The Kennedy Men: 1901-1963 (95 page)

That did not help with his allergy to milk. That allergy was particularly irritating to Kennedy, for like many of his generation he considered milk a natural wonder drug that he would have loved to drink by the quart, not to
mention the pints of ice cream he would love to have eaten. The calcium supplement that he took to make up for the lack of milk was only one of the many pills he was supposed to take each day.

George Thomas, his valet, set a box of pills before him at breakfast and lunch. There were six pills in all—Cytomel, Meticorten, hydrocortisone, Florinef, calcium, and vitamin C—that he took all at once, swallowed down with a quick swig of orange juice or water. He also took 500 milligrams of ascorbic acid once or twice a day.

Cytomel is the trade name for a T3 thyroid replacement drug that Kennedy took in 25-microgram pills twice a day for thyroid insufficiency. He also took 25-milligram cortisone pills for Addison’s disease each day, and for a number of years injections of 150-milligram desoxycorticosterone acetate pellets every three months.

The Kennedy administration was one of the most crisis-filled periods of American history, and the president was weighed down by an overwhelming burden of decision. He dealt with issue after issue that resolved itself as history usually does, not in monumental triumph or brutal defeat but in ambiguity and uncertainty. He was under such stress that healthy adrenal glands would have been pumping adrenaline into his system to give him the force and stamina to prevail. Instead, in difficult times he upped his hydrocortisone to improve his general functioning. Without the daily medicine, he would have died. The cortisone was that essential to his life.

Other doctors who had not even examined Kennedy sensed that he was not the healthy man he pretended to be. When the president stood so boldly against the elements giving his inaugural address, he was watched on television by Major General Howard M. Snyder, Eisenhower’s White House physician. “He’s all hopped up,” Dr. Snyder commented, seeing beads of sweat on Kennedy’s forehead. He hypothesized that the new president had taken a double shot of cortisone that morning. “I hate to think,” the doctor reflected, “of what might happen to the country if Kennedy is required, at 3
A.M.
, to make a decision affecting the national security.”

Dr. Snyder was suggesting that the new president was a cortisone junkie, shooting himself up with the drug. Kennedy had taken the drug orally for several years, and he
needed
more of his daily dosage of cortisone in times of stress. Just as a person who begins to exercise needs more calories, so in times of increased tension Kennedy needed more cortisone. He was seeking not a euphoric high but merely the feeling of being a healthy human being. If he did not take enough, he risked feeling an overwhelming sense of lassitude and exhaustion. If he took too much, he risked feeling a rush of manic invincibility that in some instances spilled over into despair and depression.

One of Kennedy’s physicians, Dr. Eugene Cohen, was worried that even if the president survived a plane crash, he would go into shock without his cortisone. Thus, the endocrinologist devised an ingenious mechanism through which Kennedy could keep a safe supply of cortisone. Dr. Cohen put a syringe full of the drug in a cigar holder. He surrounded the holder with cigars and placed it in a sealed humidor to be carried on
Air Force One.

D
r. Cohen had been largely responsible for the president choosing Dr. Janet Travell as the primary White House physician, but Kennedy also received medical advice from several others, including Dr. Cohen himself. In her first few months in Washington, Dr. Travell made herself into one of the most celebrated figures in the administration and was featured in a
New York Times
profile and celebrated in
U.S. News & World Report
and the
Washington Post.
Kennedy did not like his aides to get publicity. He found it an indulgence that served neither him nor them. Moreover, there was a high irony in the fact that the May issue of
Reader’s Digest
celebrated the matronly, silver-haired, fifty-nine-year-old doctor’s successful treatment of “thousands of persons with disabling back conditions, including the president,” while Kennedy hobbled around the White House, unable to get relief from his pain.

Dr. Travell was a doctor who knew only one chamber in the temple of medicine. She attempted to wall the president off from other medical advice as she continued to inject him with painkillers and stick needles in his lower back, a treatment that had always given him respite from his pain. It was not working now, however, precisely when Kennedy desperately needed relief before his European trip.

