SEMP: Biot #677

Dr. Hans Kraus Medical Care of JFK

Biot #677: January 03, 2010

Austrian-born Hans Kraus, M.D. (1905-1996), the colorful twentieth century physical medicine and
rehabilitation pioneer, cared for President John F. Kennedy in his final years, from October 1961 to
November 1963. Initially contacted by a White House physician to assess the presidents back pain, Dr.
Kraus refused, citing the ethical impropriety of treating a patient under the care of Dr. Janet Travell,
senior White House Physician, President Kennedys personal physician since 1955, and a respected
specialist, like Dr. Kraus, in physical medicine and rehabilitation.
When Dr. Travell eventually called Dr. Kraus, apparently under pressure from others, Dr. Kraus agreed
to evaluate President Kennedy. His life forever changed by the heady and exhausting experience, Dr.
Kraus successfully forged in President Kennedy a strong fitness habit. Dr. Kraus developed a unique
opinion of how John F. Kennedys back originally became so weak and tight.

Dr. Hans Kraus in white coat. Source:

http://www.fitness.gov/images/
HansKrausMD.jpg; accessed January 6,
2010.

Close up of Dr. Hans Kraus. Source: http://

www.ihpra.org/chapter_3.htm; accessed
January 6, 2010.

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1. Early Years
Hans Kraus was born in 1905 in the history-drenched port of Trieste at the head of the Adriatic
Sea, seventy miles due east of Venice, Italy. (1) Trieste was then the sole seaport of the otherwise
land-locked Austro-Hungarian Empire, whose capital Vienna was 215 miles to the northeast (as
the crow flies). Trieste was an entry point into Central Europe. (2)

Map showing the location of Trieste.

Source: http://www.pickatrail.com/
jupiter/location/europe/italy/map/trieste.
gif; accessed January 6, 2010.

Postcard of Trieste in 1908, three years

after Hans Kraus was born there.
Source: http://www.i-italy.org/files/
consulate_events_thumbnails/
Svevojoyce2_1214837915.jpg;
accessed January 6, 2010.

Hans father, Rudi, was born and raised in Pilsen (Western Bohemia, Czech Republic), about 55
miles west of Prague, where his father owned a grocery store. As a young man, Rudi moved
southward about 300 miles to Fiume (Rijeka, Croatia), a seaport on the Adriatic, about 40 miles
southwest of Trieste, where he accumulated shipping industry experience and married Ella
Schlessinger (1904). A year later, they moved to Trieste where he founded his shipping company
Marittima, while Ella bore Hans, Sisi (born 1910) and Franz (born 1916). (3)
Hans received private tutoring at home until age 11 years (1916), because cholera, diphtheria,
typhus, smallpox, influenza, and other contagious diseases frequently visited the seaport,
resulting in high mortality rates, particularly among children. The private tutoring made Hans
feel apart, isolate, and constrained. (4)
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In spring 1914, Rudi sensed imminent war in Europe and used his shipping contacts to arrange to
move his business and family to Zurich. He transferred many assets into Swiss banks. On June
28, 1914, Serbian and Bosnian anarchists assassinated Archduke Franz Ferdinand and his wife
Sophie in Sarajevo, Serbia. Rudi and Ella paid their respects to the dead royals on July 1, 1914,
when the dolorous armada put-in at Trieste where the funeral caskets were transferred from the
black-garlanded ship to a black-garlanded special train, to the accompaniment of booming gun
salutes, regiments presenting arms, and lowered colours. (5) Twenty-four hours later, the bodies
reached Vienna and then the border of the Wachau region of Austria, where they were laid to rest
beneath Artstetten Castle. (6)

Archduke Franz Ferdinand and his wife Sophie lying in state in Sarajevo after their
assassination in June 1914. Source: http://www.btinternet.com/~j.pasteur/Aftermath.
html; accessed January 6, 2010.
On August 12, 1914, as Trieste swarmed with soldiers, the Kraus family departed the city by
train to reach Zurich, about 275 miles to the northwest. (7) Hans was 9 years old. He grew to like
Zurich, because of its nearby mountains, whose foothills he climbed. James Joyce, the Irish
literary master (1882-1941) who was living in Zurich at the time, taught English to the Kraus
family.

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James Joyce when he lived in Trieste. Source: http://www.harpers.org/media/image/

blogs/misc/stanjoyce.jpg; accessed January 6, 2010.
After the war ended, Rudi moved his business headquarters and family from Zurich to Vienna,
370 miles to the east. Rudi began to groom Hans to take over the shipping business. When Hans
was in high school, however, he most enjoyed science courses taught by Dr. Schmidt, a recent
medical school graduate and a former lieutenant in the Austro-Hungarian mountain troops.
In 1921, at age 16 years, Hans attended a summer camp called Wandervogel where he and a
friend named Marcus together climbed a mountain in the Austrian Alps, down which Marcus fell
to his death by his own fault. This event traumatized Hans for decades.
2. Hans Becomes a Physician
Hans attended medical school at the University of Vienna, much to his fathers disappointment,
while continuing to rock climb in the Austrian Alps. He graduated in 1930 at age 25 and interned
in the large hospital attached to the University of Vienna Medical School. (8) He then specialized
in fracture surgery (orthopedics), because he could do something for the patient with a broken
limb, he said. Internal medicine lacked appeal for him, because it focused on diagnosis; there was
little available by way of treatment in the 1930s. Following his specialty training, Hans continued
to work as a fracture specialist at the Fracture Emergency Clinic at the University of Vienna
Hospital.

