A First-Rate Madness (43 page)

161
a three-hour operation:
Ibid., 377–378.

161
“Lincoln recalled Nixon racing into Kennedy's office”:
Matthews,
Kennedy and Nixon,
99.

161
large enough to fit a man's fist up to the wrist:
O'Donnell and Powers,
Johnny, We Hardly Knew Ye,
114–116

161
“We came close to losing him”:
Giglio, “Growing Up Kennedy,” 378.

162
seven hospitalizations:
JFK Presidential Archives, Medical Records, PP, Box 45.

162
“It is not a killer”:
Giglio, “Growing Up Kennedy,” 379. Dallek,
An Unfinished Life,
300.

162
a contemporary movie portrayed a person with Addison's disease:
Giglio, “Growing Up Kennedy,” 385.

162
This episode is documented in his medical records:
JFK Presidential Archives, Medical Records, PP, Box 45. This matter is ignored increasingly by historians. One of the first Kennedy books (Hugh Sidey,
John F. Kennedy, President
[Greenwich, CT: Fawcett, 1964]), written just one year after Kennedy's death, discusses the matter at reasonable length (one page, 98), describes real concern about Kennedy's condition among journalists and politicians (one Republican commented, “Now we've got an invalid for a President”), and even describes Travell's treatment with intravenous steroids and antibiotics. Sidey had been taking notes for something like an authorized biography of JFK for six years, and thus his records on this event were likely shared with the president. Travell herself, in her 1966 oral history, near the end of the medical part of her interview with Ted Sorensen, volunteered the June 1961 crisis as an important part of Kennedy's medical history, and considered it the most serious episode of illness during his presidency. “Interesting,” Sorensen commented, and then the interview went in a different direction. Robert Dallek (
An Unfinished Life
) received much praise for being the first biographer to gain access to more medical records, and to write a biography greatly built around Kennedy's illnesses. Yet he did not refer to this episode at all. Richard Reeves (
President Kennedy: Profile of Power
[New York: Simon and Schuster, 1993]), who wanted to describe what it was like to be president on a day-by-day basis, titled his chapters by dates, usually within days or a week of each other. In this period, he jumps from June 17 to July 19, skipping altogether the weeks of Kennedy's near-fatal illness, without comment. Evelyn Lincoln (
My Twelve Years with John F. Kennedy
) does not mention it at all in her diary of the Kennedy years, even though she was an active participant in JFK's health care. The Travell files are full of notes describing how extra steroid or amphetamine doses were given to “Mrs. L” to give to the president.

163
“The President slept later than usual this morning”:
JFK Presidential Archives, Medical Records, PP, Box 45, typed memorandum dated June 16, 1961.

163
Travell had just injected Kennedy:
IV solucortef 100 mg given with 1.8 million units penicillin + tetracycline, hydrocortisone 40 mg orally. JFK Presidential Archives, Medical Records, PP, Box 45, June 16, 1961.

163
give more steroids intramuscularly:
Cortisone acetate 50 mg IM. JFK Presidential Archives, Medical Records, PP, Box 45.

163
more oral steroids later that night:
Hydrocortisone 10–20 mg. Ibid.

163
From June 22 to July 3:
In the week of June 22–29, he received intramuscular doses of 600,000 units of procaine penicillin twenty-seven times. He also received oral steroids (hydrocortisone 10 mg in the morning and 20 mg in the afternoon daily; 0.125 mg daily of Florinef), amphetamines (2–4 tablets of dextroamphetamine, “Dexatabs,” daily), and his usual daily dose of testosterone (10 mg daily of methyltestosterone tablets). Ibid.

164
received doses of the narcotic codeine:
Codeine phosphate 750 mg, and codeine sulfate 500 mg. Ibid.

164
“mild viral infection”:
Ibid., June 22, 1961.

164
He came back to life:
Ibid. Dr. Travell's handwritten note on June 21, 1961, was ominous, describing a fever of 104.5 and “shivering,” blood cultures being drawn at 3:15 a.m., and symptoms of being “very chilly” and “perspiring profusely.” The next morning, his personal nurse's neatly handwritten notes were unfiltered (edited below only for clarity and repetition; we have no available nurse's notes for the nights of June 21 and into the early morning of June 22):

164
urine culture finally confirmed . . .
Aerobacter cloacae:
Ibid. Dr. Travell's handwritten note is as follows: “June 24—T note: Urine: aerobacter resistant to strep and pen . . . many mucus threads, much amorphous, straw hazy, rbc 2–-4 phf wbc 1–3 phf.” On June 26, a urine culture laboratory report states growth of the following organism: “Aerobacter cloacae.”

164
fatal in 20 to 40 percent of cases:
Michael E. Ellis,
Infectious Diseases of the Respiratory Tract
(Cambridge, UK: Cambridge University Press, 1998), 140.

164
mainly found in the vaginal flora:
Sebastian Faro,
Sexually Transmitted Diseases in Women
(Baltimore: Lippincott Williams & Wilkins, 2003), 98.

