Six doctors huddled around their anesthetized patient easing a gelatinous mass from his mouth. A motor chugged in the background and the floor vibrated as their operating room, the living room of a yacht, steamed at half-speed up the East River. The doctors were operating under the strictest veil of secrecy; not even their families knew where they were. This secrecy, however, only heightened the heavy tension. This patient happened to be a man that they could not lose. He began to stir, his corpulent face jiggling slightly, as the nitrous oxide started to wear off. The doctors uttered a quick prayer and administered ether, a stronger and much riskier anesthetic. The patient, President Grover Cleveland, dropped off again, still as death.

 

On the first of May 1893, President Grover Cleveland noticed a rough spot on the left side his mouth. Over the next six weeks, this insidious spot grew into an irritating inconvenience, interfering with his habitual cigar chewing. Fed up with the pain, Cleveland summoned Dr. R.M. O'Reilly, the official government doctor in Washington, to examine his mouth. O'Reilly quickly discovered the source of Cleveland's discomfort: an ulcer the size of a quarter. Worried, O'Reilly removed a sample of the ulcer and sent it to the Army Medical Museum for analysis, where a pathologist confirmed the likely malignant, or aggressive, nature of the tumor.

Dr. O'Reilly called Dr. Joseph D. Bryant for a second opinion. After examining Cleveland, Bryant looked his friend squarely in the eyes and told him that if he had an ulcer like that in his mouth he "would have it removed at once."

"At once," however, proved to be a sticking point. Cleveland insisted on discretion, refusing to have any operation before July, a month from the present. He desperately wanted to avoid public knowledge of his medical condition. He feared further inflaming the current financial panic sparked by the recent collapse of the Philadelphia and Reading Railroad companies and fanned by the Sherman Silver Act of 1890 passed three years earlier. This act required the United States Treasury to purchase millions of ounces of silver every year from western silver mining states with notes redeemable in either gold or silver. These purchases fueled further silver mining, increasing the supply of silver and decreasing its price. Understandably, people redeemed their treasury notes for gold, decreasing the U.S. gold reserves and inflating U.S. currency by about $50 million.

To make matters trickier, political maneuvering prior to the election bequeathed Cleveland with a pro-Sherman Silver Act Vice President, Adlai Stevenson. A hint of the severity of Cleveland's illness would build Stevenson's political capital while destroying the President's, thereby crippling Cleveland's drive to repeal the Silver Act.

O'Reilly, Bryant, and Cleveland confided in Secretary of War Daniel Lamont, a close personal friend and advisor to the President. Lamont quickly contacted Elias C. Benedict, another one of Cleveland's close personal friends and fishing partners, and secured his yacht, the Oneida, for the operation. Bryant and Cleveland set August 7 as the target date for the President's return to Washington. This timeframe optimistically assumed that the cancer would not metastasize, moving to other parts of his body, and that the surgery would not cause any complications.

Bryant wrote to Dr. William Williams Keen, one of the nation's leading surgeons and a good friend of Bryant, asking that they meet to discuss "a very important matter." Soon, the doctors met in New York on the deck of a deserted boat. Bryant explained the grave situation to Keen, who immediately agreed to help. The two doctors then planned the coming operation thoroughly exploring all the necessary preparations, from disinfecting the living room on the Oneida to assembling the surgical team.

Had Cleveland lived a mere fifty years earlier, this tumor likely would have been a death sentence. Only in the early 1800s did Rudolf Virchow, a pioneer in cellular pathology, conduct the observations that set the stage for the development of cancer surgery. And more importantly, only in 1846 did anesthesia become widely available, allowing the art and science of surgery to progress and develop methods to successfully remove tumors.

