President Trump’s Covid-19 diagnosis last week raised the temperature in a body politic that is already feverish. Americans achieved a temporary union over the weekend, with Democrats and Republicans wishing a speedy recovery to a hospitalized president. But the health of the republic will remain fragile as long as we elect mortals to fill the world’s most punishing job.
The sickness of presidents is an old vulnerability in our system of government. In the Federalist Papers, Alexander Hamilton argued that the Constitution would establish a “vigorous” chief executive, but the Founders didn’t anticipate how often presidential illness would lead to crisis. Woodrow Wilson’s debilitating stroke in 1919 helped to torpedo the cause of U.S. membership in the League of Nations, while Franklin Roosevelt’s declining health may have been a factor in the Tehran and Yalta conferences, which granted Stalin sway over Eastern Europe. Most of the time, the public knew little about presidential illnesses: John F. Kennedy’s severe health problems weren’t widely known until his biographers revealed them.
“ In June 1789, George Washington developed a painful, fast-growing tumor on his left thigh. ”
Some Founders worried that a president might become too powerful, but within months of George Washington’s inauguration, it became clear that presidential weakness was another kind of danger. In June 1789, Washington developed a fast-growing tumor on his left thigh, so painful that he could barely sit down. His aides feared for his life and closed down the street outside his New York residence so he could rest more peacefully. On June 17, Dr. Samuel Bard cut deeply into Washington’s leg and removed the tumor, leaving him bedridden for six weeks, unable even to write a letter. Eventually, he returned to normal duties, but it was a close call, and if Washington hadn’t recovered, the presidency might have perished with him.
Understandably, the first president never shed his worry that “the cares of the office” might “hasten my departure for that country from whence no traveler ever returns.” As the burden of the job increased, so did the danger of illness, exhaustion and mental deterioration.
In 1800, the transfer of the capital to Washington, D.C., on the banks of the Potomac, created new health risks for presidents. Throughout the 19th century, raw sewage was discharged into creeks and canals that ran very close to the White House, causing periodic outbreaks of dysentery. Even then, Washington was understood to be a kind of moral swamp, with water as pestilential as its politics.
Many presidents faltered as the job wore them down. The first to die in office was William Henry Harrison, who had been elected in 1840 in part because of his image as a ruddy general, tippling hard cider in his log cabin. But the journey from Ohio to Washington exhausted the 68-year-old Harrison, and he weakened more after giving a long inaugural address in the rain. He died a month later, setting a record that still stands for the shortest term in office.
In 1850, Zachary Taylor attended a dedicatory event for the Washington Monument on a July day so hot that Taylor, a war hero, wondered if he was back in Mexico. After drinking a lot of ice water to cool off, he developed severe abdominal pains and died days later. Americans were stunned, and a young Illinois Whig fumbled for the right words in a eulogy: “The death of the late President may not be without its use, in reminding us that we, too, must die,” said Abraham Lincoln.
Lincoln’s predecessor as president, James Buchanan, offers another example of the danger of presidential illness. Immediately after his inauguration in 1857, he fell ill with dysentery, and as the crisis of disunion deepened, he seemed to get sicker. One of his eyes wandered promiscuously, as if he didn’t know which direction to look in—an accurate representation of his politics as the North and South pulled apart. One witness reported that Buchanan “has a peculiar nervous twitching always to the left as if some unseen spirits were plucking him on that side by the sleeve.” He was probably depressed, too, judging from the glee with which he left the White House.
Buchanan’s illness foreshadowed the more famous case of Woodrow Wilson. At the peace talks in Paris in 1919, Wilson was likely weakened by the flu epidemic, and that fall, a series of debilitating strokes paralyzed the left side of his body, leaving his mouth drooping. He didn’t die in office, but for the rest of his presidency, his dire condition was hidden from the public. Again, the fragility of a president’s constitution had pointed to a flaw in the Constitution.
When Dwight Eisenhower endured two serious health crises while in office, a heart attack in 1955 and a stroke in 1957, and his successor John F. Kennedy was assassinated in 1963, it became clear that the Constitution needed to address the issue of presidential succession. That need was partly met by the 25th Amendment, ratified in 1967, which permits the transfer of power to the vice president if “the President is unable to discharge the powers and duties of his office.” But concerns remain, especially about presidents suffering from “invisible” ailments. Ronald Reagan’s son Ron suggested in a memoir that his father was entering the twilight of Alzheimer’s disease while still in office, raising the question of how to deal with a president who may not even know that he is declining.
Presidential conversations usually come back to Lincoln, and it is haunting to learn that he may have been close to death when he gave his greatest speech. After returning from the Gettysburg battlefield in November 1863, where he delivered his famous address, Lincoln fell ill with what he thought was a “varioloid,” a mild version of smallpox. But it may have been the actual disease: William Johnson, a young Black American who was traveling with Lincoln, contracted smallpox at the same time and died in January 1864. The president paid for his coffin. As tragic as Lincoln’s assassination was, it would have been even more damaging to democracy if he had been removed by a tiny bacillus long before his work was done.
—Mr. Widmer is Distinguished Lecturer at the Macaulay Honors College of the City University of New York and the author of “Lincoln on the Verge: Thirteen Days to Washington” (Simon & Schuster).
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Appeared in the October 10, 2020, print edition as ‘The Hushed Crises of America’s Sick Presidents.’