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Health and Medical History of President John KennedyPresident #35: 1961-1963
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"When Kennedy ran for and won the presidency, he was essentially gambling that his health problems would not prevent him from handling the job. By hiding the extent of his ailments he denied voters the chance to decide whether they wanted to share this gamble. It is hard to believe that he could have been nominated, much less elected, if the public had known what we now know about his health." 1a |
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![]() a mess |
From a medical standpoint, Kennedy was a mess. For example, there is the simple fact that Kennedy
was hospitalized more than three dozen times in his life
MORE
and given the last rites three times (see below).
Bumgarner provides an excellent short recap of Kennedy's medical history
2a,
although the new medical sources pioneered by Dallek
1
3
are leaving it behind.
Dr. Lee Mandel
4
has recently offered a unifying medical diagnosis for Kennedy: auto-immune polyendocrine syndrome
type II (APS II).
Dr. Mandel notes that Kennedy had signs of adrenal failure as early as 1940, and that his
autopsy almost certainly indicates this was auto-immune in origin. Kennedy was diagnosed with
hypothyroidism in 1955 and was under treatment for years (see below).
4
Comment:
[Technical] APS II is a polygenic disorder defined as: (a) auto-immune adrenocortical
failure plus (b) evidence of adrenal inflammation plus (c) either auto-immune thyroid
disease or type 1 diabetes mellitus. The peak age of onset is 30. (JFK was 30 when his adrenal
insufficiency was diagnosed.) Other associated autoimmune disorders include: atrophic gastritis
(with or without pernicious anemia), hypergonadotrophic hypogonadism, and celiac disease.
The diagram below summarizes the possible interplay between Kennedy's medical problems.
The rest of this page has details.
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![]() scarlet fever |
Contracted scarlet fever in Feb. 1920 (age 2 years, 9 months) and almost died
2b.
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![]() measles |
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![]() jaundice |
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![]() sports injuries |
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![]() minor childhood ills |
Kennedy's mother kept a card file on the medical problem of her children
2d
3c.
The entries for John (more commonly known as Jack) included
2e:
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![]() sickly child |
JFK's mother remembered him as "a very, very sick little boy" (probably in connection
with the scarlet fever) and "bed-ridden and elfin-like"
2d.
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![]() ![]() reading glasses in youth |
Another entry in the Kennedy card file says "March 21, 1931: Glasses prescribed for reading
by Dr. John Wheeler"
2e.
If the glasses were really for reading, this would be an indication that Kennedy had presbyopia
(far-sightedness) at age 13 -- a distinctly unusual occurrence. Diphtheria is one of the few
reasons a young person needs reading glasses. (See
Harry Truman.)
Kennedy underwent a Schick test for diphtheria in 1928
2e,
so there was at least a suspicion that he had it.
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![]() colitis |
Kennedy had digestive troubles as early as 1934 (age 17)
3d.
Years later, when he joined the Navy, these were described as "severe spastic colitis"
3e.
Dallek believes steroid treatment of Kennedy's colitis began in 1937
3d
and ascribes several later medical problems to complications of steroids (see below).
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![]() height and weight |
During his freshman year in college, Kennedy was six feet tall and weighed 149 pounds. He consumed
"massive amounts" of ice cream and otherwise worked hard at gaining weight, but failed
to add bulk all through college
5b.
From age 20 to age 43, available data show that Kennedy's weight was more or less constant
-- about 155-160 pounds
4,
(corresponding to a body mass index of about 21-22 kg/m/m). Between July 1960 and January 1961,
however, he gained 15-20 pounds, causing his mother to remark to her diary on Nov. 3,
1960: "Jack looks unusually well. His cheeks have filled out amazingly since I saw him
in June. He has lost that lean Lincolnesque look which I secretly like better"
4.
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![]() blood type AB+ (?) |
During its coverage of JFK's assassination, NBC news announced (at about 2:30 pm) that B+ blood
was prepared for him at Parkland Memorial Hospital. [One reader brought to my attention a published
statement that JFK had type AB blood. The printed source is too embarassing to cite. Note,
however, that a person having AB+ blood can classically receive B+ blood safely.]
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![]() pernicious anemia (?) |
In 1966 Dr. Janet Travell recalled: "When I first saw him [May 26, 1955
6a]
he was extremely anemic. He had impaired vibration sense which is indicative of peripheral
neuritis... characteristic of a vitamin B1 deficiency"
4.