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University of Vienna Hospital, ca. World War II. Source: http://history.amedd.army.

mil/booksdocs/wwii/civilaffairs/ch14fig70.jpg; accessed January 6, 2010.
Hans met a retired circus performer (strongman) named Heinz Kowalski who owned a gym
beneath Hans medical office on the second floor of a building across the street from the hospital.
Ko was short like Hans (56). Most of Hans closest male friends were short. Ko believed that
musculoskeletal injuries healed fastest and best when they were immediately gently mobilized.
The standard of care was immobilization of the injury for weeks or even months. Ko told Hans
about the circus:
We got sprains and fractures all the time, but we couldnt afford to immobilize them in
casts. Instead, when we twisted a knee or sprained a shoulder, we wrapped the injury in a
towel soaked in alcohol, then held the whole thing close to steam from a boiling kettle
Doing this numbs the injured area, which allows you to start moving it gently. We would
do this several times a day, the steam treatment followed by the gentle movements. Pretty
soon, the whole injured area loosens up, and stops hurting. After a few days of treatment,
we could find the injury healed, and we could go back to work at the circus. (9)
This approach to healing and technique resonated with Hans, who had discovered that patients
with casted wrist fractures who performed simple exercisesmovements like shrugging their
shoulders and rolling their wrists--healed better and faster than the ones who had not exercised,
even if their injuries were worse. (10)
Instead of Kos alcohol, Dr. Kraus used ethyl chloride to numb the skin over an injured area to
facilitate early gentle movement. Since his approach was based on movement, in contrast to the
traditional immobilization treatments based on bed rest and casts, Kraus decided to name his
approach, immediate mobilization. (11) His private medical practice in Vienna began to
flourish when people, especially athletes, learned about his immediate mobilization technique.

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Dr. Kraus observed that some of his patients whose injuries were long standing found only partial
relief with his early mobilization technique. To learn more about muscle function, he read
Muskelharten (1913), a book by orthopedic surgeon Dr. Max Lange, which described a muscle
condition characterized by hard, localized lumps of dead muscle fiber named trigger points. Dr.
Lange noted the most common areas for trigger point development was in the muscle overlying
the hips, buttocks, lower back, shoulders, and neck. (12) Dr. Kraus learned to break up with
needles the tissue associated with trigger points before starting his patients on exercises designed
to restore muscle strength and flexibility.
3. Emigrating to America
In 1928, the Kraus family watched Austrias economy falter as unemployment and inflation rates
increased. In 1933, Hitler became German Chancellor, and in 1934, he became absolute dictator.
In 1935, he began his pogrom against German Jews by passing the Nuremburg Laws, which
stripped them of their citizenship, legal rights and protection. Hans told his biographer that his
mother was baptized Catholic and his father Protestant, yet each had one Jewish parent, which, in
Hitlers eyes, qualified them as Jewish. The Kraus family needed to get out of Austria.
In 1934, Rudi arranged for 29-year-old Hans to visit Chicago, about which he was ambivalent,
and New York City, which he loved, to observe medical advances and scout places for the family
to live, transfer funds, and execute various financial arrangements as the early stage of
emergency plans to escape Austria. (13) Rudis preparedness moves saved the family fortune.
During this trip Hans met Dr. William Darrach (1876-1948), a well-connected and well-respected
orthopedic surgeon at Columbia Presbyterian (since renamed New York-Presbyterian), who
shared Hans passion for the importance of movement in rehabilitating orthopedic injuries and
who protested the discrimination to which Nazi Germany was subjecting Jewish doctors and men
of science. (14)
Four years later, as Hitlers army marched into Vienna, Hans Kraus left Vienna on a train bound
for Trieste (March 14, 1938). After a few days in Trieste, he entered Switzerland where he
withdrew money Rudi had deposited, and then went to France, London, back to Trieste, and then
to Naples where he boarded the nearly empty Conte Biancamano ship for New York City. The
rest of the Kraus family followed later.

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Dr. William Darrach. Source: http://

library.cpmc.columbia.edu/hsl/archives/
imgtimelines/darrach_L.jpg; accessed
January 6, 2010.

Columbia Presbyterian Medical Center,

Broadway and 168th Street, New York
City, November 16, 1937, under
construction. Founded in 1921 with the
affiliation of Columbia University and
Presbyterian Hospital, the Center was
intended as a first-rate teaching hospital
serving the poor. Ground was broken in
1935. Source: Columbia Presbyterian
http://www.mcny.org/museumcollections/berenice-abbott/a262.htm;
accessed January 6, 2010.

