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Fit To Lead: An Historical Overview Of The Health Concerns, And Medical Care Of The U.S. Presidency

Aired October 11, 2008 - 20:00   ET


DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT (voice over): It has been called the toughest job in the world, and the most important.

JOE LOCKHART, FMR. CLINTON PRESS SECRETARY: There is no job in the world that you have that much pressure 24 hours a day, 7 days a week, all year long.

GUPTA: The President.

ARI FLEISCHER, FMR. SPOKESMAN FOR GEORGE W. BUSH: It is a physically demanding job. The hours are long, stresses are great, there is a lot of travel. Everyday is a crisis. That is it, everyday is crisis. Crisis is normal at the White House.

GUPTA: But a medical crisis is something to avoid at all costs, so there is a doctor, always on call, never far from the president.

FLEISCHER: The infrastructure to keep him healthy if, God forbid, something happens this problem (ph) is massive.

GUPTA: Look here. That's a medical office right in his own home; ground floor of the White House residence. Here's an operating suite on Air Force One.

UNIDENTIFIED FEMALE: An operating room table. There is an operating room light that can be brought forward around to the front of the table.

GUPTA: It is stocked with surgical instrument and plenty of the president's blood type. Nothing is spared to keep him safe. Nothing is left to chance.


GUPTA: You know, it has been said that when the president sneezes, the stock market catches a cold. There is no question that his health is of international concern. So when something goes wrong, when the news hits, alarm bells go off around the world.


GUPTA (voice over): September 15, 1979. President Jimmy Carter collapses while running a 10-k race near Camp David. At first nobody knew what happened. The only thing for sure, the most powerful man in the world was down. Sam Donaldson was one of the many reporters who followed President Carter.

SAM DONALDSON, CORRESPONDENT: By the time we heard anything about the incident, they ruled out heart attack; they ruled out something really terrible. He simply collapsed from the combination of exhaustion. He had lost weight. He had run himself ragged, if you will.

GUPTA: Jody Powell was White House spokesman.

JODY POWELL, CARTER WHITE HOUSE SPOKESMAN: Unfortunately there was a picture and that -- anybody that collapsed, and this is being sort of carried off, doesn't look great.

GUPTA (On camera): If this had happened in isolation or just with close some people at the White House, do you think the White House would have told people what had happened?

POWELL: You are not a private citizen. You are the president of the United States and health matters are something that people kind of have a right to know about.

GUPTA: A right to know.

January 8, 1992, President Bush is in Japan at a state dinner. Then came this shocking moment.

UNIDENTIFIED MALE: What we saw because a camera had been left on was this video of President Bush slumping under the table and lots of excitement.

GUPTA: Former CNN White House Correspondent Charles Bierbauer had interviewed him just two hours earlier.

CHARLES BIERBAUER, FMR. CNN WHITE HOUSE CORRESPONDENT: You go through the questions and answers, and how are you feeling? Ah, a little tired.

DR. BURTON LEE, GEORGE H.W. BUSH'S DOCTOR: He had been not feeling well going into that dinner.

GUPTA: Bush's doctor, Burton Lee.

LEE: I had taken him aside into a bathroom and I said I think we ought to cancel. He said I can't. This is the dinner with the prime minister.

BEIERBAUER: We couldn't hear what was going on. We could only see these pictures, which only adds to the consternation.

LEE: This was pandemonium. Everybody thought the president died. So, you had an explosion of yelling, screaming, people running around. I got down on my hands and knees and went through people's legs until I got on top of him.

GUPTA: The president was taken away in an ambulance. A few hours later, we learned it was just the flu. For some reporters, uncertainty is fuelled by skepticism. Are they getting the whole story? DONALDSON: There is a difference between lying about something and telling it all. Expanding on it, giving us all the details.

GUPTA: January 14th, 2002. President George W. Bush is eating pretzels and watching football. His spokesman, Ari Fleischer.

FLEISCHER: I get a phone call from the Annie Carter (ph), chief of staff, telling me, well we have a little incident. The president choked on a pretzel, and fainted, hit the table. He is with the Doctor Tubb (ph) right now. You have to tell everybody.

GUPTA: Their strategy? Humor.

GEORGE W. BUSH, PRESIDENT OF THE UNITED STATES: My mother always said, when you are eating pretzels, chew before you swallow. Listen to your mother.

