Hidden Illness in the White House

By Kenneth R. Crispell, Carlos F. Gomez

Duke University Press

Copyright © 1988 Duke University Press
All rights reserved.
ISBN: 978-0-8223-0839-3

Contents

Foreword,
Preface,
Acknowledgments,
1: Illness and History: An Overview,
2: Strokes, Versailles, and the Pathology of Politics,
3: The Diagnosis of an “Unexpected” Death,
4: Diplomacy and Failing Health: Roosevelt and the Final Decline,
5: “I’m the Healthiest Candidate”,
6: The Twenty-fifth Amendment and the Decisions of History,
Notes,
About the Authors,

CHAPTER 1

Illness and History: An Overview

In 1960, shortly before John E Kennedy appointed him secretary of state, Dean Rusk published an article in which he constructed the following hypothetical scenario:

Picture two men sitting down together to talk about matters affecting the very survival of the systems they represent, each in a position to unleash unbelievably destructive power … one is impulsive in manner, supremely confident… and possibly subject to high blood pressure; the other … weighted down by a sense of responsibility for the hundreds of millions who have freely given him their confidence … a man with a quick temper and a weak heart.

Later commentaries on Rusk’s imaginary meeting identified Nikita Khrushchev and Dwight Eisenhower as these two world leaders. Rusk avoided specific names to argue more generally against the sort of personal diplomacy that had become so popular following World War II. What is most intriguing about Rusk’s position, however, is that he mentions the medical weaknesses of his two mythical leaders in this context. Rusk went on to warn that by circumventing the logical, impersonal machinery of foreign offices and departments of state, governments were gambling too much on imponderables, namely the personal idiosyncrasies of their leaders. Among the most insidious and least predictable of these characteristics, Rusk pointed out, was a leader’s health. He went on to speculate on the “extent to which the course of world affairs may have been affected by illnesses among those holding high public office/” later adding that “the international list of those who have carried great responsibility while ill is a long one and there are fleeting glimpses of decisions which good health might have turned another way.” The most dire decision one imagines in this context concerns the use of nuclear weapons, a decision that would have irrevocable consequences.

We need not raise the specter of a sick man poised over the trigger of a nuclear arsenal to point out the influence which one’s medical condition might have over one’s capacity to make reasoned decisions. The word “might,” moreover, is too speculative and tentative, for history presents us with an abundance of instances in which illness converges with power—often absolute power—and often with dire consequences.

We need only go back as far as the early 1970s to find examples of men who wielded incredible power while beset by illness. In Yugoslavia, for instance, the machinery of government practically ground to a halt while Marshal Tito hung on tenuously to life, obstinately refusing his physician’s warnings that his leg needed to be amputated. Generalissimo Francisco Franco was essentially catatonic for months (perhaps longer) as the government continued to insist to Spain and to the rest of the world that he was still in control of his faculties. Georges Pompidou’s death shortly after leaving the French presidency confirmed the gravest suspicions about his health during his last year in office. In China both Mao Tse-tung and Chou En-lai died while still in power and while they were negotiating perhaps the riskiest transition in that country since the Communist Revolution.

Later in the decade a troubled Israeli state would be further troubled by Prime Minister Begin’s unexplained absences from state functions and his increasing (and ominous) complaints of chest pain, leading to his eventual resignation. Far from Israel the Soviet Union would also suffer the uncertainties of an ailing and unstable leadership. Leonid Brezhnev, after a prolonged period of poor health, would die while still in office. The subsequent deaths of his successors, Yuri Andropov and Konstantin Chernenko, within months of each other further confused the already weakened leadership in the Kremlin.

One need not look abroad to find instances of illness in high office. Indeed, the focus of this study is the possible impact that hidden illness has had on the occupants of the White House. Before we turn our attention to presidents who were ill while in office, however, we offer the study of a political aspirant whose medical problem prevented him from reaching his goal. The case of Senator Thomas Eagleton is offered as both a cautionary tale and as an introduction to our subject.

Eagleton and an Illness Made Public

In the summer of 1972 Senator Thomas Eagleton from Missouri, the Democratic vice presidential nominee, saw the focus of a vigorous campaign against President Richard Nixon shift from the president’s policies to Eagleton’s medical condition. On July 25, twelve days after he had been nominated for the vice presidency, Eagleton held a press conference from George McGovern’s retreat in South Dakota and told an astonished group of reporters that he had been hospitalized for “fatigue and nervous exhaustion” three times during the prior twelve years. Responding to a reporter’s pointed questions, Eagleton outlined his history of psychiatric hospitalizations.

In 1960, following his successful campaign for attorney general of Missouri, Eagleton had voluntarily checked himself into Barnes Hospital at Washington University’s Medical Center in St. Louis and had spent “almost all of December” of that year receiving psychotherapy, chemotherapy, and electroconvulsive treatments (ECTs) for depres sion. Four years later, again following a successful campaign, this time for the lieutenant governor’s office, Eagleton entered the Mayo Clinic to be treated for depression. Finally, in 1966 he again went to the Mayo Clinic to be treated for recurring depressive episodes. Eagleton stated that he had received the ECTs during two of the three hospitalizations and that in each instance the treatments had been successful.

