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Care of JFK by Dr. Max Jacobson, aka Dr. Feelgood

Biot Report #678: January 07, 2010 Printer Printer Friendly

An amphetamine epidemic afflicted the United States between 1940 and 1970, in part fueled by physicians such as New York general practitioner Dr. Max Jacobson who legally dispensed the drug, believing until the day he died that it was harmless and helpful to his patients. Amphetamines became a federally controlled substance in the United States only in 1970. (1-3)

     

    Dr. Max Jacobson (1900-1979). Source: Boyce Rensberger: “Amphetamines used by a physician to lift moods of famous patients.” The New York Times, December 4, 1972.

     

    Dr. Max Jacobson. Source:  Mark Shaw: The John F. Kennedys: A Family Album. Farrar, Straus, 1964.

Dr. Jacobson was a German-born physician who fled to New York City in 1936, where he founded “Constructive Research Foundation” allegedly to study multiple sclerosis and a medical practice in which he dispensed cocktails of amphetamines, hormones, vitamins and other constituents as “vitamin shots” in his combined medical office and research laboratory on Manhattan’s Upper East Side. The State of New York City issued him a medical license and the New York County Medical Society counted him as a member until his reckoning by state and federal authorities between 1972 and 1975. He never held a medical staff appointment at any hospital. If his patients needed hospitalization, he turned them over to other physicians who did have hospital privileges.

    One of Dr. Max Jacobson’s bottles of medicine made in his so-called Constructive Research Foundation. Source: http://designarchives.aiga.org/entry.cfm/eid_11635; accessed January 12, 2010.

For at least two decades (1950s and 1960s), countless numbers of celebrities flocked to Dr. Jacobson. His most famous patient was John F. Kennedy whom he injected with amphetamines and other medications countless times between September 1960 (probably earlier) and November 1963. For example, John Kennedy received amphetamine injections before his first television debate with Vice-President Nixon (1960), first summit talk with Russian Premier Khrushchev in Vienna (1961), confrontation with Khrushchev during the Cuban missile crisis (1962), and confrontation with U.S. Steel over a threatened strike (1962). (4-6)

    Effect on a family of presidential candidate John F. Kennedy speaking during Nixon-Kennedy debate on September 26, 1960. Source: http://images.huffingtonpost.com/2007-09-28-GreatDebate.JPG; accessed January 12, 2010.

By 1971, Dr. Jacobson, dubbed “Dr. Feelgood” (Dr. Feel Good) by his mostly grateful clientele, was dispensing exceptional amounts of amphetamines, needles and syringes. (5) Meanwhile, growing numbers of his patients were experiencing adverse outcomes from his “vitamin shots,” including death; for example, gifted Life magazine and Kennedy White House photographer Mark Shaw died of acute and chronic amphetamine poisoning at age 47 in 1969. (7-9)

    Photographer Mark Shaw. Source: http://markshawphoto.com/markshaw_biography.htm; accessed January 12, 2010.

In 1971, New York Times reporter Will Lissner and New York Magazine reporter Susan Wood published articles (June 3, 1971, and August 16, 1971, respectively) about another Dr. Feelgood-type practitioner named Dr. Alois Peter Warren. He was indicted on January 26, 1971, found guilty and sentenced to five years in prison by a federal judge for one count of conspiring to violate the federal food and drug laws relating to stimulant or depressant drugs and of four counts of selling, delivering, and disposing of amphetamine sulphate in violation of 21 U.S.C. Secs. 321, 331(q) (2), 333 and 360a(b) (Supp. V 1969). (10-12)

More than a year later, another New York Times reporter, Boyce Rensberger, investigated and exposed Dr. Jacobson’s amphetamine practice in an article titled, “Amphetamines used by a physician to lift mood of famous patients” (December 4, 1972). (6,13) This article reinvigorated an ongoing (since 1968) investigation of Dr. Jacobson by the Federal Bureau of Narcotics and Dangerous Drugs and spawned closed-door hearings by local medical (New York County Medical Society) and state government medical licensing authorities. Their investigations (1972-1975) resulted in revocation of Dr. Jacobson’s New York State medical license (1975) and federal Drug Enforcement Agency (DEA) drug-dispensing license (14-15).

    Boyce Rensberger today. Source: http://g-ecx.images-amazon.com/images/G/01/ciu/f0/d9/1f2e51c88da05c3af8f62210.L.jpg; accessed January 12, 2010.

At age 78, Dr. Jacobson applied for restoration of his medical license by authorities in the State of New York (fall 1978). They turned him down unanimously on June 21, 1979, stating that the doctor “did not seem to be read to enter the “mainstream of practice.” (16-17) Dr. Jacobson spent his time keeping “in good shape and swam about 30 laps a day in his pool, and that’s about it,” said Robert Asher, director of the division of professional conduct.” (17) Dr. Jacobson died in December 1979. (18)

  1. Brief History of Amphetamine Use in the U.S.
  2. German chemist L. Edeleano first synthesized beta-phenylisopropylamine, later called amphetamine, in 1887, but apparently did not appreciate its physiological properties. (19) More than forty years later, Dr. Gordon A. Alles (1901-1963), a biochemist trained at the California Institute of Technology (B.S. in chemistry, 1922; M.S., organic chemistry, 1924; and Ph.D., biochemistry, 1926 [20-21]), took a job producing pollen shots for the patients of Dr. George Piness, a leading Los Angeles allergist. He spent his spare time searching for a synthetic substitute for ephedrine to treat asthma, because “the native supply of the drug had become exhausted,” said Dr. Piness. (22) The native source of ephedrine is the plant shrub Ephedra vulgaris, whose natural habitat is southern Europe and parts of western and central Asia.

     

    Dr. Gordon Alles. Source: “Noted chemist Gordon A. Alles collapses, dies.” Los Angeles Times, January 22 1963

     

    Ephedrine plant, probably during spring. Source: http://www.dietpills-with-ephedra.com/images/ephedra-plant.jpg; accessed January 12, 2010.

    Dr. Alles synthesized a series of new molecules related to ephedrine and adrenalin that relaxed bronchial muscle and decongested mucous membranes. In November and December 1928, he worked in the laboratory of Dr. Chauncey D. Leake (1896-1978) at the University of California at San Francisco to test his new synthetic adrenalines on animals. In June 1929, he received an injection of 50 mg of beta-phenylisopropylamine, i.e., amphetamine (one of the drugs he was synthesizing), noting a “feeling of well-being” and heart palpitations. (21) Amphetamine did not relieve the asthma of Dr. Piness’ patients, but was “a very reliable central nervous system stimulant” that caused an “exhilarating effect on the spirits” in moderate doses. (23)

    Dr. Alles completed a patent application claiming invention of amphetamine sulfate and amphetamine hydrochloride and other orally active amphetamine salts as new chemicals, as well as the medicinal use of same substances for their ephedrine-like effects. The patent was granted in 1932, meaning he possessed exclusive rights to his invention for 17 years (1951). In 1934, he sold his rights to the invention to Philadelphia-based Smith, Kline & French in return for 5 percent royalties on sales and fulfillment of the expectation that the firm would develop the salts commercially. (24) Smith, Kline & French had recently released a new decongestant called Benzedrine sprayed into the nose. Now the company had oral salts of the same class of drug.

    Smith, Kline & French performed extensive clinical trials with Dr. Alles’ amphetamines, looking for a disease the drug might treat. Researchers employed by the company found that amphetamines “improved efficiency in simple mental tasks and tests of hand-eye (“psychomotor”) problem solving, especially those requiring persistence and alertness. They concluded that the increased performance on mental tasks did not come from any actual improvement in thinking ability but from increased confidence and other mood effects of the drug….Psychometric tests showed evidence that amphetamine typically produces increased optimism, extroversion, initiative, and aggression.” (25) 

    In the mid-1930s, the psychiatric profession, persuaded by psychiatrist Dr. Abraham Myerson (1881-1948), embraced amphetamines to treat “anhedonia” (lack of pleasure, reduced interest in sleep, food, sex, and a low “energy feeling” that motivates work and play) and mild depression. (26) Smith, Kline & French took the drug to market as “Benzedrine sulfate” pills after the American Medical Association Council on Pharmacy approved use of the drug for narcolepsy, postencephalitic Parkinson’s disease and mood elevation in depression and other psychiatric conditions. (27) Cases of amphetamine addiction began to surface. Smith, Kline & French declared that Benzedrine presents “not much danger of drug addiction” because “only opiate sedatives like heroine and morphine were seriously addictive.” Rather, Benzedrine “may cause the formation of a habit similar to caffeine and nicotine.” (28)

    Dr. Alles then discovered dextro-amphetamines (pure right-handed optical isomer), which “made him feel better than Benzedrine had, not as jittery as he might have expected.” A 5-mg dose of dextro-amphetamine equaled a 10-mg dose of Benzedrine (an equal or “racemic” mixture of left- and right-handed amphetamine molecules). In 1939, Dr. Alles prepared a patent application on dextro-amphetamine for Smith, Kline & French, which soon marketed it as “Dexedrine.” (28)

    Smith, Kline & French market Dexedrine in this print advertisement. Source:  http://drugtrain.net/drugs/amphetamine/benzedrine3.jpg; accessed January 12, 2010.