GUPTA: You couldn't miss that bruise on his face.

(On camera): If there had been no physical manifestations would you have still told everybody?

FLEISCHER: The question is, when Annie Carter (ph) called me and told me, I hope to think yes, that if the president passes out, you must tell the country. There are some areas where the president is entitled to medical privacy, there are some areas where he is not. The country is entitled to know fully, everything.

GUPTA (voice over): But that are raises the question. Are there things we never learn about? After all, we don't know everything that happens behind that fence, behind the walls of the White House.

FLEISCHER: I'm getting there.

UNIDENTIFIED MALE: It was the kind of fainting that makes you say ouch.

UNIDENTIFIED MALE: Are you done for the night?


GUPTA (On camera): Do we, as a society, have the right to know about the health of a candidate before they become president?

LOCKHART: We have a right to know everything. I really don't think there is anything off limits, and health is a very important one. Because health impacts your ability to do the job.

GUPTA: Case and point, Franklin Roosevelt. It's 1945 and President Roosevelt is meeting with Winston Churchill and Joseph Stalin in Yalta. The president was in bad shape.

ROBERT DALLEK, PRESIDENTIAL HISTORIAN: Winston Churchill's physician Lord Moran, when he saw him, said the president is suffer a hardening of the arteries of the brain, and he will be dead in three months' time. He was absolutely right. GUPTA (voice over): Roosevelt died two months later.

Allan Solarian (ph), former chief psychiatrist at the FBI, who has studied Roosevelt's health, said the president was so out of it that Stalin took advantage.

ALLAN SOLARIAN (ph), PSYCHIATRIST: Roosevelt's illness had a profound impact on history, because at Yalta we got really exploited Russian, by Stalin.

GUPTA: There are historians who say Roosevelt's illness sealed the fate of Eastern Europe.

What about other presidents? For example, we know that along with cardiovascular disease, high blood pressure and stroke, in just the last century, United States presidents have suffered from cancer, diabetes, respiratory illness, gall bladder disease, kidney disease, prostate disease, Addison's disease, Gray's disease, pneumonia, inflammatory bowel disease and much was hidden from the voting public.

DALLEK: Presidents don't want to release the health records. If there is anything at all in those health records which might give the public pause about giving them the powers of the presidency.

GUPTA: The Clinton White House planned carefully, even for a simple physical. Connie Mariano was President Clinton's doctor at the White House.

DR. CONNIE MARIANO, PRESIDENT CLINTON'S PHYSICIAN: Traditionally you will see White House performed on a Friday afternoon before a three- day weekend, so it's not a big issue. It's not a big deal. You don't want to perform it on a Monday because the news lasts all week.

GUPTA: Whatever the spin, doesn't the public have a right to know the truth? Later, what we know about the health of John McCain and Barack Obama.

But next: Training for the worst. An attack on the president.


GUPTA (voice over): Only two months into his first term, President Ronald Reagan was leaving a hotel after a speech. Reagan is rushed first towards the White House, until he starts coughing up blood, then to George Washington University hospital.

LYN NOFZINGER, FMR. REAGAN AIDE: The president has been shot once in the left chest.

UNIDENTIFIED MALE: He collapsed, and his blood pressure was 70, very low and we put him on the gurney and the residents started IVs and got fluid in him.

GUPTA: Doctors take President Reagan to the operating room for emergency surgery. At the same time a few blocks away at the White House, a decision is made. Not to turn over power to Vice President Bush.

GEORGE H.W. BUSH, FMR. PRESIDENT OF THE UNITED STATES: My view is the more normal everything is the better it is.

DANIEL SCHORR, CORRESPONDENT: One bullet has been removed.

GUPTA: Not formally transferring power to the vice president while Reagan was incapacitated was a mistake, says Doctor Connie Mariano, White House physician under three presidents.

MARIANO: You wind up having the political people tell you what to do rather than having a medical opinion rendered, and advising the political world.

BUSH: I, George Herbert Walker Bush, do solemnly swear.

GUPTA: When he was president, George Bush decided to do things differently. Early in his administration, he met with Vice President Quayle and White House Doctor Burton Lee and others, to decide exactly how to transfer power in a medical crisis.

