The health of the President of the United States and of his immediate personal and official family is of so much importance to all our people and indeed to the whole world that I am glad in my declining years to express, in accordance with the wishes of BETTER HEALTH, my views on this subject, formed after an experience of over ten years as the official White House physician of two of our Presidents. I had the responsible honor of serving Mr. McKinley from 1898 to the date of his death in 1901, and Mr. Roosevelt from that date to his retirement from office in 1909. This experience gave me increased interest in the health of all our Presidents since that period.
Everything concerning the President's health affects society and business in a very material way and the thousands of letters and telegrams asking to be advised whenever the President is even slightly sick and offering all kinds of advice and all varieties of prescriptions for the guidance of the official physician would take up more of his time than could be spared, so that the policy has been adopted of making all acknowledgments deemed necessary through the Executive Office. And just here let me say that the White House physician should clearly have it understood that he will give out nothing in regard to the health of the occupants of the White House except through the President's secretary, and then only when it is of such importance as to demand bulletins signed by the official physician and consultants which are always given to the press through official channels. In this way the public, which has a right to the information, is kept advised in no uncertain way and nothing is given out that might unduly alarm or affect social or business life.
In the national capital of our great country are three of the finest medical establishments in the world, all kept up at Government expense -- I refer to the Medical Department of the Army, the Navy, and the Public Health Service. Officially they all come under command of the President and each of these is glad and always ready to serve their commander-in-chief. From the personnel of these services the President usually selects his official physician, who is amenable to the discipline governing them. The family physician to the President remains his private family physician called by the official physician as a consultant whenever he or the President desires it. This plan has been found to work very satisfactorily.
During my term of service as White House physician I had eminent specialists in consultation on serious cases of both Presidents and various members of their families. The serious illness of his wife or child obviously interferes materially with the President's service to his country.
Many Duties and Responsibilities of White House Physicians
The President and his personal family are the first care of the official physician, and it is important that the President keep advised as to the health of his official family, that is, the members of the Cabinet and others in official life and members of Congress in whom the President might be much interested. Here the President calls in the services of the official White House physician, especially where the illness is serious, as in the case of Vice-President Hobart, Senator Hanna, and many Cabinet officers whom I visited by the President's direction. Many of these officials had consulted me and I was their attending physician and before the expiration of my ten years' service I had more than I could care for professionally besides the duties of Chief of the Bureau of Medicine and Surgery.
The official physician includes in his duties the health of the White House office force, and any emergencies which may arise, especially in the prevention of contagious or infectious diseases, and to this end a close watch must be kept upon all those who come in contact with the President and his personal and official families. Having outlined what I believe to be important in a general sense and what I deem essential in watching and caring for the health of our President, I will give a few of my personal experiences during my service as an object lesson of what may present itself to the White House physician.
While on duty caring for the health of the National Personnel in Washington, D. C., in 1898, I received an order to accompany President McKinley, members of the Cabinet, and invited guests to the Atlanta Jubilee, Tuskegee, and Montgomery, Ala., Savannah and Macon, Ga., December 13 to 20. Mrs. McKinley and ladies of the cabinet were to accompany the party. With an emergency outfit I reported to the President and was assigned a compartment in a car adjoining his. There were about fifty persons on the special train. This being the first time I had been thrown in such close contact with the members of so august an assembly, I felt the responsibility correspondingly heavy. However, as it happened, I had only to care for minor ills. At Atlanta I was called upon for the first time to attend Mrs. McKinley, and discussed with the President her condition.
This particular tour of 2187 miles was delightful, even if the responsibility was great. As an official member of the President's party, I had to participate in everything and remain always near the President. Returning to Washington I resumed my duties at the Naval Dispensary and looked upon the very pleasant experience as a thing of the past, as I thought that Surgeon General Sternberg, who had succeeded General Leonard Wood as White House physician, would continue. To my surprise, a few days later, the President sent for me and directed that in the future I was to be White House physician and that I should make two calls, 10 a.m. and 10 p.m. at the Executive Mansion, and to hold myself in readiness to accompany him and Mrs. McKinley whenever they left Washington. I realized that this, in addition to my duties at the NavaI Dispensary, would be difficult, and also that the duties at the White House would have to be my first consideration. Mrs. McKinley, as was generally known, suffered with a mild form of epilepsy and other ailments since the birth of her last child, and the shock of the death of their children. I spent much time in the study of her condition and proper care in conjunction with noted specialists, and inside of the year I had her case well in hand. I was always at the call of my eminent patients and I had the greatest consideration that could be given a family physician, always welcome and invited, with Mrs. Rixey, to all the private and public entertainments. The relationship was that of the devoted family physician and his patients, and just here let me say that this continued through my whole time of service as White House physician, lasting over ten years.
The summer of 1899 was spent at Hotel Champlain, Bluff Point, N. Y., and it was the White House for the time being, all business being transacted from the President's quarters. Here I endeavored to have the President walk as much as possible and drive in an open trap. That was before the day of the automobile.
