The subject of former President John F. Kennedy’s health was one of great fascination both when he was alive and the president, and posthumously. During his campaign for president, JFK denied rumors of his poor health, while opponent Richard Nixon assigned his staffers to steal medical records from doctor’s offices; they were unsuccessful. This article in the Atlantic archives is a terrific read, bringing up two excellent points.

For one, people with chronic illnesses and disabilities are often questioned if they exhibit an outward appearance of good health, or are able to take on a lot of different kinds of activities. “But you don’t look sick!” and “You look good!” are common observations. These anecdotes hardly change symptoms, diagnosis, or treatment.

JFK was not only the president, but he was popular in part (like Obama after him) for being young, seemingly athletic, vigorous, and good-looking. Yet he privately suffered ulcers, colitis, osteoporosis, food allergies, a compromised immune system, and Addison’s disease. The invisibility of illness is extremely common in patients with chronic conditions.

The second point is that, then and now, we prefer our leaders to project an image of strength. In his three short years as president, JFK navigated the Cuban Missile Crisis. While there is a time and place to discuss whether he should be credited with preventing the US and the USSR from officially entering into nuclear conflict, the Crisis should be universally regarded as an extremely stressful thing to have to deal with, regardless of the commander-in-chief’s health status. That JFK was juggling both multiple serious illnesses and the possibility of nuclear conflict should speak to his fortitude, not his weakness.

Yet, even after his assassination in 1963, the Kennedy administration took great pains to conceal his health status, and concoct a false image of great health. Is this relevant today? Well, yes. We still expect the same decorum and hold the same stigmas around illness as we did sixty years ago, evidently.

In October 2020, all eyes were on Walter Reed Medical Center, where then-President Donald J. Trump was being treated for COVID-19: the very disease he was criticized for not doing enough to protect the general American public from. In two famous–and arguably very reckless–publicity stunts, Trump loaded into an SUV and waved to supporters outside Walter Reed, then removed his mask and waved from a White House balcony after his discharge. Although these publicity stunts appeared to show a president who was successfully battling the virus, American medical professionals and laypeople alike speculated a far grimmer reality.

These speculations have turned out to have been true. Trump’s oxygen saturation levels were in the 80s; a healthy person should have o2 between 95-100%. He received supplemental oxygen, and was shown to have lung infiltrates and inflammation. He was dangerously close to requiring a ventilator. Again, while many of us indeed speculated these things to be true–and they were–this was hardly the image that the then-president wanted to project.

Trump had an obvious extra political incentive to project vigor despite his COVID-19 diagnosis. If he could show that COVID-19 was non-serious, that even a man in his 70s could overcome it if he were healthy and strong enough, it would justify his early pushes to keep the economy open, and reject masks and stymie other prevention efforts. “Don’t be afraid of Covid. Don’t let it dominate your life.” These were code words for “See? It’s not so bad! Don’t hold me accountable for doing nothing to prevent hundreds of thousands of us from dying from it, and millions more being sickened”. A month later, at the polls, over 80 million Americans rejected these myths, securing Joe Biden’s presidential victory.

Obviously, JFK did not have this incentive when hiding his disease. But, with both JFK’s chronic illnesses and Trump’s brush with COVID-19, both men wanted to project this very presidential image of strength and vitality, despite being in poor health. Why? There is a clear incentive to keep the American people feeling secure during times of uncertainty and turmoil. During both 1962 and 2020, circumstances felt dire, and perhaps neither JFK nor Trump wanted to fuel that fire by worrying Americans about their health.

There’s also the very American cultural phenomenon of ignoring symptoms, taking a Tylenol, and coming to work anyway when sick. With some of the worst policies for sick leave amongst the wealthiest nations, the US in neither policy nor practice makes it easy to take a sick day.

Here’s the question I’m going to leave us all with. I want everyone to openly question the origins of “But you don’t look sick” and “You look fine”. By pretending that we are not sick, that we are fine, that we can go to work and get the job done, we allow ourselves to justify the US totally lacking material support for health. Our illnesses are rendered invisible, in order to pretend we don’t actually need things like paid sick leave and universal healthcare. People who need those things are weak, frail, and a liability to our productive capitalist economy.

Are they?

Or, are they the very people leading our nation?