A Democratic president is in such poor health that he can no longer run the country. A small circle of advisers keeps even his own cabinet secretaries in the dark about his true condition. Republicans start to publicly question the president’s fitness, and eventually, even the president decides it’s best not to run for another term.
The scenario describes very recent events, as documented in the new book “Original Sin: President Biden’s Decline, Its Cover-Up, and His Disastrous Choice to Run Again” by Jake Tapper of CNN and Alex Thompson of Axios. However, this scenario also describes the situation more than a century ago involving Woodrow Wilson — a cover-up of a health condition that involved a president born in Staunton, a first lady born in Wytheville and a doctor born in Culpeper County. Years later, yet another Virginian, a congressman from Radford, was instrumental in trying to come up with a constitutional fix for what to do about an incapacitated president, although the vehicle he helped devise has yet to be used.
The outlines of Wilson’s story are well-known — he suffered a stroke in 1919 and never fully recovered — but even all these years later, we’re still learning details about how perilous Wilson’s condition really was.
We now know that Wilson suffered at least four strokes before the most debilitating one in 1919; three of those took place before Wilson ran for president. In today’s political environment, it’s expected that presidential candidates reveal their medical records to prove their fitness for the post, although Donald Trump has skirted those expectations with only broad medical pronouncements and Joe Biden’s health records release in 2019 didn’t reveal how long he’d gone without a prostate exam that might have detected the cancer with which he was recently diagnosed.
In Wilson’s case, a 1981 book by Edwin Weinstein — “Woodrow Wilson: A Medical and Psychological Biography” — documents those prior strokes. The first came in 1896 when Wilson was teaching at Princeton University and he lost the use of his right hand. It took months for him to regain that ability. Wilson had never been in good health; he was regularly stressed and felt driven to overwork. After that first stroke, his personality changed and became even more driven. In 1904, when Wilson was Princeton’s president, he lost the use of his right hand again. At the time, he attributed that to writing too much but, in hindsight, Weinstein writes that this was probably a second stroke.
Wilson definitely suffered a stroke in 1906; he was left “nearly blind” in his left eye for a time, Weinstein writes. Two doctors advised Wilson to work less; he sought out a third who counselled that a few months of rest should be enough. That’s the advice Wilson followed.
Six years later, in 1912, Wilson was elected president. It was then he met Cary Grayson, a U.S. Navy doctor from Culpeper County who had previously treated his predecessor, William Howard Taft. The two men became close, perhaps closer than was wise. In Wilson’s first year as president, he suffered a fourth stroke. This one affected Wilson’s left arm. Weinstein writes that “The episode which affected Wilson’s left arm was particularly ominous from a clinical standpoint” and details why. Those medical details “not only increased the risk of future strokes, but also created the possibility that enduring changes of behavior, based on insufficient blood supply and impaired oxygenation of the brain, might eventually occur.”
Wilson ignored advice to slow down, but one of his wife’s doctors predicted that the president would not live out his term. Fearful of upsetting the president and triggering another stroke, Grayson did not warn Wilson that his wife, Ellen, was seriously ill. Weinstein speculates that Grayson even put off calling in specialists to treat the first lady to avoid causing the president more stress. By the time he did, it was too late: In 1914, Ellen Wilson became the third first lady to die while her husband was in office.
President Wilson certainly didn’t blame the doctor. He promoted Grayson from lieutenant to rear admiral, an astonishing jump of four ranks. Grayson moved into the White House. Meanwhile, the grieving president met a widow who had grown up in Wytheville — Edith Bolling Galt. The president was so enamored that he proposed marriage two months later. She became the new first lady and, in time, an unofficial acting president.
Five years went by. Wilson had no further “episodes.” He’d been reelected, presided over America’s entry into World War I, and, after the war’s end in 1918, was engaged in a vigorous although ultimately futile attempt to persuade the Senate to agree to enter the League of Nations, a doomed precursor to the United Nations that was thought then to be a way to prevent future wars. The nation’s isolationist tendencies were strong. In fall 1919, Wilson embarked on a whistlestop tour across the country to rally support for the League.