On June 30, 1893, the surgical team mustered aboard the Oneida, anchored a judicious distance off the coast of New York City. The President, Dr. Bryant, and Secretary Lamont slipped out of Washington, telling the White House staff and cabinet officers that they were going "fishing." They arrived aboard the Oneida late the same evening. Two hours after the President's stealthy departure, the White House issued Cleveland's call for an extra session of Congress to meet on August 7 to address the financial panic. The President now officially had thirty-eight days to fight and recover from cancer. If he and his doctors failed, the nation would face an economic conflagration fueled in part by the destabilization of the nation's leadership.

Even with this mounting pressure, Cleveland slept splendidly without any sleeping medication. The following morning, a general physician examined the President. Despite Cleveland's extraordinary girth - he was in fact twice as wide as even the most corpulent member of his cabinet - the physician found nothing wrong with the President's chest or kidneys. He recorded a pulse of ninety beats per minute, high but well within the acceptable range. After this preliminary examination, Dr. Keen conducted a second exam. He found no enlarged glands, and confirmed O'Reilly and Bryant's conclusion: the ulcer had to go. Throughout the morning, the surgical team rinsed and disinfected the President's mouth.

Before beginning the surgery, the team met to discuss concerns over using ether to anesthetize Cleveland. Fat and fifty-six, Cleveland presented a worrisome anesthetic predicament. His body type and age suggested the distinct possibility of cerebral hemorrhaging or a stroke as the result of administering ether. Additionally, the burdens of Cleveland's first four months in office had left him mentally and physically drained. In less than half a year he had faced a severe financial meltdown, mounting economic tensions between the East and West added to the residual North-South sectional divide, a rapidly expanding population, and an unending barrage of office seekers looking for a place in the new administration. On top of all this unrest, he struggled to fill high-level appointments with his desired candidates. His first choices to head the State Department, the Treasury, and the Justice Department all declined.

Accordingly, the doctors decided to play it safe with their valuable patient and conduct the first stages of the operation under nitrous oxide, or "laughing gas." Then, if necessary, they would resort to ether. Dr. Hasbrouck, the dentist charged with the administration of the nitrous oxide, argued that it would not keep the President sedated for a sufficient length of time to complete the operation. Dr. Bryant, the lead surgeon, declared that when, and if, ether became completely necessary they would use it and "pray!"

Shortly before noon the President walked to the Oneida's converted living room and sat heavily in a chair lashed to the mast for stability. The yacht set sail up the East River at half speed. While waiting for the other doctors to prepare the President for surgery, Dr. Bryant approached the captain of the boat. Fixing his piercing gaze on him, Bryant warned, "If you hit a rock, hit it good and hard, so that we'll all go to the bottom!" A jolt of that size would likely kill his patient. And what would Bryant do with a dead president? A dead president killed in a secret operation? A dead president killed in a secret operation that Bryant had sanctioned and performed?

Cancer and fear share a long history. Records of cancer go as far back as 1600 B.C.E. Writings from Ancient Egypt describe breast tumors stating, "There is no treatment." Hippocrates, a fourth century B.C.E. Greek physician and the "Father of Medicine," echoed this view. In fact, resignation regarding treatment persisted into the twentieth century. As recently as the 1970s, only half of the people diagnosed with cancer survived five years following the diagnosis. Bryant and his surgical team were about to attack what most people at the time still saw as an incurable disease. Moreover, they planned to have their patient back in Washington with no one the wiser in a little over a month.

As the yacht glided along, the operation began in the cabin. This forward motion helped add stability since a slow moving boat is generally more stable than a boat at anchor. Commodore Benedict and Secretary Lamont remained on deck staring blankly at the horizon; the wind ruffled the Commodore's thick white beard and the Secretary's full mustache.

First Dr. O'Reilly administers the nitrous oxide and inserts Dr. Keen's cheek retractor. This metal instrument pulls Cleveland's fleshy cheek out of the way, allowing the doctors access to the ulcer without external incisions. Their goal is to prevent any noticeable scarring or disfigurement of the President's cheek so that, if he lives, he will be able to appear in public without jeopardizing the secrecy of the operation.

