July 26, 2022

How the tradition of the president’s doctor briefing the president was born

By George Condon

When eleven reporters gathered in the White House Press Room on February 25, 1914, to form the White House Correspondents’ Association, it had been less than 21 years since a president had brazenly lied to the press and the nation about his health. Even though many of the WHCA’s founders were young, they all knew the story of how President Grover Cleveland had covered up his cancer and his private surgery in 1893.

Shortly after his inauguration, Cleveland had noticed a small rough spot on the roof of his mouth. It was diagnosed as cancer. Rather than announce the diagnosis and go to a hospital, the president boarded a friend’s yacht for what he said would be a four-day fishing trip from New York to Cape Cod. In his book The President is a Sick Man, author Matthew Algeo recalled, “It took about 90 minutes. They used ether as the anesthesia, and they removed the tumor along with about five teeth and a large part of the president’s upper left jawbone.”

When a reporter two months later got what Algeo called “one of the greatest scoops in the history of American journalism” and reported on the surgery, the White House and the president attacked him so viciously that it destroyed the reporter’s career.

The WHCA founders knew that history. What they didn’t yet know is that they were covering a president who would try to match or even top Cleveland in covering up presidential disability. And this despite the fact that President Woodrow Wilson’s personal physician, Dr. Cary T. Grayson, was one of their best sources inside the White House about everything other than the president’s health.

Grayson lied to reporters when Wilson came down with the flu during the Flu Pandemic and then again about his incapacity after the president suffered a massive stroke in 1919. It was a hard lesson to learn for White House reporters—access to the president’s personal physician was a good start but not as important as an overall White House commitment to be open and tell the truth. Neither was in evidence four years later when President Warren Harding became the sixth president in 82 years to die in office.

From the start, when Franklin D. Roosevelt took office in 1933, his physician Dr. Ross T. McIntire was dedicated to keeping the truth about the president’s health away from the public. “The health of the chief executive… is his own private business,” he once wrote. That was the philosophy that guided McIntire from 1933 to 1945, when Roosevelt became the seventh president to die in office.

The disconnect between McIntire’s rosy reports and the graying pallor of the president drove the correspondents to a desperate step at the WHCA dinner on March 22, 1945.

“Everybody knew he was fading, but how do you write it?”, lamented Walter Trohan of the Chicago Tribune, WHCA president in 1938-39.

With officials in the White House covering up the truth, Trohan plotted a way to get an unbiased opinion. As the reporter in charge of arrangements for the WHCA dinner that year, Trohan put an unannounced guest near FDR. “I put a doctor from Johns Hopkins underneath Roosevelt to look at him and tell me what he could,” Trohan told an interviewer from the Truman Library. The doctor told him what all 800 guests at dinner that night could see—the president was near death.

One week later, FDR left for Warm Springs, Georgia, where he would die within a month. Even as FDR was dying, McIntire continued to deny that the president had severe medical issues.

One man watching this denial was Dwight Eisenhower, who also had been a close observer of the White House cover up of Woodrow Wilson’s stroke more than three decades earlier. It was the impetus for Eisenhower, when he became president, to revolutionize the way the White House talked to correspondents about a president’s health. When Ike suffered a heart attack in 1955, he “thought back to President Wilson… and instructed his press secretary to take the opposite approach,” wrote author Kasey S. Pipes. His instructions to Press Secretary Jim Hagerty were clear: “Tell the truth, the whole truth; don’t try to conceal anything.”

Eisenhower did not always live up to his own advice. But, as only the second president ever to be hospitalized during his presidency (Harry Truman was the first), he charted a path for the 12 presidents to follow, as trips to hospitals became more routine. He had his doctors come out and take questions from White House correspondents. It became known as “the Ike Rule” for handling presidential illnesses.

Ike’s successor, John F. Kennedy, often misled the public about his own ailments in his shortened time in office. But since then presidents have generally followed Eisenhower’s example. White House correspondents over the last six decades have come to expect a president’s physician to take their questions when there is an illness or episode. There have been blips, as in 1986 when first lady Nancy Reagan, still angry about public talk of her husband’s intestines after a procedure the year earlier, barred both aides and doctors from answering questions when President Ronald Reagan went to Bethesda Naval Medical Center to have three polyps removed from his intestine.

But Reagan and the other presidents generally complied with the Ike Rule. Its biggest challenge came in 2020 when President Donald Trump was hospitalized for Covid. The White House misled on the timeline, the testing regime and the severity of his sickness. They did, however, twice bring out his physician Dr. Sean Conley, to take questions, though he refused to answer about Trump’s oxygen levels or when he had last tested negative. It showed that even a president as openly hostile to the press as Trump understood that having his physician face questions was the minimum expected.

It has worked out well for the public’s understanding of the president’s health but full disclosure has not always been easy for presidents.

When he took his annual physical in 1976, President Ford ordered White House physician Rear Adm. William Lukash to release all the findings. He did not expect the doctor to take him quite so literally. In Lukash’s summary, he described Ford’s feces and reported the president had “normal sized testicles.” An embarrassed Ford later joked, “I told Bill to put everything out. And he sure did.”

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