The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama

by Deppisch, Ludwig M. , M. D.

The president was certainly confused, probably as a result of Grayson’s misdirection and ignorance. His letters from late June to late July contain phrases such as the following: “…fear … is past and she is coming along slowly but surely”; “Ellen is making good progress”; “…at present to be making little progress, and yet it still seems certain that there is nothing wrong with her.”56

  As First Lady and Beyond

  The course and fatal outcome of Mrs. Wilson’s kidney disease probably were not related to her responsibilities as first lady. She was ill prior to her husband’s election to the presidency. When her symptoms worsened in the late spring of 1913, she temporarily retired from the White House to spend a restful summer in New Hampshire. Upon her return to Washington, she exhausted herself during the planning and organization of daughter Jesse’s elaborate wedding. However, the above opinion is not unanimous. A prominent newspaper opined: that “Bright’s disease … was aggravated by a nervous breakdown attributed to the exertion of social duties and her active interest in philanthropy and betterment work.”57

  The first lady was the recipient of the continual attention and care of the White House physician. She was one of his only two patients. Moreover, Grayson was able to command when necessary the consultations of eminent physicians, e.g., Doctors Davis, Brown and Dercum. But his commitment to Ellen was muted by his prioritization of Woodrow Wilson’s psychological well-being. Grayson successfully masked the seriousness of Ellen’s illness; the president’s connubial distractions were consequently limited, allowing him to focus on the affairs of state. Psychologically unprepared for his wife’s death, Wilson became emotionally devastated and went through a severe reactive depression that lasted four or five months.58

  Woodrow Wilson’s lifelong emotional and psychological difficulties were so prominent that Sigmund Freud coauthored with William Bullitt a book that analyzed them. Regarding his wife’s death, Freud and Bullitt wrote the following: “She had been a perfect wife to Woodrow Wilson: an admirable mother representative, a ‘center of quiet’ for his life…. [T]he loss of Ellen Axson shook the foundations of his character. He could not pull himself out of the depression caused by her death. Again and again he expressed his grief and his hopelessness … his life was unbearably lonely and sad since … death and he could not help wishing someone would kill him.” In the wake of Ellen’s demise, the president experienced grief, hopelessness, inadequacy, extreme loneliness, and guilt. He blamed his political ambitions for his wife’s death. “He felt that his life was over, and, in the depths of his depression, he expressed the wish that someone would kill him.”59

  Did Woodrow Wilson’s Bereavement Affect His Performance as President?

  Mrs. Wilson died on August 6, 1914, the same day that Austro-Hungary declared war on Russia, one of the many actions that embroiled Europe in World War I. Wilson’s doctor noted that his patient’s attention was not upon the war, and not even upon American politics, but upon his deceased wife. Instead of exercising international leadership, Wilson was distracted, confessing to his senior advisor, Colonel House, that he could “not think straight” and “had no heart in the things he was doing.”60

  Edmund Morris, in the final volume of his three-volume biography of Theodore Roosevelt, concluded that Woodrow Wilson, during the late summer of 1914, was perhaps the only statesman who could influence the outcome of the war. But the immobilized and depressed Wilson “could concentrate only on the driest details of domestic policy…. When Wilson thought about foreign policy at all, he brooded over the still-unsettled situation in Mexico.” In a grotesque coincidence, both Woodrow Wilson and his archenemy, Theodore Roosevelt, lost their first wives to Bright’s disease.61

  Grayson’s efforts to pierce his patient’s depression included golf, automobile drives, and trips on the presidential yacht, Mayflower. Any relief was only temporary. After Colonel House departed the executive mansion for a European fact-finding trip in January 1915, Wilson’s loneliness became so desperate that he approached “a nervous collapse.” Music and guests at the White House became additional parts of Wilson’s therapeutic regimen.62

  Although stories differ, the ever-concerned personal physician and by this time an intimate friend, Cary Grayson, was in some ways behind the introduction of the lonely president to his second wife, Edith Bolling Galt, “an outgoing, buxom, forty three year old widow, the owner of a thriving jewelry store.” The wedding occurred ten months after they first met, and Wilson recovered from his inactivity and depression.63

  Some Final Thoughts

  A recurrent leitmotif in this book so far is the morbidity associated with pregnancy. This situation lasted until the first decade of the twentieth century. Louisa Catherine Adams, who experienced twelve pregnancies, may have suffered from postpartum depression. A cerebrovascular stroke felled Letitia Tyler, who experienced nine pregnancies during her reproductive years. It is not farfetched to speculate upon a nexus between her repeated deliveries, the onset of hypertension, and the hemorrhagic infarction in her brain. There is an unequivocal connection between Ida McKinley’s second pregnancy and her stroke and lifelong epilepsy. Caroline Harrison’s genital organs were damaged during a difficult delivery. The resultant vesicovaginal fistula required surgical repair and a long convalescence. Finally, it is probable that Ellen Wilson developed toxemia of pregnancy with chronic kidney disease.

