The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama (29 page)

When Dr. Finney arrived at the bedside from Baltimore on September 8, he: “found her very ill, suffering from an acutely infected cystic kidney. Her pulse and temperature were high, and she appear[ed] very toxic.” The consultant confirmed Sawyer’s diagnosis of hydronephrosis of the affected kidney. This diagnosis, literally “water inside the kidney,” refers to distention of the affected kidney’s urine collection and excretion system with destruction of its ability to function. Finney advised as treatment the comparatively simple procedure to surgically drain the kidney by incision. Finney’s autobiography continued the story: “This course, however, did not appeal to Dr. Sawyer…. I insisted on seeing the president before going and stating the case to him as I saw it. Dr. Sawyer again objected, and so the matter was up to the President who sided with Dr. Sawyer. I returned to Baltimore.”
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Dr. Charles Mayo arrived on September 9 and insisted that Finney return to Mrs. Harding’s bedside. The patient’s condition remained dire. Finney resumed his lively narrative: “Dr. Mayo … strongly advised drainage of the kidney by incision…. [O]ne had to be a bit dogmatic. Perhaps nature would come to the rescue, perhaps not. If not, the chances of recovery were practically nil…. Dr. Sawyer again disagreed and said that he did not believe much in operating anyway. The question was once more put up to the President … [who] again decided in favor of Dr. Sawyer and against the operation both Dr. Mayo and I advised. It was a new experience, I am sure, for Dr. Mayo, coming from the Mayo Clinic, to have his opinion and advice summarily disregarded. I was more accustomed to it in the East.”
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Shortly thereafter, nature did take its course. The urine flow occurred and the first lady recovered, albeit very slowly. Letters written as late as February 1923 indicated that Florence Harding’s convalescence was protracted.
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Thus a poorly educated homeopathic doctor was able to stare down two of the most illustrious and respected surgeons in America and have his decision “to watch and wait” vindicated.

Dr. Charles H. Mayo founded and led the renowned Mayo Clinic with his older brother, William, in Rochester, Minnesota: “The names of William and Charles Mayo are famous throughout the world wherever surgery is practiced.” Upon entry of the United States into World War I, the brothers Mayo were made joint chief consultants in charge of all the surgical services in the United States Army.
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John Finney was a graduate of both Princeton University and the Harvard School of Medicine. He was second in rank on the surgical staff of Johns Hopkins Hospital until Dr. William Halsted’s death in 1923, and for two years served as acting professor of surgery and chief of service at Johns Hopkins Hospital and Medical School. Finney was much admired for his public spirit and as an educator.
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John Finney met Mrs. Harding socially several times thereafter at the home of Mrs. Evalyn McLean. He further wrote: “I was called on the telephone from the White House by Mrs. Harding herself, who cordially invited me to join the presidential party as a member of the medical group. She said that, as I already knew, she had not been very well and neither had the President, and they would appreciate it if I would join them on their trip to the West Coast and Alaska.” Although the surgeon regretted that he could not accept, Finney maintained contact with the presidential party by telegram.

President Warren Harding died from a heart attack in San Francisco on August 2, 1923, almost one year from the onset of his wife’s near-fatal illness.
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In stark contrast to his deft handling of the Duchess’s kidney disease, Sawyer seriously misdiagnosed and mismanaged the heart disease of her husband.
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After President Harding died at age fifty-seven, the widowed first lady went back to Marion, Ohio. In January 1924 former first lady Florence Harding returned to Washington. She was accompanied by the wife of Dr. Charles Sawyer, and upon her arrival she took up residence in an apartment at the Willard Hotel.
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Dr. Joel Boone offered to care for Mrs. Harding after the senior Sawyer resigned as White House physician. However, Doc was determined to retain his position as Florence Harding’ s personal physician. Six months after Mrs. Harding took up residence in the nation’s capital, her kidney disease recurred. Sawyer immediately traveled to Washington and refused to leave until Mrs. Harding accompanied him back to his Ohio sanitarium. There she remained under the watchful care of the Sawyers.
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On November 3, 1925, Carl Sawyer released a bulletin that Florence Harding was again suffering from nephritis and had severe abdominal pain. The younger Sawyer was quoted at the time: “She has developed a number of symptoms that were present in her serious attack in 1922 in the White House. Other complications have arisen which were not present at that time, and her condition now is rather serious.” Sawyer requested outside surgical consultation. In a strange addendum he identified the death of his father as a factor contributing to the deterioration of his patient.
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On November 8, Drs. Wood (of Cleveland) and Carl Sawyer performed an exploratory operation at White Oaks. James Craven Wood was a pillar of the Midwest Homeopathic community and specialized in obstetrics and gynecology. Their surgery report stated there was “an almost complete contusion of the right ureter, necessitating an exploratory puncture, which is hoped will afford temporary relief.” The patient survived the palliative operation, but her respite was brief. She died on November 21, 1924. Sawyer listed the cause of death as chronic nephritis and myocarditis, with evidence of hydronephrosis.
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Charles Sawyer had died suddenly, at sixty-four years of age, at his White Oaks Sanatorium on September 23, 1924, outliving his famous patient, the president, by just over one year. Florence Harding, then residing at White Oaks, was the last person to see Doc alive.
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Grace Goodhue Coolidge, Florence Harding’s successor as first lady, was a stark contrast to her flamboyant predecessor, dissimilar in personality, in political influence, in controversy, and in longevity. However, there were two similarities. Both women nearly died in the White House from a similar kidney infection. Both were under the care of the assistant White House physician, navy doctor Joel Boone.

Navy doctor Joel Boone treated first ladies Florence Harding and Grace Coolidge (courtesy Bureau of Medicine and Surgery Archives).

