Also by Ludwig M. Deppisch, M.D.
*
The White House Physician: A History from Washington to George W. Bush (McFarland, 2007)
The Health of the First Ladies
Medical Histories from Martha Washington to Michelle Obama
Ludwig M. Deppisch, M.D.
Foreword by Dr. Connie Mariano
McFarland & Company, Inc., Publishers
Jefferson, North Carolina
LIBRARY OF CONGRESS CATALOGUING DATA ARE AVAILABLE
BRITISH LIBRARY CATALOGUING DATA ARE AVAILABLE
e-ISBN: 978-1-4766-1766-4
© 2015 Ludwig M. Deppisch, M.D. All rights reserved
No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying or recording, or by any information storage and retrieval system, without permission in writing from the publisher.
On the cover: top to bottom First Ladies Martha Washington, Louisa Catherine Adams, Eleanor Roosevelt, Jackie Kennedy and Nancy Reagan (all photographs
Library of Congress); background the White House (iStock/Thinkstock)
McFarland & Company, Inc., Publishers
Box 611, Jefferson, North Carolina 28640
www.mcfarlandpub.com
To Barbara and Carl
with pride and love
Table of Contents
Acknowledgments
Foreword Dr. Connie Mariano
Preface
Introduction
Part I: Before the Advent of Modern Medicine
One. Martha Washington and Dolley Madison: The First First Lady and the First Mistress in the White House
Two. Malaria in the White House: Abigail Adams, Sarah Polk and Lucretia Garfield
Three. Letitia Tyler: A First Lady Dies in the White House
Four. Retiring and Sickly First Ladies in Antebellum Washington: Elizabeth Monroe, Anna Harrison, Margaret Taylor and Abigail Fillmore
Five. Depression in the White House: The Sad Stories of Jane Pierce, Louisa Johnson Adams and Mary Todd Lincoln
Six. Julia Grant and Lucy Hayes: Healthy, Supportive, Socially Successful and Minimal Political Impact
Seven. Tuberculosis: The White Plague Kills Caroline Harrison and Ravages Other First Ladies
Part II: The Twentieth Century
Eight. Ida McKinley and the Audition of the First White House Physician
Nine. Strokes, Stress and Smokes: Nellie Taft and Pat Nixon
Ten. Ellen and Edith: Woodrow Wilson’s Two Wives
Eleven. Homeopathic Physicians and the Kidney Disease of Florence Harding and Grace Coolidge
Twelve. Mamie Eisenhower and Menière’s Disease
Thirteen. Obstetrics in the White House: Jackie Kennedy, Frankie Cleveland, Edith Roosevelt and the Second Mrs. Tyler
Fourteen. Twentieth Century Stalwarts: Lou Hoover, Eleanor Roosevelt, Bess Truman and Lady Bird Johnson
Part III: Modern Times and Into the Twenty-First Century
Fifteen. Breast Cancer and Other Maladies: Betty Ford, Rosalynn Carter and Nancy Reagan
Sixteen. Modern-Day First Ladies: Barbara Bush, Hillary Clinton, Laura Bush and Michelle Obama
Seventeen. The Diseases, Burdens and Confidentiality of First Ladies
Chapter Notes
Bibliography
List of Names and Terms
Acknowledgments
Once again I have discovered that the writing of a book of history is a long, arduous, and complex undertaking. For an author to complete this task, the assistance of many is a necessity. To those people, the following acknowledgments in print are but a modest and inadequate expression of my appreciation.
I owe special thanks to Dr. Jeanne Clarke for her unselfish commentary and copyediting of the manuscript; to Dr. Connie Mariano for her generosity in sharing her unique perspective on the workings of the White House Medical Unit; to Dr. Katherine Morrissey, teacher extraordinaire, for her encouragement and insights; to Andre Sobocinski, a splendid public servant, for his knowledge and assistance in innumerable ways.
Hannah Fisher, research librarian of the University of Arizona Health Sciences Library, was never presented with the name of an obscure physician whose biography she failed to locate. Carl Sferrazza Anthony, historian to the National First Ladies’ Library, graciously answered my many requests for information. Mike Shaw’s computer skills were of great assistance in the final organization of the manuscript.
Special thanks are owed to the National First Ladies’ Library, Canton, Ohio. This unique institution has become a comprehensive repository of information related to America’s first ladies. Its extensive bibliography became for me an indispensible source of first ladies information.
I am grateful to the many librarians and archivists who responded to my requests with generosity and patience: Kevin Bailey, Ellen Brightly, Jennifer Capps, Tiffany Cole, Peggy Dillard, Judith Graham, David Haugard, Nancy Johnson, Laura Karas, Patrick Kerwin, Pat Krider, Nancy Miller, Nancy Hord Patterson, Arlene Shaner, Heidi Stello, Cynthia Van Ness. My sincere apologies to anyone whose assistance I may have neglected to acknowledge.
Thank you to my medical colleagues whose insights and counsel have been most helpful in the writing of this book: Doctors Rob Darling, Jonathan Davidson, Emanuel Husu, Howard Lein, Alan Levenson, Hugh Smith and Dick Tubb.
