We all woke up Friday to the news that the president and first lady had tested positive for COVID-19. In a year of wild and enormously disruptive events, things just got crazier. Just what the president’s health crisis will mean for the election, and for a nation fighting its way through several profound challenges, is unclear. It is too early to know. It may be useful to look back at several previous presidencies in which health issues caused serious disruption.

We now know that in his second term (1984-88) President Ronald Reagan was suffering from the beginnings of Alzheimer’s Syndrome. The people around him, and particularly his wife Nancy Reagan, worked hard to protect him, to limit his public exposure, and to give him as much rest time as possible. Had things worsened, it might have been necessary to invoke the 25th Amendment and let Vice President George H.W. Bush take charge of the last years of the Reagan presidency.

John F. Kennedy (1960-Nov. 22, 1963) suffered from Addison’s Disease, a severe adrenal gland disorder which produces fatigue, nausea and dizziness, and which can cause early death. The Kennedy family worked strenuously to cover up JFK’s malady, hurling vicious abuse at anyone who raised the subject. The public was unaware of how ill President Kennedy was. Several of his recent biographers, including Robert Dallek, have argued that it is not clear that JFK would have lived through a second full term, had he not been assassinated in Dallas in 1963, at the age of 46.

Franklin Delano Roosevelt stood for re-election in 1944 and won an unprecedented fourth term as president. The public had no idea how ill he was by 1944. Polio, with its enforced inactivity, coupled with the appalling strain of presiding over the United States through the Great Depression, the Dust Bowl, and World War II, had simply worn FDR out. His closest aides said he looked like the walking dead in the last months of his life. By then, the war was won, but his severely diminished capacity played a role at the disastrous Yalta Conference on Feb. 4-11, 1945 (just nine weeks before his death on April 12), where Josef Stalin forced his wartime allies to acquiesce in what would be the military domination of eastern Europe after the war. At the time of FDR’s death, Vice President (and then President) Harry S. Truman learned about the atomic Manhattan Project for the first time. One of the great what-ifs of American history is whether FDR would have chosen to drop atomic bombs on Hiroshima and Nagasaki had he lived through the summer of 1945.

President Woodrow Wilson and his wife Edith.


The most dramatic case of a stricken president was Woodrow Wilson (1912-1920), who suffered a long series of strokes beginning as early as 1896. During the extremely intense political battle over America’s entry into the League of Nations in 1919, President Wilson, now late in his second term, suffered a massive stroke that rendered him helpless. His doctors, his extraordinary second wife Edith, and his closest friends and aides kept this information from the American public, from Congress, and even from Wilson’s vice president. To a considerable degree they even kept the severity of his disability from Wilson himself. Edith Wilson essentially assumed the role of acting president in the last weeks of 1919, all the way to the end of his term on March 4, 1921. This makes her one of the most consequential of all first ladies, a list that includes Eleanor Roosevelt and Abigail Adams. Wilson’s cabinet discussed the possibility of a succession plan, but Wilson’s doctor Cary Grayson refused to sign any official notice of disability. At the time, the U.S. Constitution provided no procedure to handle the problem of a president who was still alive but unable to fulfill his duties. That was the purpose of the 25th Amendment (1967).

 President Wilson towards the end of his term when he was seriously ill. 


The Wilson crisis was the most serious in American history. It may seem astonishing that Wilson could be disabled for 17 months in his second term and the nation’s newspapers and general public never found out about it. But it was a very different time in U.S. history. The people had a much smaller daily relationship with their president, and journalists had much less access to the White House. Furthermore, the age of media deference lasted deep into the 20th century, with the result that John Kennedy’s obsessive womanizing was kept from the American public (by the old boys network) in spite of the fact that the president’s behavior could be seen as compromising the national security and domestic politics of the United States. 

