Read A First-Rate Madness Online
Authors: Nassir Ghaemi
A First-Rate Madness (42 page)
154
“Sister is insane”:
The entry is by a Dr. “E. Price.” JFK Presidential Archives, Box 45, dated December 14, 1950.
“Sister is insane”:
The entry is by a Dr. “E. Price.” JFK Presidential Archives, Box 45, dated December 14, 1950.
155
touching Rosemary severely:
It is often now stated that Rosemary worsened due to a “botched” lobotomy. There is no evidence that this was the case. Dr. Watts later described the surgery as uncomplicated. Rather than being botched, lobotomy simply did not work for those with mental illness plus mental retardation. In 1941, Rosemary Kennedy was only the sixty-sixth person in the United States to receive frontal lobotomy; hundreds of thousands would eventually get it. Unfortunately, Joseph Kennedy Sr. was too far ahead of the curve; the best medical treatment of the time, one that would receive a Nobel Prize within the decade, was disastrous: “Because of the lobotomy, she had the development of a 2-year-old. She could not wash or dress herself or put her shoes on. She had to be supervised at all times.” (Kessler, “Rosemary Kennedy's Inconvenient Illness.”) Standing in line at Ted Kennedy's memorial viewing at the JFK Library, I spoke with a union activist from Wisconsin. He told me that he and his family worked in the institution that housed Rosemary, and that he had observed that for years, without media coverage, Ted Kennedy quietly flew every month from Washington to visit Rosemary in the Wisconsin institution.
touching Rosemary severely:
It is often now stated that Rosemary worsened due to a “botched” lobotomy. There is no evidence that this was the case. Dr. Watts later described the surgery as uncomplicated. Rather than being botched, lobotomy simply did not work for those with mental illness plus mental retardation. In 1941, Rosemary Kennedy was only the sixty-sixth person in the United States to receive frontal lobotomy; hundreds of thousands would eventually get it. Unfortunately, Joseph Kennedy Sr. was too far ahead of the curve; the best medical treatment of the time, one that would receive a Nobel Prize within the decade, was disastrous: “Because of the lobotomy, she had the development of a 2-year-old. She could not wash or dress herself or put her shoes on. She had to be supervised at all times.” (Kessler, “Rosemary Kennedy's Inconvenient Illness.”) Standing in line at Ted Kennedy's memorial viewing at the JFK Library, I spoke with a union activist from Wisconsin. He told me that he and his family worked in the institution that housed Rosemary, and that he had observed that for years, without media coverage, Ted Kennedy quietly flew every month from Washington to visit Rosemary in the Wisconsin institution.
155
Born the son of a saloon keeper:
The next three paragraphs draw from Ronald Kessler,
The Sins of the Father
(New York: Warner, 1996).
Born the son of a saloon keeper:
The next three paragraphs draw from Ronald Kessler,
The Sins of the Father
(New York: Warner, 1996).
156
numerous affairs . . . trying his luck with the girls:
Garry Wills,
The Kennedy Imprisonment
(Boston: Back Bay, 1994).
numerous affairs . . . trying his luck with the girls:
Garry Wills,
The Kennedy Imprisonment
(Boston: Back Bay, 1994).
156
Wall Street insider trading:
Kessler,
The Sins of the Father
.
Wall Street insider trading:
Kessler,
The Sins of the Father
.
156
an objective assessment of two generations of Kennedys:
This section represents my summary of publicly known facts regarding reasons for death or substance abuse or diagnosed mental illness in the Kennedy family. It might be said that Joe Jr. died in combat. And couldn't the other two plane crashes be attributed to the Kennedys' access via their wealth to small-plane travel, which is more dangerous than commercial plane travel? Perhaps the same could be said for the skiing accident? Skiing is a sport associated with wealth. These many explanations could be true, but violate Occam's razor. When we need many reasons to avoid a simpler explanation, perhaps the simpler explanation is right. Joe Jr. accepted a dangerous flying mission that he did not have to take. Kathleen agreed to fly in bad weather against her pilot's objections and despite grounding of all commercial flights. Michael's skiing accident occurred while playing ski football without any helmet, while skiing down Copper Bowl, a steep slope in Aspen, Colorado.
