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The Woodrow Wilson Story Essay, Research Paper

The Woodrow Wilson Story

In September, 1919, Wilson suffered a paralytic stroke which limited

his future activity. After the presidency, he lived on in retirement in

Washington, dying February 3, 1924.

Information Please Almanac.

(Most history books are equally uninformative about Wilson’s illness.)

The Twenty-fifth Amendment, dealing with Presidential disability,

becomes part of the U.S. Constitution. It provides that the

Vice-President becomes Acting President if the President declares

himself disabled, or if the Vice-President and a majority of the Cabinet

so declare.

Adopted February 10, 1967

Diseases need heroes: men or women who have triumphed despite the disease. For

the child with polio, one could always point to Franklin Delano Roosevelt, who

campaigned on leg braces to become governor of New York and then president of

the United States. For epilepsy, there is always Joan of Arc or Napoleon. The blind

and deaf have Helen Keller. Woodrow Wilson provides a similarly inspiring story for

both dyslexia and stroke victims–but the story of his last two years in office provides

a troubling example of how brain damage can affect judgment and even block insight

into one’s own disabilities.

Wilson had dyslexia in childhood. Imagine not learning your letters until age 9, not

reading until age 12, being a slow reader all your life. Rather than being a prescription

for a life as a nonintellectual ditchdigger, this was part of the background of a man

who became a professor at Princeton University and the author of a popularly

acclaimed book on George Washington.

When Professor Wilson was 39, he suffered a minor stroke that left him with

weakness of the right arm and hand, sensory disturbances in the tips of several

fingers, and an inability to write in his usual right-handed manner. As often happens

following minor strokes, there was recovery: his right-handed writing ability returned

within a year.

Was his career impeded? No, in 1902 he became the president of Princeton. But

the problem recurred in 1904. In 1906 it happened again, this time with blindness in

the left eye (also supplied by the left internal carotid artery, which is probably where

clots were originating which plugged up various small arteries in the left eye and left

brain). While the right arm weakness went away, Wilson had enough damage to his

left eye that he could never read with it again. Some think that his judgment was

impaired in the following years–his attempts to reform Princeton academia were

often impractical. By 1910 he was essentially being forced out of his presidency by

the trustees.

But no matter–in 1910 Wilson was elected the governor of New Jersey. Being a

university president is not the usual route to such an office (from being a zoology

professor at the University of Washington, Dixie Lee Ray went on to become

governor–but her stepping stones were positions as Nixon’s chairman of the Atomic

Energy Commission and Assistant Secretary of State, not the presidency of the

university!). From the governorship, Wilson began his successful campaign for

president of the United States. He won the Democratic nomination after a protracted

contest, on the forty-sixth ballot.

During the campaign in 1912, Governor Wilson again suffered from mild and

temporary neurological problems (now called Transient Ischemic Attacks, or TIAs,

they are minor strokes without detectable lasting effects). And, a month after his

inauguration, President Wilson had an episode where his left arm and hand were

weak. All of the previous right-sided troubles had implicated the left side of the brain.

Now it appeared that the right brain was also being damaged by cerebral vascular

disease. But he once again recovered, an inspiration to the 2.5 million stroke victims

in the U.S. who must cope with their assorted disabilities.

During his first term, President Wilson suffered from serious headaches

accompanied by high blood pressure. The headaches became particularly bad at the

time of the Lusitania sinking by a German U-boat in l915. Were they just tension

headaches, or perhaps neurological symptoms? He was re-elected to a second term

in 1916, but suffered a number of TIAs during the next two years as American

involvement grew in “the” world war.

Edwin A. Weinstein, the neurology professor who wrote the authoritative

Woodrow Wilson: A Medical and Psychological Biography, also notes that

President Wilson “grew more suspicious, secretive, and egocentric.” An occupational

hazard of the presidency–or a change in personality resulting from brain damage?

The U.S. Constitution has since been amended to provide for presidential disability in

office, but what neurologist would be brave enough to declare a president disabled

from such a history?

