Robert Gilbert
Robert Gilbert
The Mortal Presidency: Illness and Anguish in the White House
ISBN: 0823218376
The Mortal Presidency
Mr. Gilbert talked about his new book The Mortal Presidency, which looks at five U. S. presidents and their medical histories. He described various types of illnesses that afflicted these former presidents. He also proposed the idea that many of these illnesses were caused by the rigors of the office of president.
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TRANSCRIPT
The Mortal Presidency
Program Air Date: January 24, 1993

BRIAN LAMB, HOST: Robert E. Gilbert, author of The Mortal Presidency: Illness and Anguish in the White House", why do we need a book on death and the presidency?
ROBERT GILBERT:(Author, "The Mortal Presidency: Illness and Anguish in the White House"): Well, I think it's a topic that hasn't gotten the attention that it deserves. All through my college career, through my graduate-student career, I'd always heard and I'd always read that the presidency is a killing job, the presidency is stressful, the presidency is debilitating, punishing and so on, and yet I could see that members of Congress tended to do very well in terms of longevity of life. They tended to grow quite old. I could see that members of the Supreme Court did very well in terms of longevity of life, and I decided to analyze whether or not in point of fact what I had always heard about the American presidency being such a punishing job was, in fact, reality. I found that it indeed is reality. As a matter of fact, it probably understates the case. The head of the executive branch, the presidents of the United States -- there have been 40 of them -- have done very badly in terms of longevity of life, and this is in stark contrast with members of Congress and members of the judicial branch of government.
LAMB: You focused on five presidents. Which five, and why did you pick them?
GILBERT: I focused on, first of all, Calvin Coolidge; secondly, Franklin D. Roosevelt; thirdly, Dwight D. Eisenhower; fourthly, John F. Kennedy, and, lastly, Ronald Reagan. Calvin Coolidge, I think, was of interest to me because at the time I began the book Ronald Reagan was in the White House. Ronald Reagan always admired Calvin Coolidge. As a matter of fact, Calvin Coolidge was Ronald Reagan's favorite president. The reason for Reagan's respect for Coolidge was that Coolidge was a very passive, non-interventionist, non-involved chief executive, and Reagan thought that this was an appropriate model on which to pattern his presidency.

In fact, Coolidge had been so passive, according to news stories, that he drew my interest because, as a Massachusetts politician, he had a long political career before he became president. He had always been an activist governor, lieutenant governor and mayor of Northhampton. He was an astute politician. He worked very hard. I guess one of the most famous speeches he gave as president of the Massachusetts Senate was "do the day's work." We have a responsibility to earn our salaries, in other words. Then suddenly when he became president, especially after he was president after a year, he changed dramatically in his behavior. He stopped doing the day's work, he stopped being involved, he stopped being astute. He became a lackadaisical, passive, non-involved chief executive, and I tried to determine what produced this radical shift in his behavior.

It seems very clearly to have been caused by Coolidge's reaction to a traumatic event which occurred in 1924 on the eve of his nomination by the Republican party for a term in his own right when his 16-year-old son and namesake, Calvin Jr., died of blood poisoning. Coolidge blamed himself for his son's death. If you look at his autobiography, he says, "Here I am, the most powerful man in the world and I couldn't save my own boy." He asks in his autobiography, "Why did God punish me this way? What did I do as president of the United States that God has actually taken the life of my 16-year-old son?" And he wrote in his autobiography, "When my boy died, the power and glory of the presidency went with him."

It seemed to me this was a case of mental illness, which is why the book is subtitled "Illness and Anguish in the White House". Calvin Coolidge, it seems to me, became enmeshed in a massive depression, and he never recovered from it. He began sleeping 12 hours every night. He began taking naps during the afternoons. He began telling members of his cabinet that he wanted them to handle the responsibilities of the departments of government. He didn't want to get involved. Basically he spent the four remaining years of his administration as an uninvolved, shattered man. So he was the first president that I chose because of his unique experience.

