Illness can impact a president’s ability to perform office, but for much of U.S. history, protocol about what happens when a president falls ill was minimal.
The founding fathers anticipated the need for a line of succession, and the Constitution stipulates that the vice president becomes interim president if the elected official dies, resigns or becomes weakened. But he left out critical details, including who has the power to declare the president unfit to serve, when and how the president should return to office, and whether the vice president is to remain president for the remainder of the term or until. ‘until a replacement is found.
It took the assassination of John F. Kennedy for Congress to pass the 25th Amendment establishing a clear protocol on what happens if the president or vice-president resigns, becomes incapacitated or disabled, or dies.
Presidential history is full of leaders who have dealt with illnesses or health issues – some openly, others in secret – during their tenure.
George washington
The first president to fall seriously ill during his tenure was the country’s first president, George Washington. Two months into his first term, Washington underwent surgery for a tumor that required him to rest on his right side for six weeks. In his second year in office, Washington survived a flu crisis that threatened his hearing and his eyesight, prompting him to write: “I have already had in less than a year two serious attacks – the last worst. that the first – a third more than likely will put me to sleep with my fathers; how far it can be, I don’t know.
The disease was rampant in early American cities, and a yellow fever epidemic in the summer of 1793 prompted Washington and the government to flee into the countryside. Washington survived, having survived diphtheria, tuberculosis, smallpox, malaria, dysentery, Quinsy and anthrax, as well as many near misses on the battlefield. He eventually died of a throat infection, but after leaving office.
READ MORE: When the yellow fever epidemic of 1793 sent the wealthy fleeing Philadelphia
William Henry Harrison
William Henry Harrison became the shortest president when he died just 34 days after taking office from pneumonia contracted on inauguration day. He was the first president to die while in office, meaning there was no precedent for Vice President John Tyler’s coming to power.
While Tyler was initially awarded the title of “Acting Vice President” by Congress, he sought a more permanent job title. Tyler moved into the White House and was sworn in as president, even giving an inaugural address.
READ MORE: Did William Henry Harrison’s inauguration speech kill him?
Grover Cleveland
In 1893, Grover Cleveland needed surgery to remove a cancerous tumor in his mouth. To avoid press attention, he underwent surgery on his friend’s yacht in Long Island Sound. He had a quarter of his upper palate completely removed, fitted with an implant, and returned to work. The public was not the wisest.
Woodrow wilson
Woodrow Wilson nearly died from the 1918 influenza pandemic during delicate negotiations with world leaders at the Paris peace talks. With the flu decimating civilians and soldiers in World War I – 20 million people ultimately died of the disease worldwide – Wilson’s doctor lied, telling reporters the president caught a cold from the rain in Paris.
Wilson’s illness wore him out, and aides began to fear that it would hamper the president’s ability to negotiate. Eventually, Wilson renounced his claims on French leader Georges Clemenceau, accepting the demilitarization of the Rhineland and the French occupation of it for at least 15 years. The resulting Treaty of Versailles was so hard on Germany that it contributed to the rise of Adolf Hitler and the outbreak of World War II.
It wouldn’t be the last time a doctor would lie about Wilson’s condition: in 1919, he suffered a series of strokes that prompted his cabinet to suggest the vice president take over. First Lady Edith Wilson and the President’s doctor Cary Grayson refused.
Franklin D. Roosevelt
The longest-serving President of the United States, Franklin Delano Roosevelt, has hidden the severity of his polio from the American public, fearing that he will be seen as weak. He avoided using his wheelchair during apparitions to “walk” using leg braces, a cane, and usually the arm of a counselor. The press was prohibited from taking photos of him walking – an offense the Secret Service was tasked to prevent.
READ MORE: Franklin Roosevelt’s Personal Polio Crusade
Dwight D. Eisenhower
President Eisenhower poses for the first photos since he suffered a heart attack, 1955.
Bettmann Archives / Getty Images
During Dwight D. Eisenhower’s tenure, he suffered a heart attack, was diagnosed and operated on for Crohn’s disease, and had a stroke. Fearing that he would not recover, Eisenhower wrote a confidential letter to his vice president, Richard M. Nixon, telling him what to do in case he did not regain his faculties.
In it, he named Nixon as the person responsible for determining whether or not Eisenhower could perform his presidential duties. The letter was not legal, and Nixon only temporarily resumed the role of president, once in 1955 after the president’s heart attack and again during his surgery in 1956.
Ronald reagan
The 25th Amendment was first formally invoked on July 13, 1985, when President Ronald Reagan ordered Vice President George HW Bush to perform his duties while undergoing surgery for colon cancer . Bush became interim president when Reagan received general anesthesia. After just under eight hours, Reagan informed the Senate that he was ready to resume his presidential duties.
George W. Bush
During his two-term presidency, George W. Bush invoked the 25th Amendment twice. On June 29, 2002, Bush invoked Section 3 of the 25th Amendment before going under anesthesia for a colonoscopy and briefly made Vice President Dick Cheney the acting president. He did the same thing again for another colonoscopy in 2007.
