The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama (22 page)

Nellie rebelled against the cultural straightjacket imposed upon young women of economically comfortable families living in 1870s and 1880s Cincinnati. Instead of remaining at home awaiting marriageable young men to woo her, Nellie Herron slipped into taverns in the working-class district of Rhineland. During a Newport, Rhode Island, vacation in 1880, she experimented with drinking alcohol, smoking cigarettes and gambling at cards.
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Frustrated with being an intelligent and ambitious young upper middle-class woman in late-nineteenth century middle America, with very limited prospects for furthering her education or initiating a career, she defied the constraints of her mother and taught, first as a substitute in French at Madame Fredin’s school, and subsequently full time at the newly opened White-Sykes School for Boys.
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Photographs taken at the time depict a handsome, though not beautiful, woman of slight build. A striking feature is her constant dour, unsmiling and determined facial expression. Determined to introduce an intellectual facet to her life, she organized and led regular meetings of young upper-class men and women to discuss the political and cultural happenings of the day. In this setting she met wealthy Yale Law School graduate Will Taft. After a long audition, Nellie decided that the genial Will would provide her ticket to the White House.

William Howard Taft married Helen Herron on June 19, 1886. A few months later, Ohio governor Joseph B. Foraker appointed the new groom to a vacancy on the Ohio Superior Court.
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Taft’s preference was for the law and the courts; his wife’s was for politics and the executive. For the next twenty years, Nellie campaigned to steer her husband’s ultimate professional goal towards the presidency and not towards the chief justiceship of the U.S. Supreme Court. She won most of the battles with her occasionally recalcitrant husband. Ironically, for Taft, achieving the presidency was only his penultimate goal; appointment as chief justice became his ultimate career accomplishment.

The Tafts became parents of three distinguished children. Robert was born in Cincinnati on September 8, 1889, and weighed eight pounds. There were no recorded problems with either this or her two subsequent pregnancies. Helen was born August 1, 1894, and the second son, Charles Phelps, followed on September 20, 1897. Robert was a longtime United States senator from Ohio; Helen earned a doctorate in history from Yale and became dean and, later, head of the History Department at Bryn Mawr College. Charles became an attorney and, later, a prominent civic leader in his hometown of Cincinnati.
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Prior to May 17, 1909, there are few hints of any illness. According to Mrs. Taft’s two biographies, her autobiography, her correspondence with her husband and contemporary newspaper reports, Nellie Taft was a very healthy woman.
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Nellie Herron Taft, inveterately determined and ambitious, easily became moody when bored. Anthony’s excellent biography refers to Nellie’s self-described “blues” during her late teenage years.
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In the summer of 1881, she identified the roots of her dark moods: “It was simply that I was not busy…. Now when my time is not fully occupied I fall back into the same fate.” In 1904 there were hints of poor health and ennui evolving into depression. After the Tafts left Washington in 1909 for New Haven, where Will taught law at Yale, both her husband and daughter worried that Nellie, without responsibility, would tend towards depression. Their solution: the first memoir of a first lady. Will worked as her literary agent; Helen “did the writing while Nellie reminisced and tweaked the narrative.”
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The future first lady spent three years in the Philippines as the wife of Governor General Taft. The country’s subtropical climate exposed her to malaria and within a year of her arrival, “medical exams soon showed that Nellie had malaria.” Her symptoms and treatment are unrecorded. However, the disease may have produced debilitating aftereffects as hinted by the following: “Despite her own physical ailments resulting from malaria, Nellie took charge of arranging Will’s third surgery.” There was also a description of her upon the Tafts’ return to the United States as “a fragile looking woman.”
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Helen Taft was not the first first lady to contract malaria but she was the first to be infected outside the United States.
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William Taft was recalled to Washington in 1904 by President Theodore Roosevelt with the appointment as the country’s secretary of war.
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In early 1905, his wife “felt the insidious approach of nerves, and she took immediate steps to tone herself up.” Medical considerations were an underlying reason for a spring trip to Europe, where she rowed with son Robert to build up her strength. She “returned to Washington looking ten years younger and with her nerves as steady as the Rock of Gibraltar.”
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Is it possible that the allusions to “ nerves” foreshadowed the cerebrovascular accident four years later in May 1909? Moreover, did Nellie, always ambitious and innately focused, use her European conditioning sojourn to prepare herself for the rigors of a first lady?

A final pre–White House medical reference was to a summer 1908 trip to Hot Springs, Virginia, to use its baths for her rheumatism.
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William Howard Taft was elected the twenty-seventh president of the United States in November 1908. His first lady, previously goal-oriented towards the White House, ceased to be her husband’s constant political prod and concentrated her energies on entertaining and the management of the executive mansion.
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Her emergence as the lady in the White House was welcomed by social and official Washington with the following encomiums: “immensely capable,” “of exceptional learning, intelligence, and ambition,” “she is probably the best fitted woman who ever graced the position she now holds and enjoys,” “has brains and uses them,” “an intellectual woman and a woman of wonderful executive ability.” Her changes in White House custom, her ride in the inaugural parade, her civic and social reform efforts—all converged to make Mrs. Taft a presidential wife of more than the usual fascination in the national press.
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This changed dramatically the afternoon of May 17, 1909, a mere thirteen weeks into her tenure. She had a stroke that first ended and then permanently affected her ability to speak. Although a shock when it occurred, in retrospect her cerebrovascular accident (CVA) should not have been. Her personality, family history, and history of smoking are all recognized as significant predisposing factors.