Franklin Roosevelt, always of interest because of the physical difficulties, as you know had polio. He never recovered from polio. Contrary to the general perception, he had never regained use of his legs. As a matter of fact, students even today are surprised when they learned that Franklin Roosevelt was confined to a wheelchair throughout his administration. Then, too, Franklin Roosevelt in his third term became seriously ill with things that had nothing to do with polio -- congestive heart failure, pulmonary difficulties, problems with the flow of oxygen to his brain -- and he had a grossly enlarged heart. He seemed perfect for a study of this kind. As you know, he died in office in the beginning of his fourth term, right after he participated in the Yalta Conference.
LAMB: Let me ask you about one thing that I read. You said that there was a study that was published in 1979 that he had cancer?
GILBERT: There was a suspicion that he might have had cancer. This has been a recurring view, I think, of Franklin Roosevelt, and it's been caused by a number of factors. One was that Franklin Roosevelt's doctor, Ross McIntire, maintained that Roosevelt had never had surgery other than the removal of a growth on the back of his scalp. If you look at pictures of Franklin Roosevelt at the beginning of his term and working through his first and into his second term, he has a growth over one of his eyebrows, and all of a sudden, the growth disappeared. Obviously there had been some kind of surgery. This fanned the rumor that the growth had been cancerous and the White House had concealed this fact from the public.
LAMB: Gen. Eisenhower.
GILBERT: He was the third president I looked at. Eisenhower was of interest because he became seriously ill while he was in the White House. In 1955, in his first term, he suffered his first well-publicized illness, which happened to be his heart attack. He had no sooner recovered from this than he underwent abdominal surgery for ileitis, and then at the very beginning of his second term in November of 1957, he suffered a stroke, and so again he seemed an extremely inappropriate president because of these three well-publicized illnesses.
LAMB: John F. Kennedy.
GILBERT: John F. Kennedy, again, a president who was very much responsible for the physical fitness craze that swept the country, became synonymous for the word vigor, urging an active lifestyle for his fellow countrymen. And yet John F. Kennedy was ill throughout his life, from the moment he was born until the day that he died. He was in intense pain. He had various kinds of maladies, a number of them minor and some of them very major, and he seemed, again, a perfect president to examine in terms of the type of illnesses and the impact of the illnesses on the performance of the president in office.
LAMB: How many presidents have died in office by assassination or natural causes?
GILBERT: Eight presidents have died in office. Four have been assassinated; four have died in other ways. In addition to the four who have been assassinated, several other presidents have had attempts made against them. President Reagan in 1981 became the first president to survive being shot while he was president of the United States. Gerald Ford survived two active assassination attempts against him. President Truman -- a very serious attempt was made against President Truman as he left the Blair House, and one of his Secret Service agents was killed in that attack on Truman. Franklin Roosevelt was riding in the car, seated next to the mayor of Chicago, and the mayor of Chicago was shot to death. It's widely assumed that the bullet which struck the mayor of Chicago was intended for Franklin Roosevelt.
LAMB: The four presidents who were assassinated?
GILBERT: Abraham Lincoln, James Garfield, William McKinley and John Kennedy.
LAMB: And the four presidents that died in office?
GILBERT: William Henry Harrison was the first. He survived one month in office. Franklin D. Roosevelt, Warren Gamaliel Harding and . . .
LAMB: Zachary Taylor.
GILBERT: And Zachary Taylor. How could I forget him? He was exhumed last year to find out if, in fact, he had been assassinated.
LAMB: What was the controversy about that?
GILBERT: Apparently a historian who is writing a book on the Zachary Taylor administration came to the suspicion that Taylor may have been assassinated by arsenic poisoning by his political opponents. He served as president for only 16 months -- 16 unhappy months -- and he died rather quickly, rather suddenly, and the cause of his death has always been undisclosed and undiagnosed. If you read traditional history books, the kind of books that high school students are reading and have been reading in this country, his death has always been attributed to the fact that he ate a great deal of fruit -- cherries, for example -- and he drank very cold liquids shortly before he died.

The suspicion was that the unwashed fruit and the very cold liquids operated in such a way as to kill him. The historian I mentioned believed that he may have been assassinated; that, in fact, he may have become the first president to be assassinated, which would have meant that Lincoln was not the first president. So Zachary Taylor's body was exhumed last year so that they could analyze hair particles, which were still in the casket, and they determined that he had not in fact been assassinated. We don't know why he died, but we know now he did not die of assassination by arsenic poisoning.
LAMB: Can you put any label on a president that might have been the sickest while in office, no matter how long they served? Who were the sickest presidents that might have even survived it all?
GILBERT: I think certainly Woodrow Wilson comes to mind. Woodrow Wilson served two terms in the White House. He was in office during World War I. Toward the end of World War I, Woodrow Wilson went to Europe to work out a peace treaty, and he spent a number of months in Europe in difficult negotiations with the European leaders and so on. He was not a well man when he came back to the United States. He sent the treaty, the Treaty of Versailles, to the United States Senate. He was having difficulties with the Senate, specifically with the chairman of the Senate Foreign Relations Committee, Senator Henry Cabot Lodge of Massachusetts.

Senator Lodge wanted to add reservations to the Treaty of Versailles, and they were relatively minor reservations. Woodrow Wilson could have accepted them with good conscience, but he was very, very stubborn. He refused to accept them, and he decided that in order to bring pressure on the Senate, he would try to rally public support. Contrary to the advice of his doctors, contrary to the instructions of his doctors who said, "Mr. President, you're not well enough to do this," Woodrow Wilson went on an extensive speaking tour. He was going into city after city after city, speaking to enormous crowds, trying to bring pressure to bear on Congress to get them to consent to ratification of the treaty.

While he was speaking in Pueblo, Colo., he was stricken with two strokes, one of which was a serious stroke. They brought him back to Washington immediately, and basically he spent the remaining year and a half of his administration as an incapacitated invalid. As a matter of fact, he was so incapacitated that this is the one period of history that has been referred to as "the regency of Edith Wilson." The rumors were that Mrs. Wilson in fact functioned as acting president, standing in for her husband and making decisions for her husband. She denied that, by the way. She maintained the only decision that she made was to decide what he would decide, which is a significant grant to power in itself, to determine what the president involves himself in. So certainly Wilson is one of those presidents, I think, who was incapacitated for almost half of one term and removed from the scene almost completely for a year and a half.
LAMB: Your book is being published in the beginning of 1993. When did you write the last word for this publication?
GILBERT: Oh, gosh, do you mean the revisions and so on?
LAMB: What I'm getting at is, was this before you knew that Bill Clinton was going to be president?
GILBERT: Yes.
LAMB: Can you tell us anything about the health of Bill Clinton?
GILBERT: This is a difficult area. The president-elect is 46 years old. Interestingly, he is one of the youngest presidents in history, but not the youngest. Theodore Roosevelt was the youngest ever. John Kennedy was the youngest elected president, and both President Grant and President-elect Clinton were 46 years old.
LAMB: Some people may be watching this after he is already president, so they'll be surprised to hear you saying "elect," but go ahead.
GILBERT: So we're replacing one of the oldest presidents in history -- President Bush was the fourth-oldest man ever to serve in the White House -- with one of the youngest. You might remember that in the campaign in October of 1992 Governor Clinton was asked by the media, specifically by the New York Times, to release his medical records, and he refused. This made front-page news across the country and led to quite an uproar. The suspicion was that he was not releasing information because he was afraid that negative medical information might impact on his campaign. He was leading in the polls at the time.