LEE: I was going to make the call as physician to the president.

GUPTA: Something else. When Reagan was shot, there was confusion and mistakes. For example, Reagan's doctor, the late Daniel Ruby, was there. But not close enough to get in the limo with the wounded commander in chief. Today White House doctors train extensively, at this Secret Service facility in Beltsville, Maryland.

DR. ROBERT DARLING, WHITE HOUSE PHYSICIAN, 1996-1999: There is a city. There is a mock town. We work hand in hand with the Secret Service. They have explosions, weapons, chemicals, probably shouldn't go into too much more, but we try to role play and figure out the various threats that we are the most concerned about.

You can't plan for everything, but you can plan for a lot of it. Everybody is having fun shaking his hand, we are scanning and looking what could happen next. The limousine is following along and the door is open. I'm on the other side of the limo, with my medical bag if something were to happen, I better be in that limousine.

MORIANO: You try to stay out of what we call the kill zone, which is the immediate five or six-foot radius around the president. One of the things I used to teach White House doctors is you can't treat the president if you are dead.

GUPTA: Everywhere the president goes, anywhere in the world, the White House doctor is there, ready to treat the president. They are on the helicopter, on Air Force One, in the decoy limousine. No effort is too much. When the president travels and there is no top-grade hospital nearby, the hospital comes to him. When President Reagan made trips to Bally and Grenada in 1986, an aircraft carrier was stationed offshore in case of a medical emergency.

(On camera): Today, White House medical care is first-rate. But it may surprise you to know that was not always the case. Many treatments given in the 18th and 19th centuries could be downright dangerous.

(Voice over): Such as bleeding, as seen here in the mini series "John Adams".

UNIDENTIFIED MALE: Tell the minister I have presented my credentials.

DR. LUDWIG DEPPISCH, AUTHOR, "THE WHITE HOUSE PHYSICIAN": That was one of the primary treatments of a physician, until almost the Civil War. Obviously that was a mistake.

GUPTA: Then there was callamil (ph), actually toxic mercurous chloride taken by President Lincoln, and others, as a laxative.

Emergency care had problems as well. When President Garfield was shot, it probably was not the bullet wounds that killed him, but infection. Thanks to his team of doctors.

DEPPISCH: Dirty hands, no gloves, no anti-sepsis around the bullet wound. The assassin's first defense was I may have shot the president, but it was his physicians who killed him.

GUPTA: There was no medical office in the White House until 1929. President Hoover had one set up where it is today. It's just across the hall from the elevator the president takes to get to the West Wing from his residence upstairs.

DR. JOHN HUTTON, WHITE HOUSE PHYSICIAN, 1984-1988: We would just greet him as he got off the elevator.

MARIANO: You can hear the three bells ring, and the president's elevator would be coming down. We would all peek outside the open door to watch the president. He would usually wave, and you knew it was a good day. He'd wave or he'd smile. He would give a thumbs up. If it was going to be a little bit of a tense day, he would have his head down.

GUPTA: Reagan's chief of staff, Kenneth Duberstein, worked out a system with the White House doctors.

KENNETH DUBERSTEIN, REAGAN CHIEF OF STAFF: The doctor would come over to my office and push open the door. I knew the president slept well the night before and was feeling good. The president didn't sleep well. Maybe he had an upset stomach. Adjust his calendar a little bit for the day. Everything is OK, proceed as normal.

GUPTA: The reason you had this relationship with the doctor and President Reagan, was there a concern there, or was it because of his age?

DUBERSTEIN: It wasn't a concern in any respects about his age, never entered into the equation. But rather how do you manage the president's time for that particular day?

GUPTA (voice over): Busy or not, sometimes the White House physician needs to intervene. MARIANO: I went over and he didn't look very good. He was nauseous. Points to a glass of water and says I'm drinking water. I said that's not enough. You really need to have some soup and you need to rest. You really need to go home and get some rest.

GUPTA: The White House doctor also takes care of the first family. In a place where proximity to the president means power, the White House physician has an all access pass.

MARIANO: The White House physician is one of the few people, on the 18 acres of the White House , who can go directly upstairs to the bedroom of the president and first lady and say, you know, are you doing OK? I need to take a look, make sure you are OK.

