Past & President: J. Willis Hurst and LBJ

March 3, 1997

Over the years, Dr. Hurst has taught more than 5,000 residents, fellows, and students, but he hasn't had enough. He teaches seven sessions each week and can be found in Emory Hospital by 7:00 each morning.

Excerpts from the book:
How it all started
From the President of the United States, Greetings
You Had Better See the Patient First
The Final Good-Bye

Sometimes uninhibited, always complex, Lyndon Johnson was a man who lived to translate dreams into reality," write J. Willis Hurst, MD, and James C. Cain, MD, in the Epilogue to their book, LBJ: To Know Him Better. "He also, in the midst of his grinding schedule, found time to be funny and humane. We were with him, and we know."

Dr. Hurst, former Candler Professor and chairman of the Department of Medicine at Emory, and Dr. Cain, a longtime Mayo Clinic staff member who passed away in 1992, were certainly in a better position than most to know the private side of Lyndon Johnson. As LBJ's personal cardiologist and gastroenterologist, respectively, they were with him, they write, "during times of joy and sadness, health and illness, success and failure." Their book, published last year by the Lyndon Johnson Foundation, is a collection of intimate anecdotes about the former president, as told by 40 of his friends, family members, colleagues-and by the good doctors themselves. The result, as Lady Bird Johnson wrote in the book's Foreword, "is a celebration of Lyndon's life, and in the telling, a triumphant reunion of beloved friends."

American history textbooks remember Johnson as the most powerful Senate leader in the post-WW II era, as architect of the Great Society, and as an often controversial leader swept up in the political turbulence of the Kennedy assassination, the civil rights movement, and the Vietnam War. But the storytellers in LBJ: To Know Him Better recall a softer, more personal side to this complex icon of Americana, one marked by humor and compassion. Both views, says Dr. Hurst, are equally real and important.

With today's cynicism toward politicians, Dr. Hurst says, "It is not uncommon for people to suspect that that these qualities were not genuine, that they were an act. But LBJ brought these attributes to the political arena, and they greatly shaped his choices in his political life." In reality, he argues, Johnson's innate optimism and love of helping others formed the cornerstone of his Great Society idealism.

"It is easy to lose sight of the fact that most of Johnson's efforts in creating the Great Society were enormously unpopular in his day," Dr. Hurst points out. "Especially in his native South. He didn't do these things for political gain, but out of deep personal conviction." This book, he hopes, will help bring those private convictions to public light.-DG

The following excerpts from LBJ: To Know Him Better are from the opening section, "Reflections of J. Willis Hurst, M.D." (Dr. Cain wrote a separate section, and a third one includes stories from such diverse figures as actor Gregory Peck and fellow Texas politician Lloyd Bentsen.) In his section, Dr. Hurst begins at the beginning-with his first encounter with Johnson, in 1955, as the then-Senate majority leader arrives at the US Naval Hospital in Bethesda in the midst of a heart attack. Dr. Hurst, 34 at the time, was chief of cardiology there and happened to be on call.

Lady Bird Johnson, in the book's Foreword, also recalls this meeting clearly: "Willis was a big, young Georgia cardiologist, and during their first few minutes I got the distinct impression that here was a man who, like Lyndon, quickly took charge of a situation. "Lyndon had turned gray; he didn't look alive, didn't look like he was breathing. It was a heart-stopping moment for me, and it lasted for the next six weeks, which was the routine stay then for heart attack patients. Dr. Hurst became the most important man in my life. He would either save Lyndon or not."

How it all started

The voice on the phone in my Washington apartment said, "The Majority Leader is coming to the hospital. He has chest pain." I returned to the hospital to await his arrival. It was a serious heart attack, and his hospitalization lasted several weeks. I was with him several times a day during the hospital stay. I spent considerable time with his wife, Lady Bird, explaining the problems to her and assisting her through the ordeal. Dr. Jim Cain of the Mayo Clinic came to visit him, as did Dr. Howard Burchell, a cardiologist at Mayo's. Jim Cain and I became friends as well as medical colleagues in guiding LBJ's medical care for the next eighteen years.

During the hospitalization, members of the press were in constant attendance. LBJ had been having great success as majority leader of the Senate and had helped President Eisenhower enormously, so his heart attack was front-page news. While LBJ was convalescing at his ranch a short time later, President Eisenhower had his own heart attack, and the publicity shifted to him. (Still later, in 1958, LBJ asked me to join him and Lady Bird in the White House as Eisenhower presented him with the Heart of the Year award from the American Heart Association, prompting LBJ to say that "heart attacks are bipartisan.")

Senator Johnson made a vigorous comeback, and in the fall of 1955 he visited me in Atlanta, where I had returned to Emory University and would subsequently become professor and chairman of the Department of Medicine, a position I held until September 1986. . . .