  A second recurring theme is the predilection of first ladies in the second half of the nineteenth century towards homeopathically trained physicians. Homeopathy in America increased in acceptance as the century progressed and peaked around 1900. Lucretia Garfield was treated for malaria by Drs. Susan Edson and Silas Boynton; Caroline Harrison was treated for tuberculosis by Franklin Gardner; Mary Taft delivered the third Wilson daughter. Last, Ellen Wilson’s New York gastroenterologist, William Van Valzah, was expelled from the Jefferson Medical College faculty because he was treated by a homeopath instead of an orthodox-trained physician. This theme will be expanded in the following chapter, as two homeopaths became White House physicians in the 1920s.

  Edith Bolling Galt: The Second Mrs. Wilson

  “[T]he practice of calling the President’s wife the ‘First Lady’ was always a disagreeable one to me. I think that if some clever person would start a little crusade against it in the newspapers it could be ridiculed to death.”64

  Political Role as First Lady

  Edith Bolling Galt married the widower President Woodrow Wilson on December 18, 1915, a mere fifteen months after Ellen, his first wife, died. He was introduced to the widow Edith in March and impetuously proposed marriage in May 1915, two short months after they first met and eight months after his wife was buried. The president’s dependency and requirement for a woman’s emotional support were well-known.65

  Edith Bolling Galt became Wilson’s policy and governmental confidante even before their December wedding.66 Their close partnership continued during his reelection, his second presidential term, America’s role as a combatant in World War I, the Paris Peace Conference, and most controversial, during the president’s dangerous disability from a cerebrovascular accident that struck in October 1919.67

  Edith Bolling Gault Wilson, the second wife of Woodrow Wilson (Library of Congress).

  Mrs. Wilson’s behavior during this period, extraordinary and extra-constitutional, is both well-documented and extremely controversial. Excellent expositions of this period abound, therefore an extensive narrative will not be included here. Many important accounts of Wilson’s disability and Edith’s commandeering role already have been written. In the words of one of her biographers: “Edith made a crucially important decision—Woodrow Wilson should remain in office. In making this and subsequent decisions, she almost certainly tried to do what she believed he would have wanted her to do.”68 As a result of her intrusion, another biographer referred to Edith Wilson as “the Unintended President.”69 Others have referred to this episode as “petticoat government” and “regency.”70

>   Medical History as First Lady

  Edith Wilson’s health as first lady was excellent. Her endurance and tirelessness invigorated Wilson’s presidency and her determination managed to keep Woodrow Wilson president. Her excellent medical condition possibly saved the Wilson presidency at the time when many were counseling resignation.

  Only two relatively minor illnesses occurred. In September 1917, the first lady was felled by a high fever and a generalized aching sensation. Her condition was serious enough that her husband postponed an important policy meeting. Meanwhile, Dr. Grayson, the White House physician, was out of town. Consequently Dr. Sterling Ruffin, previously her doctor, was summoned to the White House. His diagnosis was “the grippe” and Mrs. Wilson was bed-bound for two weeks.71

  “The grippe” is a synonym for influenza according to Dorland’s medical dictionary. A viral disease, it may have many clinical presentations and variable outcomes and has been around for centuries. It is very tempting to connect the first lady’s isolated attack of the grippe with the great 1918–1919 worldwide influenza pandemic. McCallops was convinced that Mrs. Wilson had contracted “the virulent strain of influenza that would kill millions of people around the world the following year.” However, this claim cannot be substantiated. The influenza pandemic probably commenced in Haskell County, Kansas, four months earlier, in late January 1918 and exploded among army recruits in Camp Funston, Kansas, in late March 1918. If Edith was not felled as part of the pandemic, her husband was. Woodrow Wilson contracted the pandemic influenza on April 3, 1919, when in Paris during the protracted negotiations to conclude World War I.72 It was also in Paris in May 1919 that Edith’s other physical problem occurred. An infected foot required that Mrs. Wilson hobble about with crutches for a time.73

