Image Credit: Battey, C.M. "Booker
T. Washington, Half-Length Portrait, Standing,
Against White Background", Circa 1890 to 1917.
The African American Odyssey:
A Quest for Full Citizenship,
Library of Congress.
PATIENT: Booker T. Washington
DATE OF DEATH: November 14, 1915
SYMPTOMS: In August of 1915, his personal physician wrote that Washington had “three severe attacks of kidney trouble—[was] also suffering from high blood pressure—extremely high.” In November, Washington was hospitalized at Rockefeller Hospital in New York City complaining of failing vision, headache, sleeplessness, fatigue, and loss of weight. He was diagnosed with kidney trouble and high blood pressure. The patient was completely worn out, with notable hardening of the arteries, said the hospital doctor. His records also show “a great many yellowish spots around the posterior pole of the eye.” His physicians gave him only a few days to live but did not treat his hypertension. He was released and died less than two weeks later in his own bed at the Tuskegee Institute.
OFFICIAL CAUSE OF DEATH: “Hardening of the arteries, following a nervous breakdown,” according to The New York Times obituary.
OTHER CLUES:
• Although the patient’s early years were hard to the extreme—he frequently lacked food, shelter, and clothing, and he and an older brother often ate what they could snatch from the kitchen fire—he seemed to weather them without detriment.
• Work was his obsession, and although he appeared indefatigable, in 1884, after three years at Tuskegee, he was so exhausted and ill that he had to delegate his authority temporarily and crawl into bed under a doctor’s care. He had a similar brief breakdown when he was 43.
COULD IT BE . . .
The Rockefeller physician suggested that “racial characteristics” were responsible for Washington’s poor health. He may have been implying a history of syphilis, something that Washington’s personal physician strongly denied.
DIAGNOSIS: Malignant essential hypertension. Washington’s blood pressure was so high upon admission to Rockefeller Hospital—225/145 mm Hg—that today’s clinicians would treat it as an emergency, with high doses of medication. Untreated, a blood pressure of this magnitude is virtually always fatal. It destroys blood vessels throughout the body, especially those supplying the heart, brain, and kidneys. Washington’s records show evidence of left ventricular failure—fatigue and palpitations—as well as renal complications. His visual problems and headaches may have been caused by compromised blood flow to the brain and eyes. The other critical piece of information: a negative Wassermann test, which proves beyond all doubt that he was not infected with syphilis.
Excerpted from Post Mortem: Solving History's Great Medical Mysteries by Philip A. Mackowiak, M.D. (American College of Physicians, 2007). Available at www.acponline.org/postmortem.