Dr. Hasbrouck extracts the two teeth closest to the ulcer. With Cleveland still sedated, using only laughing gas, Dr. Bryant begins to slide a large electric knife through the President's jaw.

1:14 p.m. - Dr. Hasbrouck warns that the nitrous oxide will soon wear off. Saying a brief prayer, Dr. O'Reilly administers ether.

With Cleveland once again sedated, Bryant continues to carve away the President's left upper jaw. As he works, Keen and Dr. Bryant's assistant staunch the flow of blood using pressure, hot water, and in one particularly dicey instance, electrical cauterization. With Keen hovering beside him, Bryant meticulously avoids cutting the portion of the skull that supports the eyeball. If he accidentally cuts this bone, the President's eye socket, along with secrecy of the operation, collapses.

1:55 p.m. - The operation ends. The President's pulse is 80, still well within the normal range, and only ten beats lower than his pre-operation measurement.

Throughout the entire operation, Cleveland lost only six ounces of blood. To prevent further bleeding, the surgeons packed the empty space left by the procedure with gauze and returned Cleveland to his cabin. With the President resting comfortably, the team of surgeons breathed a collective "sigh of intense relief," as Keen recounted years later in an account he wrote of the operation.

An hour later, Cleveland awoke in substantial pain. The doctors gave him a single dose of morphine, the only narcotic used during the whole procedure. Cleveland's temperature hovered around 100.8 degrees after the operation and did not get any higher. His pulse quickly returned to around 90. With gauze in the cavity and substantial effort, the President could speak understandably. Without gauze, his speech was incomprehensible.

Immediately after the operation concluded, Hasbrouck, the dentist, insisted on going ashore, claiming that he was already two days late for another important operation. The team collectively vetoed this request. They feared compromising the secrecy of the operation and, more importantly, hitting a rough current while docking and causing severe bleeding in the President's mouth and possibly a stroke. Hasbrouck fumed.

The next day, July 2, Cleveland got out of bed for the first time and by the following day he felt well enough to sign Commodore Benedict's guest log. The surgical team, save Dr. Bryant, all departed by the end of the July 3. Two days later, the Oneida arrived at Gray Gables, Cleveland's summer cottage in Cape Cod, Massachusetts. The President walked from the yacht to his house unassisted and with little noticeable effort. The President hugged his relieved wife, walked past his spacious stone hearth, and turned in for the evening.

Three days later, the Boston Herald ran an article asserting, "President Cleveland is a sick man," and attracted the attention of other newspapers. Eight reporters descended on Gray Gables in the late afternoon and sought comment from the Cleveland camp. They learned that Secretary Lamont planned to speak with them around 7:00 p.m. Past the publication deadline for their afternoon editions, they waited with all the patience that can be expected of reporters on the trail of a full-blown scoop.

At 7:00 p.m., Secretary Lamont walked over to an old barn about 200 yards away from Cleveland's house to deal with the crowd of curious reporters. He greeted them kindly and stated matter-of-factly that the President "never enjoyed having a dentist work over him. In consequence he had allowed his dental work to fall so badly into arrears that he finally felt compelled to go on the yacht; here he could be cool and comfortable and let the dentist make a thorough job of it."

The reporters fired back, demanding particulars:

"What was the name of the dentist?"

"What procedures did he perform?"

Lamont coolly dismissed these questions as "too trivial to talk about."

The reporters walked back to their hotel by the railroad station arguing. About half of them believed Lamont's yarn. That evening they held a contentious meeting to decide the story, having agreed earlier to send out a unified version of events to all of their papers. The secret along with the financial fate of the nation turned on the credibility of one man and his story.

Meanwhile, the nation continued to wobble towards financial catastrophe. On average, one bank failed every other day. Unemployment in the industrial workforce rapidly approached 15%. And, due in large part to the Sherman Silver Act, the Treasury was hemorrhaging gold, further weakening the public faith in the financial market. A serious presidential medical problem was the last thing the country needed.

