Wednesday, June 13, 2012

Grover Cleveland’s Sore Mouth

President Grover Cleveland had his hands full.  The only Democrat in the White House since before the Civil War, he had just taken office for his second term.  His first had ended in 1888 when Benjamin Harrison won the job back for the dominate Republican Party.  But Harrison had died and his Vice President, Chester Allen Arthur had proved to be unpopular with several factions of the GOP, opening the door to Cleveland’s return.

The President was settling into his new job, but the country was in turmoil as a result of the Panic of 1893 which caused wide spread unemployment and stoked already simmering labor unrest.  Cleveland, a conservative, hard money Democrat, planned to address the problem by ending the free coinage of silver and a return to a strict Gold Standard.  Although applauded by big business and even Republicans on this issue, Cleveland faced veracious opposition from parts of his own party—farmers, small businessmen, and wage workers for whom the deflationary effects of hard money would be disastrous.  He faced a tough fight in Congress over the issue.

As pressing as all of this was, it was mouth pain and a “roughness in the roof of his mouth” that bothered him enough on June 13, 1893 to finally consult his personal physician, Dr. O'Reilly.  Cleveland had a large open sore on the left side of his hard palate in the roof of his mouth.  The Dr. was alarmed.  He told the President, “It's a bad looking tenant, and I would have it evicted immediately” and fearing cancer sent a tissue sample to the Army Medical Museum for analysis.  The doctors there thought that it was a benign tumor, but recommended surgery.

Cleveland feared that if word of his condition and the surgical treatment became public that it would deepen the Panic and weaken his hand in Congress.  He and his physicians decided instead to undertake one of the deepest subterfuges ever undertaken in the White House.

It was announced that Cleveland would take a summer cruise and fishing trip from New York City to Cape Cod, where the President had a summer cottage.  Also on board the yacht Oneida was one of the nation’s top surgeons, Dr. Joseph Bryant and other doctors.  On July 1 in the open water off of Long Island major surgery was performed on the President.

Cleveland was sedated with nitrous oxide and ether. Ordinarily surgeons would have made a large incision on the patient’s cheek to easily access the tumor, but because they feared leaving a scar, operated instead through Cleveland’s open mouth.  Once engaged they revised their diagnosis.  Most of them believed it was cancer.  A more aggressive surgery than originally envisioned was completed, taking a sizeable chunk of the hard palate and of the jaw.

The operation left the President in considerable pain, but also disfigured his face and damaged his speech.  On July 17 once again on board the Oneida a second operation was performed fitting Cleveland with a hard rubber prosthesis for his jaw, restoring his appearance and speech.

But all of this required an unusually long time out of the public eye.  Some explanation was necessary.  The press was told that the President had two infected teeth extracted.  By in large, they bought the story.

Two months later one enterprising reporter, E.J. Edwards of the Philadelphia Enquirer sniffed out the story and apparently interviewed one of the President’s doctors.  But when he published the story Dr. Bryant refuted it and the White House accused Edwards of planting the story to politically embarrass the President.  The story withered and was not followed up on by other publications.  Edwards found his reputation in tatters.

Cleveland lived to suppress Coxey’s Army and crush the Pullman Strike and Eugene V. Debs’s American Railway Union in 1894.  In 1896 his party, the Democrats repudiated his hard money stand by nominating Populist William Jennings Bryan who had electrified the convention with his famous Cross of Gold speech.

After leaving the White House Cleveland lived in retirement another 12 years dying at the age of 70 in 1908, his secret safe.  And one by one all of the physicians on board the Oneida and other witnesses passed away.

All except one.  In 1917 Dr. William Williams Keen finally published, with the approval of the Cleveland family, a complete account of the diagnosis, operations, and treatment in the Saturday Evening Post. 

Even after the publication, there was controversy in medical circles about whether or not the tumor was really cancerous.  A minority opinion held that it was a benign ameloblastoma or a benign salivary mixed tumor, pleomorphic adenoma.  It wasn’t until the 1980’s when preserved samples of the tumor were analyzed using modern methods that the tumor was confirmed to be a verrucous carcinoma, a low-grade cancer with little potential for spreading to other tissue.

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