Academic journal article American Journal of Law & Medicine

The Presidents' Mental Health

Academic journal article American Journal of Law & Medicine

The Presidents' Mental Health

Article excerpt


Calvin Coolidge had a successful run in politics for over twenty years before ultimately becoming president of the United States in 1923.1 Throughout Coolidge's first term as president, he worked long, hard hours, was active in Congress, and maintained a strong relationship with the media.2 This changed, however, during the second term of his presidency. Less than a month after his second-term election, Coolidge's son died of blood poisoning.3 This traumatic event caused the President to enter into a deep depression.4 In his autobiography, Coolidge admitted that when his son died, "the power and glory of the presidency went with him."5 His grief, which has since been coined "pathological grief," had an effect on the President's mind, body and spirit.6 President Coolidge lost interest in his job and began sleeping fourteen hours a day, ultimately earning a reputation as one of the most ineffectual presidents ever to hold office.7 His depression rendered him incapable of making decisions, and as a result most of his duties were delegated to members of his Cabinet.8 Though the White House knew for four years that Coolidge's depression rendered him incompetent, he remained in office until the end of his second term.

Naturally, Americans shudder at the notion of a president suffering from a serious ailment while in office. Beyond the fact that an illness could leave the president physically incapable of performing his job, there exists the even more horrifying idea of a president who is mentally incapable of performing the job but continues to do so. This note examines what happens when the man who leads the most powerful nation in the modern world suffers from an illness that adversely affects his ability to think clearly, make decisions, and run the country. Part II examines various instances in history when a president has suffered mental and psychological weaknesses while in office. Part III suggests that considering the magnitude of the position, presidents and presidential hopefuls should be subject to a more rigorous physical and psychological screening process. Part IV discusses the care the president receives from the White House medical team, and examines the role of the primary White House physician and the physician's duty to maintain confidentiality. Part V sets forth recommendations pertaining to the president's health, including alternate means of choosing the White House doctor, a proposed exception to the doctor's duty of confidentiality in cases of presidential mental infirmity, and a more ready invocation of the 25th Amendment.


White House doctors have traditionally been concerned with four types of disabilities that have inflicted our presidents.9 First, there is physical disability, the most notable example being Franklin D. Roosevelt, who was thought to be very intelligent and capable, but who was confined to a wheelchair after the age of thirty-nine because of polio.10 Second, there is disability due to short-term illness.11 During his notorious visit to Tokyo in January 1992, President George H. Bush, stricken with the flu, vomited on the Prime Minister of Japan and then fainted.12 Although he recovered quickly, there was some speculation as to the political ramifications of the episode.13 The third type of disability stems from the influence of medication on the president's mind and judgment, and the fourth is psychological disability.14 The remainder of the discussion will focus primarily on the last two disabilities, as well as those instances where severe illness impairs the mind. Ailments of the mind, rather than the body, are often overlooked in the context of presidential health because they are the hardest to detect and the most difficult to treat.15


In October 1919, President Woodrow Wilson experienced a devastating stroke that left him incapacitated for over a year. …

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