Privacy vs Public's Right to Know

The White House had a very direct explanation for Laura Bush's initial refusal to reveal that she had a skin cancer tumor removed last month from her right shin. She is not an elected official, said White House spokesman Tony Snow.

Therefore, he said, she was under no obligation to disclose something that was not life-threatening. "Perhaps," said Snow, "if there's something more major, this would be discussed."

Mrs. Bush did not lie about the squamous cell carcinoma. She simply remained silent until a reporter asked about the bandage below her right knee, a bandage she has worn for more than five weeks. Tony Snow told reporters, "I think you guys are trying to whip this up into something much larger than it is." Unlike President Bush and Vice President Dick Cheney, he said, "other members of the family" do not reveal medical problems "and have not done so in prior administrations, and are not likely to do so."

That is not entirely accurate. Some first ladies have been forthcoming, such as Nancy Reagan, when she discovered she had breast cancer. She underwent a successful mastectomy in 1987. Earlier, Betty Ford had the same operation shortly after her husband became president. Mrs. Ford became a spokeswoman for the importance of detecting breast cancer early.

However, Mrs. Ford, while in the White House, stayed silent about another problem that had privately worried friends and family. They suspected her dependency on alcohol and opiod analgesics. According to a former staffer in the Ford White House, Donald Rumsfeld, who was White House chief of staff at the time, grew concerned about her drinking and chided a friend of hers for encouraging it.

The problem became worse after the Fords left the White House in 1977. The following year, Betty Ford's family forced her to confront her addiction. After her recovery, she established the now world-famous Betty Ford Center for the treatment of chemical dependency.

For the most part, Americans seem to give first families wide leeway in how much medical knowledge should be shared. Of course, Americans love rumors, and there was talk about alcoholism in some families long before Gerald Ford became president. But while some may have enjoyed gossip about a first lady's tippling habits, there was no public demand that the White House address whether those rumors were true.

Even as a child in Alabama, far from the chattering circles of Georgetown, I heard tales of how Mamie Eisenhower enjoyed a drink or two or three while "Ike" was otherwise occupied with government or golf. Many years later, her granddaughter, Susan, told me flatly there was no alcohol abuse. None. Nada. Zero.

When it comes to a president's health, the public has gradually come to expect full access to the results of physical examinations. It was not always so.

In 1919 President Wilson suffered a severe stroke, partially paralyzing him and leaving him blind in one eye. The country knew he was seriously ill but did not realize the extent of the damage done by the cerebral hemorrhage. Neither did his vice president. Wilson's wife took on many of the president's responsibilities, including choosing the issues worthy of his attention.

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