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Is there a Doctor in the (White) House?
The Medical Care of our Presidents
Tracing the evolution of the White House Physician illuminates
the changing practice of American medicine and the incredible pressures
that confront physicians when their patient is the President.
There are no specific criteria for the selection of the White House
Physician to ensure that the most qualified and appropriate person
is selected for the position. Presidents have chosen their own physicians.
Their choice has often been one of convenience, or as the result
of friendship, geographical location, or expediency. Rarely has
the choice been based solely on professional medical skills and
experience.
In reaction to past cover-ups and criticisms of presidential medical
treatment, questions have arisen regarding the current system of
providing medical care to the President. Does the present system
ensure that the President obtains state-of-the-art medical treatment?
What can be done to ensure the best medical care?
Many point to the White House Physician as the logical person to
determine the President's state of health and ability to carry out
the responsibilities of the office. But how can we be sure that
the White House Physician is the best person to provide this vital
information? Can the public be assured of the White House Physician's
objectivity? Should the White House Physician be loyal to the President
or to the nation? Can the White House Physician be both?
18th Century Medicine
Physicians associated health with balances among the body's four
fluids or "humors" - blood, phlegm, yellow bile, and black bile
- and the strength and elasticity of the blood vessels and nerves.
The body was healthy when these fluids could freely circulate or
be expelled from the body. There was no concept of specific diseases
with specific causes and treatments. Doctors focused on their patients'
symptoms and provided appropriate therapies. Preference was given
to drugs and treatments that had observable results - stimulants
such emetics, diuretics, and electricity, and sedatives such as
narcotics, cathartics, and bleeding.
19th Century Medicine
Medicine underwent enormous changes in the 19th century. Diagnostic
instruments progressed form the invention of the stethoscope in
1816 to the discovery of X-rays in 1895. Concepts of disease were
transformed from the humoral theory to precise identification of
specific disease-causing microorganisms. By the time of the Civil
War, chloroform and ether had been used as anesthetics for almost
20 years. Lister's antiseptic surgical techniques followed the germ
theory of Pasteur and the bacteriology of Koch in the latter half
of the century.
20th Century Medicine
This century has seen major developments in the diagnosis, treatment,
and prevention of disease. The body-imaging of X-rays has been complemented
by CAT-scans and MRIs, providing more information on physical changes
in the body, while biochemistry and molecular biology have provided
new insights into how the body functions. Asepsis (infectious) and
antisepsis (lack of infection), fully established by the beginning
of the century, have expanded the range of successful surgical procedures,
and the discovery of antibiotics such as penicillin in 1945 has
helped diminish the threat of infection. New vaccines have made
it possible to prevent many former public health hazards such as
polio and rabies, and have drastically reduced mortality from childhood
diseases.
Former White House Physicians
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Robert King Stone, M.D.
Photograph, date unknown
Reproduced from Joshua L. Chamberlain (ed.), Universities
and Their Sons... (1902)
Dr. Stone treated president Abraham Lincoln and his family
while they were living in the White House. |
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James Craik, M.D.
Portrait, date unknown
Reproduced from James Evelyn Pilcher, The Surgeon Generals
of the Army of the United States of America (1905)
During the 18th and most of the 19th centuries there was
no physician on duty at the White House. Presidents used family
physicians, or solicited treatment from prominent civilian
or military physicians whose fees they paid out of their own
pocket. Dr. Craik was a personal friend of President George
Washington and his family. |
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Brigadier General Jedediah Hyde Baxter
Portrait, date unknown
Reproduced from James Evelyn Pilcher, The Surgeon Generals
of the Army of the United States of America (1905)
Dr. Baxter served both Presidents James A. Garfield and Benjamin
Harrison. It appears that professional competition and animosity
kept his name from being included among the attending surgeons
after Garfield was shot. Harrison appointed him Surgeon General
of the United States Army in 1890. Often the president's physician
was rewarded by being appointed Surgeon General of the Army
or Navy. Today presidents continue to rely on military doctors
for their treatment. |
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Basil Norris, M.D.
Photograph, date unknown
Reproduced from supplement to Notes and Abstracts, Vol.
11 (1927)
Presidents increasingly began to rely on government medical
services in the mid-19th century. This was a custom rather
than an officially sanctioned and financed activity that caused
some controversy. Dr. Norris was a surgeon in the United States
Army who attended Presidents Andrew Johnson and Ulysses S.
Grant during their terms of office |
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