John F. Kennedy: A Chronic-Pain Chronology

[dropcap]From[/dropcap] JFK’s childhood until his assassination, chronic pain and other serious illnesses accompanied him like a loathsome running mate. Hence, the major milestones of his life come in three varieties: personal, political and medical. This timeline weaves together all three, depicting a life marked by ascending power and intractable pain.

1917

•  Born in an upstairs bedroom of Kennedy family home in the Boston suburb of Brookline, Mass.

•  Born with a left leg shorter than his right, an asymmetry that predisposes him to severe back pain in adulthood. Later in life, he’ll wear a three-eighths-inch-thick heel lift in his left shoe to offset that difference in his leg lengths.

•  Genetically predisposed to an autoimmune disease (possibly Schmidt syndrome) that, in years to come, will attack his adrenal glands (culminating in a life-threatening case of Addison’s disease) and thyroid. His autoimmune disease will also contribute to his back pain; put him at increased risk of celiac disease (a possible cause of his chronic abdominal pain, diarrhea, and tendency to be underweight); and impair his overall health in childhood and adulthood.

1917-19: Age 0-2

•  Suffers various infections, including a nearly fatal case of scarlet fever.

•  His mother Rose keeps notecards listing the medical information for each of her nine children.

1920-31: Age 2-13

•  Plagued by multiple ailments, including German measles, measles, mumps, whooping cough, chicken pox, bronchitis, and ear infections throughout the 1920s.

•  Relocates with his family to Riverdale, New York, 1927. Parents also buy a home in Hyannis Port, Mass., where they spend their summers.

•  Unexplained six-pound weight loss from Oct. to Dec., 1930.

•  Collapses from abdominal pain, Apr. 1931.

•  Undergoes appendectomy that fails to relieve his abdominal pain. The pain persists throughout his life.

•  Enrolls in Connecticut boarding school.

1933: Age 15-16

•  Suffers ongoing flu-like symptoms, constant knee pain, and is chronically underweight.

•  Diagnosed with “diffuse duodenitis” and “severe spastic colitis” (now called irritable bowel syndrome), though some current experts suspect he actually might have had celiac disease or inflammatory bowel disease.

1934-37: Age 17-20

•  Hospitalized at Yale-New Haven Hospital in Connecticut and later at the Mayo Clinic in Minnesota with jaundice, fever, hives, abdominal pain and a dangerously low white-blood-cell count. Subjected to 18 enemas in three days, and put on a bland diet of rice and potatoes. The cause of his symptoms was not identified, though doctors initially worried that he might have leukemia, 1934.

•  In a letter to a friend, reports that he “shits blood,” 1934.

•  Tells a friend, “If I ever wrote a biography, I would call it, ‘John F. Kennedy: A Medical History,’” 1934.

•  His boarding-school infirmary monitors his blood count throughout his senior year, and the results are sent to the Mayo Clinic.

•  Graduates from boarding school, ranked 65th in a class of 112.

•  Travels to Europe for the first time, summer 1935.

•  Enrolls in Princeton University but withdraws after one month when continued ailments require him to be hospitalized, Nov. 1935.

•  Spends springtime convalescing in Arizona, Apr.-May, 1936.

•  Enrolls in Harvard University, autumn 1936.

•  Earliest recording of JFK’s voice, 1937.

•  Breaks out in unexplained hives, swelling and lowered blood count while traveling in Europe, summer 1937.

1938-40: Age 20-23

•  Undergoes treatment at Mayo Clinic for chronic intestinal problems, Feb. 1938. Stomach and colon problems persist continuously for two years.

•  Hospitalized twice for intestinal infection, Feb.-Mar., 1938.

•  Develops intermittent pain in his right sacroiliac joint, 1938.

•  Travels to London, where his father is stationed as U.S. ambassador, July 1938.

•  Returns to Mayo Clinic because of abdominal symptoms, Feb. 1939. Resumes diet of rice and potatoes.

•  Travels through Europe, Feb.-Sept., 1939.

