Sometime around the inauguration, the West Wing was trending on Netflix and I thought, “You know, I should watch that.” I was not expecting to fine a massive plot line surrounding Multiple sclerosis! I decided to dive into the history of our presidents, their medical histories, and answer the question: could we today support a president with MS?
First let’s start with breaking down the nature of MS. The National MS Society describes the disease as, “an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body.” MS is an autoimmune disease that affects the central nervous system. The body’s immune system overreacts and causes swelling in the central nervous system, which erodes away at the protective coating called myelin. Myelin ordinarily acts as a conduit for nerve transmission. The nerve beneath the myelin is also damaged during an attack, and it creates lesions along the nerve.
The interruption of normal nerve transmission is the cause of the more visible symptoms of the disease. The most common symptoms include fatigue, difficulties walking, numbness, stiffness and muscle spasms, weakness, visual disturbances, vertigo and dizzy spells, difficulties controlling urination, problems participating in sexual intercourse, constipation, pain, shifts in cognitive functioning, and emotional distress. There are a myriad of other symptoms that can occur, but that gives an overview of the illness. As of now, there is no cure for multiple sclerosis though there are a few treatment options.
There are a few types of MS that a person can have. The first is clinically isolated syndrome, which is characterized by the autoimmune response causing inflammation in the central nervous system, but does not fall under the criteria for an MS diagnosis. Relapsing-remitting MS (the type our beloved Josiah Barlet has) is known for having attacks that are then followed by remission (either full or partial). RRMS can be either active, not active, worsening, or not worsening. Over time remissions move from being full, to partial with an increase of symptoms being left behind in the wake of an attack. A third type that often follows RRMS is secondary progressive MS which has a decline of cognitive abilities. The final type of MS is primary progressive MS, which is known for causing the person to show a decline in neurological functions from onset.
In the West Wing President Barlet and his wife choose to hide his relapsing-remitting MS (RRMS) from voters. Only his Vice President Hoynes, and his Chief of Staff were in the know about his condition. In our world of constant access to media, and near daily leaks coming from the White House, it is difficult to imagine anyone being able to pull off this level of deceit. As it turns out, however, our hypothetical president would not be the first to hide a condition like this.
There have been three presidents that have health conditions serious enough to use as a case study for this situation: Woodrow Wilson (1913-1921), Franklin D. Roosevelt (1933-1945), and Dwight D. Eisenhower (1953-1961). In 1919 Woodrow Wilson experienced a stroke that threw an entire country into a chaos—a chaos the country did not even know it was in the middle of.
During an emergency break from a speaking tour in which he was trying to gain support for his idea for the League of Nations from the American public, Wilson had a massive stroke that left him paralyzed on his left side, and caused him to lose part of his vision. His wife and his doctor worked together to create a cover-up to keep the world from learning not only of the incident, but also of the President’s health. He was recovering for an entire 17 months, with his wife acting as a go-between for the President and the world.
No article discussing disabilities and past presidents is complete without Franklin D. Roosevelt, who is famous for contracting polio in 1921 which caused him to initially withdraw from public service. Roosevelt is by far the most famous disabled president the US has ever elected, and the most visible. After he was paralyzed from the polio attack, he spent a long time working on rehabilitation. He would do daily exercises practicing standing (with the assistance of leg braces), swimming, and working on walking the length of his driveway-- though he never accomplished this.
It was a surprise when he returned to the political sphere. He was able to overcome the existing public opinion of people with disabilities of the time. Ultimately, Roosevelt did his absolute best to hide his disability whenever he was in the public eye. He developed a number of skills that allowed him to mimic walking with the help of a son or advisor, and learned how to maneuver stairs.
Our 34th president, Dwight D. Eisenhower, also was a sufferer from a chronic illness during his lifetime. During his terms, he experienced a heart attack, stroke, and was also diagnosed with Crohn’s disease and underwent surgery. In contrast to his predecessors, Eisenhower took an approach of full disclosure, telling the Press Secretary to tell the American public what had happened.
