George H.W. Bush and First Lady Barbara Bush wave to supporters on October 12, 1992 at a campaign rally in Springfield, Pennsylvania.

George H.W. Bush and First Lady Barbara Bush wave to supporters on October 12, 1992, at a campaign rally in Springfield, Pennsylvania. | LUKE FRAZZA/AFP/Getty Images

History Dept.

How a Medical Mystery Tilted the 1992 Election in Bill Clinton's Favor

In 1989, Barbara Bush was diagnosed with Graves' disease. Then, two years later, George H.W. Bush came down with it—just in time for his re-election campaign.

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Soon after her husband was sworn in as president of the United States in 1989, Barbara Bush began losing weight, 18 pounds in all, sudden progress after a lifelong struggle. “I convinced myself it was because I was eating smaller portions and working so hard,” she said in her 1994 memoir. But she also was having trouble with her eyes. They were inflamed and bulging, and sometimes she was seeing double. Aboard Air Force One in February 1989, heading back to Washington after a trip to China, she sat down beside White House physician Lawrence Mohr and described her symptoms.

Mohr immediately suspected Graves’ disease, just from examining her eyes. For reasons unknown, her thyroid glands were producing too much of the hormone that regulates the body’s metabolism. (Barbara Bush joked that the sobriquet “doesn’t mean you’ll go to the grave; it’s named for the doctor who diagnosed the ailment.” That would be Robert J. Graves, a 19th-century British physician.) The next day, at the White House, Mohr drew a sample of her blood to test. He consulted with specialists at Walter Reed Medical Center and the Mayo Clinic.


When the doctors told Bush their diagnosis, she was matter-of-fact. “It was like, ‘What do we have to do?’” Mohr told me. That question turned out to be hard to answer. A long process of trial and error, using drugs and then radiation, never eliminated entirely the bothersome symptoms. They would persist for decades.

Barbara downplayed her symptoms, but when her husband also contracted the disease—an improbable development, given that the disease is not contagious—many people close to the Bushes wondered if the disease wasn’t having a larger effect than the couple was letting on. In interviews, they suggested that the disease could have made Bush too exhausted to put up a strong fight against his younger upstart rival in the 1992 election, Bill Clinton.

Did a medical mystery change history? And, in the process, launch a new American political dynasty, the Clintons, that would define the Democratic Party for a quarter century in the way the Bush family defined the Republicans?

In public, Bush dismissed the notion that anything was seriously amiss. “She’s just fine; piece of cake; never broke her stride,” her press secretary, Anna Perez, breezily assured reporters after a treatment at Walter Reed that involved drinking a radioactive substance. In her memoirs, Bush expressed more concern about her dog’s medical plight than her own. Her beloved Millie had developed a different autoimmune disorder, lupus.

The first lady “wasn’t feeling great,” Mohr recalled years later, in an interview at his home in Charleston, South Carolina, where he was teaching at the Medical University of South Carolina. “Her eyes were clearly bothering her. She had lost weight. She was feeling fatigued.” More than a year after the diagnosis, in the summer of 1990, her eyes were still swollen and teary, and she was often seeing double. She was trying to wean herself off prednisone, a painful process. The steroid she had taken weakened muscles in her right hip, forcing her to take physical therapy to strengthen them. “I confess, I was in a lot of pain,” she said.

Then George H.W. Bush was diagnosed with Graves’ disease, too.

In May 1991, the president was jogging at Camp David, in Maryland’s Catoctin Mountains, when he found himself panting and unable to finish. The medical staff on duty gave him an EKG. His heartbeat was irregular, in fibrillation. Barbara had been swimming in the pool at the presidential retreat. She was hurriedly summoned and they boarded the Marine One helicopter for a short flight to the Bethesda Naval Hospital in Maryland.

“As I sat there, the most dreadful thoughts ran through my mind: Dear God, this wonderful man must not die,” Barbara Bush recalled. He would stay overnight in a hospital suite as doctors worked to restore his heartbeat to its usual rhythm. He began to do some paperwork. “A little later, as he worked away, I thought: Don’t you dare die. I’ll never forgive you.”

Bush was treated with medication, and the doctors made plans to shock his heart back into rhythm the next morning if the drugs didn’t work. That would require putting him under general anesthesia and invoking the 25th Amendment, temporarily shifting the powers of the presidency to Vice President Dan Quayle. Aides debated whether to announce that in advance; after conferring with Bush they did. (The procedure turned out not to be necessary. By morning, his heart was beating steadily again.)

