With so many new obligations, Betty had become increasingly reliant on Nancy Howe to help manage the endless requests, phone calls, and invitations. The two were comfortable with each other and found ways to laugh and have fun. At one point, Betty commented that petunias were the only things that could stand the heat in Washington in the summer—meaning not only the heat of the sun but also the heat of Congress when all the members want to go home, and they start racing through legislation and getting all disagreeable. Nancy thought it was so amusing, and so typical of Betty, that she began calling her “Petunia.”
There was an office in the East Wing of the White House designated for use by the first lady and her staff, but Betty preferred to conduct her business from the residence. She set up a small desk in the West Sitting Hall of the residential quarters, so she could write letters and answer phone calls without having to go through the time-consuming process of hairdressing and makeup. If she didn’t have to go out, she’d often remain in one of her elegant bathrobes until lunchtime. Nancy would come upstairs each morning, and she was usually the last person to leave before Jerry returned at the end of his workday. With appearances at charity luncheons and the constant social planning, there was little time for friends or personal interests.
Nancy Howe had scheduled a routine gynecology checkup for herself at Bethesda Naval Hospital on September 26. Given the tumult of the past thirteen months, Nancy knew that Betty hadn’t had any time to look after herself.
“Come along with me,” Nancy urged her. “You’re due for a checkup.” Betty agreed, and off they went.
As the doctor checked Betty’s breasts, her mind was busy with all the things she still needed to do that day. He asked her to wait for a minute and then, without any explanation, returned with Dr. William Fouty, the chief of surgery. She lay there as Dr. Fouty reexamined her breasts; then he told her she could get dressed. Neither physician indicated anything was unusual, and the two ladies returned to the White House.
Unbeknownst to Betty, the doctors at Bethesda had contacted Dr. William Lukash, the chief White House physician. Upon returning to the residence, Betty received a message that Dr. Lukash wanted to see her in his office on the ground floor at seven o’clock that evening.
Meanwhile, that afternoon, Susan felt like she was coming down with a cold and stopped by Dr. Lukash’s office to get some medication. He told her to shut the door and sit down.
“There’s something I need to tell you,” he said. “Your mother has a lump in her breast, there’s a good chance it’s cancer, and she doesn’t know, so hush-hush, don’t say anything to anybody.”
Susan was in complete shock. “It was devastating. Totally devastating,” she said. “I had never been so scared in my life.” She ran upstairs to her room, sobbing. “We have just been through this unimaginable roller coaster, and now I’m going to lose my mom? This is not fair.”
Her fears were not unfounded. At that time, in 1974, a breast cancer diagnosis was akin to a death sentence. A radical mastectomy was the best option to prolong life, but with reconstructive surgery in its infancy, it typically also meant permanent disfigurement. When Susan was about ten years old, her Grandma Ford had had both her breasts removed, and Susan remembered seeing the grotesque scars under her corset. The word breast was considered almost vulgar or pornographic, unspoken to the point that in the 1950s and 1960s, women who died from breast cancer were often listed as dying from “a woman’s disease.”
That evening, Dr. Lukash met with President and Mrs. Ford in his office and explained that the doctors at Bethesda had found a suspicious lump in Betty’s right breast.
“They want to operate immediately,” he said.
“Well, they can’t operate immediately,” Betty interjected. “I have a full day tomorrow.”
As it turned out, the hospital couldn’t schedule her surgery until Saturday morning, but she would be admitted Friday night. Dr. Lukash explained that early Saturday morning, Betty would be put under general anesthesia, and the surgeon would perform a biopsy: removing a sample of the suspicious tissue, which would then be examined under a microscope by a pathologist. If the lump was benign, Betty would be discharged. However, if it proved malignant, they would go ahead and remove her breast while she was still under anesthesia.
There were no other options. This was what the doctors recommended and what was standard practice at the time. Betty would go into surgery not knowing whether she had cancer; not knowing whether she’d wake up with one of her breasts cut from her body.
As soon as they were alone, Jerry put his arms around Betty and kissed her. “I’m sure everything’s going to turn out all right,” he said. “We’re lucky you had the examination, and we’re luckier still that you will receive the best care.”
He was deeply concerned. And so was she. But neither of them was the type to get panicky in a crisis. “We didn’t allow ourselves to break down,” Jerry said. “We had to deal with reality.”
When they sat down for dinner with Susan, it was obvious she’d been crying and that she already knew.
Betty and Jerry had always been open with their children, and they immediately called Mike, Jack, and Steve—all in different places—to let them know what was going on. Everyone was scared. They were a close family, but they also realized they were no longer just any family. The eyes of the world were on them, and they had to decide when and if they would disclose the situation to the public. Cancer and breast were two words that were whispered, not broadcast to the world, and rarely had a first lady shared something so deeply personal. But at the same time, after the secretiveness surrounding the Nixon administration, President Ford had vowed that he would be transparent with the American people.
Both Betty and Jerry were scheduled to attend groundbreaking ceremonies for the Lyndon Baines Johnson Memorial Grove on the Potomac, in Virginia, Friday morning; then Betty was to give a luncheon speech for the Salvation Army. Since this was the first time the Johnson family had been together in Washington since LBJ’s death in January 1973, she had invited Lady Bird Johnson, her two daughters, Luci and Lynda, and their husbands for tea at the White House.