GUPTA: No matter how thorough the care, it doesn't always work. President George Herbert Walker Bush had hyperthyroidism, but no one knew until he collapsed while jogging at Camp David. President Clinton had heart disease that required emergency bypass surgery just three years after leaving office, even though he had years of the best health care in the world.

JOHN F. KENNEDY, FMR. PRESIDENT OF THE UNITED STATES: The torch has been passed to a new generation of Americans.

GUPTA: Next, presidents who hide the truth about their health.


GUPTA: This is the image of a picture perfect president; robust and fully at odds with the truth.

KENNEDY: No one believes that I would be a candidate for the presidency if I didn't think I could meet my oath of office.

DALLEK: If it were known how many health problems Kennedy would have had, it probably would have jettison's his ability to get to the office.

GUPTA: That was 1960. Today, we know the truth. Here's historian Robert Dallek.

DALLEK: Kennedy had spastic colitis; he took steroids, which then touched off severe back problems. He had prostatitis. He had to take a variety of medications to deal with Addison's disease.

GUPTA: But that's not the JFK America saw. He was tan and handsome. A man who loved the outdoors, who loved to sail; a family man who adored his kids. But even at 43 years old, our youngest elected president, Kennedy was in almost constant pain. He was a medical wreck.

Shocked? Don't be. When it comes to presidents, Professor Rick Waterman says it's the image and not the reality that is most important.

PROF. RICK WATERMAN, AUTHOR, "THE IMAGE-IS-EVERYTHING PRESIDENCY: The image of being healthy is something that ties into the image of him being a vigorous president. If you have a president where there are health questions, then you also have questions about how capable they are to handle the day-to-day job of being president of the United States.

GUPTA: One man who was keenly aware of Kennedy's health problems was former White House doctor, James Young. Before he died, Doctor Young showed us the medical briefcase he used to carried whenever he was with the president. He hadn't opened it for years. Inside, row after row of powerful medicine. Darvon compound for pain, morphine as well, Equanil, for anxiety, always ready if Kennedy should need them. He also showed us a second briefcase, a back up; the combination on the lock, 529, Kennedy's birthday.

UNIDENTIFIED MALE: Image has been part of our politics from the beginning.

GUPTA: George Washington's rivals claimed it was the president's height, more than 6'2", that made him popular. Tall, typically wins. Since 1952, when Americans began following candidates on TV, the taller candidate has won the presidency more than two-thirds of the time. Despite what we often hear --

RONALD REAGAN, FMR. PRESIDENT OF THE UNITED STATES: I will not make age an issue of this campaign.

GUPTA: Age is always an issue.

REAGAN: I am not going to exploit for political purposes my opponent's youth and inexperience.

UNIDENTIFIED MALE: When you are talking about older, you are talking about potentially being more experienced, but you are talking about the fact that somebody is advanced in age and questions about whether or not they can be reelected and questions about whether or not they can be healthy throughout an entire term or two terms in office.

GUPTA: At 72, John McCain is 25 years older than his opponent, Barack Obama.

SEN. BARACK OBAMA (D), PRESIDENTIAL CANDIDATE: He is an example of him losing his bearings as he pursues this nomination.

GUPTA: Losing his bearings? Was that a jab at McCain's age? McCain certainly thought so. Here is what his campaign said.

"Let us be clear about the nature of Senator Obama's attack today. He used the words "losing his bearings", intentionally, a not particularly clever way of raising John McCain's age as an issue. A few weeks later, McCain turned the tables.

JOHN MCCAIN (R), PRESIDENTIAL CANDIDATE: I admire and respect Senator Obama. For a young man, with very little experience, he has done very well.

GUPTA: Presidents true to exude good health for the cameras. Bill Clinton often jogged in public, but initially the image backfired. The perception that came out of it was that he was sort of this over weight guy, who couldn't wait, even when he was jogging to get in and grab a Big Mac.

UNIDENTIFIED MALE: Your McNuggets, originally from Great Britain, to Somalia, intercepted by war lords.

GUPTA: Laura Schwartz coordinated events for President Clinton and now runs her own company, White House strategies.

LAURA SCHWARTZ, WHITE HOUSE STRATEGIES: Portrayed an everyday American, but then when you're doing that every day, every couple of days, it stops from being, just hey, eating with the people to, ooh, he should cut down a bit.

