The President's News Conference
THE PRESIDENT'S PLAN TO UNDERGO SURGERY
THE PRESIDENT. Good afternoon, ladies and gentlemen.
I wanted you to know that my doctors have recommended that I undergo surgery to repair a defect at the site of the incision made during the gallbladder operation a year ago.
About 6 months ago a small bulge began to appear in the region of the scar on the right side of my abdomen. Although it would disappear from time to time, I experienced a continuing soreness and a drawing, pulling sensation. The protrusion has enlarged recently and the soreness has recurred, and the doctors have therefore recommended surgery.
After final discussions with Dr. Burkley in Seoul, Korea, on Tuesday, I accepted his recommendation that the operation take place within 15 or 18 days from now.
The doctors also intend at that time to remove a small polyp from my throat.
They have recommended that I begin a reduced schedule of activity in preparation for the operation. I intend to leave tomorrow for Texas.
I would expect to put in a rather heavy day tomorrow on desk work and bills and leave sometime in the afternoon.
Mr. Moyers1 is here with the doctors who will take part in the operation, and who have participated in the diagnosis.
1 Bill D. Moyers, Special Assistant to the President.
They will come in and be glad to answer any questions you may have to ask. They will be Dr. Burkley; Dr. James Cain of Mayo's; Dr. Devine, the throat man from Mayo's; and Dr. Gould, the throat specialist from New York who has been treating me.
INTRODUCTION OF PRESIDENT'S PHYSICIANS
MR. MOYERS. The President will go back to his office and I will bring the doctors in. We will have a session with them before anyone leaves.
These will all be in the material you will receive as you leave here, but Dr. James Cain is to my far left. Dr. Cain is a longtime personal physician to the President's family.
Next on my left is Adm. George Burkley, Physician to the President.
On my right is Dr. W. James Gould, director of otolaryngology at the Lenox Hill Hospital.
You will have biographical sketches of the doctors.
Dr. Hallenbeck is not here. He is the surgeon who performed the operation last year, and will again be the principal surgeon.
Dr. Kenneth D. Devine is to my right. He is a member of the section of plastic surgery of the Mayo Clinic.
Dr. Hallenbeck is head of a section on general surgery and head of the section of surgical research of the Mayo Clinic.
Dr. Burkley has a statement, a copy of which will also be in the material you receive as you leave here.
STATEMENT ON THE PRESIDENT'S CONDITION
DR. BURKLEY. At the time of the President's gallbladder surgery, drains were placed in the abdominal wall about I inch from the end of the incision on the right side. This is routine procedure in such surgery.
Following removal of the drains, the wound appeared to heal completely. On several occasions, a drawing pain was noticed in the region of the scar localized where the drains had been removed. In April 1966 a small protrusion was noted.
There has been a continuing soreness and a drawing sensation in this area. The protrusion has enlarged somewhat in the last 3 weeks and is now approximately the size of a silver dollar. It is reducible when the President is either lying down or wearing a back brace.
Since there has been some recent enlargement of the protrusion and recurrent soreness, surgical repair is therefore advisable.
In August, a small polyp in the region of the right vocal cord of the President's throat was noted. This cleared up from time to time. This polyp was again noted just prior to the Asia trip and Dr. W. J. Gould of New York City and Dr. Kenneth Devine of the Mayo Clinic recommended that it be removed. At the time the abdominal wall is repaired, the polyp will be removed from the throat.
There is no indication of any serious problem in either instance, and his general health continues to be excellent.
Q. What is the nature of the protrusion?
DR. BURKLEY. As the word itself implies, it is just as you look at something, there is a little hump, that is what the connotation is.
Q. Doctor, could you define a polyp for us?
DR. GOULD. The polyp is a soft tissue protrusion, that is like a grape, actually.
Q. Like what?
DR. GOULD. A small grape.
Q. What would cause it?
DR. GOULD. In this instance, excess voice usage.
