John Hutton, M.D. Oral History

We’re very pleased that Dr. John Hutton is with us today for the Ronald Reagan Oral History Project. We’ve just come from lunch where you were regaling us with stories of Presidents. Hopefully we’ll remember all those stories to get them on tape. I guess the best place to start would be for all of us to go around the table and introduce ourselves just so the transcriptionist can associate a voice with a name. My name is Stephen Knott, and I’m an associate professor here at the Miller Center.

My name is Robert Martin. I’m a graduate student here at UVa.

I’m Russell Swerdlow. I’m a physician and an associate professor here at the university.

I’m Jeff Chidester, I’m project assistant for the Reagan Oral History Project.

Dr. Hutton, perhaps the best place to start would be for you to just give us a little biographical information about yourself and your career leading up to your association with President Reagan.

I was born in New York City, the son of an internist and a professor of medicine at Columbia University, grew up on Long Island. I went to a high school in New York City called Trinity School, which was a very exacting type of education compared to what I’d had in public school out on the island. At any rate, I got very interested in sports and all of this and somehow or other got into Wesleyan University, a small college up in New England.

At the end of that, as graduation was nearing, I had no direction in life. The Korean War was going on and all my friends were either going to medical school or law school. Thank goodness there was something to do other than go to graduate school, so I joined the Marine Corps and became a young lieutenant and traveled all over the world. I was in the Far East and I always joke with people that I think a coconut must have hit me on the head and when I came to I said, Medicine. I’ve got to be like my father.

So I came back and went part time to Columbia University graduate school in physics. I was accepted into medical school during that year and went on to medical school, following which the Army seemed to have a very good training program at Walter Reed [Army Hospital]. I was very impressed and I enjoyed the military. Vietnam was just starting, so the next thing I know I did my internship and my general surgery residency at Walter Reed and went promptly after that to Vietnam where I spent, I think, probably the most productive year of my life, as far as being able to take care of young people and restore them so that they could go on and have a life that was far away from gunfire.

I returned from Vietnam and then went into a fellowship again at Walter Reed with Dr. Norman Rich, who is world famous for his book on trauma of the vascular system, which he wrote from his experiences in Vietnam. There I did a fellowship with him and then went from hospital to hospital as we do in the military, out to San Francisco, finally back to Washington to be chief surgeon at Walter Reed. While there, the Surgeon General of the Army entered my office and seated himself. John, he began, I need a favor—two favors in fact. I need you to go down to Honduras and take command of the 47^th Combat Support Hospital [CSH]. We have an expeditionary force there, and I would like to demonstrate to the line [members of the combat arms] that a practicing military physician of your rank could successfully command such a venture. Secondly, President Reagan’s medical staff has an opening, and I would like you to be one of the candidates to fill this post. 

Sir, I said, Simply tell me what you would have me do. In that case, he replied, we will arrange for you to proceed with a visit and interview with Dr. [Daniel] Ruge, the current physician to the President, at the White House. Were you fortunate enough to be selected, you could take command of the 47^th CSH until your security clearance was finalized, and then assume your relocation to the White House Medical Unit as an Assistant to the Physician to the President.

I was selected to go down and join the White House medical staff, when Dr. Ruge was Physician to the President. In July 1984, upon assuming my new position, Dr. Ruge required that I review the President’s medical records, which were notable in that he was in exceptionally good health. His significant past history included a minor urological procedure 10 years previously, a badly fractured lower extremity sustained during a softball game years ago, and transient antacid use when campaigning for Governor of California. I also reviewed his laboratory data and noted that on two occasions within the past year his hematocrit had transiently fallen (the ratio of red blood cells to the total blood volume which might conceivably signal intermittent occult bleeding, most often found in the gastro-intestinal tract. I was overruled when I suggested that a search for a source of blood loss might be indicated at this time. The President was without complaint, exercised vigorously for thirty minutes each day with no limitations, and the matter was dropped.

Dr. Ruge left and ultimately I became the Physician to the President and had probably the most exciting time of my life came when looking through a colonoscope. I saw this huge mountain in the cecum, that’s the beginning of the large bowel. And I recognized it clinically as being a cancer. I must admit I said, Why me? What did I do to get into this kind of a situation?

At any rate, everything went very well as we’ll probably talk about more as this goes on. After he left office, I went out and commanded the biggest military hospital on the West Coast, called Madigan [Army Medical Center], and from thence, when I reached 60, you can’t stay on active duty any longer if you’re a general, so they throw you out with a parade and a medal. You ask about medals, sometimes you just have to pass through time and you get a medal. Anyway, I got a medal. Fortunately, we have this wonderful military medical school where I became a professor of surgery and chief of general surgery there and that’s where I’ve been for the last 12 years.

I think that what we should probably do today since Russell is only with us today, if I’m not mistaken—

I should be here a little bit tomorrow—

Oh, you will be. I was going to suggest that maybe we get into this whole question of when the President first showed signs of Alzheimer’s because there’s some dispute over that. 

There’s no definitive way of saying exactly when that happens. I may be in the throes of it myself and—

I know I am.

While he was in the White House, none of us ever noticed anything that was unusual other than that we all forget a name once in a while. When I get back home I’ll forget all of your names I’m sure, unless I have them written down. I tried to read them ahead of time so I would reinforce my memory. His behavior was so absolutely the same day after day, his punctuality, his habits, his method of speech, etc. It never gave me any cause for alarm at all. In fact, I was often amazed at how much he did remember, not just about his childhood, which had not been a very happy childhood, but about his college days. So that’s the distant memory. Then what happened yesterday and the day before, it was always just very clear. I would have him remind me of things. Now don’t forget to be such and such a place where we’re going tomorrow, etc.

I never had anybody come in and ask me, Do you think he’s all right? Until there was a problem with his Chief of Staff, Mr. [Donald] Regan, and some things had not gone well in the White House. Mr. Regan had kind of isolated the President so that when the Iran-Contra business began, the President—and he got on the television and I didn’t know—that wasn’t because he had forgotten. Don Regan had made an ultimatum, and I was sitting there when he did it, that nobody, but nobody, goes in to see the President without stopping at my desk first. In other words, I’m going to control access to the President, which had never been true when Jim Baker was the Chief of Staff. So I attributed some of the vagueness to the fact that Don Regan knew what was going on, but he wasn’t letting people go in to see the President, especially by themselves.

Now I had that privilege because of being his physician, and I could come and go as the President wished. Very often if there was a quiet moment and he saw me walking by, he’d ask me to come in and sit down. He’d ask me questions. He was always perplexed about officers who had the charge of committing men to almost certain death, Omaha Beach, etc. He always felt bad that during World War II he was prohibited from going overseas in a combat situation because of his eyesight. He had terrible eyesight.

He used to describe being on the docks at Fort Monroe, which is inside the Golden Gate, a little Army post, but it was an embarkation point. He would put all these young men on these huge ships, and he was the embarkation officer. He would tell them where they go and where the ammunition goes and all this sort of thing, and then out the Golden Gate, knowing full well that maybe a third of them wouldn’t ever get back to see the Golden Gate Bridge again. That always bothered him. But he could recount stories about that with such accuracy that you could tell it was a very real thing to him. It was a great regret in his life that he couldn’t serve the full measure, which he never got over.

Now how did I get on that? Well, he would call me in and ask me about a high-ranking officer who wouldn’t know the men. The platoon leaders would know the men, the company commanders, but the colonel who would order the charge or the landing, etc., would not. It always bothered him because he said, I’m in a position where I may have to someday commit people to certain death and how does this impact? Do they hold their age? Does it age them, such trials and tribulations, does that make them get older any faster, etc.

I had to say, Well, you look at some people like George Patton, whose son lived across the street from me with his wife for a short period of time in Washington. He thrived on it. If he hadn’t died accidentally, he might have never died. Of all the Marine Generals I knew who were involved in Korea or in World War II, it in no way seemed to affect them that I could tell. But at times, I would go into the office and he would query me about things of that sort, in a highly intellectual fashion. It always had some reason, something he was never clear on. He knew I’d been a line officer in the Marine Corps and might have had some experience along those lines. Fortunately I never had to commit anybody to anything except some senior officers to the insane asylum, I think. [chuckling]

Everybody wants to put words in your mouth that would suggest it, but I never would have even thought about it. Now, I knew his mother had Alzheimer’s, and I knew his brother was getting a little bit vague, his older brother. It was a familial thing and I understood the genetics of various diseases and Alzheimer’s, I’m sure, is one of them. But there was just never any evidence of it. The first time that I did get a scare, for sure—Remember, he got thrown off a horse. I was at Fort Lewis at the time and I had just bought this secondhand car and was showing it to some of my staff, humorously, on I think it was the fourth of July, 1989. A military police car came up, and they had chased all over the post to try to find me. They said would I get on the phone and call the White House medical unit. So I did.

They told me that President Reagan had been thrown off his horse down at the Wilson Ranch in Mexico and had had a period of unconsciousness. It wasn’t very long and they had flown him to an Army hospital at Fort Huachuca. The doctors there noticed that he had an abnormal EKG [electrocardiogram]. Well, it wasn’t abnormal for him, he had a right bundle branch block for years, and he always used to joke about it. The first time I took his pulse he was waiting for me to react, and when he saw me kind of [motion] look at my watch he said, You’re catching the extra beats aren’t you? I said, Yes, sir. He would have these premature ventricular contractions. He said he’d had that ever since he can remember. He was a very good athlete, as you know, when he went to Eureka College.

Afterwards there were some traumatologists who believed that head injuries could exacerbate somebody who had the proclivity for having a dementia of some sort or other. That’s been pooh-poohed by numerous studies, you can read whichever you want because there are that many things in the neurosurgical literature especially associating trauma with the onset of a dementia. But about two weeks after that event, he’s back in Los Angeles and he gets up out of bed and Mrs. Reagan described a dizzy spell when he kind of lost his balance. It was very transient but being the daughter of a world-famous neurosurgeon, she became the physician and she was pretty good. She said, Ronnie, CAT [computerized axial tomography] scan for you.

So that afternoon they got a CAT scan and sure enough there was a little bit of a subdural hematoma, not clinically anything you would do anything about but there it was. Anyway, he went about his business—

This was actually two months after he got thrown from the horse?

Maybe two weeks. I think. Then we were heading out to have his annual physical, for the first time, at the Mayo Clinic, and of course the Mayo Clinic was delighted to have him there. It was a lot of fun because he had such a good sense of humor. He loved physicians and Nancy felt very much at home in the milieu and a fellow named Oliver Beahrs will crop up. I think Ollie Beahrs is now 89, and he was one of the master surgeons in the United States. He’d been the chief of surgery at the Mayo Clinic way back when. Anyway, he was kind of the host.

We were going through the physical examination of both of them, finding absolutely nothing. Ollie says, Hey, we’ve got a new scanner. The only trouble with scanners is some people think—in fact, they’re terrible with medical students. You present a complicated case and you say, What are you going to order? They say, Get a CAT scan. As if that’s going to have a printout that says—and it’s too bad in a way because they’re beginning to think along these lines. They’re losing the ability to remember the algorithm of some natural courses of diseases.

At any rate, they had a new PET [positron emission tomography] scanner I guess it was, and he said, Let’s run the President through that. So we took him over to this great machine, and I went in the room with him while everybody else stood out in the hall. They were joking, having a good time. I occasionally would come back and look at the slices that were coming up. All of a sudden I went back there and a neuroradiologist happened to be going by, and I said, Would you come in here? He said yes.

I said, Can you run back and review these cuts right here? He did and he had a large subdural hematoma on the other side. You could see it starting to compress the brain, which has fluid-filled cavities in it that are called ventricles, and it was squeezing one of them and making it contract. As a result, we had to have a review. We had the neurosurgeon come over and the decision was made that now it was on the opposite side, but it was significant enough to drain. The President was perfectly asymptomatic, but the next day we went in there and Thor Sundt did a single burr hole on the right side and drained it. Sundt unfortunately was diagnosed at the time as having a lymphoma and he died several years later of this lymphoma.

At any rate, the blood that was in there was not under any pressure, it just kind of oozed out. The President woke up from the anesthetic. It was an add-on case, so to speak. Did it late in the afternoon and the first thing the President looked at me and said, Sam Donaldson was right. I said, Mr. President, what could ever make you say such a thing? He says, Well, he was. He always thought I had something wrong with my head, and I have a hole in it now. He was that crisp and that witty.

Anyway our postoperative rounds would turn into a humor session. The next day we took him back to a ward that they had built overnight so we could isolate him. We had nurses and all that. He’s in there carrying on, talking to everybody who goes by, a big turban on his head as a dressing. His brother-in-law was there, Dick Davis, also a neurosurgeon. Then there was a urologist there named [David C.] Utz, as I remember it. Anyway, we got telling jokes and started laughing. This is 11 o’clock at night. And Mrs. Reagan came out of the bedroom that they’d made for her across the hall and with her hands on her hips says, What are you doing? She thought we’d been in there joking with him and keeping him awake. She quieted down after her brother said, Wait, Nancy, we’re just in this little room here.

The next day a phone call came to Mrs. Reagan. She said, John, would you talk to the chief nurse? who was Sister somebody or other. This is at St. Mary’s Hospital. They have two hospitals at the Mayo Clinic, the Methodist and St. Mary’s, which is a Catholic hospital. They said, There’s some large man here at the desk with a bouquet of flowers and he insists on talking to the President. I immediately thought, is this a mad bomber, who knows? They said, His name is [Boris] Yeltsin. Now, two days before all of this, a call came in and I happened to be in the Presidential Room at the Kahler Hotel and it was Margaret Thatcher.

Now, do you remember when [Mikhail] Gorbachev was being overthrown? He called up to get advice from President Reagan and Margaret Thatcher. I stood there at this very interesting conversation, and they gave him advice about what to do and, Don’t start a revolution. If the worst they can do is isolate you temporarily in exile in your dacha outside of Moscow, good. It’s a good place to rest up. Boris Yeltsin had gotten on an airplane and come over to get some counsel from President Reagan, so he was talking to both parties.

I said, Mrs. Reagan, I don’t know if this is Yeltsin. She said, Send one of the agents down to find out. It was a legitimate thing and in came this huge man. I mean, he is a giant, great huge hands, carrying this big bouquet of flowers. He looked like he’d been sleeping in his clothes for a week. They were all messed up, he had a raincoat on. Anyway, he went in and sat with the President and you could hear them laughing. Now there were no interpreters. I have found very often in the political arena when people want to get the advantage of you, they may be able to speak your language, but they don’t admit it. And they have an interpreter, but they understand what you’re saying. I think when the two of them were in there alone, they understood each other perfectly well. I’m sure he was telling Yeltsin jokes. He was having a very nice visit. He got up and left.

So that even after a major operation, drilling a hole in his cranium, his recovery was extraordinary and here he is, how old was he? That was 1989, I guess, so he was born in 1911 so he was 78, 79 years old. But anyway, he was so prompt in his response and didn’t want to be held down in bed. As I’ll show you in the slide tomorrow, the only time there was a cover-up and that’s where—he has on a baseball cap that says Minnesota Twins, because they had won, and Ollie Beahrs gave him that hat. He’s getting ready to get into a small jet aircraft and half the Mayo Clinic has come out to the airfield to hoot and holler and clap. All of a sudden he takes off his hat and of course half of his head is shaved. And Mrs. Reagan’s hand, it was like watching a cobra—zoom—on top of it to cover it up. That was the only cover-up I could see, that I really experienced.

We got in the plane and she said, John, why do you let him do things like that? I said, It was a purely spontaneous act on his part. I could never have predicted that.

So as the Physician to the President, is that set up so that essentially you’re on call for him 24 hours a day?

Yes. This is when he’s retired, so the minute he got on Air Force One and went across the country, I no longer had that title.

He would call you whenever he had a question about some medical issue?

Yes, absolutely.

He was certainly someone who appeared quite vigorous—

Oh, enormously so.

Was he someone who tended to have a lot of somatic complaints? Did he ever complain?

He never complained about anything. As I mentioned that time, I was sure he had a viral thing, which was the first time I saw him with a virus, and he said it was an allergy. He said, I don’t catch colds.

Would you tell that story? I don’t think we got that story on tape. Could you just repeat that story if you don’t mind, the cold story.

He was in my office—we used to check weight. Now I was a quarter of an inch taller than he was, although sometimes when he talked to me he would stand on his toes so he could talk down to me to get a laugh. But we were always within a pound of each other. He would always try and put something else on the scale to make me look heavier, or put his foot on it. He’d be looking up here and working the thing, and he’d have his foot going.

Anyway, he came in once and he was sniffling and he sneezed a few times. I said, Can I give you something for your cold? He said, I don’t get colds. He just walked out. Then I came down with something in the next day or two and when he passed by he said, Well, how are you? I said, I think I’ve caught your allergy. He kind of snickered and headed down the hall. But every morning, my office was right across from the elevator that they’d go up and down, and he’d always come in and say good morning and try to find something humorous to talk about for a brief period of time. I saw him all the time. He never complained about anything except—Do you remember when the Iran-Contra business came out and exploded in the press and he was caught off guard?

He came in that day. Every Thursday we used to give him an injection for his allergies. I asked him, How do you feel? He says, I think I’ve caught the Iranian flu. But he never complained about anything. Even the time, I told you, his chainsaw had gone into his right thigh and he had a gash about that long. He’d done that the day before I got up to the ranch. He wasn’t going to bother with it, and the other doctor said, You’d better look at it. He just didn’t complain about it.

He came from an era when I think people saw physicians differently perhaps than many people today see physicians as service providers. Back then maybe physicians were people who possessed a special knowledge. Did he have that kind of respect for—

Yes, that was his concept entirely.

I guess he really bonded with you on a personal level, but he must have respected you as someone who had become a physician—

Yes. I don’t really know how to describe how the mutual respect, I always respected him. But I think the fact that I had a reputation as a physician that was—I knew most of the doctors in the country, for instance, who were traumatologists and were vascular surgeons, on a personal basis, because I was in some of these somewhat eclectic societies. A lot of them would come. I’d have a lot of the very well known physicians, vascular surgeons especially, come as visiting professors to whatever hospital I was at. So everybody knew who I was basically. I was fortunate in that regard.

The fact that you were a physician, did that make you more special to him?

I think so. When he first married Nancy, her stepfather was Loyal Davis, one of the big neurosurgeons during a burgeoning time of neurosurgery. Of course, Loyal Davis was a very stern—he was the old-fashioned type. Perhaps you might have seen one or two in your internship or residencies who had an iron hammer and he was always hitting you with it. He ruled the roost nationally as a neurosurgeon, and of course President Reagan respected that enormously. He said, Here’s a man who’s very learned. He does things, he’s a pioneer. He’s published innumerable articles for the advancement of medicine. He always thought medicine was sort of the ultimate in professional activity.

Was he inquisitive regarding medical conditions in general?

Yes. If he saw an article in the paper—I remember one time he read in the paper about some young girl, and I don’t know whether she was prematurely suffering from macular degeneration or something of that sort, and immediately he came by the office on his way upstairs. He’d read about it in the newspaper and asked me if I could explain this to him. Of course I couldn’t, but I knew he expected me to be able to tell him about it the next day. So I called my former colleague out at Walter Reed who was the chief of ophthalmology, and I had him fax me a good article on it and I filled him in the next day. He was very curious about medical things.

Did you say mother and his brother—his mother had had Alzheimer’s—

When he was still living down in Hollywood, before he became the Governor, his father died a little early. His father was an alcoholic. He never made any bones about talking about his father, of whom he said, He was a bright individual, but he couldn’t stand success. When things were going well he would celebrate. He described the time he had to go out, when he was 12 years old, and pull him out of the snow and somehow get him upstairs and get him to bed. He said that had a terrible impact on him and it influenced his alcohol consumption greatly, because he just never drank. When they had a state dinner he’d fill up a glass, just enough so that he would be with everybody else when he made a toast to the visiting head of state. But he was against people drinking too much. He was afraid of it actually as being detrimental to the brain.

Did he ever express any fear that maybe in the future he would go on to dement?

Interestingly, he did not. Although he knew when his brother started showing manifestations that it might be in the cards. But, like most of us, I don’t contemplate my own death because it’s not going to happen. There’s no alternative that’s pleasant to think about and precious little evidence that we go on somehow. He realized his brother was getting a little vague, and yet, if you’ll remember, two weeks after we resected the President’s carcinoma of the cecum, they got his brother, who had had the same operation two weeks before the President did. In fact, this was one of the things that spurred me on. I suspected it was there. When the brother had the operation I said, We’ve got to colonoscope the President. No ifs, ands, or buts.

The brother’s nickname was Moon. They got Moon on the television and they said, Now, Mr. Reagan, your brother’s been in the hospital for seven days now with this thing and they let you go in five. He said, Well, that’s because I’m tougher than he is. So his brother, at that age, in his late 70s or mid-70s, probably was developing this disease but he still could respond. It’s hard for anybody to say it started on this day. They may say, This is the first time I noticed it. But somebody else may have noticed it a week or a month or a year before. Because you have that phase where the switches are all—neurologically, it’s interesting. People say, Well, what is Alzheimer’s? I say, Have you ever looked at an electrical switchbox? The telephone people come around, you have all these colored wires going every which way. It’s as if you took a red hot pair of pliers and you fused them here and you fused them here and all the circuits are going every which way so the wrong words come out and others are forgotten. That’s the closest analogy that I can think of with the plaque formation that’s building up here and there in the brain and that hits some parts faster than others.

I think you could probably have a fair number of them and be able to compensate for a while, because we tend to circumvent certain neurological pathways. Remember when [Dwight] Eisenhower had his stroke, he’s sitting at his desk and he’s signing things, and he goes right off. All of a sudden he realizes he can’t tell where the end of the page is, where the paper stops, and he’s going off onto his blotter. Then he realizes that he doesn’t seem to be able to work his hand to get the telephone, to push the button and it’s confused. Finally, General [Andrew] Goodpaster, his aide-de-camp, came in and they realized he’d had a small reversible neurological deficit they would call it I suppose, because it came back.

In fact, that night I think he toasted somebody or other. There was a visiting somebody, a person of state. So here’s somebody who had that happen to him. He said, There are some words I could never articulate again, and I would have to think of some way of getting it recalled, a confabulation. Think of some other way of expressing whatever it is I’m trying to say because the pathways just are gone. There were some words he said he never could say again.

This gets into the business of when is somebody disabled? Suppose there’s a national threat when somebody is going through one of these things. Who is it who rings the bell? We’ll get into that, I’m sure you’ll ask me about that later. It’s probably one of the most difficult questions. I used to try and put myself into the situation—and it happened of course.

Right.

It happened when he was shot and it happened again when we did the colon cancer. I couldn’t believe again what Don Regan did.

What did he do?

We operated on the President. The President had written a letter—you can do that—saying, Temporarily I’m going to be out of order and would you pass the power to the Vice President. So that was done. When I told somebody, I guess it was Larry Speakes, who told Don Regan, that we’d biopsied the big lesion four times and we didn’t get cancer back but clinically you could tell it was a cancer and that we were going to operate the next day, that the President was under a little sedation then, the letter should have been in effect.

At any rate, we operated and that evening, at 7:22 I think it was, Larry Speakes and Don Regan appear at the bedside. Now, he’s just come out of anesthesia for three or four hours, and they presented him with a letter taking back the power of the Presidency, and it was absurd. I mean, would you let somebody drive a car after general anesthesia? No. And to make a decision that might influence the axis of the world—at any rate they did that. They didn’t consult with anybody. They saw a Navy doctor there who didn’t understand the 29^th Amendment or anything else and they asked him, How’s the President doing? He said, Look at him, he’s doing fine, he going to be fine. So they went and got the prepared letter and had him sign it. Apparently the signature was almost totally illegible. They tried to sign it again and it was just as bad the second time and off they went.

Now I was just around the corner when this happened. Why they didn’t come and ask me, I don’t know, but they thought I’d probably tell them no, he wasn’t ready. Mrs. Reagan was always a little bit afraid to use the White House signal board—it’s a switchboard where everything goes through—because I don’t know where the leaks are in the White House but they’re there and whether it’s through the White House signal board, we never knew. So this whole thing was so overwhelming to me—to think that I could influence something of great magnitude here. So I went down and got the public phone and I called Kennebunkport. I knew the Vice President had probably just landed up there or he was probably just getting into his house. I asked the operator if she could give me the Secret Service line and she said certainly. I got one of the agents, picked up the phone.

I said, This is the doc. Could you put Vice President [George H. W.] Bush on the phone? He said, Sure. So I got Vice President Bush on the phone and I said, Sir, I just thought I better tell you that the decision was made without adequate medical consultation that the President was all right, and he has signed the letter of retrieval of the Office of the President. I can’t explain why anybody would do that without consulting the team that operated on him, but that’s the case. Please stay by the phone because over the next eight or ten hours, if anything at all develops, I’ll get on the phone and call you. If the decision has got to be made I will make a statement that the President is not able to rise to the occasion.

So you were prepared to override until you felt—

Yes, I would tell the Vice President that in my—and I had all the docs prepared and the military aides to say that we realize nobody who is out of anesthesia for just five hours—well, you know this—is capable even of talking 100 percent coherently.

Did the Chief of Staff ever find out about this little inroad?

No. The Chief of Staff is the guy who did it. I never told him I called up the—And the Vice President was collected and calm enough. He understood. I said, Sir, I don’t understand why people would do something like this. He said, You’d never make a politician.

They were concerned about appearances.

I said, Well, I was president of my class in medical school.

Was it common that political decisions overrode medical decisions? I know that there is historically this tension between the physician’s office and the White House staff, between making certain decisions.

I don’t know. I know Eisenhower’s physician was well respected, a fellow named Howard Snyder. He was a great hero of World War II and that’s where Eisenhower first had known him. They knew of his friendship with the President. They knew that his opinion probably was better founded than some of theirs. So I don’t think they would have ever challenged it. Now remember, Eisenhower had three episodes and it was after that that he recollected, Three times I’ve been disabled and really incompetent to make a decision. We’ve got to do something. We have to make a provision. Then Birch Bayh got involved in it. He’s a good guy and it evolved, but it took years. It wasn’t until 1967 that it was ratified.

Yes.

This commission, Dr. [James] Toole got together and he had everybody from the librarian of the Woodrow Wilson, who has a tracheostomy, but he would come to these meetings, breathing through this tube into his trachea. There’s a little center across the street from the White House where we’d have these deliberations and testimonies. We finally came up with some recommendations that there has to be some way of including the doctor in the decisions and he should have more weight, he should not be an assistant. I can’t remember my own title because I never went by it. The Chief of Staff is called an Assistant to the President, and the doctor was down a layer and he was the Deputy or something like that. I can’t remember it right now, but there was a difference. Because if you were in the upper echelon your vote counted a little bit more. 

