming the object of such a spectacle. Cleveland, Bryant wrote, had a “strong desire to avoid the notoriety naturally incident to public knowledge” of his illness.

  The four men then discussed the timing of the operation. Bryant wanted it to take place immediately, but Cleveland said he needed some time to get things in order first. “I cannot leave here before the end of the month [June] under any circumstances,” the president said. “Therefore, since the time must be set, I will say to you that I will be ready on the first day of July.” And so it was decided that the operation would take place on Saturday, July 1.

  Finally, there was the crucial matter of place. It was quickly concluded that it would be impossible for the operation to be performed in a hospital. The risk of leaks was far too great. Gray Gables, the president’s summer home on Buzzards Bay, was briefly considered but also rejected—too many reporters snooping around. At Cleveland’s suggestion, it was ultimately decided that the best place for the operation would be the Oneida, a luxury yacht owned by the tycoon “Commodore” Elias Benedict, who was a close friend of the president. (Benedict was no more a commodore than Dan Lamont was a colonel.) Cleveland had logged more than fifty thousand miles on the Oneida, mostly fishing in Long Island Sound and off the coast of Cape Cod. His presence on the boat would arouse no suspicions whatsoever. The surgical team and equipment would be boarded surreptitiously before the president. The operation would take place while the boat sailed from New York to Gray Gables. For all the world it would look like the president was simply sailing to his summer home for a well-deserved respite. It was a simple solution, though the doctors understood it would pose some unusual and potentially dangerous problems.

  Unspoken was the very real possibility that Cleveland would suffer the same fate as General Grant. If the tumor had grown too large to remove, the president, like the general, would meet a most unpleasant demise, slowly suffocating.

  It was agreed that Bryant would return to New York to assemble the surgical team. Lamont would assist with the preparations from Washi
ngton. O’Reilly would monitor the patient until the operation.

  President Cleveland, meanwhile, had one week to ponder his fate— and the nation’s—before the operation.

  The four men must have shared a good stiff drink before adjourning for the night.

  Grover Cleveland was not the first president to attempt to conceal an illness from the public, and he would certainly not be the last. George Washington tried to hide the fact that he contracted influenza during his first term. The illness—which nearly killed him—left the nation leaderless for several weeks. In November 1863, shortly after delivering the Gettysburg Address, Abraham Lincoln came down with smallpox, which his aides dismissed as “varioloid,” the mildest form of the disease. In fact, Lincoln had the most virulent form of smallpox, and it took him more than a month to recover—at one of the most crucial moments in the nation’s history. When the Associated Press reported that President Chester Arthur was suffering from a fatal kidney ailment called Bright’s disease in 1882, Arthur categorically denied the report, but less than two years after leaving office, he died of complications from the disease.*

  Loath to appear weak in any way, some presidents have gone to remarkable lengths to hide their infirmities. On October 2, 1919, shortly after returning to the White House from a grueling nationwide speaking tour, Woodrow Wilson suffered a massive stroke. What followed was a most audacious cover-up. The stroke paralyzed the left side of Wilson’s body and incapacitated him so completely, physically and mentally, that, in the words of historian Robert Ferrell, “The president should have resigned immediately.” Instead, the White House physician, Cary T. Grayson, announced that Wilson was merely suffering from “nervous exhaustion.” For four months Wilson conducted virtually no official business, and for the remaining thirteen months of his term, Ferrell writes, “he could hardly focus his mind on any piece of public business beyond, say, ten minutes or so, after which he tired.” It was another critical moment in our history: At the time, the Senate was debating ratification of the Treaty of Versailles, which ended World War I and created the League of Nations. Without Wilson’s leadership, the treaty was doomed. The Senate rejected it by a vote of fifty-three to thirty-eight.

  Wilson had suffered his first stroke in 1896 at age thirty-nine. Two more followed, in 1904 and 1906. The electorate knew nothing of Wilson’s health problems, however. The square-jawed son of a Presbyterian minister, Wilson projected an image of stern vigor, and he was elected governor of New Jersey in 1910 and president of the United States in 1912 and 1916, making him the first Democrat to capture the White House since Grover Cleveland in 1892.

  Like Cleveland, Wilson concealed his ailment even from his own cabinet. For four months after the stroke, only his doctors, his private secretary, and his wife, Edith, were permitted to see him. What little business that was transacted went through Edith, whom Wilson had married in 1915, a little more than a year after the death of his first wife. Papers sent to the president were returned with notes in Mrs. Wilson’s handwriting, not the president’s. Edith Wilson, for all intents and purposes, oversaw the executive branch after her husband’s stroke. It has been said that she could be considered the country’s first female president.

  Also like Cleveland, Wilson was especially eager to hide the truth from his would-be successor. After the stroke, Vice President Thomas Marshall didn’t see Wilson until the day the two men left office.