Once in New York, Dr. Kraus again called on Dr. William Darrach, who directed him to talk
with the staff of the hospitals so-called Fracture Service. The interview went well and a few
days later, he [Dr. Darrach] asked me to join the hospitals staff as an assistant surgeon, said
Hans. Here I was, no immigration papers, no medical license, no professional recommendations,
nothing. But Uncle Bill [Dr. Darrach] wanted me, so he made sure that the hospital hired
me. (15) Dr. Darrach had served as dean of the College of Physicians and Surgeons at
Columbia from 1919-1931.
Hans worked three days per week for Dr. Darrachs clinic while he studied for his New York
State medical licensing examination, which he passed. He then set up his medical practice,
traveling periodically to climb the Shawangunks, 300-foot cliffs in Ulster County, less than two
hours north of midtown Manhattan.

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Shawangunks, Ulster County, New

York. Source: http://away.com/images/
outside/200709/shawangunks-skytopcliff.jpg; accessed January 6, 2010.

Shawangunks, looking up. Ulster

County, New York. Source: http://www.
supertopo.com/climbing/thread.php?
topic_id=697229; accessed January 6,
2010.

4. K-W Testing and Exercising

Beginning in 1940, Dr. Kraus worked with Dr. Sonya Weber, a fellow Austrian migr at
Columbia Presbyterian, in the hospitals Posture Clinic for children, which she had established to
treat children with posture problems. Drs. Kraus and Weber developed their six Kraus-Weber
tests (also known as K-W tests) to measure their patients level of strength and flexibility in the
back, stomach, and hip muscles used to hold the body erect. They prescribed various corrective
exercises, and from time to time would compare the results of these exercises with physical
changes in the patients. (16)

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Diagram of Kraus-Weber Tests. Source: http://www.ihpra.org/chapter_3.htm;

accessed January 6, 2010.
In 1944, Dr. Barbara Stimson, a prominent New York orthopedic surgeon, asked Drs. Kraus and
Weber to participate in a special back clinic she had organized at Columbia-Presbyterian
Hospital, under the auspices of Dr. William Darrach and Dr. Clay Ray Murray. Subsequently, Dr.
Howard Rusk (1901-1989), considered by many the father of modern rehabilitation medicine,
pursued the work at the Institute for Physical Medicine and Rehabilitation at New York
University. Dr. Stimson had started the clinic to find the cause for the rapidly increasing number
of back-pain sufferers in the armed services, industry and everyday life. In 80% of patients with
back pain so examined, physicians (orthopedic surgeons, internists, neurosurgeons, psychiatrists,
and neurologists) found no abnormalities in the back X-rays and routine laboratory tests. (17)

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Dr. Howard Rusk. Source: http://www.worldrehabfund.org/how_it_all_began.htm;

accessed January 6, 2010.
Drs. Weber and Kraus studied this 80% set of patients with backaches. Hans wrote:
We decided to use the six key tests we had developed for children at the Posture Clinic.
Upon administering the tests to the back patients, we at once discovered that not only
were they weak and tense but we could see exactly where the deficiencies were. Exercises
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were prescribed to fit each individual case. The benefits of the exercises were soon
evident. The patients who did them faithfully often found relief from back pain in a few
weeks or months. Those who did not exercise continued to suffer. Their suffering was
understandable, because muscles are healthy only when they are properly used. (17)
The two physicians began to give the Kraus-Weber tests to healthy people. People who failed
one or more of the six tests were prime candidates for developing future back pain; thus, the K-W
tests, Drs. Kraus and Weber believed, had predictive power.
5. International K-W Testing
Dr. Kraus first began to generate controversy when he announced the results of cross-country KW testing at a New York State Medical Society meeting in 1954. He found that European
children (Austrian, Italian and Swiss) outperformed American children on the K-W tests, and
declared that American children were not as fit as they needed to be. He attributed the difference
in performance between the European countries and the United States to the era of prosperity,
complete with television, automobiles, and appliances, that had swept over the U.S. after World
War II. Dr. Kraus wrote, Failure rates on tests shot up as a country became more prosperous. As
the most prosperous nation in the world, the United States was in an ignominious position. It had
and still hasthe most physically unfit youngsters. (18)
American physical educators disputed these facts and designed their own tests, which included
running, jumping, and throwing a softball. They calculated the average performance for each test,
and schools across the United States tested their students against this average, declaring their
students were meeting the average. Dr. Kraus objected to the methodology and the conclusion
drawn for performance of the American tests, since children from other countries outperformed
the American children on the American physical fitness tests (except for the softball throw). (17)
Dr. Kraus performed additional research, learning that physicians often put their patients on diets,
saying little about exercise. He developed the term hypokinetic disease to describe all the ailments
from back pain to heart troubleinduced at least in part by underexercise. (18)
During the early 1940s, Dr. Kraus left orthopedics, because increasingly, he could cure most of
his patients with exercise. When in 1946, Columbia Presbyterian formed a brand new department
specializing in Rehabilitation Medicine, Dr. Kraus moved into it. (18) Around 1950, he
transferred his affiliation from Columbia Presbyterian Hospital to New York Universitys Rusk
Institute of Rehabilitation Medicine. (19)
6. President Eisenhower Creates Federal Agency for Physical Fitness, Calls it Youth Fitness
Dr. Kraus noted American school gym programs focused on team sports, particularly football,
baseball and basketball. He believed that sports by themselves do not get children fit. Rather,
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children need to be fit to play sports. In most team sports the activity level is stop-and-go instead
of the crucial, sustained movement that children need, he said. Plus, team sports cater to a
small number of children who are the starsgenerally the fittest or tallestwho get most of the
playing timeThe ones who are overweight and out of shape are the ones who need exercise in
school the most, but with team sports, theyre the ones who sit on the bench. (20)
Dr. Kraus wrote many articles about physical fitness. Olympian gold medalist rower John B.
Kelly (father of actress Grace Kelly) read one and forwarded it to a friendly senator, who
forwarded it to U.S. President Dwight D. Eisenhower. The president invited Dr. Kraus to a White
House luncheon on June 29, 1955, to present his K-W childrens test results to a group that
included Vice President Richard Nixon and various American fitness experts and sports
celebrities. (21) In September 1955, President Eisenhower survived a serious heart attack,
remaining in bed for seven weeks after the event. He established the Presidents Council on
Youth Fitness (Executive Order 10673) on July 16, 1956. (22-23) Originally named Presidents
Council on Physical Fitness, objections by physical educators and others resulted in the change
to Youth Fitness, according to Dr. Kraus.