If Woodrow Wilson’s brain had suffered no further damage, the history of the

following decades could have been very different. For Wilson in 1916 wanted

Germany defeated but not crushed; he wanted Germany to be a viable member of

the proposed League of Nations. He was convinced that a dictated peace Uwould

be accepted in humiliation, under duress, at an intolerable sacrifice, and that would

leave a sting, a resentment, a bitter memory upon which the terms of peace would

rest, not permanently, but only as upon quicksand.” The overthrow of the Kaiser in

1918 and his replacement by a democratic government raised Wilson’s hopes for

rehabilitating Germany. At the 1919 peace conference in Paris, he argued against

French efforts to try the ex-Kaiser and to exact punitive reparations.

But then President Wilson suddenly took ill during the conference: he had

vomiting, high fever, and the other signs of having caught the influenza which was

sweeping Europe and later much of the world. It turned out that the virus had

affected his respiratory system, heart, brain, and prostate. Indeed, judging from some

of the mental symptoms (his top aide noted that, just overnight, Wilson’s personality

changed), Wilson may have suffered another stroke at this time or, as Dr. Weinstein

suggests, have also caught the frequently associated virus of encephalitis lethargica

(this is the virus whose victims often developed Parkinson’s disease years later,

Oliver Sacks wrote about them in Awakenings).

Even before the influenza attack, his obsession with secrecy was pronounced:

none of the other American peace commissioners were privy to President Wilson’s

thinking. Bedridden, Wilson became obsessed with being overheard, with guarding

his papers. In addition to the paranoia, he became euphoric and almost manic at

times following the bedridden phase of the illness. He even became socially outgoing

in ways quite uncharacteristic of the normally reticent Wilson.

But most striking was Wilson’s change in attitude toward the Germans: now he

himself proposed that the former Emperor be tried. Whereas he had previously

insisted that the German delegates be granted full diplomatic privileges at the

conference, now he was contemptuous of them. Herbert Hoover, who was there,

noted the change in Wilson’s behavior: before the influenza, Wilson was willing to

listen to advice, was incisive, quick to grasp essentials and unhesitating in his

conclusions. Afterward, he had lapses in memory, he groped for ideas, he was

obsessed with “precedents.”

To ask our Twenty-fifth Amendment question again, it seems likely that modern

physicians would be able to diagnose the brain damage leading to such a personality

change. They would probably recommend to their patient that he voluntarily step

down. But on such evidence, would they have been able to persuade the Vice

President and a majority of the Cabinet to force the President to step aside? One can

imagine the discussion in the Cabinet as the neurologists tried to educate them on

how brain damage can modify and affect judgment. Those not acquainted with

neurologically induced personality changes would be more likely to focus on

interwoven issues that they understood better– political issues such as the proper

attitude toward the Germans, for example, or the allowances that must be made for

people under stress.

It is hard to appreciate personality changes due to brain damage until you’ve seen

such a patient, before and after. The first one I ever saw was a man whose head had

been injured in a car accident the day before; one temporal lobe (at least) was

swollen as a result of the concussion. On the door to the patient’s room, the nurses

had posted a sign: “Do not give this patient matches!” It wasn’t that smoking was

prohibited–he was mischievously lighting matches and throwing them around the

room. There was nothing lethargic about this man: he was bright-eyed, aggressive

with the doctors, teasing the nurses, and generally acting like a sailor in port looking

for a good time. Could he have walked, it would surely have been with a swagger.

Perhaps fortunately, he also had a large plaster cast on one leg; otherwise, it might

have been difficult to persuade him to remain in the hospital where his brain swelling

could be controlled.

One week later when again stopping in to examine all the patients on the

neurosurgical service, I saw a man with an identical brain injury. This man was meek,

most hesitant in his dealings with the staff, a quiet unobtrusive soul who usually

averted his eyes when talking with anyone. After we left the room, I commented that

the neurosurgeons’ fame must have spread, that they were certainly being sent one

temporal-lobe contusion patient after another. No, the attending neurosurgeon said

with a smile, that man was the same patient that I had seen the previous week. I was

too astonished to mind that I had fallen into a neatly laid trap which had probably

been sprung upon a half-dozen insuffficiently observant medical students and

residents already that week. But which was his real personality? The present meek

one. His family had, of course, been perplexed by the change and had told the

physicians what his real personality was like. So now they knew that their patient was

getting back to normal. And, mirabile dictu, he could also walk again–there was no

longer a cast on the leg! But most cases of personality change are not this dramatic,

nor can most be treated with a leg cast and diuretics. President Wilson’s is a more

typical case–though, because of his position, having wider ramifications.

President Wilson returned home with a treaty establishing the League of Nations.