Amid the immediate speculation that this revelation would disqualify Eagleton from office, Senator George McGovern was quick to assert that Eagleton would remain his running mate. At that same press conference, McGovern stated that “there is no one sounder in body, mind, and spirit than Tom Eagleton.” Although not told of Eagleton’s condition at the time the vice presidential slot had been offered, McGovern claimed that the information would not have changed his mind. Eagleton said that he had not purposely obscured information from McGovern, but that he had considered these breakdowns no more serious than “a broken leg or a broken arm.” The McGovern-Eagleton campaign then issued a statement contending that this revelation would have no effect on the campaign and that the two candidates would continue with their previously planned itineraries.

All the major news networks carried the Eagleton story that evening, and by the following morning workers in McGovern’s campaign were disabused of their optimism. The New York Times, the Washington Post, and other major daily newspapers ran the Eagleton story on their front pages, including verbatim transcripts of the press conference. Hoping to staunch speculation about Eagleton’s being forced to resign, McGovern then issued his now infamous “1000 percent” endorsement of Eagleton, adding that he was proud of his running mate’s candor. As a counter to the murmurings from the opposition, McGovern’s campaign manager, Gary Hart, called for all candidates to disclose information regarding their health.

The issue became further muddled, however, by a column Jack Anderson published that same day, in which he claimed not only that Eagleton had a history of mental illness, but that he was a chronic alcoholic who had once been arrested on charges of reckless driving. Despite McGovern’s attempts to repair the damage, Anderson’s column escalated the histrionics of the debate. Though Anderson provided no documentation for his charges (he could not—they were subsequently proven false), McGovern and Eagleton found themselves answering questions regarding this matter long after they had hoped to put it to rest.

On the following day the New York Times, which had previously welcomed Senator Eagleton to the ticket as an “intelligent, conscientious, and compassionate legislator,” called for the vice presidential candidate’s withdrawal: “We believe that the only way the campaign can be turned back into a true test of the programs and leadership qualifications of President Nixon and his Democratic rival, Senator McGovern, is through the voluntary withdrawal of Senator Eagleton from the McGovern ticket…. it would be a helpful contribution not only to the McGovern candidacy but to the health of the American political process.” And yet as gamely as the McGovern camp tried to steer the debate around to other issues, it found itself unable to redirect the torrent of questions regarding Eagleton’s health problems.

Two days later, on July 30, Eagleton made a final effort to save his candidacy by appearing on the CBS News program “Face the Nation.” McGovern’s once firm “1000 percent” endorsement of his running mate was steadily giving way to qualified, tepid statements about Eagleton. “To a great extent,” McGovern confided “casually” to some reporters, “it’s up to Tom whether or not he stays on the ticket.” During his television appearance Eagleton strongly asserted his determination to stay in the race, saying that even if McGovern asked him pointblank to resign, “I’ll listen respectfully and attentively, and I’ll weigh his words,” but declining to blindly do McGovern’s bidding. Eagleton contended that “my health is not really the issue,” that he was fully competent to discharge his duties if elected, and that the matter would soon die down.

Eagleton met privately with McGovern in Washington the next day and during a joint press appearance with McGovern announced his voluntary withdrawal from the ticket. To the end, however, both of these men insisted that the problem was not Eagleton’s health. McGovern stated that Eagleton’s move was a noble gesture, done for the sake of the party, and that “I am fully satisfied that his health is excellent. In the joint decision we have reached tonight, health was not a factor.” Both the New York Times and the Washington Post, which had also called for Eagleton’s resignation, took up the “health was not a factor” cry. In its commentary on the resignation, the Washington Post said that the matter “was not some sort of referendum on mental health, a question, as so many persisted in putting it, of whether a person who once sought psychiatric care was to be forever denied a part in the political process. This is not and never was what the issue was about.” The New York Times echoed the same sentiments, arguing that “the withdrawal of Senator Eagleton from the Democratic national ticket was an admirable act of self-abnegation designed to permit the Presidential campaign to proceed on the issues, rather than in a sterile debate over his own capacity to stand the rigors of the Presidency in an emergency.”

One wonders, if “health was not a factor,” what, then, was a factor? Several critics complained that Eagleton had mishandled the affair by not being more forthcoming during his initial encounter with McGovern during the Democratic Convention. Others stated that the American public was not yet ready to discuss the issues of mental illnesses rationally and compassionately. Perhaps a more candid (and partisan) assessment came from one “highly placed source in the White House,” who told a reporter: “The people simply aren’t going to want to put a mental patient in charge of the nuclear arsenal.” And, indeed, had McGovern been elected and had he subsequently died in office, Eagleton would have been his constitutionally designated successor. The image of a decompensated Thomas Eagleton in charge of the nuclear arsenal—irrespective of how sophisticated and compassionate the voters might have been—was a frightening one that could not be easily repressed. It was a possibility, however distasteful, which had to be considered.

