The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama (32 page)

Mamie Doud contracted rheumatic fever at her parents’ Colorado Springs home when she was about eight years old. The acute symptoms included abnormal involuntary movement of her muscles (St. Vitus Dance) and leg pains. As a consequence she was kept home from school for the better part of a year. Complications resulted due to the inflammation of her mitral and aortic valves. Rheumatic scarring of her mitral and aortic heart valves would be a medical problem for the rest of Mamie’s life. In the pre-antibiotic era, significant valvular disease frequently resulted from untreated rheumatic fever.
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Mamie’s cardiac symptoms worsened during the war and contributed to her fatigue. As a result, military doctors restricted Mrs. Eisenhower’s physical activity and forbade her to fly.
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Surprisingly, the wife of the Supreme United States Commander in Europe was not evaluated by a cardiologist until her 1946 examination by Lt. Col. George Robb at Walter Reed. Robb diagnosed inactive rheumatic valvular disease with mild mitral insufficiency, aortic valve insufficiency and aortic stenosis. Mamie was not in congestive heart failure at this time. . Further cardiologist examinations were made in 1950 that detected a progression of her valve disease. General Eisenhower became alarmed. He worried that in the face of a gradual deterioration of his wife’s heart condition whether further harm would occur if she accompanied him to Europe as he became the first commander of NATO.
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When Mamie was in Washington in November 1951, the chief of cardiology at Walter Reed, Colonel Thomas Mattingly, assumed control of her cardiac care. He closely monitored Mrs. Eisenhower’s heart condition until his retirement from the army in 1958. He observed that the heart disease gradually worsened during his watch; her heart enlarged and shortness of breath after exertion appeared. Mattingly thereupon restricted the first lady’s physical activity. The cardiologist was consulted one last time, in 1978, by Dr. Julius L. Bedynek when the widowed Mamie Eisenhower’s heart failure progressed alarmingly. The question was whether heart surgery was indicated. Mattingly concurred that surgery was not appropriate and agreed with the medical regime of digitalis, diuretics and a low-salt diet.
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One year later, on November 1, 1979, Mrs. Eisenhower died. She suffered a stroke on September 25, 1979, and died five weeks later.
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As first lady (1953–1961), Mrs. Eisenhower worked from the bedroom she shared with the president. She routinely sat up in bed to plan her day and direct her staff, most likely an adjustment to her physicians’ advice to rest when she could. The onset of her inner ear symptoms was often unpredictable, so her behavior was precautionary. One biographer detailed her daily morning routine. Mrs. Eisenhower read the morning newspapers before breakfast and meeting her staff. She paid close attention to advertisements for sales of food and other items useful in the White House. When the head usher came in with her breakfast tray, the two discussed menus for the day and details for any upcoming social events. The usher was followed by the executive mansion’s housekeeper and Mamie’s secretary. The first lady then dictated letters for two or three hours and afterwards planned her daily schedule.
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Thereby Mrs. Eisenhower was able to minimize the symptoms of Menière’s and chronic rheumatic valvular heart disease and to enhance her effectiveness as manager of the executive mansion. Critics of the Eisenhowers, ignorant of her physical disabilities, concluded that the first lady was either inactive or incapacitated.
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As the wife of a career army officer, Mamie understood hierarchies and was skilled in commanding and directing staffs. She handled the White House finances. Its staff appreciated her clarity in direction and her effectiveness.
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This first lady handled her social responsibilities very capably and, for the most part, succeeded in her ceremonial duties. However, medical issues did limit her overseas travel. She excelled as a supportive wife for her president husband. She had long seen her role as the provider of emotional support to Ike and had endured thirty-four moves decided by the army. She summed up her White House years by declaring, “I never pretended to be anything but Ike’s wife.”
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Mrs. Eisenhower, a successful military spouse, eschewed politics. She neither participated openly in this activity nor selected a public volunteer cause during her eight-year tenure. On only a single occasion did President Eisenhower solicit her political opinion: Whether to run for a second term after he had suffered a major heart attack.
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As a result of constant and very good medical care, intelligent monitoring of her physical activity, and the cross-over benefit of medications prescribed for her heart and her anxiety, Mamie Eisenhower played an important supportive role for the president. Moreover her responsibilities as first lady did not affect her health. She was hospitalized once during this period when a hysterectomy was performed in August 1957.
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Two physicians shared responsibility for her medical care as first lady: General Howard Snyder and Colonel Thomas Mattingly. In November 1945, Snyder held a job in Washington as assistant inspector of the War Department. He previously had examined Mrs. Eisenhower and had some familiarity with her medical history. Then, at Mrs. Eisenhower’s request, Snyder’s commanding officer, General Eisenhower, directed the doctor to travel to Boone, Iowa, where she was hospitalized with bronchopneumonia. Snyder performed as ordered and upon arrival he was asked to also take care of Eisenhower’s sinus and bronchial problems. By mutual agreement, Snyder, a trained surgeon, became Ike’s as well as Mamie’s personal physician and had his military career extended for fifteen years, until January 1961. In 1953, at age seventy-one, he became the White House physician. Thus the first lady’s doctor, as in the cases of Presley Rixey and Ida McKinley, and Charles Sawyer and Florence Harding, was promoted to the position of the president’s personal physician.
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Colonel (later Brigadier General) Thomas Mattingly was chief of cardiology at Walter Reed Medical Center and became the U.S. military’s most renowned cardiologist. Dr. Snyder asked the cardiologist to monitor the first lady’s heart condition, which he followed on a regular basis. However, during the Eisenhowers’ tenure, these physicians expended far more time, care and energy upon her husband’s medical problems. The president suffered three near-catastrophic medical emergencies: A severe heart attack, obstructive Crohn’s disease of the intestine, and a transient ischemic attack of the brain.

