Addison’s disease often produces severe muscular cramping and thus may well have compounded Kennedy’s back problems. Clearly, the disease played an important role in heightening the dangers associated with his back operations in 1954. In the case of Addisonians at the time, even such a simple procedure as a tooth extraction might have been followed by death. The disease was so serious that occasionally patients who did not appear to be in any immediate danger would die suddenly. Surgery, therefore, was extraordinarily dangerous in Kennedy’s case.
An article that appeared in a 1955 issue of the AMA Archives of Surgery and examined the case of a 37-year-old male Addisonian who underwent spinal sugery at the New York Hospital for Special Surgery on October 21, 1954, is widely believed to have John Kennedy as its subject. Kennedy, after all, was a 37-year-old male Addisonian who had undergone surgery on the date and at the hospital specified. This article pointed out that the surgical procedures performed on JFK, a lumbosacral fusion and sacroiliac fusion, were considered dangerous because of his adrenocortical insufficiency due to Addison’s disease. Throughout the more than three-hour operation, the patient received hydrocortisone intravenously. In the postoperative period, this treatment was supplemented by added dosages of desoxycorticosterone, salt, and cortisone given intramuscularly. Except for a urinary tract infection which arose three days after the operation, a mild reaction to a transfusion, and a wound infection, the patient did not develop a full-scale “Addisonian crisis,” even though he suffered from “marked adrenocortical insufficiency.”
It was precisely the danger of an “Addisonian crisis” that led doctors at the Lahey Clinic in Boston to refuse to perform the operation in the first place, since they feared that Kennedy might not tolerate surgery well and die. Although their worst fears were not realized, Kennedy’s convalescence following his back surgery was protracted and painful. [White House physician Janet] Travell estimated that he suffered from a chronic infection in the soft tissues of his back for three and a half years after the back operations were performed. Addison’s disease, with its proclivity to render patients more susceptible to infection, almost certainly played a role in making Kennedy’s recovery so slow and agonizing.
By the time John Kennedy launched his presidential campaign in the late 1950s, new treatments for Addison’s disease (Meticorten and the fluorohydrocortisone derivatives or the glucocorticosteroid compounds) had been developed, the adrenal problems associated with the ailment had become entirely manageable, and a normal life span had become possible for the first time. Nevertheless, Kennedy’s physical condition was made an issue in the campaign, despite a statement by one of his physicians that he was “fully rehabilitated from the depletion of adrenal function which he had suffered as a result of his wartime injuries.”
As he battled Lyndon B. Johnson for the Democratic presidential nomination, some of Johnson’s allies made reference to Kennedy’s Addison’s disease and used it as an argument against his nomination. India Edwards, a southern Democratic party leader, told a group of reporters that “Kennedy was so sick from Addison’s disease that he looked like a spavined hunchback.” She also asserted that doctors had told her that were it not for cortisone, Kennedy would be dead. Another prominent Johnson ally, campaign manager John Connolly [not to be confused with Texas politician John Connally], charged that, if nominated and elected, Kennedy “couldn’t serve out the term” since “he was going to die.”