An Orthopedic Surgeon Analyzes Presidents’ Skeletal Maladies.

I, along with some others, take Presidents Day as an opportunity to celebrate the lives and contributions of all U.S. presidents. Amid the praise, however, perhaps I alone feel compelled to describe their skeletal maladies. I have gleaned the following information from several websites and books that carefully detail the reported injuries, diseases, bad habits, and addictions experienced by U.S. chief executives throughout their lives, starting with George Washington’s birth in 1732.

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The list may not be complete and accurate for at least three reasons. X-rays were not discovered until 1895, so a “fracture” before that time, unless the bone ends were seen emerging through the skin, might have been a dislocated joint or a bad sprain. Secondly, diagnostic terms such as gout, lumbago, and rheumatism have been tossed about without strict and uniform definitions over the nearly 300-year span of this survey. And early on, there were no confirmatory laboratory tests for such diagnoses. Finally, there have been multiple instances where a president wanted to keep his ailment(s) secret because of their implication of weakness or vulnerability; yet the truth escaped. It is possible, however, that there are other presidential ails that never became publicly known

Efforts at secrecy led to at least one other problem. It may have precluded some presidents from receiving the best care available, because for the sake of covertness, they shunned the most eminent (and most visible) doctors and hospitals. Another possible problem is that trying to maintain secrecy usually entailed lying.

Who was the healthiest president? Likely it was Millard Fillmore. He neither drank nor smoked and was conscientious about maintaining his wellbeing. He had no known medical problems until he suffered a stroke at age 74. A second stroke the same year killed him.

Conversely, John Tyler was in ill health throughout his life. His maladies included arthritis and general achiness, particularly in his post-presidential years. Nonetheless, he managed to father eight children with one wife before he was President and seven more with a second wife after his term. His last child was born when Tyler was 70. Tyler died two years later. Imagine his productivity had he been spry.

People will undoubtedly speculate forever about Lincoln’s skeletal condition. There is some agreement that he inherited it from his mother, since they shared many skeletal features. A reporter once described Lincoln as over six feet tall, lanky, with long drooping arms “terminating in hands of extraordinary dimensions, which, however, were far exceeded in proportion by his feet.” Lincoln, whatever his skeletal peculiarities, did not apparently have any noteworthy bony problems other than having a piece of his jaw extracted along with a tooth. Many of his fellow presidents were not so lucky.

Jefferson, Kennedy, and George W. Bush all had severe back pain. Jefferson’s life predated the discovery of general anesthesia, so elective back surgery at that time was unimaginable. JFK had one operation, Bush two.

Gerald Ford sustained multiple injuries playing high school and college football, which led in later life to bilateral total knee replacements. These restored his ability to play golf and tennis.

In 1893 during his second presidential term, Grover Cleveland surreptitiously had surgery to remove a cancer from his mouth (on his cigar-chewing side) along with part of his upper jaw and hard palate. The surgery was performed entirely through his mouth, so there was no external evidence of the procedure, and his bushy moustache likely concealed swelling and bruising. The clandestine operation took place aboard a private yacht cruising Long Island Sound. His five-day absence went entirely unexplained, and Cleveland allegedly said that he lied more about this event than he did during the whole rest of his life. Twenty-five years later, the truth emerged.

Here is a list of presidential fractures sorted from head to toe. Taft fell from a wagon at age nine and sustained a “minor” skull fracture, which by some accounts left him with a life-long and visible indentation in his scalp. Both Truman and Carter broke their collar bones, the former from falling out of a chair in childhood and the latter from skiing in adulthood. At an advanced age, Truman fell again and broke several ribs. Far more dramatic were Jackson’s rib fractures, which resulted from a duel. Later, in an out-and-out gunfight, a bullet shattered Jackson’s shoulder.

Jefferson, two months after becoming Minister to France, broke his wrist. This occurred either while jumping a fence during a tour of Paris with a married woman (Jefferson’s wife had died three years before), while he was jumping over a kettle, or while he was walking with a friend. Was somebody lying? Regardless, this injury nagged him for the rest of his life and further disabled him when, at age 78, he fell from a broken step at home and fractured his opposite wrist.

Reagan fell from a horse and broke his femur when he was 38. At age 90, well after retiring from public view, he broke his hip, which was successfully pinned, and he survived another two years.

Regarding non-fatal gunshots yet harrowing glimpses of death, the award goes to Rutherford Hayes. He sustained battle wounds on four separate occasions and also had horses shot from under him an equal number of times.

Even though Washington, as a child, blurted, “I cannot tell a lie,” and Lincoln was known as Honest Abe, the prize for bold truth-telling goes to Eisenhower. A White House visitor noticed him wearing a leather wrist brace and inquired. Ike responded that it was mild arthritis. The visitor said he was glad it wasn’t serious. Eisenhower exclaimed, “I should say it’s serious. I can’t play golf.”

Roy A. Meals is an orthopedic surgeon who blogs at About Bone.

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