The Sick Man in the White House

A Brief History of Presidential Illness



By Brendan Wilson


For better or worse, Donald Trump has torn up the presidential playbook, set it ablaze, and hurled it into the Potomac. The 45th president is proud of this break with tradition. He touts the unorthodox deployment of his “stable genius” to do “what no other president has done” while confronting the “tremendous” challenges facing our country. But his Covid-19 diagnosis a week ago thrust him back into the human company of his predecessors. Stock futures sank and election polls went haywire as the nation grappled with the fact that its overweight septuagenarian leader had contracted a disease fatal to overweight septuagenarians.


Thankfully, the president has since recovered, but the shock of the White House outbreak has spurred much writing of the illnesses of past presidents, their lasting effects, and the deception and mystery that has shrouded them. Because we insist on electing mortal men to an unforgivably difficult job, there are too many examples to review, so what follows is the highlight reel.


Disease came for the president just months after the first inauguration. In June of 1789, George Washington developed a cancerous growth on his leg so painful, he was unable to sit down. In a crude procedure consistent with our expectations of 18th century surgery, Dr. Samuel Bard successfully removed the tumor, but Washington was left bedridden for weeks. He was unable to write letters or leave his room and, to keep his state hidden from the public, his entire street was closed to through traffic. With the ink still drying on the Constitution, the poor health of the first president put the republic on precarious footing. Ted Widmer addressed this fragility in a recent WSJ essay, asserting that “if Washington hadn’t recovered, the presidency might have perished with him.”



He would pull through, of course, but would often lament the immense physical toll taken by the stresses of the office. Lincoln and FDR would surely agree with Washington’s often-expressed fear that the rigors of the presidency would “hasten my departure for that country from whence no traveler ever returns.”


50 years later, William Henry Harrison cruised to electoral victory in 1840 by billing himself the “log cabin and hard cider” candidate. He successfully persuaded Americans that his gritty, rough and tumble disposition made him the strong, robust leader the nation needed. Surprise!  He died in his bed just 32 days after inauguration. It is unknown whether his demise was brought on by the barrel of fermented apple booze in his bloodstream, the two-hour inauguration speech in the rain, or the typhus ripping through Washington. What is certain is that he was the first president to die in office, causing a great deal of Constitutional hubbub that would result in the eventual accession of his vice president, John Tyler.


Photo via IIP Photo Archive / Flickr

Death would again stalk the White House a decade later. President Zachary Taylor, a hero of the Mexican American War, was celebrating July 4th at an outdoor event so hot that he wondered aloud whether he was back fighting in the arid southwest. Luckily, he had iced milk and cherries to cool him down. Unluckily, he developed stomach cramps, was quickly diagnosed with cholera, and died within a few hours – open and shut case! His mysterious death gave rise to a conspiracy theory that he was poisoned due to his opposition to slavery’s spread to the western territories. Unfortunately for the tin hatters, this theory was debunked after his body was exhumed in 1991.


In 1893, Grover Cleveland was suffering from a cancerous tumor in his jaw. He told the public that he was taking a “long fishing trip,” then had the tumor removed in a gruesome procedure aboard his friend’s yacht on the Long Island Sound. Fortunately for the nation, its leader quickly recovered. Fortunately for the president, the public bought his backstory hook, line, and sinker (couldn’t resist!)


In the final days of WWI, Woodrow Wilson found himself at ground zero of the global Spanish Flu outbreak. Predictably, he contracted the virus, but told the public it was a mere “cold” brought on the by the Paris rain. Wilson’s illness forced him to the sidelines of the contentious Treaty of Versailles negotiations, yielding control to the hardline Prime Minister of France, Georges Clemenceau, who brutally punished Germany for their role in the war, thereby planting the seeds from which the murderous 3rd Reich would grow.


Franklin Delano Roosevelt was the undisputed champion of pulling the wool over the public’s eyes. He won four presidential elections while concealing polio induced paralysis and managed to strike a gentleman’s agreement with the media that prohibited photographs of him while in his wheelchair. He also suffered from other debilitating cardiovascular ailments, leading some historians to maintain that his enervated state at the 1945 Yalta Conference allowed the Soviet Russia to gobble up too much of postwar Europe. The well-concealed decline in his health concerned his inner circle as well, prompting Vice President Harry Truman to remark that he was “falling to pieces” in the runup to his final election in 1944. He died just three months after his final inauguration in 1945.


Bettmann Archive/Getty Images

A heart attack, a stroke, and a lengthy battle with Crohn’s Disease forced frequent hospital trips on President Eisenhower, but it was the assassination of John F Kennedy in 1963 that finally galvanized the leaders of our government to address the mortality of the chief executive.


The 25th amendment, ratified in 1967, clarified the line of succession. Additionally, it allows the president to willingly designate presidential authority to the vice president should he become unable to discharge his duties (Section 3) and, more confrontationally, enables the vice president and cabinet officers to remove the president from power if they deem him medically unfit (Section 4).


With little fanfare, Section 3 was first invoked when Ronald Reagan underwent a routine colonoscopy. More controversially, his staff considered Section 4 when the president began acting strangely in the aftermath of the Iran Contra scandal. Ron Jr, Reagan’s son, later affirmed in his memoirs that his father was experiencing the initial stages of Alzheimer's disease during his second term.


Since the dawn of the republic, illness has wracked the chief executive. It should come as no surprise, then, that in the middle of a pandemic, a president with an aversion for masks and socially distanced gatherings should fall ill. A more ironic sequence of events could not have been dreamt up: Trump ridicules Biden for wearing his mask “everywhere” during the first (and only) presidential debate on September 29th, then tests positive for Covid the next day. 


The president's critics rightly argue that he should now join the health experts at the CDC and NIAID in their support of masks. Further, they are right to claim that his staff could have been clearer about the details of his treatment, and sure, he should have quarantined immediately following his positive test on September 30th.


But while the president should mask up, the media should simmer down. Considering the president’s Nixonian disdain for the truth in so many other matters, we should welcome the relative transparency with which he has handled his illness since his diagnosis. He allowed his doctor to reveal details about his prognosis, ceaselessly tweeted details on his treatment, and took a bizarre motorcade lap outside Walter Reid to prove that America was not watching Weekend at Bernie’s IV.  


Yes its true that Trump could have never done what FDR did in the age of social media and round-the-clock cable news coverage. Even so, I say we give him credit for breaking with the presidential tradition of lying to the public about the health of its commander-in-chief.

Congress, C., Corbis/Getty, & Universal History Archive/Universal Images Group via Getty. (2020, October 02). How past U.S. presidents have battled illness in office. Retrieved October 15, 2020, from https://www.nationalgeographic.com/history/2020/10/how-past-presidents-battled-illness-in-office/


Rotondi, J. (2020, October 02). What Happens When a President Becomes Ill or Incapacitated While in Office? Retrieved October 15, 2020, from https://www.history.com/news/presidents-ill-25-amendment


Widmer, T. (2020, October 09). The Crises of America's Sick Presidents, From George Washington to Donald Trump. Retrieved October 15, 2020, from https://www.wsj.com/articles/the-crises-of-americas-sick-presidents-from-george-washington-to-donald-trump-11602272815