GUPTA: So, the fine-tuned his image. The unattractive shorts were replaced with a fitted jogging suit. Now, he looked the part. Again, that image thing. Laura Schwartz said says the image makers want to match what we are seeing to a political message.

SCHWARTZ: The president looks red in the face. If he looked very pale, then, all of a sudden the topic becomes look at sick he looks, instead of wow, this health care plan is really a great idea.

GUPTA: Political advertising consultant Alex Castellanos has advised six presidential campaigns. Most recently Republicans Mitt Romney and John McCain. Now he is a CNN contributor.

ALEX CASTELLANOS, CNN CONTRIBUTOR: We live in the age of brands and perceptions and images. Your little snippet on TV is all that some voters may know before they make the most important decision about leading the country.

UNIDENTIFIED FEMALE: Every place that Mitt has gone, he has solved problems.

CASTELLANOS: One of the things we had Mitt Romney doing a spot, TV commercial, jogging to demonstrate he had the energy and vitality to do the job.

GUPTA: Is it ever appropriate to exclude somebody from office because of health issues?

CASTELLANOS: Voters have a right to exclude someone on issues of health. Just as they have a right to exclude him on issues of character.

GUPTA: With presidential campaigns lasting more than a year, almost every day, around the clock. under the microscope, some say the campaign itself is a solid test of fitness for the job. But there is more to it.

Next, our investigation into the health of the two men who want to be our next president.



GUPTA (voiceover): Chief executives at many large companies including American Airlines, Boeing, Exxon are required to step down at age 65. Airline pilots must also retire at 65; a limit set by Congress. Generals and admirals in the United States Military face a mandatory retirement age of 64.

But there is no age limit for the Commander-in-Chief. If elected, John McCain would be the oldest man ever sworn in for a first term as president. He is 72.

During the primary Senator McCain faced the age question, directly, at a New Hampshire high school.


UNIDENTIFIED MALE: Do you ever worry that you might die in office of Alzheimer's or some other disease that might affect your judgment?

SENATOR JOHN MCCAIN (R), PRESIDENTIAL CANDIDATE: People will judge by the vigor and the enthusiasm associated with our campaign. Every campaign I have ever been in my life, I have out campaigned all of my opponents and I'm confident that I will. Thanks for the question, you little jerk.


DR. THOMAS PEARL: Average life expectancy for a person around 72 would get him to about age 85.

GUPTA: Dr. Thomas Pearl is geriatrician and an expert on long life. He said McCain has some advantages like good health care and good genes. His father, Navy Admiral John McCain Jr. died of a stroke at age 70. His mother, Roberta is a spry 96.

DR. THOMAS PEARL: We have found that longevity runs strongly in families. So having a 96-year-old mom who is in pretty good shape definitely bodes well for him. Not only for his ability to get to older years, but to spend a greater period of that time in good health.


FORMER PRESIDENT RONALD REAGAN: It's been the honor of my life to be your president.


GUPTA: Ronald Reagan, our oldest president was 77 at the end of his second term. One of many world leaders who have served into their 70s and beyond. Golda Meier (ph) was Prime Minister of Israel until she was 76. French President Charles de Gaulle was 78. South Africa's Nelson Mandela, 80. So let's take a closer look at John McCain. This spring in a conference call with reporters, McCain's lead doctor, John Eckstein gave the candidate an unequivocal thumbs up.

DR. JOHN ECKSTEIN (voice over): I and my colleagues can find no medical reason or problems that would preclude McCain from fulfilling all the duties and obligations of the President of the United States.

GUPTA: The clean bill of health came after John McCain's life nearly came to an abrupt end. Flying a bombing mission during the Vietnam War, McCain's A4E Sky Hawk bomber was shot out of the sky by a missile. He ejected, landing in a lake with both arms and one leg fractured.

DIANE LAWRENCE, FRIEND OF JOHN MCCAIN: He said, "I would push off, get to the top of the lake, take a breath of air, sink back down, let it out. Push off with my good leg, come to the top of the water, take another break of air." That's how he survived.

GUPTA: Captured, he spent five years as a prisoner of war and enduring frequent beatings and other torture. His broken bones were never properly set. When he was finally set free in 1973, he came to Diane Lawrence, a physical therapist for treatment.