John B. Kelly. Source: http://www.

rowinghistory.net/JBK%20Sr-1920.jpg;
accessed January 6, 2010.

President Dwight D. Eisenhower on

youth fitness. Source: http://www.
fitness.gov/50thanniversary/photosfirstfiftyyears/DwightDEisenhowercirca1956.jpg; accessed January 6,
2010.

President Eisenhower never gave the council a budget or any ability to enforce recommendations;
rather, he charged original executive director Dr. Shane McCarthy with influencing exercise
habits through persuasion. The president appointed Dr. McCarthy, skipping over Dr. Kraus or a
Kraus recommendation. The council grew to 119 members; Hans Kraus was unimpressed and
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disappointed.
Writer Robert H. Boyle covered the June 29, 1955 White House fitness event for Sports
Illustrated (August 15, 1955) in a long piece titled The report that shocked the president. Boyle
wrote that Dr. Kraus told the audience, 57.9% of U.S. youngsters tested for physical fitness
failed one or more of six tests for muscular strength and flexibility while only 8.7% of European
youngsters failed. (24) Furthermore, Dr. Kraus explained the
Kraus-Weber Tests [were] designed to determine only the minimum levels of muscular
fitness, not the optimum levels. The tests determine whether or not the individual has
sufficient strength and flexibility in the parts of his body upon which demands are made in
normal daily living. For example, the [K-W] sit-up test in which the knees are bent tests
abdominal muscles. If a person fails, it means that his abdomen muscles cannot lift the
weight of his upper body, and such a condition indicates a lack of sufficient
exercise. (24)
7. Senator John F. Kennedy Embraces Physical Fitness for Country, Then Self
Senator John F. Kennedy in a brilliant move adopted Dr. Kraus physical fitness message as his
own during his campaign for the U.S. presidency. John Kennedy worked hard to persuade the
media he was the healthiest and most vigorous candidate and therefore deserved to win over
others without these characteristics. This bold approach worked to neutralize his adversaries in
three ways. First, it refuted accusations made by supporters of Senator Lyndon B. Johnson, who
claimed that Kennedy suffered from Addisons disease and other medical illnesses and was
therefore not fit for office. Second, it deflected the words of former President Harry Truman, who
poked Senator Kennedy for being too young and too immature for the office of the presidency.
(25-29) Third, it redirected attention away from the senators Catholicism, which many observers
believed was his political Achilles heel. Beyond declaring himself the most fit of all the
candidates, Senator Kennedy dropped to the press the tidbit that four out of seven presidents
during his lifetime had suffered from heart disease, a none-too-veiled reference to Lyndon
Johnsons heart attack in 1955. (30) Not surprisingly, Senator Johnsons supporters howled about
Senator Kennedys muscle flexing and boasting about his youth and vigor.

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Sports Illustrated cover with Jack and Jackie Kennedy, boating. Photographed by:
David Drew Zingg. Source: http://sportsillustrated.cnn.com/vault/cover/featured/7698/
index.htm; accessed January 6, 2010.
Schwartz writes:
By the time Kennedy was running for president in 1959, he looked like he could have
been a climber partnering [Dr. Hans] Kraus at the Gunks [Shawangunks]: tanned, trim,
seemingly toned, turning out that dazzling smile and glowing with apparent health and vigah. Kennedy and his supporters saw a supreme opportunity to market his athletic,
outdoors image. Staged photos showed him sailing, swimming, playing football; often
bare-chested, muscles rippling in the sun.
Kennedys appearance became a huge asset in his presidential campaign. An aide to
Kennedys main rival, Lyndon Johnson, declared grumpily, that Kennedy appears so
health that its almost illegal. Even sophisticated media, such as The New York Times,
were bowled over, Crowds responded warmly to a masculine presence, a lithe figure, a
suntanned face and a natural smile. (31)
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In truth, Senator Kennedy was not a well man. He had many serious medical problems, the nature
of which his handlers, including his personal physician and later White House Physician Dr.
Janet Travell, knowingly withheld from the American plebiscite. Indeed, as if to make things
even worse, Senator Kennedy received injections filled with amphetamines and other
components, at least as early as September 1960 near the time of the Nixon-Kennedy debates,
from the notorious Dr. Max Jacobson, a 1936 German migr to New York City. Senator
Kennedy said he took the injections to counter his exhaustion. (32-33)
John Kennedy was elected president in November 1960 and almost immediately underscored
Americas need to improve her citizens level of physical fitness. The following list of articles
exemplifies the intensity of his effort:

Kennedy to push fitness program; president-elect in magazine article says flabbiness

menaces U.S. security. The New York Times, December 21, 1960.
Jack Kennedy practices the fitness that he preaches in Sports Illustrated, December 26,
1960;

Bess Furman: President opens a fitness appeal. The New York Times, February 21, 1961;

Kennedy is lauded on fitness plans. The New York Times, March 5, 1961.

Janet Travell and David Lewis: Fit to be president. Sports Illustrated, April 3, 1961.

Fitness of youths urged by Kennedy; Kennedy asks 15 minutes a day of rugged exercise
in schools. The New York Times, July 19, 1961.
Fitness parley: State officials are invited to start Kennedy program. The New York
Times, July 22, 1961.
Physical fitness in schools gaining. The New York Times, July 31, 1963.

Then came the following article on the front page of The New York Times (October 20, 1961):
Kennedy exercising daily to help back; Kennedy begins daily exercises. What was this?
8. President Kennedy Takes the Kraus Cure: Exercise
In June 1961, President Kennedys endocrinologist, Dr. Eugene Cohen, of New York Hospital,
contacted Dr. Hans Kraus to ask him to treat President Kennedy for an acute exacerbation of his
chronic back pain. The president had re-injured his back lifting a shovel of soil in Ottawa,
Canada, during a tree planting ceremony in May 1961. His back hurt so much during a
subsequent trip to Europe in June 1961 to meet Khrushchev, among other leaders, that he
required multiple vitamin injections from Dr. Max Jacobson, whom he ferreted to Europe
unbeknownst to White House physicians, Dr. Janet Travell and Dr. George Burkley, who
accompanied the president. (32)