    The U.S. military supplied Benzedrine to servicemen during the war, mainly as 5 mg tablets, for routine use in aviation, as a general medical supply, and in emergency kits, says Rasmussen. Meanwhile, during the war years, physicians prescribed amphetamines to civilians for weight loss. By the end of World War II in 1945, less than a decade after amphetamine tablets were introduced to medicine, over half a million civilians were using the drug psychiatrically or for weight loss, notes Rasmussen. By 1962, U.S. production of amphetamines reached approximately 80,000 kilograms or 176,000 pounds (88,000 tons), according to Food and Drug Administration surveys. (29)

     

    Benzedrine inhalers. Source: http://www.amphetamines.com/inhaler.html; accessed January 12, 2010.

     

    Benzedrine tablets in a United States Air Force ration kit, World War II. Source: http://wing.chez-alice.fr/USAAF/survival/E3-A_Kit.jpg; accessed January 12, 2010.

    Despite reports of addiction and other adverse patient outcomes, most people still regarded amphetamines as innocuous medicines in the early 1960s. During this time, anyone could purchase millions of amphetamine tablets with a few hundred dollars and a fake company letterhead, “notwithstanding pharmaceutical industry pretensions to self-regulation,” says Rasmussen. (29)

    The American amphetamine epidemic peaked in about 1969, as the U.S. Congress held hearings devoted to the theme “Crime in America—Why 8 Billion Amphetamines?” Rasmussen explains that when Richard Nixon finally realized his dream of winning the presidency in November 1968, he made good on his campaign promise to take decisive action on drug abuses by supporting the 1970 Comprehensive Drug Abuse Prevention and Control Act (Pub. L. No. 91-513, 84 Stat. 1236 (Oct. 27, 1970). Attorney General John Mitchell drafted the bill in close consultation with the major drug companies, thus producing a bill that came to Congress pre-endorsed and supported by the pharmaceutical lobbyists.

    The 1970 Comprehensive Drug Abuse Prevention and Control Act defined five categories or “schedules” of drugs, ranging from Schedule V (e.g., Lomotil for diarrhea) to Schedule I (e.g., heroin and other drugs with high abuse potential). The bill subjected drugs in Schedule II to “new, stricter, and more enforceable record-keeping rules allowing easier tracing from production to sale; made prescriptions non-refillable; and gave control of the production of these drugs to the Bureau of Narcotics so that the amount of drug produced justified medical demand. (3)

    Initially, the bill placed the more than six thousand different amphetamine products on the U.S. drug market in Schedule III, where they were subject to no quotas, looser record keeping, and prescriptions refillable five times as before. Rasmussen writes, “Thanks largely to [Senator Christopher] Dodd’s  influence, along with populist Thomas Eagleton of Missouri, the reforming forces in the Senate overcame stiff opposition and altered the bill so as to classify all amphetamines in Schedule II.” (3)

  3. Brief History of Amphetamine Use in Germany
  4. In the winter of 1937-1938, the Temmler-Werke pharmaceutical firm, founded in 1917 by Hermann Temmler in Detmold and relocated to Berlin in 1930, introduced to the European market Pervitin, a methamphetamine (chemical formula is 1-phynyl-2-methlaminopropan), a very close relative of amphetamine. The head of Temmler’s development department, the chemist Friedrich Hauschild, had synthesized this methamphetamine in the 1930s. Neither he nor Temmler could patent the methamphetamine, because Dr. Nagayoshi Nagai (1844-1929) had obtained the patent on methamphetamine in 1893 when he first synthesized the drug from ephedrine in Japan. (30-31) The drug was sold over the counter in pharmacies. At the same time, it was marketed to physicians for psychiatric uses along same lines as Benzedrine, and the German medical profession quickly welcomed the product. (30) Recall that a few years earlier, Smith, Kline & French had marketed Benzedrine in the United States (see above).

    Pervitin became well known within a few months. Professor Dr. Otto Ranke, head of the newly founded Institute fur Allgemeine und Wehrphysiologie at the Militararztliche Akademie in Berlin, began clinical trials in September 1938. Meanwhile many medical officers of the Wehrmacht began to dispense the drug to soldiers and officers. Eckart says, “A few medical officers practiced this already during the occupation of Czechoslovakia in 1938.” (31) The Wehrmacht used the drug during their march over Poland in 1939. Ranke found from his studies at the military academy that some subjects had “unpleasant physical reactions and mental disturbance, along with marginal performance gains on mathematical and other mental tasks.” Nevertheless, the military consumed 35 million tablets (3 mg) in April, May, and June 1940, the peak season of the Blitz. “There were no orders from Berlin to use it in any particular way, so this consumption reflects demand among the soldiers and medics at the front,” explains Rasmussen. (30)

    German-made methamphetamine Pervitin during World War II. Source: http://www.spiegel.de/img/0,1020,466902,00.jpg; accessed January 12, 2010.

    After some experience with Pervitin, German medical authorities noted some of the student subjects in the clinical trials had become regular methamphetamine abusers. In addition, military authorities “worried that too much extra time was needed for troops to recuperate after taking methamphetamine. The Luftwaffe (German’s air force) also found that performance was not as good objectively as it seemed to those under the influence and that the drug might even cause accidents by making pilots overconfident and attentive to the wrong things.” In addition, some civilians had died after abusing the drug, according to Eckart. (31)

    In mid-1941, Germany placed methamphetamine, along with amphetamine, under strict narcotics regulation,” i.e., Germany’s “Opium Law.” Authorities heavily regulated the drug so that consumers could obtain it only through a special doctor’s prescription, unless the consumer was the doctor. (30-31) For example, Dr. Theodor Morell (1886-1948), private physician to Adolf Hitler (1889-1945), injected him legally with methamphetamine liberally between 1938 and 1945, even after the drug was regulated under the Opium Law. (32-33) D. Doyle notes, “There is no doubt [Dr. Morell] gave…Pervitin to Hitler on any occasion when he needed a boost, and especially before his ‘rabble-rousing speeches’ to assembled thousands of devotees.” (32) 

    Germany regulated methamphetamines as a narcotic, beginning in 1941; the United States first regulated amphetamines as a controlled substance three decades later, in 1970. The point here is that Dr. Max Jacobson must have been aware of the adverse outcomes of amphetamines from at least 1941 when his homeland authorities figured this out, yet he denied to the end of his life that amphetamines had any harmful side effects (more below). He was therefore disingenuous, delusional, sociopathic or all three, depending on the stage of his own amphetamine addiction (more below).

  5. Early Years of Dr. Max Jacobson
  6. Max Jacobson was born on July 3, 1900, to a kosher butcher in the small village of Fordon, 72 miles northeast of Poznan (Posen) and 8 miles east of Bydgoszcz (Bromberg) in what is today Poland, but was then Germany. (34-35) The city of Poznan is about half way between Warsaw and Berlin. The word “Posen” is German for “Poznan.” Both Posen and Poznan are correct. (36)

     

    Grand duchy of Posen (in red). Source: http://en.wikipedia.org/wiki/File:Map-Prussia-Posen.svg; accessed January 12, 2010.

     

    Map showing relationship of Berlin to Poznan. Source: The World Factbook, U.S. Central Intelligence Agency, 2003 (public domain);  http://www.holocaust-history.org/himmler-poznan/poznan-map.shtml; accessed January 12, 2010.

    Before World War I (c. 1900), Fordon was in Posen District, Prussia Province, Germany. Between World Wars I and II (c. 1930), Fordon was in Bydgoszcz District, Poznan Province, Poland. From 1939 to 1945, Bydgoszcz was annexed to the Reichsgau Wartheland (Germany) by the Nazis whose Wehrmacht (unified armed forces of Germany) occupied the town on September 9, 1939, under the influence of methamphetamines (Pervitin) (see above). 

     

    Nazis in Poznan, October 1939. Source: http://en.wikipedia.org/wiki/File:Bundesarchiv_Bild_183-E11717,_Posen,_Alte_Wache.jpg; accessed January 12, 2010.

     

    Polish Jews doing forced labour at Fordon near Bydgosz (Bromberg), Poland, 1939 (b/w photo), German Photographer (20th Century) / © SZ Photo / The Bridgeman Art Library. Source: http://www.bridgemanart.com/image/German-Photographer-20th-Century/Polish-Jews-doing-forced-labour-at-Fordon-near-Bydgosz-Bromberg-Poland-1939-b-w-photo/e6a21f27404b473d876f24005c968947?key=&categoryid=35b31621-d0b5-403c-a9bc-73a98c54b52e&thumb=x150&num=15&page=28; accessed January 12, 2010.