an objective assessment of two generations of Kennedys:
This section represents my summary of publicly known facts regarding reasons for death or substance abuse or diagnosed mental illness in the Kennedy family. It might be said that Joe Jr. died in combat. And couldn't the other two plane crashes be attributed to the Kennedys' access via their wealth to small-plane travel, which is more dangerous than commercial plane travel? Perhaps the same could be said for the skiing accident? Skiing is a sport associated with wealth. These many explanations could be true, but violate Occam's razor. When we need many reasons to avoid a simpler explanation, perhaps the simpler explanation is right. Joe Jr. accepted a dangerous flying mission that he did not have to take. Kathleen agreed to fly in bad weather against her pilot's objections and despite grounding of all commercial flights. Michael's skiing accident occurred while playing ski football without any helmet, while skiing down Copper Bowl, a steep slope in Aspen, Colorado.
Could it be that excessive risk-taking, an aspect of hyperthymia, lies behind some of these unfortunate happenings? A
Time
article noted on the death of Michael Kennedy, “As a teenager, Michael jumped off a 75-ft. cliff above the Snake River in Wyoming during a rafting trip. Brother Robert, while at Harvard, leaped 10 feet between two six-story dorms on a dare. He was arrested in 1983 for heroin possession. Joe II drove his jeep off the road in 1973, paralyzing family friend Pam Kelley. Brother David died in 1984 of a drug overdose.”
http://www.time.com/time/magazine/article/0,9171,987634-3,00.html#ixzz1FCPl6rMg
(accessed February 27, 2011).
Time
article noted on the death of Michael Kennedy, “As a teenager, Michael jumped off a 75-ft. cliff above the Snake River in Wyoming during a rafting trip. Brother Robert, while at Harvard, leaped 10 feet between two six-story dorms on a dare. He was arrested in 1983 for heroin possession. Joe II drove his jeep off the road in 1973, paralyzing family friend Pam Kelley. Brother David died in 1984 of a drug overdose.”
http://www.time.com/time/magazine/article/0,9171,987634-3,00.html#ixzz1FCPl6rMg
(accessed February 27, 2011).
157
the baseline risk . . . of bipolar disorder . . . for alcohol or substance abuse . . . for accidental death:
Ronald C. Kessler, Olga Demler, Richard G. Frank, Mark Olfson, Harold Alan Pincus, Ellen E. Walters, Philip Wang, Kenneth B. Wells, and Alan M. Zaslavsky, “Prevalence and Treatment of Mental Disorders, 1990 to 2003,”
New England Journal of Medicine
352 (2005): 2515â2523.
the baseline risk . . . of bipolar disorder . . . for alcohol or substance abuse . . . for accidental death:
Ronald C. Kessler, Olga Demler, Richard G. Frank, Mark Olfson, Harold Alan Pincus, Ellen E. Walters, Philip Wang, Kenneth B. Wells, and Alan M. Zaslavsky, “Prevalence and Treatment of Mental Disorders, 1990 to 2003,”
New England Journal of Medicine
352 (2005): 2515â2523.
157
a fraction of 1 percent in the general population:
National Vital Statistics Report
59, no. 2,
http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_02.pdf
(accessed February 27, 2011).
a fraction of 1 percent in the general population:
National Vital Statistics Report
59, no. 2,
http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_02.pdf
(accessed February 27, 2011).
158
The full medical report:
Here I present, verbatim for the first time, important extracts from Kennedy's medical records. Although they are now available for study by scholars, the JFK Presidential Library does not allow photocopying of John Kennedy's medical records. Furthermore, they are open to study only by scholars who are physicians or who are accompanied by physicians. I personally transcribed the full medical report of Kennedy's naval discharge. I believe this is the first time that the verbatim transcript of the following report has been made publicly available. The same holds for other verbatim transcriptions of Kennedy's medical records, such as his back X-ray reports (see pages 298â299) and nursing notes on his near-fatal 1961 infection in the White House (see pages 300â301).
The full medical report:
Here I present, verbatim for the first time, important extracts from Kennedy's medical records. Although they are now available for study by scholars, the JFK Presidential Library does not allow photocopying of John Kennedy's medical records. Furthermore, they are open to study only by scholars who are physicians or who are accompanied by physicians. I personally transcribed the full medical report of Kennedy's naval discharge. I believe this is the first time that the verbatim transcript of the following report has been made publicly available. The same holds for other verbatim transcriptions of Kennedy's medical records, such as his back X-ray reports (see pages 298â299) and nursing notes on his near-fatal 1961 infection in the White House (see pages 300â301).