The impact was so swift and so serious that Clinton did release his medical records, or at least a portion of his medical records, and he did authorize four of his physicians to speak with the press. The consensus view is that his health is excellent. His doctors have maintained that his health is excellent, but of course, it isn't perfect. He suffers from chronic laryngitis, and usually when people hear that a political figure suffers from laryngitis, they assume it's because he does so much talking and he gives so many speeches. In Clinton's case speaking exacerbates the problem, but the root cause of the difficulty is the fact that Clinton's stomach produces excess stomach acid, and when he sleeps in a prone position, the excess stomach acid travels into his esophagus and affects his vocal chords.

Because of this, Clinton sleeps propped up in bed with his head propped up so that this gastric acid can't travel into his esophagus and affect his vocal chords. So this is one difficulty that he has. He also has allergies. He gets shots several times a month. He's allergic to various kinds of things -- certain kinds of dust, certain kinds of beef, milk products. He's also allergic to cat dander -- I don't quite understand how his cat fits into all of this, but apparently he is allergic to cat dander -- and he takes medication to reduce swelling in his eyes, which tend to swell when he is exposed to this kind of material.

But I would imagine that the most serious problem that Clinton has and the problem the doctors have talked about -- two of his doctors, as a matter of fact, have indicated that this is of some concern to them -- is that his weight tends to rise and fall fairly dramatically. During the primaries last winter and last spring, I believe he gained 30 pounds and then lost the 30 pounds. And doctors, I think, cardiologists, would say that this puts great stress on the heart. Two of his doctors, when they were interviewed and when they met the press last October, indicated that they wished he would take off weight and leave it off, that his weight would stabilize, because the rise and fall of weight is not desirable.
LAMB: Are you a medical doctor?
GILBERT: No, I'm not.
LAMB: Where do you hang your hat most of the time, and what do you do?
GILBERT: I'm a professor of political science at Northeastern University in Boston.
LAMB: What do you teach?
GILBERT: I teach the American presidency. I teach politics in the mass media. My first book dealt with television and presidential politics. I teach political parties. I've just stepped down after serving 12 years as chairman of my department, and I didn't do too much teaching while I was chairman. I was on sabbatical two years ago, and I've been back teaching basically the American presidency and politics in the mass media.
LAMB: Did you find new information for this book?
GILBERT: Oh, yes, a great deal of new information.
LAMB: Can you give us something else? Tell us what kind of new stuff you found.
GILBERT: I wanted to base the book as much as possible on primary-source materials -- materials that no one else was familiar with, materials that perhaps no one else had ever had access to, so I spent a great deal of time at the Eisenhower Library in Abilene, Kan., the Kennedy Library in Boston, Mass. President Eisenhower's records, even though he died in 1969, were only released and made available in 1989 at the Eisenhower Library. Eisenhower's long-time physician, Dr. Howard Snyder, and his cardiologist, Dr. Thomas Maddingly, each compiled massive records of the Eisenhower medical history, and so I reviewed them. Some of the most striking things that I found is that Eisenhower suffered a well-publicized heart attack in 1955. I learned that, in point of fact, the 1955 heart attack might not have been his first. It might not even have been his second heart attack. Eisenhower's cardiologist maintains that Eisenhower, when he was president of Columbia University, suffered a moderately-severe heart attack and news of the heart attack was concealed from the public because Eisenhower's doctor was afraid that it might impact negatively on his future political career.
LAMB: Did he ever lie about it?
GILBERT: Eisenhower never referred to it publicly. He just never referred to it publicly. As a matter of fact, Eisenhower's doctor even maintained that while Eisenhower was in Georgia for seven weeks, he had played golf every day on vacation, and in point of fact -- or at least Eisenhower's cardiologist maintains -- that he met the doctor that said that Eisenhower was hospitalized during this period of time and that Dr. Lydam had been in charge of taking care of him. Dr. Maddingly, the cardiologist, also maintains that in April of 1953 while Eisenhower was president, he suffered a second heart attack or at least was on the verge of suffering a heart attack. All the White House announced at that time was that the president was suffering from an upset stomach. So Eisenhower's 1955 attack might have been his third, and he might have had a heart attack in the White House in 1953.
LAMB: From what you know, could that happen today?
GILBERT: I think it could. As a matter of fact, I think it's interesting that Dr. Snyder -- and he gave Eisenhower good treatment because Eisenhower managed to survive and Eisenhower managed to exceed his life expectancy, as a matter of fact -- admits that if Eisenhower had not been president, if he was not in Fraser, Colo., when he suffered the heart attack -- he was vacationing; he was staying at his mother-in-law's home in Fraser, Colo. -- that he, namely Snyder, never would have revealed that Eisenhower had suffered a heart attack, that he would have made believe that Eisenhower was simply suffering from an upset stomach or some sort of a stomach obstruction. But the attack was so bad in 1955 that he couldn't safely do this.

