Back When Presidential Doctors Were Unsparing with the Jargon

Ronald Reagan delivers his “A Time for Choosing” speech, October 27, 1964. (Reagan Foundation/via YouTube)

As noted in today’s Morning Jolt, the president of the United States is covered by HIPAA just like any other American citizen, and thus, his doctors cannot disclose any of personal health information if the president doesn’t want disclosed. Whether or not you think that ought to be the law, that is the law.

That said, it would probably be best for the country if the president authorized his doctors to release anything they felt necessary to provide a complete picture of his condition, and/or to assure the public.

In 1985, when President Ronald Reagan was hospitalized for surgery to remove a growth on his intestine that turned out to be cancerous, his doctors and White House officials released quite a bit of information, in much more detail than we’ve seen from the briefings regarding President Trump’s health in recent days. Back then, Dr. Steven Rosenberg, chief of surgery at the National Cancer Institute and one of the surgeons assisting in the procedure, spoke to reporters himself, as did Dr. Dale Oller, chief of general surgery at Bethesda Naval Hospital. The briefing began with a description of “the formal operation known as a right hemicolectomy and we put the bowel back together by doing an ileo transverse colostomy.”

Dr. Edward Cattau, who is the head of gastroenterology at Bethesda, elaborated, “There certainly was a lot of consideration to the possibility of a colonoscopy then but because of the histologic findings — specifically that polyp was, as you know, a pseudo polyp, inflammatory tissue, not a true adenoma, the type of polyp associated with the potential for malignancy — there was no indication for a total colonoscopy because of the histologic findings.”

Q: Could you give us his vital signs, the kind of anesthesia that you used, and the drugs that he’s on right now?

A: He’s on an intravenous right now, which consists of what we call dextrose, a sugar and ringers lactate. I do not have his personal vital signs at the moment. They have been stable. He’s run a normal blood pressure. And his heart rate has been satisfactory. Now I’d be guessing, but I think that it’s slightly over 80.

Q: Is he on any drugs right now?

A: Currently he is on no medications. Of course he will be receiving post-operative antibiotics.

Q: Is he in any pain right now?

A. No, he’s not. We’re utilizing a technique in order to try to avert pain.

Q: What is that?

A: Immediately after the surgery was completed he received a modern technique of intracecal injection of a milligram of morphine. This very frequently causes people to have a totally diminished pain response and therefore are able to function normally, from a mental standpoint and from an otherwise physiological standpoint.

After the growth was determined to be cancerous, the doctor’s public statements did not sugarcoat it at all:

Rosenberg noted, however, that there is a chance of recurrence and said that Reagan would have to undergo a variety of repeated tests in years to come. These would include colonoscopies, the procedure that discovered the tumor last Friday, and CAT scans, computerized X-ray examinations that provide visual cross-sections of parts of the body.

“There is a possibility that the tumor can return,” Rosenberg said. Asked to be more specific about the chances of recurrence, he indicated that they would be somewhere between 25 percent and about 50 percent.

When he first announced the lab findings, Rosenberg said, “The president has cancer.” Although he later explained that he did not mean to imply Reagan is known for certain to still have the disease, the language did convey what doctors generally feel: that once a person has been diagnosed as having had cancer, the person must be regarded as in a special category of higher risk.

This may be a lot more than most Americans ever wanted to know about a president’s colon. But the deluge of information, with specifics, made clear that the White House wasn’t hiding anything about the procedure or the president’s condition.

The more data and detail the president’s doctors provide, the more people will conclude they’re getting the whole story. When the doctors are direct with the public about the bad news, no one fears that something worse is being hidden from them.

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