But the question that we never resolved is who would have the ultimate decision. We suggested that there be a group of very well-known, nationally recognized physicians—a cardiologist, a neurologist, a psychiatrist, an internist, and maybe one other—and that they would be called to Washington and meet at the Military Medical School, neutral ground, and all in concert. If it was a cardiac problem the cardiologist would know where to get the best person in the country or if the catheterization lab at Walter Reed was of sufficient standard. They would have this all doped out, but it would be done in concert and the American people would know that they had gotten the best people in the country to evaluate whether we should go ahead and do a cardiac bypass or something of that sort. They handed that to President [Bill] Clinton. We had it all.

He took it and gave it to the then Physician to the President, [Eleanor] Connie Mariano, and it was just relegated to a drawer basically, no attention paid to it whatsoever. They’re so afraid that there might be some kind of a cabal that would include the doctor that we’re trying to oust them. For years this Dr. Toole has tried to propose something that would make sense but it’s never gotten added as an amendment or anything of that sort. But that’s what I would have done. That’s what I did when I suspected there was a cancer and we had to operate. I had Dr. Lee Smith from the outside, who has been the president of the colorectal society [American Society of Colon and Rectal Surgeons], respected all over the world as a colorectal surgeon, he was with us. We had a fellow named Steve Rosenberg at the NIH [National Institutes of Health]. This should be off the record if it’s possible. [tape shut off] 

In talking to the press he alluded to the fact that he had done the operation and for a while some of the press was reporting—but a Navy doctor and I did the operation with Lee Smith and Steve stood on a stool in the back watching. We had asked him to be involved because he is a superb researcher, and he’s more up to date on the chemotherapy or monoclonal antibody therapy, etc. If the President had had metastatic lesions, if we saw it in the liver and here and there, because of his experience working with these terrible cases at the NIH, he might be able to say, Well, let’s back out and try this, try that, modalities other than surgical extirpation.

At any rate, I remember, he ended up with his picture in Time magazine. But he really had no influence on what was going on at all You can’t predict human behavior when something as colossal as an operation on the President takes place. I know Dale Oller, the Navy surgeon, and I, we’d known each other for years. We’re both vascular surgeons and we just said, We’ve got to treat this like it’s anybody else who walks down the street. We do what’s best for the patient. We don’t do anything fancy, we don’t take any shortcuts. If we have to leave him with a colostomy we do that, we don’t say, ‘Gosh, you couldn’t have the President with a colostomy.’ There are some people who might influence them, but fortunately we didn’t have to make a decision like that. It was a very straightforward operation, a very thorough examination; we found no sign of it anywhere. Being a vascular surgeon, I did slip my hand down to palpate his external and internal iliac arteries and his common iliac artery. As we grow older, if you have atherosclerosis very often you can feel a little rim of it in there. It was just like touching a 17-year-old’s vessels. There were no huge gobs of mesenteric fat, it was like operating on a young kid. I was just astounded how well everything looked. Just this one lump of cancer that was about as big as my fist.

He was an outstanding physical specimen?

He was remarkable. Up at the ranch when we were lifting—he knew I had a collapsed disk in my back and we’d be lifting logs—he’d always take the heaviest end. I was amazed at how far he could throw logs and do these things. One-handed he’d get up there with his ladder, one hand on the chainsaw, and I used to say, God, Mr. President, and we’re all holding the ladder for dear life. The agents are shaking their heads.

While he was President did he ever even in a joking way complain about senior moments or forgetting things?

No.

Can you recall a particular time after he left the Presidency when he started realizing that his memory wasn’t—

Yes, very definitely. After we did the burr hole and got his brain back where it belonged, every year he’d go out to the Mayo Clinic for the annual examination. One of the things he started doing was psychometric testing, reading a paragraph, answering questions, mathematical calculations, etc. The neurologist and the psychologist were doing this and it showed high intelligence, no sign of any problem. I think it was in 1993 that we saw there was a difference, and he knew that there was a difference and he said, You know, I had to read the question, read the paragraph, read the question, and then go back and search for the answer. I don’t think I finished the whole exam. It was the first time he noted that, but it was the first time he’d been tested for a year. So it was somewhere—

There was a change on his neuropsychological testing somewhere between 1989 and 1993.

Well, it was very definitely—in ‘92 he was fine.

So the neuropsych testing in 1992 was fine, and then in 1993 he was realizing it wasn’t fine.

Yes, it used to be so easy for him to read a paragraph and he didn’t have to refer to it again. His memory would generate the answer. All of a sudden it didn’t generate anymore.

There’s a beautiful anecdote from you in the David Shenk book on Alzheimer’s disease about—I guess the President was giving a talk at his birthday celebration. This was after—

February 1994.

Right before he went public.

That was in November of ‘94.

You describe watching him get up at the podium with this deer in the headlights look about him and wondering, Oh, my goodness, what’s going to happen?

What are we going to do now? And Kathy Bush was kind of his press secretary and she was standing with me. I said, Have you seen this before? She said, I’m not sure. He was hesitant, he started saying some things that weren’t germane to what he was going to talk about, little humorous quips. Whatever it was, I was so startled. I was overwhelmed because this was a colossal thing. Everybody in black tie, 2,500 to 3,000 people in the Pension Building down there in Washington. I said, Kathy, what do we do? Would I walk up on the stage and what would I say while I’m trying to get him to sit down? Margaret Thatcher was there, she had introduced him.

All of a sudden it was like he had been in the dark and somebody turned the lights on. Within minutes he had everybody laughing, he had them crying, it was a very emotionally packed speech and a lot of humor, a lot of stuff—I know it was his humor because I could tell it. He was all right. Afterwards we got thinking and one of the former chief agents, the fellow who was shot also, in the abdomen—

Tim McCarthy?

Yes, Tim McCarthy. He said, You know, I’m not sure he recognized me. This was the guy who pushed him, got him on his way into the automobile. The hoopla’s over with and I’m trying to think back. Was there any vagueness when we were sitting in the green room before he went on the dais? He certainly recognized me.

We get back to the hotel and he’s the lead. He goes in the door first and he gets about five steps and he says, I’m going to have to wait a minute. I can’t quote him exactly. He said, I’m having a little trouble, I don’t know where I am. Mrs. Reagan was holding my arm, she said, John, this is happening even in his own house. So there was a time—that was February of ‘94. That’s the first time we really started seeing—we have the psychometric testing now, we have episodes like this that were witnessed. We have to make whatever adjustments there are.

But he kept going to his office every morning. He had a routine that he could seem to remember. He could greet people, go around, show them various mementos, pictures on the wall of himself and the Pope, himself and Margaret Thatcher, things of that sort. But he would be vague about who he was showing. It was like they were just somebody, some tourists coming through. I remember the day—do you know who Sting is?

Yes.

Sting comes up with his crowd. Now, the only thing I remember about Sting is when he was giving a concert with [Luciano] Pavarotti, and there is the contrast between good and bad. Sting is trying to hit some note and you can see the veins in his forehead standing out. His accessory muscles were in full swing. Pavarotti is sitting there with a smile, with this voice that’s just dominating everything. Anyway, Sting always wanted to meet the President and he knew somebody who knew somebody, so up he comes with his group and their wives.

I get talking and I realize here’s a highly intelligent, sensitive individual. He’s totally different from when he’s on the stage, when the adrenalin gets going. He went in and the President showed him this, that, and the other thing. They came out. I had warned them not to get a complicated conversation going, simply because he didn’t have time to do it and they didn’t notice anything. But I could tell because I was in the back. He had this little routine, those synapses seemed to be still preserved for doing that. Some people would say, He’s fine.

Then in the afternoon, I’d take him out on the golf course where a couple of times a week he’d go out and just hit at the driving range. One day he said, John, that’s my mother standing over in the doorway of a house across the street.

What year was this?

About ‘95. When the book by Mike Deaver—have you talked to him yet?

Yes.

He describes what I told you. I don’t think I mentioned the part about the mother in the doorway, but he actually was hallucinating for brief periods of time. One day he hit the golf ball—he’s still hitting the golf ball pretty well. He hit it out, instead of out in the range and it went out and hit the street and he said, My God, I hope I didn’t hit somebody. I had to run out to the street and see if it had smashed the window of a car or something. I don’t know where the golf ball went. He was acutely aware that he had hit it off kilter there, and he was very concerned that he might have hit somebody or broken something. But he was starting to have problems like that.

Mrs. Reagan was very cautious about his watching television, because he was watching a football game once and he started rummaging around the house. She said, What are you doing? I’m trying to find my football gear. The coach is waiting for me. So, much to my sadness because when I’d go out and stay with them, I couldn’t watch football games anymore.

When she had to get away periodically I would go out and stay with him and take care of him. An example, I think is in here. She had gone down to represent him in 1996 at the Republican Convention in San Diego and he’s sitting there. So we turn that on and he says, That’s Nancy in there. I said, Yes, sir. She was wonderful. If you saw that, she was at her best. You’d look out in the audience and see the tears.

Anyway, he gets up and goes in to look for her in the bedroom because he can’t associate the fact that she’s on television. I would only try to explain it once because I knew that particular pathway was closed off for the moment. At this point, I guess this is ‘96, we had to watch him all the time. That was exhausting. And the one who really saved my life, because I was doing this once a month or so for a week or two sometimes, was Diane Caps. She is the unheralded heroine. She’s a very attractive, very bright gal, probably one of the best nurses I’d ever had any experience with. She moved in and took care of him 24 hours a day. When she couldn’t do it anymore she’d call me up and I’d go out. She’d go back to North Carolina, get two weeks, and then she’d come back. It was a difficult management problem simply because he didn’t sleep all that much. He was very active, and poor Mrs. Reagan—every day was painful to her. It got to the point where you could tell he was having difficulty recognizing anybody.

Then she very kindly said, He doesn’t know you anymore. I don’t even know if he knows me, but I’m going to get some full time help. What Diane used to do by herself, she’d get four people on shifts to watch him throughout the day. He had to be constantly supervised. That takes us up to 1997, ‘98.

He was still playing golf in the early ‘90s?

Yes, he’d go over with a group of friends, he’d have lunch. Then he’d go out and just hit golf balls. Everybody was very good. They didn’t make a fuss over him. They understood that he needed his exercise, just leave him alone. He’d go out and hit the golf balls. There’d be people six feet on either side of him on the driving range and they’d say, Hello, Mr. President, and leave it at that.

He used to love going up to the ranch. I imagine there must have been a point where you had to say, No more.

Yes, it got so he was getting lost up there. He got a little hesitant. He was a horseman extraordinaire. To watch him on a horse led to another one of my trying moments. We were in my office on a Thursday, and I’d given him his allergy shot. He looks up and he says, Boy, Sunday we’ll be back up at the ranch, going to be four weeks at the ranch. I’ll be on horseback. I said, Mr. President, you’re four weeks away from the operation, and the rule among surgeons is that a wound is not healed appropriately for any kind of exercise for six weeks. Don’t ask me if there’s any scientific—somebody just thought that up some time ago and nobody’s ever changed it. Six weeks. It’s different now because we don’t make such big incisions. But I said, We had an agreement that you would wait six weeks.

That’s when he stood up and stood on his toes so he could look down at me and he said, Well, I’ll tell you how I feel about it tomorrow, but I could see a little bit of a smile coming. He started out the door, and as soon as he was out I picked up the phone and said, Switchboard, get me Mrs. Reagan immediately. Hello, John? What is it? I said, The President thinks he’s going to ride a horse. She said, No, he isn’t. I said, How can you be sure? She said, Because I told the Secret Service if I saw a horse on the ranch for the next two weeks I’d fire them. She had a very good sense of humor, which most people didn’t realize.

At any rate, we get up to the ranch and the first week slips by and no horseback, and the second week. We’re getting ready. So I go down and make a perfunctory exam of his abdomen, it looks fine, looks healed. I ask him to cough and it’s a solid suture line in there. He said, Well, tomorrow I’ll ride. I said, Sir, you’ll walk. Dr. Nancy says you’ll walk on the horse for the first day or two until you get in the swing of things.

So the next day we get ready to go for the walk. I’m in the Humvee with the Secret Service agent, and we had a splint and a litter and some stuff in case somebody fell off a horse. He always rode with a crowd. He always had some visitors come up and ride; it was usually a party of eight and the military. There’s one Secret Service agent and the military aide would be there. And I’d be in the Humvee with two Secret Service agents, maybe a nurse and the splints and the resuscitation stuff as you might imagine.

A Humvee makes an awful clanky noise, like all diesel engines, so we would stay far enough away so we wouldn’t be overheard. They would go a little bit, we would go a little bit. We always were 100 or 200 yards behind them. They went over this hill and on the other side there was a bluff and then a straightaway. All of a sudden we hear all this shouting and I said, My God, he’s fallen off the horse. So we shift into gear and we go roaring up there and here’s the party that he’s riding with and off in the distance you can see the puffs of dust coming up. He couldn’t resist. He dug the spurs in and off he went. Finally they all caught up with him and they continued with their walk.

We come back to the barn and we’re in the Humvee up at the top of the hill. I see everybody walking away from the barn, which is unusual. And I don’t see him, he’s inside the barn. The Secret Service agent pushes the little hearing device in his ear. The microphone is in the cuff. All right, I’ll send him right down. He said, Doc, the First Lady wants you down outside the barn. I said, Oh, dear God. And as I’m walking down there, everybody’s kind of smiling. She gets me off to the side of the main path into the barn and she says, All right, now you sit here. We’re going to have a little discussion here, only we’re not all here yet. Now you can hear him in the barn doing busywork so he doesn’t have to face the music. I can hear him moving saddles around and doing all this stuff. Finally she gets exasperated and she goes in.

She comes out, pulling him by the sleeve. He’s got his hat off over his heart. She’s pulling on him. You stand here and you stand here. Now, she says, he says that you said he could gallop. What to do. I thought of George Washington and the cherry tree and all the history. All of a sudden a stroke of genius comes. I remembered what I had told him when I was examining his abdomen and I was telling him, Well, we’ve got to the six-week mark, or thereabouts, and at this point you can tell me better what your limitations are from how you feel than I can tell you. I recited that. His color came back and he smiled. He said, All right, Nancy. Yesterday the doctor and I were talking about it’s time for you to have a colonoscopic exam.

At this point the discussion got heated and I just said, I’m sorry, I can’t be of any value from this point on. I ran away. It was one of the humorous events. We’ve laughed many a time about his galloping.

Let’s take a quick break.

…what specialty is he?

He does research on Alzheimer’s.

Oh, really?

I think he’s a neurologist, I’m not 100 percent sure. Not a neurosurgeon, I don’t think, but again, I’m not sure.

I always marveled at neurologists, because they have memorized all of this intricate wiring and how it goes down various areas of the spinal cord. They can see somebody doing something and realize that that particular little nerve is somehow afflicted with—

He’s an associate professor of neurology and he’s an attending physician at UVa’s Memory Disorders Clinic.

Could use a little of that. People I’ve known for years and can’t come up with a name.

I was hoping you could talk a little bit more about the role of Mrs. Reagan, especially since ‘93, as President Reagan has slowly degenerated with Alzheimer’s. She’s seen in the press almost universally as being a great caregiver. I was hoping to get a little better insight from someone who has been close with her the last eight or nine years.

She’s always been a lady of enormous mettle and a mind of her own, and she’s highly, highly intelligent. She’s compulsively driven to perfection. When you were around her you realized everything had to be perfect. She inspired this in other people who were around her. She’d go John. I’d know I hadn’t got my shoe tied or there was something that needed to be addressed. But she was absolutely wonderful to everybody, with the exception of perhaps Don Regan. There was an enmity there where she realized that he thought he was the smart one in the White House and that he should be governing more freely than he was.

I think if you were to say what was the salient—it was her undying love for this man in spite of the fact that she knew sooner or later he wouldn’t recognize her. One day I remember, I was in his study, which had some of the most interesting photographs of big events that she could find. They had this circuit of speakers in all the rooms so that she could put music on in the library and it would be in every room. On came Unforgettable. You remember that old song? Occasionally, when they would have something like that going, she’d go up and they would hold onto each other and kind of dance. I was invisible. I could be there and they didn’t care. I was just accepted as somebody maybe even closer than some of the family.

 She went up and put her arms around him and started to move and he didn’t know what she was doing. And she said, Ronnie. Kind of fended it off and I remember how that brought tears.

One day they had come down the hill on their horses. They would put their horses side by side and he would get off his. Then he would walk around and stand by her horse and she would throw her leg over and leap out of the stirrups into his arms. There was a row of pine trees and I was walking up to where our quarters were. There was a little hole in the pine trees I could look through. And I watched this warm embrace and I said, Good Christopher Columbus, how does anybody keep a romance going for this many years with that intensity? I felt like I was a kid watching a sister necking on the couch with her boyfriend. I felt guilty about doing it, but I couldn’t resist.

They held hands a lot. She was an enormously loving individual. I guess they would argue occasionally, but I never witnessed an argument except when I was telling you about the galloping. As he got sicker, she became more and more attentive. One day we were sitting there and as she was apt to do, after dinner we would go out into the library, which is a very homey place, and she used to like to watch, what is the program?

Murder, She Wrote?

No, no, he loved that one. No, it was a game show that had Vanna White in it.

Wheel of Fortune.

Wheel of Fortune. It got competitive. Everybody was trying to come up with these words. After that show was over, then it was getting him ready for bed and she went over and sat in his lap. She used to always do that. When I first went out there and visited him he’d put his arms around her and they’d smooch a little bit. It was just wonderful, the warmth that seemed to always be there. I remember the last time she went over there, and he obviously didn’t understand at all what she was doing. It was kind of sad. She would tear and just get up and go off to her room.

Then when it was time to help him into bed she would come back. She would try and get him to get up out of the chair by himself, but it got so he couldn’t coordinate well enough. She’d try to get him rocking back—one, two, three—and he’d go down again. I said, Mrs. Reagan, let me get one of the agents and the two of us will lift him up. It got so that we had to kind of lift him up and he always had to be leaning on somebody.

One day I was coming down the hall with him and he stumbled on something, and fortunately I caught him by pinning him against the wall so he didn’t fall down. He was a little bit frightened by the rapidity with which I grabbed him. And I told him, Mr. President, I’ll never let you fall down. I don’t know whether he understood me or not, but finally he got his legs under himself. But his balance was gone, so you always had to be with him.

Then it was the walker, and you’d have to encourage him. What we’d say is, All right, here we go. She’d always try to get him to do it by himself thinking that somehow or other he would relearn. I would explain that the wiring was just not there to support that. But hope springs eternal. She would hope for the best. But it was her undying concern about his comfort and trying to keep him happy. So, as I mentioned, that young nurse, Diane—not young, middle-aged, enormously attractive. Diane loved him too, and the two of them would take care of him. If it wasn’t one helping him up, it would be the other. Of course there was the incontinence and all of that kind of thing, but they took care of it.

Does Mrs. Reagan still hope for a miracle?

No.

Does she think maybe stem cell research will come of age—

She thinks we ought to be supporting everything that we can but I don’t think that at his age there’s any—She’s the daughter of a neurosurgeon, she’s been told about life and death all of her life. We have made the decision that if he were to arrest, that’s that, it’s over. We wrote a passage that everybody has, the Secret Service and everybody. All the resuscitation equipment that had been there for years, it’s all gone. She’s very realistic. I think in a way, she’d hate to be alone without him. On the other hand, she hates watching him degrade from such a colossal individual to where he’s just neurologically gone.

When he was still President, did any of his staff or anyone in the government ever express any concern—I’m specifically thinking about when he was being interviewed for the Iran-Contra affair.

There was a moment of silence when he was asked some question because he just didn’t know. Don Regan had shielded him and hadn’t passed the information along. Now, interestingly, Don Regan realized he was on thin ice. He brought his own boys, it’s like a gang. When one Chief of Staff leaves, the other guy comes in and brings all his cronies. They were good people but after a while somebody was getting fed up with some of this autocratic attitude of his. It was in the wind that somebody was going to have to tell Don Regan that he was through. All of a sudden a new figure appeared on the scene.

Two men came into my office. I didn’t know them. They introduced themselves by name, which meant nothing to me. They said, We’d like to talk to you about President Reagan. I said, I don’t talk to anybody about President Reagan without his knowing it. They said, We’re just going to ask you a few simple questions. They queried me as to whether he had his mental faculties or not. I said, You’ve come to the wrong person, number one, if you’re trying to find something. As I said, I don’t know who you are, but you don’t get to this level of the White House without having passed through the sensors out there, the guards.

They explained that they were there at the behest of Howard Baker. I knew the name but I didn’t know any more than that. Then sure enough, Regan’s people had started the rumor that the President was incompetent and these two people were out there, and Howard Baker said, I won’t get into this if that’s true. Now, that’s just my own concept of what was happening. The next thing you know, I was in Kathy Osborne’s office. She was a very lovely lady and she was his personal secretary. He had a personal aide and a personal secretary. She showed me a letter from Don Regan that said one line, I am tendering my resignation. Then she showed me on one of these pads President Reagan’s accepting the resignation with very kind words, like with regret and whatnot.

Who actually told him he was fired I’m not sure. He blames Nancy Reagan. I’ve heard that it was Vice President Bush who finally came down and said, You’re through. We probably will never know because Don Regan is dead now and I don’t know whether he left some memoirs, we may never know. At any rate, all of a sudden I saw a big limousine drive up and out gets this nice-looking, short, stocky individual. He goes in and everybody is paying a lot of attention to him. The press is all humming around. I was just walking across the street there and I said, Gee, something’s going on.

The next day, I’m driving into the White House and two or three cars ahead of me is Ollie North and all of a sudden he’s backing up and he can’t get in. They’ve taken his ID card and punched holes in it. Again, it has to do with the Iran-Contra stuff, the arms. Oliver North was a good guy, and he was feeding the President information that problems were starting in Central America. The Sandinistas were building up that he could document that helicopters were being shipped in from Cuba and that Nicaragua—all of that heat that was being generated from that part of the world. 

I had spent six months in Honduras realizing that our forces down there were building airfields so that the 82^nd Airborne could get in without having to jump. They were leveling off mountaintops, Reserve Engineer Corps. We had a hospital that was getting ready for something. It was a great six months I spent down there. So I knew what was going on in that part of the world. And I knew Ollie North was going in and out of Nicaragua bringing back all this information. Don Regan was the one who was stopping it from getting in to the President, I think. We will probably never know. At any rate, your question to me was?

Did anyone else in the government to your knowledge raise questions of competency?

All of this is going on at the same time that Howard Baker is suddenly coming on to be the new Chief of Staff. It’s Thanksgiving vacation. We go out to the ranch, as I remember it, for a few days. We come back. Howard Baker is ensconced and it was as if the sunlight had come out again. Here was this lovable fellow with a superb sense of humor and a wonderful brain and political knowhow like nobody else around. Everything changed tremendously for the best. He commented that he had heard these rumors that were spread by Don Regan’s group, that the President really wasn’t fit. Howard Baker had convinced himself, with the help of people who were running around interviewing, that the President was very much in charge of his faculties. So that did happen, but it was a very directed source that promulgated this sort of thing.

I took a great affront to that. I took an affront to these guys coming into my office. In retrospect I can see what they were doing, but they should have somehow been introduced by somebody we knew.

They were just following up on some lead that they needed to track down.

That the lower level of the Reagan staff were promulgating, yes.

Did you ever see examples where Don Regan, in your opinion, overstepped his bounds and was being excessively protective or—

No, he was not protective.

Protective is not the word, but—

He protected himself.

Isolating the President. Could you give us—you told a story at lunch, I don’t know if you want to repeat it, about a presidential speech that Don Regan—

Oh, yes. Don Regan would rearrange a speech that the President wrote. He came in and I was standing there. I was a little bit like a fly on the wall, neutral, doctors don’t blab, we keep things to ourselves. So I’ll tell the story. [laughter] But I was standing there and in he came with this speech that the President had written. And he had written something else, he had crossed out a lot of stuff.

The President said, That’s not what I want to say. Well, that’s what you should say, Regan said. That’s not what I’m going to say. Then he sat down there and wrote what he wanted to say. You could tell he was starting to irritate the President. He was irritating everybody except his own cabal and he treated them badly. One day we’re on Air Force One and Don Regan comes back where the junior staff sit, and the doctor had a seat that I always had to sit in. One of his writers was writing a speech for Don Regan for some reason or other and it had to do with cows or some domestic animal. There was an analogy being constructed that had to do with the cows unfed. I forget whether it was cows or pigs. Whatever it was, they used the word corn. Don Regan came back and said, Cows don’t eat corn, they eat hay, and took whatever this poor guy had put together, all typed up and threw it on the floor in disgust, and he walked out. That’s the type of guy he was. Everybody was aghast at how he could be so insulting to somebody who was trying to help him out, to one of his workers. You could make some kind of a humorous quip about, You obviously need some time in the barnyard, etc.

I don’t want to get too off track here, but when you told that Regan story at lunch about the speech, you had mentioned something about Reagan’s intelligence in general and his involvement in writing a lot of his own speeches or a lot of his own work. Before I forget, I was hoping you’d get that down on the record, just tell us a little bit more about that.

Well, that was a perfect example, the one I gave. He had written something that Don Regan wanted to change and he said, No, this is not what I want to say. I wrote what I wanted to say and I’ll write it again. That was the one that was the most glaring because there were several people around witnessing this.

Kathy Osborne, who I mentioned is just one of the dearest people I’ve known, she—everybody wanted to protect the President. Everybody loved him except for that one individual. He had written a very nice letter on a pad similar to this, accepting Don Regan’s resignation. It wasn’t flowery, but it was just beautifully written with regrets about this or that and the other thing. I remember Kathy said, I want you to read this because it’s beautiful, number one, but it releases him from further obligation and responsibility here. I just want you to see this, because it’s in his hand. Nobody wrote this for him.

Subsequently you would see him, he always had a pad like this around and he was always writing stuff. Then I’d hear him articulate and he would take it and put it on a TelePrompTer, but you could tell there were times he wouldn’t pay any attention to the TelePrompTer. If you look at a TelePrompTer you’ll notice it allows people who look here, they have these two things that are transparent, except they reflect, some kind of magic one-way mirror I suppose, I don’t know, but it reflects how the speech goes. I would see him deviate from that all the time. He wrote beautifully. He wrote me this beautiful letter that I read to one of the ladies here. I’ll send you a copy of that.

That will be great. There were questions raised—this is on a slightly different note but not entirely—about the President’s intelligence. Occasionally he would misspeak at a press conference and that would get quite a bit of attention. I was wondering if you just would comment.

By misspeak, can you think of an example?

It’s usually factual data that he would get wrong and the press would—The impression was created that Reagan was intellectually lazy, that was a term you often heard, and I think even Edmund Morris has propagated that a bit.

Edmund Morris. Now you got me going.

I knew I would.

He made some preposterous statements in his book. The President thought he wrote beautifully and that’s why he hired him. Edmund and I were very friendly, I don’t know whether we still are after we had that battle where Edmund—it’s when we’re doing the colonoscopic exam and Edmund inserts himself in the room and he writes a dialogue as if he’s asking, Now where are you? What are you seeing? And he describes the colonoscope as getting up to altitude and taking a banking to the left and then banking to the left again and here was Mount Vesuvius of cancer. He describes this and he acts as if he’s in the room.

