Presidential illness, privacy, and a surgeon’s character: Some artifacts

As faculty at the University of Pennsylvania Perelman School of Medicine, Philadelphia, I am drawn to the significant role played by Isidore Schwaner Ravdin, MD, FACS, John Rhea Barton Professor and Chief of Surgery (1945–1959) in caring for U.S. President Dwight D. Eisenhower during his operative bout with Crohn’s disease (see photo). An anecdote and some ephemera are illustrative of his stature and character.

These pages have already been graced with an excellent article by Justin Barr, MD, PhD, and Theodore N. Pappas, MD, FACS, regarding this topic. Indeed, one of my esteemed teachers, the late Julius Mackie, MD, FACS, would relate how as a junior attending (and favored protégé), he himself was summoned by “The Chief” at some point during this episode, accompanying him to Walter Reed Army Hospital, Washington, DC. In the intervening retrospect of three decades (and several attempts on presidents’ lives), Dr. Mackie was still struck by the perfunctory security circa 1956. According to Dr. Mackie, “They just asked to see my driver’s license, and checked a list.” As the authors relate, Dr. Ravdin would be simultaneously and curiously censured as an “itinerant surgeon” and then lauded for the care he helped render.

Artifacts

In my collection, I have an American College of Surgeons (ACS) Fellowship Certificate inscribed with Dr. Ravdin’s signature as Chairman of the Board of Regents (see photo); in fact, he was at a meeting of that ACS governance board when called to Washington from Chicago, IL. His supposed surgical “nomadism” did not prevent him from serving in this post through the following year (1957) nor from ultimately ascending to his own Presidency—that of our College (1960–1961).

My further quest to acquire “Ravdiniana” has yielded two interesting, and perhaps related, items—a sterling letter opener presented to Dr. Ravdin in 1950 by Penn Medical School’s Agnew Surgical Society (see photo). This society, still extant, is an undergraduate group of medical students interested in a surgical career. Its namesake, David Hayes Agnew, MD, one of Dr. Ravdin’s predecessors as the John Rhea Barton Professor and Chief (1877–1889), would be lionized by Thomas Eakins in his famous painting, “The Agnew Clinic,” an icon in the history of American surgery and art.

Dr. Agnew himself had come to public attention as one of the surgeons who attended an earlier U.S. President, James Garfield, after his attempted assassination in 1881 but, unfortunately, with a less desirable result. President Garfield succumbed in that pre-antiseptic, pre-antibiotic, ungloved era. No doubt, it was of comfort to President Eisenhower that Dr. Ravdin had served admirably in the Pacific Theatre during World War II, organizing and commanding the huge 20th General Hospital near the India/Burma border, becoming the first physician drawn from civilian life to become a Brigadier and then Major General.

The other item is a typed, signed note Dr. Ravdin sent in reply to a letter he received from a woman in Los Angeles, CA, regarding the welfare of President Eisenhower (see photo).

I do not have her letter, and our university archives, which contain the Ravdin papers, could not locate it either. My Google search has yielded only that the writer was 76 years old at the time. Any defining personal, military, or political connection to the dramatis personae is not apparent, other than that of a concerned citizen conveying her best wishes for Ike’s recovery. (I’d like to wishfully think that this opener was used on the envelope in Philadelphia or Washington, but that is, alas, beyond proof.)

Presidential patient confidentiality

The health issues of public figures throughout our history, and the right of the public to know the associated details, has certainly evolved over time beyond stark newsworthy events like assassination or surgery; consider the recent presidential campaigns, as well as the numerous press releases and conferences surrounding former President Trump’s coronavirus 2019 (COVID-19) hospitalization, Health Insurance Portability and Accountability Act confidentiality requirements notwithstanding.

But the charm in Dr. Ravdin’s timely reply was his graciousness, reassurance, and personal tone, without being particularly revelatory nor detailed, stating, “I appreciate very much your having written to me and appreciate more than I can tell you…the sentiments…regarding our President…I had the opportunity of telling the President that I had received your letter.”

Was the latter statement truthful? We will probably never know. But the fact that “The Chief,” thrust even more than usual onto the national and international stage, found the time to answer, speaks volumes about him. He would have had my vote.

Bibliography

Barr J, Pappas TN. President Eisenhower and his bowel obstruction. Bull Am Coll Surg. 2017;102(11):57-58. Available at: https://bulletin.facs.org/2017/11/president-eisenhower-and-his-bowel-obstruction/. Accessed June 3, 2021.

Rhoads J. My teacher and chief: I.S. Ravdin. Surgery. 2000;127:584-585. Available at: www.surgjournal.com/article/S0039-6060(00)19142-1/fulltext. Accessed June 3, 2021.