If her husband was the accidental president, Betty Ford was an accidental first lady. At a time when the country yearned for truth, her disarming openness distinguished her.
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"She broke away from the traditional role," said Sheila Rabb Weidenfeld, Betty Ford's former press secretary. "She wasn't suppressed and polite and willing to pour tea."
As Ford herself told ABC News in 1998, "When my husband was sworn into office, he said that everything was going to be open."
Betty Ford spent 58 years at Gerald Ford's side. She was a former model, dancer and fashion coordinator when they married shortly before Ford was first elected to Congress in 1948.
By the time he ran for re-election as president in 1976, he was calling himself "Betty Ford's husband," and her brief time as first lady had made her a campaign asset.
From day one, she talked openly about abortion and women's rights, and answered questions about premarital sex and pillow talk with the president.
"She was almost revolutionary," said Richard Norton Smith, former director of the Ford Library. "Her candor, her honesty, sometimes it got her in hot water."
In 1974, she put a face to breast cancer, a disease no one talked much about. The first lady had a mastectomy, and women around the country flooded into doctor's offices.
"Hundreds of thousands of women in the world have breast cancer," she once told ABC News' Barbara Walters. "I felt I had to share my experience with them."
And so perhaps it wasn't so shocking when she shared another secret struggle. In 1987, Ford told Walters she had been taking 25 or 30 pills a day while her husband was president.
"I used the pills and the alcohol to help me cope," she said. "It was like an anesthetic."
The signs had been there: In an interview with Walters just before she left the White House, the first lady was visibly impaired.
Her family intervened. She got help, and went on to build a center that has helped more than 76,000 other Americans -- from celebrities to young women.
"Thank you for being such an inspiration," one of them, Elizabeth Anderson, told ABC News in 2002.
"In some ways Betty Ford's historical significance is greater for what she did after leaving the White House," said Smith, the former Ford Library director. "She's affected the way more people live their lives than many presidents do."
Her influence was so large, it once prompted former President Ford to quip, "I am indebted to no man, and only one woman."
ABC News' Kate Snow contributed to this report.