Q. What would be the size of the polyp, sir?
DR. GOULD. Three millimeters, subcortical.
Q. That might be an explanation for hoarseness from time to time?
DR. GOULD. Yes.
Q. How do you characterize it--a minor surgery?
DR. GOULD. Any surgery is a surgical procedure and minor or major, according to the individual. It is a small amount of tissue. I will put it that way.
Q. Would this polyp be tested for a malignancy?
DR. GOULD. Yes.
Q. Dr. Burkley, do you expect the surgery, the operation, to be held in Bethesda Naval Hospital?
DR. BURKLEY. The decision on where the surgery is to be performed has not been decided, it has not been made.
Q. What is the size of the protrusion?
DR. CAIN. I think that you ought to be sure you understand this pretty well. There is a small defect at the end of the scar, as Dr. Burkley mentioned, where the drains were removed. This is about the size of the end of your finger, perhaps, the area there.
Then, out from this, there is a protrusion about the size of a silver dollar, or maybe a golf ball. Let me show you here. It is something kind of this way.
Say there is a hole there, and the protrusion is something like that [illustrating], and when he lies down, it goes back in.
Q. What caused this, doctor?
DR. CAIN. Well, it is a weakness in the wall there at the area where these drains were in, and the muscles have spread apart just a small amount there.
Q. Do they call this an incisional hernia?
DR. CAIN. That would be a proper name for it.
Q. How do you repair it?
DR. CAIN. It is very simple in that you can make an incision over it and pull the muscles together and close it.
Q. Is this a frequent development?
DR. CAIN. It is a frequent development. It is reasonably frequent. You hope it won't happen, but it happens often enough that I think you would say it was frequent.
Q. What do you think causes it beyond that?
DR. BURKLEY. Well, the drainage area doesn't have the same opportunity to heal as when the whole thing is tied tightly, and that sometimes makes that area a little weaker and more apt to occur in that area.
Q. Do either of these two procedures that you describe present problems normally, with the average patients?
DR. BURKLEY. No, there is no particular problem.
Q. Is it the plan that the President will remain at the ranch until the operation?
MR. MOYERS. That hasn't been definitely decided.
DR. BURKLEY. It is recommended that the President have approximately 2 weeks' rest, at least 2 weeks' rest before any procedures are attempted.
Q. What effect does the removal of the polyp have upon the speaking after the operation? That is, for any period of time, will it be difficult to speak?
DR. GOULD. There will be hoarseness for 2 or 3 weeks, due to local tissue swelling, but there should be no permanent effect upon speech.
Q. How long would he ordinarily be hospitalized for this procedure?
DR. GOULD. Overnight for the polyp.
DR. CAIN. He will be in the hospital for several days all together, with this, but he will be in good shape as soon as he is out from under any anesthesia that he is given, and it will be a very minor disability from that standpoint.
Q. Will both operations be done at the same time and under the same anesthesia?
MR. MOYERS. Yes.
Q. Would it require as much anesthesia as in the last operation?
MR. MOYERS. No.
Q. How long is the operation?
MR. MOYERS. Probably less than an hour for both things, from beginning to end.
Q. Are these things of an emergency nature, that they have to be done?
DR. CAIN. No, these things are things that we have recognized, actually, as Dr. Burkley mentioned, for some time. Many people have these, and ordinarily, or often, you can do nothing about them. But during this trip, as some of you know, he was quite active in doing an awful lot of standing and walking and so forth, and this seemed to be enlarging very slightly.
Dr. Burkley, at that time, I think, decided that he thought we ought to go ahead and repair these.
While doing it, we decided we would take care of both things at the same time and get it done.
Q. Could it have waited until next week?
DR. CAIN. Well, once the decision is made, I think you ought to go ahead and get it done. This is the thing.
I do think that extra working and exercise, and so forth, adds to the enlargement a little bit.