I think it's interesting that Dr. Snyder was called to the Eisenhower bedside at 2 a.m. When he arrived soon after, he brought with him medications for heart problems, which suggests that Eisenhower had had a prior history of heart problems. Why would he come with all of this heart medication? Snyder, even though he knew immediately that Eisenhower had had a heart attack, did not call for assistance until noon the following day. He took care of Eisenhower alone without calling for any help, any oxygen, without making any announcements to the press. If this could happen in 1955, I see no reason why it couldn't happen in 1995.
LAMB: Dr. Max Jacobson you write about and amphetamines and vitamins and a Vienna summit with Khrushchev and the facts that you can't still get today from the Kennedy Library. Will you tell that story?
GILBERT: Well, President Kennedy, because of his Addison's Disease . . .
LAMB: What is that, by the way?
GILBERT: Addison's Disease, which he denied he had by the way, is a problem with the adrenal glands. The adrenal glands are glands that are connected to the kidneys, and they produce cortisone, which is involved in regulating minerals in the body. If you had impaired adrenal glands earlier in American history, you would probably have died within a period of five years. It was a fatal ailment; it was an incurable ailment. Kennedy was diagnosed as having Addison's Disease while he was visiting London in 1947, although there is some possibility that he even had contracted it sooner than this. But Kennedy, because of his Addison's Disease, took medication. He took cortisone because his own body could not produce the cortisone that he needed. One of the results of this cortisone that he took was that Kennedy's face would swell.
LAMB: Let me stop you because I've got the one picture where the swelling was not obvious, and then on the other side of the page, you show that it was obvious.
GILBERT: Yes, and these are just a few months apart. Apparently when Kennedy would walk into a room to hold a press conference, reporters would know immediately if he had been taking cortisone because his face would swell up so much. But in addition to this medication that he was taking, he took a substantial amount of medication. As a matter of fact, one of his doctors said that in the White House he took cortisone "all the time," and the reason is, of course, when under stress, your body needs more and more cortisone. Someone who has Addison's Disease needs artificial cortisone; he has to take cortisone shots. One of his doctors maintains that he took it all the time while he was in the White House, which caused this facial swelling and the swelling of his neck and so on. But there are rumors that in addition to cortisone -- and they really are only rumors because we have no proof of this -- that Kennedy had a friendship with a New York doctor by the name of Max Jacobson, and this doctor eventually lost his license to practice medicine in the state of New York because he was giving his patients apparently illegal drugs -- amphetamines. Truman Capote, for example, was one of his patients.
LAMB: But he didn't lose it until 1975.
GILBERT: He lost it in 1975, right. Kennedy was a social friend of Dr. Jacobson. Jacobson was at the White House, we know that. Dr. Jacobson did accompany Kennedy to Vienna, this is true. We don't have access to the passenger lists, but we do have access at the Kennedy Library to the hotel lists for the Kennedy party, of all the hotels where the various individuals in the Kennedy party were staying in Vienna, and Dr. Jacobson is on that list. Dr. Travell was on the list. She was one of the White House physicians. Dr. George Burkley was on the list. He was a White House physician. Dr. Jacobson was also on the list. Now, whether he went as a physician or as a friend of the president, someone the president could talk to, we really don't know. There are rumors, however, that while Kennedy was in Vienna, he had need of contacting a physician and the physician that he contacted was Dr. Jacobson. Now, as I point out in the book, it's possible that Jacobson was the only one of the three that Kennedy was able to reach at the particular time he wanted to reach a doctor. Perhaps the other two had gone out sightseeing or whatever. But for whatever reason, Kennedy did see Jacobson while he was in Vienna. Now, what Jacobson gave Kennedy obviously we'll never know.
LAMB: We'll go back to the amphetamines and the vitamin combination. Do you know for a fact that he was given amphetamines?
GILBERT: No.
LAMB: Why do you as a historian then put it in a book?
GILBERT: I put it in the book as a hypothesis, as a possibility. I also indicate in the book, however, that there is no evidence whatsoever that Kennedy's behavior in Vienna, even if he had been seen professionally by Dr. Jacobson, was affected in any way by any kind of medication that he may have received. Some of the books that have been written which have been critical of Kennedy by a number of people make the claim that Kennedy was supercharged in Vienna -- that he wasn't sleeping, for example, that he was hyper, you know, as he was negotiating with Khrushchev and that this hyperactivity, this inner tension that he was feeling, was created by the amphetamines that he had received from Dr. Jacobson. Even though the transcripts of the Vienna summit conference have not yet been released, I don't see any evidence whatsoever that Kennedy's activity could be categorized in these ways at all. Kennedy, I think, was very measured, very, very calm, very deliberate. As a matter of fact, when he returned to the United States, the White House was afraid that the public might have gotten the impression that he was too low-key in Vienna. So, frankly, I don't buy the theory. I don't think there's enough evidence to support it.
LAMB: You profile the health situations of Presidents Coolidge, Roosevelt, Reagan, Kennedy and Eisenhower. Which one of those five did you get the most information on and which one the least? Did any of the five resist cooperation?
GILBERT: President Reagan's medical records are not yet released, not yet available. Before I determined which of the more recent presidents I would investigate, I did speak with the people at the Reagan Library, which apparently was just opening at the time, and they indicated to me that his medical records were not available and were not likely to be available in the near future. As a result of this, I contacted Reagan's doctors. As you know, Reagan suffered or experienced two medical emergencies while he was president of the United States. Interestingly, Ronald Reagan has sometimes been referred to as "the Teflon president" because nothing bad seemed to stick to him.

As you might remember, when he left office in 1989, a number of commentators maintained that he was completely untouched by the cares of office, that he looked essentially the same as he had in 1980 when he became president and moved into the White House. In point of fact, when you look more closely at Reagan, he suffered two major medical emergencies while he was president of the United States. He suffered minor medical emergencies as well, but two major medical emergencies -- one two months into his first term and one early in his second term. In 1981 he was shot and seriously wounded.

I've interviewed most of the doctors who have taken care of him -- the surgeon, for example, the pulmonary doctor, the radiologist and the head of the trauma unit. They were very, very forthcoming, as a matter of fact. They gave me many hours of their time. I interviewed Dr. Ruge, who was the White House physician in the first term, and I think what they told me was very revealing. I don't think the American people, frankly, were given the whole truth when Reagan was shot in 1981. What we heard was that he was joking with his wife, saying, "Honey, I should have ducked," "I would rather be in Philadelphia." We heard that he joked with his doctors, "I hope you people are all Republicans," and so on.