  It wasn’t until February 10, 1920—more than four months after the stroke—that one of Wilson’s doctors finally admitted to a Baltimore Sun reporter that the president had, in fact, suffered a “cerebral thrombosis.” By then, of course, it was obvious that something was gravely amiss. Wilson, now a recluse with a white beard, hadn’t been seen in public since the stroke. Still, the White House continued the charade that the president was well. In April 1920, a clean-shaven Wilson finally reconvened his cabinet. At meetings he sat propped up in a chair, White House usher Ike Hoover remembered, “as one in a trance.” Wilson said almost nothing at the meetings. What little he did say was barely intelligible. After the first cabinet meeting “dragged on for more than an hour,” Mrs. Wilson stepped in to stop it. “The stories in the papers from day to day may have been true in their way,” Hoover said, “but never was deception so universally practiced in the White House as it was in those statements being given out from time to time.”

  Wilson’s term ended on March 4, 1921. Despite pressing domestic problems, including rampant inflation and widespread racial and labor strife, Wilson accomplished nothing after the stroke. He never fully recovered, and he died less than three years after leaving office.

  Presidents have not always received the best health care available, often because they’ve chosen their health care providers poorly. Like so many other appointments, a president’s choice of White House physician is often based on sentiment or politics, not on expertise. Wilson’s White House physician, Cary Grayson, lucked into the job. Grayson, who attended medical school for just one year, happened to attend a luncheon at the White House shortly after Wilson’s inauguration. During the luncheon, Wilson’s sister tripped and cut her forehead. Grayson stitched the wound, winning Wilson’s gratitude—and a plum job. (It helped that Grayson, like Wilson, was a native Virginian.) Another doctor might not have allowed the frail president to undertake the speaking tour that immediately preceded his stroke.

  Wilson’s successor, Warren Harding, was a genial nincompoop who chose as his White House physician the hopelessly unqualified Charles Sawyer, an old family friend and archetypal small-town doctor. Sawyer practiced homeopathy, a form of alternative medicine in which patients are prescribed tiny doses of substances that replicate the very symptoms that are meant to be cured. For example, a patient with insomnia might be prescribed a tall glass of water with a few drops of coffee. The underpinning theory articulated by Samuel Hahnemann, the German doctor who invented homeopathy more than two hundred years ago, is that like cures like. Homeopathy had been widely discredited by the time Harding became president, but Dr. Sawyer was not persuaded. Sawyer was also fond of prescribing pills by color. Once he prescribed the president a dose of soda water and two pink pills.

  When he became president, Harding’s systolic pressure was 180 (it should have been 140 or less). His heart was so weak that it was unable to pump blood out of his lungs. As a result, Harding had to sleep propped up with pillows. If he slept lying down, blood would pool in his lungs, making it difficult for him to breathe. Even his valet knew Harding was deathly ill, telling a Secret Service agent that “something is going to happen to our boss.” A better doctor certainly would have noticed the unmistakable symptoms of heart disease, but Sawyer didn’t.

  In the summer of 1923, Harding undertook a punishing tour of Alaska and the West Coast. The heat was scorching, and the president weakened by the day. He could barely stand. His speech was slurred. On the night of July 27, Harding went to bed in Seattle complaining of painful cramps. He had probably suffered a heart attack, but Sawyer dismissed it as a touch of food poisoning. Six days later, in Room 8064 of the Palace Hotel in San Francisco, Harding’s heart stopped beating. Officially, the cause of death was ruled a stroke, though the underlying cause was undoubtedly congestive heart failure.

  But when it comes to presidents receiving bad health care, it’s hard to top poor old James Garfield. As if getting shot twice by Charles Guiteau at a Washington train station on July 2, 1881, wasn’t bad enough, Garfield was then subjected to some real Keystone Kops doctoring. One of the bullets harmlessly grazed his right arm, but the other entered his lower back. The first doctor on the scene stuck his dirty finger into the wound in Garfield’s back to determine the path of the bullet and, if possible, remove it. The second doctor on the scene did the same thing. The president was taken back to the White House. X-rays were still unknown at the time, and over the next twenty-four hours more than a dozen doctors probed the president’s wound with unwashed fingers and unsterilized instruments, futilely at
tempting to locate the bullet. This triggered an infection that could have been cured only with medicines yet undiscovered.

  Outside Garfield’s room, his doctors began to argue among themselves about the best course of treatment. Some advocated immediate surgery. Others argued the risk was too great. Tensions ran so high that a fistfight broke out. No surgery was performed.

  An illustration depicting the death of President Garfield on September 19, 1881. The medical care that Garfield received after he was shot was so shoddy that he probably would have been better off—and might have lived—if his doctors had never touched him. LIBRARY OF CONGRESS

  Notably, Garfield’s White House physician, Jedediah Baxter, was not among the doctors attending the wounded president. Baxter was an excellent physician, but, due to a toxic combination of professional jealousy and personal animosity, the other doctors refused him access to Garfield.*

  At one point, Garfield’s doctors enlisted Alexander Graham Bell to help find the bullet lodged inside the president. Bell and another inventor named Simon Newcomb had devised a crude metal detector fashioned out of wire coils, a battery, and a telephone receiver. But when they passed the contraption over Garfield’s body, it seemed to detect metal everywhere. The inventors were deeply disappointed by their failure. What they didn’t realize was that the president was lying on a brand-new mattress with coil bedsprings, a recent innovation at the time.

  Garfield’s condition did not improve. The infection ravaged him. Pus oozed from his wound and filled his salivary glands, swelling his face. His weight dropped precipitously. He lingered until September 19.