John Kennedy: Medication Effects

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	The Health and Medical History of President
	John Kennedy: Medication Effects

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 and given the last rites three times (see below). It will take Dr. Zebra awhile to organize and respond to the information that recently became available in The Atlantic Monthly in late 2002 [6] and Professor Dallek's book [7]. It is already clear to me, however, that Professor Dallek has not fully analyzed the implications of Kennedy's illnesses and medications.

Bumgarner is an excellent source of information on Kennedy's medical history [3a].

The diagram below summarizes the possible interplay between Kennedy's medical problems. The rest of this page has details.

More...

Professor Dallek concludes his article with:

There is no evidence that JFK's physical torments played any significant part in shaping the successes or shortcomings of his public actions, either before or during his presidency. Prescribed medicines and the program of exercises begun in the fall of 1961, combined with his intelligence, knowledge of history, and determination to manage presidential challenges, allowed him to address potentially disastrous problems sensibly. His presidency was not without failings (the invasion of Cuba at the Bay of Pigs and his slowness to act on civil rights were glaring lapses of judgement), but they were not the result of any physical or emotional impairment. [7a]

Let's look at this claim in detail.

The first issue is whether Kennedy "felt" any psychological effect from his medications. The answer is clearly yes. He felt Dr. Feelgood's pep pills and amphetamine injections [7b].

He felt the cortisone, too. Before press conferences and televised speeches, Kennedy's doctors increased his cortisone dose to help him handle the associated stress [7b]. This is very troubling. There is certainly no untoward physical stress associated with talking to reporters or cameras. Thus, we can presume he needed extra cortisone to deal with the psychological stress of such events. The psychological stress involved in such events, however, must pale in comparison to the stress of deciding whether to end civilization in the Cuban Missle Crisis, whether to invade Cuba, or what to do with American and Soviet tanks separated by 100 yards in Berlin, loaded, and with their muzzles pointed at each other. Did he call for extra cortisone then? And if he did, what is the right dose to give? Do Berlin and Cuba decisions warrant a higher dose than Viet Nam decisions?

Next, let's examine Dallek's conclusions one piece at a time.

There is no evidence that JFK's physical torments played any significant part in shaping the successes or shortcomings of his public actions, either before or during his presidency.

Point 1: This is classic disingenuation. Absence of evidence is not the same as evidence of absence.

Point 2: Dallek does not consider whether Kennedy's medications may have played a role.

Prescribed medicines and the program of exercises begun in the fall of 1961, combined with his intelligence, knowledge of history, and determination to manage presidential challenges, allowed him to address potentially disastrous problems sensibly.

Point 1: The majority of this sentence may be translated as: "Kennedy meant well."

Point 2: Dallek does not consider that Kennedy's intelligence, knowledge, and determination may have been compromised by his medical condition or his medications (and drugs).

His presidency was not without failings (the invasion of Cuba at the Bay of Pigs and his slowness to act on civil rights were glaring lapses of judgement), but they were not the result of any physical or emotional impairment.

Again, Dallek takes medications and drugs out of the equation.

The Bay of Pigs invasion occurred in April 1961. At this time in Kennedy's administration, he was under the maximal influence of Dr. Feelgood and subjected to maximal polypharmacy. It seems cavalier to dismiss a "glaring lapse of judgment" from a man with "intelligence, knowledge, and determination" as not being influenced by a daily physical and mental assault.

In fact, the answer is probably unknowable. Absent an insightful realization and confession by Kennedy himself, there is no real way to prove that Kennedy's decisions on any particular day or in any particular month were influenced by medicines or by medical condition. By the same reasoning, it is impossible to prove that Kennedy's decisions were not affected.

In the fall of 1961, Dr. Burkley insisted that Kennedy's treatment be fundamentally altered. This ultimately led to a diminution (not elimination) of medications Kennedy took, including the elimination of Dr. Feelgood's ministrations [7]. We who live after the Cuban Missile Crisis (October 1962) may have Dr. Burkley to thank for allowing Kennedy to make his civilization-saving decisions with a clear(er) head.

Resources

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Disclosure: Doctor Zebra gets a few pennies if you click & buy from Amazon.