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Dr. Kraus listened to Cohen, neither flattered nor excited, as Cohen explained that he was
seriously worried about Kennedys worsening back problems and that Kennedys current White
House back doctor [Dr. Janet Travell] wasnt helping him. To Cohens surprise and dismay,
Kraus politely refused, No, I really cant, Gene. Kraus explained to Cohen that he was
sympathetic to Cohens worries, but added, You know I cant see Kennedy unless his current
back doctor personally asks me. It wouldnt be ethical. (35) Schwarz continues:
Kraus didnt bother adding that he also realized that treating the President of the United
States would be a total commitment, consuming what little free time he had on weekends
for his family [he had married and had two daughters] or to climb, already interrupted by
his regular practice and his unofficial practice of treatingfor freeall injured climbers
at the Shawangunks. Without having met Kennedy, Kraus wasnt sure he was willing to
take on that commitment. Kraus explained further, Too many people judge other people
on their rank or money. But to me, it wasnt that. What mattered was whether I felt there
were a good person. I couldnt treat anyone I didnt like. (35)
One more thing bothered Dr. Kraus about accepting President Kennedy as a patientPresident
Kennedys multiple earlier back operations. Even a single back operation could permanently
incur so much damage, that it could be too late, even for Kraus, wrote Schwarz. Dr. Kraus
opined, Once someone has had a back operation, even once, you never know. Backs dont like
to be operated on. (35)
On October 14, 1961, Dr. Travell telephoned Dr. Kraus directly to invite him to the White House
to examine President Kennedy. Dr. Kraus complied. The next day he was in Washington, D.C.,
setting up temporary facilities in Dr. Travells three-room medical office on the first floor of the
White House. He noted President Kennedy was 44 years old, six feet tall, and 179 pounds. Dr.
Kraus was 56 years old. He put the president through the K-W tests and palpated for muscle
anomalies. Dr. Kraus took no X-rays and read none of Dr. Travells notes or X-rays. He
concluded the following about President Kennedy (as told to his biographer Susan B. Schwarz):
Kennedy was so weak that he couldnt do a single sit-up and he was so tight that his leg
muscles felt as taut as piano wires. When Kraus asked his patient to touch his toes [one
of the six K-W tests], Kennedys fingertips dangled a good twenty inches off the floor, not
even reaching his knees. It was clear to Kraus that whatever else was going on with
Kennedys back, Kennedy was in abysmal shape. (36)
Kraus wasnt sure how much he could help Kennedy, considering Kennedys back
operations and subsequent treatments. But from the little Kraus had seen of the man, he
had a good feeling about him, and wanted to try to help him. And Kraus had no doubt
about one thing: Kennedy needed to exercise [which, after all, is what Kennedy was
urging the country to do]. Otherwise, his muscles would grow weaker and tighter, causing
only more pain and immobility. Kraus delivered his assessment to Kennedy bluntly, you
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will be a cripple soon if you dont start exercising. Five days a week. And you need to
start now.
Dr. Kraus described his clinical plan to President Kennedy. Dr. Kraus would treat the president
personally at least three times during the week, and would train the three White House therapists
so that they could supervise the two additional weekly exercise sessions in Kraus absence.
Kraus would also commit, on a moments notice, to fly to Kennedy for emergencies, whenever
he needed him, wherever he was, no matter how oftenThen Kraus got to the crucial part: what
he expected from Kennedy and the other White House doctors.
Kraus explained to everyone in the room that to him, this was his most important
condition, on which he was absolutely unyielding and completely unwilling to
compromise. It was the only way he would work with any patient, whether president of
the United States or a Gunks climber: I must have absolute control, Kraus announced
He would brook no interference from any doctor, whether Travell or even Cohen or
Burkley. He would entertain no second opinion, unless he sought it. If the other doctors,
or Kennedy, didnt like his conditions, that was fine with him. In that case, he simply
wouldnt take Kennedy on as a patient. (36)
President Kennedy expressed concern reporters would notice Dr. Kraus regular presence at the
White House and ask questions about the presidents health again, which he dreaded. Dr. Kraus
shot back, Its your decision, but when you get worse, what will they write then? President
Kennedy agreed, on one condition: absolute secrecy, that Dr. Kraus receive no publicity for
being his back doctor, and instead remain hidden and operate completely behind the scenes. If the
press tried contacting Kraus he wasnt to speak to them, even off the record, and instead refer
them to Kennedys press secretary, Pierre Salinger. (36) President Kennedy even installed a red
line (telephone) for direct secure access to Kraus. Furthermore, according to Kraus biographer,
As a precaution, when Burkley, Cohen and Kraus needed to talk on the phone, they always used
pay phones. (37) John Kennedys need for unconditional silence from his numerous physicians
is the main reason Americans know little about his medical history, even today.
President Kennedy did not offer to pay Dr. Kraus for his services and Hans did not raise the issue
for over a year. Finally, he wrote to Evelyn Lincoln, the presidents secretary, to request
reimbursement for plane fares. (36) Dr. Kraus rationalized that treating the president for free was
a form of public service.
Schwarz avers the arrangement between Kraus and Kennedy added another layer to Kennedys
presidential health cover-upTo help maintain the fiction, when Kraus stayed overnight to treat
Kennedy for the weekend, holidays, and emergency flare ups that occurred regularly when
Kennedy visited his family, Kraus stayed tucked away discreetly at small pensiones. (38)
Yet, the professional relationship between Dr. Kraus and the president was well publicized. For
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example, a story ran on October 20, 1961 (the day after they met) in The New York Times titled
Kennedy exercising daily to help back. It read:
President Kennedy has started a daily program of exercise designed to strengthen his
muscles and remove fear that his chronic back trouble will flare up again. He began the
exercises in the White House gymnasium yesterday under the supervision of Dr. Hans
Kraus, associate profession of physical medicine and rehabilitation at the New York
University Medical School. Dr. Kraus was a member of the Presidents Council on
Physical Fitness during the Eisenhower Administration. He is regarded by Mr. Kennedys
regular physician, Dr. Janet G. Travell, as an expert on the therapeutic approach to
physical fitnessAt Dr. Travells invitation, Dr. Kraus worked out an exercise program
for the President. He plans to come to Washington three times a week for about two
months to supervise Mr. Kennedys workouts in a small gymnasium adjoining the White
House swimming pool. The President exercised yesterday for about fifteen minutes, using
only body motion, not weights and pulleys with which the gymnasium is equipped. The
President is apparently hopeful that after a couple of months of studied muscle
strengthening, he will return to such favorite outdoor pursuits as golf and possibly ocean
swimming at his fathers home at Palm Beach, Florida.
There is nothing omitted or inaccurate about this story. Dr. Burkley had set up a small area next
to the swimming pool with gym equipment where Dr. Kraus and the White House physical
therapists put the president through his exercises five days a week.
Dr. Kraus grew to admire President Kennedy. His Manhattan office was ransacked once, which
President Kennedy and others blamed on J. Edgar Hoover of the Federal Bureau of Investigation.
Dr. Kraus cracked, Even if Hoover had gotten his hands on Kennedys files [which he didnt],
all that would have happened is that he would have discovered that Kennedy did exercises. (37)
Occasionally, Dr. Kraus would administer procaine injections at trigger points, just as Dr. Travell
had done for President Kennedy, but he kept this procedure as an adjunct to exercise therapy, not
as the sole treatment.
9. President Kennedy Strengthens Back
Hans Kraus discerned that President Kennedys relapses of back pain always took place on
weekends and holidays. For example, when Mr. Kennedy spent Thanksgiving (1961) with his
family at the Hyannis Port compound, he developed severe back spasms. As had become
routine, Kennedy called Kraus and sent Air Force Two for him. Six weeks later, when Kennedy
spent Christmas with his family in Palm Beach, [he] suffered another relapse, this time far
worse. (39)

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President John F. Kennedy in rocking

chair. Source: http://www.
humanillnesses.com/original/images/
hdc_0001_0001_0_img0007.jpg;
accessed January 6, 2010.