Q. Did the President ask if it could be delayed any?
DR. CAIN. He asked our advice about whether it should be delayed, and Dr. Burkley and I certainly concur that, for many reasons, one, because of the fatigue of this trip, and so forth, and getting ready for this operable procedure, I thought that he ought to take some time off. I hope he will.
Q. You don't describe this in the nature of an emergency?
DR. CAIN. It is not an emergency in that way.
Q. Did the doctors recommend against a weekend political trip with all of its talking?
DR. BURKLEY. I recommended that the President, inasmuch as this was indicated, or this surgery was indicated, have it done at an early date. On the basis of that, I recommended that he have a period of rest of approximately 2 weeks beforehand.
I feel that that indicates against a weekend trip, as you mentioned.
Q. Did this Asian trip aggravate the situation at all, Doctor?
DR. BURKLEY. I beg your pardon?
Q. Did the trip to the Far East aggravate this?
DR. BURKLEY. It aggravated it, but the symptoms were there. There was a slight increase, and we noted a slight increase in the size of the protrusion during that trip.
Therefore, I would think that there was some effect from the strenuous trip.
Q. Did it cause him great pain during the trip?
DR. BURKLEY. Not great pain, but just stress, a little disturbance there, and a pulling sensation, and a drawing sensation in the area.
Q. You mentioned he was wearing a back brace. Has the President worn a back brace very often?
DR. BURKLEY. He has been wearing it quite regularly, since this protrusion was noted. It was noted in April.
MR. MOYERS. The protrusion was noted in April, and the polyp was noted in August.
Q. Dr. Gould, is a polyp like this generally malignant or generally not malignant?
DR. GOULD. It is not generally, but it will be tested, regardless.
Q. Will anyone fill in for the period when the President is under anesthesia?
MR. MOYERS. I don't believe so.
Q. Would it be fair to say that further effort on the President's part would further aggravate his condition?
DR. BURKLEY. It is my opinion that inasmuch as he has noted some change in it during this Asian trip, that it would be advisable not to do a similar trip until the repair is accomplished.
MR. MOYERS. Let me make certain that you understand the material in the package. You will get the biographical sketches of the men who are here--Dr. Burkley, Dr. Devine, Dr. Cain, and Dr. Gould. You will also get a biographical sketch on Dr. Hallenbeck, who is not here, but who will again perform the surgery.
You will also get a biographical sketch on Dr. Edward Paul Didier, consultant in anesthesiology in the Mayo Clinic, and instructor in anesthesiology in the Mayo Graduate School of Medicine, who was the President's anesthetist last fall.
There is also a biography of Dr. J. Willis Hurst, professor and chairman of the Department of Medicine, of the Emory University School of Medicine, and continuing consultant to the President.
Also there will be a sketch on Dr. Lay M. Fox, the White House physician.
Those of you who wish to may leave at this point.
Q. What is the President's weight? Can we get some vital statistics on the President, like what does he weigh?
DR. BURKLEY. He weighs somewhat over 200 pounds.
Q. Somewhat over?
DR. BURKLEY. He contemplates a diet program during this period prior to the surgery.
Q. Do you want him below 200 pounds?
DR. BURKLEY. We would like to have him around the same weight as he had at the time of the other surgery.
Q. Which was what?
DR. BURKLEY. Around 198 or 196, I think, but he may not lose that much. He is a tall man, and actually a lot of men smaller than he is weigh around 200 or 210, and think nothing of it. If he gets down to that, he is really doing very well.
Q. How much over 200 is he?
DR. BURKLEY. I don't know exactly. He had been ranging around between 200 and 215. I don't know exactly what his weight has been the last few days or weeks.
MR. MOYERS. Thank you, gentlemen.
Note: President Johnson's eighty-first news conference was held in the Cabinet Room at the White House at 3:30 p.m. on Thursday, November 3, 1966.
Lyndon B. Johnson, The President's News Conference Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/237559