US Naval Hospital Chelsea Mass 16 October 1944
Report of Medical Survey
Diagnosis: Hernia, intervertebral disc
Disability is not the result of his own misconduct and was incurred in line of duty
Existed prior to enlistment: No
Present condition: Unfit for Duty. Probable future duration: Indefinite
This 27-year old Lt., USNR, was admitted to this hospital on 11 June 1944 with the complaint of pain in the lower back referred down the left leg. This dated from a fall aboard ship on 1 August 1943. In addition he had lower abdominal pain increased on defecation. By permission of the BuMed & S he was granted leave to report to the Lahey Clinic. While there an oxygen spinogram was interpreted as demonstrating a herniation of the fifth lumbar intervertebral disc. On 23 June 1944 an operation was performed by Dr. James L. Poppen at the Lahey Clinic in which some of the abnormally soft disc interspace material was removed and it was noted that there was very little protrusion of the ruptured cartilage present.
Investigation of the gastro-intestinal complaints by Dr. Sara M. Jordan of the Lahey Clinic revealed on x-ray examination spasm and irritability of the duodenum without a definite ulcer crater but . . . suggestive of a duodenal ulcer scar. Spasm of the colon was also demonstrated. Anti-spasomodic medication was prescribed.
He returned to this activity on 4 August 1944. The pain in the back and in the left leg continued as did the lower abdominal pain. The neurosurgeon at this hospital did not feel that the operation had corrected the condition and that some other cause might underlie the neuritis of the left sciatic nerve. An orthopedic consultant injected procaine into the left sciatic nerve with considerable relief of symptoms. Review of the films from the Lahey Clinic by the roentgenologist here failed to reveal any definite abnormality of the G.I. tract or in the spine.
. . . On 3 October 1944 his back and leg pain had improved but there was continuation of the abdominal pain. . . . Because of continued symptoms and the necessity of further time to regain strength and weight lost while on combat duty, the Board recommends that he be retained for further study and treatment.
P. P. Henson, Comdr. MC V (S) USNR, P. B. Snyder Lt. Comdr. MC V (S) USNR, W. J. Jinkins, Jr. Lt. MC V (S) USNR
158
hospitalization for physical illness:
After resting in Arizona for a few months, Kennedy felt better and decided to work as a journalist, first in San Francisco at the United Nations conference, then in Berlin for the Potsdam conference, and later in England, where he covered the elections that ousted Churchill. Kennedy was back to his old self: energetic, active, sexual. But as usual, he had another relapse. His pattern seemed to be one serious illness episode per year, lasting about two to three months, followed by six to nine months of normal health and heightened energy. In London, Kennedy had his usual high fever, malaise, and gastrointestinal pain. He was hospitalized for two days. Giglio, “Growing Up Kennedy,” 374.
hospitalization for physical illness:
After resting in Arizona for a few months, Kennedy felt better and decided to work as a journalist, first in San Francisco at the United Nations conference, then in Berlin for the Potsdam conference, and later in England, where he covered the elections that ousted Churchill. Kennedy was back to his old self: energetic, active, sexual. But as usual, he had another relapse. His pattern seemed to be one serious illness episode per year, lasting about two to three months, followed by six to nine months of normal health and heightened energy. In London, Kennedy had his usual high fever, malaise, and gastrointestinal pain. He was hospitalized for two days. Giglio, “Growing Up Kennedy,” 374.
158
walked five miles in a Boston parade:
Lee Mandel, “Endocrine and Autoimmune Aspects of the Health History of John F. Kennedy,”
Annals of Internal Medicine
151 (2009): 350â354.
walked five miles in a Boston parade:
Lee Mandel, “Endocrine and Autoimmune Aspects of the Health History of John F. Kennedy,”
Annals of Internal Medicine
151 (2009): 350â354.
