The President Is a Sick Man

by Matthew Algeo

  But amid the tales of financial disaster in the papers that morning were stories reflecting the almost naïve optimism of what has come to be called the Gilded Age.* Arctic explorer Robert Peary was on his way to Greenland for the second time. The massive engines of the navy’s newest battleship, the Maine, were successfully tested at the Brooklyn Navy Yard. At the World’s Fair in Chicago, final preparations were underway for the grandest Fourth of July celebration ever. And excited crowds were packing National League ballparks, eager to see the results of the new, longer distance between the pitcher’s mound and home plate: sixty feet, six inches. They rarely went home disappointed. Batting averages rose faster than interest rates.*

  As far as Grover Cleveland was concerned, though, the best news in the papers that day came from an unlikely source: his old foe, Benjamin Harrison. Speaking to reporters in New York, the former president announced his support for repealing the Sherman Silver Purchase Act, which he had signed into law three years before. Harrison conceded that repealing the act would have a positive effect on public opinion, which he held responsible for the crumbling economy: “I do not attribute all of the evils of the present financial situation to the Sherman Act, but in the imagination of the people; that is one strong cause, and so I believe that its repeal would be beneficial.” It was feeble affirmation, but it was good enough for Cleveland, who had won a symbolically important, if grudging, ally. For the first time in weeks, he must have put the morning papers down with a smile.

  That morning, Cleveland worked feverishly to clear his desk—literally. The president did not share W. W. Keen’s “love of order.” His massive Resolute desk was always covered with piles of paper. As president, he was required to personally sign a mountain of documents every day—military commissions, land grants, diplomatic correspondence. Cleveland never learned how to properly dictate to a stenographer, so he answered in his own hand every letter he received, no matter how mundane. He also wrote drafts of his speeches in longhand. The piles on his desk occasionally grew tall enough to obscure the enormous president behind them. Now facing an extended “vacation,” Cleveland was eager to leave behind as little work as possible.

  Later that day, Cleveland signed the commissions of four naval cadets, including the first two to be trained in steam engineering.

  He also signed the proclamation summoning Congress for a special session to consider repealing the Silver Purchase Act. The lawmakers were to convene on August 7. It would be just the eleventh special session ever called by a president. In a draft of the proclamation, War Secretary Dan Lamont scribbled in the margin: “Written the day the president left Washington on account of illness.” Lamont, of course, was the only member of Cleveland’s cabinet aware of the impending operation.

  Around four o’clock that afternoon, Cleveland and Lamont climbed into the White House carriage and rode down Pennsylvania Avenue to the Baltimore and Potomac train station, where Garfield had been shot twelve years earlier.* No bodyguards accompanied them. The Secret Service would not begin protecting presidents until the following year, when agents uncovered a plot by a group of gamblers in Colorado to assassinate Cleveland, perhaps at the behest of pro-silver forces.

  At the station they boarded a special Pullman that was attached to the end of the Pennsylvania Railroad’s New York Express. The Pullman belonged to Frank Thompson, the railroad’s vice president, who, at Lamont’s request, had loaned it to the president “with the greatest pleasure.” Inside the car, Cleveland ordered the curtains drawn. He took off his heavy Prince Albert jacket and unbuttoned his collar. His heavily starched shirt was soaked with sweat. Exhausted, he threw himself into an upholstered chair and demanded a whiskey and a cigar, which a dutiful porter promptly produced.

  The train pulled out at 4:20 P.M.—right on time. The president’s departure was unannounced. By the time reporters in the capital learned that he’d called a special session of Congress, he was already gone.

  Lamont did not disturb the president, who stared out the window, silently watching Washington melt into Maryland through a cloud of tobacco smoke. Every few miles the train passed a shantytown along the tracks, each populated by the victims of the Panic of 1893. They were known as the mudsill—the lowest of the low. Too poor even to afford the meager rents of tenements, they roamed the cities and countryside by the thousands: homeless, jobless, hungry, and desperate. “Men died like flies under the strain,” wrote nineteenth- and early-twentieth-century historian Henry Adams of the panic. Some families were reduced to eating grass.

