Grace discovered Dr. Joel Boone to be an intelligent, attentive and available listener, and she came to rely upon the physician as a counselor and friend. She requested his advice on the selection of a boarding school for her sons. He recommended his alma mater, Mercersburg Academy in Pennsylvania, which the boys subsequently attended.73 Grace befriended not only Boone, but also Boone’s wife and daughter Suzanne. Suzanne was often asked to spend nights at the White House and the Coolidges took her to the circus. The first lady, becoming estranged from her husband, enjoyed her discreet talks with Boone as a way to unwind. The Coolidges’ proximity during their long 1925–7 summer vacations led to increased marital unhappiness. No word of these problems got out, only in Grace’s conversations with Boone.
During an Adirondack summer vacation, Grace and Boone had a long conversation about John, her remaining son. She confided to the doctor that she and Coolidge were not “at all in accord on John.”74
If she challenged the president on John’s upbringing, he would retaliate and not speak to her for three days.75 Calvin Coolidge’s concept of the relative positions of a husband and wife may be a reason for any marital discord: “Marriage is the most intricate institution set up by the human race. If it is to be a growing concern it must have a head. That head should be the member of the firm who assumes the greater responsibility for its continuance. In general this is the husband…. In my humble opinion the woman is by nature the more adaptable of the two and she should rejoice in this and realize that in the exercise of this ability she will obtain not only spiritual blessing but her own family will rise up and call her blessed.”76
Ex-president Coolidge’s health declined in retirement and he died quietly on January 5, 1933. His widow lived for another twenty-four years and enjoyed a long and productive retirement in Massachusetts.77 Perhaps her daily exercise regimen of six to eight hours of walking was a reason for this. In 1952, when her health began to fail, the first sign of it was her disinclination to walk.78 Mrs. Coolidge had heart trouble during the last five years of her life and became very stooped.79 She died of congestive heart failure at age seventy-eight; the death certificate listed as the cause of death kyphoscoliotic heart disease.80 The former first lady had remained friends with Dr. Boone and his wife, and Joel Boone attended her funeral.
Chapter Twelve
Mamie Eisenhower and Menière’s Disease
In early November 1973, TV host Barbara Walters asked Mrs. Eisenhower the following: “I am going to ask you something, because it’s been a rumor for years, and I want to finally put it to rest. You know what the rumor is.” The former first lady responded: “Oh yes, that I am a dipsomaniac.”1
A First Lady Dogged by Rumors of Alcoholism
First ladies, as the wives of prominent men, are frequent objects of scrutiny by the press, by personal enemies, and by political opponents. The political station of a husband may cause pain, anxiety and even scandalous aspersion for the wife. No first lady experienced more defamation than Mary Todd Lincoln.2 But Mamie Eisenhower suffered her own aspersions. She was long troubled by a lack of balance and an unsteadiness of gait. For three years during World War II the Atlantic Ocean separated General Dwight and Mamie Eisenhower from each other. Mamie resided in an apartment in Washington, D.C., and experienced profound loneliness. After she awkwardly stumbled and spilt gravy down the uniform of a soldier while volunteering at the District of Columbia Soldiers Club, the Washington rumor mill concluded that Mrs. Eisenhower was drunk. The Washington wags conjectured that Mamie had sought the solace of the bottle to combat her marital isolation.3
A suggestion of alcoholism, once whispered, is never silenced. During the 1952 battle for the Republican presidential nomination, the campaign of Robert Taft, Eisenhower’s rival, spread stories about Mrs. Eisenhower’s drinking habits. Their credibility may have been amplified by an event at a Washington embassy party. Eisenhower requested that Mamie’s dinner partner take her by the arm since she was unsteady on her feet. During a subsequent transcontinental political railroad trip, “Mamie was acutely conscious throughout the trip of rumors circulating since the war that she drank too much.”4 A Republican convention delegate from Nebraska boldly broached the subject to the candidate: “General we’re not worried about what you stand for…. But we are worried about your wife…. We hear she’s a drunk.”5 Ironic indeed that the campaign of senator of Ohio Robert A. Taft would circulate these rumors. Senator Taft was the oldest son of former first lady Nellie Taft. An entry on the first ladies’ personal interests page of the National First Ladies’ Library recorded the following regarding the drink preferences of Robert’s mother: “Helen ‘Nellie’ Taft, lager beer and champagne cocktail (perhaps the one who imbibed the most).”6 The rumors persisted during Ike’s (General Dwight Eisenhower) 1956 presidential campaign. Paul Butler, head of the Democratic party, intimated that the first lady’s recent illness was perhaps a result of drinking.7 The allegations finally reached print, fortunately in a less than reputable source. The National Enquirer, a supermarket checkout tabloid, published the rumors in its June 7, 1959, edition.8
The Eisenhowers retired to their Gettysburg, Pennsylvania, farm in 1961, where the rumors of alcoholism persisted. Dr. William Sterrett, Mamie’s primary care physician in Gettysburg recalled: “When the Eisenhowers first moved to Gettysburg, the story was all over Adams County that she was an alcoholic.” As an example of the extent to which tales of Mamie’s drinking were embellished, Sterrett recounted this rumor: The velvet rope atop the stairs of the Eisenhowers’ previous house in Denver did not signal that the couple had retired to bed, but rather was to protect a drunken Mamie from falling down the stairs.9 Neither Ike nor Mamie publicly confronted these allegations until the Barbara Walters interview in late 1973.
