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 1957.42
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.43
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.
Chapter Thirteen
Obstetrics in the White House:
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,1 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.2 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.
Jackie Kennedy’s Obstetrical History
“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.”3
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.4 It was not until the mid–1920s that hospital births became the standard obstetrical venue; previously home deliveries were the norm.5) 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.
First Pregnancy
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.”6 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.”7
Second Pregnancy
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.8 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.9
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.10
The Washington Post reported that the senator finally arrived at his wife’s side five days after the stillbirth.11 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.12
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.13
Third Pregnancy
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.14 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.
Fourth Pregnancy
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 “c
urtail her activities for about six months.” The physician’s directive justified Mrs. Kennedy’s frequent absences from the presidential campaign.15
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 27.16 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.17 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.18
Jacqueline Kennedy, the wife of John Kennedy. Her obstetrical history was an arduous one (Library of Congress).
Mrs. Kennedy and her son were discharged from Georgetown Hospital two weeks after her C-section. The plan was to fly immediately to Palm Beach to recuperate. However, a political responsibility intervened—a social visit at the White House with outgoing first lady Mamie Eisenhower. Jackie’s nurse warned the physically and emotionally exhausted new mother that “if she got up on her feet she might die.” After walking up the White House steps and greeting Mrs. Eisenhower, Mrs. Kennedy looked desperately for a wheelchair that was not there. “If she was not ill before, she was ill now, and she took John John and the nurse and flew down to Palm Beach.” There she remained for six weeks until just prior to the inauguration.19
Secret Service agent Clint Hill observed that as soon as she arrived from Washington, “Mrs. Kennedy immediately went to her bedroom to rest, and rarely emerged for the next week.”20 This comment may be the first notice of a severe postpartum depression. Frenzied political and family activities at Palm Beach provided the opposite of a necessary recuperation. Jackie returned to Washington shortly before her husband was inaugurated president.
The inauguration and the inaugural balls were a nightmare. Anxious, exhausted and depressed, the new first lady awoke “alone and terrified…. [H]er legs were gripped by painful muscle spasms [and] to her horror, she realized she was unable to stand.” She summoned Dr. Janet Travell, the White House physician, who gave her a Dexedrine (amphetamine) pill to get through the inaugural balls. By midnight the pill’s effects had dissipated, and an exhausted Mrs. Kennedy insisted that she be returned to the White House.21
During a post-assassination conversation with Arthur Schlesinger, the widow talked about her near-catatonic state during the January 1961 inauguration ceremonies: “I left after a couple of hours because again, I was really so tired that day…. And about 9 o’clock or something. when it was time to start getting dressed, again I couldn’t get out of bed. I just couldn’t move. And so I called Dr. Travell just frantic and she came running over. And she had two pills, a green one and an orange one, and she told me to take the orange one. So I did and said, ‘What is it?’ And then she told me it was Dexedrine, which I‘d never taken in my life—But thank God, it really did the trick because then you could get dressed…. I guess the pill wore off because I just couldn’t get out of the car.”22
The first lady stayed in bed for a week after the inauguration. Dr. Travell became concerned about her depression and overall physical condition and prescribed an immediate return to Palm Beach, where Mrs. Kennedy remained secluded in a bedroom.23 In retrospect it is clear that a postpartum depression commenced almost immediately after John’s birth and was still present six months later. Jackie’s symptoms were extreme fatigue, sadness, withdrawal, and lack of motivation.