White House swimming pool. Source:

http://clean-sweep-pool.com/
SwimmingPoolOne/
SwimmingPoolOne.html; accessed
January 6, 2010.

In spite of these setbacks, President Kennedy continued faithfully to perform his exercises and,
by late 1961, Dr. Kraus was tapering off his visits to the White House to twice a week. An article
titled Presidents back reported better in The New York Times dated December 13, 1961, read:
President Kennedy is swimming and taking muscle-strengthening exercises every day,
White House aides said today. His bad back apparently is tremendously better. The
President is hoping and expecting to pick up his golf game during the holiday season at
Palm Beach, Fla. He has not played a round since he strained his back last May while
lifting a shovel of dirt at a tree-planting ceremony on a visit to Ottawa. This was just
before a rigorous trip to France, West German and Britain on which the President
concealed his injury. After he returned home he was on crutches for several weeks. About
six weeks ago, a New York expert, Dr. Hans Kraus, began coming to the White House to
supervise a series of muscle-strengthening exercises. Dr. Kraus still makes the visit once
or twice a week, Presidential aides said, and he has done wonders for the President.
By the spring of 1963, Dr. Kraus was visiting the White House once very few weeks. (39) He
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was able to do this, because the head White House therapist Chief Hendrix, whom Dr. Kraus
had trained in the K-W exercises, put the president through them, traveling everywhere with him.
After Kennedys assassination, Chief Hendrix left the White House to work for Dr. Kraus in
Manhattan, until he retired in the 1980s. Dr. Kraus said of him, He was the best therapist I ever
saw. (40)
10. Kennedys Life Ends
In October 1963, Dr. Kraus wanted President Kennedy to throw out his corset (which he had
worn since he was sophomore at Harvard College) and his crutches, and shift from physical
therapy exercises to exercises designed for staying in shape. (41) But as is common among
people who suffer chronic bad painthe psychological adjustment lags behind physical progress
Kennedy did not quite dare give up the trappings of his infirmity just yet. He did promise Dr.
Kraus that he would do so in the new year, 1964. Dr. Kraus last saw President Kennedy in
October, but was looking forward to attending his first State Dinner to which President Kennedy
had invited him and his wife, which was scheduled for Monday, November 25, 1963. President
Kennedy was assassinated on Friday, November 22, 1963 in Dallas, Texas.
Evelyn Lincoln and Kennedy aide Kenneth ODonnell independently recalled how healthy
President Kennedy was in the last months of his life. Lincoln said, I have often stated that in the
last six months of President Kennedys life he was in the best health he had ever been. He was
really in good health. ODonnell said that on the last day of his life, Kennedy turned to him and
said, I feel greatMy back feels better than its felt in years. (42)
President Lyndon Johnson asked Dr. Kraus to remain a member of the White House team of
physicians, but he preferred to return to New York and his family. Drs. Burkley and Cohen did
not plan to write memoirs of their experience caring for Mr. Kennedy, because they, like Kraus,
had given him their word, promising secrecy. (43) Yet even without capitalizing on his Kennedy
connections, Kraus practice finally took off. He treated patients, wrote books, climbed his
beloved Shawangunks, spent time with his family, and finally died in 1996 of prostate cancer at
age 91 years.

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Hans Kraus, age 50 (1960). Source:

http://www.climbaz.com/interviews/
kraus.html; accessed January 6, 2010.

President Kennedys physical fitness

patch, awarded to students who met
certain fitness requirements. Source:
http://www.jfklibrary.org/Historical
+Resources/JFK+in+History/The
+Federal+Government+Takes+on
+Physical+Fitness.htm; accessed
January 6, 2010.