Then he goes on and everything he says is inaccurate. Then he goes on to say that President Reagan’s blood chemistries—and he enunciated this to me several times—that the President was never the same after he was shot, that that was a mentally mortal wound of some kind. I said, Edmund, if he was destroyed, even physically, I can’t keep up with him when we’re out at the ranch, so he must have been really something before he was shot. He never had any regrets about being shot. He used to joke, if a balloon popped he’d say, Oh, you missed. He’d have some quip like that. He never was scared or said, My God, an inch one way or the other I’d have been a dead duck and all that. He just kind of laughed, It was only a .22. What did you expect? Now your question was—

Just general intelligence, your impression of his intelligence.

Well, we were talking about Edmund Morris, who said he was never the same. Then he said he got it from Ben Aaron. Ben Aaron was the chest surgeon, a recently retired Navy surgeon, who had been the chief of chest surgery at Bethesda [Naval Hospital]. He said he got it from the horse’s mouth, which is Ben Aaron in 1988, that there was still disarray in his blood chemistry. It was all out of whack.

I’m at home sleeping, it’s 2 o’clock in the morning, the phone rings, says, Hello, Dr. Hutton? I said, Yes. This is George Will. I said, Good morning, George. What’s on your mind? He said, Nancy just woke me up and I thought in turn it would be all right if I woke you up. Nancy says it’s all right. Let me read you a paragraph in the book Dutch. And he reads this absolute nonsense to me about the blood chemistries.

I said, It’s untrue and how would he think he could gain access to such information? So two days later, on one of the pages of the Washington Post is Dutch: A Disingenuous Work. George Will goes on to quote me as saying this was a boldfaced mistruth and this and that and the other thing. Edmund Morris writes a letter back. It is true. I know it’s true because Ben Aaron told me it was true. I remember the day that John Hutton came running into his office and I was sitting there and he had a blood-spattered tunic. A surgeon never leaves the operating room with a blood-splattered anything. Anyway, I didn’t know what he was talking about.

So Joe Giordano and I write a counter letter that at no time was there any reason that the—

Who was Giordano?

He was the general surgeon who was involved. He had been with us out at Walter Reed on and off so we all knew each other. So we wrote back and challenged this as a mistruth. And then he writes back and for a month, every Saturday, there’s a section of the paper that’s called Free for All, I think. Everybody is calling me on the phone, Why are you getting into this with Morris? etc. Anyway, finally I found Ben Aaron, who was in his house someplace up in Vermont or New Hampshire, and I said, Ben, you’re going to have to help us here. He says that you said, etc.

 He says, I haven’t—how would I have access to such information? It’s nonsense. There’s no reason for it to be true and there’s no reason why I would have access to that information. So we get Ben Aaron to write a letter with me, again challenging, and that’s the last we heard of it. But if you take those three or four pages and how much was in error on those three or four pages, and extrapolate it to the rest of the book, it isn’t worth anything. Every day, at the end of the day, when I got home, I had one of these green books that’s about this size. I would write an account of what went on that day, not politically, but with the inner workings and what the President did. What was his joke for the day, some of the humor that went on, and if there was anything significant that would be in there too.

I allowed Edmund to go through every one of those, which was a day by day by day—I missed one part when we were in the Geneva area, which I regret, although nothing exceptional happened except you could tell that Gorbachev and Reagan spoke the same language, that we were not going to have a war with Russia.

I tried to be kind to Edmund. I’ve had dinner at his house, I’ve played his piano. And yet he comes out with this outrageous part of this book. It irritated Mrs. Reagan intensely, so she called George Will who then called me and started the letter war. But now, your question initially was about his—

His general intelligence.

If Edmund Morris was trying to paint any kind of a picture to the contrary, it was with the same enthusiasm that he wrote about his blood chemistries, which had no fact at all. Edmund Morris decided, If I’m going to write your biography I should be in your bedroom, I should be in the Oval Office when you meet Margaret Thatcher. And Reagan said, Absolutely not. Nobody else who’s written a biography of somebody had to get in bed with them and you don’t either. He made that comment to me once. Not the get in bed but he said he just didn’t want to have somebody hanging around his neck second-guessing him.

No President can possibly master all of the data that’s available, and he has a historical unit and a very good fellow, who’s a Congressman now from Orange County in California named Dana Rohrabacher, a superb individual, great integrity, and he’s a little more insightful than most other Congressmen. He can see trouble before—in fact, Dana disappeared for a couple of days. I said, Dana, where have you been? I think he was in concert with Ollie North. He said he’d been down in Nicaragua. I said, You don’t have to find out stuff firsthand. The next thing you know we’re going to be down trying to rescue you. You’ll be a hostage or something of the sort. He’s a wonderful individual. He spoke very truthfully all of the time. Now how did I get into that? I’ve got this flight of ideas.

We’re still on this question of intelligence.

He had a great regard for the President’s intelligence. He was the historian. They had a historical unit that would—Example. The President was going to come out to my medical school, the Uniformed Services Medical School, and give a graduation speech. And he asked Dana, Would you go out and tell me about the founding of the school, which was founded by Congressman [Felix Edward] Hébert and all this. Of course Dana would come back with this list of stuff, dates and whatnot. The President would only get five minutes to look it over, so I don’t think that had anything to do with intelligence. I think that’s just an overload. I didn’t know how he could remember as much as he did of the things that I’d witnessed.

You perceive him certainly as a man of superior intellect.

Yes.

And I think you mentioned earlier that he could read things and had a photographic memory. Was he a speed-reader?

He could pick up a book and read it and then he used to figure that if I was a professional and had gone through as much school as I had that I could read it and then we could talk about it. The only trouble is he’d ask me the next day, What’d you think? I’d say, I’m about a third of the way through. He’d get on the airplane, at a quiet moment he always had a book. Occasionally when I’d go into his quarters it would be the Bible. He was not a churchgoer, but he was a very religious individual.

So his reading material, things like the Bible, what else would you catch him reading?

Oh, gosh. He admired Winston Churchill. On the other hand, he would read novels by Louis L’Amour too, because he could do that in about an hour. He’d give it to me. I got so I kind of liked them. There was always a hero, always won in the end, in spite of a terrible beating he took throughout the tome. I think that was relaxing for the President. I was just amazed at the information about as wide a variety of subjects that we would talk about.

You mentioned at lunch that in between clearing brush you would sit down and philosophize?

Oh, yes. Sure. About abortion, he never came out strongly as an anti-abortionist. He weighed out what he said and you didn’t know really how he felt about it. I think he felt it would be all right. Now he was once a Catholic and he became a Protestant. He was once a Democrat and he became a Republican. All of which he attributes to Eisenhower. He played golf a time or two with Eisenhower and he had, in the back of his desk there was a table with all of his favorite pictures and the two 8x10s were of him holding a golf club with Eisenhower. He beat him once and he lost to him once, so $10 went back and forth.

If you went in the library, the books on the shelf were obviously those of an educated individual, [William Makepeace] Thackeray and all, and he could talk about any of these kinds of things.

When in the midst of a philosophical discussion, did he take on more of the role of the listener or of the expounder?

Just as an equal partner in a conversation.

It must have been intimidating having a—

No, see, he didn’t do that. He didn’t intimidate you at all. He respected everybody else’s intellect, and it was just two people talking together about something and one might know more than the other. There were times he educated me about things in the business world. I can’t think of an example offhand, but I remember he was talking about someone named [Justin] Dart whom he knew—

Justin Dart.

He talked about how he had built himself up and created a business. Now, is this the Dart of the Dart Drug stores?

Yes.

He said he was a very good example of this, that, and the other thing. Sometimes he would talk about it—Abraham Lincoln was his favorite hero of all the people.

Really?

Yes, philosophically he would be more aligned with Abraham Lincoln, whose life he knew all about. He knew all the Congressmen by their first names. I remember when Joe Biden, we’re flying in the helicopter back from Camp David and the pilot gets a message and passes it on to the President that Senator Biden had just had an intracranial bleed. He ruptured a berry aneurysm and was being rushed to Walter Reed. He says, Gosh, on your way home would you stop by and see how he’s doing?

 So I drove home, went up there, and one of my neurosurgeon friends was hovering. What you do with somebody who’s had a berry aneurysm and they’re bleeding, you get their blood pressure down, a dark room, the whole business. You try to get inactivity going on in the body.

I went in and I said, Senator Biden, I’m a physician with President Reagan and he heard that you’d had a problem and would I come by and tell you that he wants you to know that he’ll be thinking about you and mentioning you in his prayers. I never saw the President pray but he talked about prayer.

Joe Biden is sitting there on a quiet Sunday afternoon in the dark and he says, Do you know, that President’s got guts. How he worded it was, I wish I had his guts. He went on to speak very admiringly about President Reagan, who was very concerned. Here was a Democrat but that didn’t matter a bit. He just said, He’s one of our legislators, he’s a man of the people. They operated on him and they found another one on the other side, so he’s had bilateral clipping. You can’t tell it. I have a house in Delaware and I see him around once in a while. He’s a good guy. I’d vote for him, I think.

Was there anyone President Reagan simply just did not like, who earned his contempt?

I’m just trying to think if I ever heard him talk contemptuously of anybody, and I don’t think so. He might say something that’s humorously sarcastic about somebody he wasn’t happy about. Doris Day is a good example. She wrote him a letter about Lucky. Lucky was getting too big for the White House so he gave Lucky a haven up at the ranch. There were three or four dogs. Lucky was up there and Doris Day wrote a very pointed letter saying, How can you take your pet and exile him? He was in dog paradise! He had a barn, he had cows to chase, he had birds to—he had a ranch, Lucky had a ranch. The President didn’t speak disparagingly but he said, I don’t know how she gets to think like this. I thought Lucky was getting a pretty fair shake. No, I don’t think I ever saw him angry.

I was just going to say, you never saw him angry or—

There was a time when he’d get a little impatient with Mrs. Reagan because she was on the telephone. They used to joke about this all the time. He’d ring the bell because it was time to go horseback riding. Sometimes he’d get a little bit—

I think one of the few stories of him actually getting angry was when Kitty Kelly finished her biography of Mrs. Reagan, but a lot of people have said it just wasn’t in his makeup to be mad at people or not like people.

Now was her book about Mrs. Reagan or about the whole—

She wrote a short one about Mrs. Reagan.

Did she write one about him too?

No.

I don’t think so.

Because she wrote one book and in the first five or six pages she lists everybody’s name, which is literary suicide, but she doesn’t reference why. The bibliography was nonexistent, just all these names, mine included. I wouldn’t recognize her if I saw her. She was a corrupt individual. I never heard him really get boiled about that. I just never saw him get irritated. He must have but I don’t remember it.

Going back to his intelligence. Some of our interviewees have spoken about how he probably knew of the image that he wasn’t very intelligent and it didn’t really bother him. I think that spoke to his confidence as a person. He knew who he was and you told stories about how he could just talk to you and it just seemed like he was a normal individual. Could you speak about that self-assurance or self-confidence?

Well, he wasn’t afraid to go up against anybody in a debate. Do you remember the debate he and [Walter] Mondale, where people said he had a lapse—

Yes, 1984, the first debate.

I ask you to get that tape and listen to that paragraph that Mondale articulated, and it’s the most jumbled ideation I’ve ever heard. It was nonsense. I was sitting there watching it and thinking, How the hell could I answer that? being the genius that I am. The President just said No, I don’t wish to comment on that. I couldn’t understand what Mondale said, it was a flight of ideas if there ever was. There was no central theme and it was about a paragraph worth of gibberish and everybody said, Oh, God, look, he can’t— But that didn’t impress an awful lot of people because he obviously soundly trounced Mondale.

Do you remember the comment he made when one of the press people said, Now, Mr. President, what do you think about your age being what it is and Mondale being so young? He paused and said, I wouldn’t hold his youth or his inexperience against him. That ended the debate right there. Everybody had a good guffaw. Mondale laughed, which I thought was a heartwarming thing.

Could we take you back and ask you about your first meeting with President Reagan. Again, I think you told us at lunch, but if you could repeat that story when you first met the President, when you were first called to see him.

One day Dr. Ruge asked that I be in his office by 8 am in the morning. I was to be introduced to President Reagan, whose course from the residence to the Oval Office led him past the office of the President’s physician. There was a signal box over Dr. Ruge’s desk that indicated the exact location of the President at all times, be it in the residence (second floor), the elevator, the ground floor, Oval Office, etc.

We waited for the signal, and promptly at 0845 hours the President stepped from the elevator almost directly across the hallway from the medical office. He came directly toward us extending his hand as he drew near. I was amazed at his stature. He was larger than I in every dimension, was immaculately dressed, and had for want of a better word, a magnetism and warmth that I had seldom experienced before. His handshake was firm, his smile infectious.

To Dr. Ruge’s introduction, the President replied that he was delighted that I was there—and with a smile asked me if he could tell me about his bad back. We laughed, and he was soon off to the Oval Office, and I was sure he would recognize me the next time we met.

When did you really meet the President?

A few weeks later it was time for the President’s vacation, which often included a trip to Los Angeles en route to the ranch, which was located in the mountain range north of Santa Barbara. Dr. Ruge would accompany the Reagans to the ranch, where I would replace him and remain for the rest of the trip. My plane was late arriving at the Santa Barbara airport, and I arrived a little behind schedule after a harrowing ride on a tortuous and narrow road along the mountainside—fortunately we met no traffic coming in the opposite direction.

Upon arrival, Dr. Ruge was justifiably perturbed that we were behind schedule, as he had a plane to catch for Chicago. He ushered me into the cabin where the military aide, the nurse, and the doctor resided, showed me where the bedrooms, the kitchen and the baths were, and then hurriedly entered the bedroom that was to be mine. There on the bed lay the President of the United States, his left thigh exposed, exhibiting a huge ragged gash about six inches long and half an inch wide. He was resting quietly with his hands folded on his chest and smiling pleasantly.

I asked, Mr. President, what happened to you? Well, he replied, let’s say yesterday I had a little accident with the chain saw.

The ragged wound extended down through the subcutaneous tissue but had not transacted the saphenous vein or Sartorius muscle or any blood vessels of significant size. The wound was clean but the skin edges were ragged; the nurse had done an exemplary job with the original cleansing and dressing, but the skin and some of the underlying tissue required minimal debridement, and skin edges needed trimming.

The President lay quietly while I used a straight mayo scissors, which I always carried with me, to trim and reshape the wound. Wisely, the wound had been left open and no attempt had been made to close the contaminated wound. The President was reassured that he could carry on with his usual activities, that we would change his dressings and inspect the wound daily. The nurse would procure the tetanus booster from the Community Hospital in Santa Barbara. And so went my first meeting with the President.

I fell in with the routine of life at the ranch—the horseback ride in the morning, and the ranch work detail in the afternoon where I became one of the ranch hands, and participated in the congenial gathering in our cabin after a day’s work had been completed, when we hosted the President for a half hour with soft drinks and humor. By the time we were headed for home, the wound was healing by secondary intention, and I felt the President was completely comfortable with my presence. Little did I know how close we would become as the years progressed.

How intimidating is it to treat arguably the most powerful man in the world?

I never witnessed the President act as if he was the most powerful man in the world. I believe one of his greatest gifts was his ability to relate with people from all walks of life and treat them with dignity and respect, and bring out the best in them. I believe it was this gift that enabled him to befriend Mr. Gorbachev when the world could have otherwise been headed for a cataclysmic end. How well I remember their historic meeting in Geneva, Switzerland. As the Russian motorcade processed into the courtyard of the designated meeting site. President Reagan descended the grand stairs of the Ambassador’s house to greet the Russian President with his hand outstretched—they grasped each other’s hands firmly, and our President’s left arm went to Mr. Gorbachev’s shoulder. His smile was infectious as was the Russian’s silent reply—the tenor of the meetings had been set.

There was an enormous sign of relief from all who had been close enough to witness this tacit exchange, and a great mutual respect and friendship had been born, and seeped down to encompass all of us who were present. 

That evening at a massive banquet our Secret Service agents sat across from the Russian KGB security officers at an enormously long table, all in the best spirit of fellowship. [Vladimir] Kryuchkov the chief of Gorbachev’s security, became the master of ceremonies, and speaking both languages toasted ad infinitum. At one time, his water glass filled with vodka, he looked in my direction and said, Vodka vas gut for das brain, yah, doctor. And down it went. Friendship was on the threshold of prevailing through this incredible gathering of men from what had once seemed the opposite ends of the earth. Such was the cascade of friendship that evolved from this historic meeting, and how fortunate I was to bear witness to such an historic event.

Would you have a high level of anxiety knowing if, in the treatment of a wound, or anything else, if a mistake were made—

It’s curtains.

It could change the course of the world.

It would be curtains for me, and perhaps for both of us. The gash in his leg, if properly treated, would heal itself well with conservative care. Had there been a major blood vessel injury such as the superficial artery or deep femoral vein, of course I would have proceeded to the local hospital and enlisted the help of the surgeons with whom I was acquainted. I cannot imagine the consequences if I had made a mistake. Of course, during President Reagan’s first term, the surgical faculty at George Washington University were suddenly forced to decide on the immediacy of a life saving situation, the decision made easily because of the degree of hemorrhage made obvious once a chest tube had been inserted into his left chest cavity (pleural space) revealing the amount of hemorrhage that mandated surgical intervention. The surgeons were taken by surprise, responded reflexively, and had little time to worry about the consequences of misadventure. The surgical procedure and follow up were remarkably benign, other than a brief penumonitis, which responded well to antibiotics.

The second medical problem was more subtle in its presentation. When first reading through the President’s medical records, I had noticed an episodic fluctuation of his hematocrit, i.e. the level or percentage of red blood cells to the total blood volume. I was concerned that this might represent a malignancy as a source for the occult bleeding, which statistically is usually found in the lower gastro-intestinal tract.

Initially there was resistance within the medical office and other staffers to pursue our suspicions and subject the President to colonoscopic examination, a relative newcomer on the horizons of diagnostic and therapeutic modalities. When our recommendation was discussed, the President and First Lady were completely amenable to our suggestion, especially when upon additional examination if was confirmed that there was evidence of a trace bleeding, most probably originating in the lower gastro-intestinal tract.

It was on a Friday afternoon when we boarded Marine One (the helicopter dedicated to Presidential transport for short distances), left the White House South Lawn and headed towards the heliport at the National Naval Medical Center at Bethesda. The President and Mrs. Reagan were introduced to Dr. Edward Cattau, the Chief of Gastro-intestinal Medicine Service who was to perform the colonoscopic procedure, which was explained in detail, and the procedural permit was signed.

Preparing for the worst, the White House Chief of Staff Don Regan had a letter signed by the President temporarily passing his responsibilities to the Vice President in the event that the President were sedated or subjected to general anesthesia.

The colonoscopic examination began about 2:30 pm with the President fully awake and responsive. As the scope was passed, the President volunteered some discomfort, but was tolerating the manipulation with great aplomb. The scope passed easily along the descending and transverse colons, with the only findings being some diverticulae and an occasional benign appearing polyp.

I was greatly relieved by our benign findings, even as we entered the descending path of the right colon. Suddenly, looming up in full view of scope and occupying most of the lumen of the cecum was an enormous mass, purple in color, and with a large malignant appearing crater in its middle. Multiple biopsies revealed a villus adenoma, a benigh entity, but the clinical appearance left no doubt that this mass indeed was a malignancy. 

I admit, I had a few moments of insecurity—I wondered for a moment how we should proceed from here. I had summoned an old friend, Dale Oller, the Chief of Surgery at the Naval Hospital, to be nearby, and upon viewing the mass, agreed that we should move towards the operating room as soon as possible. I thought, how do I tell the First Lady? What impact will this have on our country, the Presidency, and perhaps the world?

President Reagan had expressed his opinion to me that whatever the news, we should be forthright as President Eisenhower had been, and make a full disclosure of any untoward condition that might beset him.

Four of us—Dr. Edward Cattau, Dr. Dale Oller, Dr. Burton Smith and I—walked to a nearby office where Mrs. Reagan sat patiently for our verdict. We explained our findings and our presumptive diagnosis. She sat erectly with enormous composure and simply asked what path we should follow now. She reminded us that the President of China was due to visit in ten days, and she thought the President should be as close to full strength as possible—could we consider waiting until after that event? I explained that the President of China was in chronic right sided heart failure and was to be accompanied by four physicians, and would be in worse shape than the President no matter what we did.

I recommended that we proceed with operative exploration as soon as practical and that I had organized a stand-by operating team of which I would be the first assistant to Dr. Dale Oller, the Navy’s chief surgeon. Prior to operation, a few additional diagnostic tests would be necessary and most likely we would proceed with the operation tomorrow morning, that is assuming that there was no evidence of metastasis. If additional tests showed no evidence of spread, we would start at 10:00 am Saturday morning.

Mrs. Reagan was completely confident in our judgment, and agreed that we should proceed as planned. Mrs. Reagan had one request—let me be the one to tell him. I still had not fully grasped the magnitude set before us, and so we silently walked to the recovery room—I noticed how silently we approached the President, who was reclining in what we call the semifowler position, and I realized I could not hear my own footsteps. We entered the recovery area, immediately attracting the President’s attention. Our concern was too obvious and the President asked with a faint smile, Why do you all look so glum?

Mrs. Reagan immediately went to his side, sat on the edge of the bed and put her arms around him. Ronnie, she said quietly and with complete composure, the doctors have found an abnormal mass in your colon which they could not remove with their instrument. With our intestines already prepared, they think it best they perform an operation tomorrow morning, and I think that would be the best thing to do. Her aplomb was extraordinary. How easy she made it for us, as we then explained the procedure we would perform.

The President accepted the news very matter of factly, and then sorrowfully looked at his wife and said, You mean I don’t get any supper tonight. His serious countenance broke into a broad smile, and of course we all were able to laugh with him. Again, his mastery of human relations was evident; he had us at ease, and was receptive to our every suggestion—we were ready to proceed with a remarkable calm. We would be able to treat the President as we would any of our patients, with the exception that we would laugh a bit more—he told a joke as he was being put to sleep, and again as he awoke—what a magnificent patient he was.

The President’s post operative course was almost too good to be true. In spite of a long midline mission, he required little in the manner of pain medication, was quickly out of bed though still tethered to his IV pole, and the remainder of his recuperation was remarkable, requiring virtually no medication for pain.

The problems now resided with the press, who soon became critical, casting the probability of complications, inappropriate care, and exhuming all of the problems that had befallen many of the Presidential predecessors, suggesting that something must have gone wrong somewhere in the course that was being kept from the press. Ten days postoperatively the President was at his desk for half days, and seven days later he returned to a full schedule.

I would summarize the even as an insight to a patient who accepted the diagnosis of cancer with great equanimity, who allowed the surgeons and support staff to practice their trade in an absolutely normal fashion, and who kept us all at ease as we tended to his healing wound, inserting and removing tubes, catheters, and intravenous lines, and awoke him through the night by inflating the blood pressure cuff. The hospital staff missed him and his first lady when he departed.

Oh, sure. Actually I was hoping we could talk a little bit more about AIDS policy in general with the administration. 

In the early 1980s, the disease AIDS [auto-immune deficiency syndrome] was coined as a disease that incapacitates the victims’ immune system, rendering them vulnerable to a variety of infectious diseases—tuberculosis, for example. It took several years to appreciate the gravity of this epidemic’s potential, the exact causal agent still not identified though it obviously could be transmitted by sexual contact or by receiving a tainted blood transfusion. Dr.[Robert C.] Gallo at our NIH finally announced that the infectious agent was a hitherto unidentified virus from which the promiscuous man or woman suffered, or the unwary surgical patient receiving a blood transfusion before we had the technology to test for the presence of the HIV virus in the donor’s blood.

There was little that the President missed that was newsworthy, and he had noted that this new disease had the potential to mushroom in epidemic proportions and that there was as of yet no known cure.

As is so often the case, an untoward situation is not drawn to our attention until someone who is well known becomes afflicted, and the actor Rock Hudson was one of the first to make such headlines. He had been well acquainted with the Reagans, and at that point the President  then asked me about the nature of this new disease entity. Mr. Hudson had flown to Paris, where there were physicians who were dealing with this disease, hoping that he might benefit from any therapeutic treatment that might be available. The President had always been curious about the science of medicine, and wondered if our researchers were making any progress with identifying the infectious agent. I volunteered that Dr. Gallo had isolated a hitherto unknown virus for which man seemed to have no defense.

The President replied, You mean like the measles virus, but one that won’t go away, that arouses no immune response. He understood my explanation and its implication.

I’m not sure with whom he discussed this disease entity, but he soon learned of the patients being studied at NIH, and of implications for panic from ignorance of how the disease was being spread. He asked if it would help with the awareness of the disease if he went out to NIH and visited with patients—especially with the children who had contracted the disease from their mothers.

How well I remember the afternoon when our motorcade took us to NIH, and we were escorted to the ward that housed these patients. He fully understood the routes of communicability of this disease, and in an effort to lend a calmness and understanding to the nation, he moved from room to room, visited with the mothers in his most congenial way, picked up the children as would any father, all to the satisfaction of the medical staff and photographers, and hopefully the curious and concerned citizens of our country.

Within a week an advisory committee was created, initially chaired by a member of the Mayo Clinic faculty and then by a former Chief of Naval Operations.

The President has attempted to enlighten the world about this threat, and at the same time to assuage their fears about the contagious nature of this most dangerous disease from which no one had yet survived. Contrary to the opinions expressed by many, especially in the press, the President was fully aware of all the implications of the new disease and was very supportive of the activities directed at its isolation and the cure.

He wanted the photo to send a message to the country.

Yes, not to be afraid of this thing. Be afraid of the activities that create it.

This is at the Children’s Ward at NIH?

Yes, mothers and children. It was the AIDS part.

What about Surgeon General [Everett] Koop? It seems that he and Health and Human Services Secretary Otis Bowen were the major proponents of greater funding for AIDS prevention, AIDS research in the administration, and they were getting pushed in the opposite direction by conservatives like Bill Bennett, Gary Bauer. Did you see this battle or did you have any part in it?

No, no, and Gary Bauer, they’re good folks. Once again, if you want to stop an epidemic, you don’t do the things that cause it, human behavior. So the best defense is to prevent it to start off with and not try to concoct some sort of pharmaceutical thing that’s going to cure it, because we haven’t got that yet. It seems we can suppress it for a few years. Someday if you’re walking down the street and you see somebody who can’t put a shirt and tie on anymore, and his neck is like this and he’s got this hump on the back of his neck, that’s a late complication of AZT, one of these anti-viral things. It almost looks like the hunchback of Notre Dame. We just are starting to notice that because we’ve had people on this drug for ten years now. It’s a terrible disease and what it’s doing in Africa is—I have a medical student who wants to do a summer elective in South Africa, up near the border of Mozambique in a town where two out of three have AIDS.