His attempts to get the U.S. Senate to ratify it were clumsy and authoritarian, not the

actions of a skilled politician used to dealing with the Congress. Frustrated after five

months, he decided to take his case directly to the people. Within a few days after

embarking upon a speaking tour of the West in September 1919, he had developed

double vision (this usually isn’t either left or right hemisphere but suggests trouble in

the brain stem). Wilson insisted on continuing on the speaking tour, and several

weeks later, he became paralyzed on his left side: an unmistakable sign of

right-hemisphere malfunction. Another week later, after returning to the White House,

he suffered a massive right-hemisphere stroke. He lost vision in the left visual field

which, because of the previous trouble with the left eye, left him with vision from only

one-half of one eye (this is one of those unusual sets of facts which we inflict upon

medical students in a neuroanatomy quiz, to see if they can figure out that there must

have been two separate problems rather than the usual one). Wilson could feel

nothing on the left side of his body, besides not being able to move it voluntarily.

Indeed he totally neglected the left side of his body.

Though the language functions of Wilson’s left hemisphere were not affected by

the right-hemisphere stroke, his voice never regained the emotional inflections and

resonance of his earlier years; this aspect of speech (called prosody) is now known

to be controlled predominantly by the right hemisphere.

His right-hemisphere stroke also produced a curious effect: Wilson denied he had

suffered a stroke. If you have not previously encountered the denial-of-illness

syndrome, you may find this incredible. How could someone whose left body was

paralyzed deny that something had happened? He indeed considered himself

perfectly fit to be President (he fired his secretary of state, who had dared to call a

Cabinet meeting to discuss the illness with the President’s physician).

This denial-of-illness syndrome is characteristic of right parietal-lobe damage;

some patients will even deny that their left arm and leg are part of their own body.

Wilson merely referred to himself as “lame.” His spatial sense was disturbed: when

the Secret Service took him out for a drive around town, Wilson insisted they drive

very slowly and then demanded that the Secret Service chase and arrest a driver who

passed them–for speeding!

Had the Constitutional amendment on Presidential disability been in effect in

September 1919, Wilson’s doctors should have been able to declare Wilson unfit to

carry out presidential duties. But would they have done so? Like others, they could

have been drawn into an elaborate cover-up to preserve presidential authority. The

history of Wilson’s illness gives us no comforting reassurance about how either the

White House insiders or the doctors would have performed. The President’s

physician, Cary T. Grayson, was asked by Secretary of State Lansing to sign a

certificate of disability four days after the massive stroke, but he refused. In February

1920, when the White House was issuing glowing reports on the President’s health

and abilities, a distinguished surgeon, Hugh H. Young, reported to the press. He said

that the President had suffered only a slight impairment of his left arm and leg and that

“the extreme vigor and lucidity of his mental processes had not abated in the slightest

degree . . . he is in better shape than before the illness.” Dr. Young summarized by

saying that “you can say that the President is able-minded and able-bodied, and that

he is giving splendid attention to the affairs of state.”

Dr. Weinstein’s excellent biography notes that at the time of Dr. Young’s

statement, President Wilson’s left arm was useless, he could barely walk, he could

not hold himself upright so as to work at a desk, he could not read more than a few

lines at a time, he was subject to outbursts of temper and tears, and his periods of

alertness alternated with periods of lethargy and withdrawal. And that President

Wilson still insisted that he was merely lame.

Who ran the government? Gene Smith, in his book When the Cheering

Stopped, says that the President’s wife and doctors did — and that chaos and

secrecy reigned. Remember, this is not a science fiction story, nor a make-believe

White House thriller: this is the story of Woodrow Wilson’s last two years in the

White House. It not only happened, but it has only recently made it into the history

books: nearly all the books on Wilson mention none of this medical history, either

from an ignorance of neurology (it was just “flu” followed by a “paralytic stroke”) or

from the lasting effects of the cover-up conducted by Wilson’s White House insiders.

If the history books omit such a significant event so that we cannot learn from it, how

can we avoid repeating such history?

The treaty joining the U.S. to the League of Nations was defeated in the Senate,

crippling the League. Dr. Weinstein’s opinion is that Wilson’s stroke is what made the

difference: “It is almost certain that had Wilson not been so afflicted, his political skills

and his facility with language would have bridged the gap” between the two opposing

sides in the Senate, much as he had done on other occasions preceding the Paris trip.