Both her parents were stroke victims. Harriet Collins Herron experienced facial paralysis in late 1886. She recovered only to be struck again in 1901. Her father, John Williamson Herron, had a cerebrovascular accident in 1902. When Nellie was recovering from her second CVA in 1911, John Herron experienced his second and became delusional.
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A 2003 family history study demonstrated that patients suffering a stroke at 65 years of age or younger (Nellie was 48), were three times as likely to have a first degree relative with an early stroke or heart attack (Harriet Herron was 53).
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It is not difficult to characterize Nellie Taft as possessing a Type A personality. Her competitiveness and zeal for achievement fulfilled this designation; a consequence was chronic stress. Stressful activities during May 17, 1909, preceded the medical cataclysm of later in the day. A recent research study proved what was long surmised: Stressful habits and type A behavior are associated with a high risk of stroke.
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Diary entries during Helen Herron’s 1880 vacation in Newport, Rhode Island, recorded early experimentation with cigarette smoking. She started to smoke cigarettes to escape depression. She began to smoke at a time when genteel women did not, and smoking became a matter of course for her. Her habit consisted of an occasional cigarette and although she never smoked to excess, she never relinquished the habit.
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Today the dangers of cigarettes are widely acknowledged, and stroke is a recognized consequence for both men and women. The stroke risk increases with each additional cigarette. Any smoking increases the risk of a cerebral accident, 2.2 times for 1 to 10 cigarettes a day, 4.3 times for those smoking 21 to 39 a day, and 9.1 times greater for two or more packs a day.
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Nellie Taft, wife of William Howard Taft, was a determined first lady whose dour countenance reflected her inner drive (Library of Congress).

The First Stroke

During the afternoon of May 17, 1909, the new first lady was halfway through a more than usually stressful day. She spent the morning in a Washington hospital where Charlie, her younger son and favorite child, had undergone an especially bloody removal of his tonsils and adenoids. Continuing unease over her aging and fragile father and anxiety over her sixth congressional dinner scheduled at the White House that evening were inescapable. In an attempt at relaxation, still annoyed with her husband for his tardy arrival at the hospital, she decided upon an informal cruise on the Potomac to Mount Vernon. Aboard the presidential yacht, Nellie fainted. An aide attempted to revive her with the captain’s whiskey; the boat returned immediately to Washington.

Accounts of her condition and the course of it differed, partially the result of the president’s attempt to minimize the medical situation: “She made no motion and did not seem to be more than half conscious.” Upon the yacht’s return, military attaché Archie Butt carried the limp Helen Taft to her bedroom. For the next sixteen hours, the first lady was comatose and “utterly speechless.” The president admitted in a letter to their oldest son, Robert, that the first lady had lost muscular control of her right arm and leg, and that only after three days did she begin to make audible sounds, but not words.
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In the early decades of the twentieth century, home care was greatly preferred over hospital care for nonsurgical emergencies. Accordingly, Nellie Taft recuperated at the White House. Dr. Matthew A. DeLaney of the Army Medical Corps was the White House physician and accordingly took charge of his patient’s care. He administered stimulants, for her heart “was very weak,” and put her to bed. The president wrote Robert: “The doctor soon reassured us all, and her as well … that it was a mere attack of nervous hysteria.”
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Will Taft personally wrote the statement that was released to the press the following morning. Under the headline “Mrs. Taft’s Illness Due to Social Cares,” the
New York Times
reported: “Mrs. Taft’s sudden and severe illness on Monday when she succumbed to the excessive heat, is yielding to rest and care, promising an early and complete recovery.” The article continued: “In the ten weeks of her husband’s Administration, Mrs. Taft has done more for society than any former mistress of the White House has undertaken in as many months…. This with numerous official receptions and dinners within a short time, proved too much for her.” In another newspaper, it was alleged that Mrs. Taft suffered from a “slight nervous attack” and that she would be able to resume normal activities in a few days.
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However, when the previously very active first lady did not appear during the next few weeks at scheduled concerts and White House social events, the press realized that all was not well. But the public was shielded from the severity of her disease. Nellie’s sister, Eleanor Moore, served as temporary White House hostess.
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Within a short time, Nellie’s mental faculties recovered their usual acuteness and the motor control of her right arm and leg returned. During the summer, with slow care, she could write fairly legibly. The catastrophe for this forceful and energetic woman was an inability to speak at first, and later to talk only with difficulty. Mortified by her impediment, for the first two months Mrs. Taft came into a White House corridor only when assured she would not be seen by anyone.
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Sister Eleanor, daughter Helen, and even the president participated in the exceedingly slow process of speech therapy. This consisted of her repetition of what was spoken to her. Each morning Dr. DeLaney checked in and tried different therapies. In early June he experimented with a machine that applied electricity to the throat.
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Progress in restoring normal articulation was slow. Therefore Dr. Delaney sought the consultation of Dr. Lewellys F. Barker, William Osler’s successor as director of medicine and physician in chief of the Johns Hopkins Medical Institutions. Barker’s examination, conducted five months after the stroke, “found her practically normal except for the one trouble—articulation—and told her that that only required rest, time and the same treatment she has been receiving to restore her to health.”
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Nellie took comfort in the Baltimore specialist, who implied that her problem was not paralysis at all but something unusual that occasionally strikes people, and so she wanted to resume her public role. However, her doctors informed the president that if she did they would release themselves from any responsibility for her care as they feared a relapse.
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Dr. Barker again visited the White House in early 1910, and assured Taft “that she [had] made remarkable progress in the preceding two months.” When the president journeyed to Panama in October 2010, his wife no longer feared a relapse while he was gone. She was comfortable enough to speak once again with strangers. Moreover, she hosted the White House debutante party during the 1910 Christmas season.
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