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HOUSE CALL WITH DR. SANJAY GUPTA

Medical Secrets Behind Presidential Health

Aired October 2, 2004 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


BETTY NGUYEN, ANCHOR: Good morning. I'm Betty Nguyen.
Now in the news, hospitals say U.S. air strikes overnight killed nine Iraqis and wounded 12 others, several children among them. The U.S. military describes one of the attacks as a precision attack on a terrorist site and says only terrorists, no civilians, could have been killed.

They're worried about oil prices. Meeting in Washington, finance ministers of the Group of Seven industrial nations said soaring oil costs are a threat to the global economy. And one minister said if they're based on fundamental factors like real scarcity, they may not be temporary. The price of crude oil passed $50 a barrel in Friday trading.

And in Washington state, scientists think the mountain is not done yet. Check it out. Mount St. Helens briefly spewed steam and ash yesterday. It's the first eruption in 18 years. Scientists called it a throat clearing, and readings suggest that pressure is building again inside the volcano.

That is the news. HOUSE CALL with Dr. Sanjay Gupta begins right now.

DR. SANJAY GUPTA, HOST: Good morning. Welcome to a special edition of HOUSE CALL. We're talking about the medical secrets, stresses and behind the scenes care of the president of the United States.

Along with the prestige of holding this job comes an awesome responsibility. The effects of which constant day-to-day pressure and stress can take their toll.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): In 1952 on the television show Quiz Kids, presidential candidate Adlai Stevenson asked a group of children if they'd want to be president of the United States.

ADLAI STEPHENSON, FORMER PRESIDENTIAL CANDIDATE: Harvey, how about you?

UNIDENTIFIED MALE: No, I don't think -- I don't think. Frankly, I don't think so, because the president he has to have -- like you said, he has a lot of worries.

GUPTA: Harvey may have been on to something, as being president may not only be the toughest job in the world but also the most stressful. Why?

CAPRICIA MARSHALL, FORMER WHITE HOUSE SOCIAL SECRETARY: The constant demand, from everyone and everywhere.

GUPTA: Capricia Marshall spent eight years in the White House as social secretary during the Clinton administration.

MARSHALL: It's not just the issues that we're dealing with in our country or within the White House. It's issues that are occurring across the globe.

GUPTA: Many of our leaders were seriously ill while in office. Besides cardiovascular illness and stroke, just in the last century, U.S. presidents have suffered from high blood pressure, cancer, diabetes, respiratory illness, gallbladder disease, kidney disease, prostate disease, Addison's Disease, Grave's Disease, pneumonia, ileitus and obesity.

Dr. Gerald Post, an expert in political psychology, says the toll of the job can be seen in their faces.

DR. GERALD POST, POLITICAL PSYCHOLOGIST: The pictures of the president and how he ages from the day of inauguration show a really disproportionate amount of aging in response to that stress.

GUPTA: So do you still think you want this job?

STEVENSON: Brenda, would you like to be president? And don't you think it's time we...

UNIDENTIFIED FEMALE: I haven't made up my mind yet.

(END VIDEOTAPE)

GUPTA: We all experience job-related stress. While most of its not presidential in magnitude, it still can be quite hard on our bodies.

Government figures tell us stress related disorders are fast becoming the No. 1 reason for worker disability. We know that stress can cause cardiovascular disease, stomach problems, immune system vulnerability and may play a role in diabetes and depression.

We're also going to talk more about the mental health of presidents later in the show.

But first, let's bring in presidential historian Robert Gilbert. He's a professor at Northeastern University. He's also author of "The Mortal Presidency: Illness and Anguish in the White House."

Welcome, sir.

ROBERT GILBERT, AUTHOR, "THE MORTAL PRESIDENCY": Thank you very much. Good to be here.

GUPTA: Thank you. As you know, we have a special on this topic airing this weekend on Sunday at 9 p.m. And we've actually interviewed you for this.