As the train rolled west, he complained of headaches and other ailments. Then on the night of Sept. 25, 1919, in Pueblo, Colorado, Edith Wilson found her husband nauseated, his face twitching uncontrollably. The president’s tour was canceled, and the train rushed him back to Washington. His press secretary announced that Wilson suffered from “a nervous reaction in his digestive organs.” One week later, on Oct. 2, Wilson suffered his most severe stroke. By some accounts, he fell unconscious to the floor while on the way to the bathroom and Edith Wilson had to drag him back to the bed. When Grayson arrived to examine the president, he declared: “My God, the president is paralyzed.”
Very few people were allowed to know. Grayson briefed the Cabinet but told the secretaries and even Vice President Thomas Marshall as little as possible. None of them were allowed to see the ailing president. “For the next 18 months,” writes Brandeis University history professor Thomas Doherty, “the president’s inner circle — his wife, Edith, and his team of doctors — obfuscated and outright lied about Wilson’s health.”
Edith Wilson assured officials that “the president was mentally as sharp as ever; he was merely suffering from nervous exhaustion,” writes Rebecca Boggs Roberts, author of a book about Edith Wilson. “He was not accepting meetings, but she would be happy to relay any important messages and return any necessary replies.” (Her book is “Untold Power: The Fascinating Rise and Complex Legacy of First Lady Edith Wilson” and ought to be required reading for anyone who fancies themselves a student of Virginia history. This native of Wythe County was, for a time, arguably the most powerful person in the country.)
Whether Edith Wilson was truly the acting president or simply a powerful chief of staff may be a matter of semantics. She decided what the president was told but insisted she never made any decisions herself. In her autobiography, she wrote: “I studied every paper, sent from the different Secretaries or Senators, and tried to digest and present in tabloid form the things that, despite my vigilance, had to go to the President. I, myself, never made a single decision regarding the disposition of public affairs. The only decision that was mine was what was important and what was not, and the very important decision of when to present matters to my husband.” She called this a “stewardship.”
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The future Edith Wilson came from a well-to-do family in Wythe County — her father was a judge — but, like many women of her era, she had little formal education. She was homeschooled by her grandmother, then spent an unhappy semester at a finishing school in Abingdon and then a happier year at another finishing school in Richmond. When that school abruptly closed, her family decided that educating Edith any further wasn’t worth the investment, that the money was better spent on sending her brothers to school. She then did what young women of that time were expected to do: She got married, to a Washington, D.C. jeweler.
Whatever the then-Edith Bolling Galt lacked in education, she made up for with personality and grit. She is said to have been the first woman to drive a car in the nation’s capital (an electric car, by the way). She also proved herself a successful manager during a crisis — the death of her first husband. She inherited both his jeweler business and a lot of debt. She hired a manager to run the day-to-day operations, paid off the debt and had enough left over to tour Europe. She continued to own the business for years after she left the White House, not something typical for the time, before she finally sold it to the employees.
When Edith Wilson became first lady, President Wilson took her into his confidence in what might have been unprecedented ways. In the evenings, they worked together. The president gave his wife access to wartime codes and she used them to decode secret messages intended for the president’s eyes only. She screened his mail and stamped his signature on official documents — all this before he was incapacitated.
“At the president’s insistence, the first lady sat in on his meetings, after which she gave him withering assessments of political figures and foreign representatives,” says her entry on the website Biography. “She denied his advisors access to him if she determined the president couldn’t be disturbed.” When President Wilson attended the Paris Peace Conference after World War I, so did the first lady — although she discreetly sat behind a curtain during the actual talks.
