Physician details house call to Nixon

Medicine & Science

October 20, 2003

Thirty years ago, three physicians made a historic house call on Richard M. Nixon, who had resigned months earlier as president and was living in San Clemente, Calif. The doctors were appointed by federal Judge John J. Sirica to evaluate Nixon, whose personal physician said he was too ill to travel to Washington to testify in the Watergate trial of Nixon's former staffers.

Richard S. Ross, then dean of the Johns Hopkins School of Medicine, was on the team that examined Nixon. Ross described that experience in a recent article for Transactions of the American Clinical and Climatological Association, which is excerpted here.

On November 11, 1974, Judge Sirica asked me to be a member of the panel and told me that the other members would be Dr. Charles Hufnagel, Chief of Surgery at Georgetown, and Dr. John Spittell, a peripheral vascular specialist at the Mayo Clinic. ... We reviewed the deposition of Dr. John Lungren, Mr. Nixon's personal physician, and Dr. Hufnagel supplemented this account with his telephone conversations with Dr. Lungren and with Mr. Nixon's surgeon, Dr. Eldon Hickman.

FOR THE RECORD - In yesterday's Medicine & Science section, Dr. Richard S. Ross was incorrectly identified in a photo caption that accompanied an article about a historic house call to President Richard M. Nixon. Ross was in the center of the photograph, not the far left. The article also incorrectly described Ross as dean of the Johns Hopkins School of Medicine at the time; in fact, he was chief of cardiology and later became dean.

Mr. Nixon's medical problems with phlebitis over the years had been duly followed and reported by the press. He first had trouble with his left leg during a trip to Japan in 1965. In September of 1974, approximately a month after he resigned the presidency and returned to his home in California, the left leg was noted to be larger than the right, and there was tenderness in the left calf and thigh. There were also episodes of shortness of breath.

On September 23, he was admitted to the Long Beach Memorial Hospital. He was [given the blood thinner] heparin. Lung scans showed evidence of pulmonary embolism [a blood clot] in the right lung. The patient was discharged on [the blood thinner] Coumadin.

On October 23, because of groin pain and the persistent enlargement of the left leg, an ultra sound was performed. The patient was readmitted to the hospital. [Tests] showed that there was a clot extending into the left iliac vein. On October 29, Dr. Hickman operated.

The procedure took about one hour, and was finished at 7 a.m. At 12:45 p.m. the patient was awake, stood to void and fainted. The anticoagulation was stopped, and he was given vitamin K. He also received three units of blood. Over the next few days, he received several units of packed red cells and also packs of platelets. Diagnoses considered were continued bleeding or disseminated intravascular coagulation [multiple blood clots].

On October 30, a large hematoma [a swollen bruise] was noted in the flank extending to the left border of the rectus muscle. He was also noted to have a left pleural effusion [blood in the space outside the lung] that was thought to be secondary to the retroperitoneal hemorrhage [bleeding outside the membrane lining the abdomen].

He gradually recovered and was discharged November 14. He was up and around, but depressed and tired. He had lost about 15 pounds during the illness. The possibility of a hidden malignancy was considered. The caption of a picture in the New York Times stated: "A wan Nixon returns to his home after a 3-week stay in the hospital."

We decided it was a foregone conclusion that we would recommend against travel to Washington so soon after this major illness. However, we saw no course open to us but to go ahead with the plan to examine the [hospital] records and to visit Mr. Nixon at San Clemente.

[At] "Casa Pacifica," we went through an opening in the wall that led into a Coast Guard Station, past a helicopter pad, to a security office. We were told that the many dogs running around represented gifts to Mr. Nixon from various world leaders. The grounds were well kept with beautifully trimmed and manicured California vegetation. We ... were led into the former president's bedroom.

The room was darkened. The colors were subdued. The former President was lying in his bed in pajamas. The bed ... had some sort of an arrangement on it to keep his legs elevated. As we entered, he attempted to get up and greet us, and we urged him to stay in his bed. He insisted on standing and shaking each of our hands. He seemed somewhat unsteady as he stood, but possibly this was due to the difficulty in getting out of this low bed with the elevated foot.

We then asked him to lie back down in his bed while we talked to him, and we sat in chairs around the bed. The Secret Service men remained standing. Although darkened, the room was light enough to see the pictures on the wall. Over his bed was what appeared to be a Vietnamese or Southeast Asian picture. On the tables were pictures of the family. A Russian lacquered box was on one bedside table, a Dictaphone on the desk, and a needlepoint design of a Navy goat was framed on the wall.

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