  The president didn’t have to worry about eating grass, but he certainly had his own concerns, even beyond his grave executive responsibilities. Office seekers still hounded him. His wife’s pregnancy—Frances was now due to give birth in two months—preoccupied him. And he had cancer. In less than twenty-four hours he would undergo radical surgery to remove the tumor in his mouth.

  He still sat in silence, gazing out the window of the speeding Pullman, hurtling toward New York at a mile a minute. His only consolation was that not a word of his condition had leaked. The papers were oblivious to his impending operation. For that, at least, he was grateful.

  Maryland gave way to Delaware. Wilmington approached. He demanded another whiskey.

  Meanwhile, the five doctors who would assist Bryant in the operation the next day quietly gathered on the Oneida. Erdmann, Hasbrouck, Janeway, Keen, and O’Reilly were each ferried to the yacht from different piers in the Oneida’s naphtha launch, an early version of a motorboat with a notoriously unpredictable engine. O’Reilly had traveled to New York incognito under the pseudonym Major Miller.

  At 10:32 P.M., the president’s train pulled into Jersey City. Dr. Bryant was waiting for him. So were several reporters, but Cleveland was in no mood for them. On the ferry from Jersey City to Manhattan—the panic had put an end to dreams of building a tunnel under the Hudson—he growled at a New York Times correspondent, “I have nothing to say for publication, except that I am going to Buzzards Bay for a rest.” It was the first of many half-truths, exaggerations, and outright lies that the press would be told about the operation.

  The ferry ride took about twenty minutes, after which Cleveland, Lamont, and Bryant squeezed into Bryant’s landau and rode, unnoticed in the darkness, across Lower Manhattan to Pier A on the East River. The Oneida was anchored a good distance offshore to keep prying eyes at bay. The naphtha launch was waiting to shuttle the three men to the yacht.

  The Oneida was one of the most spectacular yachts of the Gilded Age. Though not exceptionally large, the boat was fast and luxurious. HISTORIC NEW ENGLAND

  Even by the Gilded Age’s gaudy standards, the Oneida was a fabulous boat. Built in 1883 and originally christened the Utowana, the yacht won the Lunberg Cup, an international race, in 1885. So impressed was Elias Benedict, a fanatical yachtsman, that he bought the boat, refitted it for comfort as well as speed, and renamed it the Oneida, perhaps to honor the first tribe to side with the Americans in the Revolutionary War. At 138 feet the Oneida wasn’t exceptionally large (J. P. Morgan’s yacht was more than twice as long), but it was fast and luxurious, capable of running thirteen knots and comfortably accommodating a dozen passengers. It had an iron hull, two masts, and a steam engine. The quarters below deck were plush, though, by necessity, somewhat cramped. The Oneida combined the elegance of a schooner, the speed of a steamer, and the comfort of a luxury liner. It had been built in Chester, Pennsylvania, by John Roach, a brilliant, self-educated Irish immigrant who pioneered iron shipbuilding in the United States. Besides building yachts for the rich and famous, including almost-president Samuel Tilden, he also built the U.S. Navy’s first fleet of modern warships. Roach died in 1887—of cancer of the mouth.

  On the deck of the yacht, the president met with the doctors who would operate on him the next day. He already knew Bryant and O’Reilly, of course, and he’d almost certainly met Erdmann, Bryant’s assistant, as well. But Cleveland had probably never before been introduced
to the other three doctors, Hasbrouck, Janeway, and Keen.

  Grover sat in a deck chair, lit a cigar, and chatted with the doctors for about thirty minutes. For the first time all day he seemed relaxed. It was one of those increasingly rare moments when the other Grover emerged, the jovial raconteur. The warm night air was filled with pleasant chatter and the sweet smell of fine cigars. At one point Grover burst out, “Those officeseekers! They haunt me even in my dreams!” Around midnight the group retired to their cabins, except Bryant and Lamont, who returned to their respective homes in Manhattan. (Lamont maintained homes in both Washington and New York.) Dr. Keen later reported that the president needed no sedatives and slept soundly through the night, office-seeker dreams notwithstanding.

  One wonders how soundly the doctors slept.

