An Unfinished Life: John F. Kennedy 1917-1963 (13 page)

In response, Jack staged minor rebellions. He refused to toe the line on her religious concerns or follow her household rules. Once when she instructed the children on a Good Friday to wish for a happy death, Jack said he wanted to wish for two dogs. He occasionally interrupted Rose’s recitations of Bible stories with impious questions. What happened to the donkey Jesus had ridden into Jerusalem on the way to his crucifixion? Jack asked. Who attended to the donkey after Jesus was gone? Jack also expressed his antagonism to Rose by keeping a messy room, dressing sloppily, and arriving to meals tardy.

His annoyance with her compulsive demands poked through a letter he wrote in response to a round-robin note she sent to all the children in 1941, when he was twenty-four. “I enjoy your round robin letters,“ he answered. “I’m saving them to publish—that style of yours will net us millions. With all this talk of inflation and where is our money going—when I think of your potential earning power . . . it’s enough to make a man get down on his knees and thank God for the Dorchester High Latin School [sic] which gave you that very sound grammatical basis which shines through every slightly mixed metaphor and each somewhat split infinitive.”

If Jack and the other children had their tensions with Rose, they were not the product of the child-rearing habits of a thoughtless, selfish mother. On the contrary, Rose saw her maternal duties as a high calling requiring considered and devoted action. “I looked on child rearing not only as a work of love and duty,” she said, “but as a profession that was fully as interesting and challenging as any honorable profession in the world, and one that demanded the best I could bring to it.” There was in fact a professionalism to Rose’s organization of her large family that rested on the conventional wisdom of the day: Dr. L. Emmett Holt’s widely read book,
The Care and Feeding of Children: A Catechism for the Use of Mothers and Children’s Nurses
(1934). Holt was the Dr. Benjamin Spock of the first half of the twentieth century, and Rose closely followed his rules, which included the need for a daily bath, regular outdoor activity, strict discipline—“spare the rod and spoil the child”—and limited displays of affection. As Holt recommended, Rose kept file cards on her children’s illnesses and made neatness and order a high priority, though to little avail in Jack’s case.

It is also essential to remember that she was burdened with a retarded daughter who consumed a large part of her energy and reduced her freedom to attend to and practice a more joyful give-and-take with her other children. Rosemary, the third child, had been born in the midst of the flu epidemic of 1918. Whether the contagion or some genetic quirk or brain damage from inexpertly used forceps during her delivery was the cause of her disability is impossible to know. By the time she was five, however, it was clear that her physical and mental development was dramatically abnormal. She could not feed or dress herself, had limited verbal skills, and could not keep up with the physical activities of her siblings or her classmates at school. Determined not to send her to an institution, as was accepted practice at the time for “feebleminded” children, Joe and Rose committed themselves to keeping her at home under Rose’s supervision, helped by a special governess and several tutors.

Rose gave the child unqualified love and attention. Eunice remembered the many hours Rose spent playing tennis with Rosemary, even though she never played with the other children. Moreover, Rose and Joe required everyone in the family to treat Rosemary as an equal as much as possible. The other children responded with an attentiveness and kindness that speaks well of all their characters and the strength of shared family purpose. To Rose, Rosemary’s disability was a kind of gift from God, reminding the most fortunate that they must give as well as receive. She also believed that Rosemary’s difficulties sensitized her other children to the meaning of daily hardship and suffering, which was the lot not just of the poor and underprivileged.

Certainly for Jack, Rosemary’s retardation gave him an uncommon compassion for human failings. One friend recalled that he had “a marvelous capacity for projecting himself into other people’s shoes. That was one of the great keys to his whole personality. He could become a little old lady who was being embarrassed by her husband’s conduct. I saw it happen so many times.” The friend recounted an episode in a New York restaurant when a drunk at a nearby table began verbally assaulting Jack, who was by then a well-known public figure. The friend suggested that they leave, but Jack, who sat stoically through the abuse, said, “Would you look at that guy’s wife and what she’s going through?” The woman looked as if she were “about to die. She was purple with embarrassment. . . . Eventually the wife did take over and get him out of there. And,” Jack’s friend said, “I thought that was so humane. There were loads of things like that.”

Jack himself was as generous toward his sister as any of the children and undoubtedly felt as much remorse as others at her deterioration in 1939-41 when she reached physical maturity. After years of effort that had produced small gains in her ability to deal with adult matters, Rosemary turned violent at the age of twenty-one, throwing tantrums and raging at caretakers who tried to control her. In response, Joe, without Rose’s knowledge, arranged for Rosemary to have a prefrontal lobotomy, which contemporary medical understanding recommended as the best means for alleviating her agitation and promising a more placid life. The surgery, however, proved to be a disaster, and Joe felt compelled to institutionalize Rosemary in a Wisconsin nunnery, where she would spend the rest of her life.