Unlike several other first ladies, notably Sarah Polk, Lucy Hayes, and Rosalynn Carter, Mrs. Eisenhower did drink alcohol.10 A January 4, 1946, notation in her medical record written by Dr. George Robb reads, “uses alcohol moderately.” During the war years in Washington, she drank no more than anyone, which was usually one cocktail. Her favorite was an Old Fashioned. Many testimonials over her career attested that she never drank to excess and was never seen drunk. Her Gettysburg doctor asserted, “Mamie’s drinking had virtually ceased many years earlier.”11
A Chronic Medical Condition
The rumors were false but they abetted scandalous gossip among the political and media classes. It was not alcohol but a chronic disease that produced Mrs. Eisenhower’s dizziness and unsteadiness. In Dr. Robb’s medical history, he noted that a diagnosis of carotid artery hypersensitivity had been made previously. Robb could not confirm this diagnosis.12 Unfortunately Dr. Sterrett used the old Walter Reed records to perpetuate an unsubstantiated diagnosis. The practice of continuing to attach a disproved historical diagnosis to a patient out of courtesy to a physician predecessor, or out of habit, has long vexed the practice of medicine. Mamie continued to harbor the misdiagnosis given her decades earlier. In a 1972 interview the widowed Mrs. Eisenhower responded: “For twenty-five years or more than that I carried this equilibrium problem, which is carotid sinus.”13
The carotid sinuses are pressure receptors adjacent to the major arteries on both sides of the neck. An exaggerated reflex of the carotid sinus (hypersensitivity) produces a sudden loss of blood pressure, dizziness, and fainting. A practical method of diagnosis is the reproduction of these symptoms by manual massage of the patient’s neck. Mamie tested negative when this maneuver was tried on her in 1946.14
Menière’s and Mamie
A far more likely diagnosis to explain Mrs. Eisenhower’s symptoms is Menière’s disease. A firm diagnosis allegedly was established at Walter Reed Hospital in 1953.15 Other biographers assert only that Menière’s disease was diagnosed sometime after World War II.16 The symptoms of this condition stayed with her until the end of her life.17
Menière’s disease is a diagnosis of exclusion, characterized by episodic spells of vertigo
that usually last a few hours and are associated with fluctuating, unilateral ear fullness, tinnitus (ringing or buzzing sound), and hearing loss.18 Prosper Menière was a prominent mid-nineteenth century French physician who connected deafness in a young woman with an excess of fluid in her inner ear. He presented his discovery in a paper titled “On a Particular Kind of Hearing Loss Resulting from Lesions of the Inner Ear” to the Imperial Academy of Medicine in Paris. Menière died a year later in 1862 with his significant discovery unrecognized.19 For over seventy years, Menière’s disease was not defined as a specific entity; nor were effective treatments identified to alleviate its symptoms. Only in 1972 did the American Academy of Ophthalmology and Otolaryngology Committee on Hearing and Equilibrium finally publish a clear definition of Menière’s disease.20 Effective therapies for the disease were discovered earlier; in 1934 a low-salt diet and diuretics were first recommended to alleviate the “water-logged” condition of the inner-ear labyrinth. Surgical techniques were introduced in the 1950s and have improved significantly since.21
Mamie Eisenhower, the wife of Dwight “Ike” Eisenhower. The consequences of Menière’s disease led to scandalous press speculation about her (Library of Congress).