    The Nazis tormented the region’s Jews and sent thousands to concentration camps or executed them on site. Bydgoszcz was the site of Bromberg-Ost, a notorious female subcamp of Stutthof, staffed by several female SS guards called Aufseherin who were under the command of senior female overseers called Oberaufseherin. Many of these female guards were prosecuted and executed after the war for the crimes they committed in these female concentration camps. A deportation camp in Smukała village, now part of Bydgoszcz, was yet another place that the 37,000 citizens of this city, whether Jewish or not, died during the war. In 1945, the Soviet army liberated Bydgoszcz. Since 1950, Fordon has belonged to Poland. (36-37) 

    The number of Jews living in Fordon in 1674 A.D. was 55; in 1772, 11; in 1871, 1,963; and on August 31, 1939, 2,055. No Jews live in Fordon today. (37)

    Around 1920, Max Jacobson says he left Fordon for Berlin, located about 200 miles due west, to attend medical school at the Friedrich Wilhelm University (named after Frederick William III of Prussia, founded in 1809-1810). He claims he earned his medical degree in 1924. (13) He completed only enough training after medical school to qualify as a general practitioner. Dr. Jacobson then apparently fled “to France (where he allegedly developed his theories on tissue regeneration and the injections to achieve it).” In his unpublished autobiography, Dr. Jacobson also claimed that in 1934 he served as medical consultant to the German Davis Cup tennis team. (38) 

  7. Tracing Dr. Max Jacobson’s Professional Activities, 1936-1959
  8. Sometime between 1924 and 1936, Dr. Jacobson married a woman named Alice who was born in Prague, Czechoslovakia. Around 1930 or 1931, Alice bore a son named Thomas Jacobson in Berlin. The last known permanent address for Dr. Max Jacobson (Jacobsohn) and his family as of July 22, 1936, was Prague, Czechoslovakia. (39) The threesome sailed from Havre, France, when he was 36 years old on the S.S. Champlain on July 22, 1936. Max, Alice and Thomas arrived in New York City on July 29, 1936. Dr. Jacobson would subsequently marry Nina Hagen (died 1964 [40]), a union that produced a daughter, Jill, who is around 61 years old as of January 30, 2009, and apparently is writing a biography of her father. (41)

     

    S.S. Champlain. Source:   http://search.ancestry.com/iexec/?htx=View&r=an&dbid=8944&iid=IMUSA1858_006-0034&rdb=nypl&fn=Max&ln=Jacobsohn&st=r&ssrc=&pid=25758724; accessed January 12, 2010.

     

    Current photo of Jill Jacobson, daughter of Dr. Max Jacobson. Source: http://educationforum.ipbhost.com/index.php?showuser=6264; accessed January 12, 2010.

    Immigrant physicians who sought to practice medicine in New York State qualified only by passing a difficult medical licensing examination, which required long study, especially for immigrants who spoke little English. Apparently, Dr. Jacobson met this and other requirements to obtain a New York medical license. The New York County Medical Society also approved his membership. 

    On September 25, 1944, according to The New York Times, Dr. Jacobson rented an apartment on the Upper East Side at 155 East 72nd Street, an area that he continued to live in for the rest of his life, although at different addresses, e.g., an office at 56 East 87th Street, a home in a building on East 86th Street, Constructive Research Foundation at 630 3rd Avenue, and an office at 155 East 72nd St., NYC. (42) These upscale addresses made Dr. Jacobson more visible to the type of affluent patient he felt most comfortable treating with his magic potions. 

    In February 1946, a physician writer named Herman N. Bundesen published a syndicated article titled “Amino acids and vitamins vital to your good health” in newspapers across the United States, including the Middletown Times Herald (Middletown, New York, February 8, 1946), the Mason City Globe-Gazette (Iowa, February 19, 1946), and Hammond Times (Indiana, February 8, 1946).

    In his article, Dr. Bundesen lauded Dr. Max Jacobson’s pills and injections containing amino acid and vitamins, which he had already given to 1,000 patients for various diseases with an average of eight to ten injections to achieve success. (43) Dr. Bundesen wrote,

    The first patients treated were suffering from exhaustion coming from physical strains, prolonged convalescence or recovery from infectious diseases and following operations. The preparation containing the vitamins and amino acids was also used for patients suffering from anemia or a lack of coloring in the blood and from poor nutrition. It was noted that not only were the patients benefited physically, but there was also relief from nervousness and sleeplessness. Appetite increased and the patients seemed to be able to think more rapidly and clearly. Examinations of the blood were made which showed that there was an increase in the amount of coloring matter and the number of red cells which often developed after the first injection. The preparation was given also to a number of workers in a defense factory, a department store and the nursing personnel of a hospital. It was found in these persons, too, there was a rapid rise in the coloring matter of the blood and the number of cells after treatment. There was a marked improvement  In general health as well as a decrease in absences from work due to sickness…It would appear that the use of the amino acids and vitamins may have value in a number of different disorders. (43)

    Who was Dr. Herman N. Bundesen? Dr. Bundesen was born in Berlin, Germany in 1881 and emigrated to Chicago where he graduated from Northwestern University in 1909, served in the U.S. Army during World War I, and returned to Chicago, where his work in a typhoid epidemic resulted in appointment as Chicago health commissioner in 1922. He maintained this post almost continuously until his death in 1960. (44) He was a very popular health administrator and wrote many books, such as Dr. Bundedsin’s Diet Book: The Safe Way to Reduce; Our Babies: Their Feeding, Care and Training; The Baby Manual; Toward Manhood; and Epidemic Amebic Dysentery Chicago Outbreak of 1933. How Dr. Bundesen and Dr. Jacobson were acquainted and whether Dr. Bundesen was aware that Dr. Jacobson was using methamphetamines in his medical practice is unknown to this writer, at the current time. 

    Dr. Herman N. Bundesen. Source: http://images.google.com/hosted/life/f?q=herman+n.+bundesen&prev=/images%3Fq%3Dherman%2Bn.%2Bbundesen%26hl%3Den%26rls%3Dcom.microsoft:en-us:IE-SearchBox%26rlz%3D1I7ADBF%26sa%3DN%26um%3D1&imgurl=cdbca967dc5becca; accessed January 12, 2010.

    By at least 1952, Dr. Jacobson was treating celebrity figures in entertainment, the arts, and politics. For example, he cared for 44-year-old actress Bette Davis (1908-1989), as noted in the following December 8, 1952, New York Times’ article by Sam Zolotow:

    Bette Davis, whose illness prevented “Two’s Company” from opening on Thursday night at the Alvin, is “coming along very well,” it was reported yesterday by her husband [actor] Gary Merrill. Miss Davis’ physician, Dr. Max Jacobson, confirmed Mr. Merrill’s observation. Today or tomorrow, Dr. Jacobson, in consultation with Dr. S. Evans Ganz [ear, nose and throat physician who lived at 300 East 74th Street in NYC (45)] will determine two factors: When the star will be allowed to resume rehearsals and when the show can open. Unofficially, it was learned that Miss Davis, who is suffering from infected larynx, may be permitted to go into rehearsal again on Wednesday.

    Two’s Company poster, 1952. Source: http://en.wikipedia.org/wiki/File:TwosCompany.jpg; accessed January 12, 2010.

  9. Patterns in Dr. Jacobson’s Medical Practice and Research Laboratory
  10. The charges for which the New York State Board of Regents revoked the medical license of Dr. Jacobson in 1975 (more below), as documented in a New York Times article, characterize what was transpiring in his medical practice during the 1940s, 1950s, and 1960s. (46)

    Dr. Jacobson permitted his office employees and at least 90 percent of his patients to self-inject depressant and stimulant drugs. (47) He used these drugs himself for non-medical purposes. He compounded his own medicinal agents in his “laboratory” (more below) to sell to buyers outside of his medical practice. He manufactured, sold and delivered adulterated and misbranded drugs not adequately tested for safety, strength, identity, quality and purity. (46)

    He failed to obtain the required applications to test and administer new drugs and failed to keep accurate records of controlled drugs. He sold depressant and stimulant drugs to practitioners, pharmacies, hospitals and others without first obtaining the necessary professional written order from the purchaser. He allegedly treated numerous persons, including victims of multiple sclerosis, with preparations that he “should have known” were not tested or were improperly tested. (46)

    Physician biographer Bert E. Park in 1993 described Dr. Jacobson’s office as “ramshackle and cluttered,” and that it “doubled as an illicit drug laboratory.” In addition, he wrote, “His injections were all Jacobson knew, a practice he continued to use on himself and all his patients (regardless of the disease he was treating) until the day he lost his license.” (47) One witness during the New York State Board of Regents’ investigation (prosecuted by the state attorney general) noted, “Treatment for a myriad of disease all consisted to the extent of almost one hundred percent of administration of injections.” Furthermore,

    Boldly manufacturing his concoctions without a license in his rush to dispense them day and night (“Nightly mailings left respondent’s office at the rate of twenty to thirty vials to locations throughout the United States and the world”), Jacobson failed to maintain adequate quality control or sterility standards. He was found guilty of malfeasance on both counts; in the words of the inquiry summation: “Adulterated drugs [were found]…consisting of filthy, putrid and/or decomposed substances.” Jacobson also failed to keep proper records of the stimulants and depressants he prescribed…Within a two-year period alone, the doctor was unable to account for 1,474 grams of purchased methamphetamine. (47)

    Dr. Jacobson operated the so-called Constructive Research Foundation, Inc., without required registration and licenses. He aided at least one employee (Alfred Freeman) in raising funds for the business. He also interfered with a lawful inspection by the state of the foundation’s premises. (46) In a 1986 publication for his Constructive Research Foundation, Dr. Jacobson wrote:

    “Without a general grasp of this [concept of Regenerative Therapy], it is difficult…to appreciate the reasons for the departure from the well-trodden paths of conventional medical thinking.” This dubious claim notwithstanding, it was by no means difficult for medical authorities to appreciate that the doctor’s unfounded practices bordered on quackery. (47)

    Park proffered more analysis of Dr. Jacobson’s Constructive Research Foundation, Inc., as follows:

    This pharmacologic cottage industry masquerading as a research laboratory rivaled the best bootlegging operation of the Roaring Twenties. To be sure, the times aided and abetted that: purporting to find a cure for multiple sclerosis during the 1950s and 1960s allowed for as much quackery as medicine. Testimony derived from his hearing underscores the point: such quests “encourage the successful exploitation of many forms of quack treatment…and orgies of polypharmacy.” Jacobson, perhaps unwittingly, took at least part of that lesson to heart. To accommodate (and exploit) those socialites who were naïve enough to judge a physician’s credentials by his social visibility, there was much to be said for this up-and-comer to erect an impressive façade over his office while cultivating a reputation as “Dr. Feel Good” among those who passed through its doors. (47)