Part of the family’s impulse in dealing with Rosemary as they did was to hide the truth about her condition. In the twenties and thirties, mental disabilities were seen as a mark of inferiority and an embarrassment best left undisclosed. Rosemary’s difficulties were especially hard to bear for a family as preoccupied with its glowing image as the Kennedys. It was one thing for them to acknowledge limitations among themselves, but to give outsiders access to such information or put personal weaknesses on display was to open the family to possible ridicule or attack from people all too eager to knock down Kennedy claims to superiority. Hiding family problems, particularly medical concerns, later became a defense against jeopardizing election to public office.

Yet there was a benefit to keeping quiet about family suffering that served Jack in particular. The corollary to not speaking openly about family problems was bearing individual suffering stoically. The Kennedys believed that people as fortunate as they were should be uncomplaining about adversity. A visitor to the Hyannis Port home remembered how one Kennedy child, seeking sympathy for an injury suffered while playing, fell to the floor in front of Rose and began to whine. “‘On your feet,’ Rose ordered. The child promptly rose and practically stood at attention. ‘Now you know how to behave,’ she added. ‘Go out there and behave as you know you should.’” The premium placed on strength and courage as answers to personal burdens would serve Jack well through a lifetime of medical problems and physical suffering.

BACK IN JUNE
1934, as Jack’s junior year at Choate ended and he began feeling ill again, Joe had sent him to the famous Mayo brothers’ clinic in Rochester, Minnesota. He spent a miserable month there. “The Goddamnest hole I’ve ever seen. I wish I was back at school,” he wrote Lem Billings. By himself at the Mayo and then nearby St. Mary’s Hospital, where he was transferred after two weeks, he kept his sanity and his hopes for a return to friends and family through a series of letters to Lem. We can only imagine how endless, painful, intrusive, and embarrassing the tests he was subjected to by strangers must have seemed to a seventeen-year-old wrestling with normal adolescent concerns about sex and his body. But having learned from his parents, Jack was stoic and uncomplaining about his difficulties. Lem Billings later told an interviewer, “We used to joke about the fact that if I ever wrote a biography, I would call it ‘John F. Kennedy: A Medical History.’ [Yet] I seldom ever heard him complain.” Trying to be optimistic that the doctors would figure out his problem and restore him to health, Jack told Billings that during a telephone conversation with his father, “he was trying to find out what was wrong with me and for 20 minutes we were trying to hedge around the fact that we didn’t know.”

Judging from his letters describing the medical tests administered to him and later medical records, Jack had “spastic colitis,” which the doctors initially thought might be peptic ulcer disease. They began by prescribing a diet of rice and potatoes preparatory to tests Jack hoped would be over in a few days. But the exams lasted much longer than he had anticipated. “I am suffering terribly out here,” he wrote Billings on June 19. “I now have a gut ache all the time. I’m still eating peas and corn for my food and I had an enema.” He expected to be there for at least another twelve days. By then, “I’ll be dipped in shit. . . . My bowels have utterly ceased to be of service and so the only way that I am able to unload is for them to blow me out from the top down or from the bottom up.”

Two days later he told Billings: “God what a beating I’m taking. I’ve lost 8 lbs. And still going down. . . . I’m showing them a thing or two. Nobody able to figure what’s wrong with me. All they do is talk about what an interesting case. It would be funny,” he declared wishfully, “if there was nothing wrong with me. I’m commencing to stay awake nights on that. Still don’t know when I’ll get home. My last eight meals have been peas, corn, prunes. Pul l l lently [sic] appetizing.”