Even so, it is curious that with all the available specialized medical care consultation with an otolaryngologist to evaluate Mamie’s Menière’s disease was never requested.

Jackie Kennedy, Frankie Cleveland, Edith Roosevelt and the Second Mrs. Tyler

Only two first ladies bore living children while a first lady. Both Frances (Frankie) Cleveland and Jacqueline (Jackie) Kennedy married older men. Frankie became first lady at only twenty-one, and Jackie, at thirty-one. Both were college-educated,
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presented a stunning appearance, and excelled at their expected social and ceremonial responsibilities. The press and the public were fascinated to excess with Mrs. Cleveland and Mrs. Kennedy during both their White House and their post–White House years.
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Both women remarried after the deaths of their husbands and were the only two former first ladies to do so.

The fecund Edith Roosevelt, birth mother of five and stepmother of one, allegedly suffered two miscarriages in the White House. These episodes escaped public knowledge at the time, and were only hinted at in retrospect.

Julia Tyler was twenty-four years old when she married the widower President John Tyler, thirty years her senior, in 1844. John Tyler was prolific and his young bride was fecund, but Julia Tyler’s short eight-month White House reign did not produce any offspring. The Tylers’ post–Washington marriage was far from barren; five sons and two daughters began arriving in the Tyler home fifteen months after his Presidency.

“The infant, an unnamed girl, died before drawing her first breath … When Jackie regained consciousness following the surgery, the first person she saw … was Bobby Kennedy.”
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Jacqueline Bouvier married John Fitzgerald Kennedy on September 12, 1953, when she was twenty-four. After Kennedy’s death she married Aristotle Onassis, on October 20, 1968, when she was thirty-nine. She was a widow again in 1975 after the death of Onassis and lived until the age of sixty-four. (Interestingly, Jackie Kennedy was the first first lady to be born in a hospital.
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It was not until the mid–1920s that hospital births became the standard obstetrical venue; previously home deliveries were the norm.
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) Jackie Kennedy was married to John for ten years and two months; she served as first lady of the United States for a brief two years and ten months. As Mrs. Kennedy, Jackie was pregnant five times; first lady of the United States, she was pregnant once.

As a fascinating person in an admired marriage, Mrs. Kennedy has been the subject of more than a score of biographies. Many of these have covered her neuroses, her amphetamine usage, and the Kennedys’ conjugal difficulties. These will be noted here only as they relate to Mrs. Kennedy’s difficult obstetrical history.