  11. Dr. Jacobson’s Appearance and the Appearance of his Medical Office/Laboratory
  12. Biographer Barbara Leaming wrote about Dr. Jacobson’s appearance:

    Jacobson, who had a powerful chest and biceps and a massive pot belly, cut a hulking, disheveled figure. Large, horn-rimmed glasses with thick lenses magnified roaming, unsettled eyes. He had lost half of a tooth many years previously in a boxing match in Berlin. His resonant voice skidded between a mumble and a shout. A former patient claimed that his thick accent…made him sound “like a caricature of Freud.”…An actress whose husband had been in thrall to the doctor described Jacobson as “sinister, like a Vincent Price character.” Though he carried a physician’s black leather bag, the pockets of his wrinkled coat and baggy trousers typically bulged with vials, syringes, and tourniquets. His fingernails were stained black by chemicals and he usually stank of medicine and cigarettes. (34)

    Leaming described his office environment:

    [T]he usually crowded and chaotic Upper East Side office,…was open seven days a week from as early as 5:30 A.M. until 11 P.M….Though the blinds were always drawn, a visit to the Jacobson office was rarely private. In the reception area, patients scanned the room in search of stars, like tourists at Chasen’s restaurant in Hollywood. Some people remained in the outer office for hours. Others, usually new patients, were ushered in immediately. The celebrity hunt continued in the rear, where patients waited for hours, either seated or stretched out on examining tables from which the interiors of other fluorescent-lit cubicles were visible. Intrinsic to Jacobson’s mystique was his fondness for injecting patients in full view of one another.

    His office, described by one habitué as a “nut house,” was notoriously dirty. Wastebaskets spilled over onto floors littered with broken hypodermic needles and crumpled paper wrappers. Shelves marked “METH,” short for methamphetamine, were crowded with vials of the mood-lifting drug that Jacobson mixed with steroids, calcium, monkey placenta, and other, undisclosed ingredients. Jacobson never published his recipes, and some patients lived in terror that if he died another physician would be unable to continue his work. (48)

  13. Dr. Jacobson Meets John F. Kennedy
  14. A New York State paper trail for John F. Kennedy’s relationship with Dr. Jacobson does not exist, because the Kennedy family sought and obtained assurances that Dr. Jacobson would not implicate the president during the two years of hearings in New York state, said Park. (47) Park also wrote the promise was apparently kept, because “in some 4,000 pages of testimony assembled over a two-year period by the New York State Board of Regents’ Review Committee on Discipline the White House is mentioned only once, and the subject quickly dismissed.” (47)

    Nevertheless, Dr. Jacobson glibly spelled out his treatment of Kennedy elsewhere and Park believed there was no reason to doubt what Dr. Jacobson said he had done for John Kennedy, as it was the same thing he did for all of his patients. In his own words, Dr. Jacobson told reporter Boyce Rensberger in 1972, “I worked with the Kennedys’ I traveled with the Kennedys; I treated the Kennedys; they never could have made it without me.” (13)

    Interestingly, at the federal level of government, the Federal Bureau of Investigation (FBI) under J. Edgar Hoover as early as 1961 had retrieved five vials that Dr. Jacobson had left at the White House for the Kennedys (he treated the president’s wife, too, more below). Analysis of the liquid in the vial showed high concentrations of amphetamines and steroids. “Robert Kennedy was so alarmed by Jacobson’s increasing access to his brother that he had the Food and Drug Administration [another federal agency] analyze fifteen separate vials.” (47) This analysis was botched, however.

    Most historians say that Charles Spalding (sometimes misspelled Spaulding), John F. Kennedy’s Harvard College roommate and lifelong friend, was the first person to suggest Dr. Jacobson to Kennedy during his grueling presidential campaign in 1960. However, Park attributes John Kennedy’s hookup with Dr. Jacobson to Mark Shaw, Kennedy’s photographer, “who spoke so highly of Dr. Jacobson that Kennedy finally agreed to see him.” (47) Mark Shaw was a regular patient of Dr. Jacobson and died from acute and chronic amphetamine poisoning in 1969 at age 47, as noted above. (7-9)

    Biographer Leamer wrote about Mr. Spalding’s experience with Dr. Jacobson:

    The first time Spalding had gone to Jacobson’s New York office, he had been taken aback by the unkempt quality of the place. Jacobson had yellow spots on his smock and to some might have appeared slightly mad. Yet his office was full of patients, some of them famous, all happily waiting for their shots. The moment the doctor injected Spalding, he felt his body fill with life, a pure energy of such magnitude that he stayed up for three days without sleeping. Spalding got his own supply of this liquid life and at home started injecting himself. It was a time when few Americans knew what amphetamines were or the dangers they represented. Spalding had no idea that he magical ingredient was Methedrine [brand of methamphetamine], an amphetamine that would in a few years become notorious as “speed.” (48)

    Mr. Spalding stipulated to Dr. Jacobson that Senator Kennedy’s visit be “private and confidential” and that he clear the office of patients. Leaming continued:

    When the presidential candidate arrived, only Jacobson, his wife, Nina, and a few employees were present. Kennedy mentioned Chuck Spalding and another patient, the photographer Mark Shaw, then on assignment for Life magazine to cover Kennedy and his family. Kennedy...complained that he felt tired and weak. The demands of the campaign had affected both his concentration and his speech. Jacobson pointed out that Kennedy’s ailments were the most common clinical symptoms caused by stress. He had just the treatment. (48)

    Dr. Jacobson wrote in his unpublished autobiography, according to biographer Laurence Leamer, the following:

    [Senator Kennedy’s] muscles felt weak. It interfered with his concentration and affected his speech….If not attended to these complaints could not only become more severe but would probably lead to more serious discomforts in the future. I took a short case history, and previous diseases he had, accidents, and treatments he had been given. I asked him about his present condition and what medication he was presently taking. The treatment of stress has been one of my specialties. After his treatment he told me his muscle weakness had disappeared. He felt cool, calm, and very alert. I gave him a bottle of vitamin drops to be taken orally, after which he left. (49)

  15. John Kennedy Becomes Dr. Jacobson’s Regular Patient
  16. Senator Kennedy summoned Dr. Jacobson before the first televised debate with Vice-President Richard Nixon on September 26, 1960, broadcast in Chicago via television by CBS Chicago affiliate WBBM-TV (ABC broadcast the final two from Washington). (50) Dr. Jacobson “injected him in the backside with a potent combination of amphetamines, steroids and vitamins,” wrote Perret, who obtained this information from Charles Spalding and another source. (51-52) “Within minutes Kennedy felt a surge of energy and optimism….Jack felt suddenly revived as if by a magical potion.” (50) Perret quotes Edward Klein, former editor in chief of The New York Times Magazine, former foreign editor of Newsweek, and author of All Too Human: The Love Story of Jack and Jackie Kennedy (1996), as saying John Kennedy then had sex with a young woman brought to his room so that “[by] the time he confronted Nixon, he was going to feel both energetic and relaxed.” (50)

    Biographer Leamer wrote about the aftereffects of the injection:

    Jack had a long, laugh-filled luncheon with Bobby and several others. Then he planned to take a nap, but he was so restless that he got up in his bathrobe and walked out on the terrace of his suite. There was a confidence in Jack, not a dumb, blustering arrogance, not a dangerous, willful pride, but a subtle understanding of his own abilities and those of his opponent. Jack paced back and forth in his bathrobe that long autumn afternoon before the first debate, hitting his fist again and again, like the challenger in his dressing room before the championship fight…(49)

    How did John Kennedy perform during the first televised debate? Perret wrote, “Jack Kennedy showed that he possessed the two essential traits of the movie star—emotional power and psychological authority” (50-53) He was focused, confident, polished and clear. He dramatically put Khrushchev, Hoffa, and the Chinese Communists on notice, lectured that the United States needed to start rebuilding its prestige abroad, and stated he was eager to participate personally in this effort. (54)

    John Kennedy was a smashing television success and won the presidency by a narrow margin provided by the good voters of Cook County, Illinois. Evelyn Lincoln, President Kennedy’s personal secretary, noted that on his first day as president (January 21, 1961), his first appointment was with former President Harry Truman and his second was with Chicago Mayor Richard Daley, Mrs. Daley and their six children, who had their pictures taken with him in the Cabinet Room. (55) President-elect Kennedy thoughtfully invited Dr. Jacobson and his wife Nina to attend the Inauguration on January 20, 1961, giving them prime seats. (48)

    In early May 1961, President Kennedy summoned Dr. Jacobson to Palm Beach, Florida, to evaluate Jackie, who was depressed and faltering on whether she could accompany the president on his first state visit out of the country, a trip to Ottawa, Canada. She initially gave Dr. Jacobson a cool reception, but he got her to talk. She complained only of a terrible headache. He spotted his opening and offered help. “He filled a syringe with the contents of several varicolored vials and, avoiding his signature theatricality lest Jackie be put off, gave her a shot. Immediately, she seemed to relax. She looked warm and happy, her headache completely gone.” (34) Park writes, “From that moment on, the stings of the ‘German mosquito’ became a family affair.’” (56) Mrs. Kennedy and Charles Spalding each developed the quirk of licking their lips after an injection from Dr. Jacobson, probably because of a dry mouth, a side effect of the drug. She accompanied her husband to Canada on May 16-18, 1961, missing only one engagement, because she “quite, simply, had crumbled under the weight of her schedule.” (57)