The following day, the reporters gave the world Lamont's version of events.

Within the next two weeks, Dr. Kasson C. Gibson, a well-respected New York orthodontist, fit the President for a vulcanized rubber jaw. This apparatus kept the President's cheek from caving in and allowed him to speak clearly.

After the fitting, Dr. Bryant examined the site of the operation to check the healing progress and the fit of the artificial jaw. To his dismay, he discovered that the first procedure missed some diseased tissue. He urgently summoned the surgical team. Cleveland had to be in Washington on August 7, or all the secrecy and all of the yarn spinning and all of the lying would be for naught.

The team traveled to Commodore Benedict's home in Greenwich, Connecticut, and boarded the Oneida once again. The yacht picked up the President and Bryant at Gray Gables. On July 17, Dr. Bryant excised all the remaining questionable tissue and cauterized all of the bleeding portions of Cleveland's mouth. Mercifully, the operation was short, and the President recovered quickly.

The day after the operation, Dr. Keen left the Oneida at Newport, RI. On the boat home, Keen ran into his brother-in-law, Spencer Borden, before he managed to hole up in his room. Surprised to see Keen, Borden exclaimed, "Hello! What are you doing here?" Once again, the secrecy of the entire operation hinged on creative bluffing.

Keen casually explained that he had a "consultation near by, and did not have time to visit the family in Fall River." Fortunately, Borden respected the concept of doctor-patient confidentiality and did not press Keen for more details.

On August 5, President Cleveland left Gray Gables for Washington and the special session of Congress he had called to address the financial crisis by repealing the Sherman Silver Act. While in Washington he stoically argued his case without betraying a hint of the medical crucible he recently survived. However, Cleveland needed a bit more time to fully recover and returned to Gray Gables on August 11.

At the end of August, with both Houses of Congress fiercely debating the repeal of the Sherman Silver Act, the Philadelphia Press almost unraveled the entire frayed secret. An article, published on August 29, claimed that a team of surgeons had recently performed major oral surgery on President Cleveland aboard the Oneida. The article was factually correct. The leak was traced to Hasbrouck.

When Hasbrouck finally managed to leave the Oneida after the first operation, he traveled to assist society doctor Leander P. Jones. To explain his tardiness, Hasbrouck told Jones what he had been doing. Angry that the President had not requested his medical expertise, Jones tipped off a friend at the newspaper, telling him to talk to Hasbrouck. The reporter convinced Hasbrouck that the story should be public knowledge by playing to Hasbrouck's pride in participating in such a nationally significant event.

Fortunately for Cleveland and the effort to repeal the Sherman Silver Act, the story was met with incredulity, and soon entirely discredited by those close to the President. Secretary Lamont continued to convincingly spin his dentist yarn and Dr. Bryant later said he lied more during this breach than during the rest of his life combined. The men around Cleveland painted Hasbrouck as an incompetent dentist and a liar. They portrayed the reporter who wrote the article as a scandal hound overly hungry for a story.

On August 30, President Grover Cleveland left Gray Gables for the winter, returning to Washington to help guide the repeal of the Sherman Silver Act. Two days later he arrived at the White House. On this day, a brief note by Dr. Bryant observed that the President was "all healed."

After nearly three months of bitter debate, Congress finally repealed the Sherman Silver Act on November 1, 1893. While this did not immediately reverse the financial crisis of 1893, it did help stabilize the U.S. currency, eliminating one of the major factors that contributed to the panic. According to The New York Times, "at that moment, as so often before, between the lasting interests of the nation and the cowardice of some, the craft of others, in his own party, the sole barrier was the enlightened conscience and the iron firmness of Mr. Cleveland."

Grover Cleveland served until the end of his term in 1897. He retired to Princeton, New Jersey, and spent his time lecturing and serving as a trustee of the university. He died on June 24, 1908, fifteen years after the operation. The sarcoma never recurred.

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