You brought up what I thought was a pretty interesting fact, that several presidents in the past century have died from stress-related illness. Talk about that.

GILBERT: Well, the stresses of the presidency are different from the stresses of any other position. And if you compare the longevity of life of American presidents to the longevity of life of members of the Supreme Court and members of the legislative branch of government, there's a striking difference.

Members of Congress and members of the court tend to exceed their life expectancy by many years.

GUPTA: Why is that?

GILBERT: Well, I think the -- the nature of the stress is very, very different.

When members of Congress adjourn -- for example, when they go home at Christmas time and when they go home for their summer recess and recesses during the year, the media leave them alone. They have no responsibilities. They can relax. They can go on vacation.

In June of every year, the justices of the Supreme Court go home to their homes. And they relax and they're not -- they're out of the public eye until the following October.

But presidents of the United States, the office travels with them. They -- they never leave the office behind them. Whether they're on vacation or in Washington, they're always president of the United States.

GUPTA: Let's keep talking about the health, both physical and mental, of the president. We sent our cameras to find out what people wanted to know about the president's health. Take a listen to this, sir.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: I'm curious to know who was the most physically fit president.

(END VIDEO CLIP)

GUPTA: And many of our presidents, as you know, have been physically active. Who do you think wins the award of fittest president?

GILBERT: Well, I think it's difficult to really know with certainty. But I think the first name that would come to my mind would be Herbert Hover.

Despite being president during the Great Depression and having just incredible amounts of stress during his four years in office, Herbert Hover didn't suffer from any physical ailments that I'm aware of. And, also, he managed to survive to the age 90.

GUPTA: Wow!

GILBERT: So of all of the presidents, he's the one that stands out in my mind as perhaps the most physically fit.

GUPTA: We're talking to Professor Robert Gilbert. When HOUSE CALL returns, medical cover ups at the White House.

(BEGIN VIDEO CLIP)

ANNOUNCER: Coming up on HOUSE CALL...

ROBERT FERRELL, PRESIDENTIAL HISTORIAN: He gave Kennedy shots in the throat, which is almost horrible to think of, because you doesn't know what he was putting in there.

ANNOUNCER: From chronic pain to strokes and hidden surgeries. Health secrets presidents have tried to hide.

Plus, with first-rate healthcare, do presidents have a longer life expectancy than the average American? The answer to our "Daily Dose" quiz after the break.

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

ANNOUNCER: Checking the "Daily Dose" quiz, we asked, "Do presidents have a longer life expectancy than the average American?"

The answer is no. Given the enormous pressures and stresses of the job, over two-thirds of presidents have failed to reach the life expectancy of average Americans.

(END VIDEO CLIP)

GUPTA: That's not a very good statistic at all.

We've been talking about the health of the nation's commander in chief. So how much do we really know about any president's health? If history is any guide, the answer is, not nearly as much as you think.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: I, John Fitzgerald Kennedy...

GUPTA (voice-over): America's youngest elected president, 43- year-old John F. Kennedy.

A veil of secrecy has often shrouded the Oval Office. And when it comes to Kennedy's medical history, there was something lurking beneath the surface. FERRELL: There's only one word for it. It's weird.

GUPTA: Presidential historian Robert Ferrell says Dr. Max Jacobson, known for his work with high society, was never officially the president's doctor but treated him nonetheless.

Farrell says his research found that Jacobson, known as Dr. Feelgood, gave what he called, quote, vitamin injections to the president.

FERRELL: With dirty hands he would spill pills out on a desk, and he would take whatever suited his fancy.

When Kennedy went to meet with Khrushchev, Jacobson was along and he gave Kennedy shots in the throat, which is almost horrible to think of because you don't know what he was putting in there.

GUPTA: What was in there, Ferrell says, were amphetamines.

Some 40 years after the president's assassination, the JFK Library granted historian Robert Dallek access to Kennedy's medical records.