165
His urologist's records are silent on sexual habits:
JFK Presidential Archives, Medical Records, PP, Box 45, Dr. Herbst's notes, 1954–1955.

166
Galbraith . . . and admired both presidents:
John Kenneth Galbraith,
Name Dropping
(Boston: Houghton Mifflin, 1999).

166
Jefferson scored highest:
Dean Keith Simonton,
Greatness: Who Makes History and Why
(New York: Guilford, 1994), 271–276.

166
“I know nothing can happen to him”:
Seymour Hersh,
The Dark Side of Camelot
(Boston: Little, Brown, 1997), 15–16.

170
William Osler once said:
William Osler,
Aequanimitas
(Philadelphia: P. Blakinson's Son & Co., 1914).

171
Kennedy ingested a standard set of daily medications:
Florinef 0.25 mg, hydrocortisone 20 mg, methyltestosterone 10 mg, and Meticorten 2.5 mg, Lomotil (a narcotic-derived antidiarrheal agent), thyroid hormone, and sometimes penicillin. JFK Presidential Archives, John F. Kennedy Personal Papers (hereafter PP), Medical Records, Boxes 45 and 46.

171
he also took amphetamines and barbiturates:
Dextroamphetamine (Dexatabs) and Tuinal (an equal mixture of secobarbital sodium and amobarbital sodium). Ibid.

171
injections of procaine:
Ibid., Box 46. David Owen,
In Sickness and in Power: Illnesses in Heads of Government During the Last 100 Years
(Westport, CT: Praeger, 2008), 161.

171
Kennedy took mysterious injections from Max Jacobsen:
Owen,
In Sickness and in Power,
164–170. Robert Dallek,
An Unfinished Life: John F. Kennedy
(Boston: Little, Brown, 2003), 398–399. Richard Reeves,
President Kennedy: Profile of Power
(New York: Simon and Schuster, 1993), 146–147.

171
“I don't care if it's horse piss”:
Dallek,
An Unfinished Life,
399.

171
New York State investigated the doctor's injections:
Owen,
In Sickness and in Power,
165.

172
injected an anabolic steroid, methyltestosterone, at Kennedy's frequent request:
JFK Presidential Archives, Medical Records, PP, Boxes 45 and 46.

172 a medical coup d'état:
The medical coup d'etat was not a one-day affair. David Owen best discusses the timeline (
In Sickness and in Power,
pp. 176–177). The process began in October 1961, when Admiral Burkley, the naval officer assigned as the official White House physician, decided to take on Travell, Kennedy's personal physician. Burkley had the important support of Dr. Eugene Cohen, a New York endocrinologist who was Kennedy's prime consultant for Addison's disease. Burkley and Cohen had decided that Travell's many injections needed to be replaced by a physical exercise and muscle-training regimen, for which they enlisted a New York specialist, Hans Kraus, MD. Travell opposed the proposal, but, over a year, Burkley and Cohen, apparently with the support of Robert Kennedy, gained the president's approval for the change. By October 1962, Owen notes, the medical coup d'etat was complete, and Travell, though still nominally personal physician to the president, was greatly weakened. The animosity and distrust between Travell and Burkley can be seen in a medical note in Burkley's records: “3 February 1962 Requested the medical records on X [the president] for the last six months. Dr. Travell said she would like to straighten them up before she gives them to me. I said that this was not necessary, but she said she would like to straighten them up. . . . Within the last few days Dr. Travell has been inferring that
all
the recent improvement of X's condition is due to the fact that he is now getting Gamma Globulin and injections of vitamins. Several days ago while discussing the chair for the helicopter a very obvious effort to cover information on the upper part of the sheet by covering it with an additional paper. Contents were not divulged to me” (JFK Presidential Archives, PP, Box 48). Burkley had the upper hand as the official physician, backed by the military and the White House bureaucracy; Travell had been hired by the president alone. Over time, Travell remained in the White House but was closely watched and controlled by Burkley. This is captured in a note by Jackie Kennedy to Burkley in late 1963: “Memo for Dr Burkley: August 21, 1963 I have asked Dr. Travell to put suitable bulbs and reading lights in all the places where the President and I read in the White House. So, please, let's not get excited if you see her tip-toeing up to our floor in the elevator! JBK” (JFK Presidential Archives, PP, Box 48).

172
He still took four kinds of daily steroids:
As above except methyltestosterone injections were replaced by oral Halotestin 10 mg daily.

172
suggested by gynecomastia:
This is documented as early as 1955 during one of JFK's hospitalizations. JFK Presidential Archives, PP, Medical Records, Box 45. New York Hospital admission note, August 29, 1955: “Gynecomastia, unknown etiology.”

172
Kennedy always took
anabolic
steroids:
Later Halotestin. JFK Presidential Archives, Medical Records, PP, Box 46.

172
in 1966, in her oral history:
JFK Archives, Oral History Program, interview of Janet Travell by Ted Sorensen.