Politics, not Public Good, Will Guide what We Know about Trump’s Health
On Monday, President Trump returned to the White House after being hospitalized for three days to treat the coronavirus. The decision by his physician, Sean Conley, to release only partial information about Trump’s condition raises two urgent questions for all Americans: What obligation do the president’s doctors have to tell the public what they know about an ailing president? And who takes charge when the president falls ill?
The 25th Amendment to the Constitution, which was adopted in 1967, sought to address the latter question. It spells out how a president can voluntarily and temporarily transfer power to the vice president. It also allows for the Cabinet to remove a president who is unwilling to cede power, though it sets a very high bar in such a case: a two-thirds vote of both houses of Congress. For this reason, as well as the political damage that can be done by appearing ill or weak, presidents are reluctant to share personal medical information in the midst of a health crisis.
The origins of the amendment lie partially in the experience of President Dwight “Ike” Eisenhower, whose frequent illnesses while in office were artfully hidden from the public by his doctors and by Eisenhower himself. Even as Eisenhower endured three serious health crises in office, the public was given only a limited amount of information, and at no time was power transferred to the vice president, despite the disability of the president.
Eisenhower was 62 years old when he took office in 1953 — young by today’s standards. Only three previous presidents had been older than Eisenhower at the start of their terms: William Henry Harrison (68), Zachary Taylor (64) and James Buchanan (65). Harrison and Taylor died while in office.
Eisenhower was a chain-smoker most of his life, until 1949. He also endured frequent bouts of agonizing abdominal pain, later diagnosed as ileitis. He had a volcanic temper, often erupting in fits of red-faced rage, and he worked under enormous stress while serving as supreme allied commander in World War II. All of these risk factors caught up with him during his eight years in office (1953-1961).
In the late summer of 1955, Eisenhower left Washington for Denver, intent on enjoying a long vacation of golf and fishing. On Sept. 23, in his seventh week away from Washington, Eisenhower played 18 holes of golf at Cherry Hills Country Club, then rapidly ate a hamburger for lunch and headed back to the links for nine more holes. He began experiencing heartburn and indigestion, so he went home, picked at his supper and went to bed early.
At 2 a.m., he awoke with a searing pain in his chest. His wife, Mamie Eisenhower, called Howard Snyder, the presidential physician, who swiftly arrived and administered morphine to the ailing president. Snyder was an Army doctor, with adequate but limited training. He assumed Eisenhower was having a bout of indigestion. In the morning, Snyder examined the president again and told the staff that the president was resting after a “digestive upset.”
But by the afternoon, Snyder had grown anxious. He called nearby Fitzsimons Army Hospital to order a cardiologist to administer an electrocardiograph to the president. Now the picture became clear: Eisenhower had suffered a serious heart attack. Snyder ordered the president to be transferred to Fitzsimons by the Secret Service. Once there, doctors gave Eisenhower oxygen and anticoagulants.
Most of Eisenhower’s closest advisers were still on the East Coast. Snyder reached press secretary James Hagerty, who was napping at home in Washington, by phone. Hagerty in turn called Vice President Richard M. Nixon and a few other senior Cabinet members. The public was informed about the heart attack late on Sept. 24, but given only partial information. The staff in Denver released a statement that Ike had suffered a “mild” coronary thrombosis, or a blood clot in his coronary artery. But in fact, the heart attack was not mild, and Eisenhower’s condition — under sedation, in an oxygen tent, lying still in a hospital bed — was not made plain to the public.