•  Returns to Harvard to complete his senior year, Sept. 1939.

•  Hospitalized for recurring, severe back pain that began during a tennis game, 1940. Says it feels like,“something had slipped.” Begins wearing a back brace and continues to do so for the rest of his life.

•  Graduates from Harvard.

•  Publishes Why England Slept, a book based on his senior thesis.

1941-45: Age 23-28

•  Travels to Latin America with mother and sister Eunice, spring 1941.

•  His father pulls strings so JFK can join the Navy after failing to pass the physical exams to enter Army Officer Candidate School and Navy Officer Candidate School, Oct. 1941.

•  Suffers flare-up of back pain while doing calisthenics, Mar. 1942. Also still suffering from abdominal pain.

•  Hospitalized with sacroiliac pain, Apr. 1942.

•  Hospitalized with back pain, May 1942.

•  Put in charge of a PT-boat in the south Pacific, June 1942.

•  Hospitalized with acute gastroenteritis, early 1943.

•  His PT-boat gets cut in half by a Japanese destroyer, Aug. 2, 1943. While towing a seriously injured crew member, he and surviving crew members swim to a small island, where they’re rescued seven days later. Suffers flare-up of back and abdominal pain from the ordeal.

•  Assigned to a new PT-boat converted into a gunboat and patrols areas of the south Pacific, autumn 1943.

•  Hospitalized with stomach pain, Nov. 1943.

•  Has new symptoms: fever and yellowish-brown complexion. Diagnosed with malaria, May 1944.

•  Diagnosed with a herniated disc; undergoes unsuccessful back operation, June 1944. Later writes to a friend, “. . . the doc should have read just one more book before picking up the saw.”

•  Takes codeine to treat constant stomach pain, July 1944.

•  His brother Joe is killed in England when his Navy bomber, packed with explosives, explodes in mid-air, Aug. 1944.

•  Resumes active duty despite back and abdominal pain, Aug. 1944.

•  Hospitalized with colitis, Nov. 1944.

•  Hospitalized again with colitis, Dec. 1944.

•  Convalesces in Arizona, early 1945. A friend describes him as “jaundiced—yellow as saffron and thin as a rake.”

•  Discharged from the Navy, which deemed him permanently incapacitated by colitis, Mar. 1945.

•  Returns to Mayo Clinic because of severe back pain, Apr. 1945.

•  Takes job as correspondent for Hearst Newspapers, May 1945. Travels on assignment to San Francisco, Great Britain and Germany.

1946-48: Age 28-31

•  Collapses while marching in a Boston parade. Witnesses say he “turned yellow and blue,” an indication of life-threatening adrenal insufficiency stemming from his autoimmune disease. Given last rites, June 1946.

•  Despite excruciating back pain and other health problems, successfully campaigns for seat in U.S. House of Representatives, Nov. 1946.

•  Hasn’t been taking his medications consistently. While in Europe, suffers another near-fatal adrenal-insufficiency crisis. Diagnosed with Addison’s disease, Oct. 1947.

•  A friend witnesses JFK take DOCA, an adrenal-extract pellet that helps control his adrenal insufficiency. To administer DOCA, JFK uses a small knife to cut open his thigh and slip the pellet underneath his skin. Side effects from long-term corticosteroid use can include increased susceptibility to infections and also osteoporosis of the lower back. (JFK may have been taking DOCA as early as 1937 to treat his colitis, and experts differ on the role that DOCA played in causing and/or contributing to his back pain).

•  His sister Kathleen dies in a plane crash in France, May 1948.

1950-51: Age 33

•  Compression fractures of lower spine revealed by X-rays.

•  Almost dies from another adrenal-insufficiency crisis while in Japan, 1951.

1952: Age 35

•  Defeats Henry Cabot Lodge, Jr., in race for U.S. Senate seat. Still extremely thin and often reliant on crutches, Nov. 1952.

1953: Age 36

•  Sworn in as U.S. Senator, Jan. 1953.

•  Treated again for malaria, July 1953.

•  Marries Jacqueline Bouvier, Sept. 1953.