  Cleveland was awakened the next morning by a knock on his cabin door. Begging his pardon, Janeway asked the president if he could examine him before he dressed. Grover consented unenthusiastically. His ambivalence toward doctors was well known. To an ailing friend he once wrote, “I hope that either by following your doctor’s directions or defiantly disobeying them (the chances probably being even in both contingencies), you will soon regain your very best estate in the matter of health.”

  Janeway found the president to be in surprisingly good shape. He was overweight, but his heart and lungs were healthy. He had little if any hardening of the arteries and no enlarged glands. His pulse was ninety beats per minute.

  Janeway washed out the president’s mouth with a disinfectant called Thiersch’s solution and declared him fit for the operation.

  Keen also examined the president that morning, personally inspecting the tumor for the first time. It was even larger than he’d expected. The grayish growth covered much of the left side of the palate. The surface was rough and cauliflowerlike. It looked like a giant wart.

  When he concluded his examination of the president, Keen was troubled by just one thing: a urinalysis revealed early-stage chronic nephritis, a kidney disease that is often dangerously aggravated by ether. The question of anesthesia vexed the doctors greatly. Keen held out hope that the entire operation could be performed with nitrous oxide, thereby avoiding ether altogether. Nitrous oxide (N2O), or laughing gas, was a popular recreational drug until its anesthetic properties were discovered by a Hartford dentist named Horace Wells in 1844. It was considerably less powerful than ether, which made it difficult to use in long operations, but it was also much safer, since ether frequently triggered pneumonia and other side effects. Ether was also highly combustible, an especially grave concern in a confined, poorly ventilated space—such as the saloon of a yacht. Like Keen, Bryant had hoped to “do this job with the use of laughing gas.” But Hasbrouck, the dentist who was also an experienced anesthetist, didn’t think nitrous oxide would be strong enough for the Cleveland surgery. “In the use of nitrous oxide for the operation about to be made,” he wrote in his case notes, “it is very doubtful in my opinion about keeping him under the influence of it for a sufficient length of time to complete the various steps of the operation as explained to me.” The doctors compromised: they would begin the operation with nitrous oxide and switch to ether only if absolutely necessary.

  Grover Cleveland (seated right) and “Commodore” Elias Benedict (standing right) on the deck of the Oneida in 1898, five years after the operation. NEW JERSEY STATE PARK SERVICE; PHOTO RESTORATION BY AL J. FRAZZA

  The preoperative examinations complete, Grover dressed in his usual dark suit and joined Commodore Benedict on the deck for a leisurely breakfast. They were joined by Bryant and Lamont, who had returned from their homes. The mood was relaxed, but the president’s famously voracious appetite was absent. He had only coffee and toast, though even that was too much. Surgical patients today are instructed to fast immediately before an operation, to minimize the risk of vomiting and possibly choking while anesthetized.

  After breakfast, it was solemnly noted, the president “moved his bladder and bowels in a natural manner.”

  Benedict ordered anchors aweigh, and the Oneida began steaming up the East River at half speed. It was a clear, bright Saturday morning, and the water was crowded with ferries and trawlers and schooners and even a few other yachts, but they all made way for the majestic Oneida, its spotless white hull gleaming in the fetid water. Like a bride gliding down the aisle, the boat effortlessly sailed the narrow channel between Manhattan and Queens. Cleveland, Benedict, Bryant, and Lamont sat casually on the deck chatting, looking to all the world like four carefree gentlemen on a pleasure cruise. On both shores, crowds gathered to catch a glimpse of the grand yacht and its esteemed passengers.

  The rest of the surgical team was hidden from view. “Passing the foot of 56th Street opposite Bellevue Hospital,” Dr. Erdmann remembered, “Dr. Bryant was particularly careful that we on board should not be recognized by any of the staff of Bellevue Hospital looking out. We went into the cabin so that we should not be recognized.”

  After navigating the treacherous currents of the Hell Gate, the Oneida turned eastward and headed for the cleaner, bluer, bigger waters of Long Island Sound. The weather was perfect, and, much to everyone’s relief, the water was calm. As the Oneida entered the sound, the mood on board turned more serious. When Bryant excused himself to join the other doctors below deck, he called out to the captain jokingly, “If you hit a rock, hit it good and hard, so that we’ll all go to the bottom!” Nobody laughed.