It was precisely this possibility which McGovern and his advisers preferred not to consider. Despite their claims that Eagleton had come forth with his statement in order to be completely candid and “to educate the public” on mental illness, McGovern’s operatives had known about Eagleton’s past maladies for six days before they went public with the information. Tipped off by a friendly reporter, McGovern had learned that both Knight newspapers and Time magazine were piecing together final details of this story and were imminently ready to publish their own accounts. Even before a definitive account appeared in the press, there were rumors circulating about Eagleton’s alleged drinking problem. McGovern, Eagleton, and their aides debated the matter for another six days before concluding that they could salvage most of their political capital by airing the matter publicly before the press did. Nowhere in any record does it appear that the question of Eagleton’s possible incompetence, based on his medical history, dominated the discussion. If at all, the competency question arose because Eagleton had not been candid about his hospitalizations when he was offered the nomination, which seems less a matter of competency than of candor and political savvy.

McGovern was more forthcoming in his political memoirs, From Grassroots, when he stated that he was prepared to run with Eagleton until he consulted Dr. Karl Menninger. The eminent psychiatrist had no hesitation as to McGovern’s proper course of action: “For the sake of the nation … you can afford no risks and I would therefore hope that you would ask Mr. Eagleton to resign.” What McGovern fails to mention, however, is that he took no action until it became obvious that Eagleton’s public revelations were having a disastrous effect on his standing in the polls.

Even while the debate over Eagleton’s resignation was raging, there were some sober voices expressing concern, not over the specific tragedy of Thomas Eagleton’s illness in relation to the campaign, but over the larger tragedy of a political process which left questions of this sort to be answered so haphazardly. One of McGovern’s supporters, Matthew J. Troy from the New York Democratic Committee, noted that Eagleton would have failed the physical examination for less demanding or responsible positions in the armed forces and in industry. How, he asked, could we possibly allow this man to have come so potentially close to being in charge of the country’s nuclear decisionmaking process? Mortimer Rostow, president of the Psychoanalytic Research and Development Fund, noted that “I have always contended that an individual who has been mentally ill should be denied no opportunity for advancement. However, to positions in which reliability is a major factor, he [Eagleton] brings a significant degree of risk…. This country is not so poor in administrative talent that in order to obtain brilliant leadership, it must also accept a risk of this order of magnitude.”

Perhaps the most cogent explanation of the problem came from James Reston, who wrote the following shortly before Eagleton resigned: “The Eagleton Case demonstrates once more the need for a coherent policy of checking the medical records of men and women who are being considered for positions of great power. Senator Eagleton is not the cause but only the latest example and victim of a much more serious problem.” Reston noted that every other American institution which had some larger public responsibility regularly checked and rechecked its leaders’ health. Citing instances in recent history in which an American leader had either died in office or had been incapacitated by illness, Reston asked, “Why do we forget the elemental lessons of the past? Why rely in such important matters on the valuable but accidental and often imprecise disclosures of newspaper reporters or the reassurances of Eagleton and McGovern, who are obviously more concerned with the political than with the medi cal facts?” Again, Reston was not necessarily faulting McGovern and Eagleton (though he had few kind words for the way they handled this matter). Rather, he was bewildered by a political system which seemed to forget the harsh lessons of its own past.

Illness, Power, and the Gambles of History

Reston’s analysis of the Eagleton case provides a concise introduction to this study, for he argues forcefully for a reform of the way the current political process handles this problem:

This is the fault of the system, a system that is very compassionate to human beings whose age and health interfere with the efficient execution of their work….

Maybe the Republic can bear this human compassion in the Supreme Court and the Congress—even though there it is highly questionable—but at the level of the Presidency and the Vice Presidency in this age of atomic weapons abroad and human violences and political assassinations at home, the present system is wildly out of date.

What is at once so intriguing and frightening about this topic is that in the modern West we have invested a great deal of power in the ideal of rationality: rational belief, rational politics, and rational causes and explanations. Perhaps this notion provides the tacit motivation for many of the postassassination theories. It is easier to believe, for example, that Lee Harvey Oswald was part of a larger conspiracy, however sinister, than to believe that his act of violence resulted from a deranged mind. To assume otherwise is to admit to a certain amount of randomness and chaos, to admit to the possibility of irrational acts that escape our defenses. Yet the concept that an undetected sickness in a powerful man can alter the course of history falls within the realm of irrational politics.

Many of the recent writings in history revolve around the twin con cepts of causality and predictability. Indeed, at least one political scientist, James David Barber of Duke University, lays claim to the idea of predictability in presidential politics. One has to understand, he says, that “the crucial differences in the presidency can be anticipated by an understanding of a potential president’s character, his world view, and his style.” What we will suggest in this study borrows, in part, from Barber’s notion of character, yet in extending that term to include a president’s documented illnesses, we will see the idea of character not as an organizing principle or concept but as a source of randomness and unpredictability in history.

(Continues…)Excerpted from Hidden Illness in the White House by Kenneth R. Crispell, Carlos F. Gomez. Copyright © 1988 Duke University Press. Excerpted by permission of Duke University Press.
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