LAWRENCE: It was bad. His leg was frozen straight out 180 degrees straight out. It was frozen. He had to be able to flex that knee to 90 degrees to pass a flight physical. That was his goal.

GUPTA: After nine months of brutally painful therapy, he did it.

LAWRENCE: He came in to the clinic and said, "Honey, I made it." We both cried. It took a long time.

GUPTA: Even today McCain walks with a limp and can't raise his arms above his shoulders. Yet he bristles with energy on the go for long hours on the campaign trail.

This spring I was one of a select group of reporters allowed to look through John McCain's medical records.

GUPTA (on camera): It's sort of a different experience than I am used to as a medical doctor. We are going to be (inaudible) in this room for a period of time. No electronic devices are allowed in. I have my notes, sort of prepared the things that I'm looking for and we're going to see what we find.

GUPTA (voiceover): They gave us three hours to pour through more than 1100 pages. They only covered the last eight years and there's no way to determine what might be missing.

What we mainly focused on was cancer. Since 1993, doctors have removed four melanomas, the deadliest form of skin cancer. McCain's biggest health scare came right after the 2000 campaign when he was diagnosed with malignant melanoma on his left temple.

MCCAIN: We were campaigning and I really didn't pay much attention, enough attention, to it obviously and I just let it go too long.

GUPTA: It was only after he left that presidential race that he finally got it checked out. The cancer was about as big as a dime, a little thicker than a nickel. By today's standards his surgeon took an extremely aggressive approach, removing 33 lymph nodes near the cancer. You've probably noticed the puffiness on the Senator's left cheek. That's the result of the operation.

MCCAIN: My health is excellent. I see my dermatologist every three months.

GUPTA: This July McCain's dermatologist, Dr. Susanne Connelly removed a small patch of skin from McCain's face. It was part of a regular check up, just a precaution. She said it has been years with no recurrence. The chance of the melanoma coming back is less than 10%.

But that hasn't satisfied critics. With the election just weeks away, a petition organized by the liberal advocacy group, Brave New Films and signed by more than 2700 doctors ran as a full page ad in the "New York Times." It calls on McCain to release his medical records to the public for everyone to see, not just a few reporters.

One doctor who signed the petition, Dermatologist Wendy Epstein.

WENDY EPSTEIN, DERMATOLOGIST: We need to know, did this melanoma spread or didn't it? That can be only answered by an independent group of dermapathologists who look at the slides. So my concern is and I think the concern for the American people is, will Senator McCain, if elected in 2008, be able to finish out his term?

GUPTA: The McCain campaign said it's "unacceptable for doctors who haven't examined McCain to second-guess his own physicians. This is a highly respected team he has been working with. They have concluded he is in perfect health." The campaign added that nothing will be released to the public.

In our investigation, we found McCain has revealed far more about his health than do most candidates. Far more than his election rival. Coming up, what we do know about the health of Barack Obama.



MCCAIN: That Al Queda is going back into Iran and receiving training and are coming back into Iraq from Iran. That's well know.

GUPTA: When Senator John McCain mixed up Iran and Iraq during a press conference, the moment was all over the news.

MCCAIN: I'm sorry, the Iranians are training extremists, not Al Queda, not Al Queda, I'm sorry.

GUPTA: But what about this?


GUPTA: 57 states? Candidates do make mistakes, but can you imagine how it would have been scrutinized if John McCain said that? There is a lot of talk about McCain's age but what do we really know about the health of Barack Obama?

At age 47, Barack Obama is one of the youngest nominees of a major party ever. Only John Kennedy and Bill Clinton were younger.

Bowling? Not his thing. Obama's game is basketball. In high school his nickname was Barry Obomber. Today he's still got game.

DR. TED MITCHELL, HEAD OF COOPER CLINIC: The things you do for good heart health, they give you good brain health.

GUPTA: Dr. Ted Mitchell runs the Cooper Clinic where President Bush got his physicals while governor of Texas.

GUPTA (on camera): You've been mountain biking with President Bush. What was that like?


GUPTA: Is he a good rider?

MITCHELL: Well, his saying was if you are not falling, you are not riding.

GUPTA (voice over): Dr. Mitchell says anyone running for the White House is hyper competitive in any arena. Obama is no exception.