Tuberculosis is coming right along with AIDS because your immune response goes down and you become very susceptible, and there’s a lot of it in Africa. Hepatitis—and so communities in Africa are being decimated by this disease, and it’s all because of sexual contact. I think the President—everybody says, Well, he should have been in there taking the lead. Suppose there was a war someplace and he says, All right, we’re going to declare war. He doesn’t go down there, the generals then take that responsibility of waging war. That’s why he had the NIH. He went out to NIH and he made this commission.

Now, the selection of the commission, interestingly he got a very successful guy who was the CEO, chief of staff at the Mayo Clinic, who failed miserably. He then decided that what we needed was a hard-core administrator, and he got Admiral [James] Watkins who had been Chairman of the Joint Chiefs of Staff, whom I met down in Honduras when he was inspecting the far-flung battle line. But I don’t know what they expected President Reagan to do more than he did. He was still a little worried about the Russians and all these other things that were going on in the world. He put the ball in play and said the government was behind this thing. Koop was a very sophisticated physician, but I don’t know if he was the right guy to be a Pied Piper. Again, he was more on the preventive, Let’s prevent this thing from spreading. How do you do that? Obviously it isn’t simple because human nature can’t be reversed in some respects.

I remember I had somebody come over to the White House. Walter Reed, again, was one of the pioneers in the research. I had one of the experts come down to Walter Reed to address our medical unit, and I tried to get people from George Bush’s staff. I said, Just for an hour. I believed that this was a national emergency. I didn’t get much interest from the staff of Bush and I was a little too timid to go up and get a hold of the President and the Vice President. So I might have missed an opportunity there.

Would you travel with the President often?

Always.

Are there any trips that in particular stand out in your mind, any vivid memories?

There would be several. I remember one, our trip to a meeting with the European Coalition in Belgium, as an event that was second to the historic trip to Moscow. That was one of the few times when he was not accompanied by the First Lady. As we were leaving for the helicopter that was to transport us to Andrews Air Force Base, home of Air Force One, the Boeing 707 that had transported many a President in the past, the First Lady drew me aside with last minute instructions. Now John, she instructed, when you’re crossing the ocean tonight, I don’t want you to keep the President up talking all night. I want you to make sure he is lying down in his cabin, and with a cover over him. Let him get some rest. 

The President was to meet with leaders of the free world in the next day or two, and Mrs. Reagan wanted him to be well rested. This meeting was to be at SHAPE Headquarters [Supreme Headquarters of Allied Forces Europe] in Belgium.

I would estimate that the President spent about a third of any of our many trips back in the after compartments, and we would always be on the lookout, and awaken those who had drifted off in spite of the sometimes raucous conversation and laughter. Occasionally one of us would be asleep in spite of the President’s presence. I remember the time when Marlon Fitzwater had dosed off, and after about 15 minutes the President put his hand on his shoulder and asked Are you all right? which brought about great laughter. He would eventually leave, but we always tried to be alert—you never could tell when he might come back again.

We were not airborne for twenty minutes when the President was amongst us in the staff compartment and the conversation was lively and included many of the humorous stories for which he was so famous. I finally attracted his attention and reminded him about our instructions, to which he acquiesced, retired to his cabin, assumed a supine position with cover, and was photographed in his repose. This must have been accomplished with a Polaroid camera, the image then faxed to the White House, attention Mrs. Reagan. I never heard how this turned out, but being well acquainted with Mrs. Reagan’s sense of humor, I’m sure it brought on some laughter.

The President always slept well when he was tired, and never hinted of fatigue during this trip.

The return was a different matter, We were now on European time and crossing the ocean again would put us in Washington at 10:00 pm eastern standard time, which would be 3:00 am if we still were in Europe, when the President was to address the Congress about his recent meeting with the chiefs of state of the free world. While the rest of us were exhausted, the President seemed refreshed, though no one could report that they had seen him sleeping. I would awaken periodically and go forward only to find the President wide awake preparing some notes for the speech he was to deliver. I thought this was asking too much but my opinion didn’t carry much weight. 

A new medical team accompanied the President and his staff to the Hill where I was told his speech, as were all of them, was strong and vibrantly presented, which was a surprise to many, considering the vigorous schedule during the just completed trip. Half an hour later he was again at home on Pennsylvania Avenue. 

Once home he left the staff with his usual thanks and appreciation for their support, and then with his parting quip, Well, take the rest of the day off.

In short I seldom observed the President appearing sleepy while we traveled, nor did I ever know him to oversleep. Usually he was in bed by 10:00 pm, fell immediately asleep, and awoke refreshed promptly at 7:00.

Was there anything interesting about the Moscow Trip?

Our first stopover en route to Moscow was in Helsinki where we spent one or two (I can’t remember which) days before pressing on to Moscow. Helsinki was a beautiful city, filled with pleasant and friendly people.

One afternoon I joined the President and First Lady for a walk through a park. We were alone save for photographer Bill Fitzpatrick and one Secret Service Agent. As the President and First Lady walked along, surprisingly very few people paid much attention. I really didn’t think many recognized who strolled in their midst, which was quite contrary to the usual crowds that would gather. 

As we walked along, two small girls of perhaps ten or 12 years of age appeared from the opposite direction with a huge friendly dog who headed straight for the President and First Lady. The Reagans stopped, gave the dog some welcome attention, and visited with the young ladies. I was surprised that other pedestrians walked by, glanced in their direction but courteously let them enjoy a normal ambience, which was refreshing to say the least. Our camera man Bill Fitzpatrick was in his element. We could never have witnessed such a pleasant stroll anywhere else in the world.

The next day we boarded Air Force One and headed for Moscow. We had left some of our medical personnel at the University hospital and if time permitted, in case of a sudden illness we would use the medical facility (University Hospital) in Helsinki. One of our physicians had preceded us to Moscow to survey their medical situation, which lacked the sophisticated level of care that was present in Helsinki, and one aircraft, AC-9 medical evacuation plane was placed on standby at the Moscow Airport. The Russians had a reasonable setup at their University Hospital, but only the President, First Lady or Secretary Shultz would be eligible for care there. Obviously our using such facilities was unreasonable unless the emergent situation allowed no other option. We were well satisfied with both the professional standing and depth of expertise among the professional staff in Helsinki.

Our landing at the Moscow Airport was unforgettable. The staff disembarked from the aircraft as usual and found ourselves in the midst of the welcoming party, including an honor guard that was every bit a match of our own who are quartered at Fort Myer. The President and First Lady descended from the President’s plane amidst cheers and applause. The President then trooped the line of the Russian color guard, who were enormous in stature, almost head and shoulders above the reviewing party. Contrary to our guard, who stood rigidly with eyes front, the Russians with heads leaning back followed the reviewing party with their noses—a sign of respect and honor as it was explained to me. 

After much hand shaking and introductions, the Presidential party boarded the limousines and were off to our quarters at the Embassy. I was amazed at the crowds along the streets cheering over the President. I did not expect such enthusiasm from what I had thought was an adversarial people. I thought we would be at war with these people and here they were, crowded on both sides of the street cheering and waving with great enthusiasm, the foreboding of an exciting visit.

We settled into the Embassy where the President, First Lady, a few others and I were to stay. One day the President decided it would be interesting to walk down a few streets to a nearby avenue that hosted their more elegant shops, restaurants, etc. The crowds were in abundance, but were held in check by Russian security personnel. How disappointed when we reached the Main Avenue—by comparison to downtown Connecticut Avenue, the windows seemed barren of anything salable and the contrast seemed illustrative of the relative economics fostered by our two forms of government. 

It did not take long for a crowd to be attracted to our presence, and suddenly I realized some of the staff was being separated from the President and First Lady and I realized that if anything happened to our President, I could not have reached him. The crowd wanted to shake their hands—some satisfied with just getting close enough to touch them. I think this was probably the most frightening event that I had witnessed, and it was a great relief when I realized that there was a carriage nearby that they stood on, waving back to the crowd that was getting out of hand. Fortunately, the Russian security sensed the uncontrollable enthusiasm of the crowd, surrounded the President and First Lady and began physically herding a path for our Secret Service and their charge, which led to some violent behavior on the part of the Russian security, but in reflection I could see no alternative.

Soon, a pathway was created and our party moved rapidly from the friendly citizens and we were on our way. Somehow reporter Helen Thomas, senior member of the White House Press Corps, tried to follow us along and was intercepted by General [Vladimir] Kryuchkov, head of the Security Branch of the KGB [Komitet Gosudarstvennoi Bezopasnosti]. A battle ensued, proving Helen to be a formidable opponent, even to one of Russia’s most highly decorated heroes of WW II. By the time this came to my attention she was pummeling him with her purse, and at this point the First Lady turned and went to Helen’s rescue, explaining that she was a friend and would walk with them back to the Embassy. I wasn’t sure that Helen totally appreciated this favor, but I’m sure General Kryuchkov subsequently gave her plenty of room.

That night we went to the Bolshoi [Ballet], and they were going to give us a little piece of all the great ballets. When the Gorbachevs and the Reagans came into that center box on the first tier, the crowd went absolutely wild. It was a good 20 minutes before we could get everybody settled down and get the show on the road. After that we went out to the dacha, which was the Gorbachevs’ summer home. It was immense, but it was somewhat plain. All of the staff were back where they have the servants’ quarters, but they didn’t have any servants there.

We sat and talked and in comes this little guy who battled Helen Thomas. He was a wonderful little man. He, I was told, was the last living person to have won the Red Banner of [Nikolai] Lenin for the Battle of Leningrad. He was a young lieutenant of 19 or 18 and apparently had done all sorts of heroic things. He was a very rational, well-educated individual. He spoke English quite well. So there were three or four military aides and Jim Kuhn and maybe two or three others, Kryuchkov and one of his young lieutenants. 

We got into the discussion about world power and atom bombs and things and this little general, hard-core, said, You must never, never allow another war. I have grandchildren, my wife is dying of cancer of the cervix, and these grandchildren are the most precious things I’m going to have. To think that they might be consumed in some kind of an idiotic war is more than I can stand. The whole tenor of the intelligence people was, We can’t fight a war, it’s self-annihilation. By this time the President and Gorbachev were becoming fast friends. You could tell it when they first when they met at Geneva that something good was going to happen, just the way they held each other’s hands and President Reagan put his arm around him. I said, Boy, we’re going to be all right here.

One evening we boarded the motorcade and headed to the Russian Embassy. I was in an ambulance, and the Russian authorities would not let the ambulance through the gate. I disembarked thinking they would let me through but such was not the case. I came face to face with a moderate sized KGB agent who was steadfast in his resolve to keep me out, and was winning until one of our Secret Service Agents came to my rescue. After he reassured the Russian that I was the President’s physician, I was able to join the junior staff and our own agents in a reception in a large hall with immaculate floors—about the size of a basketball court.

Initially the Russians stayed by themselves, as did we until we were summoned to take our places at this huge long table. The U.S. (Junior staff, medics, US Secret Service) was seated on one side of this well-set table, the Russians on the other. Initially, no one said a word—there was a distinct language barrier with consequential silence until the appearance of General Kryuchkov, who I mentioned earlier was in charge of the Security Division of the KGB, and a great hero as a very young lieutenant in the Battle of Leningrad during WW II. He rose and called us to attention and began an elegant speech that had to do with comradeship, humanity, and that we must become friends.

We all had small glasses at our settings about the size of a jigger. The General rose and in fluent English instructed us all to fill our glasses (the jigger with vodka). He looked up and across the table to me, and taking his water glass, filled it to the brim. Ah, Doctor, we drink—is good for brain, na? And down it went, only to be quickly filled again. Then he proposed a toast to their new friends (us). Our agents were in a quandary—they were forbidden to drink while on duty—was this a plot to catch us off guard?

Spill it, I recommended, pour it into your napkin, but do it with stealth—are there any potted plants nearby?

I can’t recollect what they did, but there were toasts after toasts, and each time the General filling his water glass. The food was served and as we ate I noticed that conversation was breaking out—some of the Russians could speak some English—and it seemed as if some sort of universal language and rapport had been generated, and there was laughter. The General would pop up and down with friendly comments, and occasionally would smilingly look at me as he downed another glass and would reiterate Iss gut for brain.

Interestingly, midway through dinner the Russian directly across from me was replaced by a very refined gentleman who spoke English quite well, and seemed to know who I was and was curious as to what were my responsibilities and was I with the President when he was wounded.

Finally the party at the Embassy was over and we boarded the motor coach with friendly farewells from our hosts—and seemingly newly won friends.

The next night we have a little more selective dinner and Edmund Morris, he’s a South Afrikaner but he speaks French fluently. I spent nine years trying to speak German and I did pretty well, and sitting at this table were the two of us and six Russians. One was a young Russian major in the Army and I can’t remember what the others were but by halfway through between his French and my German, we were having a wonderful time. It was a wonderful night, a great success. You could tell these people had the same ambitions that we did. Human beings—we’re built the same and there was a natural camaraderie if you get enough grog in you. The whole evening was absolutely one of the most memorable in my life. Edmund Morris held up his end brilliantly with his French. These people, they’re well educated, the hierarchy over there—There was a very interesting discourse at the end so—

You said that you went on a side trip to Leningrad with Mrs. Reagan.

Yes, Mrs. Reagan, we went out to Leningrad.

Was she with Raisa Gorbachev on that trip?

Interestingly, no, she was not. She was by herself.

Did you see any signs of the supposed tension between those two?

I did not, but I’d hear, Mrs. Reagan just quietly—this obviously was a new experience for her. She was a little bit of a grandstander, Mrs. Gorbachev was. Poor lady’s dead of cancer, I believe, I think it was cancer of the breast a couple of years ago. But the trip up there was—we got on these fast boats that had like wings—What do they call those boats?

Hydrofoil?

They have these foils underneath and after you get to a certain speed it all breaks up out of the water so that the only thing in the water is your propellers and these foils. So with minimal energy you get real speed. So we went up the river to Leningrad. The main thing was to see the St. Peter’s castle or whatever it is up there.

Here’s an impoverished land for the most part, and here’s this splendid castle with 110 rooms. The floors were immaculate, gilt everywhere. Now the Germans, as their last passing shot, leveled this St. Petersburg castle, just for spite, just to be bad guys. The Russians said, we’re going to build it and build it better and let them try and come up again. It was magnificent, the artisans at work in there. Then we went to the Hermitage. Every place Mrs. Reagan went, a crowd was there. It was amazing. I felt like I was safer there than I would be in parts of New York City.

How about the Geneva summit, you just mentioned it in passing, but any other memories from the first summit?

Geneva, of course, was the first time that he was going to meet Gorbachev. It was a very quiet and dark, dank, misty day. Not rain, but if you stood out long enough you could feel the moisture on your face. We got there first, we were going to be the host. Somebody had vacated their villa. Lake Geneva was just down the way. There was a bathhouse and whatnot. There was going to be a meeting with all of them in this mansion. I guess it’s big by Swiss standards, but by our standards it would not be a mansion.

Then Gorbachev and Reagan were going to go down by themselves and have a one on one in this bathhouse, which looked like a cottage by the sea. Once again, it was a very friendly atmosphere. Everybody was a little anxious initially. Then all of these limousines came out and their equivalent of our Secret Service, these KGB security, would get out. They all had fedoras turned up in the front and these big burly guys, big coats, with collars up and looked around. Gorbachev got out, he had a very elegant coat, a Chesterfield with a little velvet collar, and he had a nice hat, which he took off. He walked toward President Reagan, who came down the steps with a broad smile, and Reagan has an infectious smile. The way they almost embraced, but they shook hands and their other hand didn’t just sit by the side. They really got into it. Everybody watching this could feel that there was a camaraderie here that was going to be of benefit to the world.

They spent time prior to that communicating over the phone or through letters?

I’m not sure, I don’t know. Anyway, by the time they got down—it was an example of how they wanted to be alone with just the interpreter but Don Regan was right there, right in between them. He wasn’t really scheduled to be there. It was almost like, If I don’t watch what you say, you may make some kind of a mistake. It spoiled it a little bit, especially the photographs and TV coverage. That was a great meeting. Then the two of them got together and they formulated some kind of a, almost a peace package, which they presented at a big meeting downtown.

The first time we went into the embassy—this is three or four days prior to what I’m talking about now—somehow or other I was riding in an ambulance and they wouldn’t let the ambulance come in the gate, so they locked the gate. There was this security agent, probably the ugliest guy I ever saw. He looked like somebody who would slit your throat just for the fun of it. He’s out there, Nyet, nyet, nyet. We’re explaining, Doctor, doctor. It was Nyet. Finally, one of our agents came down and said that it was okay, that this was the doctor, so we went through. But I never forgot this guy and his dogged determination to not let us come in the gate.

The next day we’re in this long motorcade that has both the Russians and us, and we’re going to this big meeting hall where they’re going to publicly sign an agreement of some kind, whether it was for nuclear containment, I don’t know. At any rate, they’re up on the stage and everybody seems to be of a good nature. We’re caught up in the traffic and we can’t get through, and all of a sudden here’s this ugly face looking at me again. He shakes my hand, grabs me by the arm, and takes me through the crowd, clearing the crowd. It was an unusual transformation. He turned out to be a great friend. He always said hello to me every place where we interfaced.

I used to, as I mentioned, write in this sort of a diary, and I’m very sorry that I neglected to do that while I was over there. Number one, I was afraid I’d lose it or somebody would steal it from me or something of that sort, so I can’t remember accurately. But it was probably the most successful of his trips. Pretty soon we were on the plane again and headed for Germany. We went to Berlin. I think it was on the same trip.

We went to Berlin and that’s where—I was standing about 40 feet away when the President got up there and said, Mr. Gorbachev, take down this wall. Boy, I thought, that’s throwing out the gauntlet. Was that a little too bold? But by God, the wall was down sometime afterwards. I can’t remember what the time was.

Now did you have a counterpart on the other side? Would you swap stories with Gorbachev’s physician?

We couldn’t understand each other. What little English he could speak, yes, we got along fine. He was a nephrologist, believe it or not. Yes, he was a good fellow, I have a picture of myself standing out there, shaking hands with him outside the back of the White House. A solemn moment. I’ll talk about that later.

But we went then to Germany, there was the Take down this wall. Then we went to Rome and met with the Pope. I have a picture of myself shaking hands with the Pope. For a heretic that’s, nobody believes I would achieve that. I met with him three times, twice traveling with Congressmen and once with the President. The time with the Congressmen was really interesting because we were all in this room and we were told you can’t sit with your legs crossed, that when he comes in we stand and we don’t sit down until he gets up on his platform and sits down on sort of a throne and the usual amenities.

All of a sudden he got up from the throne and came down to the floor. He knew we had been in Poland, and he went on in very good English about Poland and how it had been the doormat war after war and could we please do all we could to help his fatherland. It was amazing, very emotionally packed. But that had nothing to do with the President, that was before I was in the White House.

But anyway, I got down there and we met with the Pope, had a good party at the embassy and then departed, as I remember. That was our last stop, we departed for home. A wonderful trip because I think the course of the world did change with that meeting.

Then they met at Reykjavik as you remember. I wasn’t on that trip because I was hospitalized with a ruptured disk in my back. Then the next time was when Gorbachev came to the United States and came to the White House. The most moving part of that was when they were leaving. It was a drenching rain and the Marine band, which is a superb organization, and they have these red coats, but the red was sopped with water so it looked like red-brown. They’re playing Russian folk hymns. Gorbachev got up and made a very elegant speech about his friendship with Reagan and his friendship with the American people. Then Reagan got up—the press got some beautiful pictures. In one of them it shows Steve Chilandar holding the umbrella up over Gorbachev. The paradox, here is the leader of the enemy world to us and here’s one of our top—he was an Air Force F-16, former Thunderbird pilot, holding the umbrella over Gorbachev. The whole thing was very moving, and I think they left with a deep love for the United States. After he was ousted, he came out and I believe he went to the ranch.

The President wanted to show him that in America we have an economy, and he wanted to fly over housing developments and say everybody has the opportunity here of owning their own house and that it is an incentive to their life and their lifestyle and that’s what freedom is all about. He was very adamant in getting that across and I think he did it.

Were you on the trip to Germany when the President went to the Bitburg Cemetery?

No, and I can’t remember why. I had something else, I think at the school. Either that or I’d gotten a case that I didn’t want to leave the country, somebody who was not doing that well or something of the sort. I thought I’d let one of the other doctors have the opportunity to go. I was not at that time the Physician to the President.

Did you ever sense any nervousness on his part prior to a big meeting with Gorbachev? 

Absolutely not. No, everybody else was running around making sure everything was all right. Jim Kuhn was kind of worrying, Oh, God. He was just as calm, When the time comes to go out and meet President Gorbachev, I’ll go out and meet him. He was enormously confident that things were going to turn out for the best.

Did preparation for these meetings involve extensive briefings?

Not that I was aware of. They would prepare schedules and topics and whatnot, but as I said, he could assemble that kind of information in his mind very rapidly, and he always had people like Jim Kuhn to be the reminder. Sometimes he’d go off a little bit on his own just to entertain us but for the most part he was very well organized. It was like you were watching a movie where everybody knew their part and when to speak and when not to.

I wish I’d brought the tape, I couldn’t find it, where he’s in one crowd as a diversion, and he tells this joke. I’ve seen him get to one audience and they just said, More jokes, and they didn’t want to hear anything else. This was down in Anaheim. It was the last trip before the election.

Anyway, he tells this joke about a would-be Congressman driving through the backwoods of North Carolina on a dirt road. He sees this farm up there, a silo and a barn and some animals and the hired hands doing this and that. He decides he’ll drive up there and do a little campaigning at the ground level. With his accent—he can mimic almost anybody—he then speaks and you can imagine the farmer who comes out and says, Oh, what can we do for you? You come up here in a big fancy car and all that. You need some gasoline or what is it? 

No, I’m so and so and I’m running for Congress in this district and I thought I’d get to know you people and know what I can do to help you, get some input from you. And the old guy says, Well, you going to give us a speech? And he says, I will if you want. Ma, get the hands, this fella is going to give us a speech. He’s getting the idea that he’s in a heavily Democratic area. So he gets there and they’re all assembled and he says, Well, if I’m really going to give a speech, I need something to stand on. There’s nothing. But he noticed a big pile of manure over to one side. He says, Okay, I’ll get up on that. So he gets up on that and the farmer says, Well, you know, we never heard one of them there Republicans talk. And he says, Well, I’ve never talked from a Democratic platform before either. The way he tells it, it’s absolutely hilarious.

If we could go back to the Moscow summit, you mentioned how President Reagan might have well made one of his greatest speeches.

Yes—unfortunately I missed this monumental moment. The First Lady was scheduled to travel to Leningrad the same day that the President was to address 2000 students at the Moscow State University. When they were separated, the President would always ask me to accompany the First Lady. I think he feared some ill might befall her, so a nurse and I would join her excursion.

Meanwhile, the President was taken to the University for his interaction with Moscow’s next generation of leaders. I had asked my assistant, Dr. (Colonel) Larry Mohr if he would accompany the President, and so he was able to experience this event first hand. Larry was a brilliant, young physician who reported when the day was done that he had experienced the President at his best, and I will herein add his condensed assessment of the proceedings with the Russian students. His recollection will speak for itself. 

Below are his words, taken from an article that was published in a local biweekly newspaper, the Charleston Mercury, on June 24, 2004, after President Reagan’s death:

In May, 1988, I was part of the delegation that accompanied President Reagan to the former Soviet Union. During that trip the President addressed a packed auditorium of students at Moscow State University. Standing squarely in front of a huge bust of Vladimir Lenin at the epicenter of communist teaching, he spoke about the ‘possibilities of tomorrow:’ freedom, entrepreneurship, democratic government, and the fact that every individual life is infinitely precious with something to offer. The students were mesmerized, leaning forward in their seats and listening intently to every word spoken by the man who had once called their nation ‘the evil empire.’ It was something to experience; the impact of the President’s message was palpable, smiles appeared on previously stoic faces and the applause was thunderous. Those of us who were there sensed that we had just witnessed the beginning of the end of the Soviet Union. Three and a half years later the Soviet Union was dissolved and the Cold War was over.

What year was that?

I think it was May ‘88.

The year we went to Moscow.

May.

If you can judge somebody’s intelligence it’s by how they respond in a question-and-answer period because they have to have composure and factual data and experience. They have to have all these things. That’s when he used to really prove himself. Like the quip that broke up the Mondale-Reagan joust. He ended that with a very off-the-cuff comedic response.

You told us earlier about your brief stint as a photographer for the Gorbachevs and Reagan. Do you want to put that on the record?

Sure, and I wish I had the pictures.

I wish you did too.

We were at the American embassy in Moscow. Of course Gorbachev was there and sitting directly across the table from President Reagan was Ekaterina Gordeeva. That name ring a bell? The little tiny figure skater, what do they call it in ice skating, couples. She and her husband won the gold medal just about every time. She wasn’t married at that time, but she’s a little tiny thing and she sat directly across from President Reagan. She was so nervous she couldn’t eat anything. I tried to console her.

Anyway, as this dinner is progressing, Gorbachev is going to give a short talk, as is President Reagan. President Reagan is sitting there looking like this and Jim Kuhn comes in and says, Jesus, he’s asleep. Why don’t you go in there and nudge him? I said, Why don’t you? You think he’s dead or something? Anyway, he’s sitting there and when it’s his time he gets up and gives a few remarks after Gorbachev gives the first remarks. When the President is going to get up he puts these cards in his pocket and he gets up and makes his comments and afterwards they’re all coming out. The President comes out first and then they get the people to go out another exit or something.

But the President comes out and it is the President and Mrs. Gorbachev and President Reagan and Mrs. Reagan, and they’re taking pictures. They’re having their pictures taken with various dignitaries who are also coming out. Finally, when the coast is clear, they’re about to break up, the four of them, the Russian photographer and our two photographers said, We’ve never had our picture taken with them. Will you take the picture? Now, I’m a reasonably good amateur photographer. I’ve been on the cover of Yachting magazine 34 times, I have calendars that I’ve made, but that’s boats. Here I’m going to take— 

They have a battery pack, so I have that battery pack and I get this big camera and I’m standing there and push the thing to take the picture and nothing happens. Well, when you’re using a battery pack there’s another trigger and Pete what’s-his-name comes out and he points to it and he goes back and stands. I’m trying to get it and BAM the thing goes off when I didn’t want it to. Finally I get two or three of everybody and they’re all in the frame, etc. Mrs. Reagan says, John, are you really supposed to be doing this? I thought, God, I’ll have her on my neck now. Finally I faded into the background where I used to hide. Nobody says anything about it.

I get back to my office and about two days later I come in and on my desk is this picture. All you can see is trousers and the legs and the shoes of all these people. In other words, I had totally missed in the picture. On the bottom it said, Very nice work. Nancy. Fortunately the second and third pictures I got it, but if that had been the only picture I’d got off I would have been skunked.

We were asking you before whether President Reagan ever seemed to lose his temper. Did Nancy ever seem to lose her temper?

Yes, she could. She could get irritated and you could tell it, but it wouldn’t last very long. It would be the type of thing where you had to right something. I’m just trying to think of an example. I told you about the meeting outside the barn when the President galloped.

Yes. She got a little teed there for a minute or two.

