By Jared Rhoads
This week marks the 90th anniversary of the sad and untimely death of Calvin Coolidge, Jr., President Calvin Coolidge’s younger son. The general story is well-known: while playing lawn tennis with his brother on the White House grounds, sixteen-year-old Calvin, Jr. developed a blister atop the third toe of his right foot. Before long, the boy began to feel ill and ran a fever. Signs of a blood infection appeared, but despite doctors’ best efforts, young Calvin, Jr. was dead within a week.
The suddenness of this loss causes many to wonder about the medical-historical context of his death.
The microorganism that took the President’s son was Staphylococcus aureus, a relatively common bacterium. On the skin, Staph can lead to minor irritations and infections. In the bloodstream, however, Staph can result in sepsis, a serious condition that can affect the major organs and be potentially fatal.
Deaths from sepsis unfortunately were quite common in Coolidge’s time. Ordinary wounds, accidents, and childbirth were all ways in which bacteria could get into one’s normally sterile blood.[i] Patients presenting with fever, low blood pressure, and an obvious site or cause of infection could be diagnosed with relative ease, but the treatment options available were minimal, and the mortality rates were high. Success with the application of antiseptic chemicals was mixed, with healthy tissue often being damaged in the attempt to control the infection.
The Coolidge case was not the first time that blood infection struck a Presidential family. In 1890, Abraham Lincoln’s only grandson, Abraham “Jack” Lincoln II, also 16 years old, died from a similar blood poisoning after a French surgeon performed a procedure to remove an abscess under his arm.[ii] Nine years before that, President Garfield famously died not from the assassin’s bullet that was lodged in his body, but from the infection that ensued after repeated unsanitary attempts to remove it. Antibiotics could have easily treated the infection that killed Calvin, Jr. But in 1924 Alexander Fleming’s discovery of penicillin was still four years away. The realistic clinical use of penicillin to treat such an infection was even further away, as it was not until the early 1940s that the use of penicillin started to become practical, and it was not until the war effort hit its stride that the drug was finally available in adequate quantities. As late as 1940, the entire nationwide stock of penicillin, produced by Merck & Co., had been enough to treat approximately ten patients.[iii]
Hindsight or not, there was little that the Coolidges could have done to save Calvin, Jr. They sought the opinions of multiple doctors, confirmed the diagnosis with numerous laboratory tests, and admitted the boy to Walter Reed Army Medical Center, which was one of the best hospitals of the day. As is often the case, the best guard against this tragedy would have been prevention, i.e., to take precautions against acquiring the blister in the first place. Today, although sepsis is still a major concern in certain hospital settings (e.g., post-operative areas and intensive care units), and although some antibiotic-resistant forms of Staph have emerged and are causing concern, we can be relatively free of the worry that we might succumb under the same unfortunate circumstances as the President’s beloved son.
Jared Rhoads is a health policy researcher and graduate student in public health at The Dartmouth Institute for Health Policy and Clinical Practice. He lives in Lebanon, NH, with his wife and young son.
[i] Funk, et al. “Sepsis and Septic Shock: A History” Critical Care Clinics, 25:1, pp 83-101, January 2009
[ii] Schwartz, Thomas F. “A Death in the Family : Abraham Lincoln II ‘Jack’ (1873–1890)” For the People. Abraham Lincoln Association. 9:30, Autumn 2007
[iii] Rutkow, Ira. Seeking the Cure. Scribner, New York, 2010. p223