The Stroke That Secretly Paralyzed a President

On the morning of October 2, 1919, President Woodrow Wilson rose from bed, his left arm hanging limp. As he staggered toward the bathroom, his legs buckled and he sank to the floor.

When Wilson’s personal physician Dr. Cary Grayson finished his emergency examination, he delivered the shocking news to Chief Usher Ike Hoover: “My God, the president is paralyzed.” A massive stroke had rendered the 28th president’s entire left side immobile and imperiled his life at the age of 62.

That night, Grayson issued a statement both true and vague: “President Wilson is a very sick man.” But he never revealed a diagnosis.

That secrecy was just the beginning. With the president incapacitated for weeks and secluded for the remainder of his term, an unprecedented cover-up orchestrated by his innermost circle concealed the severity of his condition from his Cabinet, Congress, the press, the American people—and even Wilson himself.

Even before his presidency, Wilson had never been the picture of health. Historians now believe he may have suffered a series of cerebrovascular disorders starting in 1896. After a stroke in 1913, neurologist Silas Weir Mitchell predicted the frail president wouldn’t survive his first term.

Wilson’s fragile health worsened during the six grueling months he spent at the Paris Peace Conference following World War I. While negotiating his pet project—an international peacekeeping organization known as the League of Nations—the exhausted president became violently ill from a strain of the “Spanish flu” and was confined to bed for five days. When he returned to negotiations, he abandoned most of his Fourteen Points agenda.

“He was never the same after this little spell of sickness,” Hoover recalled.

Returning from Europe, Wilson defied Grayson and launched an arduous cross-country tour on September 3, 1919, to rally public support for the League of Nations and the Treaty of Versailles. After traveling 8,000 miles in three weeks, Wilson was wracked by nausea, asthma attacks and blinding headaches. His speech slurred, facial muscles twitched and his left side grew numb.

Grayson, first lady Edith Wilson and private secretary Joseph Tumulty convinced the crestfallen president to cut the tour short. “This is the greatest disappointment of my life,” Wilson lamented.

Wilson suffered his debilitating stroke five days after returning to the White House. His life hung in the balance, exacerbated by a urinary tract infection that triggered a high fever. The doctors’ prescription, however, was incompatible with Wilson’s singular job.

“The treatment for a stroke at the time was to be kept very quiet and not face stress or difficult decisions or hear bad news,” says Rebecca Boggs Roberts, author of Untold Power: The Fascinating Rise and Complex Legacy of First Lady Edith Wilson. “Well, what does the president do all day?”

According to Edith Wilson’s memoir, neurologist Francis X. Dercum warned her: “Every time you take him a new anxiety or problem to excite him, you are turning a knife in an open wound.” When she raised the prospect of his resignation, the neurologist cautioned that Wilson’s fight for the League of Nations was keeping him alive. “If he resigns, the greatest incentive to recovery is gone,” Dercum said.

“So if he does his job, he dies. And if he quits, he dies—and there might never be world peace,” Roberts says. “Those are the stakes given to Edith in her retelling.”

Caught in a paradox, the first lady conspired with Grayson and Tumulty to hide the full extent of Wilson’s incapacitation. “The White House never at any time—right to the end of Wilson’s presidency—admitted that he had a stroke,” says John Milton Cooper Jr., author of Woodrow Wilson: A Biography.

At the time, constitutional guidance for handling a disabled president was murky at best. Article II of the U.S. Constitution authorized the vice president to assume the presidency following a chief executive’s “death, resignation or inability to discharge the powers and duties” of office—but never defined who could declare a president unfit to serve. The only precedent came from 1881 when President James A. Garfield lingered for 79 days after being shot without relinquishing authority.

When Secretary of State Robert Lansing suggested Vice President Thomas Marshall assume the presidency at an October 6 Cabinet meeting, Grayson refused to sign a declaration of disability, insisting Wilson’s mind was “not only clear but very active.” Further complicating matters, Marshall was petrified at the thought of becoming president.

“Thomas Marshall was not close to Wilson. He was not in on anything important. He was not somebody who could step in easily,” notes Cooper.

Since her 1915 marriage to Wilson, the first lady had been far more knowledgeable about the inner workings of her husband’s mind and administration than Marshall. “Before they were married, he sent her confidential documents and legislation, so she was very well attuned to what’s going on inside the government,” Roberts says.

Edith became her husband’s gatekeeper, shielding him from stress and bad news while he convalesced. She filtered his mail and official papers and required Cabinet secretaries to submit only yes-or-no questions.

“I, myself, never made a single decision regarding the disposition of public affairs. The only decision that was mine was what was important and what was not,” the first lady later wrote. Edith insisted she never signed official documents and described herself merely as a “steward.”

Her control over communications, however, made that claim tenuous. “Whoever controls access to the president to some extent is president,” Cooper says. “Almost by default she was making decisions. She was an acting president.”

For nearly a month after Wilson’s stroke, no government official saw the bedridden president. Rumors spread that he was completely paralyzed and unable to speak or write.

On December 5, 1919, Senators Albert Fall and Gilbert Hitchcock visited the White House under the pretext of discussing relations with Mexico, but their true mission was to assess Wilson’s condition.

After a 45-minute meeting, they told reporters Wilson was lucid and speaking clearly. “Senators Find President’s Mind ‘Clear as a Bell,’” proclaimed the New York Tribune. The encounter, however, was carefully orchestrated. Edith and Grayson had propped Wilson up in bed, concealing his paralyzed left side under a blanket, and stacked papers within reach of his functioning right hand.

The meeting temporarily quelled concerns, but Wilson’s recovery was slow. He struggled to concentrate and carry on conversations. He eventually walked again but with the assistance of a cane. “There’s gradual improvement, but he’s never again fully functioning as president,” Cooper says.

Beyond a few interviews with friendly news outlets and periodic automobile rides—where Secret Service agents had to lift him into the seat—Wilson lived in near seclusion through 1920 as the government grappled with the Palmer Raids, Prohibition and the League of Nations. Shielded from the truth of his own decline, he even made plans to secure a third term.

Wilson left the White House in 1921 as a ghost of his former self. The Senate had rejected the Treaty of Versailles, and voters had delivered his party a stinging rebuke.

It wasn’t until President John F. Kennedy’s assassination in 1963 that the need for the 25th Amendment came to light. Ratified in 1967, it spells out the process for removing a president incapacitated by illness or injury.