Ceremonial and social events that required Mrs. Kennedy’s grace and style began to appear on the 1961 “New Frontier” calendar. The president increasingly worried that his wife’s depression would mar state visits to Canada, Paris, and Vienna. Since neither time nor Travell had lifted his wife’s mood, he took the desperate and dangerous step of inviting Dr. Max Jacobson, also known as Dr. Feelgood, due to his happy and invigorating potions, to Palm Beach. Kennedy and a close friend had been injected previously by Jacobson with positive results. The general reaction to Feelgood’s injections in the arm, hand, hip, buttocks, or solar plexus, was “a sense of being lit up from within.”24 Eventually Robert Kennedy, JFK’s brother and closest advisor, apprehensive over Jacobson’s treatments, had five of Feelgood’s therapeutic vials analyzed by the FBI’s laboratories. Analysis revealed high concentrations of amphetamines and steroids in all five vials.25 Counseling, antidepressants, and hormonal therapy are the usual treatments for postpartum depression. Instead, the first lady, whose position could command the best medical care in America, was subjected to the amphetamine shots of Dr. Max Jacobson.26
Max Jacobson may be the most fascinating of all the physicians who medically ministered to America’s first ladies. A Jew from Berlin, Jacobson fled the Nazis to establish a medical practice on Manhattan’s Upper East Side. His treatments consisted almost exclusively of injections of his potions, which contained amphetamines as their principal ingredient. His patients were a “Who’s Who” of the entertainment industry and included Eddie Fisher, Alan Jay Lerner, Tony Curtis and Milton Berle. Later he treated Jack and Jackie Kennedy. The Secret Service agents that guarded JFK code-named the physician “Dr. Feelgood.”27
When beckoned by the new president, Jacobson flew to Florida, interviewed the first lady, noted her depression, and injected her. As a result her mood changed completely. Her presence during the subsequent state visits charmed both the Canadians and French president Charles DeGaulle. The only annoying side effect was a dry mouth.28 Max Jacobson continued to treat both Jackie and Jack. Mrs. Kennedy was injected on at least six occasions, and undoubtedly more, in Palm Beach, in the White House, and in Paris.29 After her husband’s assassination, Jacobson flew from New York City to the White House at Jackie’s request. On the night of November 23, 1963, he injected the first lady with his medicinal cocktail. Afterwards, Mrs. Kennedy told her brother-in-law, “I have no idea what the shot contained. All I know is that my nerves have finally begun to settle.”30
Fifth Pregnancy
In 1963, Jackie Kennedy was pregnant for the fifth time. She summered at Cape Cod near the Kennedy Hyannis Port estate, but planned to return to Washington to deliver by the inevitable C-section at Walter Reed Army Hospital.31 Previously Dr. John Walsh, her obstetrician, Dr. Janet Travell, the official chief White House physician, and Mrs. Kennedy’s Secret Service agent Clint Hill, auditioned several Cape Cod area hospitals to determine the one most suitable if once again premature labor would occur. The trio selected the hospital at Otis Air Force Base. Dr. Walsh offered to remain at Hyannis Port for the remainder of the summer to monitor the first lady, an unusual obstetrical perquisite specific to the wife of a United States president. Moreover, the air force spent nearly five thousand dollars in refurbishing the hospital’s eight-room suite should the first lady become a maternity patient there.32
Columnist Jack Anderson wrote of a different situation: “It will take a major crisis to keep President Kennedy from his wife’s side when their baby is born. For his presence, say confidants, has become an issue in their marriage.”33 Kennedy was certainly apprehensive over the upcoming birth. In mid–July, Jackie awoke with an uncomfortable feeling. A frantic search for Dr. Walsh ensued and Mr. Kennedy became “very upset over the doctor’s absence.” The physician had been on a walk, but Kennedy insisted that he “always tell someone where you are, how you can be reached immediately.” The discomfort was a false alarm.34 Despite JFK’s admonition to the obstetrician, it was Kennedy who was once again absent for the delivery.
&n
bsp; On August 7, Mrs. Kennedy experienced sudden labor pains, and Walsh and his patient boarded a helicopter for Otis. A four-pound, 10.5 ounce baby boy, named Patrick Joseph Kennedy, was born there shortly after midnight, once again by C-section. The infant was five and one-half weeks premature and almost immediately had difficulty in breathing. The diagnosis of idiopathic respiratory disease syndrome was established and the chief resident of Boston Children’s Hospital, Dr. James E. Drobaugh, was summoned to transport the baby to Boston by helicopter. Despite intensive therapy and the expertise of prestigious physicians (Drs. Stephen Clifford, William Bernhard of Harvard and Dr. Samuel Levine of Cornell), Patrick died after a life of 39 hours and 12 minutes.35 Unfortunately, Patrick was born too soon. Fifty years later medical advances have allowed neonatal intensive care units to save babies born at thirty-two weeks of gestation. A senior neonatologist at Boston’s Beth Israel Deaconess Medical Center was quoted in a recent article: “We hardly worry at all about a baby like the Kennedy infant.”36
Mrs. Kennedy was discharged from the hospital after a week (at the time a seven-to-ten day postpartum hospital stay was routine). Once again she required two units of blood.37 Kennedy press secretary Pierre Salinger announced the first lady’s recuperation plans: “Mrs. Kennedy has made a very satisfactory recovery. However, in order to assure her complete rehabilitation and continuing good health, it will be necessary for her to curtail her activities and not undertake an official schedule until after the first of the year.” The plan was to recuperate at Cape Cod until mid–September, then to go to her parents’ home near Newport for several weeks, and then to Virginia. Lady Bird Johnson and the Kennedy sisters-in-law were expected to fill in for Jackie at social and ceremonial activities.38
The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama Page 23
