Sickest Presidents Part Four: Slicker and Sicker

Finalist number four: John F. Kennedy

What JFK, super stud? Well about that…

One theme that jumps out with our more modern examples is just as with celebrities such as Michael Jackson, being a famous person does not mean you are going to get famously good medical care. In fact Wilson, FDR, Harding and JFK had personal physicians of very minimal competence and/or a tendency to be more interested in maintaining their privileged position than ensuring that their patients got the best possible care.  Physicians can be star struck just like everyone else. I think also that some of the blame rests with the patients involved. A president tends to be someone with a controlling and domineering nature, leading them to select doctors that would give them the drugs and treatment they wanted, rather than needed or would not press them successfully to give up control, for example by making them adapt unwanted lifestyle changes.

JFK’s health problems started long before his presidency. He was a sickly child you seemed to get every childhood disease and to get them worse than other children. By his late teens-early twenties he was in and out of hospitals multiple times a year with infections, physical collapses and “jaundice.”

Did you know that Kennedy attended Northwestern University, Stanford, Princeton and the London School of Economics? He did, briefly. Each time he had to drop out due to health problems. He might have sort of completed OCS at Northwestern. He did eventually graduate from Harvard, but not without some leave of absences for health reasons.

Finally his problem was diagnosed in London in 1947. It was Addison’s disease, the result of the destruction of the adrenal gland cortex (which is the outside of the gland, even though the name sounds like it should be inside –the “core—tex.”) Addison’s disease is usually an autoimmune condition where the body’s antibodies attack the gland itself. Symptoms include weakness, hyperpigmentation, weakness, fever, vomiting, nausea, diarrhea, lightheadedness when standing, anxiety and joint and muscle pain. Once you loss your adrenal cortex you can’t keep salt and potassium in the body and this is what causes a lot of these symptoms. In case you are now worrying that you have Addison’s disease, simple blood tests to check your salt and potassium will quickly rule it out. People with Addison’s disease also have hyperpigmentation; their skin darkens especially around skin creases and scars and so on (like being pregnant.)

Up until the late1940s, Addison’s disease was a death sentence. Kennedy was given a year to live. People usually did die within a couple of years after diagnosis, as in addition to the chronic mineral depletion you no longer make cortisol, the “stress hormone.” Although chronic stress is bad for you, no cortisol stress reaction means that any stressful event such as surgery, illness, exercise, etc. will simply kill you. I wonder if possibly some of the many doctors who treated JFK at various hospitals knew what he had, but saw no point in giving him a depressing and untreatable diagnosis—it was a different time in terms of patient-doctor communications.

JFK was lucky, in that he was alive just as the first treatments for Addison’s disease were being propagated. It wasn’t an instant fix—he was so ill on the ship ride back to the US that he was administered the last rites. Once back in Boston, he was treated with cortisone and DOCA shots and his condition improved.

But it was not a cure. He continued to have physical breakdowns on a regular basis if he tried to do too much. For example he went on a world tour with his brother Bobby, developed a 106 degree fever and was once again administered the last rites.

All this time his Addison’s was on a collision course with his other great health issue—a very bad back. Kennedy had had back problems since he was young, and he exacerbated them with sports injuries and his famous PT boat accident in World War II. By 1954, he was in excruciating pain and barely able to walk. He desperately needed surgery. Remember however the “stressful event such as surgery” above? The doctors of the time had little experience doing major surgery on someone with Addison’s disease and there was a real chance that the surgery would kill him.

Kennedy could stand it no longer as his life wasn’t worth living. Obviously we all know the surgery did not end up killing him—quite. He was in the hospital for 2 months, administered the last rites (again), couldn’t walk three months later, and had to have hardware taken out in February 1955, due to infection. Six months after the surgery he could still barely walk.

JFK back was never without significant pain from that time forward, although his condition stabilized somewhat with pain killers, Novacaine injections, a back brace, and shoes to correct unequal leg length. Unfortunately, jumping ahead a bit, he reinjured it during a tree planting photo op in Ottawa in May 1961 and was in increasing agony after that.

Naturally Kennedy’s health was a closely guarded secret at the time, because if his true condition were widely known, it would have stalled or ended his political career. Ironically, Kennedy’s Addison’s and its treatment gave him an appearance of health and vitality. The steroids he took caused him to put on needed weight and broadened his face, and the Addison’s bronzed his skin—giving him a great tan.

Probably everyone knows the story about how the Kennedy campaign finessed the question of Addison’s disease. They put out a press release stating that JFK did not have “Addison’s disease” that referred to destruction of the adrenal cortex by tuberculosis, which is one of the definitions of Addison’s disease. (Even that might have been a lie since no one really knows how he got it.) They forgot to mention that he did have adrenal insufficiency, whatever you want to call it.

To top off his medical issues Kennedy was taking a slew of medications, including a number of mind-altering substances. He was of course on opiates that have a profoundly depressing effect on sexual functioning, which is perhaps why he was taking high doses of testosterone. He visited a quack doctor, Max Jacobson, who gave all the rich and famous shots of amphetamines mixed with various nonsense like bone marrow and ground up animal organs. Kennedy’s personal doctor, Dr. Jannette Travell, doesn’t come down through the ages as a Nobel prize candidate wither, but she sure had a quick hand with prescription writing. She was also prescribing him barbiturates.

Kennedy finally got tired of his back pain, however and got a new doctor who improved his conditioning with swimming and physical therapy. It is said that JFKs back was better than it had been in years in the Fall of 1963.

So was Kennedy the super stud that the Internet wants him to be? I doubt it. Oh, I don’t doubt that he was a mid century macho man, with lots of leering, butt grabbing, smutty remarks and so on, that today would be considered sexual harassment/assault, but in those days were considered good (un)clean fun. We’ve come a long way. And we know that a lot of women have been eager to claim they were intimate with President Camelot.  But my professional opinion would be that someone who had trouble walking due to severe back disease, Addison’s disease with recurrent crises, and taking medications that destroy sexual functioning would not be able to actually perform to any high standard, if he was able to perform at all. But that doesn’t suit the myth.

Kennedy undoubtedly had the worst overall health of any of our contestants. He was life threateningly ill on a regular basis since early adolescence. How did this affect his performance as president? This is a question that’s been asked over and over again, and at least he performed well enough to make the answer unclear. He was never in an actual coma like Wilson. On the other hand his physical problems were present through out his presidency whereas Roosevelt’s only became a problem in his later presidency.

Next time: A review and a winner!

Doc Contrarian

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