Touring With The President
The next tour of the President was to Chicago and the Northwest from October 4 to October 19, 1899. The members of this party were Mrs. McKinley, as the only lady, and most of the Cabinet. The distance traveled by special train was 5009 miles. The President or his physician were with Mrs. McKinley constantly and she stood the tour better than I expected. Before starting on a tour the President always consulted me as to how it would affect his beloved wife and he would give up the tour rather than have her run any risk to her health. The responsibility was correspondingly heavy on me; but I knew the President considered this long tour important as well as the still longer one from April 19 to June 15, 1901, from a campaign standpoint. There was an insistent demand from all sections of the country to hear him and he thought it desirable to speak personally to the larger body of the American people on the eve of his nomination and election.
I expressed my deep concern as to Mrs. McKinley being able to stand such a strenuous journey, but her anxiety to go with her husband finally prevailed and I reluctantly gave my consent. I knew that I would have every assistance the country could afford if she should be unable to continue the tour. All went well and she seemed to enjoy the immense enthusiasm which everywhere greeted the President. We had traversed Virginia, Tennessee, Alabama, Texas, New Mexico, Arizona, and arrived at Los Angeles, Calif., on the 8th of May, just ten days after leaving Washington, D. C. Mrs. McKinley was not so well and gradually developed a slow fever with a bone felon (Whitlow) forming on her left thumb. This was relieved by operation and then dysentery developed. This, in her weakened condition, was serious, and I admonished the President that his wife must have absolute and complete rest. Mr. Henry Scott of San Francisco had offered his home to the President and I advised that we go there by special train. He at once ordered that the tour be continued and his place be taken by Secretary Hay, Postmaster General Smith, Secretary Long, Secretary Hitchcock, and Secretary Wilson, who were in the party, and when they had completed the California itinerary they were ordered by the President to report to him at San Francisco.
The President, Mrs. McKinley and myself, left Los Angeles on May 12. I soon had my patient where we could make the best fight for her life. Her strength was going fast. We had made nearly half of the 10,581 miles which the tour called for, and I felt that even if Mrs. McKinley should improve she could never finish the tour as planned I so informed the President and the rest of the tour was given up
I immediately called in consultation Dr. Hirschfelder, Dr. Cushing, and Dr. Gibbons. More than once we almost considered our patient hopeless, but heroic efforts prevailed, and on May 25 she recovered sufficiently for us to start back to the White House.
During the time the Henry Scott home was occupied by the President it was the official White House and everything the city could do was done for its inmates. When I reported to the President that at our consultation on the 24th of May it was decided that it was reasonably- safe to move his wife to Washington, he said: "That will not do, you must decide that it is safe."
I had informed my confreres that Mr. McKinley would object to the word reasonable so I called them together again and, after conscientious consideration, we eliminated the word and immediate preparation was made for the start.
I left nothing undone to make the trip safe, a special train, two trained nurses, everything that could be needed in an emergency -- even a tank of oxygen was put on board. The train was to run slow or fast or be sidetracked as the patient's condition demanded. Dear Mrs. McKinley was so anxious to be home that she aided me immensely on this trip. Her condition on arriving at the White House was as good or better than when she started. Early in June, Mr. McKinley decided that he would take Mrs. McKinley to their old home in Canton, Ohio. It was made the White House for the rest of the summer and I was ordered to continue on duty with them and to live in their home. Mrs. McKinley steadily improved and was in better health when we left Canton than she had been since I knew her.
Shot in The Line of Duty
Early in September, 1901, the President's party went to the exposition at Buffalo, N. Y. Having been inaugurated for his second term in March and his wife so much improved in health, the President never seemed so happy as when he left his Canton home for Buffalo. Here the crowds of people all trying to get as near him as possible gave me great concern. At 4:07 p.m., September 6, 1901, he was shot by Leon Czolgosz. "In line of duty while receiving the people," was the heading of my official report to the Navy Department. This report is on file and is a matter of history. The hope, fear, and agony of the next seven days cannot be expressed in words. He died at 2:15 a.m., September 14, 1901. The sorrow of a whole people was tragically impressive to witness, as I did from Buffalo, N. Y., to Washington. The official funeral services at Washington and the interment at Canton, Ohio, demonstrated what a firm hold McKinley had on the affections of the American people.
During all this I was bowed down by my personal loss but not for one moment did I forget my professional charge, Mrs. McKinley. Her grief for her idolized husband was heart-rending and strong mediums had to be administered to enable her to be with her Dearest (as she called the President).
After the interment at Canton I remained in Mrs. McKinley's home until her condition warranted my leaving, about October 1, when I resumed my duties at the Naval Dispensary in Washington, and by direction of President Roosevelt I was to continue my duties as White House physician. At the same time he directed that I should go to Canton to see Mrs. McKinley as often as necessary. A trained nurse was left with her and her family physicians, Dr. Philips and Dr. Portman of Canton, were to keep me informed as to her health. In the professional care of President and Mrs. McKinley I had a patient who, on account of his invalid wife, refused to leave her to take proper exercise, and, indeed, the only exercise he did take was short walks and drives usually in a closed carriage. The result was that he had poor resistance to disease or injury, as was proven when stamina was needed following the fatal shot.