  Cary Grayson continued as the personal physician of the Wilson family for the entire two-term presidency. It does not appear that he was called upon to treat the second Mrs. Wilson at any time during her more than five years as first lady. But Dr. Sterling Ruffin did. Ruffin was “well-known as a diagnostician,” “one of the city’s better physicians,” and “a man of distinguished appearance, of great dignity of manner, and of outstanding ability.”74 Grayson was on good professional terms with Ruffin and requested his advice during the period of Wilson’s disability. Later Ruffin was asked to consult during the illness of Edith Wilson’s successor as first lady, Florence Harding.75

  Sterling Ruffin was Edith Bolling Galt’s personal physician prior to her becoming Mrs. Woodrow Wilson. She described Ruffin as an old friend and the physician was an invitee to her 1915 wedding. Ruffin, a lifelong bachelor, was rumored to be romantically linked to Edith both prior to her second marriage and after Woodrow Wilson’s demise.76

  Significant Personal and Medical History Before the White House

  Edith Bolling was a ninth-generation direct descendant of Pocahontas, the fifteenth-century Native American princess. Pocahontas was the daughter of the Virginia Algonquian chief Powhatan, who befriended the English colonists when they landed in Jamestown in 1607. She married the English settler John Rolfe and bore him a son named Thomas Rolfe. Thomas’s granddaughter wed Robert Bolling. The first lady’s heritage was through the Bollings of Virginia. There was much publicity about Edith’s Indian heritage at the time of her marriage to the president.77

  Edith Bolling was a widow when she met President Wilson. She previously was married to Norman Galt for almost twelve years (April 1896–January 1908). Galt died, leaving to his widow the well-known Galt Jewelry Store in Washington, D.C. The future first lady smartly selected a capable manager who provided for the store’s continued operations and a reasonable income for the owner. Mrs. Galt gave premature birth to a baby boy on September 23, 1903. The infant lived only three days; the delivery was said to render the mother unable to bear more children. Thus, this was her only pregnancy. In 1906, Edith required an emergency appendectomy.78

  A third, intriguing and ultimately significant, story line from Edith’s pre–White House biography was her very close relationship with Altrude Gordon and Ms. Gordon’s future husband, Dr. Cary Grayson. Edith was a friend of James Gordon, an elderly millionaire. James Gordon died in early summer 1911, but before his death he extracted a promise that Edith would look out for his motherless seventeen-year-old daughter, Alice Gertrude (Altrude). Subsequently the widow and the orphan became close friends and traveled together to Europe and Maine. A few years later Altrude was introduced to Dr. Grayson, fourteen years her senior, at a dance. They soon became a romantic couple; Edith encouraged the romance and often acted as their chaperone. She stood up for Altrude at the Gordon-Grayson wedding in New York City in May 1916.79

  The relationship between the first lady and, later, widow and the presidential physician was supportive and ultimately consequential. Edith referred to Grayson as “my dear boy” and called him “long a valued acquaintance of mine.” She successfully lobbied President Wilson to promote “my dear boy” to Rear Admiral ahead of many senior medical officers.80 There is no report that Dr. Grayson provided medical care to Mrs. Wilson. More significant was his allegiance to the first lady’s successful plot to retain the presidency for her husband.

  Social and Ceremonial Roles as First Lady

  The second Mrs. Wilson was a successful White House hostess and enjoyed the pomp, notice and attention afforded by the ceremonial aspects of her position. She did well during Woodrow Wilson’s triumphal tour of European capitals in 1918 and 1919. Her presence as social mistress of the executive mansion was but a brief interlude. The United States’ entrance into World War I, the Wilsons’ protracted presence at the Paris Peace Conference and Woodrow Wilson’s medical disability prohibited significant Washington entertaining.81

  Health as Caregiver to the Ex-President (1921–1924)

  President and Mrs. Wilson retired to a Washington, D.C., home where Edith was an almost constant caregiver for her disabled husband. Her physical endurance and strength held up until late 1923. At that point she became tired and exhausted, and Cary Grayson, who had remained Woodrow Wilson’s physician, prevailed upon her to take a brief vacation. When she returned, she was confined to bed for five days with a high fever.82