Dallek says the records paint a very different image from what many Americans thought of the young president, revealing a president in almost constant pain from a bad back.

ROBERT DALLEK, PRESIDENTIAL HISTORIAN: They were shooting him up with procaine (ph). He couldn't go up the staircase the way a normal person might, couldn't roll over in bed at night. He couldn't pull the shoe and sock on his left foot.

GUPTA: Kennedy flatly denied his Addison's Disease, a hormonal deficiency that can cause fatigue, low blood pressure and weight loss. But he had it.

Dallek believes President Kennedy showed sound judgment in the face of great suffering.

(END VIDEOTAPE)

GUPTA: President Kennedy had chronic pain along with his Addison's Disease and his injured back. He was on so many medications to deal with these diseases and pain, it was pretty amazing, really, that he functioned at such a high capacity.

Presidential historian and author Robert Gilbert has written about all these sorts of cover-ups.

Professor Gilbert, a lot of people so fascinated with Kennedy. What do you think about the fact that someone could function as president on that many medications? And how did it stay a secret while he was president?

GILBERT: Well, I think a number of presidents have functioned with severe illnesses. I think Kennedy did function at a high level. I believe he missed one day of work in three years in the White House because of his illnesses.

I think the White House tried very hard, and I think they tried successfully, to conceal those illnesses. And the media in those days was not as aggressive as it is now. I don't know if it would be quite as easy today to conceal this sort of thing as it was 40 years ago.

GUPTA: I can't imagine that it would, with organizations like CNN and the cable news network.

And as you know, JFK wasn't alone in keeping his medical problems a secret.

In the summer of 1893 President Grover Cleveland had a major operation aboard a friend's yacht while the country was embroiled in a financial crisis.

(BEGIN VIDEO CLIP)

FERRELL: He was on the yacht for two or three days. He went up to Massachusetts. And what happened there was that he was secluded from the public for perhaps six weeks.

GUPTA (voice-over): The president had an operation to remove cancer in his jaw. The operation was covered up from the public for 24 years.

A plaster mold was made of Cleveland's jaw after the surgery. You can see a hole even bigger than a golf ball. A portion of that tumor is in a Mutter Museum in Philadelphia.

Historians say another classic cover up came in 1919 when Woodrow Wilson had a massive stroke.

FERRELL: He was just a shell of a man. It was impossible for him to show any large decisiveness. He could concentrate on a problem and not very well at that, for perhaps 10 minutes. And for the rest of it, just simply shuffled around the White House.

Servants had to remove rugs when he went from room to room. And you could hear the tapping of his cane.

GUPTA: Only his wife and a few associates knew how ill the president really was. They told the public their leader was suffering from exhaustion.

(END VIDEOTAPE)

GUPTA: And we're talking with Professor Robert Gilbert about this.

Let's get to an e-mail now. Rosalind in Arkansas wants to know, "Even though the physical examination results are made public, will a physician withhold a public diagnosis if it is in the best interest of the country? Also, does a president have the right to not disclose some information to the public?"

What about it, professor? This seems like sort of a fine line here between medical privacy and the country's rights.

GILBERT: Well, first of all, yes, the president does have a right to conceal parts of his medical records from the country. I think there -- if a medical condition doesn't impact on a president's performance in office, it really isn't any of the public's business, and the president, I think, would be justified in concealing it.

GUPTA: OK. Well, I mean, it's tough to sort of know where that line is drawn sometime.

But let's continue talking about the president's team. There is a team that stays close to the president, as close as the Secret Service at times. We'll tell you who they are when HOUSE CALL returns.

(BEGIN VIDEOTAPE)

DR. E. CONNIE MARIANO, FORMER WHITE HOUSE PHYSICIAN: In this compartment we have an operating room table that can be brought out and placed in the center of the room.

ANNOUNCER: Treating the first patient. We'll go inside the White House when we come back.

Plus, could your commute be killing you? A new study takes a look.

