Taft and Pickwick: Sleep Apnea in the White House

John G. Sotos, MD

CHEST. 2003;124(3) 

In This Article

Medical Science, Taft, and the Physicians

Sleep apnea was not a recognized clinical entity in Taft's era. Although case reports of sleepy obese patients existed,75,76 the significance of hypersomnolence was generally unknown. However, William Osler, the leading physician in the English-speaking world in the early 20th century, was an exception. Osler knew the case reports, and his textbook[77] popularized Dr. Christopher Heath's observation[78] that patients in these reports resembled a severely obese, hypersomnolent boy named Joe in Charles Dickens' 1836 novel The Posthumous Papers of the Pickwick Club. By 1905, Osler had seen a case himself,[77] and earlier had described obstructive apneas in sleeping children,[79] including their behavioral sequelae.[80]

Osler and Taft maintained a warm, but mostly long-distance friendship from 1902[81] until Osler's death in 1919.[82] Osler had multiple opportunities to observe Taft from 1904 to 1905 (Fig 5),[83,84] years when Taft would have been somnolent as Secretary of War. Although Osler gave medical advice regarding Taft's daughter,[17(p160),85] their correspondence does not mention Taft's health or sleepiness. Osler resided in England during Taft's presidency; thus, one of the few physicians able to appreciate the President's symptoms did not have access to the President.

Program from the Taft-Osler dinner of March 11, 1905. Reprinted with permission from the Alan Mason Chesney Medical Archives of The Johns Hopkins Medical Institutions.[84]

Taft had a doctor-patient relationship with some 30 physicians during his life, including White House physicians Matthew DeLaney[86,87] and Cary Grayson.[6(p445,449)] Whether they learned of the Butt-Jackson conversation is unknown. Dozens more physicians were socially acquainted with Taft, including W. W. Keen,[88] who had operated on President Grover Cleveland's maxillary cancer in 1893; Harvey Cushing[89] ; and S. Weir Mitchell,[90] the dean of American medicine, who himself had a long interest in sleep medicine.[76]

Apart from James Marsh Jackson, no physician mentioned Taft's somnolence, although most of Taft's health-related correspondence occurred during his nonsomnolent post-presidential years. Nevertheless, it appears that physicians close to Taft did not regard him as disabled.


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