What we did not hear was that Reagan apparently was within five minutes of death. Ronald Reagan, if I could speak about this for a few minutes, was not shot directly by John Hinckley. What happened was, Hinckley opened fire at the president when he left the Hilton Hotel in Washington and struck a number of policemen from the District of Columbia or Secret Service agents, and the press secretary, Jim Brady, was struck in the head. The bullet that hit Reagan didn't hit him directly. It hit the limousine that Reagan was getting into, and when it struck the limousine, it flattened down into the shape of a dime.

Reagan happened to be waving at the crowd at the time. The bullet flattened to the shape of a narrow disc, a dime-like object, and struck Reagan under his left arm. He was waving, you know, and it just entered his body under the left arm. The wound was so small that he didn't bleed from it. There was no external blood, so when he got into the car, the Secret Service agent pushed him into the car and threw himself on top of Reagan's body. Reagan felt intense pain, but he thought it was because he landed on top of the bump which covers the transmission in the back of his automobile. He said to his Secret Service agent, "You're hurting me. Get off me. You're hurting me. I think maybe you broke one of my ribs." When the agent got off of Reagan, Reagan sat up, the agent looked him over, saw no blood and told the driver, "Return immediately to the White House."

As they sped back to the White House, fortunately for Reagan he coughed, and when he coughed, he coughed up blood. When the agent saw the blood, he said, "Go immediately to George Washington University Medical Center." They sped to the medical center, Reagan walked into the hospital, waving once again to the crowd, and as soon as he got inside of the hospital, he collapsed. The doctors had a hard time finding any sign of blood pressure when they first took a reading after he arrived at the hospital, and one of his doctors, Dr. Aaron, indicated to me that he may have lost as much as 50 percent of his body's blood supply by the time he reached the hospital, so he was in grave danger of death. If he had kept losing blood, he would have been dead in a matter of minutes. That was Reagan's first medical emergency. His second was colon surgery in 1985, and his third was prostate surgery in 1987. This occurred at the height of the Iran-Contra scandal, and Reagan did not bounce back as quickly as his doctors and his aides thought he would. He was under a great deal of stress at the time, and it was a very difficult recovery period for him.
LAMB: You also indicate -- and you can tell me whether this is new or not -- that with Ronald Reagan, when they took the cancer out of the colon, he never referred to the fact that he had cancer.
GILBERT: Yes.
LAMB: Why?
GILBERT: Ronald Reagan, as a matter of fact, all through his life, viewed illness as a sign of weakness. For example, when as governor of California he developed an ulcer, he writes in his autobiography, "I never told anybody that I had an ulcer. I never announced it publicly because having an ulcer always seemed to me to be the same thing as being weak. I didn't want to be weak, and so I just didn't tell anybody except the wife and family that I had an ulcer." This was Reagan's view toward illness throughout his life. He downplayed the impact of being shot, trying to emerge as a hero very much like the role he had played in movies. He always wanted to play the hero. He downplayed the impact of cancer surgery. He describes it as a minor incident in his autobiography. This is major cancer surgery, cancer that had progressed to level B of seriousness. It had extended beyond the growth and had penetrated the wall of his intestine, so they not only had to remove the cancerous growth, they had to remove two feet of his intestines. He still described that as a minor episode in his life.
LAMB: Does that work if you tell yourself that you haven't been sick?
GILBERT: I don't think it works completely, no. I think this is largely for public consumption. He wrote this in his autobiography, which he wrote many years later -- as a matter of fact, after he left the White House -- so he would have written it four or five years later. Remember, Reagan when he had this surgery did not know he had cancer. They had discovered a polyp in his intestine, but they did not know the polyp was cancerous. When they did a colonoscopy, they removed a polyp or two and then they saw through the scope a large, ominous growth. One of the doctors told Larry Speakes, who was the press secretary, left the room where Reagan was being examined and told Speaks, "This is cancer. It's a large growth. It's the size of a golf ball. I'm not certain it is -- we haven't biopsied it yet -- but it looks very, very much like cancer." Reagan was told after he came out of the mild anesthetic that he was given that they had to do further work. They needed to operate. Would he like to go to Camp David for the weekend as he planned and come back on Monday for the exploratory operation, or would he like to go right into the operating room and have the operation? Reagan, not wanting to go through the medication that he had just taken to empty his intestines decided to undergo the surgery right away. The operation lasted three hours -- a long operation. When Reagan came out of anesthesia -- and by the way, this is the one time in history when the 25th Amendment was invoked. This is the only time the vice president became acting president of the United States, during the period of time Reagan was under anesthesia and during the recovery period, so roughly 10-11 hours.

When Reagan came out of anesthesia, he still didn't know what the outcome of the biopsy was going to reveal. The operation was on Saturday, and Reagan was told on Monday. His doctors came in and told him in point of fact, "You had cancer. We had to remove not only the growth but two feet of your intestines." This is bound to have had a tremendous psychological impact on him, someone who had always prided himself on being vigorous and, even though he was in his seventies, chopping wood and riding horseback and so on. Now suddenly here is that dreaded "C" word. It couldn't help but have an effect on him.
LAMB: How often in the preparation of writing this book did you say to yourself, "Oh, I didn't know that"?
GILBERT: Oh, many times.
LAMB: Can you remember what you found that intrigued you the most?
GILBERT: First of all, I didn't know that I would be able to attribute Calvin Coolidge's depression to the death of his boy. I never realized the depression was so great. I had always heard that Coolidge's son died, but I never realized that he moved into a state of clinical depression. Even his wife, Grace Coolidge, said that he never regained his zest for living as a result of the death of his son.
LAMB: Where did you find the information?
GILBERT: I read Grace Coolidge's letters in the Forbes Library in Northampton, Mass. A lot of Calvin Coolidge's papers were destroyed, by the way. He burned them after he left the White House. I read, though, her personal letters to some of her friends in which she discusses these things. I think, very interestingly, now Grace Coolidge also lost a son, and her reaction was to be grief-stricken, but very different from Coolidge. Grace Coolidge, when she wrote to friends, said things like, "I know my boy is safe now. I know my boy is in heaven. I can see his smiling face. I know no harm can come to him now." She writes, as a matter of fact, to one of her best friends that when she stood at the cemetery at the grave site of her son, she said, "Suddenly I became so peaceful. The sun was shining, I heard birds singing, and I knew my boy was safe. I knew my boy was at home with God" -- a very, very positive outlook. Coolidge, however, didn't take this approach. Coolidge blamed himself. Coolidge every year wrote letters to his father, for example, about the death of the boy. "It's time to begin sending flowers to the grave. I hope you'll see to it."