  Health as a Widow

  Edith Bolling Wilson was again a widow, upon the death of President Wilson in 1924, and lived as one for nearly thirty-eight years. When she died in Washington on December 28, 1961, at 89 years of age, she was at the time the longest living former first lady.83 Her role as a widow was to shape Woodrow Wilson’s history for posterity, similar to the mission of that of a successor, first lady Jacqueline Kennedy, forty years later.84 Despite chronic cardiac disease and episodic congestive heart failure, Edith remained active. She sat on the platform during John Kennedy’s January 1961 inauguration. But less than a year later Edith was dead from a respiratory infection and the complications of heart disease. She passed away on Woodrow Wilson’s birthday.85

  Chapter Eleven

  Homeopathic Physicians and the Kidney Disease of Florence Harding and Grace Coolidge

  Charles E. Sawyer … was suspicious of anyone—particularly medical experts—whom he perceived as threatening his status as close friend and homeopathic physician to the Hardings. The Duchess said Doc was the only person who could keep her alive. He was, Alice Longworth later said, the first lady’s own Rasputin.1

  Calvin turned to Mrs. Hills and said: “Hillsey, I’m afraid Mammy will die.”2

  Introduction

  After the death of Ellen Wilson from chronic kidney (renal) failure, the spouses of the two presidents who succeeded Woodrow Wilson, Florence Harding (1921–1923) and Grace Coolidge (1923–1929), were both stricken in the White House with acute renal failure. In both patients the disease was centered in the drainage system of the kidneys and not in the kidneys per se.

  Mrs. Harding died as a consequence of her disease one year after her departure from the White House. In contrast, Mrs. Coolidge’s illness was transient; she survived for another thi
rty years, leading an active and productive life. A second contrast was the degree of transparency accorded their illnesses. Florence Harding’s symptoms, medical course, treatment and attending physicians were the stuff of newspaper headlines. Grace Coolidge’s illness would not be revealed until many years after she left Washington.

  Another similarity was their treatment by homeopathically trained physicians, Charles Sawyer and Joel Boone. Previous chapters have addressed the influence of this medical philosophy upon first lady care during the apogee of homeopathy in America during 1880–1900. Lucretia Garfield’s malaria was diagnosed first by Susan Edson, a homeopath. The primary care of Caroline Harrison, dying from tuberculosis, was administered by homeopathic doctor Franklin Gardner. Future first lady Ellen Wilson engaged Susan Taft as the obstetrician during her third pregnancy. Taft’s treatment is unknown, but she was able to guide her patient through the very difficult pregnancy and delivery. Interestingly, Woodrow Wilson’s concern about his wife’s physician selection was based on gender, not on training.

  Homeopathy

  Homeopathy was developed in Germany by Dr. Samuel Hahnemann (1755–1843) and was introduced to the United States in the 1840s. Its minimalist treatment regimen attracted many patients, which resulted in a protracted and vituperative conflict with the dominant orthodox, or allopathic, medical culture as promoted by the American Medical Association.

  The practice of homeopathy was based on the principles of similia and infinitesimals. The principle of similia held that a specific disease would be cured by remedies that produced in a healthy person the same or similar symptoms as those produced by that disease. The law of infinitesimals proposed that the smaller the dose, the more effective it became in stimulating the body’s vital curative force. Therefore arose a paradox: The more dilute the dose of medicine, the greater its potency.3

  The homeopathic principles of similia and infinitesimals, while perhaps ineffective, at least did no harm. In contrast, the hallowed treatments of nineteenth century orthodox medicine—cathartics, emetics, scarification and bleeding—often did. This kinder, gentler form of medicine attracted many patient-adherents, especially in urban areas and among the well-to-do. Orthodox-homeopathic strife was kindled with the transplantation of the unorthodox philosophy in America, smoldered while homeopathy increased in popularity, and burst into flames during the 1880s and 1890s. The American Medical Association forced its members to avoid all contacts with all practitioners of the Hahnemann school. If this prohibition were violated, the transgressor was punished. An example was that of Ellen Wilson’s New York gastroenterologist, William Van Valzah, who was chased out of Philadelphia by his orthodox medical colleagues because he preferred the personal care of a homeopathic physician. Whether the AMA’s motivation was primarily philosophical or financial is unknown.4