The White House Physician: A History from Washington to George W. Bush (review)

Most historians of medicine know that the physicians of presidents Woodrow Wilson, Franklin D. Roosevelt, and John F. Kennedy misled the public about their patients' illnesses, but what about the dozens of other men (and, occasionally, women) who have cared for American chief executives?

In The White House Physician, Ludwig M. Deppisch, a pathologist, has carefully told the stories of these other individuals. Not surprisingly, many of the trends he documents parallel larger developments in the history of medicine.

Not until William McKinley appointed Navy physician Presley Rixey to care for himself and his wife in 1898 did presidents employ regular doctors. Previously, different physicians had been summoned depending on the malady in question and where the president was located. Most of these physicians, like Rixey, worked for the military, but others were civilians.

Deppisch has done his homework, reviewing secondary sources and presidential papers and even unearthing obscure documents like a dissertation written about William King, who served as Franklin Pierce's vice president for only one month before dying of tuberculosis.

Readers will recognize several famous names. For example, Samuel Bard, one of the founders of the New York Hospital in 1773, successfully treated George Washington in 1789 for what was probably a bacterial abscess of the thigh. Thomas Jefferson periodically asked medical advice of Benjamin Rush, who had also signed the Declaration of Independence, although the president said that he was "ever opposed" to his friend's theory of bleeding.

Other names are more obscure. James Crowdhill Hall, an elite District of Columbia physician, had the unfortunate distinction of being present at the deathbed of three presidents: William Henry Harrison, who died of pneumonia in 1841; Zachary Taylor, who died of possible typhoid fever in 1850; and then Abraham Lincoln. And, befitting the prominence of medical sects in the nineteenth century, one of James Garfield's physicians was Susan Edson, a homeopath who was also the first woman to attend a president.

Deppisch entertainingly covers a series of topics central to presidential medicine. These include the VIP syndrome, in which too many physicians participate in patient care; professional infighting between doctors of different specialties and training; and the constant fear that political concerns might interfere with prudent medical decision making.

The White House Physician contains its share of interesting trivia. For example, the first sitting president to be hospitalized was Harry S Truman, in 1952, with a fever. I particularly liked Deppisch's chapter on the medical care of vice presidents. It turns out that seven vice presidents, including King, died in office between 1812 and 1912. None has died since.

And while well-known, the medical cases of Wilson, Roosevelt, and Kennedy, with their power struggles, misleading press releases, and secret injections, never cease to amaze. Of course, physicians routinely told lies about serious illnesses during the first portion of the twentieth century, regardless of who their patients were.

Deppisch's final chapters describe the professionalization and bureaucratization of presidential medical care that has occurred over the past several decades. The twenty-fifth amendment, adopted in 1967, laid out a formal procedure by which sick or incapacitated presidents should pass along power to the vice president. Several subsequent commissions have made recommendations about implementation procedures, including the tricky cases of mental illness, addiction, and senility.

Moreover, today's White House, the author notes, has become "an apolitical, professionally focused, tightly structured, military staffed health maintenance organization" (p. 150). In addition to the physician to the president, who is a political appointee, there is now a formal White House Medical Unit staffed by physicians, nurses, physicians' assistants, and other health professionals. This group not only cares for the president and the president's family but also White House staff and even tourists.

These developments are welcome, to be sure, but the stories that emerge about the presidential physicians of the twenty-first century will...