People always ask me if it was difficult to be LBJ's physician. The answer sometimes surprises the questioner: It really was not. He followed his doctor's advice without too much debate. We did at times "negotiate" with him, as he liked to do, but he always listened.

LBJ accepted retirement well; I detected no bitterness in him. He felt he would have won the 1968 election if he had chosen to run, but he was content with his decision not to throw his hat in the ring that one last time.

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LBJ and Lady Bird came to Atlanta to visit me in the fall of 1955. He had recuperated at the ranch and was ready to return to his busy life as majority leader of the Senate. We admitted him to Emory University Hospital for examination. I was very pleased with the results and, at LBJ's request, informed the press that he was doing well and that his electrocardiogram had returned to normal. He was ready for work.

The following Sunday afternoon I received a telephone call from Dr. Paul White. Dr. White was my mentor; I trained with him at Massachusetts General in Boston during the late 1940s. He was internationally known and respected, and was President Eisenhower's senior cardiologist. He asked, "Willis, is Johnson's electrocardiogram normal?"

I answered, "Yes, sir. It is within the normal range. It is not identical to the electrocardiogram made on him prior to his attack, but if one did not have the old tracing for comparison, one would call his current electrocardiogram normal."

He chuckled. "President Eisenhower called. He wanted me to explain to him why his own electrocardiogram had not returned to normal, like LBJ's has."

Dr. White taught me to rehabilitate patients after heart attacks. He believed that almost all patients should go back to work. His influence on me prevailed at a time when other unsolicited advisors were urging me not to allow LBJ to return to work. Now, of course, it is different; physicians have learned that virtually all such patients can and should resume normal activities.

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From the President of the United States, Greetings

My frequent trips to Washington and to foreign countries with him prompted LBJ to say to me one day, "I believe it would be wise for you to sign up with the Naval Reserve. Then when I call you to come on a trip, you will be on duty when you leave home and go off duty when you return home."

I did not answer for a moment. I considered that I had already served in both the army and navy and was in no hurry to join the reserve. I muttered something that did not sound too enthusiastic. LBJ became noticeably impatient and said, "I can draft you, you know!" He later brought it up again, and for years I was concerned that I would receive some sort of draft notice in the mail.

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You Had Better See the Patient First

President Johnson called me one night to ask if I would travel to see a foreign leader who was seriously ill from a heart attack. I would leave Atlanta by Jetstar early the next morning. We discussed it for a while and I suggested that Dr. Tom Mattingly, one of President Eisenhower's cardiologists, might also go with me.

Then I asked how long I would be gone. At the time, it seemed a reasonable inquiry. LBJ paused and answered, "Don't you think you'd better see the patient first?"

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The Final Good-Bye

Texas weather can be fierce, and one winter day in 1973, it was terrible. Rain, thunder, lightning; it was daytime but it was dark. The little plane was waiting for me on the LBJ ranch runway. Barney was a seasoned pilot and I had no real worry about flying the short hop from the ranch, where I had been visiting, to the airport in San Antonio. I was worried about LBJ, however. Although we had talked a lot and he seemed to be in control of things, he looked worn.

The time arrived for me to depart and he, Lady Bird, and I walked to the doorway just off the kitchen to say good-bye. The moment was somber. The walk was slow. We paused, not too far from the spot where we stood in 1955 when the three of us came down from Washington after his first heart attack. Now, almost eighteen years later, he said, "Here is something for you, to express my gratitude." It was a Rolex watch. He said, "Please have it engraved as follows: 'To JWH Love LBJ.' I would have had it done but I am staying on the ranch these days." I choked up. The three of us hugged simultaneously. Then I joined Barney in the plane.

Back in Atlanta I reflected on LBJ's gift. I knew he could have had the watch engraved in Austin, but for some reason he had chosen not to wait. He wanted me to have the watch then, at that point in time, rather than later. Not even a few days later.

I wrote and thanked him again, and I asked him to write me a note indicating the wording he wanted engraved on the watch. I was too embarrassed to ask the engraver at Maier and Berkele's to take my word for such a thing. LBJ obliged me with a letter that I presented, along with the watch, to the jeweler.

There had not been much talk during that good-bye at the ranch, but the messages transmitted by the three of us were clear-very clear. It was the last time I saw him.

Lady Bird called. He had died. She said, "I want you to come and be at my side the next several days." I went with the family, first to the ranch, then to the LBJ Library, to the Rotunda and to Blair House in Washington, then to the church, and finally back to the family burial site in a grove of live oaks on the bank of the Pedernales River.

I saw thousands of people pay their respects. I saw glistening streaks of tears on thousands of faces. My friend was gone, and an era was over.

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For copies of LBJ: To Know Him Better, write to the Lyndon Baines Johnson Library, 2313 Red River Street, Austin, Texas 78705.

Reprinted from Emory Medicine Magazine, pp 28-33, Autumn 1996

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Copyright ©Emory University, 1996. All Rights Reserved.
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