CHARLOTTESVILLE, VA (JULY 11, 2017). "Camelot," the term used to describe the John Fitzgerald Kennedy (JFK) presidency after JFK's death, conjures up an image of youth and vigor, an image the 35th president of the U.S. promoted of himself as a young, healthy, strong-bodied man. But this image belies the truth: that Kennedy had been plagued by illnesses and discomfort since he was a small child and required strong medication to perform his tasks as president.
Scarlet fever, long-standing gastrointestinal disease, Addison's disease, and chronic back pain--these are some of the medical issues faced by JFK during his short life.
In a new article in the Journal of Neurosurgery: Spine, "John F. Kennedy's back: chronic pain, failed surgeries, and the story of its effects on his life and death," authors T. Glenn Pait, MD, and Justin T. Dowdy, MD, focus primarily on JFK's back problems, which remained a constant companion from his college years until his death. In preparing this paper, Pait and Dowdy reviewed case notes written by various physicians who undertook care of JFK's back. They also examined spinal imaging studies obtained over decades of treatment, documenting a history of debilitating structural changes. In addition, the authors discuss JFK's other intermittent and chronic health problems, their relationships to his spinal disorder, and the possible effects that his ill health may have played on his career and even on his death.
JFK first experienced low-back pain while an undergraduate student at Harvard University, perhaps as a result of a football injury sustained in 1937. His back problems initially prevented wartime enlistment in the armed services in 1940, but his father's political influence helped JFK obtain a commission in the US Naval Reserve in 1941.
History books recount the events on PT-109 that earned JFK a medal for heroic conduct. During World War II, the PT (patrol torpedo) boat to which Kennedy was assigned was rammed by a Japanese destroyer in 1943. JFK rescued an injured crewman by swimming for 5 hours with the crewman in tow. The impact of the ship collision and the physical exertion of the rescue exacerbated the future president's back problems, and less than one year later, JFK underwent the first of four spine surgeries.
The authors describe preoperative and postoperative physical and imaging findings associated with these surgeries, which spanned the years of 1944 through 1957. The first two surgeries did little to improve JFK's condition and in fact resulted in severe complications and additional pain. The third operation was performed to remedy the effects of the second operation, and the fourth operation to clear out infection at the previous operative site.
The authors discuss the relative value of diagnostic tests of the time and the decisions leading to the spine surgeries. They also discuss the means used to reduce JFK's chronic pain so that he could function as president and maintain his image of a strong, vibrant leader at the top of his game. Last, the authors address the controversy over whether JFK's use of a back brace contributed to his death at the hands of an assassin in 1963.
When asked about the paper, Dr. Dowdy said, "The most surprising finding during the research for this paper was the overall amount of severe pain JFK endured throughout his short life and, frankly, how he was able to hide his pain and medical ailments from the general public so well."
The Journal of Neurosurgery: Spine occasionally includes historical vignettes that bring to life past events related to our understanding of spine injury, prevention, and cure. For an engaging discussion of JFK's back problems and their effect on his life and legacy, please read Pait and Dowdy's article.
Pait TG, Dowdy JT: John F. Kennedy's back: chronic pain, failed surgeries, and the story of its effects on his life and death. Journal of Neurosurgery: Spine, published ahead of print, July 11, 2017; DOI: 10.3171/2017.2.SPINE151524.
Disclosure: The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
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The Journal of Neurosurgery: Spine is a monthly peer-reviewed journal focused on neurosurgical approaches to treatment of diseases and disorders of the spine. It contains a variety of articles, including descriptions of preclinical and clinical research as well as case reports and technical notes. The Journal of Neurosurgery: Spine is one of four monthly journals published by the JNS Publishing Group, the scholarly journal division of the American Association of Neurological Surgeons. Other peer-reviewed journals published by the JNS Publishing Group each month include the Journal of Neurosurgery, Neurosurgical Focus, and the Journal of Neurosurgery: Pediatrics. All four journals can be accessed at http://www.thejns.org.
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 8,300 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system including the brain, spinal column, spinal cord, and peripheral nerves. For more information, visit http://www.AANS.org.