11. How President Kennedys Back Originally Became Weak and Tight
Dr. Hans Kraus believed that John F. Kennedy grew up as an invalid, because of the
astonishing number of weeks and months he spent lying in bed in hospitals, clinics, and
infirmaries to undergo diagnostic testing and treatment for his many mysterious and unending
illnesses. After the testing and treatment, he would withdraw for days, weeks, and sometimes
months to Hyannis Port or Palm Beach to recuperate, again lying down most of the time. (44)
Without chances to run around and play games, the boyhood Kennedy would not have
developed normal muscles, averred Dr. Kraus. By late teenager years, Kennedys muscles
would have been growing too weak to support his maturing, heavier frame. As an adult, Kennedy
was going to be a prime candidate for developing back pain anyway, but he sealed his fate in
college [by] permanently donning an artificial support that keeps muscles from working--whether
back corset, brace or crutches. These supports are about the worst thing a back pain sufferer
like Kennedy could do. (44)
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Notes:
1. Justin Coffin writes, The history of Trieste can be read as the record of ascendancy in Middle
Europe. The Romans founded the city as they expanded their empire in the second century BC.
When Rome collapsed in the fifth century AD, Trieste was overrun by the Huns, and then fell
under Byzantine rule. Next in line were the Carolingians, followed by the Venetians. For one
year, 1381 to 1382, Trieste held a tenuous independence, which ended when it submitted to
Austria as a preferable alternative to Venetian rule. The French, this time led by General
Bonaparte, conquered it again in 1797 and handed it over to the Austro-Hungarian Empire.
Finallyor rather, for nowit has been a part of Italy, having been awarded after World War I
as a trophy for Italys participation on the side of the Allies. Recent decades have not been so
calm in neighboring Istria, which was part of Yugoslavia and now sits on the border between
Slovenia and Croatia. Source: Justin Coffin: Microcosms by Claudio Magris (book review).
Boston Review. February/March, 2001. Available at http://bostonreview.net/BR26.1/coffin.html;
accessed January 3, 2010.
2. For more about the history and culture of Trieste, see
Jan Morris: Trieste and the Meaning of Nowhere. Cambridge, MA: Da Capo Press, 2002; and
Claudio Magris: Microcosms. Translated by Iain Halliday. London: Harvill Press, 2001.
3. Susan E.B. Schwartz: Into the Unknown: The Remarkable Life of Hans Kraus. New York:
IUniverse, 2005, p. 4.
4. Ibid, p. 5.
5. Franz Ferdinand: Aftermath. Available at http://www.btinternet.com/~j.pasteur/Aftermath.
html; accessed January 4, 2010.
6. Arstetten Castle. Available at http://www.schloss-artstetten.at/englisch/schloss.htm; accessed
January 4, 2010.
7. Susan E.B. Schwartz: Into the Unknown. New York: IUniverse, 2005, p. 6.
8. Ibid, p. 22.
9. Ibid, p. 39.
10. Ibid, p. 38.
11. Ibid, p. 41.
12. Ibid, p. 46.
13. Ibid, p. 52.
14. Hitlerism scored by doctors here. Forty-nine sign statement condemning discrimination against
physicians. They assert science should not recognize and racial or political boundaries. The New
York Times, July 10, 1933.
15. Susan E.B. Schwartz: Into the Unknown: The Remarkable Life of Hans Kraus. New York:
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IUniverse, 2005, p. 64.

16. Hans Kraus: Backache, Stress and Tension: Cause, Prevention and Treatment. New York:
Fireside Book, 1965, pp. 38-39.
17. Ibid, pp. 44-46.
18. Susan E.B. Schwartz: Into the Unknown: The Remarkable Life of Hans Kraus. New York:
IUniverse, 2005, p. 91.
19. Ibid, p. 112.
20. Ibid, p. 114.
21. Susan E.B. Schwartz: Into the Unknown: The Remarkable Life of Hans Kraus. New York:
IUniverse, 2005, p. 121.
22. Hans Kraus: Backache, Stress and Tension: Cause, Prevention and Treatment. New York:
Fireside Book, 1965, pp. 47-48.
23. The Federal Government takes on physical fitness. Available at http://www.jfklibrary.org/
Historical+Resources/JFK+in+History/The+Federal+Government+Takes+on+Physical+Fitness.
htm; accessed January 5, 2010.
24. Robert H. Boyle: The report that shocked the president. Sports Illustrated, August 15, 1955.
Available at http://sportsillustrated.cnn.com/vault/article/magazine/MAG1130060/index.htm;
accessed January 10, 2010.
25. Margaret R. OLeary: Dr. Janet Travells Rendezvous with JFK. Securitas Magazine, Apr-Sept
2009, Volume 8, Issue 2. Available at http://www.semp.us/publications/securitas_reader.php?
SecuritasID=40#Article4; accessed January 5, 2010.
26. Janet Travell: Office Hours: Day and Night. Cleveland, OH: New American Library, 1968, p.
328.
27. W.H. Lawrence: Johnson backers urge health test. The New York Times, July 5, 1960.
28. Robert Dallek: The medical ordeals of JFK. The Atlantic Monthly, December 2002. Available
at http://www.theatlantic.com/doc/200212/dallek-jfk; accessed September 6, 2009.
29. Lee R. Mandel: Endocrine and autoimmune aspects of the health history of John F. Kennedy.
Annals of Internal Medicine, September 2009, Volume 151, Number 5.
30. Richard Norton Smith: The president is fine and other historical lies. Columbia Journalism
Review, September 2001. Available at http://www.entrepreneur.com/tradejournals/article/
print/78535553.html; accessed January 5, 2010.
31. Susan E.B. Schwartz: Into the Unknown: The Remarkable Life of Hans Kraus. New York:
IUniverse, 2005, p. 165.
32. Michael R. Beschloss: The Crisis Years: Kennedy and Khrushchev 1960-1963. New York:
HarperCollins, 1991, p. 190.
33. Boyce Rensberger: Amphetamines used by a physician to lift moods of famous patients. The
New York Times, December 4, 1972.
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34. Jack Kennedy practices the fitness that he preaches. Sports Illustrated, December 26, 1960.
35. Susan E.B. Schwartz: Into the Unknown: The Remarkable Life of Hans Kraus. New York:
IUniverse, 2005, p. 166.
36. Ibid, pp. 178-179.
37. Ibid, p. 188.
38. Ibid, pp. 180-181.
39. Ibid, p. 192.
40. Ibid, p. 193.
41. Ibid, p. 203.
42. Ibid, p. 207.
43. Ibid, p. 211.
44. Ibid, p. 236.

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