The underlying problem was diagnosed as Graves’ disease, the same disorder his wife had, although it affected them in different ways—his heart, her eyes. Like her, his treatment included drinking radioactive iodine. Doctors began drawing blood every day as they tried to carefully moderate his hormone levels. Too little would leave him lethargic; too much risked tripping his heart into fibrillation.

The oddity of both Barbara and George Bush being diagnosed with the same noncontagious disease while at the White House posed a medical mystery that was never authoritatively settled. The fact that both were under stress, perhaps coupled with a genetic predisposition for the disease, was the least conspiratorial medical explanation. Their son Marvin’s diagnosis in 1985 of ulcerative colitis was another indication of a possible genetic predisposition for autoimmune disorders in the family.

Still, some wondered if there had been an environmental trigger at the White House or in the vice president’s residence, where they had lived for eight years. Or perhaps some aftereffect, innocent or nefarious, from their time in Beijing, where Bush served as the top U.S. diplomat for more than a year. Barbara Bush told me there were “all sorts of rumors about the Russians looking down on us.” The Soviet Embassy was less than a mile from the vice president’s residence, and built on higher ground. Had the Soviets been up to no good?

The water and air in the White House already were managed in ways to guard against contamination. The vice president’s residence, though, built in 1893 for the superintendent of the U.S. Naval Observatory, was aging. Second lady Marilyn Quayle was concerned that the Bushes’ ailments might signal some problem there. The water, the plumbing, the paint were tested; nothing notable was found. But there was never a full-fledged investigation into what might have contributed to both Bushes developing the same autoimmune disorder, and within 15 months of each other, not to mention Millie’s ailment.

Barbara Bush told me she was inclined to see it as just one of those weird coincidences in life. At the time, she reported that George W. Bush jokingly had called to say she “could end all the talk if his dad and I would just stop drinking out of Millie’s bowl.”

There was an unspoken reason some advisers weren’t interested in unleashing an aggressive inquiry: They saw nothing to gain in focusing too much attention on Bush’s diagnosis and in the process fanning concern about his stamina for a second term. Despite his record-breaking approval ratings after the first Gulf War, he ended up facing a difficult reelection campaign. Conservative commentator Pat Buchanan mounted a damaging challenge from the right in the GOP primaries, and a half-dozen Democratic senators and governors vied to take him on in November.

“They didn’t want people to think that they were going to elect a damaged president,” John Sununu, then the White House chief of staff, later told me. White House press secretary Marlin Fitzwater said: “The campaign people were in mortal fear.”

In private, Fitzwater and some others close to Bush believed the disease was having a serious impact on the president and on his campaign, though the White House never publicly acknowledged that to voters at the time.

“If they hadn’t had Graves’ disease, he would have been reelected, I think,” Fred Malek, his campaign chairman, told me. “Nobody at that point recognized the depths of what that caused.” He said the president “had the energy to get up in the morning and handle his in-box, but he didn’t have the mental energy to initiate, to cause change.” He found it difficult to respond aggressively to the country’s economic challenges and to the political challenges presented by Clinton, whose campaign was emphasizing his youth, vigor and empathy.

Bush realized something was wrong. He told Colin Powell, then chairman of the Joint Chiefs of Staff, that the medicine he was taking caused “a slowing down of the mental processes” for a time. During the campaign, “I saw a passive, sometimes detached George Bush,” Powell said, not the vigorous leader he had been before.

Fitzwater, who was constantly by Bush’s side, said incidents of fibrillation continued, sometimes leaving the president pale and tired. “He was sick,” Fitzwater said. “He was a different person.”

The Clinton camp had a tactical edge and an energy that the Bush team did not. There would be little suspense on Election Night. In the three-way race, Clinton won with 43 percent of the popular vote, carrying 32 states and the District of Columbia. Bush received just 37 percent of the vote, carrying 18 states. And H. Ross Perot received 19 percent of the vote, the largest share of the popular vote for an independent candidate since Teddy Roosevelt ran as a Progressive in 1912.

“We all gathered in Dad and Mom’s suite to watch the returns,” daughter Doro Bush Koch would recall. “We were in the living room, and Mom was in the bedroom reading a romance novel. Things were not looking good at all, casting a pall over the room. Periodically, however, Mom would walk in the room and say, ‘What’s it like to drive a car?’ And then walk back out. A few minutes later, she came in and asked, ‘How do you buy an airplane ticket?’”

Like it or not, they were about to find out. Evicted from the White House, they were heading back home to Houston.

Excerpted from THE MATRIARCH: Barbara Bush and the Making of an American Dynasty by Susan Page. Copyright © 2019. Available from Twelve Books, an imprint of Hachette Book Group, Inc.

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