A First-Rate Madness (44 page)

173
but she obeyed the commander in chief:
For example, November 14, 1961: “Hypo Testosterone aq. Susp. 37.5 mg.im right buttock . . . requested med. For trip given to Dave Powers Requested MT. 25 q.d.” Or September 21, 1961: “7:15 pm Asked me to come up . . . back still aches. More tired today . . . asks if his medication has been cut back. . . . Pulse fast very keyed up and just back from pool. Given fluorinef 0. 1 stat. Also box of codeine 32 mg. Ritalin 5 mg. to take just before leaving shortly for state dinner, or during evening.” JFK Presidential Archives, Medical Records, PP, Box 46.

After the somewhat haphazard care he had received in early 1961, culminating in his Addisonian crisis of June of that year, Kennedy's doctors began to keep better track of his testosterone use, and they have left us monthly summaries of his total dosages for ten months from August 1961 onward. (JFK Presidential Archives, Box 46, Travell notes.) I have added up those doses, keeping in mind that for the first eight months he received methyltestosterone, and in the last two months (beginning May 1962) he was switched to Halotestin. In the first eight months, he received a total dose of 3010 mg of methyltestosterone, either orally or intramuscularly; this is about 12.5 mg of methyltestosterone daily. In the final two months tallied, he received 610 mg of Halotestin, or about 10 mg daily. These are not exceedingly high doses of anabolic steroids, but they are consistent and chronic.

173
athletes take similar doses . . . to make themselves more “aggressive”:
http://www.steroid.com/Halotestin.php
(accessed February 11, 2010).

173
At least three double-blind, placebo-controlled studies:
F. Talih, O. Fattal, and D. Malone, “Anabolic Steroid Abuse: Physical and Psychiatric Costs,”
Cleveland Clinic Journal of Medicine
74 (2007): 341–352.

173
Summaries of large clinical populations:
T. P. Warrington and J. M. Bostwick, “Psychiatric Adverse Effects of Corticosteroids,”
Mayo Clinic Proceedings
81 (2006): 1361–1367.

173
steroids improve mood and cause fewer psychiatric side effects:
Penelope J. Hunt, Eleanor M. Gurnell, Felicia A. Huppert, Christine Richards, A. Toby Prevost, John A. H. Wass, Joseph Herbert, and V. Krishna K. Chatterjee, “Improvement in Mood and Fatigue After Dehydroepiandrosterone Replacement in Addison's Disease in a Randomized, Double Blind Trial,”
Journal of Clinical Endocrinology and Metabolism
85, no. 12 (2000): 4650–4656. E. Ur, T. H. Turner, T. J. Goodwin, A. Grossman, and G. M. Besser, “Mania in Association with Hydrocortisone Replacement for Addison's Disease,”
Postgraduate Medical Journal
68 (1992): 41–43.

174
“a slight sniffle” . . . “Received a call” . . . a small dose of Stelazine:
JFK Presidential Archives, Medical Records, PP, Box 46. The Stelazine dose was 1 mg twice daily. Note of Dr. George Burkley, December 13, 1962.

175
The most extensive journalistic work is by Seymour Hersh:
Seymour Hersh,
The Dark Side of Camelot
(Boston: Little, Brown, 1999).

176
they prefer cocaine:
C. E. Johanson and T. Aigner, “Comparison of the Reinforcing Properties of Cocaine and Procaine in Rhesus Monkeys,”
Pharmacology Biochemistry and Behavior
15, (1981): 49–53.

176
pleasurable feelings similar to those of cocaine:
Bryon Adinoff, Kathleen Brady, Susan Sonne, Robert F. Mirabella, and Charles H. Kellner, “Cocaine-like Effects of Intravenous Procaine in Cocaine Addicts,”
Addiction Biology
3 (1998): 189–196.