At one point she was being accused of using an astrologer to guide decision-making. How did she respond—?

There was some lady in San Francisco, a Vassar graduate, a self-styled astrologist, and yes, Mrs. Reagan did call her. She knew her. It was in the desperate hour after the President was gunned down. There was something coming up and I think she said, I have all these intelligence reports here, but what do you think? Is it safe to travel? Something simple like that. But it wasn’t worth a picture on the cover of Time magazine or Newsweek. I forget which one had a picture of her with all these astrological signs. No, she was not hooked on astrology, but she knew this person and I think it was out of a morbid curiosity that she called her. Kitty Kelly said that this lady set the time of departure on airplanes. Kitty Kelly is crazy, she’s a madwoman. How she could get away with doing all this stuff, I don’t know. But she quotes me, and I wouldn’t recognize her if I saw her. She’s just a fabricator. She’s got a mental illness, I’m sure. Is she still alive?

I think so.

She’s somebody I’d like to get. You can create such an uproar with just total fiction. What else?

You spent quite a bit of time at Camp David with the Reagans; you have a rare insight into their lives up there. I was wondering if you could just regale us with some stories that stand out in your mind from your time at Camp David with the Reagans.

Well, there was the time I was on a bicycle. We had these cabins. The box was always full of wood so in the winter you had a crackling fire and the deer would look in the windows at you if you weren’t moving around too fast. It was a paradise. One day I’m riding a bicycle up to the tennis courts with my daughter. My daughter was a very-well known tennis player in college. We were going to go up and hit a few of them. Somehow or other my racket came down off the handlebars and got stuck in the spokes. We were racing actually, I was going fast, and I went head over heels and crashed into the tree. It destroyed the bike. I bent the rim on it. I didn’t know what to do. I had damaged government property. They had phones on the tree. I went up closer to the court, called the camp commander’s office and I explained myself. With great humility I said, There’s been a bad accident on the path to the tennis courts. Within minutes some sailor comes up with a brand-new bike. Takes the old one and goes away.

 Anyway, that night the President had obviously heard about this from somebody. He made some comment about it that I was trying to do acrobatics on the bicycle and how did it turn out? So I had to tell him I ruined the bike. I was willing to pay for any damage that I incurred. But he had a sense of humor, he enjoyed things like that.

Can you tell us a bit about Mrs. Reagan?

Mrs. Reagan was to undergo her annual physical exam, which began with a trip to the Naval Hospital (Bethesda) for her yearly mammogram. I patiently sat in the waiting room while the radiologist and technician performed the evaluation. When it was over the doctor told me that she thought there needed to be some different views, which immediately set off an alarm in both me and Mrs. Reagan. Yes, she had now several views that illustrated the earliest images of a possible malignancy and though no masses had been palpable on physical exam, there were three distinct flecks of calcium in a small cluster in the left breast, easily reachable for biopsy and excision.

The First Lady accepted this suggested diagnosis and our plan, which would include members of the Mayo Clinic staff with her childhood friend Dr. Oliver Beahrs, the former Chief Surgeon of the Clinic. The discussion over, we drove back to the White House, one of the most interminable trips I had ever taken over such a short distance. The silence was broken when I was told that I would have to break the sad news to her husband, a scene that I shall never forget, and for a short while I had lost my voice.

Once within The White House grounds and at the South entrance, Mrs. Reagan straightened herself and walked erectly into the South entrance outwardly appearing cheerful as she greeted those who were inside awaiting our arrival. I turned to the left and proceeded to the outer office where Jim Kuhn sat in his small but vital office. He seemed to sense something was amiss and asked if everything was all right.  No, I replied, but I need to see the President right now.

Fortunately he sat alone at his desk. Jim closed the door behind me. The President asked me if I wouldn’t sit down. I declined and stood in front of his desk. Thank god my voice had returned to full strength. Sir, I began, we’ve just returned from the Naval Hospital as you know, and I’m afraid we’ve made an early discovery that will necessarily require surgical removal and macroscopic examination on Mrs. Reagan’s left breast. We won’t know if it is definitely malignant until the area in question is removed, and if it is positive we will have various options of treatment depending on her wishes. The best news is that it is an early discovery, which is very much in her favor.’’

The President was stunned to silence—he initially could not speak—he sat looking at me. Obviously his mind was elsewhere. I think I bore the worst news that he had ever encountered. After a few moments he regained his focus and remarked slowly and with an infirm voice that I had not heard before. I know that you doctors will take care of her... and he could say no more. He looked away in silence. I thought it best I leave him alone.

I went up to the residence where Mrs. Reagan calmly asked how he had reacted. I said that he sat in disbelief and expressed his faith that we doctors could do all that was humanly possible.

That evening he came up to the residence appearing normal in all respects, greeted the First Lady with a warm hug and kiss, and it was time for me to leave.

The next morning he stopped by my office and wished that I had stayed last night. The subject of the possibility that Mrs. Reagan might have breast cancer never entered their conversation. He thought I should have been there.

Soon it was announced that the First Lady was to have a biopsy, and if it proved to be malignant, had elected to have a mastectomy and node dissection. Experts from across the country volunteered to help, and I reassured them that the Naval Hospital was well staffed, and that we would have consultation from the Mayo Clinic, and Mrs. Reagan had elected her option of mastectomy, other options having been explained.

It is well known that Mrs. Reagan underwent the surgical removal of her left breast, from which she made a remarkable recovery. About three months later she developed a marble-sized lump on the inner aspect of her left arm. My first fear, of course, was that this mass might represent a recurrence of the disease in a lymph node below the axillary region where all the nodes had been removed.

Of course it needed to be removed and arrangements were made to perform the minor surgical excision in the examining room adjacent to my office. Dr. Beahrs was to assist in the procedure as was Dr. [Thomas E.] Beam from Walter Reed. The mass was easily removed under local anesthesia and was what was called a benign hyperplastic node, and the wound was easily closed. As fortune would have it, but not a rare complication the wound turned into a lymphocele (a small clear fluid-filled cavity), which needed to be drained, a minor experience. The cavity was packed with a ribbon like mesh called iodoform gauze, requiring daily dressing changes and gently repacking the defect. This seemed as if it was going to go on indefinitely, which was bothersome to both of us, and certainly impacted on her wardrobe.

We had all (the Kuhn family, the camp commander, the senior helicopter pilot, and lead secret service agent, and guests if visiting the Reagans) gone down to the Reagans’ cabin after dinner where we would view a golden oldie film (vintage 1945-50) on Friday night and a more contemporary film on Saturday night. I cannot remember what film we saw this particular Saturday night, but as usual at the end we all filed out, but Mrs. Reagan pulled me aside and reminded me that it was time for a dressing change.

Back through the bedroom and into her bathroom we went, she sitting on a convenient hamper, and I on the edge of the tub. I unwrapped the gauze dressing from her upper arm, and teased the iodoform gauze from the wound that was not closing as rapidly as I had expected, but there were no signs of infection, just normal granulating tissue.

I carefully opened the sterile dressing packet and donned rubber gloves. I had the small bottle containing some untouched iodoform gauze, and with a tweezers went to pull it from its container. It had wadded up somehow, and no matter what angle I held the bottle I had no luck, at which point Mrs. Reagan, thinking back to her days as a volunteer assistant nurse during WW II, suggested that I needed some help, took the bottle, held it on its side and tapped the bottom while I attempted to tease out the gauze. This was certainly the most obstinate pieces of gauze I had ever encountered. With each failure we increased our efforts, and suddenly with one good tap the sterile gauze ribbon flew out of the bottle onto the floor. The whole scene struck us simultaneously as a demonstration of total incompetence, and we began laughing, which progressed to spasms of uncontrollable hilarity. I thought I would lose credibility if I couldn’t take this event seriously, but then to look down and see the gauze limply lying on the floor was more than I could handle and we would be off on another binge of laughter—and finally poor Mrs. Reagan laughed so hard that her abdominal muscles cramped and she couldn’t straighten up.

My lord, I thought, what would the President in the adjacent bedroom wonder what was going on —and little by little we got control of ourselves. We had no more gauze, which prompted me to announce We didn’t need it anyway, which started the laugher again. Well, finally we adjourned to the bedroom where I apologized to the President for the ruckus, but he had just been in the shower and was without his hearing aids. I had put the simplest of dressings over the wound—there would be no more packing to open—and it healed nicely with a week.

On the way back in the helicopter I tried to avoid eye contact, but I glanced up forward where Mrs. Reagan sat facing me. I was sitting in the back and I could see her starting to laugh. Then I saw the President turn around to see what was so hilarious. Of course I began to laugh, and I guess he thought it best to ignore the situation and went back to his book. I laugh as I recall this event. I don’t think I had ever known the equal of this comedy. Fortunately when settled on the White House South Lawn, I stayed behind while they exited, lest the welcoming crowd see me lose control in public.

Any other memories from Camp David? Would you have to be up there every time they went?

Occasionally I would have one of the junior doctors go up there.

Did you enjoy the amount of time you had to spend up there?

Oh, it was wonderful. These wonderful dinners, the main cabin had a Cabinet room in it, had a dining facility, windows all around, great fireplace. You could be eating your breakfast or whatever and have the deer run by. It was just a very nice place to be. With all the Marines around, they would go out and be in the woods and the President could ride through the woods along the trail and enjoy himself. It was a great, great relief for him.

And movies were always a feature—

Yes, there were always movies, it was always a tasteful movie, and his commentary added immeasurably to the enjoyment of the thing. Especially if he was in it, and he would tell you about all the bungles when they were trying to make the film.

I saw in President Reagan’s memoirs that you were on the plane when they left the White House for the final time.

Yes.

I’m wondering if you had any comments that you had on that, the general mood on the plane, for President and Mrs. Reagan?

Yes, there was the departure and we went down out of the Capitol. There were so many photographs going on, I stayed in the distance. We had a photograph that we hung up in our clinic in the Old Executive Office Building and it shows the President and George Shultz and somebody else. Then it shows this head, the end of the picture comes here and it shows this guy who’s obviously trying to get in the picture. It was one of the medics and underneath it said, Who doesn’t belong in this picture? We understood that we were not to be in the pictures. So I’m not hiding, I came along the side and we had this big bandage on the President’s hand, you’ll notice if you ever see a picture.

We had taken him to the hospital about a week before and released a Dupuytren’s contracture. He used to wave at the crowd and you could see his finger like this. In fact, I even found a paper doll of him that you can put different suits on and his hand is like this. Can you imagine the paper doll being that accurate? So he had this huge bandage on his hand. We got on the helicopter and the pilot was the pilot who had been flying him around for six or seven years. We circled the Capitol a few times. He circled the White House and he took his last look. Mrs. Reagan couldn’t look down as I remember, but he was looking down.

Then out to the airplane. There was a fair amount of celebration on the airplane but still there was a lot of regret that this was it for us. This was it for the Reagans. We landed and a small group of us who were the most intimately involved went to the residence with them. I carried all the medical records and stacked them here and there. He was ready to get on with what comes next. She was a little more reticent. She was a little sadder. It was a sad event when we left them there, just the two of them with the housemaid and the cook. But still we left them and we felt that we’d abandoned them. Can they make it on their own type of thing?

The President, as soon as he set foot in there he showed us very definitely he could make it on his own. He started putting stuff away and he was ready to go.

You mentioned that there was some talk of postponing that hand surgery but he would have none of that.

Yes, he said, It’s the Christmas vacation, it’s Christmastime and George Bush is getting all the attention, what do I need—?

Some people were concerned that his bandaged hand would appear in all the inaugural photos—

It did, every one of them, and he just said, We’ve got to accept some things in life. He just didn’t want to have to go out there and go through all of it where he didn’t have the support staff that he was familiar with. We took him to Walter Reed. He wouldn’t go on the gurney to the operating room. He said, I’ll walk. I have this picture of him with the hand surgeon who was going to do it and then the President and then one of the other doctors and Larry and I are way in the background. I used to try to get other people involved to enjoy relating with him as much as possible.

We walked him down, he got up on the operating table, and he entertained. It was done under what is called Bier block. So he had no sensation in his hand, but he talked throughout the whole thing and told jokes. He’s a very sociable individual. He’s an excellent patient. You couldn’t get a patient to behave better than he or Mrs. Reagan. They’re models. They weren’t demanding and they did everything they were told, except one night the President decided he’d get up out of bed and go to the bathroom by himself. About the second night after the operation. He got all tangled up between the railing, the side railing on the bed and the IV bottles. We hear this awful noise. We were sitting down at the nurses’ station outside his room. We opened the door and he’s up. Mr. President, what on earth are you doing? Well, can’t a fellow go to the bathroom around here?

I said, No, sir, not when they’re all hooked up. You’re tethered to these bottles. He started to see if he could untangle them himself. We finally got to him and we got him all untangled and then said, Now you use this IV pole to steady yourself. He said, I don’t need it, but if you want me to take it with me, if it needs to go, I’ll go. He went to the bathroom and he came out. But he would entertain us at night. He said, It’s a shame, do you all have to stay here? Mr. President, under the circumstances, yes, we do. He said, Well, come on in and let’s watch a movie. He’d get the TV and was clicking all over the place. Absolutely a delightful person to be around. I must say George Bush was pretty down to earth also. President Reagan, the reason he liked the medical unit, we had very attractive nurses, very capable nurses. We used to call it face time. Everybody is always trying to get in front of him and get in the pictures with him, and some of his junior staff people are always clustered around. You get fed up with all that.

If he came over and started talking to us, we had no political agenda, he couldn’t promote us to anything. So he would come over and just talk with us, mainly because we were a shield, I think. They would think, Well, he’s talking about something medical, better stay away. He’d be telling us a joke or something. He’d just be very funny with the doctors.

Did he like to discuss politics with you?

No. Occasionally he’d have a humorous comment to make about somebody, it was a kind of cartoon he would create verbally about somebody in the opposing party. I didn’t know enough about politics except that I had been president of my class in medical school. No weight behind that.

You’ve painted a picture of Ronald Reagan as a very affable, approachable—

Absolutely.

You know there’s other testimony out there that there was this kind of wall, that he was very private. Do you have any comments about that? It’s not just Edmund Morris who says that.

Edmund, as I say, thought he ought to be right there in the bedroom, so that was Edmund’s opinion. But you talk to anybody who was on the White House staff or any of his staff people, and he’s one of the most affable individuals you’ve ever met. So I don’t know where some of these people get these things that they write. There are times when Morris probably couldn’t get to him because Don Regan was in the way or Howard Baker was in the way, or something of that sort.

Howard Baker let him go on his own because Howard had his own charisma. One day, we were coming out the back door getting ready to go someplace in the helicopter, and the press all swarm around Howard Baker and he’s giving little tidbits of meaningless information in exchange for film. He’s saying, I’ve got two rolls. He had this wonderful sense of humor also.

He was a gifted photographer too, wasn’t he?

He was indeed, and we used to compete, sort of. But he said, The nicest picture you have of me is the one you took of me and Marlin Fitzwater. He was a good photographer. He was a wonderful individual. He’s over in Japan now as the ambassador with his wife, Nancy.

One day they were gracious enough—Nancy Kassebaum was on that committee that had to do with women in the armed forces. She went and watched basic training, and her conclusion at the end was women are built differently than men so certain things have to be taken into consideration because they all aren’t designed to do the same thing. With medical problems there is a profound difference between men and women, especially young people who are sexually active. There’s no doubt about it, in every unit, especially when they deploy, about 20 percent of the women get pregnant in spite of it all. Where on a ship you go I don’t know, lifeboats or something.

So we had this big meeting and we had these people from DACOWITS [Defense Advisory Committee on Women in the Services]. You ever hear of DACOWITS? Department in the Army, Women’s Integration something or other. Talk about women who are masculine. And they are wicked. We had this big thing and Nancy Kassebaum came out because she had been on the official committee that was reviewing this thing. Howard Baker came out with her. It turned out to be an uproarious session. We had a big dinner party afterwards, and I must say Howard Baker is probably one of the sanest individuals we’ve ever had in the government.

His first wife was Senator [Everett] Dirksen’s daughter, and I was downstairs in the residence when Dirksen came in. I think he had a cancer of the lung, it was inoperable, but he fell out of bed and broke his hip. I guess they didn’t do his lung. I was a resident and I met up with some of the orthopods and helped him get back in the bed. His daughter smoked herself virtually to death. She had cancer of the oropharynx and cancer of the lung and cancer of the breast. Poor lady was really beset with it.

Nancy Reagan said, Howard is without—and Nancy Kassebaum is without—They ought to be together. So they got married.

She fixed them up.

She likes to joke that she did.

You had about eight or nine months with Ken Duberstein as Chief of Staff.

Good fellow, just a wonderful, very considerate—I hope I got him to stop smoking. He and his wife smoked unbearably. He has a new wife now, I guess. But one day I walked into his office and I noticed he had a pitcher of water and a glass. God, he was drinking water all the time. I said, Ken, how long have you had this unquenchable thirst? He said, A couple of weeks now. I said, Would you go see a doctor at Georgetown? I fixed him up with an endocrinologist, he had full-blown diabetes. He was a great friend, he was a very calming influence on everything, logical, thoughtful. He was another blessing. He didn’t have quite the charisma of Howard Baker, but then he was much younger.

Did you get to know Colin Powell at all during his time as National Security Advisor?

Of course. I haven’t talked to Colin recently, but he always used to get after me because my tie clasp was a Marine emblem. He’d look at that, he’d kind of flick it. He’d say, What’s going on here? I said, I was a Marine once. He’s say, Well, you’re not a Marine now, are you? No, sir. Well, do I need to say any more? he’d say. No, sir.

A month or two later I figured he’d forgotten and he’d come up and I’d have it on again. He’d say, Tell me if I’m wrong, but didn’t we go through this once before? I said, Yes, sir. He says, Well, we’re going to do it again. He sort of chewed me out again. I couldn’t tell whether he was trying to be funny or not. You’re always safest to pretend he’s serious. But this time I said, This was given to me, sir, by a fellow named [William Groom] Leftwich. 

Now Leftwich was one of the most famous Marines of all time, and he and I were the number one doubles partners on the Marine Corps tennis team. He’d been first in his class, I believe, at Annapolis, a brigade commander, he’d done it all. He’d gone over to Vietnam and the second time over there he’d sent a patrol out that had gotten into trouble. He went out on one of these big Chinooks, they have a propeller on both ends to rescue—he had no business being on that plane except that he said, They’re my men, I sent them out there and I’ve got to retrieve them. On the way back they went into a hill in a rainsquall and killed all 47 or 50 of them. 

Anyway, I told him that this was a great hero in the Marine Corps, a Navy Cross winner, and he was a fellow soldier and I thought I could wear it once in a while. He didn’t say anything at that point and we didn’t discuss it again. But if I thought I was going to see him tomorrow, I’d put it on again. He’s a good guy and he was a great general. He handled himself as chief of the Joint Chiefs of Staff brilliantly. He didn’t get in [Norman] Schwarzkopf’s way, but he knew how to control Schwarzkopf, who was a bull in a china shop, which you need sometimes. He was at the right place at the right time, absolutely no doubt about it. He certainly fixed things. How long did that one last, five or six days? A hundred hours, I think.

I think we’re through for today. We’ll pick it up again tomorrow morning.

This is round two of the John Hutton interview. It is Friday morning at 9 o’clock. It’s Jeff Chidester, Steve Knott, and Dr. Hutton. We’re about to see a slide show.

We don’t need to spend much time. Everybody recognizes this wonderful individual and his coterie of friends. I show it simply to remind people, because the most common question I’m asked has to do with disability of the President. Did the President have Alzheimer’s while he was in the White House? When you look back, a lot of the Presidents who were elderly all had some sort of a problem, and indeed there was a publication—Anyway, he did realize that if something happened to him there had to be some provision for the passage of the Presidency. A lot of people don’t realize that eight out of 40, now this was a couple of years ago, eight out of 40, when I was there, had died of something. [William Henry] Harrison, who got up and gave a four-hour inaugural address without a coat on on a cold, blustery, rainy day. Now what sort of a mind would do that?

 Zachary Taylor went out on the fourth of July and had some cherries and some milk at an exposition on the mall, and he got a gastroenteritis, probably typhoid, and died.

So he would have gotten that from the milk?

Yes, probably so.

It had gone bad?

Probably so. Abraham Lincoln, of course, and [James] Garfield and [William] McKinley, all from gunshot wounds. [Warren] Harding, somewhat poorly understood, but probably went into congestive heart failure. [Franklin D.] Roosevelt of course was sitting at his desk down in his resort home in Hot Springs—

In Georgia.

Suddenly got this incredible headache and probably ruptured an aneurysm. He was hypertensive, he had a lot of medical problems. People say at Yalta some of the decision-making, he just couldn’t stand up to [Joseph] Stalin, and [Winston] Churchill tried to save the day but Stalin really got pretty much what he wanted.

 And of course gunshot wounds—were you alive when [John F.] Kennedy was shot?

No.

That was an incredible event. Now, other than injuries, you can see that there were some that were non-fatal. [Andrew] Jackson was shot. He was a duelist and he was shot several times. Finally he got the piece of lead taken out of his shoulder. He had one in his chest that abscessed periodically, and he had what they call a bronchopleural fistula. He would cough up this terrible sputum and they said he had the bad breath of the century, very difficult for the President to talk.

Grover Cleveland, I’ll talk about a little bit, but here was the first incredible cover-up of a disabling type of lesion, which turned out to be a verrucous carcinoma. Woodrow Wilson was kicked upstairs. The president of Princeton University, he’d already had several stuttering strokes. We would call them now reversible ischemic neurological deficits. Whether he was shedding them from his heart as emboli or from his carotid artery nobody will ever know, but he was so impaired that he actually learned how to write with his left hand. But he was really right handed.

They have an old gentleman, I don’t know if he’s still alive, he’s got a tracheostomy, and he is the curator of the Wilson Library up there at Princeton University. I was in a fraternity at Wesleyan that was on the grounds of the house that he lived in when he was a professor at Wesleyan.

Eisenhower, whom I knew personally, had three serious things that would have kept him out of the limelight as far as the action in the government, and he also, just like George Washington, said, We have got to make some provision. When he was incapacitated, especially after that large myocardial infarction, the first of his events, that was something he thought needed to be addressed. That’s how finally the 25^th Amendment started again. Birch Bayh was the one who really took it and made it happen.

How did you know Eisenhower personally? From your military career?

The first time I was a young Marine officer candidate and they were having a big NATO meeting at Quantico. All the generals from all over the world would wear every description of uniform. He came down to preside for a short period of time. And one morning there was this obscene sergeant who was our drill instructor. Officer candidate is the lowest form of Marine. You go from nothing to being a second lieutenant. You’re demeaned daily.

He got us in formation one Sunday morning and says, Youse candidates, youse is Protestants, you’re going to church. So he got a contingent to make it look like some of the Marines went to church. It was a scam. So he marched us all and he told us we had to sing heartily. Afterwards there was a reception, and President Eisenhower came around and shook all of our hands and talked to us a little bit and said he was delighted that people of our ilk were still ready to defend the world for freedom.

Years later, I had gone into the Oval Office about a reasonably trivial matter, and apparently there was a 15-minute block in President Reagan’s schedule and he asked me to sit down for a few minutes. It didn’t take long before I asked the President about two photos that stood on a table in back of his chair. Both photographs showed President Eisenhower and then Governor Ronald Reagan obviously just having finished a round of golf—each having won one game. This called to mind an interesting event in my life when I was a Senior Resident in Surgery at Walter Reed Army Medical Center.

I explained that when I just met President Eisenhower (1968) I had been sitting behind a large desk and was balancing a patient chart on my knee drawing the details of a complicated operation that I had performed on a high ranking general’s wife. I heard a door open part way almost adjacent to the desk, and an elderly gentleman peered out of the narrow opening and softly addressed me, Doctor, I’m having a little indigestion and I think there is an order in my chart for some medication. Could you please summon the Ward-Master (the enlisted corpsman who was well trained in patient care) and ask him to open my windows, it’s getting very stuffy in here, and might he open the windows.

I sat there—in awe that I was talking to a five-star General and past President of the United States, and I repeat, I just sat there, the chart balancing on my knee. The door eased shut when I leaped to my feet—it dawned on me that the President was expressing the subtle symptoms of myocardial ischemia (a lack of blood flow through the coronary arteries) and that a myocardial infarct (heart attack) might be in the offering. I reopened the door and asked if I could help him back into his bed. No, no, young man, I can manage myself if you would get the medicine that Dr. Hall had ordered. I hurriedly got on the phone and called Col. Hall (Chief of Cardiology) explaining the situation, and within ten minutes the Presidential Suite was filled with senior physicians. I was able to withdraw, there was nothing a surgeon could do at this point.

But I never got over the fact that I did not stand when being addressed by a five-star General and former President of the United States. This I confessed to President Reagan,  blushing as I spoke, I’m sure.

Well, he said, that seems like a terrible burden for a young man to carry on his shoulders, and he paused—the silence broken when he partially stood, reached across his desk, put his right hand on my shoulder, and quietly said, How about a Presidential Pardon. I laughed with him and accepted the pardon gracefully. I could do no better and I thanked him for his rescue from the dark cloud that hung so gravely over my head and left him with a broad smile on his face. I only regret I had no witness for this monumental occasion.

The next time was when I was about to help one of the junior residents do a gallbladder. I was chief resident at Walter Reed at that time. The chief resident of anesthesia came by and said, John, quick, grab a tracheostomy tray. I ran by the place where they have such things and Colonel Lozniak knew that it was coming. She handed it to me, ran down the hall and into the Eisenhower Suite at Walter Reed. There was poor President Eisenhower lying there, cyanotic. His lips were blue, he obviously was not exchanging air very well. He seemed to be in extremis. We thought he was going to die. One of the first things you do is create an airway and breathe for him.

I had one assistant with me and here I was going to—without any preparation, and a terrible place to do it, in somebody’s bedroom—do a tracheostomy. I could think of a thousand things that could go wrong and I would be finished. I had the knife and I painted his neck with alcohol solution. The anesthesiologist, one shot, a laryngoscope, he got an oro tube down into his trachea, inflated the cuff and with two or three squeezes on the Ambu bag the President pinked up. He looked fine. So he quickly took the tube out. The President realized he’d had some major event. Afterwards he was in the hospital for some time, and he asked all the people who were involved to come up and just sit with him for a little bit and talk. He was interested in the fact that I’d met him when he was President, etc. That was the first time.

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That’s pretty impressive.

Wilson, Eisenhower, Kennedy. Addison’s disease, which was really well masked. He was admitted to Cornell University under many assumed names. He had this terrible back. He had missed a whole year of prep school, I think it was Andover, Exeter, one of those New England schools.

Choate, I think. 

All right. Because of this, he was sort of a sickly kid.

Yes.

Yet here he ends up commanding a PT boat, which if you had a bad back it’s like getting on a bucking bronco. But he apparently handled himself reasonably well there although some speculators wonder how you get your boat run over by a destroyer without firing a shot.

