Eisenhower’s Heart Attack: How Ike Beat Heart Disease and Held on to the Presidency
The abiding plight of those who would write the history of presidential illness is the dearth of accessible medical records. This is not the case with Dwight D. Eisenhower, however: because of his military connection, we have a monumental array of medical information covering most of his adult life—including actual histories, physical examinations, and progress notes on all his known illnesses, supported by hundreds of laboratory reports, electrocardiograms, X rays, and even nurses’ notes. His personal physician, Howard Snyder, kept exhaustive progress notes during some of the presidential years. Snyder and Thomas Mattingly, Eisenhower’s most trusted cardiac consultant, compiled independent narratives of the medical record after his death, with the unrealized intention of publishing accounts of their famous patient’s health.
Eisenhower’s presidential years coincided with my training in internal medicine, so the nuances of the records are easily familiar to me. Yet, when I began preparing lectures on Ike’s health, the first hurdle was how to deal with such an immense clinical cornucopia. Clarence Lasby’s assimilation and condensation of this complex medical material is a remarkable feat. His grasp not only of literal meanings but of clinical subtleties is far beyond impressive. Add his deft interpolation of the political, social, and personality aspects of Eisenhower’s story, and it is unimaginable to me that anyone will try to improve on this account.
Eisenhower had two acute illnesses during his first term, and one in his second. In 1955 he suffered the famous heart attack that led to a salutary revision of the public’s perception of coronary artery disease. The following year he underwent emergency surgery for intestinal obstruction due to ileitis, and thereby finally learned the nature of an undiagnosed condition that had been his major health nemesis for more than thirty years. Because of these two episodes, he and the public agonized over his capability to serve a second term, which story forms the main thrust of Lasby’s book. In 1957 the president had a transient decrease in the blood supply to the speech area of the brain, which had no major sequelae beyond the fear of a major stroke that it engendered in him and his supporters. [End Page 161]
Eisenhower is justly admired as the first president to deal candidly with his illness, but two historians have recently come to a different conclusion. In 1949 and again in 1953 Eisenhower had bouts of serious illness that were unknown to the public until he recounted them after leaving office. Snyder reported both as gastrointestinal events, but Mattingly was convinced that they were heart attacks, and that Snyder, perhaps with his patient’s complicity, had deliberately disguised their nature to protect Eisenhower’s political future. This conclusion is shared by Robert Ferrell in Ill-Advised: Presidential Health and Public Trust (1992) and somewhat more cautiously by Robert Gilbert in The Mortal Presidency: Illness and Anguish in the White House (1992). Both relied too heavily on Mattingly’s estimate. Employing solid medical reasoning and the historian’s ultimate tool, common sense, Lasby threads his way through these clinical thickets to what I believe is the correct conclusion: the two attacks were caused by the same intestinal condition that had struck Ike repeatedly over the years.
Still, there was a good deal of deception associated with Eisenhower’s health. Although the president made certain that the important aspects of his three major illnesses were known, he soon realized that insignificant details were not always perceived as insignificant in a president, and grew more cautious in what he allowed the public to know. At times he also altered his regimen without his physician’s knowledge. The larger deceptions involved those around him. For example, Snyder did not inform his patient that X rays taken a month before the emergency surgery of 1956 had revealed the cause of the mysterious intestinal attacks dating back three decades. He also withheld data from his consultants, revealed things to Mamie without Ike’s knowledge, and fudged on laboratory reports because he knew that his patient was obsessed with the numbers. Press secretary Hagerty was not above putting his own spin on medical events, although his sins were distinctly venial by today’s standards.
The most egregious cover-up involved the 1955 heart attack. Eisenhower was stricken at the Doud home in Denver in the early hours of 24 September. Snyder issued a deceptive press report, and did not arrange the confirmatory electrocardiogram until after noon. Contrary to prevailing medical practice, he then walked the president down the stairs and out to a car. In response to the ensuing criticism, Snyder revised the notes he had kept during the attack and mounted an elaborate campaign to salvage his reputation. Lasby’s analysis here is superb, severely critical but balanced, and without a hint of gratuitous “doctor-bashing.” Indeed, he summarizes Snyder’s overall care of his patient with praise that would please any physician. And justly so: after a life of heavy stress and many illnesses, Eisenhower’s years ran well past the biblical quota.
In addition to its inherent merit, Lasby’s achievement will stand as a landmark in the history of medicine generally. Never again can a reasonable case be made for the proposition (mea culpa) that complex clinical chronicles are beyond the reach of nonphysician historians.