Sen. John McCain, the presumptive Republican presidential nominee, released 1,173 pages of personal medical records this week. Such candor in politicians is a recent development. Dr. Jerrold Post—director of the political psychology program at George Washington University and author of "Leaders and Their Followers in a Dangerous World" (Cornell University Press, 2004)—has studied the history of presidents and their health problems. He spoke with NEWSWEEK's Anne Underwood. Excerpts:
NEWSWEEK: John McCain has been candid about his health. Does that represent a break with the past?
Jerrold Post: There has been increasing pressure for candidates to reveal information that was once considered a personal matter. Today, you have to give up that privacy to run for the highest office.
But even in recent years, not all candidates have been that honest. I'm thinking of Sen. Paul Tsongas, who competed against Bill Clinton to be the Democratic nominee in 1992.
That was a cover-up. He indicated that he had had non-Hodgkins lymphoma. He and his doctor attested that, because of his bone-marrow transplant, his prognosis was as good as anyone else's. But at the time the statement was made, he had already had a recurrence of the cancer that wasn't made public. That kind of information needs to be revealed.
The public is demanding more information today. But are people also more forgiving, now that better treatments exist?
Yes and no. Part of the distinction has to do with what kind of illness it is. Dwight D. Eisenhower had a heart attack in 1955, an abdominal operation in 1956 and a stroke in 1957. People were sympathetic after the heart attack, because it was clear that it was mild and he would survive it. But the stroke, which temporarily affected his speech, raised the specter of a president who was unable to communicate. People look to their leaders for wisdom, strength and clarity of speaking.
What about cancer?
In France, François Mitterrand was an interesting example. When Mitterrand came to office, he swore that his would be an open presidency. But on his first day in office in 1981, he called in the presidential physician, Dr. Claude Gubler, and told him that his prostate cancer had spread to his bones. Mitterrand solemnly declared, "We must reveal nothing. These are state secrets." He led for 14 years with the constant and painful companion of metastatic cancer. How could that not have affected his decision making?
What about depression? There used to be such a stigma attached.
Depression is interesting. In 1924, just after Calvin Coolidge's nomination to a second term, his favorite son, Calvin Jr., developed a blister after playing tennis on the White House grounds without socks. He developed septicemia and died three days later [at the age of 16]. This was before antibiotics. Coolidge was called a do-nothing president, but it was probably as a consequence of a severe grief reaction from which he never recovered. After that, he spent 11 hours a day sleeping. His work day shrank. He was irritable and disinterested in affairs of state.
Today much of the country seems to be on anti-depressants. Aren't we more tolerant now?
In 1972, George McGovern [the Democratic candidate] chose Sen. Thomas Eagleton as his running mate. But when it was revealed that Eagleton had had electroconvulsive therapy for depression years earlier, it created a huge uproar. There was such a fear of shock therapy and the possibility of a mentally ill president [if McGovern should die in office] that Eagleton had to step down. Interestingly, Eagleton returned to the Senate, where he had an excellent reputation. We can tolerate a history of depression in the Senate, but not in the highest office.
What are some of the more intriguing cases of presidents who have concealed information about their health?
Grover Cleveland [who served as president 1885-1889 and 1893-1897] was brushing his teeth one morning, when he noticed a lump in the roof of his mouth. He called in his dentist, who summoned a head-and-neck surgeon. The surgeon diagnosed the lump as a carcinoma of the roof of the mouth. Cleveland thought it would cause an economic crisis if the information was released that he had cancer, so during the night, he smuggled an anesthesiologist, nurses, his dentist and the head-and-neck surgeon onto the presidential yacht under the guise of a pleasure trip on the Hudson River. During the trip, they removed the roof of his mouth up to his left eye, and inserted a rubber prosthesis internally. People were suspicious, but it wasn't revealed until 15 years after his death what had happened.
In more recent years, after the assassination attempt on Ronald Reagan, how cheered we all were when he waved from his window at George Washington University Hospital. But what people didn't know was that Reagan was only alert for one hour a day. The nightly news regularly showed clips of a vigorous Reagan in good spirits. But in fact, these moments were carefully chosen. When he went back to the White House—Bob Woodward conveyed this vividly in his book "Veil"—he showed only brief intervals of lucidity and vigor. This was only the beginning of the Reagan presidency, but according to Woodward, his aides were afraid it would end up as a crippled presidency, like Wilson's caretaker presidency.
You're referring to Woodrow Wilson after his stroke.
In the fall of 1919, Wilson had a disabling stroke while he was on a train trip across the country to mobilize support for his cherished League of Nations. The public knew he was ill, but they didn't know how ill. Only Edith Wilson, chief of staff Joseph Tumulty and his personal physician, Cary Grayson, were allowed to see him. Issues were brought in, and decisions would come out. We talk today about the possibility of having the first woman president, but we effectively already had one in Edith Wilson. After her husband partially recovered, Mrs. Wilson said, "I don't know what you men make such a fuss about. I had no trouble running the country when Woody was ill."
I guess Franklin Roosevelt would be the most famous example of a president who concealed information about his health.
His polio was well known—and it humanized this aristocratic man—but the press was respectful. There were only two or three pictures of him in a wheelchair. What wasn't so well known was how ill he was when he went to the Teheran summit with Winston Churchill and Joseph Stalin in 1943. He came back quite ill. The White House doctor, [Vice] Admiral Ross McIntire, directed cardiologist Howard Bruenn, a Navy [lieutenant] commander, to examine Roosevelt. Bruenn was alarmed at the gravity of Roosevelt's illness. He diagnosed congestive heart failure, hypertension, acute bronchitis and longstanding pulmonary disease. McIntire told Bruenn, you must not tell the president and his family the extent of his illness, and you certainly cannot tell the American public. He issued a reassuring communiqué to the effect that, for a man of his age, Roosevelt was in remarkably good health. But Franklin's son, James Roosevelt, later said he'd never been reconciled to the fact that his father's physicians allowed him to run for a fourth term. It was his death warrant. At the Yalta summit in 1945, Churchill's physician said that Roosevelt looked old and drawn and sat staring ahead with his mouth open. He intervened little in the discussion. He died shortly after the summit of a massive cerebral hemorrhage.
President Kennedy had Addison's disease.
Yes, but it was only in Robert Dallek's 2003 biography of John Kennedy that we learned the extent of Kennedy's illnesses, which he concealed and which his family continued to conceal after he was assassinated—colitis, duodenal ulcers, osteoporosis and Addison's disease, which is a life-threatening insufficiency of the adrenal glands, requiring twice daily steroids. By 1950, he had constant back pain from vertebral collapse. From the mid-1950s, he was taking powerful narcotics like Demerol and methadone. He took barbiturates for sleep and tranquilizers for anxiety—as many as eight medications a day. There's some indication that he may have abused amphetamines. Before press conferences, he often required injections in the back to control his pain. Throughout his career, he concealed his illnesses.
If elected, John McCain would be 72 when sworn in. Is age an issue?
The first generalization is that one shouldn't generalize. There are some highly creative individuals who function well into their 90s. Konrad Adenauer [who served as German chancellor until the age of 87] was one. Having said that, the danger is that one may attempt to force a new situation into a template from the past and draw false parallels. With the passage of years, there can also be an increased sense of urgency that makes you want to accelerate the pace of change and fit a political timetable to your own. In China, the Cultural Revolution was related to Mao's realization that his time was short and his desire to fully consolidate the revolution before he died.