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Examiner
  • Lori Boyajian-O'Neill: The great, dying president

  • Abraham Lincoln, our nation’s 16th and perhaps most revered president, is again back in the forefront of American discussion. With the release this week of the movie, "Lincoln," Steven Spielberg brings the president to the big screen and into our daily conversation. Daniel Day-Lewis eerily and easily morphs into Mr. ...
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  • Abraham Lincoln, our nation’s 16th and perhaps most revered president, is again back in the forefront of American discussion. With the release this week of the movie, "Lincoln," Steven Spielberg brings the president to the big screen and into our daily conversation. Daniel Day-Lewis eerily and easily morphs into Mr. Lincoln taking on his physical characteristics and giving us an eyewitness view of the man amid the moment.
    The physical Lincoln has been written about extensively with much speculation about his health. Much myth, some truth. Now some very good medical science investigation is providing greater insight into the health of the Great Emancipator.
    Lincoln’s health, what do you know? T or F?
    1. He had syphilis.
    2. He had cancer.
    3. He had malaria.
    Lincoln, as did most Americans of his time, suffered from many acute illnesses and diseases, some of which were long ago eradicated and all of which are more successfully treated now. Diagnostic and therapeutic interventions were generally limited to the abilities of physicians to recognize clinical signs and symptoms of disease and then to wait. No imaging studies. No lab tests. People, including the President, simply got sick and suffered through diseases such as "consumption” and “melancholy” modern day descriptions of tuberculosis and depression, or died. Time, herbals and crude surgeries would prove either curative or lead to death. That was that.
    Lincoln suffered through two bouts of malaria, syphilis, frostbite, concussions, depression related to deaths of family members and smallpox. He was diagnosed with smallpox after he became ill on the train following the Gettysburg Address November 19, 1863.
    It has long been speculated that Mr. Lincoln had Marfan’s syndrome, in part, because of his height, 6 feet 3.75 inches, (7.5 inches taller than average). It is serious, even today, because of associated heart problems which can lead to sudden cardiac arrest (think really tall athletes). Most historians now believe that Mr. Lincoln did not have Marfan’s syndrome. Rather, they believe his physical characteristics including, long asymmetric face, long hands, fingers, legs and feet, large lower lip, high voice mixed in with family history and his severe symptoms during the last months of his life lead to one explanation: cancer.
    During the last six months of his life (the movie chronicles the last four months) Mr. Lincoln lost a lot of weight, documented by friends, continuing a decline readily apparent in a comparison of photographs from 1860 to 1865. He grew his beard right before taking office at the behest of many supporters and the New York Republican Party so his face would look more full and hide his long neck.
    During the final months of his life, at age 56, Mr. Lincoln developed persistent headaches, cold feet and hands, exercise intolerance, episodes of profuse sweating and severe, debilitating fatigue. The pressures of the presidency and Civil War could not explain these symptoms. Rather, many historians believe that Mr. Lincoln had a rare genetic form of cancer which affects the endocrine glands, likely the thyroid and adrenal (a small gland which sits atop the kidneys). Known as MEN2B (multiple endocrine neoplasia) it is also thought to have caused or contributed to the untimely deaths of his mother (age 34), son Tad (age 18) and very possibly his son Eddie (age 3) (his son Willie died at age 11 from typhoid fever). His former co-workers and friends provide background information that also support the thinking that Mr. Lincoln began exhibiting signs of cancer years prior including chronic constipation and fatigue, unusual for such a physically active person.
    Page 2 of 2 - The evidence for this is very compelling but autopsy, performed only on his head, provides little insight, except that related to the gunshot. In Lincoln Daniel Day-Lewis provides us with a physical picture of a brave and dying president. And that was before the trip to Ford’s Theatre.
    Answers: 1. T; 2. T; 3. T
     
    Dr. Lori Boyajian-O'Neill, D.O., can be contacted at lori.boyajian-oneill@hcahealthcare.com.
     

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