President Wilson persisted in his effort to win renomination for a third term.

Pictures appeared before the 1920 Democratic convention showing Wilson in right

profile (the left side of his face was paralyzed) seated at a desk holding a pen. But

Wilson had no support. The Democratic party leaders prevented his name from being

placed in nomination; James M. Cox and Franklin Delano Roosevelt were nominated

for president and vice president. The Republican nominee, Warren Gamaliel Harding,

won the election with the biggest landslide vote in recorded history. He has been

described in retrospect as a “handsome and genial man, undiscriminating in his

associates, lacking in political ideas or fortitude . . . totally unfitted for the

presidency.” American historians, when polled on who was the worst president in

history, regularly select Harding.

Many feel that some consequences of Wilson’s illness outlived his presidency (he

completed his term of office and lived until 1924, surviving Harding) and were to be

seen in the events of the following decades–in the disastrous German inflation of the

1920s during the reparations exacted by the Allies, in the ensuing reaction to social

disorder which led to the rise of the genocidal Nazis, and in a second world war. All

had multiple causes, but the pre-influenza Wilson anticipated many. Woodrow

Wilson was a great liberal and reformer, the first world leader to fire the masses with

a vision of world peace, and a courageous person who repeatedly conquered the

afflictions of his chronic cerebral vascular disease. At a critical juncture in history, his

brain failed him–but not obviously enough to remove him from office and let others

take up the reins. During the last two years of his term following the Paris illness,

Woodrow Wilson was unfit to lead the United States. He no longer had the same

judgment and personality as the man whom the voters had elected.

Just as a lawyer tries to cover all the unlikely inheritance possibilities when

drawing up a will, so lawmakers must try to provide for an orderly succession when

the holder of a critical office is disabled– which can happen in a number of ways.

Would the Twenty-fifth Amendment, which seems so inadequate to deal with

Wilson’s earlier problems, have covered the final Wilson tragedy?

Even if neurologists could diagnose a serious change in perceptual abilities or in

personality, could they convince the President to voluntarily step aside? What

happens when a strongwilled President’s judgment, like Wilson’s, is clouded by his

illness? Judging from the difficulty that physicians have in persuading ordinary patients

with right-parietal-lobe damage that they are ill, the physicians would probably have

been rebuffed. Could they then convince the Vice President and a majority of the

Cabinet to notify Congress that the President was disabled? The Twenty-fifth

Amendment seems to assume that either a President will be rational enough to

declare disability personally, or that the President will be in coma, unable to interfere

in the Cabinet’s decision. Suppose that, like Wilson, a President were to fire the

questioning Cabinet members first? The Twenty-fifth Amendment would seem not to

cover the most serious and most prolonged Presidential disability yet encountered in

more than two centuries and forty Presidents. It remains to be seen if the

Constitution’s disability provisions function any better than those of the Divine Right

of Kings (which allowed George III–the bete noire of the American colonists–to

rule England for many decades while insane on and off, even confined to a

straightjacket at times).

Neurology was established as a medical specialty in the nineteenth century by a

series of great physician-investigators, but the recognition of subtle intellectual deficits

in stroke patients was only beginning in Wilson’s time. Because such “higher

functions” cannot be studied easily in experimental animals, progress has been slow in

comparison to other areas of brain research. In 1920 a remarkable era began, during

which the individual nerve cells have been explored, the reflexes extensively studied,

great inroads made into understanding the functions of sensory and motor systems,

and many specialized cortical areas identified. We now know more about

developmental dyslexia, from which Wilson initially suffered, and about recovery of

function after strokes, which permitted Wilson to recover from his many earlier

strokes so successfully. We now have diagnostic techniques such as computerized

tomographic (CT) scans and magnetic resonance imaging (MRI) which would have

detected much of Wilson’s brain damage. We have therapeutic techniques such as

vascular surgery which, if performed at age 39 after Wilson’s first stroke, might have

cleaned out the arterial lining problems in the carotids which probably formed the


Yet we still lack a body of reliable physiological and anatomical facts with which

to understand personality change and denial of illness. One must rely more on the art

of the experienced physician in such cases, not on the hard facts of science dispensed

by machines. But it is not clear whether even the most expert of modern physicians

would be able to protect the world from the consequences of a similar brain

malfunction in a modern president.

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