Richard levinson confronts three myths about president s and their health. We also hear about how doctors contributed to the deaths of president s, and without the public knowing. The parkway central library, part of the free library of philadelphia, hosted this hourlong event. Im now pleased to introduce tonights speaker, librarian richard levinson. He is a librarian here in the Central Senior Services department of the library, and he was one of the motivators behind the entire series of speakers on president ial history. The series really would not have come about without his effort. Throughout his time at the library, where he has worked since 2009, richard has promoted a variety of intellectually challenging programs for mature adults here at parkway central library. He is an occasional contributor, and spent a director of he is a history buff in general, but is particularly focused on issues of president ial health. He will shed light on desperately ill and dying president s, who deceived the public to stay in power. I asked him earlier if he was going to talk about our current candidates and their health conditions, but he promised this is entirely historically focused. [laughter] i hope you will enjoy his talk. [applause] richard i want to thank jeff for that gracious introduction. I also want to tell you that our program on Robert Kennedy has proved to be so popular, we have actually moved it from room 108 to the auditorium. Please join us there next week. So often in life, the people who are laboring behind the scenes, doing the real work, never get any recognition at all. I want to take a quick minute to thank three remarkable women at the free library of philadelphia. Autumn mcclintock, sarah moran, and siobhan riordan. Im here to tell you without them, tonights program and our entire american presidency series would never have seen the light of day. Now, the first key theme i want to focus on this evening is the idea that american president s have always gotten the very best health care available, in whatever era they lived. I want to tell you that this is a charming myth, and problems began almost immediately with george washington. After retiring from the presidency, washingtons real job was administering the family plantation, mount vernon. Typically, he would spend hours every day on his plantation, keeping a very close eye on what was going on, and intervening whenever necessary. He was a tough bus. For one day in december 1799, washington rode out about 10 00 in the morning. It was snowing. Soon, the snow had changed to a cold, unrelenting rain. Washington was not properly dressed. In minutes, both his head and neck were soaked. He did not return back indoors until 3 p. M. Once he did that, he did not do the commonsense thing that you and i would have done immediately. He did not change out of his wet clothes and put on dry ones. He answered some letters, became involved in various projects around the house, enjoyed a leisurely dinner, did not really change out of his clothes until it was time for bed. Its not very surprising that within two days, he is feeling really, really sick. The locus of the problem was washingtons throat. What the problem was depends on which historian you want to believe. Some say he had a terrible case of tonsillitis. Others, a bad strep throat. Some historians have referred to the soft tissue at the front of his voice box, speculating that tissue grew so large and inflamed that it began to choke off washingtons windpipe. It became agony for the former president to swallow, and breathing was pretty hard, too. And this was all complicated by the fact that in washingtons time, american medicine was mired in the middle ages. The prevailing medical model suggested that human beings were made up of various fluids called humors, and the key to good health was keeping them in the proper balance, the right alignment, as if human beings were automobiles. There really werent any tools you could use to balance the humors. There was bloodletting and purging. Bloodletting is a very tricky business, and you can do a lot of damage if you dont know what you are doing. I would be willing to bet there are fans of robin hood and audience. I bet you remember in those legends, robin would meet his and as a result of being bled to death by a treacherous relative who betrayed him. Washington was a great believer in bleeding. Before there were any doctors, he had members of the household bleed him repeatedly. When the three doctors who were ultimately caring for washington arrived, what do you think happened . They bled him again. Not just once, but repeatedly. On a practical level, what they did was destroy whatever strength or resilience the former president had left, and that he would so desperately need to recover from this infection and get well. As a result of this bleeding, he was in a very weakened state. Of the three doctors, the youngest, dr. Dick, argues strongly on behalf of a new experimental treatment, a tracheotomy. He wanted to make an incision in washingtons throat, believing it would make it easier for the president to breathe. I can tell you that the two older doctors had a fit, because they were obsessed with the idea that if an experimental treatment was tried, in washington died, they would go down in history as the doctors who killed george washington. Given that he was very weak, we dont know whether he would have survived if the tracheotomy had been performed, but the sad truth is, that by refusing to allow dr. Dick to do the tracheotomy, they guaranteed the one outcome they were trying most to avoid. Now, we are going to take a big jump ahead in history. The year is now 1881. The president is an ohio republican, james a garfield. I want you to think for just a minute about the fact that we are now 16 years from the assassination of Abraham Lincoln, and apparently, people in the white house still have not gotten the message, have not read