Dr. George G. Burkley was the other day-to-day source of medical advice in the White House. Dr. Travell was so possessive of her access to the president that the assistant White House physician had been on staff for two months before Dr. Travell even introduced him to Kennedy. Dr. Travell had little choice but to let the rival doctor see the president eventually since the navy captain, soon to be named a rear admiral, always traveled with the presidential party.

In Ottawa, Dr. Burkley told the president that he had aggravated his back by the way he held the shovel. The navy doctor suggested to Dr. Travell that the president see Dr. Hans Kraus, who believed in the efficacy of exercise and physical therapy in treating Kennedy’s pain. Dr. Burkley’s proposition was a subtle criticism of the now-celebrated White House physician. Dr. Burkley and his colleagues at Bethesda Naval Hospital were becoming increasingly worried by Dr. Travell’s promiscuous use of novocaine. It was not a drug to
be injected two or three times daily, day after day. Eventually its effect would be deadened and the president might move on to employing narcotics to assuage his pain.

Dr. Burkley and his Naval Hospital colleagues were not the only serious critics of Dr. Travell. Dr. Dorothea E. Hellman, a highly regarded doctor at Georgetown University and the National Institutes of Health, was growing dismayed. “I had the opportunity to see a great deal of Mr. Kennedy and was aware of the fact that he was not only pigmented but often ‘Cushingoid,’ “she recalled. “This meant that he was alternating between periods when he received too little cortisone and periods during which he received too much cortisone. Clearly he had chosen a physician [Dr. Janet Travell] who was an expert on his back but knew little or no endocrinology and simply did what she thought was best.”

Travell’s ministrations to the president had also begun to worry Dr. Cohen, who was treating Kennedy’s adrenal problems. “Dr. Cohen got her the White House job,” reflects a former close colleague. “He liked to be a kingmaker but he didn’t always recognize the frailties of those he chose and he sometimes came to regret what he had done.”

Dr. Cohen reluctantly concluded, as he wrote his colleague Dr. Burkley later, that Dr. Travell was “a deceiving, incompetent, publicity-mad physician who only had one consideration in mind and that was herself.” Dr. Cohen was not an argumentative man, but he was a passionate doctor whose main divertissements were his wife, Regina, his German shepherd, a white Cadillac convertible, and his dahlias. “He was totally devoted to his patients,” reflected Dr. David V. Becker, his former student at the Cornell University College of Medicine and later his colleague there. “As a teacher, he made major points about always listening to the patient and responding to the patient’s need.”

Dr. Cohen looked on with growing concern as Dr. Travell refused to invite Dr. Kraus down to consult with the president. Instead, she agreed to call in another prominent physician, Dr. Preston Wade, who in 1957 had drained the soft-tissue abscesses in Kennedy’s back. Dr. Wade prescribed treatments that did not include Travell’s novocaine injections, but she continued nonetheless with her dangerous treatments. “Then, as you know,” Dr. Cohen wrote Dr. Burkley in 1964, “there were just repeated series of injections without any response—injections that were not to have been given as outlined by Doctor Wade.”

Dr. Travell’s jealous hold over the president’s care was threatened even more ominously by the arrival in the White House of Dr. Max Jacobson. The New York doctor, who had first treated Kennedy during the campaign, was a kindred spirit to Dr. Travell. He too promised absolution from physical
pain, traveling always with a magical syringe that contained not novocaine but a mixture of amphetamine, vitamins, and other drugs. Kennedy had called Dr. Jacobson when Jackie was suffering from depression and headaches before his Canadian trip. His beautiful, young, outwardly healthy wife continued to be so disheartened with her life as first lady that she might not be able to accompany her husband on his European trip. Dr. Jacobson flew down to Palm Beach, where he spent four days, and gave Jackie injections that miraculously perked her up.

Kennedy fooled his constituents, and he fooled many of the women he slept with, rarely playing the invalid. Now he would have to play the healthy man on the largest stage in the world, and he had only a few days to effect this transformation. The president invited Dr. Jacobson to Washington. Dr. Jacobson’s visits to the Kennedys were not going unnoticed. “Does JFK have a new personal physician?” a gossip columnist asked in the New York
Daily News
on May 12. “Dr. Max Jacobson, with offices at 155 E. 72nd St., has been making frequent phone calls to the White House.”