(Note: Deficiency of vitamin B1 does not cause anemia, but deficiency of vitamin B12 causes
anemia and impaired vibration sense.) She further recalled: "Senator Kennedy was put on
a course of vitamin B12, vitamin B1, and B-complex injections. His blood count -- his hemoglobin
and red cells -- did respond"
4.
The problem with Travell's recollection is that Kennedy was hospitalized the same day she
met him, and the hospital records neither say Kennedy was anemic nor list anemia as a diagnosis
4.
Thus, Travell's memory may be inaccurate.
Comment:
It would not be surprising if Kennedy had pernicious anemia, as it may be part of the APS II
syndrome.
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![]() hypothyroidism |
One of JFK's physicians, Dr. Janet Travell, reported that Kennedy was diagnosed with a sub-normally
functioning thyroid gland in May 1955 and underwent iodine treatment. Hospital records show
that Kennedy's thyroid function was only mildly subnormal (a "basal metabolic rate of
-15"). He took iodine throughout his Presidency (liothyronine, 25 mcg twice daily).
4
In both 1935 and 1939, Kennedy's basal metabolic rate was -11, which Dr. Walter Alvarez
regarded as "well within normal limits"
4.
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![]() ![]() gonadal function |
Kennedy took daily testosterone pills throughout his Presidency
4.
The reason(s) he took this medication are unknown. Certainly, his body was not completely
devoid of testosterone, as he fathered four children from 1956 to 1960. It is possible that
his testosterone level was reduced by the cortico-steroids he chronically took, or as a consequence
of APS II (see above)
4.
It has been written that Kennedy took testosterone to keep his weight up
4a.
This may be true, as he gained 15-20 pounds between July 1960 and January 1961
4.
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![]() ![]() ![]() ![]() steroid complications |
Dallek believes steroid treatment of Kennedy's colitis began in 1937
3d.
Steroid therapy often comes at a cost, because of its propensity to cause adverse health effects.
This was especially true in Kennedy's case, as steroid therapy was still new to medicine in
the 1930s. The consequences of steroid excess, now known as "Cushing syndrome," were
not described by Cushing until 19__.
Dallek believes steroids were the "principal
contributor" to Kennedy's duodenal ulcer (see above) and back problems (see below)
3d.
(Steroids cause thinning of bones.) Steroids also altered the shape of Kennedy's face (see
below) and, perhaps, body.
Another complication of steroid use is suppression of adrenal
gland function. Kennedy was diagnosed with underactive adrenal glands in 1947, a condition
known as Addison disease (see below). If Dallek is correct, Kennedy had by then been on steroids
for 10 years, although not continuously
3.
This makes it extremely difficult to know if Kennedy's Addison disease was the result of chronic
steroid use, or whether it was the result of some other process (e.g. auto-immunity).
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![]() ![]() ?sexually transmitted disease |
Kennnedy had "occasional burninng when urinating, which was the result of a nonspecific
urethritis dating from 1940 and a possible sexual encounter in college." This was left
untreated and became a chronic condition by 1946
3f.
At some point the illness was described as "a mild, chronic, non-specific prostatitis."
Sulfa drugs were able to suppress the symptoms.
3f.
As late as May 1955 he still had "prostatitis marked by pain when urinating and ejaculating,
as well as urinary tract infections"
3g.
In January 1956 he underwent cystoscopy under anesthesia
3h.
Comment:
Was this a sexually transmitted disease? (1) The response to sulfa suggests it was infectious.
(2) Kennedy had a large number of sexual contacts before he was even out of college, and
(3) it seems unlikely he practiced safe sex
3i.
As one female acquaintance remarked, "He was not much for planning ahead"
3j.
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![]() back |
Back problems started in 1938. From 1941 they were "a constant source of difficulty"
3d.
[There is much history here, yet to come.]
Dallek has suggested that steroid treatments, "which apparently began in 1937," may
have been causative
3d.
He wore a back brace. For example, on the day he was shot, he wore a brace that consisted
of a canvas brace with metal stays, together with an Ace bandage with extra padding
7a.
Some people think this back brace killed him. (See below.)
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![]() ![]() coral wound |
In August 1943, JFK's PT-109 was sunk by a Japanese destroyer in the South Pacific. Kennedy
and the other survivors swam to an island three miles away, where they were rescued several
days later. Afterwards, JFK wrote to a friend: "I went in to see the Doc about some coral
infections I got. He asked me how I got them -- I said `swimming!' He then burst out with,
`Kennedy, you know swimming is forbidden in this area, stay out of the goddamned water!'"