Six days later he gave another graphic description of his ordeal. He had heard that he might have to stay in the hospital until July 4. “Shit!! I’ve got something wrong with my intestines. In other words I shit blood.” He feared he might be dying: “My virility is being sapped. I’m just a shell of the former man and my penis looks as if it has been through a wringer.” The doctors were still trying to determine the cause of his illness: “I’ve had 18 enemas in 3 days!!!! I’m clean as a whistle. They give me enemas till it comes out like drinking water which,” he said in an expression of rage toward his caretakers, “they all take a sip of. Yesterday I went through the most harassing experience of my life. First, they gave me 5 enemas until I was white as snow inside. Then they put me in a thing like a barber’s chair. Instead of sitting in the chair I kneeled . . . with my head where the seat is. They (a blonde) took my pants down!! Then they tipped the chair over. Then surrounded by nurses the doctor first stuck his finger up my ass. I just blushed because you know how it is. He wiggled it suggestively and I rolled them in the aisles by saying ‘you have a good motion.’ He then withdrew his finger and then, the shmuck, stuck an iron tube 12 inches long and 1 inch in diameter up my ass. They had a flashlight inside it and they looked around. Then they blew a lot of air in me to pump up my bowels. I was certainly feeling great as I know you would having a lot of strangers looking up my asshole. Of course, when the pretty nurses did it I was given a cheap thrill. I was a bit glad when they had their fill of that. My poor bedraggled rectum is looking at me very reproachfully these days. . . . The reason I’m here is that they may have to cut out my stomach—the latest news.”

On June 30, he was “still in this God-damned furnace and it looks like a week more.” He had become “the pet of the hospital.” It was testimony to his extraordinary stoicism and good humor that he had managed to charm the staff despite his ongoing ordeal. “I only had two enemas today so I feel kind of full,” he told Billings. “They have found something wrong with me at last. I don’t know what but it’s probably something revolting like piles or a disease of my vital organ. What will I say when someone asks me what I got?” His question was not posed hypothetically. As with Rosemary, Jack and the family were determined to hide the seriousness of his medical problems. Nothing good could come from revealing that Jack might have some debilitating long-term illness that could play havoc with his future.

All the gastrointestinal tests indicated that Jack had colitis and digestive problems, which made it difficult for him to gain weight and threatened worse consequences if the colon became ulcerated or bled. In July 1944, Dr. Sara Jordan, a gastroenterologist at Boston’s Lahey Clinic, would note that Jack’s diagnosis at the Mayo Clinic and then at Lahey was “diffuse duodenitis and severe spastic colitis,” intestinal and colonic inflammations that could become life-threatening diseases. The premium was not only on finding a better diet for him but also on relieving emotional stress, which in those days was assumed to be a major contributor to ulcers and colitis.

Judging from accounts of colitis therapy published in the January 1934 and December 1936 Mayo Clinic journal,
Proceedings,
the treatment given to Jack was a combination of restricted diet and injection or subcutaneous implant of a serum obtained from horses. Although the clinic claimed a measure of success with this treatment, it was clearly no cure-all. Indeed, in November 1935, the
American Journal of Medical Sciences
recommended a “calcium and parathyroid” therapy. The use of parathyroid extract (parathormone) paralleled the development of adrenal-hormone extracts, which the Mayo Clinic, along with other research centers, was then testing. These extracts held promise in the treatment of a variety of illnesses, including chronic spastic and ulcerated colitis. Obtaining these extracts was then very costly. “We always had adrenal extract for those who could afford it,” Dr. George Thorn, an expert at Harvard and Boston’s Peter Bent Brigham Hospital, said in 1991. There seems no doubt that Joe was able to pay for the medication.

There are intriguing questions about Jack’s medical history that remain difficult, if not impossible, to resolve. In 1937, the first clinical use of adrenal extracts—corticosteroids, or anti-inflammatory agents—became possible with the preparation of DOCA (desoxycorticosterone acetate). This drug was administered in the form of pellets implanted under the skin. It is now well known that Jack was treated with DOCA in 1947 after his “official” diagnosis of Addison’s disease (a disease of the adrenal glands characterized by a deficiency of the hormones needed to regulate blood sugar, sodium and potassium, and the response to stress; it is named after the nineteenth-century English physician Thomas Addison). But there are earlier references to Jack implanting pellets. Early in 1937, in a handwritten note to Joe, Jack worried about getting his prescription—probably the parathyroid extract, or DOCA—filled in Cambridge. “Ordering stuff here very [illegible word],” he wrote his father. “I would be sure you get the prescription. Some of that stuff as it is very potent and he [Jack’s doctor] seems to be keeping it pretty quiet.” Nine years later, in 1946, Paul Fay, one of Jack’s friends, watched him implant a pellet in his leg. He remembers Jack using “a little knife . . . [to] just barely cut the surface of the skin, try not to get blood, and then get underneath and put this tablet underneath the skin, and then put a bandage over it. And then hopefully this tablet would dissolve by the heat of the body and be absorbed by the bloodstream.” Thus, before the diagnosis of Addison’s, Jack may have been on steroids—still in an experimental stage, with great uncertainty as to dosage—which may have been successfully treating his colitis, but at the possible price of stomach, back, and adrenal problems.