President McKinley was most appreciative of my professional services as White House physician and informed me a few months before his death that he intended to appoint me Surgeon General of the Navy when the vacancy should occur, which would be in about a year.
After his death, Mr. Roosevelt carried out Mr. McKinley's promise and I was not only White House physician and Chief of the Bureau of Medicine and Surgery of the Navy, but also had the professional care of many friends in private and official life. The duties of White House physician under the Roosevelt administration were entirely different from those of the previous one, as the President and Mrs. Roosevelt and the six children were devoted to the outdoor life, and all in good health. Deciding that the worst I would have to contend with professionally would be children's diseases or accidents, I fitted up in the White House an emergency outfit and planned to care for contagious or infectious disease if occasion should arise, in order that the official White House would not be quarantined on account of infectious disease among the children. My foresight proved of great service as cuts and bruises were frequent; but Archie's attack of diphtheria in 1907 was the only serious contagious case. The President himself was seriously injured in the collision of his automobile with a trolley car in which one of the secret service men was killed. It was part of my service to accompany the President on his outing trips, hunting, riding, walks, etc. We rode horseback from twenty-five to one hundred miles a day. We had many long walks, wading or swimming streams. The hunting trips were for all kinds of game, big game being his preference. My services on these trips were frequently required, not only for the President but for others who might be of the party. When at the close of the Roosevelt administration I was reIieved of duty as White House physician I realized how great had been my sense of responsibility.
During the time of my service at the White House I was consulted by both Presidents as to important health appointments, notably in the appointment of Dr. White in regard to the appointment he still holds as the head of the St. Elizabeth's government asylum for the insane, and on the occasion of President Roosevelt's visit to the Panama Canal I assisted him in his inspection in all matters pertaining to the health of the employees of this great undertaking and I was glad to be of considerable help to General Gorgas in obtaining the necessary authority for carrying on his great work in the Panama Canal Zone. Likewise, I was consulted on all matters of sanitation and health, and after I was made Chief of the Bureau of Medicine and Surgery my position at the White House enabled me to obtain many important reforms in my own Corps and to assist the sister services of the Army and Public Health.
Doctors for Taft, Wilson, Harding and Coolidge
President Taft succeeded President Roosevelt and elected to have an Army Medical Officer to relieve me of duty at the White House, Col. M. A. Delaney. President Wilson succeeded President Taft and appointed P. A. Surgeon Cary T. Grayson of the Navy as his official White House physician. Surgeon Grayson came into the Navy during my administration of the Bureau of Medicine and Surgery and was with me occasionally at the White House and notably on the one-hundred mile ride made by President Roosevelt, Major Archibald Butt, and myself, to Warrenton, Va., and return the same day. His service was so much appreciated by Mr. Wilson that he was promoted over the heads of two grades of older medical men from the rank of Surgeon, Lieutenant Commander to Medical Director, Rear Admiral, an unprecedented action, but not more so than the unprecedented service he was called upon to render President Wilson in foreign countries as well as at home.
President Harding elected to have Dr. Sawyer as his official physician, and gave him the rank of Brigadier General in the Army, and he had Past Assistant Surgeon Boone of the Navy as his assistant.
A short time after President Harding's death I wrote to General Sawyer and suggested that he write an official report of President Harding's illness and death as he was his official physician and it would become a matter of record and of great interest to the people and profession. He replied as follows:
President Coolidge has an army surgeon, Major Coupal, as his official physician.
In conclusion I wish to emphasize the importance of the President's health while in office, and in caring for his physical well-being among many other things I suggested these simple rules: Ten minutes setting-up exercise before breakfast, one hour's walk before going to his office, from one to three hours' exercise in the open air before dinner at 8 o'clock. These simple suggestions as to exercise, accompanied by proper advice of the White House physician as to observing ordinary rules of diet and personal hygiene, will help greatly if illness or injury should come to the President.
How would you like to shake hands with thousands of persons who desire to express their admiration and affection by squeezing your hand until it swells? In my opinion the President should not shake hands on the occasion of large receptions of the people. Instead, as each one's name is called and he passes in close review the President can greet him or her as cordially without shaking hands. A good rule might be that as each person in the line approaches the President he should place his right hand over his heart instead of reaching for the President's hand. It would seem that the few thousand who would forego the handshaking would be glad to do so in order that the tax on the President's energy might be reduced to a minimum and the prevention of such a terrible tragedy as came to President McKinley.
As to the White House physician, he must always sink his own interests in that of the health of the President and of his personal and official families. In other words, his desires, pleasures, and all other duties must be subordinated and devoted to this special service.
a pp.454-461Comment: Dr. Rixey was the White House physician for both William McKinley and Theodore Roosevelt.