Tuesday, June 16, 2009
James Wiedeman MD, FACS has a cool piece in this week's JACS (not free to the public, sorry) on seven American presidents who underwent surgical procedures during their lifetime. He does a little Monday morning quarterbacking, retrospectively reviewing the cases and discussing how the management would have been different today. Some highlights:
George Washington contracted acute epiglottitis after a horse ride in the cold rain. The doctors treated this by bleeding him (to "decrease congestion") of 2.5 liters of blood. One doctor eventually recommended an emergency tracheotomy, but Washington refused. He died 12 hours later.
Grover Cleveland had a hard palate verrucous tumor removed (along with a chunk of his maxilla) while secretly drifting up the East River in NYC on a yacht.
Dwight Eisenhower was a train wreck. I had no idea. He apparently sustained 7 heart attacks over the course of his life. In 1956, he presented with a high grade bowel obstruction secondary to severe ileocolic Crohn's disease. The surgeons, for some reason, elected to simply bypass the problem area rather than resect it. That's certainly not what we'd do nowadays. Ten years later, he had another operation for recurrent SBO and died from a post op MI.
FDR likely died of metastatic melanoma (brain mets).
Ronald Reagan deferred a colonoscopy for 16 months, despite the insistence of his personal physician. When the scope was finally done, they found a large tumor in the cecum. He underwent a right hemicolectomy and did well.
Lyndon Johnson had an open cholecystectomy. (see picture above)
My favorite. James K. Polk suffered from recurrent kidney infections as a teenager. His surgeon diagnosed cystolithiasis (bladder stones) as the underlying etiology and recommended surgical intervention. This was in the early 19th century, remember. So they strapped him to a table and suspended his legs in the air with restraints. They gave him some brandy to sip and then the surgeon made an incision in his perineum and used a gorget (most terrifying name of a surgical instrument of all time) to burrow through his prostate, into the bladder, and scoop out the bladder stones. OH MY GOD. That may have pinched a bit. Strangely enough, President Polk never fathered any children.
I was a bit surprised that Dr Wiedeman neglected to write about the frontal lobe lobotomy performed on our 43rd President. Apparently the details are still classified....