[Lyndon] Johnson had a gallbladder problem. They tried to do two operations at once. He had a urethral stone in his GU tract, genitourinary tract. They tried to get that out at the same time, which they did. His wound got infected subsequently. These were the Mayo Clinic guys and we never heard much about that. I remember them out there showing one of the wounded soldiers from Vietnam and he said, I’ve got a scar too and he lifted up his shirt. Anyway, I had met him when he came out to see the soldiers at Walter Reed when I was the chief resident. And Reagan, of course, who had more things and we’ll get into that as time goes.

Okay, there’s Zachary Taylor. Rough and Ready, the Indian fighter, etc. Recently somebody, I think somebody in the media, decided he had symptoms that were compatible with arsenic poisoning. They exhumed his body, looked in his hair. I think they found nothing. There it is, the mysterious death.

Then of course [John Wilkes] Booth, who was a poor man’s actor so everyone around the Ford’s Theater knew who he was. He had constructed the door so that when he got in there he could put a block of wood, I think actually it was a dagger. Anyway, this was a widespread conspiracy. Secretary of State [William] Seward was attacked the same night, so there were multiple prongs in this thing. Booth’s body was consumed in the fire of a barn, but then some relatives decided, Well, we’ve got to find out, he may be buried out west someplace and started digging around. Anyway, with one shot—there was a Lieutenant [Charles] Leale in the next booth apparently who jumped over and was one of the first recorded cases of mouth-to-mouth resuscitation and got him going again so they could carry him to Peterson’s lodgings across the street. He was so tall his feet hung over the end and they had to get some boards and put them—he died early the next morning. That’s the path they think he took.

Then poor old Garfield going up to give the graduation address at Williams College and this fellow named [Charles] Guiteau—most assassins yell out some epithet. I forget what he said, I am a stalwart, or something like, Now his Vice President can be President. He was a little more moderate or something. They took him back to the White House where he lived on, and everybody and his mother came to see him. This is the path of the bullet that they hypothesize. You see it’s right near the pancreas. An injury to a pancreas was a death knell in those days because it secretes these enzymes that sort of auto-digest you. Whether it was that or whether it hit the splenic artery and built a false aneurysm that then ruptured, they figured he wasn’t really getting any better.

Everybody in town, every doctor, came in and put his finger in there and contaminated it further. Some doctor said, Let’s take him up to his country home up there along the Jersey coast. The sea air will invigorate him. He’d lost about 60 pounds by this time, and that’s where he died suddenly. Some say of a heart attack, some say he ruptured it and bled to death internally. So that was Garfield.

There’s Alexander Graham Bell with his galvanometer. He’s got an electric device and he’s trying to locate the bullet. That seemed to be very important. It never worked very well.

McKinley was going to an exposition, in Buffalo I believe it was, and as he was getting out some fellow came up with a napkin over his hand and simply shot him in the abdomen. It would have been a perfectly benign wound. Surgery could have helped him, but I think this is 1891. You realize that even in World War I they were afraid to open the abdomen. It was just too mysterious. They took him to a hospital nearby, and they did go in and repair the hole in the anterior part of the stomach, but missed the one in the back. The rule of thumb, which is really good for thumbs only, is that if you see a hole in the intestine there’s probably another one someplace. He just leaked gastric contents, had regional peritonitis. Here he is in the last throes and he has some comment. All the doctors were hovering, and he says, Gentlemen, I think it’s time for a prayer, meaning he realized the jig was up.

I show this because very few people realize he was shot too. He was going up to a convention someplace. Was it Rochester? I can’t remember. As he was getting out of the car some fellow shot him. One grazed the arm, the other one hit him right in the chest. Now a chest wound in those days was a mortal wound. Obviously it didn’t get into any vital structure in the mediastinum. So he went in and apparently took out his speech and told the audience, I’m going to have to speak a little quietly, because I have a bullet in my chest. They hushed. In front of 5,000 he gave this speech after which the doctors decided they’d get him to Chicago where there was a doctor named J. P. Murphy, a very famous surgeon, one of the leaders in the country, and turn his care over to him, because he seemed all right vital signs-wise, etc.

They got him on a train and got him up there and there was a lot of political hassle as to which doctor would have his name affixed to the care and Murphy won out. He did it by taking charge. He knew the train was coming, he got a step ahead. He went down and got on the train ahead of time, one stop south. So he announced when he got there, I’m taking care.

Is that a direct quote?

No, no, but he said something.

Kennedy, there’s the building that he was shot from, the first bullet probably penetrated his neck and went into the Governor. There they are. We can all remember that day very well—except for you, of course.

The first bullet, as you see, went out the front of his neck as you can illustrate here very well because it was a big ragged wound. But the second bullet that went in the back of his head, he was going forward—if you look at the films often enough—like this, and the second bullet then hit him and took out really the right side of his brain.

Grover Cleveland was the big cover-up. One morning in May Cleveland felt he had something growing on the roof of his mouth. Called Major [R.M.] O’Reilly, who was his sort of part-time doctor, who came over, took a look, and said, This looks bad. Lesions on the roof of the mouth in those days were either syphilis or cancer. He got a fellow named [Joseph] Bryant up at New York University Medical College to come down, and he decided that this had to be removed and how could they do this in secret because Cleveland was convinced if he were a lame duck, his Vice President, Adlai Stevenson, would swing them, would keep them on the silver standard. Cleveland felt we had to get back on the gold standard because we were faced with a major depression. The railroads were collapsing, and so forth.

The Secretary of War, whose name escapes me at the moment, knew somebody who had a yacht called the Oneida. We’ll take him out and do it out in the ocean. So he got a group of doctors together and off they went in the boat. This is the main salon of this yacht, the Oneida. They’re all getting ready, they’ve got an anesthesiologist, a dentist, because they’re going to have to remove teeth. They took him out and one of the people named [W. W.] Keen was a neurosurgeon, one of the early ones, and he was an expert with the galvanocautery, the electrocautery we use now routinely for hemostasis. Dr. O’Reilly was there because he knew how to administer ether. Can you imagine using a spark when you’ve got somebody’s lungs filled with ether? That’s enormously explosive. They went at it and they actually didn’t lose much blood, though that’s a very bloody area, and they resected this thing and sent it down to Dr. [William] Welch at Johns Hopkins, without any name on it. He thought it might be a verrucous carcinoma, but they didn’t get it all.

So they went back out on this yacht and excised it again. Now, the first time he had kind of disappeared. He got on the boat without an awful lot of people—there was one press person who was on the ferryboat that took him to the tip of Manhattan Island where he got on a smaller boat and went out to the yacht. The doctors all hid below deck so nobody would ever see them all together. At any rate, it was a very well-kept secret. When he got off the boat, the press was there, he waved at them, and one of the doctors said, He’s suffering from gout. He has a little gout, and that’s why he was on the boat relaxing.

When they took him out again, the press was stunned again, and I can’t remember exactly what the excuse was the second time, a fishing expedition, I think it was. Then they rode him ashore, there he was and he waved at everybody. The hero was a dentist they’d gotten who learned how to mold false teeth and he molded something because there was a huge hole and he talked like somebody with a cleft palate, very nasal sound. As a result he didn’t make an appearance, but he had scheduled an emergency gathering of Congress, I think it was August 7, this was all taking place in July—to make his speech that we ought to go back on the gold standard.

The second time they got it all. The dentist made a plate there, and nobody ever knew. One of the doctors, I think it was the first dentist, was upset about this whole secrecy because they kept him out of doing something he wanted to do. He was going to do some kind of an operative case and when they had the boat go south, back from up there in Martha’s Vineyard, where his summer home was, they dropped one off at each port so nobody would ever see them together. But the dentist told a reporter who came out with the absolute truth, and he was decried and called a maniac and lost his credentials as a journalist.

This whole story came out in 1917, I think it was, after Cleveland died and he wouldn’t get upset about this breach of confidentiality. Of all things, Dr. Keen published the truth in the Saturday Evening Post, to vindicate this poor reporter whose life was ruined by this cover-up.

There’s the hole operatively up above and down below, you can’t see it very well, but it’s amazing how it did heal. This is the area up in here where they did the big resection, removed the teeth.

Wilson we’ve talked about, multiple strokes. Probably his feebleness was responsible, or at least some people attribute it, that he couldn’t rally Congress behind us joining the League of Nations, and consequently we lost out on that peace accord.

Here’s Roosevelt. I remember watching this newsreel of these three and my father sitting next to me saying, He’s had a stroke. Very coincidentally, my father used to occasionally go up and take care of the older Mrs. [Sara Delano] Roosevelt, his mother, up in Hyde Park.

Eisenhower is visiting his wife’s family, the Dowd family. In the middle of the night, one evening he says to Mamie [Eisenhower], Something’s wrong, I feel terrible. She calls Howard Snyder, the doctor. He staying at the Air Force base across town, and they diagnose a myocardial infarction. He’s cold and clammy. He tells Mrs. Eisenhower to get in bed with the President—they slept in different rooms—and comfort him and warm him up. He gave him some morphine and an anticoagulant called heparin. Why he was carrying those two things will forever be a mystery in my mind. The next morning they got Fitzsimmons Army Medical Center ready to transfer him. It wasn’t until he was behind the old isinglass covering, kind of a tent they put over there so they could get moist oxygen, that they told him he’d had a heart attack. And they said tears came to his eyes when he realized that he was in serious trouble. But he left there in great spirits. Like Washington, he said, We’ve got to do something about this, because apparently they had a little trouble getting [Richard] Nixon. This all happened early in the morning. With the time difference, he was hard to locate.

So anyway, there’s your 25^th Amendment. Finally President Reagan. I remember this day because I was in San Antonio teaching young medical officers how to do emergency surgery on goats. All of a sudden all of the TVs went on. Every four anatomical tables had a TV over them and we saw this. It’s hard to believe. There’s McCarthy who was injured, Mike Deaver. Here’s [James] Brady back here and that’s Mike Deaver.

Right. The police officers are looking the wrong way, the assassin is right behind the guy—

Yes, down here is the—and here’s a depiction of how the bullets all went. President Reagan didn’t really think he’d been hit. Here are serial photographs of him being pushed into the back of the limousine and the armrest was down, and his rib went on that, so he thought the pain probably was from that. He looked at [Jerry] Parr, the Secret Service agent, and says, I think you’ve just broken my rib. They were heading back to the White House because, of course, he has plenty of security there, when he coughed up blood, hemoptysis. Parr was smart enough to say, That means there was some sort of internal injury, take him to George Washington. They always have Secret Service men in the various hospitals wherever he’s going, in town or out of town, and these agents take over in a case like this and they did.

He wouldn’t be helped from the car, stubbornly got out. And he’s told me, I thought I could make it in there but as soon as I got through the door, my legs weakened and I had to admit I had to be lifted onto a table. He had lost 1250 cc of blood. Anyway, whether he is hit in that top picture I don’t know, a lot of speculation. But there were people who were felled by the assassin and the car took off and Dr. Ruge didn’t know where they went until he heard it on the news. This is the bullet that went in and went over his seventh rib and lodged in his lung tissue about an inch from the heart.

It was a simple operation. They had the blood stopped and all that and then they said, Should we leave the bullet in there? How many people come back from the war with bullets lodged in their bodies? And they said, The press will kill us if we don’t get the bullet out. Everybody will want to see the bullet. So that’s what extended the operation by 25 minutes, trying to locate the bullet, which looked like a dime. It was all flattened out from bouncing off the fender. It didn’t explode. It was a devastator, it has that compound with explosive in it called lead azide.

At any rate, it was such a small bullet the doctor said, You know, there must be another piece of the bullet somewhere. Call the Secret Service and ask them what kind of a bullet it was. They didn’t know, they said the FBI [Federal Bureau of Investigation] had the weapon. So they got a hold of the FBI and they said No, it was a .22 caliber. But by this time they decided that he might have a bullet in the abdomen so they did what they call peritoneal lavage. They put fluid in through a needle and swirl it around. If you see any blood or vegetable matter, anything like that coming out, you know you’ve got a wound in there. Nowadays they’d use the ultrasound.

How close was he if the agent who saw the blood had not said, Let’s head for the hospital, and instead they’d gone back to the White House?

Well, he would have certainly gone into profound shock, because the thing was still bleeding when they operated on him. But shock is a bit of a protective thing. Your blood pressure goes down, and if it’s not a big vessel sometimes it will simply clot. So, hard to say, but if they had gone to the White House, he would have certainly gone into shock and it would have been a much more difficult operative case because once you’re in profound shock and it goes for any period of time, for unexplained reasons it’s just harder to get all of the organs working again.

At what point did they know that he had been shot, when he got to the hospital—

When they got to the hospital at the first cursory physical examination. It was a very small hole and his arm was down there. In my experience I’ve run into people who say they know somebody who was there. If you listen to all the accounts and if I’d kept a list, there’d be 50 doctors who were in the operating room, and each one of them had discovered where this thing was.

Some say it was a nurse who said, There’s a little defect here. Of course, they realized from physical examination, Dr. Giordano, that he had blood in his chest. They put in a chest tube and got him in the elevator and that’s when he made that famous comment, I hope you’re all Republicans. Joe Giordano is actually so far to the left he says, Sometimes people think I’m a Socialist. But he answered back, Sir, today we’re all Republicans. And his comment, Tell Nancy I forgot to duck.

What a sense of humor.

He didn’t take this seriously at all. He never wanted to know all the details of it. Anyway, his recovery was hampered a little bit by getting a sort of pneumonia, or an atelectasis, got infected and they put him on antibiotics. They realized they probably should have had him on antibiotics to start off with. Nonetheless, there he is, that’s a very typical pose. When you’ve had a thoracotomy and they sew it together, deep breaths are very painful. One way to keep from stretching when you breathe is to list a little bit to one side and that’s what he’s doing there. But he looks great and Mrs. Reagan looks like a million dollars.

She was frantic. Of course, people say this is when she called her astrologer and did all this kind of thing. She did call her. She doesn’t deny it. She says, When you realize you may lose your husband, sometimes you do things like that. She laughs about it.

There have been reports that this assassination attempt reinforced his desire, for instance, to bring down the Soviet Union. Did you ever hear anything like that?

Sounds like Edmund Morris.

Well, it’s partly Morris.

Well, Edmund Morris, as I said, said he was a different man pre- and post-injury. Everybody I know said, Geez, he picked up the pace. He recovered faster than anybody— Ben Aaron said his recovery was miraculous. He was well motivated, he followed the directions, he used his lung expander, we’ll get to that in a minute. There he is in the hospital. This is the part that I photographed when he talks about how his recovery is going nicely. But it was an act, he was just putting us on. Here [quoting]: He emerged slowly. He had some of his Cabinet members up in the residence on the second floor. He limped from his bedroom to an adjoining room in the upstairs residence. He emerged slowly, walking with hesitant steps. He was pale and disoriented.

This is the part that really got the President a little bit perturbed. If I was disoriented, I shouldn’t have been President. If I was disoriented, but I wasn’t.

[Quoting]: Those who observed were frightened. Reagan hobbled from the Yellow Room upstairs, started to sit down and fell the rest of the way, collapsing. He spoke a few words in a raspy whisper and then had to stop to catch his breath. He looked lost. The pause wasn’t enough. He reached for the inhaler, a large mask-like breathing device to get his breath back and to get oxygen.

 There was never such a device up there. This is an absolute fabrication.

Do you know what this is from, Dr. Hutton? What is this excerpt? What are we reading here?

You’re reading an article about his recovery in Time magazine, Time or Newsweek. I think it was Time.

This is his, you can’t see it, here there are just three columns, the ping-pong balls. Everybody who has had a thoracotomy or a major operation takes one of these home and you suck on it and see if you can get the ping-pong balls up. If you get all three up you’re getting an A+. So that’s what he brought in and he showed him. He said, Do this. He went [blowing] showing how he could absolutely fully expand his lungs and he came out, he gave that to me and I took this gag picture here just to show. This is the huge oxygen inhaler that [Bob] Woodward described. I don’t know where he got this information. I threw that thing out. I mean, can you imagine? That belongs in his museum, the large breathing apparatus.

The first trip I go—four more years. They couldn’t stop, he had to stop, he tried multiple times holding up his hands. Four more years, four more years. This is where, as I mentioned yesterday, he started his speech and after a few minutes this raving lunatic up in the upper tier came running down and everybody thought he was going to jump at this point. He was shouting some sort of incantation, which nobody reported or totally understood. The President just stopped for a minute. The press swarmed across and he made a great speech. The crowd was wild and that night I watched on the news, and the only thing they showed was the Reagan maniac and the commentator said, Well, so much for freedom of speech because they carried him out before his message was totally delivered, whatever his message was.

So you joined the administration during the reelection campaign? 

Yes, I got there July 4^th or 5^th.

‘84?

Yes, 1984, so this was the ‘84 campaign.

So you traveled with the President for most of the campaign?

Often. Because Dr. Ruge was still there but he was fed up with all this stuff. He said, You go. It’s your turn now. So I went to most of the things like this. This is out at the University of Portland, I think. Anyway, I took both of the pictures, much to the annoyance of some people. Anyway, here we have Lesley Stahl. I never can remember her name but any rate, one of the reporters. You see her all the time in Washington.

The one on the end?

Chris Wallace, of course, Sam Donaldson. I don’t know who this is and the crowd is shouting and cheering. These people are lost, they can’t find a chink. 

Anyway routine. I get to give him his allergy shot every Thursday. I’d go up to Camp David intermittently. Dr. Ruge didn’t like doing that. I’d only been doing this for four years on his behalf. He had a nice home in Georgetown, he said, I have to devote some time to my house.

Here we are going out for the colonoscopic exam, which we discussed earlier. 

Here he is, he’s gotten off the helicopter, he’s waving to everybody, you see the Marines around and this is that fateful Friday. The only thing it wasn’t Friday the 13^th, it was Friday the 12^th as I remember it, the 13^th was the day we operated on him. Two weeks before, his brother had the same operation, same spot, cancer of the colon, in the end of the colon, the beginning of the large bowel, called the cecum.

Here the doctors find cancer. Of course, this dominated the news of the world. And pretty soon, Surgeon’s decision likely to be debated. You can’t leave it alone. You’ve got to leave a niche that somehow this had been another bungle in the White House. Friends are calling up, What the hell did you do? after listening to some commentator say that this was—

What was the issue? I don’t understand why it would be an issue.

Why didn’t we do this earlier? Why didn’t we find this out? You can say that for anybody who has cancer. Why didn’t we find it when it was at its first cellular state? So everybody is very happy about that. Then Mrs. Reagan in the next days draws my attention to the next time— John, have we no privacy? Does everybody have to have some kind of an image of the President’s rectum? She was doing this with a little bit of a sense of humor. At any rate, here’s the whole thing. This is a very well-written article.

The main thing is it shows where the cancer was, it was illustrated very accurately. Here’s the polyp I mentioned, on a stalk. Here it’s getting to be like a verrucous and it’s starting to invade. So that’s called a Duke’s, they have a classification. Here’s a Duke’s A, his was a Duke’s B. His was not a Duke’s C. This is the one that’s perforated, you’ve contaminated the peritoneal cavity, probably cancer cells have been unleashed in the peritoneal cavity. He was at a Duke’s B. But we did not put it in the classification. We gave it the anatomical description because everybody classes this differently. We said it had gone through the muscularis and was going through the submucosal layers, but it did not penetrate or perforate into the peritoneal cavity. Some people say that’s a Duke’s C, some say it’s a something or other Z, there’s all this controversy. But we described it anatomically. I said you can call it whatever you want but it hadn’t perforated. So it was advanced but it hadn’t advanced to the point where we thought it had contaminated the peritoneal cavity. Here’s a picture of the cancer with the appendix sitting here. These are all lymph nodes that the pathologist mapped out. There were 40-some odd, as I remember it. We found no cancer in any of them, which was really rewarding.

I remember after the operation Larry Speakes marched us down to the big auditorium there and I kind of felt like we were all astronauts. We had our white coats and our scrub suits still on, operating shoes, and we marched down the aisle. There were 300 and some odd reporters there, flashes going off. We got up on the stage and it turned into a symposium on cancer. It went on and on. Finally I called Larry Speakes over and you can see this if you watch the tapes here. I said, Larry, if he doesn’t get us off the stage, Mrs. Reagan is going to fire the bunch of us. We’re talking out of school here. Don’t get seduced by the press. So he waited for a comment or two more and then he got up. I’m sorry, they have to get back to their patient. We’d totally neglected the President who was up in the recovery room, but Burton Smith had stayed up with him and missed the fanfare.

Then here comes Suffering in Secrecy. Everything that had ever gone wrong with anybody they started, here it is. The President said, I did more lying during this period than the rest of my life all put together. They said, Somewhere we’ve got to get to the bottom of this. There has been an egregious breach of integrity. We probably have no idea what they did. Anyway, they showed all these examples of things that went wrong. Then the next day, Sick Presidents and Bad Doctors. This article went on to enumerate all the people and criticizing people back in the 19^th century when we had no diagnostic—we didn’t know where the bullet was and all that. 

So Healthcare Changes Urged for the President. End of Choosing His Own Doctor. Who was I, who was Dale Oller, who are these guys anyway? I’m afraid this was stimulated by one of the doctors who was marginally involved, from the National Institutes of Health, who somehow fashioned himself as the one who should have been the guy in charge. He was nationally far more prominent than Dale Oller or I. He had trained at Harvard, and the chief of surgery at Harvard called me up and said, Hey, John, you didn’t let this guy operate, did you? I said, No, sir, why? Because, he said, he’s a brilliant researcher but he was the worst operating surgeon we ever graduated from our program.

Anyway, I think he felt that if the president of the surgical societies at large nominated somebody, they would have nominated somebody like a seasoned gastrointestinal surgeon.

What was this doctor’s name again?

You don’t need to know. He’s a friend of mine. Anyway, finally Saturday comes and every person on active duty comes out to say good-bye. Here’s Dale Oller and me, of course, Mrs. Reagan and the President, and the band is playing some Navy stuff. Mrs. Reagan says, John, we’ve got to get out of here, we’re going to cry. So we swept him into the limousine here and drove over to the heliport and off we went.

His recovery was absolutely remarkable. He was ready to go to work that Monday. Mrs. Reagan put her foot down, No, sir. He persevered with his protestations to her dictum. He said, Half a day. Sold. But that half a day I had to make sure because she was going up to Nantucket to visit somebody. She said, You make sure. I want him in bed with the covers on. So I tried to sit outside, just get him in. Let him lie on the bed. John, come in here. We’d talk about humor—the range of things we could talk about was enormous. I was getting this wonderful lesson in political history. So every day I’d go up and just sit in there and talk to him because otherwise he was going to be isolated. He wanted to be out with the Cabinet and where the people were around. 

Everything is going very well, then comes time for the summer vacation. I give him his allergy shot and he says, Boy, next week I’ll be on— I can’t remember the name of his horse. Anyway, this is the group that goes riding. He’s got his horse and he grooms it himself, he brushes it, he doesn’t let anybody else do these menial things for him.

Over here there’s a bell and a post and when everything’s ready and he’s got the First Lady’s horse ready, he clangs the bell and she comes up the stairs and they kiss. He helps her up in the saddle. But Mrs. Reagan put her foot down. No galloping. She tells me, Now you’ve got to tell him no galloping. I’d examined him Monday, we’d gotten there Sunday, and I did remember telling the President at this point I can feel the scarring, the healing, and there were no defects in the line where we’d sewn the abdominal wall together. Unfortunately, I remember saying to him that at this time he could probably tell me how he was doing better than I could tell him from physical examination.

They get on the horses and I get on the Humvee that follows them along with the Secret Service with splints and stuff in case somebody falls off their horse. He gets over a hill from us where there was a straightaway and he couldn’t resist it. He put the spurs to the horse and he galloped. We heard this yell. So we put the Humvee in gear and I expected to see he had fallen off the horse and fallen on his head or something, and all we could see was these little puffs of dust as his horse went whipping down this trail. I knew there was trouble, but I didn’t think it would get to the point that it did. Finally he stopped and waved his arm to join him, and he walked the rest of the way around the trails.

Now we’re up the hill in back of this orange roof here, and they’re putting the horses away and everybody seems to be leaving the area more rapidly than usual. The Secret Service guy with his little earphone here says, Yes, I’ll send him right down. So I walked down, as everybody else is disappearing wishing me the best of luck. I come face to face with Mrs. Reagan, whose jaw is very firm. She says, John, we’re going to have a little meeting here. We’re not all here yet. The President is idling in the barn and you can hear him moving stuff around, postponing as long as he could whatever is going to happen outside because he knows he’s in trouble.

Finally she says, I guess I’ll have to go get him. So she goes into the barn and here he is. He’s immaculate in his short-sleeved plaid shirt and his riding breeches and boots. He came out. He had his hat off over his heart and she’s got him by the other sleeve. Now she says, You stand here, and you stand here. Now, he says—pointing at the President—that you said he could gallop. I could feel the sweat coming down off my bald head. What do I do now? This is the climax of my career. I hesitated. All of a sudden it dawned on me that I hadn’t said he could gallop, but I had said he could tell me how he was doing, how he was progressing better than I could tell him. So that’s how I replied. Mrs. Reagan, yesterday the wound seemed solidly healed, and the six-week period is over that we initially had agreed upon. I wish he hadn’t galloped but obviously no harm was done.

The President started to smile. His color actually came back a little bit and he said, Now Nancy, the doctor and I have been talking that it’s time for you to have a colonoscopic exam.

 With that I was backpedaling. I said, Ma’am, sir, I can’t add any more to this discussion. I retreated up the hill. They stood there and were talking for a while.

It’s a really good story.

Here we are, then in the afternoon we go out and you can see I have a big pair of shears and probably—Dennis [LeBlanc] has one of the chainsaws, we had two or three of them out. Dennis and Barney [Barnett] and I and the President would go out there and clean up all the brush and saw branches that were obstructing a view or a trail that he would like to ride, a branch that might bump somebody in the head. It was a great time because he was one of the boys and he would take orders. Dennis would say, Sir, be careful with the saw. Let me get it started for you, and this kind of thing. He was just a delight, he was just one of the boys. We had many a good time out there.

 I show this picture because when he was in the hospital—anybody who has gastrointestinal surgery has a nasogastric tube that’s in the stomach to keep it decompressed and you can see a little irregularity here. Well, we had this tube taped in there. After we took the tape off, it started bleeding. It crusted and then it started bleeding again. This is very typical, I can speak from personal experience, for what they call basal cell cancer. A benign thing unless you ignore it for ten years at which time it’s eating into your nose and your skull. So I was sure it was a basal cell carcinoma. We couldn’t let it go. It was going to get bigger. We had one of the doctors at George Washington come down one night, and it was just after the Achille Lauro hijacking. Things were a little bit tense, but we excised this in my examining room, snuck over to George Washington Hospital, put it on the freezers. It’s now 9 o’clock at night. We looked at the slides, and we had gotten as much as we thought we could without disfigurement and it looked all right, we couldn’t see any around the margins. So we came back and we sewed it up, put this huge bandage on. He looked in the mirror and saw this big bulge and he said, I look like W. C. Fields.