the memo, have not learned what we need to do to protect americas president s and keep them secure. Because like some of the people in this room, James Garfield had a summer house at the jersey shore, and one very hot summer, he simply wanted to be reunited with his family. He wanted to take the train from washington dc to the jersey shore. And people in the white house allowed him to drive to the train station with his secretary of state, james blaine, but with no security whatsoever. When they arrived at the train station, they were met by another member of garfields administration, robert todd lincoln, the son of our most revered president. But no security whatsoever. That is how garfields assassin was able to sneak up on the president from behind, pull out a pistol, and shoot him point blank in the back. Garfield explained exclaimed, oh my god, what is this . And collapsed. This man was a low level federal employee, a clerk in a federal agency. He was a pathetic little man, and it is also true to say that he was insane. This is a man who sadly, failed at everything he tried to do in life, with the single exception of killing president garfield. But he suffered from delusions of grandeur. He believed he had been put on earth to fulfill certain missions, given him by the almighty. One of those missions was to make it possible for chester alan arthur, who is actually garfields Vice President , to become president. The Republican Party was divided into two factions at this time. He was a great believer in the fashion headed by chester alan arthur. He believed by carrying out this, he was the filling gods will. In terms of what happened to garfield, i want to talk about the state of medicine. Once again, american medicine was lagging behind. I think many of you have heard something about joseph lister, the pioneering british surgeon and humanitarian. As early as 1867, he had demonstrated by using carbolic acid, it was possible to spare a life sterilize medical instruments before surgery. It was possible to clean out a patients wounds, so that he or she would not die of infection, like millions and millions of people before. He believed this so strongly that when america celebrated its great centennial in 1876, and here in philadelphia, there was a terrific world fair, lister actually came here because it was an opportunity to talk to some of the most important members of the american medical community, who were based on the east coast. Lister actually gives a talk is part of the centennial exhibition. The room is packed. Almost important doctors, from the eastern part of the u. S. Where there wer including the man who would ultimately be responsible fore there, garfields care. This is before the era of scientific medicine. Germs could not be seen. Those doctors wrote lister off as a wellmeaning kook. This was a time when doctors did not wash their hands before operating, they did not sterilize instruments before operating, and took particular pride in wearing filthy, blood encrusted, white coats, we got the week, month after month, year after year. It was a point of pride for many of them. In terms of garfields situation, im sorry to say, what happens is, as a result of the doctors constantly poking and probing in his wounds with their unwashed fingers and unsterilized metal probes, the people who wanted to help garfield actually killed him. The bitter irony is, if ever a man was meant to survive, James Garfield was that man. He lingered from more than 60 days after being shot. If he had only received less attention from doctors, he almost certainly would have survived. [laughter] i would like to quickly call your attention to accomplish points. S. A couple of point i think it is very interesting that america survived without any real president for 80 days, and we were absolutely fine. There were no ill effects whatsoever. I think it tells you something about how much americas position in the world has changed, from 1881 until now. Secondly, i want to Say Something about the tragic case of robert todd lincoln. He was present for all three president ial assassinations that occurred during his lifetime. I wonder what the statistical odds are of Something Like that being possible. I wanted to mention a man whose name, unfortunately, is often forgotten today. Charles purvis. He was the chief surgeon of what was then known as the freed mans hospital in washington dc. He is the first black doctor to care for an american president. We should all know his name. I think it is a shame we do not. Now, i want to jump ahead in history once again. We are now at the year 1901. We are in the first year of the 20th century. The president is another ohio republican, William Mckinley. In the city of buffalo, they are having a Great International exposition, a worlds fair. The organizers said, we have to embrace invite the president. Mckinley wanted to come and give a speech. Here again, we are now 36 years from the time that Abraham Lincoln was assassinated, and we are still doing things the same way. People in the white house allowed William Mckinley to become a sitting duck. They arranged for him to participate in an open receiving line, where any Interested Party could join the line, greet the president , shake his hand, and thats exactly what his assassin did. This gentleman was an anarchist. He believed the best thing for mankind was for people to rise up and kill as many president s, Prime Ministers, and kings as possible. This man was immaculately dressed. He certainly seemed to fit right in. Interestingly, people noticed that his hand was covered by a small tea towel. What they assumed is he was hiding some kind of injury or wound. In reality, when he got very close to mckinley, he whipped away the towel, and hidden in his hand was a small caliber pistol. He proceeds to shoot mckinley several times, point blank in the stomach. Even today, that is a very serious injury. Im afraid from that point