If so, he may have paid a high price. Physicians in the 1930s and 1940s did not realize what is common medical knowledge today—namely, that corticosteroids are effective in treating acute colitis but have deleterious long-term effects, including osteoporosis of lower-back bones and increased incidence of serious infection (owing to suppression of the body's immune system). Kennedy would suffer from all these problems, including outright degeneration of his lumbar spine. In addition, the long-term use of cortico-steroids suppresses normal adrenal function; it may have been the cause of Kennedy's Addison's disease. (Jack's sister Eunice also had Addison's, however, indicating that his disease may have had an inherited component.)

From September of 1934 to June of 1935, Jack's senior year of prep school, the school infirmary had kept a close watch on his blood count; Joe Kennedy passed these records on to the Mayo doctors. At that time there was still concern that Jack might be suffering from leukemia. In retrospect, any changes in his blood count may have been a reaction to the drugs he was taking. When he fell ill the following autumn, a doctor advised that Jack had agranulocytosis, a decrease in granular white blood cells, which made him more susceptible to infections.

Shortly after leaving Choate, Jack had to spend two months at the Peter Bent Brigham Hospital, in Boston. Uncertain whether they were dealing strictly with colitis or with a combination of colitis and ulcers, and worried that his medicines were playing havoc with his white-blood-cell count, his doctors performed additional tests. According to a letter Jack wrote to Billings, his white-blood-cell count was 6,000 when he entered the hospital and down to 3,500 three weeks later. "At 1500 you die," Jack joked. "They call me '2000 to go Kennedy.'"

By the end of January 1936 he was more worried than ever about his health, though he continued to use humor to defend himself against thoughts of dying. "Took a peak [sic] at my chart yesterday and could see that they were mentally measuring me for a coffin. Eat drink & make Olive [his current girlfriend], as tomorrow or next week we attend my funeral. I think the Rockefeller Institute may take my case ... Flash—they are going to stick that tube up my ass again as they did at Mayo."

From 1938 to the end of 1940, while Kennedy attended Harvard, intestinal problems plagued him relentlessly. In February of 1938 he had gone back to the Mayo Clinic for more studies, but with no good results. In June he spent two weeks in New England Baptist Hospital for the same complaints, but again with no improvement. In October he was still "in rotten shape," but he refused to re-enter the hospital for more of what now seemed like pointless tests. In February of 1939, however, he gave in and went back to the Mayo Clinic. It was the same old routine: a diet of bland foods three times a day and another inspection of his colon and digestive system. By November, under the care of William Murphy, of Harvard, the physician and Nobel laureate who co-discovered the treatment for pernicious anemia and had an uncommon faith in the healing power of liver extracts, Jack recorded that he was going to "take my first liver injection today and I hope they work." They did not. A year later he was still wrestling with abdominal pain, spastic colon, and low weight. If he was taking DOCA and it was limiting the effects of his colitis (and it is not clear that it was), it was certainly worsening his stomach problems. The steroids may also have contributed to the onset of duodenal ulcers, which weren't diagnosed until November of 1943. But there would be no public acknowledgment of any of these ailments, or any outwardly evident self-pity. Refusing to let health concerns stop him became a pattern that allowed Kennedy to pursue a political career.

"Yellow as Saffron"

Serious back problems added to Kennedy's miseries from 1940 on. In 1938 he had begun having "an occasional pain in his right sacro-iliac joint," according to a Navy medical history recorded in December of 1944.

It apparently grew worse but at times he was completely free from symptoms. In the latter part of 1940 while playing tennis he experienced a sudden pain in his lower right back—it seemed to him that "something had slipped." He was hospitalized at the Lahey Clinic ... for ten days. A low back support was applied and he was comfortable. Since that time he has had periodic attacks of a similar nature.

Kennedy's service in the southwest Pacific on PT boats —which he managed to arrange by calling on his father's connections to hide his various illnesses from military physicians—added to his pain, especially after a Japanese destroyer sank his boat, leading to a week-long physical ordeal. (For all the accuracy of the popular accounts praising Kennedy's valor on PT-109, the larger story of his endurance has not been told. Lennie Thom, his executive officer, wrote letters home discussing JFK's back problem and his refusal to report to sick bay: "Jack feigned being well." Kennedy acknowledged to his parents that life on the boats was "not exactly what the Dr ... ordered." But he did not let on to his crew or his commanding officer that he was ill or in pain. And except for his chronic back ailment, which he simply could not hide, and which he seemed to take care of by wearing a "corset-type thing" and sleeping with a plywood board under his mattress, the men on PT-109 saw no poor health. Before the war was over, however, Kennedy found himself once again in the hospital for both back and stomach problems.)