Beschloss, Michael. [Interview]. PBS NewsHour with Jim Lehrer. KQED-TV, San Francisco, 21 January 2005. The interview was about an exhibition at the National Archives of photographs of Presidents in casual situations..
Web site for the interview, including a picture: http://www.pbs.org/newshour/bb/media/jan-june05/exhibit_01-21.html
Boller, Paul F. Jr. Presidential Anecdotes. New York: Oxford University Press, 1981. ISBN 0-19-502915-1 @ Amazon
Bumgarner, John R. The Health of the Presidents: The 41 United States Presidents Through 1993 from a Physician's Point of View. Jefferson, NC: MacFarland & Company, 1994. ISBN 0-89950-956-8 @ Amazon [a] pp. 234-249
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.
Cooper, Pauline. The Medical Detectives. New York: David McKay, 1973. ISBN 0-679-50382-X @ Amazon
Crenshaw, Charles A.; Hansen, Jens; Shaw, J. Gray. JFK: Conspiracy of Silence. New York: Signet, 1992. ISBN 0-451-40346-0 @ Amazon
This book has been roundly criticized by other physicians involved in the Kennedy case.
Dallek, Robert. The medical ordeals of JFK. Atlantic Monthly. 2002 (Dec);290(5):49-61. [a] p. 61
Dallek, Robert. An Unfinished Life: John F. Kennedy 1917-1963. Boston: Little, Brown, 2003. ISBN 0-316-17238-3 @ Amazon [a] p. 61 [b] p. 60
Freedman, Nancy M. Joshua: Son of None. New York: Delacorte Press, 1973.
We don't normally cite fiction, but this is an intriguing novel about cloning and the assassination of JFK. The book starts in the emergency room at Parkland Memorial Hospital. The President has just been pronounced dead. Unable to accept this, a young physician on the scene removes some of Kennedy's lung tissue and puts it in liquid nitrogen. Many years later, after cloning technology has evolved, he approaches a wealthy industrialist named Kellogg with the idea of growing a new JFK. He recognizes, however, that to replicate the kind of man Kennedy was, the clone's upbringing and formative experiences will have to match JFK's. Thus, Joshua Francis Kellogg's life is carefully scripted with analogs to the death of Kennedy's older brother, the PT-109 incident, and so on. Among Kennedy's medical history, only his bad back is mentioned. Amazon
Lattimer JK, et al. An experimental study of the backward movement of President Kennedy's head. Surg Gynecol Obstet. 1976 Feb;142(2):246-54. Pubmed.
Lattimer, John K. Kennedy and Lincoln: Medical & Ballistic Comparisons of Their Assassinations. New York: Harcourt Brace Jovanovich, 1980. ISBN 0-15-152281-2 @ Amazon
MacMahon, Edward B. and Curry, Leonard. Medical Cover-Ups in the White House. Washington, DC: Farragut, 1987. ISBN 0-918535-01-8 @ Amazon
Marion, Robert. Was George Washington Really the Father of our Country?. Reading, MA: Addison-Wesley, 1994. ISBN 0-201-62255-6 @ Amazon
McKusick, Victor A. Mendelian Inheritance in Man. 9th ed. Baltimore: Johns Hopkins University Press, 1990.
Later print editions have appeared, e.g. the 12th in 1998: Amazon (ISBN is 0801857422). The entire contents are freely available on the web as "Online Mendelian Inheritance in Man (OMIM)." The online version is more current than the printed version.
Nicholas JA, Burstein CL, Umberger CJ, Wilson PD. Management of adrenocortical insufficiency during surgery. Archives of Surgery. 1955;71:737-742.
JFK is case 3
O'Leary C, Walsh CH, Wieneke P, O'Regan P, Buckley B, O'Halloran DJ, Ferriss JB, Quigley EM, Annis P, Shanahan F, Cronin CC. Coeliac disease and autoimmune Addison's disease: a clinical pitfall. QJM. 2002 Feb;95(2):79-82. Pubmed.
Post, Jerrold M. and Robins, Robert S. When Illness Strikes the Leader: The Dilemma of the Captive King. New Haven, CT: Yale University Press, 1993. ISBN 0-300-06314-8 @ Amazon
At one time Post worked for the CIA, profiling foreign leaders.
Summers, Anthony; Dorril, Stephen. Honeytrap: The Secret Worlds of Stephen Ward. London: Weidenfeld & Nicolson (91 Clapham High St. SW4 7TA), 1987. ISBN 0-297-79122-2 @ Amazon
Much sensationalism and drivel has been written about JFK. Thus, it is very hard for anyone devoting less than full time to Kennedy studies to discern what is credible and what is not. This book strikes me as containing a mixture of credible, verifiable statements and statements best treated with skepticism.
Travell, Janet. Office Hours: Day and Night. Cleveland, OH: New American Library, 1968.
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.
The John Kennedy web page at the White House.
(71 matches when checked in November 2003)

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