Her first pregnancy ended in a miscarriage in 1955. She was three months pregnant; the event received no media coverage at the time. Heymann recorded Senator Kennedy’s flamboyant womanizing during this period and postulated a link with marital anxiety and the ill-fated pregnancy: “Her doctor told her that if she remained so high strung she might have trouble bearing children.”
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Political columnist Jack Anderson summarized how Jackie prepared for her first baby at Hickory Hill in the Virginia hunt country, but was often left alone in the huge house while her husband was off politicking. “After her miscarriage, she couldn’t bear to enter the nursery she had so lovingly designed.”
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Jackie’s failed second pregnancy in 1956 was far more traumatic, both physically and emotionally. Senator Kennedy narrowly lost the Democratic vice presidential nomination at the 1956 August convention. His subsequent behavior has been severely condemned by biographers Thomas Reeves and C. David Heymann.
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Within a few hours, Kennedy left his eight-month-pregnant wife to fly to a carousing vacation on a yacht on the Mediterranean. Available young women joined the senator and his lusty chum, Florida senator George Smathers, aboard the party-yacht.
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Jackie was warehoused at her parents’ estate in Newport, Rhode Island, while her husband was away. Following the excitement of the convention she was beset with considerable discomfort, which was compounded by rumors of her husband’s infidelity. Severe stomach cramps and hemorrhaging necessitated an emergency ambulance trip to Newport Hospital, where doctors performed an emergency caesarian section. An infant baby girl was stillborn on August 23, 1956. Arabella Kennedy was named by Jackie Kennedy posthumously. Arabella and her brother Patrick are buried with their parents at Arlington Cemetery.
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The
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reported that the senator finally arrived at his wife’s side five days after the stillbirth.
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A Newport Hospital spokesman attributed the stillbirth to “nervous tension and exhaustion following the Democratic Convention.” A friend attributed it to lack of sleep. Rose Kennedy placed the blame on Jackie’s nicotine addiction, while Janet Auchincloss, Jackie’s mother, implicated Jack’s absence. After leaving the hospital Jackie remained at her parents’ Newport estate, a considerable distance from Washington, and from her husband.
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Jackie’s mother-in-law had a point. The future first lady was a secretive but habitual smoker. Rose Kennedy was prescient; recent medical studies have reported that smoking during the first trimester of pregnancy doubles the risk of miscarriage.
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Mrs. Kennedy’s third pregnancy was successful; her postpartum recovery was both uneventful and a very happy interlude. On November 27, 1957, Caroline Kennedy entered the world at New York Hospital after a normal nine-month gestation. Caroline weighed seven pounds, six ounces. The delivery was once again by caesarean section. Her mother was twenty-seven and her father forty.
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Jackie Kennedy’s fourth and fifth pregnancies, in 1960 and 1963, bookended both President Kennedy’s brief presidency and her own abbreviated reign as America’s first lady.

Mrs. Kennedy’s fourth pregnancy coincided with JFK’s successful campaigns for the 1960 Democratic presidential nomination and for the presidency of the United States. Her obstetrician, John Walsh, advised his pregnant patient to “curtail her activities for about six months.” The physician’s directive justified Mrs. Kennedy’s frequent absences from the presidential campaign.
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After the election, the president-elect spent most of his time planning policy at his father’s Palm Beach, Florida, estate while Jackie remained in their Georgetown, D.C., home. A caesarian section was planned for Georgetown University Hospital on December 6; the baby was due on December 27.
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Kennedy flew to Georgetown to spend Thanksgiving with Jackie, but he dismissed his wife’s plea to remain in Washington until the birth. He flew back to Palm Beach and his wife went into premature labor two hours after his departure.
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Mrs. Kennedy was rushed to the hospital, where Dr. Walsh delivered a healthy, 6-pound 3-ounce, John Fitzgerald Kennedy Junior. The doctor informed the press that the infant was premature only chronologically. The soon-to-be first lady required a transfusion of two units of blood. The president-elect immediately flew back to Washington in a desperate, but unsuccessful, dash to be present at the birth. Jack Kennedy was absent from all of Jackie’s deliveries, except perhaps for the birth of Caroline.
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