8a
Kennedy took 10 days to recover from "symptoms of fatigue and many deep abrasions
and lacerations of the entire body, especially the feet"
3k.
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![]() ![]() malaria? and green skin |
Kennedy may have contracted malaria while stationed in the Pacific. He had an illness with
high fever in 1945 that was treated with atabrine (a.k.a. quinacrine).
Atabrine can cause yellowish discoloration of the skin. Kennedy was well-known by Washington
newspaper correspondents to have a "greenish complexion" after the war
5c.
Whether the green hue was caused by atabrine, Addisonism, or something else is unclear.
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![]() cigars |
Kennedy liked to smoke cigars, but did not like to be photographed doing it. He feared it made
him look like a stereotypical "old Irish pol, which he didn't want to be sees as"
9.
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![]() ![]() campaign exhaustion |
Kennedy was exhausted by the 1960 Presidential campaign. At a press conference the day after
the election, "his hands, although out of camera range, trembled"
3l.
Even two weeks later he had not fully recovered: advisor Ted Sorenson found JFK's mind neither
"keen" nor "clear" and the President elect "tired" and reluctant
to tackle work
3m.
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![]() fatigue or hypersomnolence |
Kennedy was not especially concerned with the Department of Agriculture. While interviewing
a candidate for ?secretary, Kennedy fell asleep
3n.
Comment:
Dallek sees this incident as indicating Kennedy's boredom with the man and the discussion,
as well as evidence that Kennedy intended to rely little on his cabinet. Most sleep physicians,
however, view falling asleep in a conversation as a cardinal sign of hypersomnolence. It would
be interesting to know more of the interview setting, i.e. whether it was a one-on-one interview
or a group effort. Falling asleep in a one-on-one conversation would be remarkable indeed.
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![]() Addison disease |
Kennedy's Addisonism was diagnosed in 1947 by a physician in London. Kennedy had probably been
suffering (literally) from the disease for years, if not decades. After the diagnosis, he was
given less than a year to live. He was so ill during the sea voyage home from England, in October
1947, that he was given the last rites
2f.
Yet, during the 1960 presidential race, the JFK campaign flatly denied that JFK had Addison
disease. The Kennedy campaign used a very narrow definition of Addision disease, namely, insufficiency
of the adrenal glands caused by tuberculosis. This was deliberate, calculated, and grossly
misleading. Bumgarner calls it "undoubtedly one of the most cleverly laid smoke screens
ever put down around a politician"
MORE
2g.
Adrenal insufficiency, no matter how caused, is a serious matter.
MORE
Dallek reports that "Doctors who treated Jack's Addison's or read closely about his
condition have concluded that he had a secondary form of the disease, or a 'slow atrophy of
of the adrenal glands,' rather than a rapid primary destruction"
3o.
Dallek is hinting that Kennedy's Addisonism was due to chronic use of steroids, but he does
not take a stand.
While a U.S. Senator, Kennedy underwent major surgery on his back even though the effects
of Addison disease on
the tolerance of surgery was largely unknown at the time.
10.
In fact, JFK's case was published in the medical literature in 1955, although this was not
publicly realized until 1967
7b.
Post-operatively, he developed a urinary tract infection and had a transfusion reaction, characterized
by "mild angioneurotic edema." He also had a repeat operation four months later
10.
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![]() ![]() moon facies |
Kennedy worried about the effects on his appearance of the steroids he took as treatment for
Addison disease. The steroids made his face look puffy and made him look overweight. Four days
before his inauguration Kennedy caught sight of himself in a mirror and declared "My God,
look at that fat face, if I don't lose five pounds this week we might have to call off the
Inauguration." Kennedy's secretary heard this and could barely contain her laughter.
3p
Comment:
Steroids classically cause a facial appearance known as "moon facies." This refers
to the round shape the face assumes. Dr. Zebra always checks for moon facies by looking
at the outer corner of the eye sockets. If there is facial tissue behind the eyes that projects
laterally from the bony outer border of the orbit, then some degree of moon facies are present.
Several photographs of Kennedy have this appearance.
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![]() ![]() year-round tan |
It is sometimes mentioned that Kennedy had a tan year-round. In most of North America, this
is unusual, and raises the question of disease. Addison disease, for example, causes bronzing
of the skin that is often mistaken for a tan. (An Addisonian tan would suggest that, despite
the use of steroids, Kennedy's Addisonism was under-treated.)