The father was up in Vermont and the boy is buried in Vermont. Coolidge, just before one Christmas, wrote his father a very unusual letter. I was very surprised to find it. He said to his father, "Now that it's getting to be Christmastime again, I think of Mother" -- his mother had died when he was 13 years old -- "I think of Abby" -- his sister Abby who had died when he was 14 years old -- "and now I think of Calvin," his 16-year-old son. And he said, "Soon we'll all be together again for Christmas. You might get there before I do, but soon we'll all be together again." He was having recurring thoughts of death -- a very, very negative reaction. He simply could not pull himself out of the depression in which he found himself. This I found very surprising -- very moving and very surprising.
LAMB: When else did you have that same reaction when you found something?
GILBERT: I was surprised that Eisenhower was as ill as he was. Eisenhower had always seemed -- first of all, he lived to be 78 years old. He had been a successful military commander, an effective military commander. Eisenhower had told the press when he was president, "I'm one of those fortunate creatures of good health." I assume that this was true, even though Eisenhower had suffered three well-publicized ailments. I thought they were basically the only ailments that he had experienced.

I found out that Eisenhower throughout most of his adult life suffered from excruciating stomach problems, to the point that he asked that his appendix be removed. He thought it must be appendicitis. The doctors didn't want to remove his appendix. He insisted that his appendix be removed. They removed it; the pain continued. All through his life, as a matter of fact, right until just before his death, Eisenhower never recovered from the painful stomach difficulties that afflicted him for decades. This I never realized. I never knew, for example, that at the Republican convention in 1952 and 1956 Eisenhower was ill and was in intense pain. I never knew, for example -- as a matter of fact, I think this is one of the most interesting things that I found in the book.

We have always heard the in the campaign to succeed him in 1960 -- the race between Vice President Nixon, Eisenhower's own vice president, and John Kennedy -- Eisenhower did little public campaigning. We've always heard that he had done little public campaigning, but we never knew why. There were rumors that perhaps Nixon had asked him not to because he wanted to win it on his own. We have heard that perhaps Eisenhower was unenthusiastic about Nixon and didn't want to stump across the country on his behalf. We know now, however, that Eisenhower ended his campaign for Nixon because while he was campaigning in Detroit, Mich., he suffered a major heart problem -- ventricular fibrillation, in which the heart vibrates but doesn't pump blood -- and the White House physician Dr. Snyder, who happened to be with him, said, "I almost missed the plane when Eisenhower went to Detroit. If I had, Eisenhower would have been in grave danger."

Snyder had medication there; Snyder had oxygen, for example. He was able to treat Eisenhower and get him safely back to the White House. But this was a major cardiac irregularity, and this was never announced to the public.
LAMB: I don't know what this has to do with the thesis of your book. I wanted to bring these statistics out and you tell us -- 33 out of 40 presidents in our history, now 41, have been college graduates. Seven of them didn't graduate from college.
GILBERT: Yes.
LAMB: Do you remember some of them?
GILBERT: I think they're listed in the book.
LAMB: They are, and I can help you on this: Washington, Jackson, Van Buren, Fillmore, Lincoln, Cleveland and Truman.
GILBERT: Yes. Some of the earlier presidents -- a lot of the earlier presidents. This is not too surprising because the proportion of people who actually went to college in the early days of American history -- as a matter of fact, until fairly recently -- has been pretty low. I think as of maybe 1965 only 14 percent of the American people went to college. Now that number has expanded dramatically. So, I don't think it's too surprising that so few have, and as a matter of fact, you may have seen in the news the other day how few first ladies have been to college -- I believe eight.
LAMB: Another statistic you have is 25 out of 40 have been lawyers.
GILBERT: Yes.
LAMB: That means 15 haven't. You also point out here that the ones that have not been lawyers are Washington, William Henry Harrison, Zachary Taylor, Andrew Johnson, Ulysses S. Grant, Theodore Roosevelt, Harding, Hoover, Truman, Eisenhower, Kennedy, Lyndon Johnson, Carter, Reagan and Bush. Recently there have been fewer lawyers than in the earlier days.
GILBERT: Yes. President-elect Clinton is a lawyer. Maybe we're going back in the other direction now. The reason why I include those facts in the book is that college-educated people generally do better than the general population in terms of longevity of life, and lawyers tend to be an occupational group that do better than the general population in terms of longevity of life. Even though presidents tend to come from these groups, even though presidents tend to be socioeconomically well off -- they tend to be well educated and they have access to superior medical care, not only while they're in the White House but after they leave the White House -- they do less well than the general population, which I think is an interesting juxtaposition of facts.
LAMB: Which president lived the longest?
GILBERT: Certainly President Hoover lived to be 90 years old. Ironically, you might expect some of the earlier presidents to have died prematurely because the life span in those days was not very favorable. They did very, very well, the earlier presidents, and I think the reason for that is that the office didn't become the stressful office that it is now until maybe 150 years ago or something like that. The office became more and more complicated. During this century, for example, the office has become extremely complicated with foreign policy now added on to all the other responsibilities that a president has to deal with. But of the more recent presidents, President Hoover and President Truman both lived long, long lives -- 90 and 88.
LAMB: You refer often to the list of great presidents and historians. Who do you think are the great presidents in history?
GILBERT: I basically would agree with the judgments that have been made. Abraham Lincoln is certainly one of the most effective presidents. George Washington certainly was an effective president because everything Washington did was a precedent that other presidents could build on. Franklin Roosevelt was certainly one of the great presidents in history. I would think those three are the top three. Some historians might rank Washington first and others might rank Roosevelt first and some might rank Lincoln first, but I think there would be pretty much of a consensus that those would be the three best or most successful.
LAMB: The worst?
GILBERT: Warren Harding, certainly, a very unsuccessful president; Ulysses Grant, an unsuccessful president; Calvin Coolidge, a very unsuccessful president.
LAMB: Let me read something, and the audience might want to guess who said this: "Judd, you have a college education haven't you? I don't know what to do or where to turn on this taxation matter. Somewhere there must be a book that tells us all about it, where I could go to straighten it out in my mind, but I don't know where the book is and maybe I couldn't read it if I found it. There must be a man in the country somewhere who could weigh both sides and know the truth. Probably he is in some college or other, but I don't know where to find him. I don't know who he is, and I don't know how to get him. My God, this is a hell of a place for a man like me to be." Who was that, why did you put it in the book, and if we knew that of a president today, what would our reaction be?
GILBERT: The president was Warren Harding, and Warren Harding, as I mentioned a few minutes ago, is commonly rated one of the least effective presidents in American history. Warren Harding, I think, is one of the tragic figures of American history. Warren Harding in 1920 arrived at the Republican national nominating convention not as a major contender for the office. As a matter of fact, no one was really thinking of Warren Harding except perhaps some of Harding's close aides and associates. When all the major candidates at the convention deadlocked and no one could get an adequate majority, the party leaders, in order to break the deadlock, met in the famous smoke-filled room in the Blackstone Hotel in Chicago, and they said, "Who can we come up with who can hold the party together? Who can we unite behind without going through additional ballots?" Someone suggested Warren Harding of Ohio because Ohio is an important state. It's a large state, it has a large block of electoral college votes, it's a state that sort of is a northern state and a southern state, and so the hope is if a candidate has carried Ohio, the candidate might be able to do well in both the North and the South. Warren Harding became the nominee of his party. He was not up to the job. He spent three very unhappy years in the White House. His friends betrayed him. Scandal after scandal was beginning to accumulate. Warren Harding in 1923 decided to go on a so-called goodwill trip to Alaska.