176
the claim made by Kennedy biographers:
The first historian to see most of Kennedy's medical records (in 2002), Robert Dallek, documented the steroid use and other medications, but concluded that Kennedy, though ill, was unaffected in his role as president. As summarized by another historian, James Giglio, “despite the potential risks, his health seemed to have had no negative impact on his presidential performance.” James N. Giglio, “Growing Up Kennedy: The Role of Medical Ailments in the Life of JFK, 1920–1957,”
Journal of Family History
31 (2006): 358–385 (quote on 379).

176
has been challenged only by Dr. David Owen:
Owen,
In Sickness and in Power,
141–190.

177
“When you commit the flag”:
Reeves,
President Kennedy,
71.

177
“How could I have been so stupid?” . . . “Those sons-of-bitches” . . . “I've got to do something”:
All from ibid., 103.

177
“The President was completely overwhelmed”:
Ibid., 174.

177
“Too intelligent and too weak”:
Ibid., 166.

177
“Gentlemen, you might as well face it”:
Ibid., 196.

177
“Walking out on generals was a Kennedy specialty”:
Ibid., 182.

178
“Does this mean Germany”:
Dallek,
An Unfinished Life,
624.

179
“The first advice I am going to give my successor”:
Benjamin Bradlee,
Conversations with Kennedy
(New York: Pocket Books, 1976), 117.

179
Robert Kennedy later described the pragmatic aspect:
JFK Presidential Archives, Oral History Program, interview of Robert F. Kennedy by Ted Sorensen, 1966.

179
Martin Luther King was invited to the White House:
Reeves,
President Kennedy,
100.

180
“In the election, when I gave my testimony”:
Harris Wofford,
Of Kennedys and Kings
(Pittsburgh: University of Pittsburgh Press), 128–129.

181
“Negroes are getting ideas”:
Reeves,
President Kennedy,
357.

181
“Don't tell them about General Grant's table”:
Ibid., 359.

181
“Go to hell, JFK!”:
Ibid., 360.

181
“People are dying in Oxford”:
Ibid., 363.

181
The president placed a phone call to Dr. Max Jacobsen:
The role of Jacobsen is documented well by Dallek (
An Unfinished Life
) and Owen (
In Sickness and in Power
). Jacobsen first saw Kennedy in 1960. Owen documents the high likelihood that Jacobsen's injections involved amphetamines and steroids. In fact, when the Bureau of Narcotics and Dangerous Drugs interviewed Jacobsen in 1969, it noticed track marks on his arms, and the doctor admitted to injecting himself with 25 mg of methamphetamine every two to three days (Owen, 165).

There appears to have been a gradient of medical competence. Burkley and Cohen saw Travell as incompetent, and they all thought Jacobsen was a dangerous quack. Thus, in 1961, before the break between Travell and Burkley, all the White House physicians were banding together to get a handle on Jacobsen. In the JFK Library Archives, I believe I have found the first probable documentation of this effort involving Travell and the others. The following note by Travell refers to the president; GGB stands for George G. Burkley: “April 11 1962, 6:00 pm. Went upstairs early to rest. Did not swim, and said that he was too tired to do exercises. Creep in town, left White House about 8 PM. (GGB),—also yesterday PM” (JFK Presidential Archives, PP, Box 46). If we can infer that “Creep” refers to Jacobsen, then it appears that Burkley had discovered that Jacobsen had visited the president and had informed Travell. As with the medical coup d'etat, Jacobsen was not ousted overnight because the president resisted. However, Jacobsen's visits became less frequent and faced overt opposition by the White House medical staff, Travell included. Robert Kennedy, as in many other matters, had a major impact, and his June 1962 intervention against Jacobsen was likely the beginning of the end. Thus, though Jacobsen injected the president as late as September 1962, his injections were less frequent and thus likely influenced the president for the worse to a lesser degree than had been the case in 1961.

David Owen has reviewed Jacobsen's unpublished memoirs and reports that Jacobsen mainly describes visits to the president on a frequent basis in the spring and summer of 1961, in the new administration's first year, when Kennedy was at his worst politically and at his sickest physically and mentally. Jacobsen saw Kennedy less frequently in 1962, and it is highly probable that his last visit was during the Oxford, Mississippi, crisis of September 1962 (Owen, 169; Dallek, 582).

