Tuesday, August 7, 2012

The final curtains


Cholera morbus: two of the creepiest words I've read since starting this project. Cholera, as any child of the 80's remembers, is one of the icky diseases that kills off members of your party in the game Oregon Trail, while morbus (Latin for "disease") sounds too much like mor-bid for comfort. The term, out of fashion today, was used in olden days to describe a patient's general "getting really sick in a way that may or may not actually be cholera and may also be fatal" - as it was for at least two presidents.

I say "at least" because cause of death isn't always obvious today, much less in times when we didn't know everything we know about medicine and health. Hence diagnoses like "cholera morbus" - we know he died of some kind of illness, though we'll be damned if we know which one. Zachary Taylor and James K. Polk are said to have died of cholera morbus; Taylor had had flare-ups of some kind of illness throughout his short presidency, while Polk is said to have worked himself to death. In these and many other cases, the presidential cause of death is more in the realm of "probably" than "definitely. "

The most definite, of course, was John F. Kennedy, one of the few presidents to receive an autopsy, and near as we can tell the only one whose demise was captured on film. Assassination is that way - though we should point out that medical minds today are convinced two presidents who were felled by an assassins bullet would have survived the attacks had the medical minds of their day not introduced infections into the wounds. From what I've read, James Garfield unquestionably would have lived, McKinley had a pretty good shot chance as well, and a few folks even suggest Abraham Lincoln could have physically survived, though he would have been mentally incapacitated.

update: in rereading the post I realized that saying William McKinley had a good "shot" at surviving is a pretty awful word choice given the situation. Ouch. Yeah. 

Pneumonia has been a common cause of death for presidents, taking George Washington, Ronald Reagan and both Harrisons, though I've read that this, back in the day, was another one of those "ah, he's sick, just call it something" terms, like cholera morbus. If so, the only definite case of pneumonia was Reagan, and I've been told that's a common complication for people with Alzheimer's disease.

Another euphemism: debility. John Adams, Jefferson, Madison and Monroe all succumbed to this phrase essentially meaning "being really old." Three of the four died on the Fourth of July, and the fourth (Madison) died a few weeks shy of the Fourth, so maybe it should be called "Independence Day-related debility." James Buchanan died of respiratory failure, while Martin Van Buren is said to have died of "asthma," though the fascinating site Doctor Zebra suggests this is an "unsatisfying" explanation and that sleep apnea is one of a number of alternatives. 

A few presidents didn't even get euphemisms; it's just not known what did them in. Grover Cleveland has been said to have died of about 700 different things; it sounds as if he was unwell and a lot of systems started going haywire. Theodore Roosevelt officially fell to a "coronary embolism" but that's not certain. And neither Gerald Ford's family nor his doctors have, to my knowledge, ever released a cause of death, though "being 93" does leap to mind. Or I guess it's called "debility."

A few cases are more cut and dried, such as the presidents who died after strokes - in fact, each of the three presidents who returned to legislative activity after their presidencies died of strokes. This included Andrew Johnson, who had only recently returned to the US Senate; John Tyler, a member of the Confederate House of Representatives, and, most dramatically, John Quincy Adams, who collapsed on the floor of the House of Representatives after shouting "NO!!!!" to a bill on the Mexican War.

Heart disease is another common killer of presidents - though it took more than six heart attacks to take Eisenhower and at least three for LBJ. The deaths of Andrew Jackson and Theodore Roosevelt are both blamed on coronary events, though in each case they had been getting progressively sicker over time and finally just ran out of steam. Jackson, in particular, was in bad shape, short of breath, in constant pain and puffed up from water retention - "I am a blubber of water," he said, which luckily did not end up on his tombstone.

Lastly, only one president - U.S. Grant - has died of cancer. Am I the only one to find this unusual? I certainly don't know medical statistics, but I'd expect it to be higher. Then again, presidents are a small group and not necessarily an "average" group at that.

The full list is below - it's based largely on two sites: Dead Presidents: Causes of Death and Doctor Zebra. I put asterisks next to the cases where the cause of death is less than certain.

debility - John Adams, Jefferson, Madison, Monroe
pneumonia - Washington, William Henry Harrison, Benjamin Harrison, Reagan
stroke - John Quincy Adams, Tyler*, Fillmore, Andrew Johnson, Wilson, Nixon
heart disease - Jackson*, Hayes, Truman, Eisenhower, Lyndon Johnson
“asthma” - Van Buren
cholera morbus - Polk, Taylor
stomach inflammation from alcohol use - Pierce
respiratory failure - Buchanan
assassination or related - Lincoln, Garfield, McKinley, Kennedy
cancer - Grant
cerebral hemorrhage - Arthur, Franklin Roosevelt
not clear - Cleveland, Ford
coronary embolism - Theodore Roosevelt*
heart attack - Taft, Harding*, Coolidge
gastrointestinal hemorrhage - Hoover

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