    Meanwhile, beginning on May 14, 1961, white and black “Freedom Riders” advanced in buses to the Southern states, precipitating intense violence, which required the intervention of President Kennedy. On Monday, May 20, 1961, he asked Dr. Jacobson to come to the White House the next day, when Mrs. Kennedy was due back from Glen Ora, the estate they had leased near Middleburg, Virginia. (58) “Instructed to carry an attaché case rather than a physician’s bag, Jacobson assumed he was to treat the First Lady.” A gossip columnist with the New York Daily News on May 12, 1961, asked, “Does JFK have a new personal physician? Dr. Max Jacobson, with offices at 155 E. 72nd St., has been making frequent phone calls to the White House.” (58)

    A government car delivered him on Tuesday, shortly after Mrs. Kennedy’s helicopter landed on the South Grounds at 10 A.M. A maid then led him to the First Lady’s bedroom and he gave her another injection (her second from him). Leaming continued:

    At the close of the session, Kennedy’s valet materialized and led Jacobson through the connecting closet. The President, still in agony because of his back, waited in his bedroom. As far as he was concerned, there were two drawbacks to Jacobson’s treatment. The shots caused a general lack of control that Jack very much disliked. And, though other patients claimed otherwise, Kennedy insisted to Chuck Spalding that in his own case the drugs impeded sexual performance. Still, he wanted another injection. (57)

    Kennedy offered Jacobson a chair beside the fireplace and recounted the tree-planting ceremony in Canada. Since Thursday [May 16, 1961]. He had spent as much time in bed as possible and been treated with Novocain [by his personal physician, Dr. Janet Travail (58)] to no avail. Annoyed by Dr. Travell’s suggestion that he use crutches openly in France [for his upcoming trip to Europe], he vowed not to face [French President Charles] de Gaulle as a cripple. He had developed considerable tolerance for pain over the years, but this time it was so severe that he could not imagine being able to concentrate with de Gaulle and Khrushchev. Was there anything Jacobson could do for his back? Jacobson said that he could help, but only if the president obeyed certain conditions. The doctor strictly ruled out alcohol, opiates, and codeine as incompatible with his treatment. (57)

    Apparently, Jackie had found a vial of Demerol in the president’s bathroom. “Dr. Jacobson wrote in his unpublished autobiography that he told the president that this was a dangerous step he was taking [in taking Demerol]. The drug was addicting and might affect his performance in the White House. If Kennedy did not throw the drug away, the doctor [Jacobson] would no longer treat him.” (60)

    President Kennedy agreed and Dr. Jacobson injected him with methamphetamine. “Kennedy merely rose and paced the room, reporting that he felt ‘very much better.’” He then invited Dr. Jacobson to Paris and Vienna on the upcoming state trip. “Kennedy declared that in anticipation of the trip he and Jackie must start treatments at once, and asked Jacobson to stay a few days.”

    Dr. Jacobson agreed to remain, returned the next morning to give Jackie another injection, and booked a separate flight to Paris on Air France for himself and Nina, his wife, to avoid press speculation about the presence of a doctor other than Dr. Travell on Air Force One. “By no means discreet, however, he boasted to some of his celebrity patients that he was to accompany the Kennedys to Europe.” (57) At President Kennedy’s request, Dr. Jacobson injected Jack and Jackie (with tranquillizers?) the evening of May 30, 1961, in Air Force One as it sat on the tarmac at Idlewild Airport in New York, getting ready to fly to Paris. Dr. Jacobson then boarded his Air France flight. (57)

    President and Mrs. Kennedy with Charles de Gaulle in Paris, June 1961. Source:  degaulle http://www.jfklibrary.org/Asset+Tree/Asset+Viewers/Image+Asset+Viewer.htm?guid=%7B17740F12-21B4-430B-BA24-54EB5AC56835%7D&type=Image; accessed January 12, 2010.

    Dr. Jacobson injected the president on the first day of three days (June 1-3, 1961) in Paris, when he needed to be especially alert. Dr. Travell also injected him with novocaine at trigger points two or three times a day to ease his back pain. When President Kennedy flew to Vienna from Paris, Dr. Jacobson travelled with him for the first time on Air Force One. “The need to be certain that he had access to a shot before he met Khrushchev had apparently overridden the need for discretion.” (61) Around noon, “Just before [his] first meeting with Khrushchev,…called in Dr. Jacobson. ‘Khrushchev is supposed to be on his way over,’ Jacobson recalled Kennedy saying. ‘The meeting may last for a long time. See to it that my back won’t give me any trouble when I have to get up or move around.’” (62)

     

    U.S. President John F. Kennedy welcoming Soviet Premier Khrushchev (right) in Vienna, June 1961. Source: http://www.realclearpolitics.com/images/wysiwyg_images/kennedy-krushchev.jpg; accessed January 12, 2010.

     

    U.S. President John F. Kennedy gesturing to Soviet Premier Khrushchev (left) in Vienna, June 1961. Source: https://www.trustedpartner.com/images/library/000198/Kennedy%20at%20Khrushchev%20at%20the%20Vienna%20Summit.jpg; accessed January 12, 2010.

    Dr. Jacobson injected the president. President Kennedy and Premier Khrushchev “talked for five hours, and when the President came back up the stars he was fidgety,” wrote Evelyn Lincoln who accompanied the Kennedys on their European trip. She continued, “He said he wanted to rest, but he didn’t rest. Then he wanted one of his cigars, and after searching we were able to find them. He did lie down for a short time.”

    The meetings between Premier Khrushchev and President Kennedy on June 4 and 5, 1961, did not go well. (63) Park wrote in 1993, “Jacobson’s pharmacologic props notwithstanding, the inexperienced president had clearly been intimidated by Khrushchev. Arriving in London the following day in a state of thinly disguised depression, Kennedy sought out Jacobson for yet another ‘treatment.’” Park obtained this information from Dr. Jacobson’s unpublished autobiography (p. 18). Dr. Jacobson administered five separate treatments to the president during his European tour, according to his memoir. (64)

    What did the Soviets think of President Kennedy? Andrei Gromyko offered his impressions: According to the report, despite efforts to

    create the impression that he is a strong personality of the caliber of Franklin D. Roosevelt…Kennedy, while not a mediocrity, is unlikely to possess the qualities of an outstanding person. He has, by all accounts, an acute, penetrating mind capable of quickly assimilating and analyzing the evidence of a given phenomenon, but at the same time he lacks a certain breadth of perception, the ability to think a matter over philosophically and make appropriate generalizations. By the make-up of his mind he is more of a good catalyst and consumer of others’ thoughts, not a creator of independent and original ideas…Temperamentally, Kennedy is a rather restrained, dispassionate, and reserve person, although he knows how to be sociable and even “charming.” (65)

    Leaming continued, “It was his charm to which the [Gromyko] report attributed his success with voters. Particularly striking is the assessment of Kennedy as a ‘typical pragmatist’ who ‘in his political activity…is not governed by any firm convictions, but by purely pragmatic considerations, defining his positions…most importantly, on his own interests.’” (65)

    When President Kennedy arrived back to Washington, D.C., (Jackie remained in London with her sister, Lee Radziwell) on June 6, 1961, he “bounded” from his plane to adoring crowds and then went directly to bed, barely leaving it for the next week. (66) “For the first time the White House announced that the president had hurt his back on his Canadian trip and that he was being treated with Novocain shots and swimming. He flew down to Palm Beach, where he took over the estate of Charles Wrightsman and swam laps in the heated pool.” (67)

    President Kennedy developed a fever and sore throat in June 1961 for which he received medical care from Drs. Janet Travell, George Burkley, and other physicians. However, Dr. Jacobson was never far from his thoughts. Secret Service files and the White House gate log substantiate that Dr. Jacobson visited President Kennedy there no less than thirty-four (34) times through May 1962. (68) Mrs. Evelyn Lincoln, the president’s secretary, saved in her files “a bill [showing] that Jacobson was seeing the president roughly once a week. (69)

    Beyond that, the doctor gave favored patients doses that they could inject themselves. Many of his patients returned repeatedly delighted at the bounce they had in their steps when they left his office, but others ended up ravaged, emotionally destroyed when they tried to stop the injections,” said Leamer. (69)

  17. President Kennedy’s Mainstream Physicians Throw Down the Gauntlet
  18. President Kennedy’s “mainstream” physicians, Dr. Janet Travell (physical medicine and rehabilitation [59]), Captain George Burkley (internal medicine and [cardiology[70]), Dr. Eugene Cohen (internal medicine and endocrinology), and Dr. Hans Kraus (orthopedics, physical medicine and rehabilitation [71]) often were at each other’s throats. On one subject, however, they all agreed—the medical malificence of Dr. Max Jacobson.

    Dr. Janet Travell, who had cared for the president since 1955, was an essential player in his successful campaign for the presidency, as described elsewhere. (59) She wrote in a widely distributed letter dated July 21, 1959, the following statement about his health:

    Senator Kennedy has tremendous physical stamina…The outstanding vigor with which he meets an incredibly demanding schedule, often seven days a week and with the briefest of vacations (only once as long as two consecutive weeks in the past four years), is clear evidence of his fine physique and remarkable vitality. (72)

    After an interview with Senator Kennedy in summer 1959, historian James MacGregor Burns wrote: “Kennedy feels…that no statements will put the rumors [about his poor health, Addison’s disease] to rest. They are inherent in a campaign situation. The best way he finds to answer them is by keeping up his strenuous physical schedule. Anyone interested in his condition, he says, can try the pace of his next barnstorming tour.” (72) Many observers did just that and “found it exhausting.” (72) Beverly Smith, Jr., a writer with The Saturday Evening Post, wrote on January 23, 1960, “His schedule is enough to wear down a six-day bike racer. His day usually starts at dawn and carries on until the small hours of the following morning.” (72) In light of his true medical condition, these early observations cast doubt on his declaration that he first obtained treatment from Dr. Max Jacobson only near the end of his presidential campaign.

