Woodrow Wilson’s hidden stroke of 1919: the impact of patient-physician confidentiality on United States foreign policy

Abstract

<jats:p>World War I catapulted the United States from traditional isolationism to international involvement in a major European conflict. Woodrow Wilson envisaged a permanent American imprint on democracy in world affairs through participation in the League of Nations. Amid these defining events, Wilson suffered a major ischemic stroke on October 2, 1919, which left him incapacitated. What was probably his fourth and most devastating stroke was diagnosed and treated by his friend and personal physician, Admiral Cary Grayson. Grayson, who had tremendous personal and professional loyalty to Wilson, kept the severity of the stroke hidden from Congress, the American people, and even the president himself. During a cabinet briefing, Grayson formally refused to sign a document of disability and was reluctant to address the subject of presidential succession. Wilson was essentially incapacitated and hemiplegic, yet he remained an active president and all messages were relayed directly through his wife, Edith. Patient-physician confidentiality superseded national security amid the backdrop of friendship and political power on the eve of a pivotal juncture in the history of American foreign policy.</jats:p> <jats:p>It was in part because of the absence of Woodrow Wilson’s vocal and unwavering support that the United States did not join the League of Nations and distanced itself from the international stage. The League of Nations would later prove powerless without American support and was unable to thwart the rise and advance of Adolf Hitler. Only after World War II did the United States assume its global leadership role and realize Wilson’s visionary, yet contentious, groundwork for a <jats:italic>Pax Americana</jats:italic>.</jats:p> <jats:p>The authors describe Woodrow Wilson’s stroke, the historical implications of his health decline, and its impact on United States foreign policy.</jats:p>

Daniel Ruge: the first neurosurgeon to serve as physician to the president

“…The political involvement of the White House physician has varied over the years. 9,20 In a letter to his wife, Dr. Grayson remarked, "I am hurrying off to Philadelphia with him at six o'clock tomorrow morning to consult an eye specialist. We are going by motor.…”

When Disease Strikes Leaders: What Should We Know?

“…Woodrow Wilson had a long history of hypertension complicated by a first stroke at age 40, and a second one in 1906 that left him blind in the central portion of the left eye. 5 He had more neurovascular symptoms in 1907 and 1910, followed by a third stroke in 1913 that caused left arm weakness. In July 1919, he experienced transient amnesia.…”