Upstairs he went, we were going to check him once more, make sure it wasn’t bleeding. Came down and the President says, I know you won’t say anything, but Caspar Weinberger and George Shultz just had me on the red line and they know that these hijackers are on some Israeli airline or something. We know we’ve got them and there’s a carrier in the region and I made the decision, yes, bring that plane down and we’ll get those hijackers. That’s how they got them. He made that decision at probably 10 o’clock at night after undergoing a lot of this stuff. We didn’t have to give him any sedation or anything of that sort. But he was very decisive. He made that decision with these other things going on his life without any difficulty at all but had to share the information with us and swear us to secrecy. He said, We’ll have a press conference at 2 in the morning and we’ll reveal it. By this time it’s midnight. So anyway, that was a minor thing.

Of course, the press made absolutely as much of it as they could. Here they are. Obviously one of these fellows is Sam Donaldson. When we said we had to go back and we were going to have to evaluate this thing again, Sam says, What a good doctor. Dr. Hutton botched the job. Only Sam could do stuff like that and still think he was your friend. And Marlin is saying, What the devil are you talking about? We ultimately did take him out to the hospital and swing a flap. It’s nicely photographed, it’s a wonderful teaching tool. I never say who it is, but we swung a flap. We had to take a fairly good-sized divot out of his nose and swing this flap over and we put the most God-awful bandage you ever saw in your life. It’s a very difficult place to bandage, the nose.

Anyway, being very forthright, I had put the worst bandage I’d ever put on anybody, and I made it worse by trying to disguise it. So when the press—and meanwhile, the specimen was over at the Pentagon. I said, I need the slip for the doctor to carry it over there. So we had a nurse race across town, come back, so that I could then make a pronouncement that it was clear, the borders of this were clear. Then he got right up there, you can’t see this bandage, but he said, I’ll do a service to the community if I tell them, ‘Kids, use sun block and don’t bake yourselves alive every summer.’

Then things quiet down. It’s time for Mrs. Reagan’s yearly mammogram. The only trouble is it’s not yearly, it’s 14 months. We take her out, and I don’t know why I went with her. Usually a nurse used to go with her but I went with her. There are three little white dots here, pathic pneumonic, we say, of trouble. I knew we were going to have to biopsy this and it was probably going to be a carcinoma, not 100 percent. I went in. She was still on the X-ray table, the mammogram table, and I said, Mrs. Reagan, we’ve located a highly suspicious area. It’s very small. If there’s any value in mammograms, this is where it is with the early pickup of something that nobody would ever, ever palpate. No tears, nothing. She just sat there and said, What do we do next?

I said, I think this calls for a biopsy. I’ll explain to you the various options. We have to get it biopsied and there are various ways. She was very familiar with it, I wasn’t telling her anything she didn’t know. She read a lot, and she’s very bright, incredibly bright. She said, Now that it’s me and not the President, I’d like to call Ollie Beahrs. Ollie Beahrs is one of the great men of the century in surgery. At one time for instance, he was fast enough that he could do 12 operations of some magnitude in a day—now that’s with help, with residents opening the abdomen and closing it and he’d go from room to room. He was well known when he was a medical student at Northwestern because he always had been a fan of prestidigitation. Now there’s a word that describes a magic man and I can’t ever remember it, some kind of a fancy Latin or Greek word meaning a magic man, but I used to say prestidigitation. He used to put on shows for Mrs. Reagan’s mother when she would have a social event. He would come in for 15 minutes and make rabbits come out of hats and all this kind of stuff. 

One time, I became his fall guy. We were at one surgical meeting and he got me with my dress blue uniform on and with a hat on, a high hat. He got me holding a funnel under my elbow and all of a sudden he’s going like this with my elbow and water is running out of the funnel. It was really amazing, and he never would tell me how he did any of this stuff.

He came to our medical school a couple of times and he always had to get me something. The Secret Service agents would back up against the wall because he was known for having gotten a firearm away from some policeman once, and they were all afraid he would have their handcuffs or he’d handcuff them or something.

So I called Ollie. Ollie has a high squeaky voice, and he said, Oh, John, I’ll be on the next plane. So Ollie came to town and we had a meeting, and we decided we would schedule it in ten days. We had a big American College of Surgery meeting, and she had to do something with the Just Say No. We had assured her that this was very early and we could wait ten days with no issue at all. When we explained it to her she said, I want a mastectomy. We said, Now, the more conventional thing is to do a lumpectomy. She says, Listen, I know a little bit about cancer. What do I need a breast for, number one. Number two, I know about multicentricity. If you have a lump here you may have a lump there in two or three years. Why not just take all the breast tissue away?

Perfectly logical. I said, I think if it were my wife, that’s what I would say. Because I’d always be afraid that more would crop up somewhere, and this way you don’t have to go through chemotherapy, radiation, and all this other stuff. People who have a lumpectomy have to have a fair amount of radiation because sometimes when you’re doing a lumpectomy you don’t know where you are down there and you may cut the thing right in half. As you trail it through the wound you drop off malignant cells. They can apparently sterilize it with the radiation. 

At any rate she said, Well, John, let’s go back. Finally we got somewhere. She said, You’re going to have to tell Ronnie. Again the why me internally. So we got back and as we’re riding down the George Washington Parkway from near the hospital, she asked me a question, I couldn’t even—my voice had failed. Get hold of yourself here. I had trouble talking. This is a very brave moment in life.

So we got back and she walked very straight ahead and said hello to everybody, knowing she had cancer of the breast. She went upstairs and I went toward the Oval Office and Jim Kuhn, my great friend and the President’s great friend, said, John, what do you need? You need to see the President? I said, Yes. He said, It’s bad, isn’t it? I said, Yes. He looked through the little peephole and there was nobody in there, so in I went.

The President had one of his yellow pads and he’s writing. He looked up and said, Sit down. I said, No, sir, I’d rather stand up. He said, No, sit down. While I was sitting down, a fellow named [William] Fitzpatrick, one of the photographers, came and took a picture of me sitting across the desk from him, telling him that his wife had cancer. I’ve seen him taken aback, but he was stunned. He absolutely couldn’t digest this information. While his mind was trying to come to grips with the fact that this was his Nancy, he summarily dismissed what she said. He said, I know you doctors will take care of it. It was totally, totally out of character. It was just more than he could really understand.

So I left and went upstairs. Mrs. Reagan said, What did he say? I said, Mrs. Reagan, I might as well have hit him with something. He really was stunned. He’ll probably call me over a little later in the day and ask for more information about options and all that, which he never did. So I went up to see how she was doing, and I was up there when all of a sudden he was ahead of schedule, I heard the buzzer and out he comes. She knows that he knows, he knows that she knows and he brought up some presents. People are always bringing things. She put them aside, and he gave her a very warm embrace. Well, how are you? It was as if there was no issue at all. It was the ultimate in denial for these two wonderful people. His Nancy was now in the same jeopardy that he had seemed to live through.

The next morning he gets off the elevator, the buzzer rings in my office, and I open the door and he says, John, I wish you’d stayed here last night. I said, Why, sir? He said, Because I needed a good kick in the rear end. I said, Sir, what makes you say that? We never discussed it, we never discussed it.

He and Mrs. Reagan never discussed it?

So I went up and said to Mrs. Reagan, He was so apologetic this morning. And she said, He’ll come around, it will be all right, and of course very shortly thereafter she made the decision she wanted to do it.

Did you get the sense that she was hurt?

No, not at all. I think she realized that he was numbed by this. Anyway we had her in the hospital, we took her out Friday night. We were going to do this Saturday when we could get full attention, close all the other operating rooms. Dr. Beahrs brought the chief surgeon at the Mayo Clinic, Ollie being retired really from operating, and they brought in an anesthesiologist and a pathologist. It was a team of six. It was just a routine operation, took 15 minutes. Again, no nodes were found. Mrs. Reagan was just wonderful, how she came through this thing. Of course he was there and in his own book, An American Life, he describes, he knew we didn’t know for absolutely sure that the biopsy was going to be—we’d biopsied it, yes, and it was malignant.

When Ollie and I went back and told him, he thanked us and he really sort of collapsed. He sat down in a chair. He needed to be alone or in a woman’s hands. I walked down, and Paula [Trivette], whom they loved immensely, was one of the best nurses I’d ever had any experience with. I said, Paula, you’ve got to go back there and put your arm around him. She did and he describes this, you’ve read this I’m sure, how he says, she brought hope into his life. He said, It raised me from a bottomless pit, or some kind of a pit, he used the word pit. Dick Davis is over here sitting on the side, not knowing exactly how to interplay with this. Anyway, Paula saved the day.

Once again, after the operation, she didn’t have to stay in the hospital very long. She did very well. But it was an example of a man who was still deeply, deeply in love with this wonderful lady.

This is the picture that Fitzpatrick took. I’m trying to tell him that—there it is after the operation.

Then the press again. Early detection, we were great. Then Mrs. Reagan’s surgery controversial. It goes on to say we set back treatment of cancer ten years.

Because of the mastectomy?

Yes, because everybody was doing the lesser, and everybody was into the mutilation.

 Anyway, final topic here, Entourage heads for the hospital. The President is having trouble with his urological tract. He’s very candid about it, he said, Gee, there’s something wrong. We decided to get the Mayo team because Dr. Smith was then the Physician to the President. Dr. Smith had different concepts of how to take care of his hematuria, a little blood in the urine, which were not up to date. I explained this to Mrs. Reagan and she said the tactful thing to do would be to get Ollie and Dr. Utz, the president of the American Urological Society, to come and sit in.

Because I suspected that it might be a cancer in his prostate, the first thing the press would say is that it’s from the original colon and now it’s spread to the prostate. A speculation that probably wasn’t going to be true. So we did this with some chicanery or whatever you want to say. The President thought this was kind of fun. We had these doctors coming into town. They brought their own equipment and stuff and we had a Saturday afternoon event at the Naval Hospital. The press were wondering why we weren’t at Camp David, and we didn’t say anything. We got the whole team from the Mayo Clinic. They came in two at a time through various exits. [chuckling]

The President said, This is better than the CIA [Central Intelligence Agency] could do it, I bet. We had a big conversation and the next afternoon out to the hospital where he did a transurethral resection, which is—Lord knows most males probably have some experience along this line if they live long enough. No cancer. Nothing. The President once again told jokes all the time they were doing it. They did it under spinal, but he was constantly—it was almost like poor Dr. Utz couldn’t really work his instrument because he was always having to stop to laugh a little bit or something. It was a delightful event. The President made very light of it, and again, his recovery was absolutely remarkable. That was his last event except taking the Dupuytren’s contracture, which was a nothing.

There it is, Mrs. Reagan liked that one. He said, I don’t want to go in a wheelchair or a litter, I’ll walk down. So we walked him down from the VIP suite. Al Smith is on the far side and here’s Jim Longbaugh, the fellow I told you died after a parachute jump. He came to the hospital and I’m in back with Larry Mohr. I used to take every opportunity to let the President have his picture taken with some new faces.

Anyway, he walked down and there we are. This is probably the only time the President has ever photographed—this is the Dupuytren’s contracture that had his finger caught over like this. This is very close to the end. There he is, his hand dangled up there and putting a cast on. Then the press again: Visibly aged and hurt…. Where they get this visibly aged business I don’t know. Many Americans sense that the nation has been out of control. Now this is the people. The press is attributing this to some sort of a majority opinion it sounds like. Little do they know that they also came out with this about the same week, World Run by the Soviets.

Here’s the big bear of Russia. And here we are, first trip to Moscow. Remember how I told you yesterday, the way they followed us there, they honored people. They look very snooty, don’t they? I’m the same size as President Reagan. I mean, look at the size of these people.

Here are the crowds as we’re going to town. Everybody in Moscow seemed to be out. There they are down at the bathhouse, they’re trying to speak just to each other. Remember the band is playing Russian music. Here are the two of them. You can tell they really have become very fond friends.

Here, I remember, our top F16 pilot is the fellow holding the umbrella over Gorbachev.

Here we are, Bush is being nominated, and they’re still yelling to President Reagan, Four more years.

Here we are heading down the way, I’m back up here hiding on the steps but I got on the helicopter afterwards. You commented about the helicopter yesterday. Somebody asked me a question. Here, as you can see, his bandage on his left hand, but here we are taking a spin over the Capitol and I was able to take this picture.

You took this photograph?

Yes. I think I did. Now, one day—this is while he was still President—he gets a call from Washington on the red line so all the golf carts come in. A perfect day, it wasn’t really cool but it wasn’t hot either. Everybody went inside, and I sat out there and said, Geez, what a scene. The [Walter] Annenberg estate. He came out and went through this. I never knew it, but he staged it, took the picture, and afterwards I remember Ambassador [William A.] Wilson going by and saying, You all right? I didn’t know he was poking a little fun. I said, Certainly I’m all right.

What does the quote say?

It says, Look at the pain I’m in, John. Can’t I have just one aspirin, please? A week later I found this on my desk when we’re back at the White House.

For the record, it’s a picture of Dr. Hutton. Are you taking a little snooze here?

I’m sound asleep.

He’s snoozing in a golf cart and the President is sneaking up behind him with his hand out, hat in hand.

As if he’s in terrible pain. Anyway, he fell off the horse and that led to the—this is what they call subdural hematoma. This is what we found. He had a very minor one, it was on the opposite side, but he was back in LA. You can see the compression of the ventricle. This is going to become symptomatic that it will get bigger. This is where we decided we’d better do a burr hole. And the newspaper: Undergoes Brain Surgery. 

Remember my telling you he took his hat off, he’s holding his hat. The real cover-up was when Mrs. Reagan didn’t want anybody to see—and kind of admonished me afterwards, Why did you let him do that? I said, Ma’am, I didn’t really encourage it—

There they are riding, just a shot or two up on the hills. Here he is when she would jump off the horse and leap into his arms.

Here he is, 1994, he’s giving a speech where initially he was lost. Larry Altman went back and he got that film from the press. He ran it by and he said, I don’t see what you see. I said, That’s because you don’t know him. You couldn’t detect his faltering because he did get on track.

Is this his last public appearance?

Yes.

It was.

There’s the closeout. See how well he looks. Would you say he had gray hair?

There again, that was my office and if he was waiting for the caravan to take him someplace, he’d always come into my office because he knew there was always something interesting to talk about. That’s it.

Why don’t we take a little break and we’ll resume questioning later.

I think Jeff has a few questions he’d like to ask, so let’s begin there.

I’d like to get some information down about the office, the White House Physician’s Office, but before we get into that I wanted to ask you a quick question. You showed us some pictures over the break, one is of you and President Reagan and Prime Minister Margaret Thatcher. You said they were really close friends and that’s a relationship that’s commented on frequently. I was wondering if you had anything you could add, for history’s sake, on tape as far as the relationship and how close they were as friends.

I think she thought he was the ultimate in government. I think she was bright enough to realize that within his body was a great genius and he seemed to know how to handle himself in almost any situation, to come out and do the right thing and say the right thing. They had this enormous mutual respect. I think, if we look at it, the two of them were really the major factors in convincing Gorbachev that we weren’t really hostile, we meant nobody any harm, we weren’t trying to take over anything, but it was his predecessors who had seemed to want to bury us. Who was it?

[Nikita] Khrushchev.

As Khrushchev had said. I don’t think either one of them could have been influential. I think the sum of their intellect and their histories really would overcome almost any problem. She was Prime Minister for what, ten years?

Eleven years.

That’s staying power. I can’t really answer your question, because it doesn’t hinge on anything medically except I remember the day that picture was taken. I was back in my civilian clothes and I can’t remember her name but she used to be in charge of the Blair House where all the dignitaries would stay. It was across the street. She said, Dr. Hutton, Mrs. Thatcher’s been up all night on the plane, she’s got a sore throat and thinks she’s coming down with something. Would you come over and examine her?

I said to little Joanie Huber, a little redheaded Navy captain, Joanie, get one of the doctor’s bags and get some antibiotics, let’s get some decongestants. She threw it in the bag and we went upstairs and this gal’s name, Bunny something? She took us around the back. I didn’t realize that the Blair House was a series of houses that looked like independent townhouses but they’re all hooked up. We went in because the press was all out front. Up the stairs, in this great drawing room, were a chair and a table and Mrs. Thatcher. I asked, What do I call her? Do I call her Madam Prime Minister? That’ll do, but I think she likes to be referred to as Mrs. Thatcher.

 We went up. If this were any other head of state, at least that I was associated with, there’d have been a huge crowd, their equivalent of Secret Service, let’s say it was from Germany or something, a big crowd. She traveled with two people, two assistants who carried the papers and whatnot. She sat there all alone, and I went in and she’s sitting in the chair. I said, Now let me examine you. I felt for lymph nodes in the neck and Joanie gave me a tongue blade and I said, Now I’m going to ask you to say ah. You know, I don’t know why we ask people to say ah, but just stick your tongue out. I looked in there and it was all inflamed. She was coming down with a respiratory tract infection. So I said, There’s nothing we can do to thwart the virus that you picked up, hopefully not in this country, but I can give you something to make you comfortable. I took her blood pressure, which was fine. I said, During the daytime, this is called Sudafed and it tends to be a decongestant, it tends to make you a little bit more active too, it’s a stimulant. Then at night we’ll give you some Actifed, which has some Sudafed in it but it also has an antihistamine to sort of dry the secretions, and it has a sedative-like effect. So I gave them to one of her attendants.

She said, I have to give two speeches this afternoon. I said, Well, I brought some lozenges along called Cepacol. Oh, she says, That sounds scientific, I’ll take those. So she took her Cepacol lozenges and had an eventful day or two. I think that was her last trip to the White House. Mrs. Reagan always used to object because she said, Ronnie gets to sit with her and I have to sit with her husband.

That’s great. As we talked about earlier, there’s not much out there on the White House Physician’s Office so I was hoping you could just begin with a general overview of what the office is made up of and what your role is as White House Physician.

There didn’t used to be anybody there and then some years ago they did have somebody who was at least known as the Physician. You would call if any trouble came. As the government became more complex, the White House became more complex with more people and more fighting for office space and somehow or other somebody thought that there ought to be somebody there all the time. Back in Woodrow Wilson’s time there was a fellow named [R.T.] McIntire, I think that was his name, and he was a cover-up specialist. He was an otolaryngologist, which was probably inappropriate, but he knew that the President was at times totally out of it, and he had a stroke and continued to have minor strokes.

This is FDR?

No, Wilson. Yet he kind of clouded the issue. Wait, have I got the name wrong? One is [Cary] Grayson and one is McIntire.

I thought Grayson was Wilson.

I think you’re right. I stand corrected. Anyway, it got to be where the doctor had an office there and was in residence. He didn’t stay there at night. Then as the travel increased and they realized they needed to have coverage, it became the unit it is today. Half the nurses were always out in the city we were going to tomorrow, looking over the medical facility, getting to know people, who were their first responders. We had a plan called the capital plan. In every city we had certain designated doctors who we knew practiced the highest type of cardiology or trauma.

Was that your job to select these experts around the country?

Yes. I gathered all that. A Fellow in the American College of Surgeons, whose name escapes me now, was the one who suggested it to Dr. Ruge, and he had started it. Dr. Ruge put it in a desk drawer and didn’t pay much attention to it. When I saw it, I thought this was absolutely what we need. I embellished it and we got more and more people. I belong to the National Trauma Society so I knew who was who in various cities. Then it really got formalized. These nurses would go out, tell them that the President was coming, etc. Would they either shut down their practice or make sure one operating room was dedicated to the President, with nobody else in it, check all the equipment, that sort of stuff. Then when we landed they would meet us. There would always be an ambulance in the motorcade. They’d ride in that. So it became a very systematically efficient and very careful, thorough group of people.

How large is the staff?

There were four nurses and most of them had a master’s degree in critical care or something of that sort. They were all certified in the critical care area. We had four corpsmen who were inhalation therapists and would help us when we would do the histories and physicals, the drug testing. Then there were four doctors. I don’t know what they’re doing now but I insisted, and with the approval of the President, that they all continue to practice medicine. They didn’t all have to be sitting there all the time. He felt very strongly, If you think I need to have three or four doctors hanging around all the time, I probably shouldn’t be here.

Were you all military?

Yes.

Everybody’s military, the nurses—

Yes, that was when I was there. When Dr. Ruge was there and Dr. Smith was there, of course, they were not.

Did Reagan’s role as Commander-in-Chief have any effect on the medical staff all being military?

No, that just sort of evolved, and everybody who came along just accepted it for what it was. It came out in the paper, the Staten Island Chronicle or some paper in Staten Island that he—somebody asked George Bush what he was going to do about the medical unit. It had been very prominent and very necessary during the Reagan administration. He said, I’ll go with the military, I don’t need anybody else. He didn’t live up to that. He got a fellow named Burton Lee.

I didn’t know Burton Lee at all, but I had gone into his office about three weeks before the inauguration and said we had some superb military physicians who can dedicate themselves, they don’t have to worry about giving up a private practice. I have to move on, but the people we have here now I would advise you making sure that they stay. He saw what I was talking about and made the same mistake as was made before by getting a fellow there who was not there to take care of the President. He said, I’m here to help establish medical policy. He told me that. I said, Admiral Koop has taken care of that situation. It didn’t turn out very well.

Do you know, has that problem happened in other administrations as well where the Physician sees himself as a policy advisor as well as—

No, because the majority of them have been military and don’t have any agenda other than hoping that they’ll get to be an admiral or a general, something of that sort.

Who did you deal with most often within the White House? For instance, if there was a trip coming up would it be the Advance Office?

Yes, the Advance Office. The one thing that President Reagan had the ability of was gathering a very collegial group. Everybody knew who everybody was. We supported the people in the Advance Office when they went off on a trip and got diarrhea. We were really there for the whole shooting match. One trouble that I tried not to relate with was the Military Office. They have about 2,000 people, communicators, the signal, because when we would go to a different town they would wire up a whole internal set of telephones in the hotel. I would pick up a phone and a guy would say, White House signal. I would say, Get me so-and-so, and they would get them or page them. It was independent of the hotel phone system, so we could have some security. We took care of everybody.

There were times when people, the press, our enemies would need some medication and we’d accommodate them. We were there for everybody. The press people forgot our good nature very rapidly if it was to their advantage.

This may sound like an odd question, so if it is just dismiss it out of hand. When you would have to operate on the President, basically his life is in your hands, is the Secret Service in the room there?

Yes.

Are they watching you essentially or what?

No, they wouldn’t get close. They were good, bright people. Most of them had master’s degrees in something and they would stand one on one side and one on the other side, and if there was an amphitheater they’d be up in that looking down. No, they didn’t try to look in or make sure we’re not leaving sponges in there or something.

Right.

No, they were very good about that.

Were there particular individuals in the second term on the White House staff that you were especially close to, a Jim Kuhn or somebody like that?

Ken Duberstein and Jim. I can’t believe that Jim Kuhn’s got a daughter in college now. I remember when she was just a little tot running around up there. As I say, it was a wonderful place, everybody was so friendly. He stimulated that sort of thing. I couldn’t cite anybody over anybody else. With four doctors that’s plenty of people to keep the conversation going and the nurses were all very highly qualified. The President really appreciated their efforts.

During your four and a half years in the White House there were a couple of extended visits to the hospital for Reagan. I’m sure there was discussion within the White House, within your office, about invoking the 25^th Amendment. In those discussions who had control over whether the amendment was invoked? Was it more a political decision or was the decision made by your office?

No, I would advise them that the President would be incapable of normal neurological or electrical function for eight hours after some sedation or eight hours after the surgical procedure. I told you yesterday, didn’t I, how in spite of that Don Regan came in and had the President sign over that he was going to reassume the office of the President when he could hardly write his signature. And I went outside and called Vice President Bush and told him, You’re not off the hook yet because he really isn’t terribly responsive.

I guess that was really what I was trying to get at. Was that generally the case, that decisions by the top White House staff generally trumped the decisions of the medical staff?

Yes, but I always knew a way to get around it, but I didn’t when they didn’t tell me they were doing this. If they told me I would have said, It’s against my advice and I feel that the Vice President should know what you’re doing. I would have said something. But the Chief of Staff is an important guy, and it’s interesting in these movies that they have about the White House, the Chief of Staff is usually depicted as a bad guy. Did you see the movie Dave? The cleverness in that movie. But remember the fellow who was the Chief of Staff who was trying to take over and they finally gave him a trouncing at the end. All of his friends left when they realized he was through. The Vice President was going to be the next President. I think I enjoyed that movie as much as any I have ever seen. There were times that it brought back—they did so well with the architecture and talking about the tunnel, which nobody was supposed to know about. You could hear the jackhammers going, they were creating a tunnel while I was there, and everybody talked about it of course.

We also had a dental chair down one flight, down toward the underground meeting room. One day the President was going to have something done to his teeth, a crown put on or something, and a Navy dentist came. I would periodically open the door and look in. There’s the President with his mouth held open and his hands are just white, and the guy is buzzing away. He isn’t saying a thing. The guy is just sitting there. I said, God, he looks like he’s in terrible pain. Well, anyway, he sat through it, came up and walked upstairs from the dentist and stopped in and said, We’re all done for the day, we hope. The dentist then took one of the nurses down. If he’s going to be there all day, he might as well take care of the nurse too. She came up and her face was enormous. I said, What the devil is the matter? She said, He kept injecting me and injecting me and injecting me, and it hurt and it hurt and it hurt. Finally I think he just abandoned it.

 About a week later the phone call comes from the Naval Hospital to take that lot of xylocaine and destroy it, that it was all either too old or it was just saline, and the President just put up with it, but he got no anesthetic. Tracy Malone was the nurse and she said, God, he just couldn’t seem to get the anesthetic to work.

He never complained.

He never said a word. He could put up with a lot.

To follow up with what Jeff just asked, I don’t think we’ve gotten you on the record about this proposal to firm things up in terms of who decides, who actually makes the call regarding disability.

There’s a book and that book ought to be in here someplace, and the fellow who authored it is down at Wake Forest. For three or four years they’ve had an annual meeting where they discuss this and it’s never gotten through, it’s never penetrated into the working of the White House. So the next time we’ll go through the same dither of who makes the call.

They asked me that. Suppose you thought that Reagan had been incompetent, had had a stroke, and the Chief of Staff came in and said, You’re not to breathe a word of this to anybody. What would I have done? I said, I probably would have had a very interesting ride across town to try and get the Speaker of the House or the Senate and tell him, because I felt my obligation was to the Constitution and not to the Chief of Staff and the White House. Then I got thinking what a great movie that would make with the doctor—with a chase across Washington, D.C., with the Secret Service after him. The good guys were after the good guy. But it’s something that just never—

Now, Larry Mohr, when I left, and the senior President Bush came into office, he went over. He somehow got Dr. Burton Lee to come over with him and try and address this with the President. I think that even made a little piece in the paper about this discussion, but it never was really formalized or written into any code or anything of that sort. Certainly with President Clinton he just took it and set it aside, or gave it to Connie [Mariano], who was the one who authored it, and it’s in her drawer. So it never was really taken to heart, which is too bad, because the provision is there. But it’s just, who is it? It can be the Cabinet voting that he’s incompetent. Can it be the Vice President? Well, he mentions the Vice President can make such a move and try and get the Cabinet or the Congress behind him. But it’s like a ship, what do you do on a ship at sea, in the Navy, when the commander is going off his rocker, so to speak, and nobody really knows who’s the one who does it but it’s usually the second in command who will go up and relieve him. Of course, he can turn around and relieve the captain.