    Dr. Janet Travell evidently got wind of Dr. Jacobson’s treatment of the president at least by May 1961 (between May 1 and May 12, 1961) when, according to Leaming, she called him from the White House and grilled him “on his methods for treating stress. When Jacobson asked whether this was in reference to the President, Travell said yes.” (48) Dr. Travell never mentioned Dr. Jacobson in her autobiography, indicating the importance placed on him by the Kennedy family and her willingness, like President Kennedy’s other physicians, to follow the Kennedy family orders.

    White House physicians Janet Travell (right) and George G. Burkley (left), ca. 1961. Source: http://images.google.com/hosted/life/l?imgurl=a37d1aa063a2f951&q=dr.%20travell&prev=/images%3Fq%3Ddr.%2Btravell%26hl%3Den%26rls%3Dcom.microsoft:en-us:IE-SearchBox%26rlz%3D1I7ADBF%26sa%3DN%26um%3D1; accessed January 12, 2010.

    Dr. Janet Travell and Dr. George Burkley accompanied him on Air Force One to Paris. They did not know Dr. Jacobson was on an Air France flight to Paris at the same time. (73) Imagine their surprise when Dr. Jacobson boarded Air Force One to travel between Paris and Vienna, at the president’s request (see above). They were worried. Indeed, Dr. Jacobson’s increasing presence in the White House concerned Dr. Travell. Leamer wrote:

    Dr. Jacobson recalled that once when he was in the White House personal quarters, the first lady’s maid, Providencia “Provi” Paredes, came running to him saying, “Dr. Travell has daringly entered the second floor.” No one entered the private residence without permission, but Dr. Travell was so incensed at Dr. Jacobson’s access that she had dared to seek him out even there.

    Dr. Jacobson slipped away and at his next meeting gave Kennedy a letter saying that from now on he thought he should see the president outside of the White House. “That’s out of the question,” Kennedy replied and tore up the letter. (74)

    Meanwhile, Dr. Cohen, a long-time colleague of Dr. Travell, turned on her, lecturing the president in letter dated November 12, 1961, that the president should initiate a housecleaning of his medical staff, because “Dr. Travell…had for her own interest obstructed the proper therapy for the president,” which, in Dr. Cohen’s opinion, was to bring in Dr. Hans Kraus, as described elsewhere. (70) Dr. Travell complied by inviting Dr. Kraus to the White House to evaluate the president. However, she intermittently continued to give her own trigger point injections to the president, which caused Dr. Cohen angst. He wrote another letter in November 1961 to the president in which he declared he would act against a doctor (Dr. Travell) who “is a potential threat to your well-being…When Cohen had finished lecturing Kennedy that he should turn over his medical treatment to a team headed by Dr. Burkley, he turned to an even larger problem:

    You cannot be permitted to receive therapy from irresponsible doctors like M.J. [Dr. Max Jacobson] who by forms of stimulating injections offer some temporary help to neurotic or mentally ill individuals. I should state that these individuals are mesmerized to the extent that they believed they cannot perform without these injections. With such injections they may perform some temporary function in an exhilarated dream state. However, this therapy, [which] conditions one’s needs almost like a narcotic, is not for responsible individuals who at any split second may have to decide the fate of the universe. (74)

    Leamer continues, “This esteemed doctor [Dr. Cohen] accused Kennedy of risking the future of the world by indulging himself in drug use. The president was being put on the firmest notice of the risks he was taking. And he did nothing. Dr. Jacobson continued to come to the White House, and the government continued to get his treatments. (74)

  19. President Kennedy Ignores Calls to Terminate Dr. Jacobson’s Services
  20. A December 1961 reorganization of the White House medical staff placed Dr. George Burkley in charge. Dr. Travell remained at the White House, but she no longer had any control over the medical care provided to the president. Dr. Burkley oversaw the physical rehabilitation care provided to the president by Dr. Hans Kraus, as described elsewhere, which seemed to benefit the president. (71) Dr. Max Jacobson, however, continued to visit the White House, because “the President assured [him] that he would be kept on no matter what…” (75) In June 1962, when Attorney General Robert Kennedy advised his brother to stop using Jacobson’s concoctions, the president replied, “I don't care if it’s horse piss. It works.” (5)

    Mrs. Kennedy also had become devoted to Dr. Jacobson’s injections. By 1962, “Her drug use had escalated to the point where she wanted shots all the time, even when alone on a private trip that involved no official duties,” wrote Leaming. (75) Secret Service Agent Larry Newman, who accompanied her for three days in New York City, beginning on Wednesday, June 6, 1962, noted she “attended the theater, dined at Le Club with Truman Capote, and saw Dr. Jacobson...She did not, however, visit Jacobson’s office near the Carlyle [Hotel]. ‘He would sit in the lobby of the hotel until he got a call and then he would go up,’ Newman recalled.” The Secret Service could always tell when she had received an injection because she would start licking her lips in a characteristic way. Secret Service agents said, “We knew he was going up to see her and giving her shots. But that wasn’t our call.” (75) The agents did, however,

    make a point of subtly harassing Jacobson. They stared stonily and addressed him disrespectfully. “Once in a while we checked his valise just to give him a hard time,” said Newman. “Of course, there was just a bunch of bottles in there. It looked like he made Kool-Aid in different shades. We just looked in it like we were looking for a gun. We didn’t really talk to him. It’s in the air, like between animals. He knew we didn’t like him.” (75)

    Dr. Jacobson was having his own set of problems. First, his wife Nina began having an affair with Chuck Spalding, which resulted in the breakup of Mr. Spalding’s marriage. Second, Dr. Jacobson, who nursed his own amphetamine habit, around May 1962 became “increasingly erratic,…displaying paranoia,” which alarmed those who knew him. Leaming wrote, “Convinced he was being spied on, he insisted that the paintings in the White House were ‘bugged.’” Once, as he walked from the West Wing to the elevator that led to the family quarters, he raved, in the presence of several agents, that the Secret Service had “eyes in the portraits” and that men “in the wall” monitored his every word. On another occasion, Jacobson marched up to a White House policeman, indicated a portrait, and demanded, ‘Is that one bugged, too?’” (75)

    In February 1963, Dr. Jacobson was still close enough to the Kennedys that Mark Shaw, the photographer who overdosed on amphetamines provided him by Dr. Jacobson, snapped a rare photo of the doctor in Palm Beach ministering to Chuck Spalding and Prince Stas (Stash) Radziwill, who were attempting a 50-mile-hike after President Kennedy bet them one thousand dollars each that neither could walk fifty miles. (76)

    Rare February 1963 photo by Mark Shaw of (left to right) President John Kennedy, Chuck Spalding, Stash Radziwill, and Dr. Max Jacobson. Source:  Mark Shaw: The John F. Kennedys: A Family Album. Farrar, Straus, 1964.

    Radziwill was the husband of Lee, Mrs. Kennedy’s sister, and already a patient of Dr. Jacobson. Mark Shaw wrote, “The President was worried about Stash [he was out of shape], but Dr. Max was on hand. It was difficult to keep Dr. Max from competing; as always, he was everybody’s ‘good friend,’ and insisted on treating everyone in sight.” (77) Leaming wrote, “Fueled by Dr. Jacobson’s shots, Spalding and Radziwill won the bet by completing the fifty-mile hike. (76)

    On November 17, 1963, President Kennedy left New York for Palm Beach. “His back had been bothering him again, so he asked Dr. Jacobson to fly down to Florida separately to treat him that weekend, the last one he would be alive. Dr. Jacobson, as always, was delighted to oblige.” (79) Five days later, President Kennedy was dead in Dallas.

    Mrs. Kennedy continued to see Dr. Jacobson after the assassination. For example, biographer C. David Heymann wrote:

    [Lem] Billings [one of JFK’s oldest and dearest friends] recalled a luncheon invitation he received from Jackie in early 1964. He arrived at her Georgetown home just as another visitor, Dr. Max Jacobson, was leaving. He said, “I knew Jacobson, because Jack had sent me to see him on several occasions during 1961 and’62. He dispensed methamphetamine injections. It was dangerous stuff. Several of his patients had developed serious infections from the shots [e.g., Mickey Mantle (79)]; others had become addicted. In no uncertain terms, I told Jackie what I thought of him. The next day I called Bobby Kennedy. I reported seeing Jacobson at Jackie’s house, and Bobby went ballistic. He telephoned Jacobson’s office in New York and warned the good doctor to stay away from this sister-in-law. ‘If you show up again,’ Bobby told him, ‘I’ll see to it that you never practice medicine again.’” (80)

  21. Dr. Jacobson’s Activities 1963 to 1979
  22. Dr. Jacobson continued with his medical practice and Constructive Research Foundation activities in New York City after the death of President Kennedy. His wife Nina died in 1964 and he remarried. In 1969, his friend and patient, photographer Mark Shaw, overdosed on amphetamines he had prescribed. Years of medical malpractice were catching up to Dr. Jacobson. As noted at the beginning of this Biot Report, New York Times reporter Boyce Rensberger exposed Dr. Jacobson in his December 4, 1972 article (13), which prompted first the New York County Medical Society to take action and then the New York State Board of Regents, who were responsible for issuing medical licenses to physicians in New York. On April 26, 1975, the regents voted unanimously to revoke Dr. Jacobson’s medical license, finding him guilty of 48 counts of unprofessional conduct in 11 specifications and one count of fraud or deceit.