And finally, and most important, thank you to my wonderful family: my children, Barbara, Carl and Rich, my grandchildren Nick, Joey and Jake, and, above all, my dear wife, Rosemarie. The book is done. I am back in your lives.
Foreword
Dr. Connie Mariano
When I first arrived at the White House in 1992 as the new White House physician, I received a detailed orientation covering my responsibilities. I was to take care of the president but was also responsible for the care of the first lady. I was instructed early in my nine-year White House tour that any statements regarding the president’s health were to be issued though the White House press secretary with the approval of the president. On the other hand, there were to be no statements issued about the health of the first lady. Since the wife of the president was not an elected official, her health and medical history were considered private issues and not for discussion in the press.
In his The Health of the First Ladies, Dr. Lud Deppisch breaks taboo and tradition. He explores the health history of each of the first ladies in a scholarly and comprehensive manner. He demonstrates that each first lady is representative of the women of her ea. He divulges through his meticulous research their medical issues, access to care, and the way they were each treated in sickness and in health.
Why is the health of the first lady significant? When you look at the inner circle of the president of the United States, no one has greater access to, and intimacy with, the president than the first lady. She is the first voice he hears every morning and the last voice he hears every night. If the first lady suffers from an illness, her condition most likely would impact the president’s attention, concern, and, ultimately, his ability to function in office. Dr. Deppisch offers an illuminating and fascinating look at the importance of the health of the presidential spouse.
Dr. Connie Mariano was the White House physician from 1992 to 2001 and is the author of The White House Doctor: My Patients Were Presidents
Preface
Rising Interest in the Lady in the White House
Eleanor Roosevelt shattered the mold that traditionally confined presi
dential spouses to the background, if not to obscurity.1 Mrs. Roosevelt stepped far beyond the shadow cast by the formidable figure of her quadruple-elected husband to become a public political figure in her own right. Later, in a different fashion, Jacqueline Kennedy illuminated the visual and print media with her stylish success in fulfilling the social and ceremonial responsibilities of a first lady. Pat Nixon, Hillary Clinton, Laura Bush and Michelle Obama increasingly traveled abroad without their presidential husbands and attracted significant attention while doing so. At the onset of the twenty-first century, the president’s wife has become a celebrity, not a subsidiary. A simple expression by first lady Michelle Obama that Americans should drink more water received disproportionate and substantial wide publication and commentary.2 Consequently, it is timely to examine in detail a significant aspect of their lives: their health and medical histories. To my knowledge this subject has not been addressed in either a systematic or comprehensive manner.
Dispositive proof of increased interest was the establishment of the National First Ladies’ Library. This institution was founded in 1998 in Canton, Ohio, the hometown of President and Mrs. William McKinley. Mary Regula, social science teacher and wife of Ohio state legislator Ralph Regula who later became congressman was the force behind its establishment. She was both frustrated and dismayed by the dearth of published information about presidential spouses. Consequently Regula focused her leadership, drive and political savvy to combine the renovation of a historic house in downtown Canton with the establishment of a first ladies bibliography of 40,000 entries. The result was the National First Ladies’ Library located within the renovated Saxton-McKinley House, in which president-to-be William McKinley and his wife, Ida Saxton McKinley, resided for fourteen years while he was a congressman. The library also serves as the museum of the Saxton-McKinley homestead. It presents frequent exhibits and events and has become an important and invaluable resource for education and research about America’s first ladies.3
Biographies and autobiographies of individual presidential spouses have long filled the shelves of university libraries. Occasionally these books have reached prominence either by placement on best-seller lists or by the published accolades of prestigious academic panels.4 Several writers have broadened the scholarship on this topic; these historians have either authored or edited biographical synopses inclusive of all first ladies at the time of this publication. Perhaps the first to attempt this task was the prolific Laura C. Holloway. Her The Ladies of the White House: Or, In the Home of the Presidents; Being a Complete History of the Social and Domestic Lives of the Presidents from Washington to the Present Time, 1789–1881 was published in 1881 by the Bradley publishing house in Philadelphia.5
Historian Betty Boyd Caroli has updated her compendium, First Ladies, at least three times since 1987. In the introduction to her initial edition, she wrote the following: “In the beginning, I considered writing a history of the institution of first lady, a book that would have documented the decision making process, the level of staff performance, and the rise in power of the distaff side of the White House. I abandoned the project when I realized that most readers would want more biographical information than that volume would have involved…. Whatever the future, the bicentennial of the Constitution approaches, and it seems appropriate to look at presidents’ wives and see how the role of First Lady was transformed from ceremonial backup to substantive world figure.”6
Carl Sferrazza Anthony is the consultant historian to the National First Ladies’ Library. In his two-volume 1990 biography, First Ladies: The Saga of the Presidents’ Wives and Their Power, 1789–1961, he wrote: “What intrigued me most was their varying degrees of power…. How much power did she exercise? How much influence did she seek to wield, and how successful was she? … Another consideration was how well they embodied their eras…. So I have placed great emphasis on the times, and one woman is used to represent each of the periods. Particular to each, like civil rights, women’s issues, the press and public, technology, and how the women responded to or were affected by them—are woven through the two hundred year story.” In the end, he said, “almost every one of them missed the power.”7
The First Ladies’ National Library, Canton, Ohio, the Saxton McKinley House, the family home of first lady Ida Saxton McKinley and longtime residence of President and Mrs. McKinley (courtesy National First Ladies’ Library).
