Ailing Cleveland

In 1893, Grover Cleveland - the US President commonly remembered as little more than the only Commander in Chief to serve two terms that weren't consecutive - disappeared for five days, having boarded a friend's yacht and not returned to shore. Though his term coincided with a burgeoning era of American journalism (in volume, if not universally in accuracy), standards being as they were at the time, his prolonged absence wasn't considered terribly unusual, and the official excuse of a leisurely fishing expedition marked by the extraction of a bad tooth was taken at face value. In fact, Cleveland was aboard that yacht for a then-pioneering surgery to remove a cancerous growth from the roof of his mouth. It had been decided that the surgery had to take place in secret to preserve national faith in the recently-reelected Cleveland - and by extension, the economy, which was faltering under the weight of railroad bankruptcies and a crisis over the question of a Silver Standard. (Oral cancer was a particularly touchy subject for the contemporary American public as it had recently killed Ulysses S. Grant, following an extended battle that had been covered with morbid curiosity in all the country's newspapers.) The story was broken by a single reporter, E.J. Edwards, who would face lasting repercussions for his journalistic daring.

This story is covered in The President is a Sick Man, an outstanding book by Matthew Algeo. The narrative is written in a compulsively entertaining fashion, making for presumably the most entertaining history yet written of an otherwise forgotten President. The book also does an excellent job of providing a succinct, detailed explanation of factors that contributed to the cover-up - Grant's death, and especially the Free Silver movement - and the evolution of modern medicine. The latter is particularly appropriate, given not only the stature of the patient, but the extremely complicated nature of the surgery itself. Despite being only a handful of years removed from the advent of antiseptic surgery, the skilled medical team managed to leave a wound that healed quickly even by modern standards, and to craft an adequate prosthesis to leave Cleveland's speech and appearance (relatively) unchanged by the radical alteration in the shape of his mouth. Cleveland's cancer was also never known to recur: certainly, it never reappeared in his mouth, and though he was too fat to check for certain using the diagnostic tools of the age, his eventual death (15 years later!) was not suspected to be related to cancer metastasized from his mouth. Of course, this alone led interested doctors to question for years the nature of his tumor. The questions were finally answered in March 1980, when studies on the preserved remains of the tumor were published in Transactions and Studies of the College of Physicians of Philadelphia. Cleveland was found to have had verrucous carcinoma, a comparatively benign cancer that rarely metastasizes, but one that would have restricted his eating and breathing if left untended. The doctors were thus posthumously found to have been precisely right in their choice of treatment - a fitting cap to an already remarkable feat. The study itself, published by John Brooks, Horatio Enterline, and Gonzalo Aponte, is incredibly difficult to track down, online or otherwise. When I wrote to ask him if he knew where I could find a copy, Mr. Algeo was kind enough to scan all 26 pages and email them to me. On the off-chance that anyone else on the internet was looking, and with any luck to save him the trouble of sending them again, the article can be downloaded here.