1954-56: Age 37-39

•  Diagnosed with a collapsed 5th lumbar vertebrae and a narrowing of his 4th lumbar vertebrae.

•  Insists—contrary to his doctors’ advice—on undergoing a high-risk spinal-fusion procedure that involves inserting a metal plate into his back. A post-surgical infection nearly kills him, and he’s given last rites—again, Oct. 1954.

•  Prompted by the infection and JFK’s continuing pain, surgeons remove the metal plate four months later, Feb. 1955. The surgeries leave him with an open wound in his back that takes a long time to heal.

•  Because of health problems, has one of the worst absentee records in the history of the U.S. Senate.

•  Writes Profiles in Courage while convalescing.

•  Selects physician Janet Travell to be his personal physician, May 1955.

•  Birth of stillborn daughter Arabella, Aug. 1956.

•  His back surgeon publishes a medical-journal article that describes JFK’s health problems in great detail, Nov. 1955. The public never discovers the severity of JFK’s pain and other ailments because he’s identified in the article only as “Case 3.”

•  In the running to be Democratic presidential nominee Adlai Stevenson’s running mate, 1956. Estes Kefauver is chosen instead.

1957-60: Age 40-43

•  Hospitalized to drain abscesses resulting from his earlier back surgery, Sept.-Oct. 1957.

•  Birth of daughter Caroline, Nov. 1957.

•  Wins reelection to the U.S. Senate, 1958.

•  Announces candidacy for presidency, Jan. 2, 1960.

•  Under Travell’s care, successfully gains weight after a lifetime of being chronically underweight and, as a result, looks healthier than he did eight years earlier.

•  Aides to political rival Lyndon Johnson tell the press that JFK has Addison’s disease; JFK’s physicians publicly deny it, 1960.

•  Burglars attempt to break into the offices of two of JFK’s physicians in hopes of stealing his medical records, July 1960.

•  Accepts Democratic nomination for the presidency, July 15, 1960.

•  Defeats Richard Nixon in the presidential election.

•  Birth of son, John, Jr.

1961-63: Age 44-46

•  Sworn in as president on Jan. 20, 1961.

•  JFK’s first televised press conference, Jan., 1961.

•  Janet Travell appointed White House physician, Jan. 1961.

•  Creates Peace Corps, Mar. 1961.

•  Authorizes Cuban exiles to invade Cuba at the Bay of Pigs. Invasion quickly ends in failure, Apr. 1961.

•  Announces goal of landing a man on the moon, May 25, 1961.

•  Routinely takes 26 different kinds of medications, including amphetamines, barbiturates, opioids, hormones, and allergy shots, 1961.

•  Receives several monthly injections of penicillin throughout his presidency, likely in response to JFK’s concerns about venereal disease. Also receives procaine (painkiller) injections—sometimes multiple times a day—to relieve his back pain. His doctors strongly disagree with each other about the validity of these treatments.

•  Suffers a flare-up of disabling back pain, blamed on his participation in a tree-planting ceremony in Ottawa. Canada issues a public apology, May 1961.

•  Attends Vienna summit with Soviet leader Nikita Khrushchev, June 1961. JFK brings physician Max “Dr. Feelgood” Jacobson, who injects him with a concoction of amphetamines and hormones prior to JFK’s meeting with Khrushchev. Also soaks in bathtub to ease his back pain.

•  Uses cherry picker to board Air Force One because back pain prevents him from climbing stairs, 1961.

•  Announces military build-up in Germany, July 1961.

•  Signs bill creating Cape Cod National Seashore, Aug. 1961.

•  In United Nations speech, endorses complete disarmament, Sept. 1961.

•  Begins doing back-strengthening exercises in the White House gym under the guidance of physician Hans Kraus, Oct. 1961.

•  Sends U.S. military advisors to South Vietnam, Nov. 1961.

•  The FBI analyzes the contents of vials that Jacobson delivered to the White House. They contained high concentrations of amphetamines and steroids, 1961.

•  JFK’s father suffers a major stroke, Dec. 1961.