Education and Research Center (courtesy National First Ladies’ Library).
Margaret Truman, the daughter of President Harry and first lady Bess Wallace Truman, scrutinized the lives of these women from an insider’s perspective. Her biographical work, First Ladies, was released by Random House in 1995.8 Professor Robert P. Watson in his 2000 book, The Presidents’ Wives: Reassessing the Office of First Lady, analyzed the evolving social, ceremonial and political responsibilities of this unofficial position and has measured the success of each in fulfilling these responsibilities.9
In 2001 Louis L. Gould edited and contributed to America’s First Ladies: Their Lives and Their Legacy. The book was a compendium of short biographies of all of the first ladies up to the publication date. Gould’s purpose for the work was stated in the introduction: “By the early 1990s the outlines of a distinct research area devoted to First Ladies had emerged where history, political science, and women’s studies intersected…. Despite these constructive achievements the new field lacked a reliable up to date reference work that included the essential facts about each First Lady in a brief biographical essay.” Therefore, he produced his book as an “effort to assess … place in the development of the institution of the First Lady.”10
Both professors Robert Watson and Louis Gould have edited an ongoing series of concise biographies of individual first ladies. The Presidential Wives series is edited by Watson and published by Nova History of New York. Modern First Ladies is edited by Gould and published by the University of Kansas Press. Watson’s purpose is public enlightenment regarding the important office of first lady and the power and influence of its occupants.11 Gould’s foreword to his series’ biography of Grace Coolidge is more personal and specific: “[It] will leave readers … with the real sense of Grace Coolidge as a human being and a contributor to the historical legacy of presidential wives.”12
The Genesis of This Book
My previous book, The White House Physician: A History from George Washington to George W. Bush, focused on the complex nexus of the health of American presidents, their medical care, their medical practitioners, and the evolution of medical practice in the United States. During my research, I discovered that presidential wives lived compelling and interesting histories. They were frequently ill; their health often suffered because of their husbands’ ambitions; some were crushed by the responsibilities of a first lady, while others thrived. The influence of their health on their spouses’ executive performance was both complicated and at times ambiguous. The subject of the health of the first ladies of the United States became too intriguing and enticing to abandon. Hence this book. The chapters that follow explore various aspects of the first ladies’ health. The histories are presented in a broadly chronological sequence. However, in a few instances, exceptions will occur when individual stories from different times will be conflated for purposes of interest and explanation.
The medical histories of the first ladies will be examined. Focus will be upon, but not restricted to, their years in the White House. Their medical care will be analyzed, with respect to both diagnostic and therapeutic standards of the times and the qualifications and competence of their physicians. With the passage of time, public and preventative health measures, refined medical skills and major scientific advances have influenced the types and severity of illness. Over two and a quarter centuries, America’s first ladies have battled in rough sequence: infections (yellow fever, malaria, tuberculosis); pregnancy-related disorders; mental problems; kidney ailments; vascular disease, including stroke; cancer; and, lastly, autoimmune
disorders such as Barbara Bush’s bout with Graves’ disease.
Particular attention will be given to this question: Did health influence performance as first lady? The role of the first lady encompasses social, ceremonial, familial and political responsibilities in variable degrees. Did illness affect any first lady’s success in accomplishing her duties? Conversely, did these responsibilities affect the health of the first lady? Also, does marriage to a very ambitious man take a toll on the health of his wife? Admittedly this is a question that in many cases has no definitive answer.
Illness may plausibly affect the performance of a president who is confronted with the sickness of a loved one. However, any generalization is a Herculean task far beyond the scope of this book. The specific responses of two presidents, Franklin Pierce and William McKinley, when faced with this situation will be described.
The position of first lady accrues medical advantages that may be unavailable to other citizens, which gives rise to the following questions: What sort of medical attention did the first ladies receive and from whom? Was their care equivalent to that received by other women of that era? Therefore, the selection, training, and success or failure of the treatments by their physicians will be discussed. Moreover, it was possible that presidents were given different, and possibly better, medical care and attention than their wives. Over the years physicians to the first ladies were burdened with additional conflicts: patient confidentiality versus the public’s right to know; homeopathic care versus orthodox medicine; and when and whom to employ as medical consultants.
Lastly, consideration will be given to the use by the first lady of the “bully pulpit,” or, more appropriately, the “velvet voice,” to raise public awareness through a personal experience with a disease. This has occurred with increasing frequency since the mid-twentieth century and has become a significant point of political discourse.
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