Mrs. Eisenhower had a long history of vertigo (a spinning sensation with disorientation). In 1929 after a descent down the Alps, her husband noted her dizziness and “stomach upsets.” These symptoms subsequently recurred in other situations. Later, while stationed in the Philippines, she developed an equilibrium problem described as a “pitching sensation.”22
During the war years, while the Eisenhowers were in Washington, D.C., the attacks became more acute than those previously experienced in the Philippines. The symptoms were devastating and frequently disabling. When a sudden attack occurred, Mamie “couldn’t stand steady for any length of time without assistance, and even the simplest tasks could become unfortunately complicated. Sometimes … she couldn’t even hail a taxi without someone lending her an arm.” Although she had a car, she was afraid to drive it. The unsteadiness forced her to curtail her volunteer work with the American soldiers. “I crawled on my hands and knees from my bathroom to the kitchen. I didn’t dare to walk …. I couldn’t walk.” Her antidote was smelling salts, which she always kept in her possession when she left her apartment. Her husband, concerned about her problem, wrote from Versailles, France, in September 1944: “It would be wonderful if the medicos could find out what is the reason for your lack of balance.”23 The Eisenhowers lived in New York City while Ike was the president of Columbia University (1948–50). Mamie could not walk the block from their apartment to the university without someone holding her arm.24
The anatomical cause of Menière’s disease is well established. Its symptoms are produced by the accumulation of excess fluid within the semilunar canals (labyrinth) of the patient’s inner ears. Less certain is what provokes the excess fluid. Many associations have been postulated: diet, allergy, autoimmune disorders, and psychological distress. Anxiety, stress and depression have been linked with Menière’s symptoms. Whether these are a cause or a result of the disease remains a conundrum.25
Mamie Eisenhower’s long marriage to an ambitious army officer was often beset by worry and nervousness. Gastrointestinal symptoms were a frequent accompaniment and may have resulted from her anxiety. During Ike’s 1922–24 assignment to the Panama Canal Zone, Mamie repeatedly suffered from digestive complaints. Her symptoms were significant enough to require a transfer to Walter Reed Army Medical Center in the District of Columbia. After several months of hospitalization she was released, feeling better but without a definitive diagnosis.26
The Eisenhowers’ next army post was Fort Leavenworth, Kansas. Once again there was a hospitalization, this time at the Leavenworth base hospital in 1926. The diagnosis is unrecorded, but the treatment was sedatives. Her gall bladder was removed in Pueblo, Colorado, in July 1931 (Mrs. Eisenhower’s parents lived nearby in Colorado). Preoperative history at the time recorded six years of flatulence and pain and years of emotional distress. The concomitant physical examination revealed a very irritable and easily upset patient who was described as the thin, nervous type.27
Eisenhower was stationed in the Philippines as General Douglas MacArthur’s adjutant from 1936 to 1940. During this chapter of Mamie’s life, gastric complains coincided with “a pitching sensation,” most probably an early symptom of Menière’s. A specific diagnosis escaped her physicians until an upper gastrointestinal ulcer began to bleed profusely. Mamie collapsed, became comatose for days, and barely survived. She lost thirty pounds and went to a weight of 105 pounds after the near-catastrophic event.28 Gastrointestinal complaints would persist until her death.