From those experiences, Encyclopedia Virginia says, “She came to believe she understood the president’s plans and desires, a fact that both enabled and emboldened her when he later fell ill.” For a time, Edith Wilson’s “stewardship” seemed to work. Cabinet secretaries went about their business, following written instructions. Washington is sometimes a town that runs on rumors, and eventually rumors got around. Wilson’s biggest critic was Sen. Albert Fall, a Republican from New Mexico. “We have petticoat government,” he declared on the Senate floor. “Wilson is not acting. Mrs. Wilson is president.” That declaration didn’t produce the desired response, though.
Fall’s opportunity to press the matter further came when Secretary of State Robert Lansing testified before the Senate Foreign Relations Committee in December 1919. Lansing’s relationship with the president had been frosty — they had policy differences. When an American diplomat in Mexico was kidnapped, Lansing, operating without presidential guidance, had sent a more strongly worded diplomatic note than the more pacific Wilson himself would have. Fall questioned Lansing about whether he had consulted with Wilson on the matter. “With visible anger, Lansing replied that no, he had not consulted with the president at all since September,” Boggs Roberts writes. “As far as Lansing knew, not a single member of the cabinet had met with the president about anything in months.”
Fall demanded that a Senate delegation visit the president, officially to talk about the diplomat’s kidnapping but unofficially to see what his health was really like. Edith Wilson, Grayson, the president’s press secretary and the press secretary for the Democratic Party hastily plotted out how to respond. They prepared a “show.”
“Woodrow, who by necessity would star in this little production, had good days and bad days,” Boggs Roberts writes. “His entire left side was still paralyzed. He tired easily, and sometimes his speech slurred. In his weakness and exhaustion, he could find it hard to concentrate on a conversation, and Edith would have to gently prod him to respond. But he also had windows of clarity and wit.”
Edith Wilson draped a blanket over the president’s paralyzed left side. The chairs for the visiting senators were positioned on the right side of the bed to make it difficult to see the president’s paralysis. The lights were arranged so that they shone into the senators’ eyes while the president’s bed was in shadow. A copy of the Senate Foreign Relations report on Mexico was conspicuously placed on a nightstand within easy reach of the president’s good right hand. When Fall quizzed Wilson on whether he had seen the Senate report, the president dramatically reached for his prop. “I have a copy right here!” he declared. It was one of the president’s good days.
Wilson’s inner circle had even more good luck that they couldn’t have anticipated: The meeting was interrupted with the news that the diplomat had been unexpectedly released. With that news, the meeting effectively ended. Even the critical Fall told reporters waiting outside the White House that that stricken president “seemed to me to be in excellent trim, both mentally and physically.”
He was not. Fall had been snookered.
The president’s health improved, but Wilson wasn’t up to the third term he had hoped for. The public caught only glimmers of all this. The harsh glare of media inquiry was far dimmer then than it is today. In the days before television, Americans simply had no expectation of ever seeing their president, so it was much easier to keep Wilson hidden from the view even of Washington insiders. Not until June 1920, nine months after Wilson’s stroke, was a photograph of the president released. It was posed in such a way as to hide his paralysis.
Those who did have some hint into the president’s condition weren’t sure what to do. Lansing, the secretary of state who didn’t much like Wilson, urged Marshall to take over as acting president. The vice president demurred. The constitution was vague on the matter of an incapacitated president, and Marshall wanted to err on the side of caution. Wilson didn’t like Marshall, either, and that went double for Edith Wilson. They kept Marshall away from the president until the two men’s final day in office in March 1921.
Not until after the assassination of President John Kennedy in 1963 did Congress seriously confront the constitutional issues involved in having a president physically unable to do the job. The result is the 25th Amendment, which sets out a formal procedure to have a president declared incapable. The primary driver was Sen. Birch Bayh, D-Ind., but the main author was Rep. Richard Poff, R-Radford, for whom the federal courthouse in Roanoke was later named (until last year, when the name was changed).
The book “Original Sin” shows that we still haven’t really resolved how to respond to a president who isn’t fully able to do the job; history shows this isn’t the first time.
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