  In the saloon, the six doctors made final preparations for the operation. Quietly they washed their hands. Adhering strictly to Lister’s advice, they sterilized their instruments by boiling them in water. They pulled crisp white aprons over their dark suits.

  The doctors would be assisted by Charles Peterson, the Oneida’s “extremely loyal and faithful” chief steward, who would fetch hot water, towels, and bandages as needed.

  It’s worth mentioning just a few of the tools that the surgeons would not have at their disposal, simply because they had not yet been devised or perfected. They would have no suction apparatus for draining blood and other fluids from the operative site and no means of artificially resuscitating the patient should his heart stop. There would be no electronic monitors, no ventilators, no laryngoscopes, no endotracheal tubes. Surgery had come a long way since the Civil War—but it still had a long way to go.

  Shortly after noon, Cleveland returned to his cabin and stripped to his underwear. Then he walked into the saloon cum operating room. All but naked, the president of the United States stood before the surgeons in whose hands he now placed his life. He was calm, Keen remembered. It was a scene unprecedented in American history. Yes, presidents had undergone surgery before. Just six weeks into his first term, Washington had had a large carbuncle—a benign tumor—removed from his thigh without the benefit of painkillers. But never before had a president submitted willingly to a radical operation under anesthesia.

  Cleveland took his seat in the operating chair. His legs were stretched out, and his head was tilted back, as if he were trying to catch a nap.

  ”Commodore” Elias Benedict was one of Grover Cleveland’s closest friends and favorite fishing partners. It was on his yacht that the president’s secret operation took place. LIBRARY OF CONGRESS

  Pillows tied to the chair helped hold him in position. The doctors and Charles Peterson, the steward, took their places around the patient. No one else was in the room. Lamont and Benedict stayed up on the deck, lounging conspicuously, struggling to project an air of nonchalance to passing boats.

  Keen, ever the devout Baptist, offered a brief prayer, and at thirty-two minutes after noon Hasbrouck put a mask to the president’s face and began administering nitrous oxide. As Cleveland inhaled the gas, his hands trembled and twitched, but he didn’t succumb. Hasbrouck had to give him a second dose, and it took four minutes for the president to be sufficiently anesthetized. Keen’s heart sank. Hasbrouck had been right. Clearly, nitrous oxide would not be strong enough for the whole ope
ration. At some point, ether would have to be administered.

  It had been decided that the president’s two left upper bicuspids should be removed first. With a pair of dental pliers, Hasbrouck expertly extracted each tooth with a sharp yank. The president began to bleed. The hemorrhaging was stopped with manual pressure and an electric cautery, a device that sealed the wound by burning it. The scent of seared flesh began to fill the saloon. “Pulse remained first rate,” O’Reilly noted. “No pain.”

  A cocaine solution was injected around the edges of the tumor; at 12:50 P.M., more gas was administered.

  Using what was essentially a small electric carving knife, Bryant began making an incision around the tumor, cutting through the soft palate and the gums. Suddenly, Janeway noticed that the president seemed to be regaining consciousness. Frantically, Hasbrouck grabbed the mask and pressed it to Cleveland’s face, swiftly administering yet another dose of nitrous oxide. Assured the president was anesthetized once more, Bryant quickly finished the incision.

  It was now time for what Keen called “the more severe and bloody part” of the operation: the removal of the affected bone and tissue. For this there was now no question that ether would have to be administered. Keen murmured another short prayer as O’Reilly carefully placed the mask of the ether inhaler over the president’s mouth and nose.

  At 1:14 P.M., Bryant began to remove the tumor. Using the ingenious little retractor that Keen had bought in Paris nearly thirty years earlier, Bryant pulled back the president’s left cheek and, using a small scalpel, he cut the fleshy jowl away from the upper jaw. Then he began removing part of the president’s upper left jaw. “The front of the jaw was then chiseled loose from the first bicuspid to the posterior extremity of the bone,” Keen noted. Then, with a pair of heavy forceps, known as a ronguer, Bryant removed the affected parts of the president’s hard palate. Three more teeth were also removed. All the excised matter was carefully placed in a small jar.