No sooner had it become known that President Trump had tested positive for the coronavirus than controversy arose over the amount and detail and truthfulness of the information about his condition that was coming from the White House.
The timeline of Trump's diagnosis and treatment over the past few days continues to evolve. His medical team's briefings from Walter Reed National Military Medical Center have at times resulted in more confusion than clarity.
He said the president had received supplemental oxygen, after declining to confirm that on Saturday, and announced that Trump had started taking a steroid after a second drop in his oxygen levels. Conley explained some of his Saturday statements as "trying to reflect the upbeat attitude" of the doctors and Trump.
In an additional display of optimism, Trump even left the medical center to drive by and wave to supporters gathered outside on Sunday. In a rare move, the White House did not inform reporters that the president would be taking the excursion.
None of opaqueness should come as surprise, though. Few occasions of historical importance have been so shrouded in secrecy — and even outright deception — as the health emergencies of world leaders. The U.S. may have been more transparent about these events than most countries, but, even here, the truth has only come to light over time.
"This is one precedent this president is following," says Barbara Perry, director of Presidential Studies at the University of Virginia's Miller Center.
Perry says the American public has a right to know the health of their presidents, especially now, given that voters are also just weeks away from deciding at the ballot box who is most fit to inhabit the Oval Office.
"They used to say when the president gets a cold, the stock market drops," Perry says. "It really has an impact on people's lives, whether it's the economy, or in this instance, it would help us to know, is he now even capable of governing?"
Here are a few of the more egregious cases of obfuscation in the past, when the health of the president was in question while he was in office.
Exhibit A: The incapacity of Woodrow Wilson
As coincidence would have it, the news of Trump's diagnosis broke 101 years to the day President Woodrow Wilson suffered a stroke that nearly killed him and paralyzed his whole left side.
While far from being the first health crisis Wilson had experienced – he may have had the "Spanish flu" earlier that same year — it was by far the worst.
"From that point on," writes historian Thomas J. Knock, "Wilson was but a frail husk of his former self, a tragic recluse in the White House shielded by his wife and doctor." Edith Wilson was "the arbiter of what and whom the president saw," according to Knock and other chroniclers of the period, although allegations that she ran the government may have been overblown.
It seems incredible to us now that a president could serve out the last 17 months of his term so diminished in his presence and power. But neither the vice president at the time, Thomas R. Marshall, or the Cabinet members or congressional leaders saw fit to intervene or raise formal objections. Neither did they have a clear constitutional instrument by which to do so.
The White House was also able to conceal the health problems of Wilson's successor, Warren G. Harding, including the heart disease that led to his fatal heart attack in 1923. As Harding toured the West Coast, reporters in Seattle had been told Harding had suffered "an acute gastrointestinal attack" that caused him to cancel a visit to Portland.
Arriving in San Francisco, Harding walked from the train to a car and suffered a relapse. Doctors treated him for heart problems and pneumonia. When he died in his hotel four days later of cardiac arrest, reporters were told the president had suffered a cerebral hemorrhage.
Reporting on the president
As for the public, it had far less information about goings-on in Washington during Wilson's time than now. In the 19th and early 20th century, the nation was not accustomed to daily or even weekly reports on the president's activities. Radio and TV were still some years away, and when newspapers paid attention to Washington, they tended to focus on important decisions in Congress, federal courts or government agencies.
The idea of the White House as a "beat" did not begin until late in the 1800s. The nascent White House Correspondents Association had just 11 members at its birth in 1914, and there would not be a formal position of White House press secretary until 1929.
There had been earlier cases of individual reporters who strove to find the truth about the physical condition of various presidents. In one notable case, a Philadelphia newspaper reporter named E.J. Edwards learned that President Grover Cleveland's 1893 "fishing trip" on the yacht of a friend had in fact had a different purpose.
A team of surgeons had accompanied the president on the four-day excursion and removed a cancerous growth from the roof of his mouth. The public was never told. And when Edwards learned the truth from a medical professional involved, his reported story was flatly denied — and his reputation assaulted — by the president himself.
The hidden conditions of FDR
White House reporting had become more extensive by the time Franklin D. Roosevelt took the oath in 1933. Press conferences were now "a thing," and FDR held lengthy, chatty sessions with reporters in his office – under his own strict rules of disclosure and attribution. He also initiated the custom of an annual "press reception."
