The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama (17 page)

Consequently both were a success in accomplishing the social and ceremonial roles of a first lady of the United States. During Julia Grant’s stay, the White House was restored as the center of Washington’s social life. Formal dinners took on an opulence rarely seen before or since and the first lady presided at Tuesday afternoon receptions for the public.
⁷
Moreover, she renovated and replaced the run-down executive mansion furnishings with enthusiasm and skill: “She not only turned the White House into a comfortable place to live, but made it the focus of the capital’s social life.”
⁸
There was even an elegant White House wedding. In 1874, daughter Nellie Grant married Englishman Algernon Sartoris.
⁹
Julia also was assisted at public receptions by the wives of cabinet secretaries and senators. Significant support and advice was offered by the sophisticated and socially prominent Julia Fish, the wife of Grant’s secretary of state.
¹⁰

Lucy Hayes also was a successful social hostess as first lady. Her tenure had an auspicious beginning: Mary Clemmer Ames, a popular columnist for a New York newspaper, was so impressed by Lucy’s graceful appearance at her husband’s March 1877 inauguration that the writer referred to Mrs. Hayes as “the first lady of the land.” Following Ames, other correspondents and many social leaders began to refer to Mrs. Hayes as “first lady.” The title stuck and it has adhered since to the wife of the American president.
¹¹

Mrs. Hayes thoroughly enjoyed her role as White House hostess, but like Mrs. Grant, she discovered that the social schedule had grown to such an extent that she required assistance. Numbers of young matrons, mostly nieces, but also daughters of friends, resided in the Hayes White House; these young, and attractive, young women were employed as social aides by the first lady.
¹²
After several successful receptions, “Washington reporters began to praise Lucy’s competence as a hostess” and appreciate her hospitality and helpfulness. The Hayes also hosted a White House wedding; niece Emily Platt married an Army General on June 19, 1878.
¹³

Julia Grant, wife of Ulysses S. Grant (Library of Congress).

Lucy’s most memorable contribution to White House ceremonial lore is her role in continuing the Easter egg roll. Dolley Madison had initiated an Easter egg roll for children on the grounds of the Capitol building. However, when this event on the Capitol grounds was banned for some trivial reason, Mrs. Hayes let word out on the Monday after Easter Sunday in 1877, that children would be welcomed to play egg-rolling games on the White House South Lawn.
¹⁴

Julia Dent Grant and Lucy Webb Hayes were relatively healthy as first ladies. There is no record of either significant illness or medical treatment during their tenures and therefore no history of any difference in care from what was available to any member of the contemporary body politic. The rigors of managing the executive mansion, offering constant support to their husbands, and providing social leadership in the nation’s capital did not affect their health. Finally, no illness of theirs affected the political decisions or policy-making of their husbands. But there were medical matters.

Mrs. Grant experienced, as far as is known, four uncomplicated pregnancies between 1850 and 1858. She was the mother of three sons and one daughter.
¹⁵
Her major physical issue was principally a cosmetic one—strabismus. Beginning at a young age her eyes “troubled her considerably. She had a mild case of strabismus [a lazy eye, squint], a defect common enough in the early nineteenth century. She could not sew for any length of time. Moreover, it tired her to do too much reading, and she did not write if she could avoid it. All through their married life the General tried to save her eyes when he could, reading to her, writing letters that normally would fall to her and helping her in sundry small ways.” Even in later years her vanity precluded her wearing glasses to improve her vision.
¹⁶

Julia Grant. A “lazy eye” was a cosmetic problem for her. Therefore most images of her were side views of her face (Library of Congress).

The strabismus did not bother her greatly until she became on display as a public figure. As a result, for cosmetic purposes Julia wished either to hide or to correct her squint. She began to pose self-consciously for portraits to mask any notice of the “lazy eye.”
¹⁷
“During the war she had consulted Saint Louis physicians about remedying the condition but she had been advised that it was too late. [As first lady] she intended to risk a simple operation in Washington, on the chance that it might be successful. But at the last minute the General overturned everything.”
¹⁸
Grant’s caution may have been appropriate since, at the time in the United States, the surgical correction of strabismus was in its infancy.
¹⁹

Mrs. Grant outlived her husband by seventeen years. Late in her widowhood she suffered a severe case of bronchitis that was complicated by heart and kidney disorders. She died in Washington on December 14, 1902.
²⁰

Mrs. Hayes was pregnant eight times and all pregnancies resulted in living children, seven sons and one daughter. However, only five of the Hayeses’ eight children survived to adulthood. Three sons died before their second birthday.
²¹
Mrs. Hayes long suffered from rheumatism and headaches, although neither significantly affected her performance as first lady. However, these maladies occurred frequently enough for one biographer to state that “the periodic recurrences of this rheumatic condition plus the severe headaches she had throughout the years belie the impression that Lucy possessed robust health.”
²²

