As Americans prepare to elect a new president in November, everything about the candidates will be open to public scrutiny, including their medical histories. After all, a president should be healthy and hearty, right? But history doesn’t lie, and many presidents have had serious health issues. We all know about George Washington’s dental problems, William Howard Taft’s morbid obesity and Franklin Roosevelt’s crippling bout with polio, but American presidential history is full of surprising medical facts – and proof that serious health issues don’t necessarily preclude someone from succeeding at what is arguably the hardest job in the world. Every week until the election, HealthLeader will focus on the medical histories of a variety of presidents. This week, we will learn more about Woodrow Wilson, the 28th president of the United States.

A leading intellectual, former president of Princeton University and former governor of New Jersey, Woodrow Wilson was first elected president in 1912 and re-elected in 1916. He seemed to have had a relatively healthy life until the age of 40, when, in May 1896, he reportedly suffered a seizure that caused weakness in his right arm and sensory disturbances in his fingers, which rendered Wilson unable to write normally for almost a year afterward. In June 1904, Wilson again suffered from weakness in his right arm, which lasted for several months. This right-side weakness occurred again in May 1906, November 1907, July 1908, December 1910, April 1913, and periodically throughout the year 1915. These episodes were usually accompanied by severe headaches that would last several days, leading most modern physicians to conclude that President Wilson suffered numerous small strokes throughout his adult life.

By September 1919, Wilson was experiencing an almost constant and severe headache, double vision, and several signs of a weakened heart. At the time, he was on a grueling public speaking tour of the country to promote the League of Nations. On Sept. 25, 1919, Wilson collapsed after a speaking engagement in Pueblo, Colorado. He quickly returned to Washington D.C., where, on Oct. 2, he suffered a massive stroke that almost completely incapacitated him. He was paralyzed on his left side, permanently blind in his left eye, and confined to a wheelchair for several months.

The full extent of his disability was kept secret from the public, and many people now believe that Wilson’s wife Edith, his doctor, and a close friend colluded to hide his condition from the vice president, Congress, and White House visitors. Edith, historians now agree, made all of the presidential decisions from that point until her husband left office in 1921. She herself alluded to it, saying to friends later, “When Woody was ill I had no difficulty running the country.”

What she did find difficult, however, was hiding her husband’s condition from his political enemies. Wilson faced enormous opposition to the League of Nations from the Senate, and six weeks after his stroke a suspicious Henry Cabot Lodge, his main nemesis, sent two senators to meet with the president.

“It’s a fascinating story,” said Sean Savitz, M.D., assistant professor of neurology at The University of Texas Medical School at Houston. “His enemies in the Senate knew the president was sick, but they didn’t know to what extent, or even what had really happened to him. Edith Wilson and the president’s doctor carefully prepared everything so that the extent of the president’s incapacitation was hidden. They lowered the lights in the room, propped the president up in his bed, and draped a blanket over the left side of his body. By this point, the president was able to speak normally. When one of the senators told him, ‘We’re praying for you, Mr. President,’ Wilson retorted, ‘Which way, senator?’” Wilson’s grim retort resulted in the senators reporting back to Lodge that the president was still in possession of all of his faculties.

“Wilson had high blood pressure and a series of strokes throughout his adult life, but he always managed to recover from them until the 1919 stroke,” said Savitz. “That event was probably a major hemorrhage in the brain. We’ve made incredible leaps in the treatment of ischemic strokes, which are caused by a lack in blood supply to the brain. Today, a hemorrhage like the kind Wilson may have had might have been treated with a surgical evacuation or medicine to stop the bleeding. But no treatment has been definitively shown to be effective in clinical trials. So it’s possible to say that there hasn’t been significant advancement in the treatment of some types of brain hemorrhages since Wilson’s event.”

Wilson lived another three years after leaving office, dying at home on Feb. 3, 1924. Nine months later, his adversary Lodge suffered a stroke of his own and died. As the facts about Wilson’s long illness were made public, it drove the movement to ratify the 25th Amendment to the Constitution of the United States, which provides for the peaceful transfer of executive power in cases of death, disability and resignation.

Last Updated: 9-24-2008

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