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As the two presidential candidates get ready for their first in-person faceoff on Tuesday, it's hard to imagine a more consequential debate than June's fateful match between Donald Trump and Joe Biden. But one in the past stands out: the first 1960 debate between Vice President Richard Nixon and Senator John Kennedy.

As they met in a Chicago TV studio on September 26, the two men were fairly evenly matched in the polls. Then the cameras turned on and viewers got a look at a pale, sweaty, gaunt Nixon next to a hale and handsome Kennedy. "My God! They've embalmed him before he even died," the Democratic mayor of Chicago reportedly jibed.

A well-known tale about the debate -- that TV viewers thought Kennedy won because he looked great and radio listeners thought Nixon won because he spoke well -- may be an urban legend. But there's no doubt that Nixon's rough appearance gave JFK a boost. A month later, he'd win the presidency by a whisker.

Why did Nixon look like "an awkward cadaver," as journalist Ben Bradlee put it? At least, in part, because he was still recovering from being mighty sick. Less than 3 weeks earlier, he'd left Walter Reed Army Medical Center after an 11-day hospital stay to treat a nasty case of septic arthritis.

Nixon had been diagnosed by Raymond Scalettar, MD, the hospital's 32-year-old chief rheumatologist. One of the first specialists in the then-fledgling field of rheumatology, the Brooklyn native would become a mainstay of medicine in Washington, D.C.

Scalettar, who's now 95 and clinical emeritus professor of medicine at George Washington University Medical Center & Health Sciences, only stopped seeing patients in 2016 when he got tired of fighting traffic to get to the office. In an interview, he spoke to MedPage Today about convincing Nixon to accept hospitalization, treating his very serious condition, and wishing his patient would have agreed to a few more days in the presidential hospital suite.

How did you meet Nixon at the hospital?

Scalettar: In August 1960, I got a call from the chief of orthopedics: "Hey, Ray, come on down to the emergency room. I want you to see a VIP, and I want to get your opinion."

I walk in, and there's Vice President Nixon on a gurney. I shook his hand and said, "Good Morning, Mr. Vice President."

I learned that about 10 days earlier in North Carolina, a car door cracked his knee and tore his pants. He developed a boil over his kneecap. It was red hot and swollen, and he was in pain and taking either Aureomycin or Terramycin [oxytetracycline] prescribed by his medical aides. He was resolute but obviously anxious with the burden of a campaign weighing on him.

The orthopedist thought it was gout, but 90% of gout is in the big toe. I took a culture, and two days later the chief of bacteriology called me and said it was growing hemolytic Staphylococcus aureus.

What did you do?

I informed the chief of medicine and said, "The vice president has hemolytic Staphylococcus aureus." Recognizing how serious this was, I also directly called the Army surgeon general, Leonard Heaton. He said, "Thank God you called me."

That evening, we met with Nixon and his aides and sycophants about what should be done. It was pretty obvious that the staff individuals were more concerned about the campaign than recognizing the seriousness of the problem – septic arthritis, red-hot joint. And it was difficult for Nixon to realize how vulnerable he was and how serious the problem was.

Nixon finally turned to me and said, "Hey doc, you made the diagnosis. What do you have to say?" I said, "Mr. Vice President, if you don't come to the hospital tonight, there's not going to be an election."

"WHAT?"

Nixon turned to the General Heaton and said, "you heard what the young doctor, the young captain, said." General Heaton replied immediately that "he's absolutely right. You're seriously ill. If you don't come in tonight, there's not going to be an election."

The hospital got permission from President Dwight Eisenhower for Nixon to use his presidential suite rather than the other rooms in the VIP suite. Nixon checked in that night. Then what happened?

We started him on antibiotics, and Heaton said to me, "You stay with him night and day. Your job is to get him out of here alive." "Yes, sir." I slept in the anteroom next to his room for several days.

What about other treatment?

Traction was used by orthopedics to decrease pressure on the joint. The orthopedic surgeon would aspirate the joint and remove the infected synovial fluid, and ice packs were applied to the joint.

Whatever you might think of Nixon, he was a tough patient. I have a healthy respect for him knowing what he went through and the burden of the campaign as the Republican standard bearer. [Nixon later that "the physical pain I suffered those next 2 weeks was bad enough, particularly when they lanced the knee to shoot antibiotics into the infected area. But the mental suffering was infinitely worse."]

Could Nixon, then age 47, have died?

Yes. The infection was in the knee joint, where it had spread from the skin infection. He could have gotten septicemia. If not treated properly, he might have died.

I often have thought about what would have happened if I'd missed the diagnosis. I do not think he could have campaigned and might become seriously ill and even died. I knew how serious this was and raised the appropriate alarms for him to be treated aggressively.

How did Nixon's staff deal with the media regarding his illness?

Once his staff understood, they cooperated, especially after General Heaton without hesitation said I was absolutely right!

I have one thing about to say about [Nixon's press secretary] Herb Klein. Every day we wrote the [press] dispatch, and he never countered us. We wrote it honestly. He did ask why we had to say Nixon had hemolytic Staphylococcus aureus. The answer was that we wanted the public to know how serious this was.

Nixon was initially expected to be in the hospital for 2 weeks. What happened next?

On a Friday, 11 days after he was admitted, Nixon departed Walter Reed. Although I was concerned that he was still in trouble, I was no longer solely responsible for his care.

In an ideal situation, he would have been better to stay longer in the hospital for physical therapy and observation. I would have advised him not to leave the hospital for several more days. But the pressure of the campaign prevailed and he was not to be denied.

You've regarding presidential illness. How open do you think the White House should be?

Presidents and candidates have a right to privacy. However, it's important that we know as much as possible about any serious illnesses. They have to be fair and square about their problems.

When I read the opinions and recommendations of scholars as to what should be done when a President or presidential candidate is disabled, I'm always secretly amused because many of them were never confronted with a real-life situation as I was.

Nixon lost the 1960 election to Kennedy but won the presidency in 1968. Did he keep in touch with you?

About a month after the election, he had a reception at his house. He hugged my wife and said, "you have one tough husband."

Later, [Nixon secretary] Rose Mary Woods provided me with upfront VIP tickets to his inauguration in 1969. [Woods would later .]

In my lifetime, I have been a Republican, Democrat, and independent. I always kept politics out of my practice. My job as a physician was and has always been to get my patients well.

Scalettar would practice medicine for another 56 years after treating Nixon. He helped develop the National Rehabilitation Hospital in Washington, D.C., and served as chair of the American Medical Association board of trustees.

"When I started, the AMA was a White, family-practice-dominated reactionary organization whose major interest was in the protection of private fee-for-service practice," he recalled. "I was in the forefront of changing the racism of the 'old white boys club' and turning the AMA into a vibrant organization. Bylaws were also changed to ban discrimination because of sexual orientation. I began the minority and international affairs coalition and worked to achieve parity for psychiatric services."

Scalettar said he's especially pleased that the AMA has had Black, gay, female, and Jewish Presidents: "I am proud!"

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