But first here's a tip from our health conscious Bod Squad.

HOLLY FIRFER, CNN CORRESPONDENT: You're on your third soda, fifth bag of peanuts and your tenth "People" magazine, and there's still three hours to go.

DAVID BARTON, FITNESS TRAINER: One, two, three, four, five, hold it.

FIRFER: David Barton says don't just sit there: tighten those glutes, strengthen those abs and build those muscles.

BARTON: You can squeeze and feel the muscle tighten. Feel that?

FIRFER: He's developed a workout routine in the sky with Song Airlines as he demonstrates with our interns in our studio.

BARTON: I've came up with a way of stabilizing the body in a seated position while you're doing these exercises. So you can get a great workout, work your entire body in 15 minutes.

FIRFER: For $8 you can buy the compact workout kit and use it while traveling in the air, or you can even use it in your hotel room, at home or in your office.

JOANNE SMITH, SONG AIRLINES: We want them to feel refreshed and rested and we want those glutes to be a little sore.

FIRFER: Holly Firfer, CNN, Atlanta. (END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL.

We've all heard of the Secret Service. They're there to protect the president at all times. But there's another team, as well, that plays a crucial role in maintaining the president's well being.

They're called the White House medical unit, ready to administer immediate medical care to the president at any time, anywhere in the world.

(BEGIN VIDEOTAPE)

UNIDENTIFIED FEMALE: You're on his plane. You're on his helicopter. You're in his motorcade. The doctor is always within a few feet away, so you essentially shadow the president.

GUPTA (voice-over): Dr. Connie Mariano ran the White House unit under President Clinton.

Five military doctors, five nurses, five physician assistants, three corpsmen or medics and three administrators. The mission: executive medicine. Keep the president healthy day to day.

And protective medicine. Treat the commander in chief in a worst-case scenario, like an assassination attempt.

The nerve center for White House medical care since President Hoover is an office next to the map room, across from the elevator the president takes to get to the West Wing from his residence upstairs.

MARIANO: It's beautifully situated because it's right opposite the elevator so the president and first family can just walk across.

GUPTA (on camera): How would you rate the medical facilities of the White House?

MARIANO: At the White House itself it's very much your typical doctor's office. It's -- it's got a private exam room on the ground floor, which has a crash cart.

GUPTA (voice-over): A crash cart is used for emergency resuscitation. The goal, stabilize the president and get him to a hospital.

Air Force One also comes equipped with tremendous medical capabilities, including a pharmacy, a burn kit, even an operating room table.

MARIANO: This is a patient like no other. Their decisions impact millions of lives.

(END VIDEOTAPE) GUPTA: Also an interesting note on that point, when President Clinton went to Africa, there were no trauma centers nearby, so the Air Force sent a field hospital complete with surgeons and set it up in an airport hangar just in case. They also brought four units of the president's blood type.

We're talking with presidential historian Professor Robert Gilbert of Northeastern University. You know, we've received lots of questions about the medical care of the president. Let's try and get to a couple now.

Teri in Kansas asks, "Does the first family have access to the same medical team as the president? What type of education and experience does each member of the team have?"

Let's start with the first part of that. Does the medical team also treat the whole first family?

GILBERT: Yes, as a matter of fact, not only the first family has access to the medical team, but all employees of the White House have access to them. So the White House medical unit, which has gotten bigger in recent years, is a -- is a very busy place.

GUPTA: And most people think that if you're the president's doctor, you've got to be one of the nation's best. Are they sort of hand picked to be the president's doctor?

GILBERT: Well, it -- various presidents do it different ways. President Reagan ended up choosing his -- the first lady's father's partner to be a White House physician. Different doctors have used military physicians. So it varies very, very greatly according to the president.

GUPTA: And I know a lot -- I know the current White House physicians actually from the military, actually a family practice doctor from the Air Force.

Another e-mail now from Russ in Maryland, who asks, "Is it true that the president's food is tasted before he eats it?"