And then there is Theodore Roosevelt. The hectic, often reckless Roosevelt broke and scratched and bruised nearly every part of his body in 60 years of unrelenting adventure. The list of his relatively minor injuries is endless. He was thrown from horses in the Dakota Territory. He broke his arm in a fox hunt on Long Island. A spinning windmill at Sagamore Hill opened a vein in his forehead (his wife Edith told him not to bleed on her carpet!). He engaged in robust and often painful stick fighting in the White House. He fell down part of a cliff in Idaho while trying to get a photograph of a waterfall. The list goes on. And of course, because he was TR, he reveled in his injuries. After one such mishap he said, “I don’t grudge the broken arm a bit… I’m always ready to pay the piper when I’ve had a good dance; and every now and then I like to drink the wine of life with brandy in it.”

 Newspaper headline announcing the assasination attempt on Theodore Roosevelt.


On Oct. 14, 1912, in Milwaukee, Wisc., during the famous Bull Moose campaign, former President Roosevelt, now running for an unprecedented third term, was shot from the curb while settling into an open car on his way to a rally. “He pinked me,” Roosevelt said of his would-be assassin John Schrank. The bullet was slowed by TR’s steel spectacles case and by his 50-page speech, which was folded inside his coat. The bullet lodged in his rib and caused considerable bleeding, but TR — a seasoned big game hunter — soon determined that he was not mortally wounded. If you can imagine it, he then insisted on going to the political rally as scheduled, over the frantic appeals of his handlers. 

At the lecture hall, Roosevelt asked the audience to be patient with him because he had just been shot! And then TR went on to deliver an 84-minute speech! He held up the speech with the bullet hole clearly visible and gave away pages as souvenirs. Eventually he grew weak from the trauma and the loss of blood, and he allowed himself to be taken out of the auditorium. As he walked through the aisles, he was heartened to see so many citizens of Milwaukee line up to shake his hand. One of his aides later said, “You know, everyone just wanted to be the last person to shake your hand.”

The 50-page speech in TR's coat that slowed the assassin's bullet.


When the Roosevelt party reached the hospital, TR naturally refused to be taken inside on a stretcher. He walked into the hospital like the fearsome Rough Rider he always was, before permitting the staff to give him proper medical attention.

The 1912 campaign involved three remarkable candidates for president: Roosevelt, who had already served two terms (1901-1908), his hand-picked successor William Howard Taft (1908-1912), and Woodrow Wilson, who won the election on Nov. 5, 1912. Wilson suspended his campaign for 14 days out of respect for the stricken former president. Roosevelt, inevitably, felt that the campaigns should go on full stride, and he sent surrogates out to hammer his adversaries on the stump. TR recovered fast enough to deliver a major speech at Madison Square Garden on Oct. 30. He was every bit the full Bull Moose, though he could not raise his right arm enough to pound his other palm in his characteristic way when making a point.

Roosevelt even believed that the near assassination might increase his chances of victory in the election. He argued that a political warrior was no different from a patriotic soldier who could not enter a battle without the possibility of being wounded or killed. This was a man who, late in life, said his only regret about his war campaign in Cuba in 1898 was that he had not received a disfiguring and life-threatening wound! When TR finally died on Jan. 6, 1919, of an embolism, the sitting Vice President of the United States Thomas R. Marshall said, “Death had to take him in his sleep, for if Roosevelt had been awake, there would have been a fight.”

How Roosevelt would have loved that sentence. It doesn’t get any better than that.

We are fortunate to have the 25th Amendment now. Continuity in government is essential in any nation, especially one as consequential as the United States.

For more of Clay Jenkinson's views on American history and the humanities, listen to his weekly nationally syndicated public radio program and podcast, The Thomas Jefferson Hour. Clay's most recent book, Repairing Jefferson's America: A Guide to Civility and Enlightened Citizenship, is among the core readings for a five-week online humanities course Clay will teach on the state of the U.S. Constitution, beginning Nov 7. Learn more and register for “The Future of Constitutional Democracy” today.