To be sure, Addisonism may
not be the whole story. Even in youth, Kennedy liked having a tan, saying "It gives me
confidence. ... It makes me feel strong, healthy, attractive"
3q.
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![]() celiac disease? |
There is speculation that Kennedy's gastrointestinal ills were due to celiac disease. Of note,
there is an association between celiac disease and Addison disease
11.
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![]() ![]() libido |
In 1963 JFK confided to Britain's Prime Minister Macmillan that he got a headache if he went
too long without a woman
12a.
Kennedy's close friend, Senator George Smathers, once remarked "He has the most active
libido of any man I have ever known," and a fellow congressman observed that "traveling
with him was like traveling with a bull"
12b.
Kennedy was taking testosterone in 1963
4,
and this could have had an (enhancing) effect on his libido. It is not clear when Smathers'
statement was made and whether Kennedy was then taking testosterone.
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![]() ![]() invasion diarrhea and UTI |
Immediately before and after the failed invasion at the Bay of Pigs in Cuba (April 17-18, 1961),
Kennedy had "constant," "acute diarrhea." He simultaneously had a urinary
tract infection. The treatment included increased anti-spasmodic medication, a puree diet,
and penicillin. He was also scheduled for a sigmoidoscopy.
3r
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![]() post-invasion depression |
Though composed and philosophical in public, in private Kennedy was deeply depressed after
the Bay of Pigs invasion fiasco. On April 19, 1961 his wife Jackie remarked that the only time
she had seen him more depressed was in connection with surgery. The same day Pierre Salinger
found him weeping in his bedroom. Shortly after Kennedy appeared at a meeting with Senator
Albert Gore (the father), his hair unruly and his tie askew
3s.
At a Cabinet meeting on April 20 he looked "quote shattered" and would talk to himself.
Even weeks after the invasion he could not sleep
3r.
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![]() psycho-active poly-pharmacy |
During the first six months of his presidency, Kennedy's physicians "administered large
doses of so many drugs that
[Dr. Janet] Travell
kept a `Medicine Administration Record'"
1b.
Many of the drugs Kennedy received affect thinking:
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![]() head movement |
Massive sympathetic discharge is postulated to cause his head to move toward the bullet's approach
path
14.
Some think that Kennedy's back brace killed him
7a
1.
It kept him erect after Oswald's first bullet went through his neck. Had he been able to fall
forward after this first bullet hit, the second, fatal bullet may have missed him.
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![]() ![]() resuscitated? |
There is a legend that Kennedy's heartbeat was resuscitated in the Parkland ER. But now what
are you going to do with a President whose brain has flowed out onto the stretcher?
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![]() three last rites |
Kennedy received the last rites three times:
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Before Presidency | In Congress (maybe) | During Presidency | Post-mortem |
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Ampres Series
![]() ![]() 25 reviews
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Kansas Series
![]() ![]() 6 reviews
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![]() ![]() 269 reviews
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![]() ![]() 217 reviews
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![]() ![]() 345 reviews
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![]() ![]() 44 reviews
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a p.61 b p.60
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a pp.234-249 b p.234, 235 c pp.234, 235 d p.234 e p.235 f pp.240-241 g p.243
Comment: Devotes one chapter to each President, through Clinton. Written for the layperson, well-referenced, with areas of speculation clearly identified, Dr. Zebra depends heavily on this book. Dr. Bumgarner survived the Bataan Death March and has written an unforgettable book casting a physician's eye on that experience.
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a citing Dallek and Kelleman
Comment: Available on the web at: http://annals.org/cgi/content/full/151/5/350
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a p.174 b p.175 c pp.177-178
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a p.5
Comment: Travell was one of Kennedy's physicians during his Presidency. Although all autobiographies are inherently narcissistic, the level in this one is tough to stomach -- almost as bad as Jerry Linenger's, in fact.
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a p.198 b p.209
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a p.300
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![]() | Comment: Web site for the interview, including a picture: http://www.pbs.org/newshour/bb/media/jan-june05/exhibit_01-21.html |
![]() | Comment: JFK is case 3 |
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a pp.69-70
Comment: At one time Post worked for the CIA, profiling foreign leaders.
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![]() | Comment: Sarah Burgess wrote me about this on 2010-05-02, but when I checked on 2016-10-11, the video had been taken down. The disclosure was reportedly made at the 3 minute, 16 second mark in the video. |
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a p.121 b p.120 c p.133
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a p.74
Comment: This book has been roundly criticized by other physicians involved in the Kennedy case.
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