When he left Washington, his spirits improved. He was under tremendous stress. He went to Alaska. When he left Alaska, he traveled down to California. He played cards all night and wouldn't let his aides sleep. He wanted people to stay up with him, playing cards all the time. He was so tormented by all of the scandals that were beginning to break, enveloping his administration. When he got to San Francisco, he didn't feel well. A doctor came into the presidential cabin in the compartment in the train and told him he should not walk to his hospital room, he should be carried by stretcher. Harding insisted that he walk so that he could wave to the crowds. He left the train, he was taken to a hotel in San Francisco and he was put to bed. The White House announced he was suffering from crabmeat poisoning, an upset stomach, and, in point of fact, he was suffering from cardiac difficulties. All of a sudden the White House announced that Warren Harding was dead.
LAMB: You have a dedication, "To the memory of my mother." Who did you devote your first book to, and why did you do this one for your mother?
GILBERT: The first book was devoted to both of my parents. This was written soon after I left graduate school. The reason why I devoted this one to my mother is that she died while I was writing the book. She became ill, as a matter of fact, while I was at the Eisenhower Library. I returned from Abilene to her hospital room, and she died in February of 1991. So, I thought it would be fitting that I dedicate the book to her.
LAMB: Is your dad still alive?
GILBERT: Yes, he is.
LAMB: Where would you say in your own life you got the interest in political science and writing and being a professor?
GILBERT: I've always been interested in politics. I think politics is extremely important. I think politics can be ennobling. I don't think it has to be squalid, as it sometimes is viewed. I think the political system produces heroes as well as villains, and I think it's important who serves as president of the United States. You know, there is a great deal of attention now being given to individual health, and this individual health has been a crucial issue, perhaps since Kennedy in the 1960s, that people are concerned about exercise and eating the right kinds of foods and the fat content of foods and the cholesterol content of foods.