But his main contribution to White House communications was an end-run around the press in the form of radio addresses called "fireside chats." They were wildly successful, helping FDR build a direct relationship with ordinary citizen-voters that stood him in good stead through the Depression and the Second World War.
FDR also benefited from a set of informal rules by which the press, and later the radio correspondents and commentators, largely did not focus on his physical disabilities. A polio victim in his young adulthood, FDR used a wheelchair much of the time. But photographs of him in the chair rarely saw the light of day.
Later in this presidency, as a variety of maladies pursued him and limited his ability to handle the Second World War and negotiations over a postwar world map, FDR's well-practiced obfuscation kept that information from general view. Even his vice president, Harry S. Truman, was shocked when Roosevelt's death was announced less than three months after he was inaugurated for his fourth term.
The unhealthy side of John F. Kennedy
Rarely has the actual condition of a president's health been more at odds with his image than was the case with President John F. Kennedy in the early 1960s. Just 43 when he was elected president, JFK made youth and "vigor" themes of his campaign and early months in office.
But Kennedy himself was far from the physical ideal he sought to project. As biographer Michael Kazin has noted, the young JFK "suffered from a variety of ailments that frequently confined him to bed and plagued him throughout his life." Many of these were typical childhood ailments such as chicken pox, measles and ear infections. But he also contracted scarlet fever, a life-threatening disease in 1920.
Historian Robert Dallek devoted an entire book to JFK's medical history. He detailed how Kennedy had dealt with fevers as well as issues of the stomach, colon and adrenal glands. At 30 he was diagnosed with Addison's disease, an endocrine disorder that could have ended his life even earlier than an assassin's bullet did in 1963 — especially given the added presence of hypothyroidism. The contentions between his doctors and their competing prescriptions were also a factor in his performance in office.
But absolutely none of this reached the public during Kennedy's active years in politics, nor in his three years in the White House. When he needed treatments, reporters were told it related to chronic and severe back pain, which could be vaguely attributed to his exploits as a Navy hero in the Second World War. The full story of JFK's illnesses would not be told for decades.
The near-death of Ronald Reagan
President Ronald Reagan took the oath of office in January 1981 and just two months later was shot at close range by a deranged young man outside a Washington, D.C., hotel. Reagan was rushed to a nearby hospital, where TV cameras recorded him walking in the door — but did not see him collapse a few steps inside.
At that point, a bullet in his chest was close to costing him his life. According to Del Quintin Wilber, a Washington Post reporter who wrote a book about that day called Rawhide Down, Reagan lost almost half his blood volume and came within seconds of dying.
What the public saw and heard, however, was far different. White House spokesmen described a plucky patient who bantered with the surgeons ("I hope you're all Republicans," he reportedly said) and his wife ("Honey, I forgot to duck").
In reality, the president was desperately close to death. But that went largely unreported for nearly 30 years, while the tale of his miraculous resilience persisted throughout his lifetime.
Later, in Reagan's second term, there were signs of deteriorating mental acuity. In his reelection campaign of 1984 he showed lapses of memory and awareness. In 1988, he mispronounced the name of George H.W. Bush, his vice president, who had been nominated by his party to succeed him.
But that story, too, went largely unreported. The former president was officially diagnosed with Alzheimer's Disease in 1994, five years after leaving office.
NPR producer Sam Gringlas contributed to this report.
STEVE INSKEEP, HOST:
A scholar of presidential history made an observation about the president's health the other day. If he has said less about his condition than many people would like, Barbara Perry of the University of Virginia says this is one time that he is following precedent. Many presidents have obscured their conditions, as we've been learning from NPR senior correspondent Ron Elving. Hey there, Ron.
RON ELVING, BYLINE: Good to be with you, Steve.
INSKEEP: What makes it hard for a president to just be frank?
ELVING: A president is a man on the world stage, and there are other foreign leaders watching, assessing how certain America is of its leadership. Plus, there's Congress, and they're wondering if the president is still the leader of one party, if he's really calling the shots, who is calling the shots? So there's that curiosity. The American people have every right to know whether or not their leader is up to the job, is operating in full command of his faculties. All of those things the American people expect to know. And let's face it, too. I mean, there is just the need on the part of any individual to show themselves as robust as possible. I think it's fair to say that President Trump is a man who has shown some concern about his own personal image.