158
a visit by the physician Sir Daniel Davis:
Some biographers assume that Dr. Davis was an expert in Addison's disease. He was not. He appears to have been simply a successful physician, with relationships with many members of the British upper classes. Giglio, “Growing Up Kennedy,” 375. Dallek,
An Unfinished Life,
105.
a visit by the physician Sir Daniel Davis:
Some biographers assume that Dr. Davis was an expert in Addison's disease. He was not. He appears to have been simply a successful physician, with relationships with many members of the British upper classes. Giglio, “Growing Up Kennedy,” 375. Dallek,
An Unfinished Life,
105.
159
chronic physical symptoms:
It is clear, though, that all of Kennedy's Lahey Clinic doctors and his later doctors accepted and concurred with the Addison's disease diagnosis. Sara Jordan, for instance, wrote a 1952 letter clearly saying so and explaining the condition to Joseph Kennedy; she made it clear at that time that John Kennedy's main medical problem (all the previous gastrointestinal diagnoses notwithstanding) was Addison's disease of the adrenal glands. (Giglio, “Growing Up Kennedy,” 376.) I could not find any evidence that Kennedy was ever rediagnosed with laboratory tests in the 1950s, but such testing would likely not have been definitive anyway since he constantly received steroid treatment throughout the rest of his life.
chronic physical symptoms:
It is clear, though, that all of Kennedy's Lahey Clinic doctors and his later doctors accepted and concurred with the Addison's disease diagnosis. Sara Jordan, for instance, wrote a 1952 letter clearly saying so and explaining the condition to Joseph Kennedy; she made it clear at that time that John Kennedy's main medical problem (all the previous gastrointestinal diagnoses notwithstanding) was Addison's disease of the adrenal glands. (Giglio, “Growing Up Kennedy,” 376.) I could not find any evidence that Kennedy was ever rediagnosed with laboratory tests in the 1950s, but such testing would likely not have been definitive anyway since he constantly received steroid treatment throughout the rest of his life.
159
“hasn't got a year to live”:
Giglio, “Growing Up Kennedy,” 375.
“hasn't got a year to live”:
Giglio, “Growing Up Kennedy,” 375.
159
Kennedy took DOCA the rest of his life:
Giglio, “Growing Up Kennedy,” 375â376. Dallek,
An Unfinished Life,
76.
Kennedy took DOCA the rest of his life:
Giglio, “Growing Up Kennedy,” 375â376. Dallek,
An Unfinished Life,
76.
159
“deeply preoccupied with death”:
Matthews,
Kennedy and Nixon,
48.
“deeply preoccupied with death”:
Matthews,
Kennedy and Nixon,
48.
159
on a trip to Indochina:
JFK always traveled with a medical bag including his steroids. Once in the 1960 election, his bag was lost and Kennedy went to great lengths to contact political allies so as to find it. Giglio, “Growing Up Kennedy,” 377.
on a trip to Indochina:
JFK always traveled with a medical bag including his steroids. Once in the 1960 election, his bag was lost and Kennedy went to great lengths to contact political allies so as to find it. Giglio, “Growing Up Kennedy,” 377.
160
aides placed a pin in every town:
Kenneth P. O'Donnell and David F. Powers,
Johnny, We Hardly Knew Ye
(Boston: Little, Brown, 1972), 78â80.
aides placed a pin in every town:
Kenneth P. O'Donnell and David F. Powers,
Johnny, We Hardly Knew Ye
(Boston: Little, Brown, 1972), 78â80.
160
Without steroids, this pace would have been impossible:
Before his Senate run, Kennedy put out a press release attributing his hospitalizations to malaria. He had already begun treatment with his first endocrinologist, Dr. Elmer Bartels of Boston, who had started to treat him with DOCA and later cortisone, as noted earlier in the text. Bartels warned Kennedy that despite such treatment, he would always be prone to Addisonian crises triggered by infections of any sort. Giglio, “Growing Up Kennedy,” 376.
Without steroids, this pace would have been impossible:
Before his Senate run, Kennedy put out a press release attributing his hospitalizations to malaria. He had already begun treatment with his first endocrinologist, Dr. Elmer Bartels of Boston, who had started to treat him with DOCA and later cortisone, as noted earlier in the text. Bartels warned Kennedy that despite such treatment, he would always be prone to Addisonian crises triggered by infections of any sort. Giglio, “Growing Up Kennedy,” 376.