Now, of course, health care is in the news because President-elect Clinton has indicated that he supports some sort of national health care for the American people. It seemed logical and it seemed appropriate to look at health as it affects the behavior of presidents of the United States. Presidents are key figures in the American political systems. Presidents have become the initiators. The center of gravity, in a way, has shifted in the American political system away from Congress and toward the executive. I think this would surprise the framers of the Constitution, but it's happened. It seems to me that if the president of the United States is in such a unique position, the health of the president is something that should be analyzed by political scientists.
LAMB: You're at Northeastern University.
GILBERT: I'm at Northeastern University in Boston, Mass.
LAMB: How big is that school?
GILBERT: Very large. We have I guess now about 42,000 students.
LAMB: What kind of a school is it?
GILBERT: It's in the heart of Boston. It is a school that is devoted to the co-op plan, which means our students are in school, most of them, for five years. I would guess around 75 percent of our students are on the co-op plan, which means students go to classes for two quarters, approximately six months of the year, and then the university's co-op department finds them jobs that are hopefully relevant to their long-term career interests and that also will enable them to earn some money to pay for the next two quarters.
LAMB: How many years have you been teaching?
GILBERT: I've been at Northeastern for 20 years now.
LAMB: Where did you get your education?
GILBERT: I have bachelor's and master's degrees from Fordham University in New York, and my Ph.D. is from the University of Massachusetts at Amherst.
LAMB: What do you think of today's student?
GILBERT: I think today's student is interested in politics. I think the pendulum is beginning to swing back now to more activism. I think students after the 1960s became very, very passive, and students, I think, are becoming more involved now. I think this is one of the reasons why I like political science because so many students take our classes.
LAMB: In the back of this book you have recommendations on change, a couple of things that you really think ought to be changed as relate to the presidency and succession and health.
GILBERT: Yes, well, I think we have spent a good deal of time considering legal remedies. The 25th Amendment to the Constitution is supposedly a legal remedy to the problem of presidential health and ill health and disability and so on. As a matter of fact, the 25th Amendment is sometimes referred to as the presidential disability amendment. As you know, the 25th Amendment, which was added to the Constitution in 1967, interestingly has its roots in the Eisenhower administration because after Eisenhower became ill, Eisenhower asked his attorney general, Herbert Brownell, to draft a constitutional amendment that would protect the country from a president becoming incapacitated. The Eisenhower amendment, or the Brownell amendment, almost duplicates perfectly the language of the 25th Amendment as it appears now in the Constitution. So the 1967 amendment really was written in the 1950s by Herbert Brownell.
LAMB: You say that Sam Rayburn, the speaker of the House, didn't want it?
GILBERT: The Democrats didn't really support it because they thought that Eisenhower might turn his powers over to Vice President Nixon and Vice President Nixon might become acting president and that Nixon might get advantage from this in the 1960 election. So, in order to keep Nixon from becoming acting president, they blocked the enactment of the 25th Amendment.
LAMB: One of your recommendations is that there should be a mental health unit in the White House.
GILBERT: Yes, I think so. It's politically incorrect in the United States, unfortunately, for a president to admit or indicate that he or any member of his family needs the services of a mental health specialist. Presidents and their wives and their families see regular physicians, but to announce that they wanted to see a psychiatrist or a psychoanalyst or whatever would damage their careers, would shake up the confidence of the country in the president's ability to govern. I think this is clear from George McGovern's experience in 1972 when he chose as a running mate Senator Eagleton of Missouri.

When Senator Eagleton announced that he had undergone psychiatric help and had experienced shock treatment, the public outcry was so great that Senator Eagleton was removed from the ticket. So to have a mental health unit in the White House seems to me to make very, very good sense. The mental health specialist would be able to observe the president at close hand, and the president could consult him without a public revelation of the consultation. I think it would be something that would be extremely useful.
LAMB: On the back of your book you have an endorsement from Michael Dukakis. He says, "Breaks new ground in its treatment of presidential health problems and tells us things that I, for one, never knew about the health problems of some of our presidents." How did you get that endorsement? Remember back in the campaign of '88 where the Washington Times reported psychological problems with Michael Dukakis? Did that hurt him?
GILBERT: Yes, absolutely it did. There were rumors in 1988 that Michael Dukakis had seen a psychiatrist and that this information was being withheld from the public. As a matter of fact, when President Reagan was asked about this, he issued one of the statements that became a powerful sound bite during the 1988 campaign. Reagan said, "Well, I wouldn't want to pick on an invalid." This got national news coverage, namely that Gov. Dukakis was in some way an invalid. Overnight Dukakis' standing in the polls dropped by 8 percentage points.

This story has been told to me, as a matter of fact, by Gov. Dukakis. To answer the first part of your question, Gov. Dukakis, after he left the governorship of Massachusetts, became a professor of political science at Northeastern University, so he's one of my colleagues there. Right now he's spending the winter teaching at Florida Atlantic University and getting out of that cold New England air. But he's now a visiting professor of political science at Northeastern.
LAMB: As a student of the presidents, what kind of a president do you think President Clinton will be, both from a substance standpoint and from a health standpoint?
GILBERT: From a substance standpoint he will be an issue-oriented president. He has an interest in issues; issues interest him. Some presidents are not interested in issues. Ronald Reagan, for example, was not interested in the details of governance. He was removed from the details of governance. Clinton is very much interested in these things. As the governor of Arkansas he was a hands-on governor, and I think he's going to be a hands-on president. I think he's going to be a cautious president, and I think he demonstrated that when he put together his cabinet. He wasn't stampeded. When the media would clamor for some sort of a name -- "Who's going to be the secretary of state?" or "Give us the first name of your appointees" -- he refused to do it. He took his good time.

I believe the first cabinet member announced wasn't announced until the first week in December, which is a month after the election, and that, of course, was Lloyd Bentsen. So I think he's going to be a very careful president, a cautious president, a president who is not going to be pushed into making rash actions and decisions, and I think he's going to be deeply involved in issues. With regard to his health, again, all we can do is rely on what his doctors say. He seems to be in good health. There is no evidence of heart disease. But I think he should give his attention to stabilizing his weight.
LAMB: When you see him running, what reaction do you have?
GILBERT: I think it's good that he has that exercise. I sometimes worry a little bit when I see him running side by side with his vice president. Vice presidents and presidents rarely appear together. They don't travel together, they don't ride in the same limousine, they don't ride in the same automobile, and I sometimes become concerned that they're perhaps too close together physically, considering the number of presidents who have been assassinated.
LAMB: Next book?
GILBERT: I think it's too soon to be planning another book. I have given some preliminary thought, though, to doing something maybe tentatively titled "The Politics of Assassination" in which I would look at the impact of the death of Lincoln and McKinley and Garfield and Kennedy, and perhaps non-American leaders, in terms of what their sudden, violent death meant in terms of the kind of policies that were being implemented and proposed by the executive branch of government at the time.
LAMB: Professor of political science at Northeastern University, Robert Gilbert. This is what the book looks like. It's called "The Mortal Presidency: Illness and Anguish in the White House", and we thank you for joining us.
GILBERT: Thank you for having me. I enjoyed it.


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