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Presidential Health No Longer a Secret?

Although patient privacy is shielded by law, presidential health is everyone's business -- or at least it should be. That's the view of Larry J. Sabato, PhD, director of the University of Virginia's Center for Politics and author of more than 20 books on the American political process. He says presidents and would-be presidents have a duty to be forthcoming about their medical histories.

"The public has every right to the basic knowledge about the candidate's medical situation," Sabato tells WebMD. "Voters want to know they're electing someone healthy enough to do this incredibly intense job." He adds that Americans count on the media to investigate matters of presidential health.

But historical records show a pattern of medical cover-ups, says Jerrold M. Post, MD, director of George Washington University's Political Psychology Program and co-author of When Illness Strikes the Leader. "Even in America with a vigorous press and vigorous opposition parties, concealment has been an issue," Post tells WebMD.

Presidential Health Cover-Ups

Post divides presidential health cover-ups into two categories. The first is when the very existence of a presidential illness is kept secret. Two examples are Grover Cleveland and John F. Kennedy.

• Grover Cleveland -- Cancer of the Mouth
  On July 1, 1893, President Grover Cleveland boarded the yacht Oneida, purportedly for a pleasure cruise along New York's East River. In fact, the yacht became an operating room for secret surgery to extract a cancerous growth. "By nightfall, he was spirited onto the presidential yacht and had the roof of his mouth removed," Post says. The operation didn't leave a scar, so the public was none the wiser.
• John F. Kennedy -- Addison's Disease
  "John F. Kennedy had major problems with health throughout his life," Post says. Although he may have seemed the picture of youth and health, he was suffering from Addison's disease. This is a rare condition in which the body cannot make enough cortisol, a hormone vital to coping with physical stress. Symptoms include weakness, fatigue, and loss of appetite. "JFK was very sick, and it's remarkable more didn't come out," Sabato says. "Because he was so young, people assumed he was vigorous."

The second type of cover-up occurs when the public knows the president is not well, but the full extent of medical problems is concealed. Post cites Woodrow Wilson, Franklin D. Roosevelt, and Ronald Reagan as examples.

• Woodrow Wilson -- Stroke
  In 1919, President Woodrow Wilson suffered a massive stroke while trying to promote U.S. participation in the League of Nations. The public was told that Wilson collapsed from exhaustion and only needed a rest, when the truth was far bleaker. "The stroke caused paralysis of the left side of his body and severely impaired his intellectual functioning and ability to communicate," Post tells WebMD. For the remainder of his term, Wilson saw only his doctor, a close personal aide, and his wife, Edith Bolling Wilson. Historians believe key presidential decisions were made by these three people, rather than Wilson. According to Post's book, Leaders and Their Followers in a Dangerous World, Mrs. Wilson later remarked, "When Woody was ill, I had no difficulty running the country."
• Franklin D. Roosevelt -- Various Ailments
  Franklin D. Roosevelt suffered from a wide range of medical problems, both before and during his presidency. "Everyone knew about his polio disability," Post says, "but what isn't widely known is the degree of his other disabilities from a series of illnesses later in his career." In March 1944, while Roosevelt was campaigning for his fourth term, an examination revealed a variety of heart ailments, high blood pressure, and bronchitis. This information was not shared with the public or even Roosevelt's own family, Post says. Instead, Roosevelt's doctor gave a news conference saying FDR was in remarkably good health for a man of his age. Roosevelt died a year later, just a few months into his fourth term. Sabato calls this a "press scandal," saying that journalists who saw FDR noticed his failing health. "They knew he was very sick and didn't report it."
• Ronald Reagan -- Recovery from Attempted Assassination
  In March 1981, less than three months after his inauguration, President Ronald Reagan was shot in the chest by John Hinckley Jr. According to Post, the following week's news clips showed Reagan "waving cheerfully from his window, but in fact he was seriously disabled." A wounded lung required him to use an inhaler, and his workday remained short throughout his recuperation.