Ronald Reagan was the fortieth president of the United States and the fifth to be shot at by a would-be assassin. On March 30, 1981, a deranged young man, John Hinckley Jr., fired six bullets at him outside a hotel in Washington, D.C. One bullet struck his chest, ricocheted off his left seventh rib, and grazed his lung. He lost a great deal of blood but survived the attempt, as did earlier in the century Theodore Roosevelt, but unlike Abraham Lincoln, William McKinley, and James Garfield who were killed. Reagan was rushed to George Washington University Hospital, where surgeons removed the bullet and repaired the damage to his lung. He recovered slowly over the next six months and continued in office. His health and some other medical details of his presidency are of sufficiently recent memory to remain of interest to the American public.

Reagan was born in 1911 and his birth was so long and difficult that his mother was advised not to have any more children. His childhood was free of illness, but in school he was so shortsighted that he had to sit in the front of the class. He also had difficulties in playing sports because he could not see well, and he was rejected for active service. As an actor in his youth, he likewise had to deal with poor eyesight and had to wear thick glasses. He later wore contact lenses.

In 1945 a bout of pneumonia caused Reagan to lose seventeen pounds. In 1949 he sustained a fracture of the femur, perhaps from falling off a horse. Throughout his life, he showed a penchant for physical fitness and sports, exercised every day, and he stopped smoking supposedly after his brother developed cancer of the larynx. In 1966 he had prostate stones removed surgically and a year later he underwent a trans-urethral prostatectomy for benign prostatic hypertrophy and recurrent prostatitis.

In 1977 he required a cortisone injection for temporomandibular dysfunction and later had some osteoarthritis of the right thumb. In 1983 he began to wear a hearing aid, the hearing loss being possibly related to the revolver being fired close to his ears during the earlier assassination attempt.

After a routine colonoscopy In July 1985, Reagan underwent surgery to remove polyps from his colon. The polyps were benign, but during anesthesia he experienced a dramatic drop in blood pressure. Doctors were concerned about potential cardiac problems and found he had an arrhythmia and a pericardial effusion, apparently related to the surgery and post-operative inflammation but not a separate heart condition. He recovered well and underwent follow-up surgery to repair an abdominal hernia.

In January 1987 Reagan underwent another transurethral prostate surgery. A small basal cell carcinoma was removed from his nose on July 31, 1987. Later, a larger area of tissue surrounding the lesion was excised under local anesthesia at Bethesda Naval Hospital. In January 1989, at the end of his presidency, Reagan had a procedure to correct a buildup of fluid in his middle ear, and also a correction of a Dupuytren’s contracture of his left hand. Another basal cell carcinoma was removed from his neck in 1995.

In 1989, just a few months after he completed his second term as president, Reagan underwent surgery to drain a subdural hematoma caused by a fall from a horse in Mexico. Such brain injury can increase the likelihood of developing Alzheimer’s disease or perhaps even cause it. It appears that earlier on Reagan had an earlier subdural hematoma that resolved with conservative management and no surgical intervention.

In 1994 Reagan himself dramatically announced that he had been diagnosed with Alzheimer’s. As his condition worsened, Reagan’s family and his wife Nancy in particular became his primary caregivers, but he continued to insist on maintaining an active lifestyle.

In 2001 Reagan had a fall and broke his hip. He had pins, a metal plate, and small screws inserted in the broken bone and recovered well, being able to sit in a chair and walk with assistance.

He lived to the age of 93, making him the longest-lived president in U.S. history at that time. He died from pneumonia in 2004.

Some critics have contended that by his second term Reagan was already suffering from early Alzheimer’s or senile dementia. This has been denied by his physicians, who have maintained that while he may have exhibited some forgetfulness, Reagan did not show signs of mental changes until well after he left office in 1989.

Further reading

• Health and Medical History of President Ronald Reagan. Medical History of American Presidents. Doctor Zebra. https://doctorzebra.com/prez/g40.htm.
• President Reagan’s Medical Procedures. Ronald Reagan Presidential Library & Museum. National Archives. https://www.reaganlibrary.gov/reagans/reagan-administration/president-reagans-medical-procedures.
• Lou Cannon. Actor, Governor, President, Icon. The Washington Post, June 6, 2004.
• JW Milsom. The medical history of President Ronald Reagan. J Am Coll Surg. 1994 Dec;179(6):763.
• GA Parker: The medical history of President Ronald Reagan. J Am Coll Surg. 1994 Dec;179(6):763.
• OH Beahrs. The medical history of President Ronald Reagan. J Am Coll Surg.1994 Jan;178(1):86-96.