CANDY CROWLEY, POLITICAL CORRESPONDENT: He almost always carves out time and this sense he reminds me of George Bush who always carved out time for exercise.

GUPTA: According to actuarial tables, Obama can expect to live another 32 years. One red flag, he was a long time smoker. He gave it up to run for president although he admits he slipped off the wagon a few times.


UNIDENTIFIED MALE: How did you quit, because I'm quitting now and I'd like...

OBAMA: Nicorettes. You want one? Here try one out.


CROWLEY: He does chew Nicorette. His aides carry it around in their pocket for him whenever he feels the need.

GUPTA: Dr. Thomas Pearls is an expert on aging.

PEARL: There's no doubt that smoking is an age accelerator. It enhances vascular disease, it predisposes to cancer, it predisposes to Alzheimer's disease.

MITCHELL: While the risk gets better every single year that goes by that he has not smoked, it never leaves him.

GUPTA: Quitting is no magic bullet, but it does cut the risk of heart disease in half after just a year. After 10 years, your lung cancer risk is also cut in half.

Obama's mother died of ovarian and uterine cancer at the age of 52. His grandfather of prostate cancer at 73. But Dr. Jennifer Ellis says, neither of those affect Obama's chance of getting cancer.

DR. JENNIFER ELLIS: His mother's history has actually no increased risk to him whatsoever.

GUPTA: In May, the Obama campaign released a statement from his doctor of 21 years. It was a one-page summary of his medical records.

Here's what it said, "Senator Obama has been in excellent health. He has been seen regularly for medical check ups and various minor problems like upper respiratory infections, skin rashes and minor injuries."

Dr. Ellis says there is no reason to doubt the official statement.

ELLIS: His blood pressure is great. His cholesterol is good. In the next five to 10 years, you would think it would be unlikely that he would have any major health issues.

GUPTA: Obama's diet, despite some of the pictures we have seen on the campaign trail is generally well balanced. All his lab work, normal.

On the on the Democratic ticket, when it comes to health, it's the vice presidential candidates who has the story.

Neither Joseph Biden nor Sarah Palin has released their medical records. But in 1987, the Democrat Biden suffered severe headaches during his presidential run. He didn't see a doctor until he dropped out. The doctor found a ruptured aneurysm and sent him straight to the hospital for surgery.

SENATOR JOE BIDEN (D), VICE-PRESIDENTIAL CANDIDATE: They gave me the last rights and gave it to me in the hospital in Delaware. Then when I got down to Walter Reid...

GUPTA: Doctors later fixed a second aneurysm. Biden said if he stayed in the race, they would have never been discovered and he would be dead.

Barack Obama is just a-year-older than Biden was then. His doctors say he is healthy and since they only put out the one-page statement, that's all we have to go on.

A McCain spokesman told CNN, it's a "complete double standard", and said "he's essentially running on a doctor's note. I had a harder time getting out of high school math class." Historian Robert Dallek says Obama should reveal everything.

ROBERT DALLEK, HISTORIAN: Frankly, its shrewd politics because the more he reveals and the more it shows he is in good health, the more it puts the issue, the focus on the question of McCain's health at the age of 72.

GUPTA: An exclusive CNN opinion research poll reflects that. 47 percent of Americans are concerned that John McCain might not finish his first term in good health compared to just 19 percent who are worried about Obama's health.

Coming up, the last taboo. Mental health.


GUPTA: Richard Nixon once said that a public figure is a lonely man. With any president, we know little about his true physical condition. Even less about his mind.

It was 1948; Richard Nixon's star was rising on the heels of the Alger hiss spy investigation that he launched as a young anti-communist congressman.

Two years later, Nixon was a senator. Two years after that, vice president. But even then, he was keeping at least one big secret.

GUPTA (on camera): It was here, 1951 at 829 Park Avenue in New York when Richard Nixon first met with Dr. Arnold Hutschnecker (ph) an internist interested in the mind -body connection. Nixon was irritable, nervous, not sleeping well. He came back again and again.

GUPTA (voiceover): That all changed in 1955 when Hutschnecker (ph) because a full time psychotherapist.

ROBIN SWAN, NIXON BIOGRAPHER: There was no longer any guide under which Nixon could visit Dr. Hutschnecker (ph) without people becoming immediately aware he was seeking psychiatric help.