INSKEEP: That is a very diplomatic way of putting it. Thank you very much. I want to throw out some names of some past presidents who've had health issues while in office. And let's just run through them; first, Grover Cleveland in the late 1800s.
ELVING: 1893 - Grover Cleveland went on a four-day boat cruise that seemed like a nice thing to do, go fishing for a little while. Along on the cruise were six surgeons, and at one point on the cruise, they operated on the president, put him under full sedation, what they had available in 1893, and they removed a large growth on the roof of his mouth, which was cancerous, also took out part of his upper jaw and some of his teeth. And the public never was informed. Power was never transferred to the vice president or anything of that nature. And this did not come out for some period of time. When it was reported, the president denied it.
INSKEEP: Wow, secret mouth cancer surgery and nobody found out until years later. Let's go now to Woodrow Wilson in the early 1900s.
ELVING: Woodrow Wilson had a series of health problems as president, might have had the Spanish flu in 1919, definitely had a stroke later that year, and that incapacitated him for the last 17 months of his presidency. His wife and his doctor controlled everything that he saw and who got to see him.
INSKEEP: But he just hid out in the White House and people didn't really know this.
ELVING: That is correct. And of course, there were people who knew the president was unwell. They knew that he had had some sort of an episode. But at that time, the powers that be in the Congress were not really in any kind of a position to do anything about it. And there was no means for transferring power to his vice president, a guy named Thomas Marshall, who never tried to insist on it.
INSKEEP: Now, I want to talk about Franklin Delano Roosevelt. And, of course, he was in a wheelchair after being stricken with polio. But that's in a special category. I want to ask about health problems he had beyond that.
ELVING: Late in his presidency, FDR was suffering from a number of maladies, particularly a heart condition. And people had no idea just how sick he was. People who saw him could see he was not well. And some pictures showed him looking sickly, but no one knew just how close to the end he was. But very shortly after taking the oath of office for the fourth time, in 1945 he died while on a trip to Georgia. And it was such a shock to the country. It was even a shock to his vice president, Harry Truman, who had no idea the president was that close to the end.
INSKEEP: What about Richard Nixon in the 1970s?
ELVING: In Richard Nixon's case, he was suffering from really an emotional breakdown as Watergate reached its final conclusion, and he was about to be forced to resign. As he fought to save his job and fought against impeachment, he was drinking heavily. And this has all been extensively reported since the time. It was not known at the time. But some of his closest aides were really covering for him because he was very close to being incapacitated.
INSKEEP: Weren't there some issues with Ronald Reagan?
ELVING: Ronald Reagan almost died in 1981 just a few weeks after he had become president. He was shot, and the wound was much more serious than was initially disclosed. He lost a great deal of blood and could easily have died that very afternoon. That was not known for a number of years just how serious, how close he came to death. In his second term, he did have a couple of procedures that required him being under full sedation. So power was transferred to his vice president, George H.W. Bush, under a constitutional provision that allows that to happen if the president assents to it and also sets up a structure for taking the power away from the president if he's incapable of actually making that decision.
INSKEEP: OK. So now there's a system for a president to hand over power temporarily if there's an emergency. What if people around him think the president needs to be nudged out of power and there's no interest in going?
ELVING: We haven't had a case of that. And presumably it would involve a president who simply wasn't capable of making a decision. But there is a process. It involves the vice president. It involves the president's Cabinet. And Congress can eventually get involved as well. And then there's a process for giving the power back to the president as long as he regains his abilities.
INSKEEP: In recent decades, hasn't there been a custom that presidents are quite thoroughly checked out and we, the public, receive a pretty thorough report on their medical condition?
ELVING: Yes, as candidates, generally speaking, that's true. But after someone actually becomes president, that person then has a great deal of control over who their physician might be and how much of that information might reach the public. What we've had with President Trump has been a succession of presidential physicians who praise his conditions to the sky and tell us that everything is fine and are seemingly rather uncritical about the president's physical condition. And certainly that has been true in the past several days with his current team.
INSKEEP: NPR senior correspondent Ron Elving, good health to you.
ELVING: Thank you, Steve, and to you.
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