Medical Examiner

There’s a Long History of Presidential Health Being a Well-Kept Secret

The American public has mostly found out about health problems only after past presidents have left office.

President Donald Trump against a background of pills.
Photo illustration by Slate. Photos by Olivier Douliery-Pool/Getty Images and Thinkstock.

On Tuesday, White House physician Ronny L. Jackson released the results of Donald Trump’s first presidential physical. His assessment, that the president is in “excellent” health, has been met with a substantial amount of skepticism. As Jeremy Samuel Faust wrote in Slate, Trump’s height and weight put him so close to the cusp of obesity that the numbers are worth questioning. In a story in the New York Times, several cardiologists expressed their dismay with Jackson’s conclusions, given Trump’s rather high cholesterol numbers. In between, many regular citizens have expressed alarm at the thought that the official presidential physician—one who also assessed Barack Obama and George W. Bush—might have glossed over health problems. But this criticism belies everything we know about presidential health. There is a long history of presidential health problems being kept secret, from the more well known cases of FDR to JFK to secret strokes and heart attacks that the public only learned about after a president left office. In the story below, Marc Siegel recounts the fascinating history of presidential health and public disclosure. —Susan Matthews

President-elect Donald Trump is 70 years old, which makes him the oldest incoming president by a few months. What does this mean for his health? According to his private physician, Dr. Harold Bornstein, Trump has normal blood pressure and no extensive medical history. He takes Lipitor and aspirin for cardiac prevention. Though he reportedly doesn’t exercise regularly, doesn’t adhere to a healthy diet, and does not sleep properly, as far as we, the public can tell, he is in good health.

The biggest health concerns facing all older Americans remain heart disease and cancer.
Testimony from Trump’s physician suggests that he does not suffer from either of these conditions. There are other illnesses and medical problems that could befall him while he’s in office, but given the incredible technological advances in medicine, Trump’s medical team has the ability to react quickly and effectively, whether it be to bronchitis or back pain or worse.

Of course, even if these things do happen, it doesn’t mean that we the public will know everything about it. In fact, we almost certainly won’t.

There is a long history of camouflaging presidential health issues. In March 1981, President Ronald Reagan, then 70, was shot and lost nearly 50 percent of his blood volume before reaching George Washington University Hospital. Dr. Joseph Giordano, head of the trauma team there, utilized new techniques developed during the Vietnam War to save the president and remove an exploding bullet that just missed his heart.

The public was not aware that he had nearly died.

In 1919, President Woodrow Wilson, then 62, suffered a severe stroke in Pueblo, Colorado, while on a strenuous nationwide tour to mount support for the proposed League of Nations. The public wasn’t aware that Wilson was paralyzed on his left side and partially blind in his right eye and that his wife Edith began managing state affairs with her husband bedridden. This continued for a year and five months, until he left office. The White House physician at the time, Dr. Cary Grayson, participated in the cover-up.

In July 1944, Dr. Frank Lahey, a prominent surgeon, reviewed President Franklin Roosevelt’s medical records and concluded in a memo that he likely would not survive four more years in office. This information and Roosevelt’s general health condition were kept from the public until Roosevelt famously died of a stroke just three months into his fourth term.

President Dwight Eisenhower was a longtime chain smoker. On Sept. 23, 1955, nearing his 65th birthday, he was on a four-day fishing trip in Denver. As Bret Baier documents in his comprehensive and compelling new book about Ike, Three Days in Januaryhe had a large hamburger stuffed with onions and a pot of coffee for lunch, and suffered what he thought was indigestion. Finally that night his wife, Mamie, called for his personal physician, Maj. Gen. Howard Snyder. Snyder didn’t send him to the hospital but instead treated him with amyl nitrate for angina; heparin, a blood thinner; and morphine for the pain. But his chest pain persisted, and he was finally taken to the hospital the following afternoon.

He had had a heart attack. Baier writes:

Snyder’s actions that night are shocking in retrospect and they earned him a great deal of censure at the time. Why the twelve-hour delay? He later said he thought Ike was suffering from a chronic digestive complaint, not a heart attack, but that explanation does not account for his choice of medications, which were definitely related to a heart condition.

Of course, as Baier notes, the treatment choices were limited at the time—Snyder could not have performed the dramatic artery-opening bypasses, angioplasties, and stents of today even if he had wanted to.

Eisenhower eventually recovered, though his entire second term was riddled with heart problems including high blood pressure, recurrent arrhythmias, heart failure, and a mild stroke in 1957, which affected his vigor and the degree to which he was able to campaign for other candidates, including Richard Nixon in 1960. As with previous presidents, the public was largely shielded from Ike’s health problems.

Though the next president, John F. Kennedy, was our youngest elected president at 43, he too had serious health concerns that were largely hidden. The public wasn’t aware of his severe back pain and Addison’s disease, which required steroid injections several times a day.

Since Reagan, our presidents seem to have been relatively healthy, based on what we’ve learned mostly after they’ve left office. George H.W. Bush suffered from a thyroid condition (Graves’ disease) and a brief associated arrhythmia (atrial fibrillation) while president, but was otherwise vigorous. Bill Clinton famously loved fast food and didn’t keep his cholesterol under control, but didn’t develop his heart problems until later. George W. Bush is an amazing athlete who jogged regularly in his first term and rode mountain bikes during his second, after developing knee problems. He was in great health while president, despite a famous incident where he choked on a pretzel while watching a football game and briefly passed out. Barack Obama reportedly stopped smoking before becoming president, has remained thin, and has also exercised.

President-elect Trump doesn’t smoke and he doesn’t drink alcohol, both good prognostic signs for a septuagenarian. Lipitor is a great heart-saving drug when used properly for cardiac prevention. Aspirin prevents heart attacks and strokes. (If only this information had been available back in Wilson’s, Roosevelt’s, or Eisenhower’s time.) The average life expectancy for men now in the U.S. is 76.3 years, a good improvement over the 66.7 years for men back in 1955. But Trump should survive past 76; according to the Social Security calculator, if you are a male and live to 71, your average life expectancy increases to 85.7 years. And thanks to the effect that medical technology and the latest treatments have on quality of life, where the damage from a coronary event, for example, is limited by an artery-opening heart-sparing surgery or balloon angioplasty and stent placement, he will likely survive his years in office in good health. Screening colonoscopies, modern imaging, and comprehensive blood tests play an important role in prolonging and improving quality and length of life, too. “Today’s 70 is yesterday’s 60,” is borne out by the numbers.

My prescription for Trump’s continuing health would be to add more sleep, a better diet, regular exercise, and some weight loss to his daily routines. In any case, if he does experience health issues, despite the brightest media lens, we still aren’t likely to know the full scope of them, at least not right away. That’s one presidential tradition that is likely to remain.