Are there such things as actual professional food tasters for the president still?

GILBERT: Well, I don't know if there are food tasters. But I do know this. The Secret Service exercises very tight control over the president's food: the way it's prepared, where it's prepared.

And my understanding is that the president's food is always prepared separately from everyone else's food. So in this sense, I think there is a testing of the president's food.

GUPTA: I don't know that I'd necessarily want that job.

When we come back, assessing the mental health of the commander in chief. Stay tuned.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE: It's all right to have a physical abnormality, gallbladder problem or something of that sort. But to have a mental problem is very touchy.

ANNOUNCER: How much do we really know about the psychological well being of our presidents? We'll take a look coming up next on HOUSE CALL.

But first, some of this week's medical headlines in today's edition of "The Pulse."

CHRISTY FEIG, CNN MEDICAL CORRESPONDENT: The popular pain killing drug Vioxx was pulled from the market this week after a new study showed long-term use of the drug could increase your risk of heart attack and stroke.

Merck and Company, the maker of Vioxx, voluntarily took the drug off the market, stating it was the only responsible course of action.

Vioxx has annual sales of more than $2.5 billion worldwide and is used to treat arthritis and severe menstrual pain.

Suburban sprawl may increase conditions like high blood pressure. A study by the Rand Corporation found those who live in suburban areas are more likely to drive cars rather than walk. This often promotes obesity and increases a person's risk factors for conditions like high blood pressure, arthritis and breathing difficulty.

Christy Feig, CNN.

(END VIDEOTAPE)

GUPTA: For more information on presidents, their health and medical cover-ups, go to CNN.com/FirstPatient. You can view a time line of presidential health issues and find firsthand accounts from those treating the first patients, including the doctor who treated a dying President Kennedy.

We've been talking about the physical health of the president, but a recent CNN/Gallup poll showed the majority of Americans, 79 percent, think we should require an annual mental health checkup as well, for conditions such as depression and Alzheimer's.

Experts have speculated about the mental stability of presidents Richard Nixon, Lyndon Johnson, Ronald Reagan, Calvin Coolidge to name a few.

Presidential historian Robert Gilbert can give us some insight on this sensitive issue. We expose a little bit further in this weekend's primetime special, but Professor, let's take a quick look at some of these claims.

First of all, Richard Nixon.

GILBERT: OK. Well, Richard Nixon certainly showed some signs of paranoia. He was obsessed with enemies, felt that enemies surrounded him and he had to be prepared to battle against them at all times. Never publicly diagnosed as having paranoia, but it might very well have been.

GUPTA: What about Ronald Reagan? Lots of concerns with him and Alzheimer's.

GILBERT: Well, Ronald Reagan -- Ronald Reagan's doctors maintained that his memory loss was the memory loss associated with aging rather than memory loss associated with Alzheimer's. So whether or not he had it while he was president, uncertain. Probably not.

GUPTA: Calvin Coolidge?

GILBERT: Calvin Coolidge. President suffering from clinical depression following the death of his son in July of 1924.

The White House physician, who was not a psychiatrist, did describe Coolidge in his unpublished autobiography as being mentally unbalanced and mentally deranged. And Coolidge's secretary also said that the president was showing signs of mental illness.

So definitely, Coolidge was a president who had psychological difficulties.

GUPTA: Really interesting stuff. Could talk about it all day, but that's all the time we have for today.

I want to thank Professor Robert Gilbert from Northeastern University for your insights.

Thank you, as well, at home for your questions.

Be sure to tune in Sunday. I'm going to take you inside the most stressful job in the nation. The special is called "THE FIRST PATIENT: HEALTH AND THE PRESIDENCY." That's Sunday at 9 p.m.

Remember this is the place for the answers to all of your medical questions. Thanks for watching. I'm Dr. Sanjay Gupta.

Stay tuned now for more news on CNN.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com


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