    Each specification covered a general area, such as drug labeling. Most of the specifications concerned allegations of violation of state and Federal laws affecting controlled drugs, the manufacture of drugs and their labeling and distribution. The counts under which the physician was found guilty also included charges that he endangered patients’ health with his amphetamine injections, that he misrepresented his activities to drug suppliers (this was the count of fraud or deceit) and that he manufactured adulterated drugs consisting in whole or in part of filthy, putrid, and/or decomposed substances. (14)

    This decision by the Regents, the state’s highest professional disciplinary body, endorsed most of the punitive recommendations of the five-member panel of investigating physicians (the Committee on Professional Conduct of the State Board for Medicine) which held 19 hearings—18 of them attended by Dr. Jacobson—over a 14-month period ending” in June 1974. (14)

    After the Regents’ decision, Dr. Jacobson instructed his attorney Simon Rose (80) to tell the media, “The findings are totally inconsistent with overwhelming testimony that was submitted in his favor and that he intends to appeal this decision, and that he is confident that he will be vindicated.” (14) He was not vindicated, despite several attempts. He faded away into oblivion in 1979, leaving not even an obituary.

  23. Summary
  24. Dr. Jacobson was a dangerous fraud, enabled by the times in which he lived. He profited materially and psychologically from dispensing amphetamines like candy to patients. His fall was precipitated by a newspaper reporter, Boyce Rensberger, and a society that finally awoke to the addictive properties of amphetamines.

    A United States’ president addicted to mood-altering drugs is a chilling thought. In President Kennedy’s case, “despite some notable early stumbles in the arenas of covert operations and diplomacy, the drug factor seems to have had no appreciable impact on what came to pass—at least as far as we have yet been allowed to know…One wonders , too—assuming that Jacobson’s involvement was as prevalent as the record suggests—what might have happened as a result of Kennedy’s drug indulgence had he survived to live out his term [and sought another, as he was clearly planning to do]. In the final judgment, perhaps we [the American public] dodged that bullet only because the real thing on November 22, 1963, made such considerations painfully moot.” (82)

 Notes:

  1. Bert Edward Park: Ailing, Aged, and Addicted. The University Press of Kentucky, 1993, p. 169.
  2. Nicolas Rasmussen writes in On Speed: The Many Lives of Amphetamines (New York: NYU Press, 2009): “Post-1970 legal restrictions on speed [became a controlled substance] brought unwanted attention to amphetamine prescribing habits, and revealed that Jacobson was not alone. By 1973, many ‘speed doctors’ around New York fell afoul of the law, like Robert Freymann, Alois Peter Warren, Jack Cohen, and John [M.] Bishop, now prosecuted for prescribing practices they had been engaged in throughout the 1960s. Some patients, it emerged, were seeing several of the doctors at once; ‘if you wanted to make a big night of it,’ one reported, ‘you’d go over to Max’s and get a shot, and then over to Freymann’s and then down to Bishop’s.’ (Bishop, physician to Timothy Leary and many filmmakers and entertainers, treated the whole case of the hit musical Hair while it was playing on Broadway). These cases raised important questions about the autonomy of the profession: the limits of physician authority to decide appropriate treatment, physician duties toward patients, and society’s right to interfere with doctor--patient relationships. (p. 170)
  3. Nicolas Rasmussen: On Speed: The Many Lives of Amphetamines. New York: NYU Press, 2009, pp. 212-215.
  4. Bert Edward Park: Ailing, Aged, and Addicted. The University Press of Kentucky, 1993, p. 172.
  5. William Bryk: “Dr. Feelgood.” New York Sun. September 20, 2005. Available at http://www.nysun.com/out-and-about/dr-feelgood/20251/; accessed January 7, 2010. “His amphetamine purchases became sufficient for more than 100 strong doses daily. He was buying a weekly average of 1,270 needles and 650 syringes.”
  6. James M. Giglio: The Presidency of John F. Kennedy (Second Edition, Revised ed.). Lawrence, KS: University Press of Kansas, 2006, p. 280.
  7.  “Mark Shaw, John Kennedy’s photographer, dies.” The New York Times, January 28, 1969. His obituary in part reads: “Mark Shaw, the White House photographer for President Kennedy, died of a heart attack Sunday night in his apartment at 343 East 30th Street. He was 47 years old…Mr. Shaw met Mr. Kennedy while on assignment for Life magazine during the 1960 Presidential campaign. He was a frequent guest at White House dinners and parties and took the only picture of Pablo Casals performing at the White House concert in November, 1961.”
  8. For a brief biography of Mark Shaw, see “Mark Shaw” at http://markshawphoto.com/markshaw_biography.htm; accessed January 7, 2010.
  9. About Mr. Mark Shaw’s death, New York Times reporter Boyce Rensberger wrote on December 4, 1972: “The autopsy by Dr. Michael M. Baden [born 1934, first licensed in the State of New York January 6, 1961], associate [New York City] medical examiner, showed…no evidence of heart disease, but Mr. Shaw’s internal organs were laden with methamphetamine residue (methamphetamine is a form of amphetamine). There was heavy scarring and discoloring along the veins in Mr. Shaw’s arms--“tracks” of someone who repeatedly injects himself with drugs.” His cause of death was acute and chronic intravenous amphetamine poisoning, although Dr. Jacobson disagreed, saying Mr. Shaw died of “a blow to the head that caused Mr. Shaw to vomit and then inhale the vomitus, causing asphyxiation.” Dr. Baden responded there was “no evidence at the autopsy to support such a contention.” For more on Dr. Baden, who is still a practicing pathologist, see “Michael Baden.” Wikipedia. Available at http://en.wikipedia.org/wiki/Michael_Baden; accessed January 8, 2010.
  10. Susan Wood: “Dr. Feelgood goes to jail.” New York Magazine, August 16, 1971, pp. 39-43. Available at http://books.google.com/books?id=7eICAAAAMBAJ&pg=PA39&lpg=PA39&dq=alois+peter+warren&source=bl&ots=hvv-wN3-_G&sig=vg2qLs8pXk1q_hk_9iiRjlMsMEA&hl=en&ei=M8lGS8XPPIrKsAPP24z2Dw&sa=X&oi=book_result&ct=result&resnum=3&ved=0CA0Q6AEwAg#v=onepage&q=alois%20peter%20warren&f=false; accessed January 8, 2010.
  11. “United States of America, Appellee, v. Alois Peter Warren, Appellant,” decided January 5, 1972. Available at http://cases.justia.com/us-court-of-appeals/F2/453/738/386068/; accessed January 7, 2010.
  12. Will Lissner: “Physician draws jail in drug case; doctor convicted of abusing amphetamine also fined.” The New York Times, June 3, 1971. Dr. Warren did not treat John F. Kennedy. However, he did sell a narcotics agent a “large quantity of liquid amphetamine and 260 hypodermic syringes, which together cost the physician $105, for $2,400,” wrote Lissner.
  13. Boyce Rensberger: “Amphetamines used by a physician to lift mood of famous patients.”The New York Times, December 4, 1972.
  14. Iver Peterson: “Regents Vote Unanimous.” The New York Times, April 26, 1975.
  15. “U.S. agency voids drug ‘registration’ Dr. Jacobson held.” The New York Times, December 23, 1975.
  16. “Physician reapplies after losing license.” The New York Times, May 30, 1979.
  17. “Doctored spirits.” The New York Times, September 30, 1979.
  18. “Max Jacobson.” Wikipedia. Available at http://en.wikipedia.org/wiki/Max_Jacobson; accessed January 7, 2010.
  19. Nicolas Rasmussen: On Speed: The Many Lives of Amphetamines. New York: NYU Press, 2009, p. 22.
  20. “Dr. G. Allen donates $350,000 to Cal Tech.” Covina Argus Citizen (Covina, California), May 8, 1958, p. 16.
  21. Nicolas Rasmussen: On Speed: The Many Lives of Amphetamines. New York: NYU Press, 2009, pp. 13-16.
  22. “Speed has a long history.” Arcadia Tribune (Arcadia, California). July 29, 1973, p. 6.
  23. Nicolas Rasmussen: On Speed: The Many Lives of Amphetamines. New York: NYU Press, 2009, p. 17.
  24. Ibid, p. 23.
  25. Ibid, p. 29.
  26. Ibid, p. 33.
  27. Ibid, p. 40.
  28. Ibid, pp. 50-52.
  29. Nicolas Rasmussen: “American’s first amphetamine epidemic 1929-1971.” RedOrbit. Available at http://www.redorbit.com/news/health/1413747/americas_first_amphetamine_epidemic_19291971/; accessed January 9, 2010.
  30. Nicolas Rasmussen: On Speed: The Many Lives of Amphetamines. New York: NYU Press, 2009, pp. 54-55.
  31. Wolfgang Uwe Eckart: Man, Medicine, and the State: The Human Body as an Object of Government, Franz Steiner Verlag, 2006, pp. 60-68.
  32. D. Doyle: “Adolph Hitler’s medical care.” Journal of the Royal College of Edinburgh, 2005, Volume 35, pp. 75-82. Available at http://www.rcpe.ac.uk/journal/issue/journal_35_1/Hitler's_medical_care.pdf; accessed January 10, 2010.
  33. David Irving: Adolf Hitler: The Medical Diaries: The Private Diaries of Dr. Theo Morell. London: Sidgwick & Jackson, 1983. This book is available online at http://www.zogsnightmare.com/books/irving/Morell.pdf; accessed January 10, 2010. Dr. Morell did not record the methamphetamine injections he administered to Hitler, in the one diary that has survived.
  34. Barbara Leaming: Mrs. Kennedy. New York: Simon & Schuster, 2001, p. 105.
  35. Fordon is located at 53 degrees 9 minutes North, 18 degrees, 11 minutes East. Source: http://data.jewishgen.org/wconnect/wc.dll?jg~jgsys~shtetm~-500955; accessed January 9, 2010.
  36. Source of information on Posen and Poznan is http://www.holocaust-history.org/himmler-poznan/; accessed January 9, 2010.
  37.  “Bydgoszcz.” Available at http://www.iajgs.org/cemetery/poland/bydgoszcz-bydgoskie.html; accessed January 9, 2010.
  38. Bert E. Park: Ailing, Aging, Addicted: Studies of Compromised Leadership. University of Kentucky Press, 1993, p. 176.
  39. Source Citation: Year: 1936; Arrival: New York , United States; Microfilm serial: T715; Microfilm roll: T715_5837; Line: 26. Ancestry.com Operations Inc, 2006. Original data: Passenger Lists of Vessels Arriving at New York, New York, 1820-1897; (National Archives Microfilm Publication M237, 675 rolls); Records of the U.S. Customs Service, Record Group 36; National Archives, Washington, D.C. Passenger and Crew Lists of Vessels Arriving at New York, New York, 1897-1957; (National Archives Microfilm Publication T715, 8892 rolls); Records of the Immigration and Naturalization Service; National Archives, Washington, D.C.
  40. Jill Jacobson wrote, “I have written a book, not finished yet about my life with my father, the late Dr. Max Jacobson. So I suppose one could say I am a writer. I am now 61 years old.” She also posted the following text at the same site: “I am the daughter of Dr. Max Jacobson and would appreciate it if you could elaborate about Mark Shaw and his involvement with the Cuban situation. Also I want to offer the fact that Dr. Jacobson made frequent trips. vacations with his family to Puerto Rico where we had friends, one which was Dona Felisa the Mayoress of San Juan. I am interested to know more about the Antonio Betancourt and Antonio Morales connection. Both these men were patients and friends of my father. Please could you elaborate on the Antonio Morales charges ‘he was a bag man for the syndicate’??? What does that have to do with Dr. Jacobson??” The Education Forum, January 30, 2009. Available at http://educationforum.ipbhost.com/index.php?showtopic=13531; accessed January 11, 2010. Scroll down to find her entry dated January 30, 2009.
  41. “Jacobson.” Obituary. The New York Times, May 30, 1964. Full text: “Jacobson—Nina, devoted wife of Dr. Max Jacobson, loving mother of Jill, loving daughter of Louis Hagen, dear sister of Carla, Louis, Peter, Anne, Candida and Yvonne. Reposing at Frank E. Campbell, Madison Ave. at 81 St., Saturday 5 to 9 P.M. Private funeral for family. In lieu of Flowers contributions may be made to Constructive Research Foundation, 630 3rd Ave., N.Y.C.” Constructive Research Foundation was Dr. Jacobson’s research laboratory.
  42.  “Apartment rentals.” The New York Times, September 25, 1944.
  43. Herman N. Bundesen, M.D.: “Amino acids and vitamins vital to your good health.” Middletown Times Herald (Middletown, New York) February 8, 1946, p. 5.
  44. “Dr. Bundesen, 78, health aide, dies.” The New York Times, August 26, 1960. 
  45.  “Dr. S. Evans Ganz dies, 69, Ear and Throat Surgeon.” The New York Times, January 22, 1976. 
  46. Jane E. Brody: “State accuses Dr. Jacobson of giving himself amphetamines for nonmedical purposes.” The New York Times, April 19, 1973.
  47. Bert E. Park: Ailing, Aging, Addicted: Studies of Compromised Leadership. University of Kentucky Press, 1993, pp. 171-176.
  48. Barbara Leaming: Mrs. Kennedy. New York: Simon & Schuster, 2001, pp. 103-104.
  49. Laurence Leamer: The Kennedy Men 1901-1963. New York: Perennial, 2001, pp. 449-451.
  50. Geoffrey Perret: Jack: A Life Like No Other. New York: Random House Trade Paperbacks, 2001, pp. 261-262.
  51. Charles F. Spalding interview, Nigel Hamilton Papers, Massachusetts Historical Society.
  52. C. David Heymann: A Woman Named Jackie. Secaucus, New Jersey, 1989, pp. 222-223.
  53. A video of the first Nixon-Kennedy  (September 26, 1960) debate is available at http://www.youtube.com/watch?v=C6Xn4ipHiwE; accessed January 11, 2010.
  54. Evelyn Lincoln: My Twelve Years with John F. Kennedy. New York: David McKay Co., p. 217.
  55. Ibid, p. 192.
  56. Bert E. Park: Ailing, Aging, Addicted: Studies of Compromised Leadership. University of Kentucky Press, 1993, p. 181.
  57. Barbara Leaming: Mrs. Kennedy. New York: Simon & Schuster, 2001, pp. 106-110.
  58. Laurence Leamer: The Kennedy Men 1901-1963. New York: Perennial, 2001, p. 527.
  59. Margaret R. O’Leary: “Dr. Janet Travell’s Encounter with JFK.” Securitas Magazine, April-September 2009, Volume 8, Issue 2. Available at http://www.semp.us/publications/securitas_reader.php?SecuritasID=40; accessed January 11, 2010.
  60. Laurence Leamer: The Kennedy Men 1901-1963. New York: Perennial, 2001, p. 528.
  61. Barbara Leaming: Mrs. Kennedy. New York: Simon & Schuster, 2001, p. 123.
  62. Laurence Leamer: The Kennedy Men 1901-1963. New York: Perennial, 2001, p. 536.
  63. Evelyn Lincoln: My Twelve Years with John F. Kennedy. New York: David McKay Co., pp. 225-226.
  64. Bert E. Park: Ailing, Aging, Addicted: Studies of Compromised Leadership. University of Kentucky Press, 1993, p. 258, notes 73 and 74.
  65. Barbara Leaming: Mrs. Kennedy. New York: Simon & Schuster, 2001, p. 124.
  66. “A Chronology from The New York Times.” John F. Kennedy Presidential Library & Museum Historical Resources, June 1961. Available at http://www.jfklibrary.org/Historical+Resources/Archives/Reference+Desk/New+York+Times+Chronology/1961/June.htm; accessed January 11, 2010.
  67. Laurence Leamer: The Kennedy Men 1901-1963. New York: Perennial, 2001, p. 539.
  68. Records of the United States Secret Service (Record Group 87); White House Police Gate Logs, boxes 2-11, JFKL. Quoted by Bert A. Park: Ailing, Aging, Addicted: Studies of Compromised Leadership. University of Kentucky Press, 1993, p. 257, note #55.
  69. Laurence Leamer: “A Kennedy biographer assesses the Dallek disclosures.” History News Network, November 25, 2002. Available at http://hnn.us/articles/1124.html; accessed January 12, 2010.
  70. Margaret R. O’Leary: SEMP Biot Report #674: “Dr. George G. Burkley’s rendezvous with JFK.” December 21, 2009. Available at http://www.semp.us/publications/biot_reader.php?BiotID=674; accessed January 11, 2010.
  71. Margaret R. O’Leary: SEMP Biot “Dr. Hans Kraus’ medical care of JFK.”http://www.semp.us/publications/biot_reader.php?BiotID=677.
  72. Janet Travell: Office Hours: Day and Night. New York: The World Publishing Company, 1968, pp. 327-328.
  73. Robert Dallek: An Unfinished Life: John F. Kennedy 1917-1963. New York: Back Bay Books, 2003, p. 398.
  74. Laurence Leamer: The Kennedy Men 1901-1963. New York: Perennial, 2001, pp. 544-45.
  75. Barbara Leaming: Mrs. Kennedy. New York: Simon & Schuster, 2001, pp. 201-202.
  76. Ibid, pp. 260-261.
  77. Mark Shaw: The John F. Kennedys: A Family Album. Farrar, Straus, 1964, Pp. 159-160.
  78. Barbara Leaming: Mrs. Kennedy. New York: Simon & Schuster, 2001, p. 326.
  79. Tony Castro: Mickey Mantle. Washington, D.C.: Potomac Books, 2009, pp. 202-203. Castro wrote: “Mel Allen, a Yankee broadcaster who was privately pulling for Mantle in the home-run derby [against Babe Ruth], saw Mickey and urged him to see his doctor, Max Jacobson, immediately…Upon returning to New York, Mickey hurried to an appointment with Dr. Jacobson that Allen had made for him, not suspecting that he would regret that visit for the rest of his life. Jacobson gave Mantle a shot in his hip that Mickey later said made him scream in pain….He eventually made it into bed with a fever…He couldn’t play the next day’s game and eventually wound up at Lenox Hill Hospital. An infection formed, and doctors had to lance the area with a three-inch star-shaped incision over the hip to permit the area to drain. The hole was big enough to fit a golf ball.”
  80. C. David Heymann: Bobby and Jackie: A Love Story. New York: Atria Books, 2009, p. 47.
  81. “Simon Rose.” Obituary. The New York Times, January 20, 1981.
  82. Bert E. Park: Ailing, Aging, Addicted: Studies of Compromised Leadership. University of Kentucky Press, 1993, p. 186.