Boone was the naval presence in the White House during three presidential administrations. He was the naval medical bridge between Admiral Cary Grayson, who served Woodrow Wilson, and Admiral Ross McIntire, who was Franklin Roosevelt’s personal physician. Dr. Boone was admitted directly into medical school after high school and graduated from the Homeopathic Hahnemann Medical College of Pennsylvania in 1913. In contrast to Sawyer, he completed a year of postgraduate training as an intern at Hahnemann. Thereupon he immediately enlisted in the U.S. Navy. After 1900, American homeopathic and orthodox physicians compromised on their differences; similarities in diagnosis, treatment and patterns of consultation emerged. As a result, Boone’s professional philosophy and practice were indistinguishable from that of a member in good standing of the American Medical Association.
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Grace Coolidge was a professional woman. At a time when it was unusual for a woman to even enter a university, whether because it was not the norm or affordable, she graduated from the University of Vermont in 1902. Furthermore she commenced upon a career of teaching the hearing impaired. After graduation she entered teacher training at Clarke School for the Deaf in Northampton, Massachusetts. She taught at Clarke for three years until her marriage to Calvin Coolidge. Her support for Clarke and the hearing impaired was lifelong and unwavering.
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Born Grace Anna Goodhue in Burlington, Vermont, on January 3, 1879, she was an only child. In adulthood Grace measured five feet four inches and had “masses of lustrous dark hair.” Her biographers credited her eyes as being her most remarkable feature, which were described as “gray-green … wide set and grave, even when her face was alight with laughter.” It was her habit to focus them with close attention on anyone she was addressing.
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The future first lady possessed lifelong good health, with the exception of a clandestine kidney crisis while she was living in the White House and several obscure illnesses during her early years. She initially enrolled at the University of Vermont for the 1897 fall semester, but withdrew fewer than three months later because “she needed to improve her health,” and, in an opaque reference, “an oculist [eye physician] had recommended she take time off.” Biographer Isabel Ross noted that Grace “had trouble with her spine as a child but vigorous exercises had strengthened her.” Grace definitely liked long walks and made them a lifelong daily habit.
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At age 24 Grace Goodhue married attorney and ambitious politician Calvin Coolidge in Burlington, Vermont. The groom was 32. It was a marriage notable more for its dedication to duty and responsibility than for its joy and happiness. Eleven months later John Coolidge was born; twenty months after that, Cal Jr. made his appearance.
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Grace Coolidge’s autobiography, written many years later, contained this retrospective: “The wedding ceremony has seldom united two people of more vastly different temperaments and tastes than on the fourth of October 1905, when Mr. Coolidge and I made our marriage vows standing in the bay window in the parlor of my father’s home.”
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Coolidge biographers underscored the personality contrast: “They made an uncommon pair—the girl with the wide smile, fine eyes and friendly manner, and the spare, tight-lipped lawyer…. His mouth was his most forbidding feature—a thin slash sweeping down at the corners with a suggestion of perpetual gloom. He seemed aloof because of his remote and frosty manner, plus his declarative chopped-off statements, as sharp as exclamation points.” The groom was characterized as notable for his “shy disposition, somber demeanor, and conscientious devotion to duty.”
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In 1920 Massachusetts governor Coolidge, whose political star was burnished by his successful handling of the Boston police strike, was selected as the vice presidential nominee for Warren G. Harding’s successful presidential candidacy. Coolidge was an inconspicuous vice president. Grace Coolidge gracefully bore both the traditional obscurity of her position and the hostility of first lady Florence Harding. Everything changed when Warren Harding died from a heart attack. In the early morning of August 3, 1923, Calvin Coolidge was sworn in as the nation’s 30th president by his father, a Vermont justice of the peace. The ceremony took place in John Coolidge’s remote farmhouse in Plymouth, Vermont. The quaint domicile was without a phone, central heating, electricity or indoor plumbing.
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As first lady, Grace was underappreciated, especially by her husband, the president. The 45-year-old Mrs. Coolidge fulfilled the social, ceremonial and supportive roles of her position with great charm, poise and grace. Her personality was her strongest point; it brought spontaneity and joy to the White House. Grace had an eye for style; she became a fashion leader during the Coolidge presidency.
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One biographer summed up her White House tenure: “She was comforting and nurturing to her partner, her husband, the president. Yet she was not a presidential partner since she did not get involved in politics. In addition, her management of the White House menus and staff was often overruled by her husband. With a change in housekeepers in 1926, she had more control over the budget and her husband was pleased with the arrangements.”
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However, for a while the penurious and controlling Coolidge examined all household bills and personally initialed the payment checks.
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Three events shaped Grace Coolidge’s experience as America’s first lady: Her near fatal kidney attack in 1928; the death of her younger son, Calvin Jr., in 1924; and the estrangement from her husband during most of his presidency.

The first lady nearly perished from renal failure in early 1928. Her prominence elicited the medical services of six physicians: four consultants and the two White House physicians, Charles Coupal and Joel Boone. The professional relationship between the latter two was fractious. Although army doctor Coupal, as the President’s personal physician, was senior, navy lieutenant commander Joel Boone was a prolific and opinionated writer. His diary entries provide most of the historical narrative of this episode and form the core of the following discussion.

On February 2, 1928, Grace Coolidge was fortified with both bromides and codeine to get her through an evening White House reception. When she left the social engagement, a physical examination revealed exhaustion and a weak but rapid pulse. The patient’s condition improved over the succeeding two days. However, on the second day Boone judiciously sought advice from two eminent private internists, Drs. Walter Bloedorn and Paul Dickens. They advised an emergency cystoscopy, a visualization of the lower urinary tract.
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