The Manhattan physician flew down to Washington on May 23, only a week before the beginning of Kennedy’s European trip. The doctor once again gave Jackie an injection that immediately cured her migraine and ended her pouting uncertainty about whether she would accompany Kennedy. Then Dr. Jacobson saw the president, whose condition, to his eyes, appeared to have worsened: Dr. Travell had sprayed freezing ethyl chloride on his back, numbing it for a few minutes, but causing longer-term problems.

Dr. Jacobson was a German Jew who had fled Berlin before the war and had a thick accent, a comforting manner, and a mystical, knowing aura. He applied to the president the same psychologically astute approach he took to all his patients. He first talked to Kennedy about scrubbing away all the detritus of his life—giving up alcohol (though that was hardly the president’s vice) and taking no opiates or dangerous drugs. He then lectured Kennedy on various exercises he should do to help his back. Only then did he administer what his patients had come to him for, a treatment that after all this worthy advice seemed just some more healthy business.

Dr. Jacobson injected his own medical cocktail into the buttocks of his patients, talking about it as if it were no more than a laying on of hands. The treatment varied from patient to patient, but what Dr. Jacobson said he gave his patients was a mixture of hormones, vitamin B complex, vitamins A, C, D, and E, novocaine, enzymes, steroids, and amphetamines. Dr. Jacobson later claimed that he gave twenty milligrams of amphetamines to his patients. Most doctors prescribed only five milligrams for legitimate medical reasons, but Dr. Jacobson argued that his dosage was too small to be addictive and was made not toxic by its interaction with the other ingredients.

The reality is that amphetamines cause extreme psychological dependency and a craving for larger and larger amounts in order to obtain the shortlived burst of euphoria. “That dosage would have made Kennedy very energetic for three or four hours,” says Dr. Mauro Di Pasquale, a world-renowned expert on steroids. “That begs the question of how often he was given these injections—often enough to make him an addict, say at least a few times a day, or just intermittently to give him that boost?”

For his preferred patients, Dr. Jacobson mixed up batches of individualized dosages that they could inject themselves with when he was not there. Kennedy had long been adept at giving himself injections. If he did give himself the treatment, there were no markings on the vials to suggest just what he was shooting into his system or how the ingredients may have been changing. The doctor may have been particularly generous with the leader of the Free World, for whatever it was in the magical cocktail, the president stood up and pranced around the room like a Harvard quarterback ready to be called into the game.

The next morning after treating Kennedy, Dr. Jacobson returned to the White House. He was becoming a familiar face to the Secret Service agents, who saw him walking in and out of the private quarters with his black bag in his hand. Dr. Jacobson recalled that Jackie showed him a vial of Demerol that she had found in Kennedy’s bathroom. The drug is a narcotic analgesic; while it would have deadened his pain, it was nothing that the president should have been taking without medical direction. The fact that Jackie showed Dr. Jacobson a vial suggests not only that the president was injecting the drug into his own body, but that Dr. Burkley and his colleagues were justified in their fear that Dr. Travell’s promiscuous use of novocaine would drive the president to try narcotics.

Dr. Jacobson wrote in his unpublished autobiography that he told the president that this was a dangerous step he was taking. The drug was addicting and might affect his performance in the White House. If Kennedy did not throw the drug away, the doctor would no longer treat him. Dr. Jacobson’s ultimatum was doubly important, for not only was it the kind of admonishment that Kennedy rarely heard, but it surely suggested that in taking Dr. Jacobson’s own injections, the president ran no such risk. As it was, Kennedy was being treated by several doctors—Dr. Travell, Dr. Burkley, Dr. Wade, Dr. Cohen, and Dr. Jacobson—who were not all on good terms with one another and may not have informed one another about just what drugs they were administering to the president.

W
hile Kennedy created the illusion of health, Bobby was assuming burdens of authority he might not have had if his brother had been healthy. At nine
o’clock on the evening of May 9, the attorney general walked along the dark empty space of the Washington Mall. Alongside him walked Georgi Bolshakov, a gregarious intelligence agent of the Red Army posing as a Russian journalist.