These three incidents certainly lay out the groundwork for a president with a chronic illness, such as MS, to be elected. However, these past experiences also point to a few things that could become a problem for our hypothetical Barlet. While it is true that Wilson successfully hid his illness from the public: it clearly had disastrous consequences. So much so, in fact, that the event helped to spark the ultimate creation of the 25th amendment that cleared up the previously very ambiguous explanation of transfer of presidential power stating that: in case the president dies, is incapacitated, or resigns, the Vice President becomes president.
So, if our Barlet were to run, he would certainly need to be upfront about his condition. Another modern-day pitfall is our 24-hour news cycle, and our near constant access to what the president is doing. I was twelve years old and I still remember the George Bush pretzel incident of 2002. The FDR Presidential Library and Museum notes that "FDR requested that the press avoid photographing him walking, maneuvering, or being transferred from his car. The stipulation was accepted by most reporters and photographers but periodically someone would not comply."
That would certainly not fly today. We would get a barrage of photographs of the president in several situations. If our hypothetical president had any medical slip, it would be plastered in the newspapers immediately. Articles complete with what-ever pictures photographers would be able to get snaps of, to be followed shortly there-after by flashy headlines of, "Is this the end of the Barlet Presidency?"
An advantage 2017 (2020?) Barlet would have over Roosevelt is the passing of the Americans with Disabilities act in 1990. The law was a huge game changer for millions of disabled Americans across the country. The increased protections for people with disabilities has allowed more people to enter the public eye because of forced accommodations, employment protection, and guaranteed access to telecommunication. In other words, this is not 1920s America where we hide people with disabilities behind the walls of institutions.
This increased protection and visibility could counteract the earlier problem of being unable to hide a disability, a clear tried and true tactic. While it is a stretch to say that people are accustomed to seeing people with disabilities, it doesn't come with the same discomfort people felt in years past.
Our real life Bartlet has another disadvantage to TV Bartlet. Writers are controlling TV Bartlet and when his MS acts up, and when it doesn’t. Real life Bartlet with relapsing-remittent MS doesn’t have the advantage of having writers pull him out of danger at the last second. He would have relapses much more randomly, and at potentially extremely inconvenient times. As is discussed in the show as well, there would be a significant difference between a four and an eight-year term length. We’ve all seen (or heard spoken of) the famous before and after pictures of Presidents in office and how much presidents age in only 8 years. A job of that caliber would put an unprecedented amount of stress on the body of an MS patient.
So, would it be possible for our hypothetical Bartlet to be elected in the next presidential election?
Yes, it is possible for it to occur. He would need to be upfront about his condition, but also do what other people with disabilities in office have done: acknowledge that it is there and then use it as a segue to discuss their policies and views. He would also need to be prepared for a potential fight, and be aware that the media would be in his face about his medical condition. Every illness, every tired day, anything off at all and a reporter might bring up the MS diagnosis. Additionally, he would need to be prepared to allay fears that he was incapable of being a strong leader.
He would also need to be prepared, I think, for a short term in office. I can reasonably see a four-year term being doable with the right supports. I feel that, though I’m not a doctor, an eight-year term in office might be an unwise decision for someone with an illness like this. I also won’t go as far to say it’s impossible, because I know so many people who have accomplished amazing things. I can say confidently that making the decision to go into office would definitely take a toll on our Bartlet’s health, and the shorter the term the better the outcome of that.
Though I firmly believe that it is possible, I cannot say that I am very optimistic about the prospect of that happening in the near future. People with disabilities are still seen as being less-than in a physical sense that our able-bodies peers. Something that FDR and Wilson did not need to deal with was how global of a society we are. While both presidents served during world wars, they also served during very cloistered periods of time. The President of the US is watched from cultures all over the world, many of which have far worse treatment of people with disabilities than we do. While the people of the world do not vote for our presidents, here at home people could vote based on perceived perception from other countries. Meaning they will look at which candidate makes us look the "strongest" in the eyes of foreign nations.
Despite my cautious optimism, I hope to someday be able to vote for an openly disabled person running for President of the United States.
Like this article? Subscribe to receive our bi-monthly newsletter and keep up with our 100% accessible geek content!