Mrs. Hayes’ most significant medical problem occurred during her eighth pregnancy. A son was born on August 1, 1873, four weeks before her forty-second birthday. This final pregnancy was complicated by severe convulsions both before and after the delivery. A diagnosis of eclampsia, the most dangerous form of toxemia of pregnancy, must be assumed. Her symptoms were so alarming that a second physician was called to attend the patient. Morphine was prescribed to relieve her pain and to induce sleep.
²³

Modern obstetrical care is well aware that an elevated blood pressure is the basis for the eclamptic convulsions. It is very likely that, in the era before hypertension could be diagnosed or treated, Lucy Hayes had long suffered from undiagnosed high blood pressure. Headaches, a common marker of high blood pressure, had bothered Lucy since her mid-twenties. On an 1857 trip to visit relatives in Chillicothe, Ohio, she wrote that her “back felt as though it would certainly give way, and [her] head was in the same condition.” Headaches, frequently alluded to in her letters, would become a coda to be repeated during the rest of her life.
²⁴
In 1875 Rutherford Hayes, the soon-to-be president, noted his wife’s headaches but did not seem to realize that they were more frequent and severe than before.
²⁵
On Election Day of 1876, when it appeared that Hayes had lost the presidential election, “Lucy retired to her bedroom with a bad headache, a physical torment with which she was on familiar terms.” Before his inauguration, the president finally realized that “the only drawback is her frequent attacks of sick headaches. Perhaps twice a month she suffers for a day or two.”
²⁶

Lucy Hayes, wife of Rutherford Hayes. He commented that his wife “was large, but not unwieldy” (Library of Congress).

The most devastating consequence of high blood pressure is a cerebrovascular accident (stroke). On the afternoon of June 22, 1889, at the Hayeses’ Fremont, Ohio, home, the former first lady experienced difficulty with her fingers while threading a needle. She was unable to speak and slumped back into her chair. Conscious at first, she became depressed and frightened. Subsequently she slipped into unconsciousness from which she never recovered. She died three days later; the cause of death was an “apoplectic stroke.” She was only fifty-seven years old.
²⁷

The date of origin of Lucy Hayes’ presumed hypertension is unknown, but the condition may have commenced during the early years of her marriage. Her frequent pregnancies predisposed her to this condition, and certainly her eighth pregnancy exacerbated it. Contributing to the likelihood of high blood pressure was a significant weight gain. Mrs. Hayes’ weight had increased from 127 pounds in 1861 to 161 pounds in 1875. In mid–1879 her figure had ballooned to 174 pounds, fifty pounds greater than when she was a young matron.
²⁸
It led her husband to comment, “She is large but not unwieldy.”
²⁹

Mrs. Hayes fulfilled the classic patient profile that is a predictor of gall bladder disease: “fair, fat, female, fecund and forty.” In 1883, she was unable to attend the annual meeting of the Woman’s Home Missionary Society, of which she was president. Rutherford Hayes was informed that she had been attacked “by rheumatism or neuralgia of the stomach.”
³⁰
Geer commented that a “modern doctor might have diagnosed as a gall bladder disease.”
³¹

Lucy Hayes’ other chronic and persistent complaint was labeled as rheumatism, but it was likely rheumatoid arthritis. Arthritic complaints had bothered her even before her third pregnancy in June 1858 when she was in her mid-twenties. Two weeks after the birth of the Hayeses’ third son, Lucy developed a severe case of rheumatism, an attack similar to the one she had suffered prior to her marriage: “For ten days has had her rheumatism creeping over her from one place to another, giving her great pain. It began in her left shoulder and arm and in her neck.” There is no treatment recorded for her rheumatism. Mrs. Hayes did not utilize baths or spas to alleviate her discomfort as others did during this period.
³²

Neither Mrs. Grant nor Mrs. Hayes required the attention of a physician while serving as first lady, although treatment by a military physician was available. Basil Norris, the surgeon general of the army, and Jedediah Baxter, chief medical purveyor, are listed as the Washington family physicians for the Grants and the Hayeses. Both of these military doctors were criticized by their civilian counterparts for providing services or pharmaceuticals to the family of the president, their commander in chief, for free.
³³

The White Plague Kills Caroline Harrison and Ravages Other First Ladies

Caroline Harrison

[He] made a thorough examination and left at noon. He says he finds no organic trouble. We all feel much relieved.
¹

Caroline Harrison, the spouse of one-term president Benjamin Harrison (1889–1893), became the second first lady to die in the White House. She died on October 25, 1892, shortly before the voters decided the fate of her husband’s reelection campaign. She was sixty years old. The cause of death was a significant infectious disease—tuberculosis. Other infectious diseases, yellow fever and malaria, that challenged the well-being of preceding first ladies, would be controlled or eliminated in the United States soon after Mrs. Harrison’s demise. Tuberculosis, after experiencing a precipitous decline in incidence during the twentieth century, remains today an occasional public health concern.
²