The Jacobsen story, so similar to Hitler's relationship with Theodor Morell, which is discussed in the next chapter, first came out in the media in 1972, but many of the facts were unknown at that time. Dallek's 2003 biography first broke the story in detail. Owen's book in 2008 first made the link to Kennedy's performance.

181–182
Come down here, Kennedy told him:
Reeves,
President Kennedy,
364.

183
“I hope that every American”:
Ibid., 521.

183
He knew he would lose the southern states:
Robert Kennedy was later asked in an oral history whether the Kennedys thought they would gain any political or electoral advantage with their new policy. (JFK Presidential Archives, Oral History Program, interview of Robert F. Kennedy by Ted Sorensen, 1966.) No, he recounted; they did not expect that black voting rights would change elections in the South for years to come, perhaps in the 1970s or later, but not so soon as to have any effect on JFK's reelection. They fully expected to lose the South, even Johnson's Texas, during the 1964 election, Robert said; they might even lose the whole election. They knew their civil rights plan would mean electoral losses to some extent, but they were also savvy enough to have Lou Harris polling in the North and Midwest, with increasing support for Kennedy's civil rights position. JFK had made a dangerous gamble, the first Democrat since the Civil War to do so: he would enter reelection, he had decided, with a plan to win by taking all of the country except the South. In fact, with the exception of Jimmy Carter, Democrats have only won the presidency since JFK by peeling off, barely, a few southern states either because of personal roots or special circumstances. Of the ten standard southern states—Virginia, North and South Carolina, Georgia, Tennessee, Alabama, Mississippi, Louisiana, Arkansas, and Texas—Lyndon Johnson, riding a wave of post-assassination sympathy, won only five; Bill Clinton won four in 1992 and three in 1996; and Barack Obama, even with a major black turnout, won only one. Only Jimmy Carter was successful, winning all southern states but Virginia in 1976. In fact, since JFK, no white non-southern Democrat has won the presidency.

183
“Every single person who spoke about it”:
Wofford,
Of Kennedys and Kings,
172.

184
The White House practically took over:
Reeves,
President Kennedy,
580–582.

184–185
He changed a line in . . . John Lewis's speech . . . asked Lewis to remove an analogy:
Ibid., 581–582.

185
“He's damned good”:
Ibid., 584.

185
“You made the difference”:
Ibid., 585.

185
JFK “frankly acknowledged that he was responding to mass demands”:
Wofford,
Of Kennedys and Kings,
177.

185
“I have a dream”:
Reeves,
President Kennedy,
584.

185
In her 1966 oral history:
JFK Presidential Archives, Oral History Program, interview of Janet Travell by Ted Sorensen, 1966:

186
“It is my considered opinion”:
JFK Presidential Archives, Medical Records, PP, Box 45, November 29, 1963.

188
was advanced . . . by Hannah Arendt:
Hannah Arendt,
Eichmann in Jerusalem: A Report on the Banality of Evil
(New York: Viking, 1963). Arendt previously had been a student and mistress of the philosopher Martin Heidegger, who later became pro-Nazi. Arendt, who was Jewish, then rejected Heidegger's ideas and maintained close personal and intellectual ties to Jaspers.

189
the memoirs of his closest friend from young adulthood:
August Kubizek,
The Young Hitler I Knew
(Boston: Houghton Mifflin, 1955; Norwalk CT: MBI Publishing Company, 2006).

189
Most historians accept the general veracity:
Some historians express concern that Kubizek's memoir may not be entirely valid, partly because some have claimed that it was commissioned by the Nazi Party, a claim vehemently denied by Kubizek and by his publisher Stocker Verlag. Though a party member in 1942, Kubizek had not joined in previous years and was never an active member. He also turned down Hitler's offers of special positions throughout the Nazi period. Another critique is that Kubizek's claim that Hitler was anti-Semitic early in his life has not been corroborated, apparently, from other sources. With such caveats, most historians accept the broad outline of Kubizek's memoir. (Martin Kitchen, personal email communication, July 31, 2010.)