•  At his doctors’ urging, regularly swims in the White House’s indoor swimming pool at noon and prior to dinner. An artist hired by Kennedy’s father decorates the walls surrounding the pool with a Caribbean-motif mural, 1962.

•  Pressures steel companies into withdrawing price increases, Apr. 1962.

•  Bans employment-related gender discrimination in federal agencies, July 1962.

•  Confronts Cuban Missile Crisis, Oct. 22, 1962.

•  Issues executive order banning racial discrimination in the sale or lease of federally funded housing, Nov. 1962.

•  Calls for major income-tax cut, Jan. 1963.

•  Audio recording of JFK requesting “a little extra medication” from his physician, Mar. 1963.

•  Gives American University “Peace” speech, June 10, 1963.

•  Proposes a civil-rights bill and sends troops to the University of Alabama when Gov. George Wallace attempts to prevent black students from enrolling, June, 1963.

•  Gives speech at Berlin Wall, June 26, 1963.

•  Son Patrick born 5½ weeks premature and dies two days later, Aug. 1963.

•  The New York Times reports that JFK is walking and climbing stairs with a noticeable limp caused by back-pain flare-up, Aug. 28, 1963.

•  Ratifies the Limited Nuclear Test Ban Treaty, Oct. 1963.

•  Assassinated, Nov. 22, 1963. His back brace may have kept him upright after being hit in the neck by the first bullet, thereby making him a more conspicuous target for the fatal next bullet that struck him in the head.

•  Buried in Arlington National Cemetery, Nov. 25, 1963.

1969

•  Federal authorities seize all drugs in Jacobson’s possession but fail to locate a significant stockpile of methamphetamines that he bought and should have been able to account for.

1975

•  A New York State medical board finds Jacobson guilty of unprofessional conduct and other violations and revokes his medical license.

Hear the Painopolis podcast episode, “JFK: A Profile in Pain.”

JFK Chronology Source List:

Dallek, Robert, “The Medical Ordeals of JFK,” The Atlantic, Dec. 2002

Dallek, Robert, An Unfinished Life, 2001

“Life of John F. Kennedy,” John F. Kennedy Presidential Library and Museum website, jfklibrary.org

McDermott, Rose, “The Politics of Presidential Care: The Case of John F. Kennedy,” Politics and the Life Sciences, Fall 2014

McDermott, Rose, Presidential Leadership, Illness and Decision Making, 2007

Mandel, Lee R., “Endocrine and Autoimmune Aspects of the Health History of John F. Kennedy,” Annals of Internal Medicine, 2009; 151 (5): 350-4

The New York Times, “Kennedy Doctor Prescribes Swim,” Jan. 27, 1961

The New York Times, “President’s Back Strain at Tree Planting Is Disclosed,” June 9, 1961

The New York Times, “Crutches Easing Kennedy’s Back,” June 10, 1961

The New York Times, “President’s Physician Describes His Condition as a Common One,” June 14, 1961

The New York Times, “Kennedy Exercising Daily to Help Back,” Oct. 21, 1961

The New York Times, “President’s Back is Ailing Again,” Aug. 28, 1963

The New York Times, “Janet Travell, 95, Pain Specialist and Kennedy’s Personal Doctor,” Aug. 3, 1997

The New York Times, “John Kennedy’s Doctor Recalls Break-Ins Before ’60 Convention,” May 3, 1973

Nicholas, James A., et al, “Management of Adrenocortical Insufficiency During Surgery,” A.M.A. Archives of Surgery, Nov. 1955, 737-42

Pinals, Robert S. and Hassett, Afton F., “Reconceptualizing John F. Kennedy’s Chronic Low Back Pain,” Regional Anesthesia and Pain Medicine, Sept.-Oct., 2013, pp. 442-6

Tennant, Forest, “John F. Kennedy’s Pain Story: From Autoimmune Disease to Centralized Pain,” Practical Pain Management, Sept. 1, 2012

The U.S. National Archives and Records Administration, presidentialtimeline.org

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