There’s a precedent in history for the underlings usurping the right to choose their own commander, but it’s a very rare thing to do because if you fall short, you’re through. Some people in the military have taken that chance and paid the consequences. Like the young captain in Korea whose superior told him to go up and take a hill or a ridgeline or something, and he knew it was an annihilating task and he didn’t do it. They were going to shoot him, and President [Harry S.] Truman intervened because the guy saved 180 lives by refusing to do something that had no chance at all.

As a former White House Physician, what general changes would you make to the office?

I would arrange the office so it would be very much like it is now but they would have at their beck and call five or six nationally renowned specialists: psychiatry, neurology, surgery, internal medicine, cardiology, and I can’t think of anybody else, but those for sure. They would convene every year and review the President’s medical history since they’d last been there, be part of the examining group. Do that at the Naval Hospital or at our medical school. Publish the results so that the people in the country realize that we really were on top of this kind of thing.

Yes, something could happen between the yearly visits, but this would be a body that was recognized by the Congress as being consultants to the Physician to the President, and they would have that special immunity that the Physician to the President could call this august group to come and weigh in on a decision of competence. I think that would solve the problem, but then again, the Chief of Staff is a very powerful individual. He may try and convince the Physician for political reasons that it would be unwise. If something had happened to President Reagan, would it have been unwise for Gorbachev or Khrushchev or somebody of that sort to know that he was now a lame duck. There are so many things that go into this that it’s a very intricate, convoluted, decision-making process. You just wonder how on earth you could make it foolproof and you can’t. There’s no way you could do that.

I’m interested in this question about disclosing health information. There were occasions when you opted to protect particularly the First Lady’s privacy, perhaps even President Reagan’s sometimes, I’m not sure. But I was wondering if you could just address that question, how much information do you feel—

The President wanted me to be very forthright. He thought Eisenhower was and there was that one time when, before they got him to the hospital the press asked his physician, Howard Snyder, what was wrong. He said he just had indigestion, until he could get him into the hospital and until he could get Nixon on line and have all the bases covered so that there wouldn’t be some kind of a panic on Wall Street.

Twice while we were on Air Force One the President came back and said, John, take my pulse. He said, All right, am I still alive? I said, Sir, why do you ask? He said, There’s a rumor in Singapore, I think it was Singapore, some financial capital of the Far East. The rumor is out that I’m on Air Force One and I died. I said, I’d get on the phone and tell them there’s no such thing. You can see where somebody might—one of these Enron type of geniuses might say, Here’s our way to make a fast buck, we’ll just do an anonymous call and it will start a ripple that you won’t be able to stop until we’ve got our pockets full.

 So what was the question that got me on this?

About openness.

He wanted me to be absolutely open. He never told me not to say anything. He said, You just tell them what’s going on.

There was a report, I don’t have the newspaper right in front of me, but right around the time where you take over as head physician, late 1986, when Mrs. Reagan allegedly called for some new rule for the Physician’s Office, that only the press spokesman was allowed to divulge medical information. Is there any truth to that?

Absolutely. I don’t think the doctor has any business, for his own aggrandizement or to get his name in the paper. No, I agree with that. I would always ask Mrs. Reagan, Is it all right if I talk to Helen Thomas? ████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████████

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But I agreed, because I had been so often misquoted, not in abundance, it was such a relief to say, No, it has to come from— We’d always type it, post it on the bulletin board, so everybody had an equal chance to get whatever the message was, and we controlled it that way. I don’t remember her ever telling me that. I think she just assumed—in fact, I might have even suggested it. I’m not sure, because I certainly got tired of talking to them.

Unfortunately, they know most physicians are not rude and they don’t know how to handle rudeness. They tend to be able to be imposed upon. I think she was trying to help us protect ourselves too. I was delighted, because then I could say I’m sorry. I’d come from my office, past the press room, it was like a moth caught in a spider web. They’d all rush out. Chris Wallace, How’s he doing? What’s this we hear that such-and-such? I’d say, It’s nonsense. It was so much easier to say, I’m sorry, you have to talk to Marlin if you want any information. That saved me. I was very grateful. I didn’t remember her—I just remember we kind of started doing that. I thought I’d thought it up, but she may have said something to me about that. I remember they were always trying to pick on the nurses who were good-natured, lovable people. Just say, I’m sorry. If they wanted to interpret that as hiding it, well, that’s—

Do you think it would help to have the position that you held subject to Senate confirmation or would that be more of a burden?

Probably every Senator would say, I want some guy from my district. I think you’d find yourself cluttered with nominees. I think if they just kept it to a rule that it would be a military physician who had held the job of chief surgeon or chief of internal medicine or chief of cardiology at Walter Reed or at Bethesda, somebody who was nationally recognized. The one thing I did bring, I think, was an element of national recognition because I was recognized as a vascular surgeon and as a trauma surgeon. Everybody in every city certainly knew who I was if they were in those organizations, which were the ones we were interested in. I think it should be somebody who knows his way around. Lord knows, to have a President in a strange hospital, someplace where you don’t know who’s who, even with all of the protection that went on—the President was at George Washington, one doctor who nobody ever checked, who had no business being in there talking to the President, made his way through.

Just wanted to chat?

I guess he just wanted to think he had been named as a consultant. People’s personalities change when they’re put in a position like that. I used to have to say to some of them, Please don’t try and take over here. But they do.

I met so many people. My neighbor was being seen by an orthopedic surgeon somewhere around the District of Columbia. And in introducing himself he talked about how he was a consultant, helped take care of Reagan. She said, Oh, then you must know John Hutton, my neighbor. He immediately changed the subject. It’s amazing. The number of people who say they were in the emergency room when President Reagan was brought in. The Secret Service just let the few doctors who knew what they were doing in there, and then they didn’t let anybody else unless the doctors requested that somebody else come in. It’s a difficult situation to control.

Did you notice, to switch gears a bit, the President’s mood during the Iran-Contra timeframe when you were there? There were some reports that there were occasions when he was uncharacteristically down, feeling besieged. Did you ever notice anything like that?

I remember when he came in to get his allergy shot we asked him how he was doing. He said, I didn’t sleep very well last night, which was uncharacteristic of him. He said, I think I’ve got a case of the Iranian flu. I never saw him depressed or dejected. The only time I saw him look like he couldn’t handle it was when I told him about his wife. In other words, if I had been isolated from the news and I didn’t know about Iran and all this stuff, nothing would have alerted me that he had any depression. He was an incredibly and uncannily stable individual. Just like I never saw him really get upset.

If I were he that time when he didn’t know that the White House signal officer sitting there like that had the key on. The famous time he’s out at the ranch and he said, Ladies and gentleman, it is now five after twelve and the bombers have been released and will be on target— It went down to the White House press office in Santa Barbara and everybody thought it was hilarious, they all hooted and hollered. And there was one female reporter who was new and said, Here’s my chance to get a byline. She blew it out, then everybody else did the same thing and the poor guy almost got—but he was kind of unfazed. In fact, he did it again.

He did?

He told an ethnic joke, over in Italy, almost the same setting. I can’t remember the joke, it was about an Irishman. And the joke was on the Irishman and he’s Irish, and they all said, Hey, you can’t be doing this. He said, What do you mean I can’t be doing that? I’m telling a joke on myself. But somehow it got out. I guess he could have let it ruin his trip to Venice and his trip to see the Pope, but he didn’t let it faze him.

Did you ever see him in situations where he would interact with his family, I don’t mean Nancy Reagan but with his children? There are these reports that there was some distance there.

If there was any distance it was on the part of the children. No, one of those times I was sitting with him talking, after his operation, his son called and they had a very pleasant conversation.

This is Ron, Jr.?

Yes. There seemed to be an estrangement somewhere along the line. I couldn’t say where it started or why it started, but I told you about when he started wearing his hair like Tiny Tim. His father told him, I have a good barber. But he didn’t say any more than that. After he left he didn’t say, What a kid. I would have said something were it my son. I would have physically cut his hair off. But he’s a man of great equanimity. I never heard him say anything disparaging or derogatory about any of his children. He did say, Well, gosh, I wish that Ron had stayed at Yale and finished, but he didn’t. That’s when he saw the Joffrey Ballet and said, This is for me. So he went down and carried stage equipment around. He was kind of a reserve. If somebody got sick he might get on the stage or something. He wasn’t bad. But he just regretted the fact that he didn’t follow a more standard approach to life by getting a college degree.

Did you ever hear him talk about his parents?

Oh, yes.

You mentioned a little bit yesterday about his father and alcoholism.

He was a very temperate and abstemious individual because he said, A sad day, the day when I was 12 I had to go out and help my father, get him in the house and put him to bed. That had a profound impact on him. He often talked about his mother as being marvelously loving. A lady, he credited her with being the intelligence in the family. He said, She was really the one who taught me what my standards are to this day. When he talked about how she started becoming senile, probably Alzheimer’s, in the old days everybody had a senile psychosis, now they have Alzheimer’s. It’s exactly the same thing we’re talking about. He would refer to his mother in endearing terms.

Did you go with him on the trip to Ireland? I don’t remember what the timing was.

No. One of the trips he took, I have three collapsed disks in my back, and I don’t know what I was doing but I got put in the hospital. That was when he went to Reykjavik, I guess. So no, I’ve never been to Ireland. I’ve been to London a few times with him, but I—

I was just wondering about his reaction to his Irish roots, going to the town one of his ancestors had left from.

You saw more of his personal side than most people get a chance to.

I think I was a little closer to being one of his family than most others, but there were a lot of people in his family.

There’s this public image of Reagan that historians have drawn over the last ten or fifteen years. What have we gotten wrong about his personality? What is there in his personality that we in the public haven’t really understood as someone who knows him might?

Most of the people who try and write about this write that he’s distant, and mainly it’s because he didn’t sit down and have time to talk with a lot of these writers and spill out his whole life. He was an extraordinarily busy individual with a lot more on his mind than talking about himself. The fact that they said he was distant, he was far closer to many people than anyone I’ve ever known. All of his staff, for instance, and all of his friends in California.

I remember one day, it was the day he’d been elected for the second time. I expected that to be a thriller, that we’d be sitting there watching the big board, the red states and the yellow states, or whatever the color scheme was, I’ve forgotten. We were at one of his friend’s homes out there in Bel Air. Jimmy Stewart was there, everybody was there. Poor Jimmy Stewart was getting, he was at the stage, his poor wife would come around, Have you seen Jim lately? Well, we thought we saw him. She said, Gosh, he’s getting lost again. He was getting a little confused, I guess.

The states were colored, and they were all going whatever the Republican color was. By 9 o’clock it was over, so everybody had a big hoot and it broke up the party. Everybody went home and he went over to the Century Plaza where the crowd was whooping it up. It was like a New Year’s Eve party. Following him along in the crowd was an actor—Forest Tucker.

From F-Troop.

F-Troop, that’s right. You could tell he was getting fed up with just being jostled in this big mob of people who were trying to keep step with the President. He saw me sitting over there looking bored, and he sat down next to me with his wife. I introduced myself and he introduced himself to me, and I said, During World War II you worked in a signal outfit that was run by my father-in-law, Morris Joyce. Joyce the voice! he says. Sure, I remember him. Say, give me your program, I want to write a little note to him.

Then he got to looking at the President. He says, Look at this man, and look at me, he says. I’m all wrinkled, I’m old. I don’t want to stand up anymore, I’m tired. He’s out there, look at him going out there. You know, he took better care of himself than anybody I’ve ever known. Sometimes we’d all be working on the set and afterwards we’d go over and say, ‘Let’s go down and have a drink.’ They’d all go and President Reagan would go with them and he’d sit there and toy with his glass. Then he’d get up. They’d say, ‘Hey, wait a minute, come on, sit down.’ He said, ‘No, you asked me for a drink, I’ve had the drink and it’s time to go,’ and he’d leave. The rest of us would be poisoning ourselves for the rest of the evening. He just knew when to stop, when to do this.

He was very disciplined.

Very self-disciplined, absolutely. Does that answer?

Did he talk about nuclear weapons to you? There are reports that he almost viewed them in sort of biblical terms, that the fate of the planet hung in the balance.

An example, the day that I was talking to him about AIDS and how this had a potential of leveling the population like nothing else that had ever come because our bodies couldn’t develop any kind of any immune—there was nobody safe from it. He said, I thought someday we’d probably all go up in a big flash. So I think that was on his mind. I think he realized that we had these weapons, and he always wanted to be ahead technologically on weapons delivery. He felt very strongly about building up the Navy. The Navy had been 600 ships and it was down to 316 or something. The admirals would get to him and say, We just haven’t got much to work with here if we’re going to have an eastern and a western. We have two sides we have to defend. He did everything he could in budget terms to help them build themselves up. That’s why the military loved him because he suddenly realized that our whole security depended on a strong, retaliatory military.

You certainly knew Ronald Reagan very well, but you did know George H. W. Bush to some extent. I was wondering if you might compare and contrast those two individuals.

Their personalities were quite different. They were both very bright. President Bush had gone to Andover Academy where he’d been an All-American baseball player. No, that’s at Yale, excuse me. But anyway, when World War II started he didn’t go right to Yale. He joined the Navy and became this very young aviator, one of the youngest to earn Navy wings during World War II.

 As you know, he got shot down. He’s not sure what hit his plane the first time when he was just getting off the carrier and he went into the water. The second time he was shot down and bailed out and lived on the submarine for two months, and nobody knew whether he was alive or dead. I’m trying to think how I can describe him because he was somebody—and watching him go out of an airplane at the age of 70-whatever with a parachute describes him. He needed, loved excitement. He loved a good tennis game that was close. When you’d go up to Kennebunkport with him, it was a terribly tiring day because the first thing is the run. That’s 6:30 or 7 o’clock, and all the Secret Service guys are in their running shorts. I didn’t know any better. I’d just come up from Honduras where I’d built a little expeditionary hospital. I was in great shape because we spent a lot of time running, fearing that we’d have to run away from either [Fidel] Castro or the Sandinistas, so we were all in good shape. I was running with him and I could keep up, but at the end of the first day I realized I was all hot and sweaty. Now supposing he had fallen down and hurt himself and we had to bundle him up and take him to a hospital. They wouldn’t have let me go into an operating room with him, looking like I looked. So from that point on the others were running and I sat in the limousine following him along.

 One of the agents said, Hey, doc, can’t you can’t get this 62-year-old man to take it easy on us 38-year-olds? He was unstoppable. He would run, then he’d eat breakfast. Then the next thing you’d know we’re in this boat, this cigarette boat. I have a beautiful picture that I took of him sculling along, going hell-bent for election driving this cigarette boat. Then I would be out in the boat and he’d get tangled up in the lobster pots. I have a picture where two Secret Service fellows are holding him by the legs and he’s got his shirt off and he’s down, half immersed in water trying to take the line from the lobster pot off the propeller. He came out with his chainsaws that afternoon, and he’s got these chainsaws on Walker Point. Have you ever seen Walker Point?

I’ve seen it.

What a piece of real estate, unless a hurricane comes. He’s got all these bushes that kind of grow out of rock and he’s trying to trim them off and he’s got this chainsaw, and he’s going like this—like you’re slicing something. The only trouble is this was rock. I was afraid that thing was going to buck and go into his face. I said, Let me do it, let me do it. He says No. He keeps sawing. He was a little bit of a daredevil.

Now President Reagan probably had a stronger arm than he did. President Reagan would get up the ladder on a tree, holding onto the ladder with one hand and holding onto a big 16-inch chainsaw with one arm, and he’d be cutting limbs and we’d be ready to catch him. We were all down there holding on to the ladder for dear life. We rode for two hours and that was over, lunch and whatever. Then we worked out in the field for two hours.

 After his operation, that had to be commuted also. Only one hour, John. You bring him in at one hour. Now Mrs. Reagan spent a lot of time on the telephone, everybody knows that. When she was on the ranch and isolated from Betsy Bloomingdale and all of her friends, she’d be on the phone. We were in the Jeep and the Jeep’s got the trailer with all the equipment in it. He knows she’s going to be standing looking out the window, but she wasn’t there so he beeps his horn until she comes so she knows he’s in charge again. Maybe makes some remark. He says, That’ll show her. On that particular thing she never said anything to me about it. Admonished me not to, I had made them ride across the front lawn with the boys.

You mentioned that you kept fairly detailed notes, almost like a diary I guess.

Yes.

Do you have plans to write a memoir someday?

Oh, everybody asks me that. It would have to be after Mrs. Reagan was gone. There are some insights and some very poignant moments that we all went through that I commented on. She had some moments of sadness. I think she was upset about the fact that her son Ron was incommunicado so to speak. She was a remarkable, remarkable lady. She was just right. They complemented each other, she and her husband. She was just the right person. It was quite a wonderful romance.

He went to her rescue when she was put on the pinko list by that crazy fellow. People would say, He’s reading scripts and he’s just an actor. Have you ever seen that film where Senator [Joseph] McCarthy is up there and he’s got President Reagan as president of the Screen Actors Guild, and the President talks back to him like he was a child. He says, And if you think that that’s what goes on in this democracy— I forget what he said but it was very much to the point and he really spoke out, he was fearless. I thought that particular speech of his—that was right out of his heart. There was no time to prepare any kind of a response to the question. I’ve often wished I could find that again.

You still keep fairly regular contact with Mrs. Reagan?

Yes.

Telephone conversations?

Yes.

Weekly?

About every two weeks. You hate to bother her. I think she likes to have people call. The phone is busy a lot so I know there’s a lot of traffic. I don’t always get through. But she’s usually there. Once in a while, thank God, her nurse picks up the phone and her nurse recognizes my voice, so she talks to me and says, She’s over at the Bloomingdales or She’s over with Merv Griffin doing something. So she does get out. She doesn’t stay very long. When the final act is there I think she would feel terrible if she wasn’t there to hold his hand.

About two months ago I was talking to her, she had this terrible bronchitis and coughing, and her voice was almost raspy. I said, How’s the President doing? She said, He’s the only one who didn’t get it. It went through the house. It’s a phenomenon. Usually what happens with the Alzheimer’s patient, either they’re trying to eat food and they’ve lost their swallowing reflex and some of their food goes down the lung and they get what they call an aspiration pneumonitis. That’s very often the exit, because it’s very difficult. You have foreign material down there and until you can get that out—you usually can’t. The cough reflex isn’t good enough to get it out, and there’s terrible chemical and then bacterial pneumonitis and that very often is the end.

One night I was talking and I could hear him coughing in the background and I said, Is the President sick? This was maybe six months before the epidemic went through the household, and she said, No, he seems to have bronchitis. I thought, Maybe he’s aspirated something, but in a week he was back with a normal respiratory system.

When was the last time you saw the President?

I guess about two years ago. I used to go out there all the time so she could get away and so the nurse could have a break. I’d go out there and stay for a week or sometimes even two weeks. It was arduous. I realize what the nursing personnel out there were going through, and yet I kind of missed being there when I left. In spite of his immobility and all the rest, it was a pleasure to be able to help him out. He would look at you sometimes as if he appreciated what you were doing, but you just don’t know. You just don’t know what’s behind the eyes.

Do you have one particularly favorite memory of either the President or Mrs. Reagan?

Gosh, there are so many. There are so many that none stands out that much above the others. I think the one I remember the most is the incident of the galloping. I think I’ve told that one as much as any because it was kind of an admonishment on one hand. On the other hand, I lost out with her but I won with the President. I saved him from getting into big trouble. I walked away like it was my fault that I hadn’t made it more clear that he couldn’t gallop, which I had not done.

Is there anything that we have not touched on that we should make sure is included in the record?

There’s so much material, I could talk about it for hours, depending on the variety of questions.

There is one more thing I’d like to ask. This is way off subject but there’s really no other good time to ask it. You’ve been cited as commenting on Bob Woodward’s characterization of getting in to speak with William Casey on his deathbed. I was hoping to get that on this record about how you’d said that there was no way that he had gotten in to speak with him.

Yes. I think Woodward is the one who wrote that thing about the oxygen machine. The guy has no scruples, if that’s a word that’s used anymore. Casey had a tumor in his brain and basically, talking to the neurosurgeon, he had to remove about half of his brain. It left Casey with total inability of speech, a few words, and they weren’t very pleasant words. It’s an interesting phenomenon, when we lose the front of our brain. Anatomically, the area up in the frontal lobes that modifies all the impulses we have, when that goes it seems that our vocabulary reverts to the most foul words you can come up with. I don’t understand whether it’s that you use so much of the brain trying to suppress these awful, awful words, but you get somebody after they’ve had a stroke or something like that where they’ve lost that suppression and every other word is bad.

He had gotten to the point where his speech was really very much impaired. Woodward says he got into that room and this is the paragraph, a well-constructed paragraph of a man who has just had half his brain removed, and he states, this is verbatim what he said about the Iran-Contra thing. Now the CIA has its own sort of Secret Service. They call them law enforcement officers, I believe, something of that sort. I talked to somebody who knew the guy who said, Yes, he did try and get in the room once. We had a shoving contest and I threw him on the ground. He never got through the door, and if he had Casey couldn’t have—he was on his deathbed. He couldn’t have come out with a paragraph that was coherent. So Woodward is a—what’s this fellow recently in the New York Times making up all sorts of references and sources? The press does this sort of thing. Why we’re not more suspicious of it, I don’t know, because we tend to think of the New York Times as being the bible of newspapers and here’s this guy whose been making up stories.

 The lady who got the prize, what’s the prize that you can get—

Pulitzer.

Talking about a family and their drug problems.

Janet Cooke.

And it was all, it was a story, absolute story, and the people down at the Washington Post, We stand by our story. That’s what they always say. I used to call up and say, You’ve got this absolutely backwards. And they’d say, We’re going to stand by it. It’s too bad that we have to believe that kind of thing.

Was it your experience in the White House that shaped your attitude?

Yes, I’d be at an event and wonder when I read about it if I was really there or whether it was a dream. I used to wonder, Where do you get this stuff? Especially if it was derogatory. They seem to specialize in that. Sam Donaldson. If you sat down with Sam Donaldson, he would charm you right out of your shoes. He’s amazing, he has a super intellect. You’d be sitting there talking about something and all of a sudden he’d catch the President going by and he’d yell, Mr. President, is it time for you to be impeached?

 I remember once he was yelling that. He was underneath a wing of an airplane. As the President gets down off the airplane he starts yelling, Is it time for you to be impeached? The President kind of liked him because he was spunky and he could joust with him, and sometimes the President could come up with a quip that would defeat him. When it was a question that would take too much time to organize a defense, the President would simply point to his ear like his hearing aid was off. So he had a shelter. He used to laugh about that.

By the way, how bad was the President’s hearing?

It was bad. Somebody shot a blank cartridge in one of the westerns, right here, and he noticed within a month a profound difference in hearing between the two ears. He also had terrible eyesight, but he had been able to discipline himself so he had what they call monocular vision. He had one lens that could see in the back of the room and one that he could see up close, and he was able to kind of look at everything like he had normal eyes. It was amazing.

The hearing aids—he hated to have anybody come up and have to do anything menial. He could take care of himself. He’d gotten some wax in his hearing aid. He tried to clean it out and he perforated it with a paper clip. He brought it down somewhat sheepishly and showed it to me. So I called up the hearing aid people and of course they couldn’t get here fast enough. At the same time, there was a company on Long Island that made surgical loupes. Have you ever seen a surgeon and he’ll have these, they look like little telescopes? We all use them when we get down to the micro, when we’re trying to put together two vessels that are rather small.

So I got in touch with one of the people I used to see at all the American College of Surgery exhibitions and I asked him, Would you come down and fit the President for a pair of these so he can clean some delicate things that he has? Oh, yes, sir. Within a week they were down there, the president of the company comes down. They fit him and then they go back. They make these little scopes, and I have a picture of him with these little telescopes coming out of his glasses and he’s learning how to clean his earpiece. He was overjoyed with those. I don’t know where they are now. He was very kind to these people who came down and I told them, You’ve got to send me a bill or you’ll get us into trouble. They never did, they never did. I said, He feels very strongly about that. Some people won’t cooperate with you.

Sure.

We took a picture of him. I guess Fitzpatrick took a picture of him working at his desk. You can’t see what he’s working on. If you go into the headquarters of this big corporation that fits all surgeons, there’s a great big poster-size thing of him with his loupes on. They love it, they love it. They always see me at these meetings, Hey, the picture’s still up. 

Any last words?

I hope I haven’t talked too much.

No, no.

I mean from Mrs. Reagan’s standpoint. There won’t be something in the headlines tomorrow.

No, no absolutely not. We’re very grateful for all the time you’ve given us.

As you say, someday I might sit and write my recollections because they were absolutely—and I’m sure this has been reflected by everybody you’ve talked to, you couldn’t help but love this couple. To have them ask you into their house like it was your house, up at Camp David for instance. I could walk upstairs anytime. I could walk into their bedroom anytime.

On the next to the last morning, I went up either to get a blood sample or do something of that sort and that little dog, he died about a year ago. He would sit on the bed, he was a little cocker spaniel of some kind, brown and white. He’d sit there on the bed and he’d look at me as I came in. He wouldn’t move, he’d just look at me and as I went to leave he would attack. The thing was to get out the door before he had my pants in his mouth.

So I knew the last time I was going to be attacked and I quickly slammed the door, shut the door before he could get to me. I opened it up and I said, I’m really going to miss this little guy. They laughed. Rex the dog. They could see the humor in this kind of thing, realized I put up with this for two years or so.

You and Rex just never hit it off.

It had to do with me going out the door. You’d think if he was going to attack, to defend them—in other words, he attacked me behind my back. If you were staring at him he wouldn’t budge. The minute he could see my back he launched the attack. He loved my little daughter, little Beth.

Every Saturday we had the Saturday five after noon speech to the country. There was a ritual and my family would be there. Beth was the only one still with us, the rest were all off in college. Mrs. Reagan would come in and Rex would be there yapping. When the President went in to do this Mrs. Reagan used to accompany him. She would take Rex and plunk him in Beth’s arms. Rex really got to like my daughter. She was a teenager at the time. She’d hold him dutifully until Mrs. Reagan came out and they’d put him on the leash and take him off. So Rex did have one of my family he liked.

Again, thank you very much.

It’s been a very pleasant visit.

For us too.

I enjoy being able to reminisce, and I enjoyed giving that talk because I’m still able to feel like I’m living it. I have such an abundance of photographs that I took myself of the ranch or Camp David. Nobody else could take a picture of him until Howard Baker came and then the two of us would go at it. I told you the anecdote about him letting out a little priceless piece of information and getting two rolls of film in exchange.

All right.