on, everything that could go wrong, did go wrong. First of all, in a community the size of buffalo, there was at least one gentleman with a national and International Reputation as a surgeon. Wouldnt you know, the day that mckinley is shot, he is hours away from the city, consulting on another case. A stomach wound is serious business. The president needed Urgent Medical attention. The only doctor that they could get on such short notice was an ob gyn. [laughter] really not qualified for the mission he was given. Can you imagine the terrible pressure this man was under . It must have been awful. It is really not very surprising, that he didnt clean the president s wounds properly, did not close them up properly afterwards. Those two mistakes guaranteed that William Mckinley would die. Once mckinley was dead, the first thing that his number one patron and friend, mark hanna an ohio businessman and important political boss at this time. When he learned mckinley was dead, he said the following. Now, that damn cowboy is president of the United States. He was referring to theodore roosevelt, who was in fact, our Vice President. And how t. R. Happened to become Vice President is a really intriguing story. Roosevelt might have been a devout republican, but he was a liberal. By temperament and inclination, he was a reformer. That was enough to make them public enemy number one in the mind of tom platt, the republican boss in the state of new york, and the man who ran one of the most powerful and effective political machines in all of america. Platt had had a belly full of roosevelt and his conscience, and his complaints, and his objections. He resolved to use his political power to force roosevelt onto the political ticket of William Mckinley. He figured that if he could do it, he would never have to be bothered with roosevelt again. [laughter] i guess that was not a very good call. The second theme i want to focus on tonight is the idea that president s have always been truthful and honest with congress and the American People, about the state of their health. Well, sadly, that is another myth. That is true, partly because people are almost never giving up power voluntarily. The other thing, i would say, if there is one take away from tonights talk, you are about to hear it. The other thing is that a president s shortterm political need always trump longerterm health concerns. Always, always, always. The first president i want to talk about in relation to this is actually a democrat, finally. Grover cleveland, who was a democrat in the state of new york, the only american president to serve two nonconsecutive terms. He had the misfortune to serve his second term during what was the worst economic crisis in the United States until the great crash of 1929. Cleveland was not a brilliant man, not an intellectual, but he had a lot of common sense. And he was a democrat who embraced the gold standard, which meant he was popular on wall street, that he had good relationships, and so cleveland working with people in the business and financial communities i think was slowly but effectively working his way out of this mess, when one morning he awakes to discover a lump on the roof of his mouth that had not been there two or three days before. Subsequently, a biopsy reveals that it was cancerous, and now cleveland is truly panicked. For two reasons. He had made a commitment to address a joint session of congress, and to lay out his strategy for getting america out of this financial crisis. Can you imagine if a president of the United States makes a commitment like that, and then doesnt show . That sends a pretty powerful message that something is terribly wrong. The other thing that cleveland was worried about was his Vice President , because as a result of a political deal, he had accepted as his Vice President a man named Adlai Stevenson. Not the stevenson we remember from 1952 and 1956. His grandfather. This stevenson was a very popular politician, and amiable man. Somebody very difficult to dislike, except that he was an inflationist. He was a believer in soft money. To people on wall street, that made him worse than satan himself. One of the things concerning cleveland was the idea that if he died, and Adlai Stevenson became president , the Financial Institutions of the country would collapse. That is why Grover Cleveland had to undergo a secret operation on a yacht. They cheer he rigged a barber chair. They strapped the president in, and began to operate. In fairness, given some of the other comments i made earlier about doctors and american medicine, these doctors did a wonderful job. They not only removed the growth, but they got all the cancer. We know this is true, because cleveland lived on in very good health, until the year 1908. There was still a serious problem, because cleveland, as you recall, had made this commitment to address a joint session of congress. The problem was, you dont have to take very much tissue out of somebodys mouth before they can no longer communicate in a way so that other people can understand. Interestingly, medical progress never moves along a unified front at the same time. It is always moving ahead here, falling back there. Fortunately, at the time that cleveland had the surgery, one thing that we did know how to do was folk and eyes vulcanize rubber. What the doctors did was to craft a prosthesis, so that when cleveland wore it in his mouth, he could speak normally. He was able to keep the congressional appointment. The crisis past. Everything was fine, but you now know what a close call it really was. Now, i would like to Say Something about a president you know a lot about, Woodrow Wilson. A man who was previously president of Princeton University and governor of new jersey. What was little known and understood in wilsons own time, and still a little understood today, is that Woodrow Wilson was a very fragile man. We now believe he began suffering mini