160
Six months later, he was back in the hospital:
JFK Presidential Archives, Medical Records, John F. Kennedy Personal Papers (hereafter PP), Box 45. Giglio, “Growing Up Kennedy,” 377.
Six months later, he was back in the hospital:
JFK Presidential Archives, Medical Records, John F. Kennedy Personal Papers (hereafter PP), Box 45. Giglio, “Growing Up Kennedy,” 377.
160
noting throughout his medical chart that he was already diagnosed with Addison's disease:
JFK Presidential Archives, Medical Records, PP, Box 45.
noting throughout his medical chart that he was already diagnosed with Addison's disease:
JFK Presidential Archives, Medical Records, PP, Box 45.
160
X-rays repeatedly showed mostly normal bone structure:
Ibid. My assessment of these medical files conflicts with the conclusion drawn by Robert Dallek and his medical collaborator that Kennedy had some osteoporosis, which would be expected with long-term steroid use. (Dallek,
An Unfinished Life,
81.) As late as 1962, Kennedy's back X-rays did not show osteoporosis or osteoarthritis or any other bony explanation for his pain. Here is a summary by Dr. George Burkley, White House physician, who concluded from this evidence that most of the president's back pain was due to muscular spasm, not bony arthritis: “The lumbar-sacral X-rays were examined in New York and were found to show very little difference from those taken in 1958. In other words no increase in the lesion in the left sacral iliac region and there was no evidence of any change in the intervertebral spaces, no evidence of osteoarthritis in any area. The X-rays indicate that there has been no bony change since 1958. I recommend that the exercise be continued as they are done now and to be increased in the judgment of Dr. K.” JFK Presidential Archives, Medical Records, PP, Box 48, March 19, 1962.
X-rays repeatedly showed mostly normal bone structure:
Ibid. My assessment of these medical files conflicts with the conclusion drawn by Robert Dallek and his medical collaborator that Kennedy had some osteoporosis, which would be expected with long-term steroid use. (Dallek,
An Unfinished Life,
81.) As late as 1962, Kennedy's back X-rays did not show osteoporosis or osteoarthritis or any other bony explanation for his pain. Here is a summary by Dr. George Burkley, White House physician, who concluded from this evidence that most of the president's back pain was due to muscular spasm, not bony arthritis: “The lumbar-sacral X-rays were examined in New York and were found to show very little difference from those taken in 1958. In other words no increase in the lesion in the left sacral iliac region and there was no evidence of any change in the intervertebral spaces, no evidence of osteoarthritis in any area. The X-rays indicate that there has been no bony change since 1958. I recommend that the exercise be continued as they are done now and to be increased in the judgment of Dr. K.” JFK Presidential Archives, Medical Records, PP, Box 48, March 19, 1962.
Here is the full report on the back X-ray from 1962, located in JFK Presidential Archives, Medical Records, PP, Box 45:
Â
Xray: Lumbar spine and pelvis, 14 March 1962, by John H. Cheffey and L. T. Brown, Captains MC USN. “The available projections demonstrate the distal three thoracic and the upper four lumbar vertebrae to be normal. Interspaces between these vertebrae have been well maintained; the interspace between L4 and L5 is normal. The interspace between L5 and S1 is narrow. Contiguous bony surfaces are increased slightly in density at L5-S1 except for the posterior-inferior half of L5 where loss of clarity of the surface is apparent. There appears to be minor subchondral dissolution of bone at L5-S1. In oblique projections, apophyseal joint space between L5 and S1 [is] incompletely obliterated but definite loss of clarity exists, especially on the left. Evidence of fusion is shown posteriorly between L5 and the upper sacrum. . . . The fusion is solid. . . . The right sacroiliac joint is slightly narrowed. The left sacroiliac joint is irregular in contour. Particularly in the middle portion of the joint contiguous bony surfaces present pronounced sclerosis. Several irregular areas of radiolucency are shown in this region, apparently in the sacrum particularly. Changes demonstrated in this region are compatible with those to be seen following operative intervention and are not inconsistent with findings to be seen with bone infection. . . . Hip joints as shown in a single frontal projection are normal in appearance. Soft tissues and other bony structures as they are seen are within normal limits.”
160
His father concurred:
Giglio, “Growing Up Kennedy,” 377.
His father concurred:
Giglio, “Growing Up Kennedy,” 377.
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