During the war years, Mamie, separated from General Eisenhower, lived alone in a Washington apartment. Digestive complaints and Menière’s attacks kept her bedridden much of the time. Anxiety for her husband’s safety led to insomnia and recurrent significant weight loss. Unsurprisingly, she suffered from depression.29
Episodes of Menière’s continued in the White House, and curtailed some of Mrs. Eisenhower’s ceremonial appearances. She did not accompany President Eisenhower to his May 1960 Paris summit with Nikita Khrushchev or on his 1959 and 1960 overseas goodwill trips at the conclusion of his presidency. The first lady feared for her balance.30 Serendipitously, medications prescribed for her other maladies probably controlled the Menière’s symptoms of vertigo and unsteadiness. Phenobarbital was given to control anxiety and a diuretic together with a low-salt diet were proposed for her heart disease.31
Rheumatic Heart Disease
Mamie Doud contracted rheumatic fever at her parents’ Colorado Springs home when she was about eight years old. The acute symptoms included abnormal involuntary movement of her muscles (St. Vitus Dance) and leg pains. As a consequence she was kept home from school for the better part of a year. Complications resulted due to the inflammation of her mitral and aortic valves. Rheumatic scarring of her mitral and aortic heart valves would be a medical problem for the rest of Mamie’s life. In the pre-antibiotic era, significant valvular disease frequently resulted from untreated rheumatic fever.32
Mamie’s cardiac symptoms worsened during the war and contributed to her fatigue. As a result, military doctors restricted Mrs. Eisenhower’s physical activity and forbade her to fly.33 Surprisingly, the wife of the Supreme United States Commander in Europe was not evaluated by a cardiologist until her 1946 examination by Lt. Col. George Robb at Walter Reed. Robb diagnosed inactive rheumatic valvular disease with mild mitral insufficiency, aortic valve insufficiency and aortic stenosis. Mamie was not in congestive heart failure at this time. . Further cardiologist examinations were made in 1950 that detected a progression of her valve disease. General Eisenhower became alarmed. He worried that in the face of a gradual deterioration of his wife’s heart condition whether further harm would occur if she accompanied him to Europe as he became the first commander of NATO.34
When Mamie was in Washington in November 1951, the chief of cardiology at Walter Reed, Colonel Thomas Mattingly, assumed control of her cardiac care. He closely monitored Mrs. Eisenhower’s heart condition until his retirement from the army in 1958. He observed that the heart disease gradually worsened during his watch; her heart enlarged and shortness of breath after exertion appeared. Mattingly thereupon restricted the first lady’s physical activity. The cardiologist was consulted one last time, in 1978, by Dr. Julius L. Bedynek when the widowed Mamie Eisenhower’s heart failure progressed alarmingly. The question was whether heart surgery was indicated. Mattingly concurred that surgery was not appropriate and agreed with the medical regime of digitalis, diuretics and a low-salt diet.35
One year later, on November 1, 1979, Mrs. Eisenhower died. She suffered a stroke on September 25, 1979, and died five weeks later.36
First Lady Mamie Eisenhower
As first lady (1953–1961), Mrs. Eisenhower worked from the bedroom she shared with the president. She routinely sat up in bed to
plan her day and direct her staff, most likely an adjustment to her physicians’ advice to rest when she could. The onset of her inner ear symptoms was often unpredictable, so her behavior was precautionary. One biographer detailed her daily morning routine. Mrs. Eisenhower read the morning newspapers before breakfast and meeting her staff. She paid close attention to advertisements for sales of food and other items useful in the White House. When the head usher came in with her breakfast tray, the two discussed menus for the day and details for any upcoming social events. The usher was followed by the executive mansion’s housekeeper and Mamie’s secretary. The first lady then dictated letters for two or three hours and afterwards planned her daily schedule.37 Thereby Mrs. Eisenhower was able to minimize the symptoms of Menière’s and chronic rheumatic valvular heart disease and to enhance her effectiveness as manager of the executive mansion. Critics of the Eisenhowers, ignorant of her physical disabilities, concluded that the first lady was either inactive or incapacitated.38
As the wife of a career army officer, Mamie understood hierarchies and was skilled in commanding and directing staffs. She handled the White House finances. Its staff appreciated her clarity in direction and her effectiveness.39 This first lady handled her social responsibilities very capably and, for the most part, succeeded in her ceremonial duties. However, medical issues did limit her overseas travel. She excelled as a supportive wife for her president husband. She had long seen her role as the provider of emotional support to Ike and had endured thirty-four moves decided by the army. She summed up her White House years by declaring, “I never pretended to be anything but Ike’s wife.”40 Mrs. Eisenhower, a successful military spouse, eschewed politics. She neither participated openly in this activity nor selected a public volunteer cause during her eight-year tenure. On only a single occasion did President Eisenhower solicit her political opinion: Whether to run for a second term after he had suffered a major heart attack.41
The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama Page 22