Should Our Presidential Candidates have Medical Exams?

Robert G. Lahita MD, PhD

John F. Kennedy looked like the picture of health, and he was a young Presidential candidate with a very busy campaign schedule.  The Bunker Hill Day parade in Massachusetts in the downtown district of Charlestown was a must for a young candidate. After a hectic schedule of speaking tours, hand shaking sessions and various political parties, a Kennedy aide said, “Jack was ill”.  He simply turned yellow and blue and collapsed.

                  The crowds murmured and were worried that their candidate was to ill to go on.  However, he was not taken to a hospital, but rather to the home of Bobby Lee, a Kennedy aide. The information at the time suggested “exhaustion”, but an insidious diagnosis of Addison’s Disease (adrenal gland insufficiency) came many years later, one that should have been disclosed to the public long before the Bunker Hill incident and known by the Kennedy family since 1948.     That candidate, John Fitzgerald Kennedy was seriously ill before he was elected President and throughout most of his short time in office.  His ability to lead and make decisions could be impacted by this serious adrenal gland condition that the public never knew about until long after his death.

                  We will never know how physical and mental illness influenced decisions throughout the history of our republic, but there is no question that maladies existed, and the country moved forward with zeal despite not knowing about them.

                  As with JFK, the illnesses of many men seeking the highest office have been concealed before their elections.  There have been many examples, some of which have been frightening. President Woodrow Wilson’s poor health and dangerously high blood pressure before his election resulted in numerous strokes that incapacitated him during hid term and allowed his unelected second wife considerable power as his surrogate in running the country.  The White House staff took great pains to conceal Franklin Delano Roosevelt’s polio, hiding both his braces and his wheelchair and even worse, for fear that the world would see him as debilitated and unable to govern in a desperate time for the country.  Before his election Dwight Eisenhower suffered health problems like high blood pressure, abdominal pains, and intermittent fevers.  After the election, he had coronary thrombosis, regional enteritis (bowel inflammation, and cerebral occlusion (stroke).  He obviously came very close to death.

While in Office

                  Presidents are human and consequently affected by the same maladies from which we all suffer. To the peril of the country most Presidential illnesses and health conditions were kept from the public more often after they were in office and until recent times few knew about the overall health of the President. Lyndon Johnson lifted the veil of secrecy from Presidential illness, even allowing his gall bladder removal to hit prime time TV.  His transparency paved the ways for many future Presidents.

                  Perhaps the best coverup of Presidential illness was Grover Cleveland’s cancer of palate that was found during the serious monetary crisis at the end of the nineteenth century.  Surgery on his palate and jaw occurred on his yacht while traveling from NYC to Buzzards Bay Maine, the President’s summer home.  This operation was hidden for decades from the public. Had e died on the yacht or become otherwise incapacitated the country would have suffered a financial catastrophe, namely the Sherman Silver Act becoming law.

                  Throughout our history, the country evolved despite illnesses and attempted and successful assassinations. The 25th Amendment to the US Constitution, a response to the Kennedy assassination, ensures that the vice President immediately step in to replace the President and govern in the event of illness or tragedy.  The amendment clarifies the lines of succession and the limits of a sick incapacitated President.  This amendment is often mentioned today when political parties become frustrated. George H.W. Bush had a known thyroid condition, which is often said to have affected his judgement, especially in the case of the 1991 Gulf War.  The 25th amendment was considered at that time, because there were concerns about his emotional lability,

                  The attempted assassination of Ronald Reagan and his absence from the White House while hospitalized for trauma surgery and his stay in the ICU illustrated the lines of succession allowing George H W Bush to be President until Reagan recovered.

                  While the health of Presidents is clearly a priority for the country and succession is well defined in an emergency, the fate of those running for office is not. What if the candidates for office are ill before they win office? Shouldn’t the public know the health of the candidate before he or she runs for office. The health of candidates should be apparent before they seek office and available to the public as part of their selection criteria.

Prior to election

                  Many candidates in recent years have succumbed to one or another illness known to exist prior to their candidacy. One such candidate was Hilary Clinton who for unknown reasons had “fainting spells”  at public events like the 911 Memorial in NYC..  There were concerns of course and these “spells” were most likely the result of a minor fall with some injury to her head.  Aspirants like Paul Tsonga at age 55 and Fred Thompson at age 75 both succumbed to lymphoma shortly after their failed bids for the nation’s highest office.  Even Vice-Presidential candidates like Thomas Eagleton, subsequently disqualified as a candidate because of a psychiatric history, could have suffered serious events in office.  Moreover, once elected it is too late. 

                  The issue of age is currently a great concern for the health of the current President Joe Biden and certainly for candidate Doanld Trump if he is re-elected.  If these candidates are the two individuals for which Americans must vote, transparency is important.

                  The future of our nation rests in the health and well being of both the President and Vice President of the United State. American voters deserve to know the health status of the candidates for present and vice President after the primaries and the selection of candidates, this should happen well before the national election.  Shareholders would accept nothing less from the CEO and executive staff if they were a Fortune 500 Company into which they invest.  When Americans go to the polling booth, they invest in the country and its leaders.

                  I and others have called for mental health assessments of candidates in addition to examination of their physical health. A bipartisan team of physicians could objectively conduct physical examinations months before Election Day.  The results of these exams should be publicly released.

                  As a physician I do not believe that this is draconian or biased.  If this is done properly at a foreseeable time prior to the election, the American populous would have extra confidence in their choices.