If it were ever known he had sought psychiatric help, it would be the end of his political career.

GUPTA: Nixon biographer, Robin Swan, interviewed Hutschnecker (ph). Her tape recording, the doctor's voice, is being broadcast for the very first time.

DR. ARNOLD HUTSCHNECKER (voice over): Then that means immediately reaction is he must be cuckoo.

SWAN (voice over): Right

HUTSCHNECKER: And so therefore he was advised not to see me.

GUPTA: But Nixon ignored his aide's advice. He even hosted Hutschnecker at the White House.

HUTSCHNECKER: We called it transference. Trust.

SWAN: He came to you in a crisis situation?

HUTSCHNECKER: When something was pending and he couldn't - it troubled him. SWAN (on camera): It's clear that he was important to him. He was a real lifeline and that without that kind of a crutch, without that kind of a person to turn to; Nixon was in serious emotional difficulty.

GUPTA: During Nixon's 1968 campaign, some news reports question his connection with Hutschnecker who denied at the time being Nixon's therapist.

But two decades later, the doctor wrote a memoir, never published, about his relationship with the former president.

What you're looking at is an early copy of that manuscript given to us by the family. Hutschenecker describes the former president as fragile and racked by fear. In hand-written notes, an over controlled rumbling volcano. Burning ambition and a hunger for love and to be loved.

HUTSCHNECKER: He wasn't psychotic. He had no pathology...

SWAN: Right.

HUTSCHNECKER: ... but he had a good portion of neurotic symptoms.

ROBERT DALLEK: Nixon was a troubled man. There is no question that he had inner demons and that he struggled with these.

GUPTA: Not just Nixon, many presidents have suffered under the strain of office. John Quincy Adams, Lyndon Johnson, Franklin Pierce and Calvin Coolidge to name a few. Even the greatest leaders are not immune.

DALLEK: We have had some people in office who suffered from depression and did brilliantly. For example, Abraham Lincoln. Winston Churchill was plagued by depression and yet they acquitted themselves brilliantly.

GUPTA: Before becoming president, Lincoln wrote prolifically about his depression then called melancholia.

"I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be one cheerful face on the earth."

150 years later, mental health in politics is still taboo.

The best-known example, Missouri Senator Thomas Eagleton.

In 1972, just 18 days after being named George McGovern's running mate, Eagleton quit when it was revealed that he had electroshock therapy for depression.

Then in 1988, Democratic candidate Michael Dukakis was rumored to have seen a psychiatrist. He refused to release his medical records.


UNIDENTIFIED MALE: Do you think that American people deserve to know whether he is fit to govern by having his medical records made public?

REGAN: Look, I'm not going to pick on an invalid.


GUPTA: We've come a long way in terms of diagnosing and treating Depression. That's a good thing. In 2007, 10 million Americans were treated for depression. A new CNN opinion research poll finds that two thirds of Americans would be somewhat or very concerned if the president did the same.

GUPTA (on camera): At this day and age, is mental health still put into a separate silo versus physical health?

JOE LOCKHART, FORMER CLINTON PRESS SECRETARY: We are not in the era of Tom Eagleton but we're not into the era of openness and everyone hold hands and it's OK for the president to go to therapy once a week.

GUPTA (voice over): Hutschnecker once said there was nothing more taboo. Not even visiting a "whore house".

GUPTA (on camera): It has been said that it's easier for a president to visit a whorehouse than it is to go see a psychiatrist. Is that still true today, you think? Is it the kiss of death?


GUPTA: CNN reached out to both of Nixon's' daughters and his brother Edward. All declined to appear on camera. But Patricia Nixon Cox did tell us her father overall, had "very positive mental health".

SWAN: He should be credited with recognizing this. Fall on himself in reaching out for help. But he criteria in which we judge political leaders and presidents is different from the criteria from which we judge normal human beings.

UNIDENTIFIED MALE: All presidents want you to think they walk on water and you know the public in a sense is complicit with this. Because they want to believe that presidents are different from the rest of us.

GUPTA (on camera): We know our leaders are flesh and blood. Prone to the same injuries and illnesses as the rest of us. But history teaches us they'll only reveal as much of that as the public demands.

I'm Dr. Sanjay Gupta, thanks for watching.