The back brace

[Guest Mark Valenti]

Don't know if this was discussed previously -- this is from Scott Allen of the Boston Globe, April, 2006:

When Dr. Hans Kraus began treating President John F. Kennedy's aching back in October 1961, he was appalled by what he discovered: JFK's abdominal muscles were so weak that he could not do a single sit-up.

Worse, the Austrian-born exercise guru believed the treatments that another doctor had prescribed were making Kennedy weaker.

But over the next two years, Kraus used an ambitious exercise routine to rebuild the president's strength to the point where he felt Kennedy was ready to take up jogging and throw away a rigid back corset he had long worn for support. Kennedy's secretary, Evelyn Lincoln, would later write to Kraus that, thanks to him, Kennedy was able to toss 2-year-old John-John in the air for the first time.

Kraus's files on Kennedy, made public this week by the John F. Kennedy Presidential Library, suggest that after years of pain and sickness, Kennedy was actually starting to feel like the robust young man that White House image makers always made him out to be. Kennedy suffered from a debilitating hormonal disease as well as a very bad back, but Kraus's records show that the president's vigor and comfort were increasing as he performed more of the leg lifts, knee bends, and other exercises Kraus oversaw during at least 85 meetings with the president.

''It was so satisfying to build someone up, to start from scratch and make someone so well," Kraus, who died in 1996, told his biographer, Susan E. B. Schwartz. ''Kennedy was my baby."

In recent years, historians have tended to view Kennedy's touch football games in Hyannis and other athletic feats largely as photo opportunities to distract attention from his overall poor health. Medical records released by the Kennedy Library in 2002 showed he was taking steroids to combat low levels of the hormone adrenaline caused by Addison's disease; shots of procaine to dull his back pain; and other medications for everything from diarrhea to difficulty sleeping.

''Lee Harvey Oswald killed Kennedy before the president's medical ailments could," concluded Robert Dallek, author of ''An Unfinished Life: John F. Kennedy, 1917-1963."

But Dallek did not have access to Kraus's files, kept in a folder marked ''K" and stored for decades in a family vault until his widow donated them to the library. Though the public knew that Kraus was treating Kennedy, he promised the president that he would not talk about the treatments or Kennedy's condition, so Kraus's work has largely been overlooked. Allan Goodrich, chief archivist at the Kennedy Library, said Kraus has been seen more as a ''physical trainer" rather than the doctor in charge of the president's back.

In reality, as made clear in Kraus's files and Schwartz's new biography, ''Into the Unknown," Kraus demanded ''absolute control" over Kennedy's back and Kennedy promised to take no phone calls while he was with Kraus unless it was a national emergency or his mother, Rose Kennedy. In return, Kraus got measurable results: Within a month, Kennedy could nearly touch his toes again.

''It wasn't rocket science. It was basic, and it made a tremendous difference," Goodrich said. ''When you look at those records in conjunction with the rest of the medical records that are available, people will get a full appreciation of the medical history."

Kraus, trained as an orthopedic surgeon at the University of Vienna, was called to the White House on Oct. 17, 1961, after two of Kennedy's regular physicians became alarmed by the president's condition. For months, Kennedy had found it difficult even to rise from a chair, and he often relied on crutches when not in public. Doctors George Burkley and Gene Cohen wanted help from the New York City-based Kraus, already well known for using exercise to speed recovery from injuries.

But Kraus was skeptical that he could help his 44-year-old patient, described in the doctor's records as 6 feet tall, 179 pounds. By then, Kennedy had endured more than 20 years of back pain -- which has variously been blamed on a car accident; a football injury; the sinking of his boat, PT-109, during World War II; and the long-term effect of taking steroids for Addison's disease.

Twice, in 1954 and 1955, Kennedy had been so close to death from infections after back surgeries that a priest had been called in to perform the last rites. For the preceding six years, Dr. Janet Travell had treated him with ''trigger point injections," in which she used a needle to break up clumps of dead tissue in his back and to deliver the pain reliever procaine.

''In view of the past history, I would not venture a long-range prognosis," Kraus wrote of his patient after their first meeting.

But Kraus, a legendary rock climber who had successfully pushed President Eisenhower to launch a physical fitness campaign for children, agreed to treat Kennedy and set a plan of three therapy sessions a week in the White House gym and a drastic reduction in the back injections. He also set a goal of getting rid of the corset. Kraus believed both the injections and the corset were making Kennedy weaker.

Over the next two years, Kennedy made dramatic progress under Kraus's tutelage, getting so proficient at stretching exercises that Burkley said he would ''do credit to a gymnast," taking stairs instead of elevators, and donning swim fins to make kicking in the White House pool more challenging. By May 1963, two years after Kennedy had last swung a golf club, Kraus told the president he could safely resume playing, according to medical records. Shortly thereafter, Kennedy made a film of his stroke that he planned to send to golf great Arnold Palmer for advice.

But even as his overall condition improved, Kennedy still had flare-ups of back pain, and he was reluctant to give up comforts such as his rocking chair and the tightly-laced back brace he had worn since he was a student at Harvard. Eventually, Kraus persuaded Kennedy to do without the extra padding in his famed rocker, but Kennedy continued using the corset long after Kraus felt it was unnecessary.

When Kraus saw Kennedy for the last time, in October 1963, Kennedy agreed to expand his workouts to include jogging and other fitness activities. He also promised to stop wearing the corset. Kraus hoped that Kennedy was about to lead a national fitness crusade, as he had urged, ''to combat the physical and psychological effects of our soft, sedentary, self-indulgent way of life."

Schwartz, who reviewed Kraus's medical files and interviewed him extensively for her biography, believes all the exercise changed Kennedy's self-image profoundly. ''For the first time in his life, Kennedy was starting to see himself as a healthy man," she said.