“I want to go through my activities without making any kind of announcement,” Betty insisted. The plan was for her to check into the hospital around six o’clock the following evening. Then the White House would send out a press release.
“She was adamant about going public with it,” photographer David Kennerly recalled. “And women didn’t do that—not in 1974. And not only that, but President Ford agreed, and he stood by her. It had nothing to do with politics, and it had everything to do with the love and support for his wife.”
That night, Betty and Jerry lay in bed, and after kissing good night, they held hands and prayed.
They were the president and first lady of the United States. But on this night, they were simply a man and a woman facing the terrifying unknown of cancer.
The next morning, Betty and Jerry went through the motions, and no one would have guessed anything was wrong. Betty was happy to see her friend Lady Bird, and was eager to show her and the Johnson daughters how she had added her own touches to make the White House living quarters their home. She brought them into the bedroom that she and Jerry shared, and as the Johnson family members looked at the Ford family photos on the wall, none of them noticed the packed suitcase sitting on the bench at the foot of the bed.
Just before six o’clock, Betty entered the hospital, accompanied by Nancy Howe and Ric Sardo, a Marine military aide who had been assigned to her and whom she adored. Once she was securely in the presidential suite, the White House sent out a press release announcing that Mrs. Ford had checked into Bethesda Naval Hospital. The wording about her upcoming procedure was blunt.
“The purpose of the surgery is to determine through a biopsy whether the nodule is benign or malignant. Should it prove to be malignant, surgery would be performed to remove the right breast.” It was announced on the evening news, and, before long, there were reporters and cameramen staked outside the hospital, their searchlights shining up at the windows of Betty’s hospital suite.
Mike and Gayle had flown down from Boston, and they accompanied President Ford and Susan to have dinner with Betty. Everyone was trying to be lighthearted, avoiding the subject of the surgery and the unknown, but it was difficult to hide the fear they all felt inside.
“We were all scared to death,” Mike remembered. The one person who was holding it together best was Betty herself.
“She and Dad had talked about whether to share this very personal issue,” Mike recalled, “and Mom said, ‘I just feel like there are other women out there going through the same thing, and they’re scared, and here I am getting the best medical care in the world. I have an obligation. I need to talk about this.’ ”
“She showed no apprehension,” President Ford confirmed. Finally, it was time for all of them to leave. “I held her for a long moment and then squeezed her hand,” he said. “She gave me a loving smile and squeezed my hand right back.”
It was a somber ride back to the White House. And even though he had Mike, Gayle, and Susan with him, President Ford would recall it as the loneliest night of his life.
“The thought that the woman I loved might be taken away from me was almost too much to endure,” he wrote. He called down to the florist and asked that they send three dozen red roses to Betty’s suite. They were her favorite, and he wanted her to see them as soon as she woke up.
Before he went to bed, he wrote her a short note on White House stationery. He would give it to her the next morning.
No written words can eloquently express our deep, deep love. We know how great you are, and we, the children and Dad, will try to be as strong as you.
Our Faith in you and God will sustain us. Our total love for you is everlasting.
We will be at your side with our love for a wonderful Mom.
xxxx Jerry
At six thirty the next morning, the family went up to the presidential suite at the hospital, and there was Betty, sitting in her favorite robe, smiling to greet them like she was the hostess of a party. Pointing to the toeless socks they’d put on her, she said with a grin, “Here’s one for Women’s Wear Daily.”
“She was the strong one, holding us all up,” Susan recalled.
Photographer David Kennerly was there taking photos. “No fear,” he said. “I didn’t see any fear outwardly or inwardly. She was like ‘Come on, we’re just going to deal with this.’ ”
Even Dr. Lukash remarked on it. “Throughout this ordeal,” he said, “Mrs. Ford exhibited an atmosphere of confidence, and, more interestingly, I thought that she demonstrated a kind of inner strength that sustained the first family, her close staff, and even the doctors.”
President Ford returned to the White House while Susan, Mike, and Gayle waited in the suite. “We all sat around and prayed,” Susan remembered.
Jerry was sitting in the Oval Office, trying to focus on the speech he was to give later in the day at a summit conference on the economy, when Dr. Lukash called. It was not good news. The nodule had been removed, and the pathology report determined it was malignant. They wouldn’t know for several days whether the cancer had spread, but with Betty still under anesthesia, Dr. Fouty was going to perform a radical mastectomy.
President Ford’s aide, Bob Hartmann, was with him in the Oval Office, and could tell that his boss was struggling to hold it together.
“Go ahead and cry,” Hartmann said. “Only strong men are not ashamed to cry.”
Tears streamed down the president’s face, his emotions pouring out. “Bob, I just don’t know what I’d do without her. I just don’t know what I’d do.”
When Dr. Lukash informed Susan, she crumpled. She thought for sure this meant her mother was going to die, and she couldn’t control her sobs. “How am I going to live the rest of my life without my mom?” she wondered.
Her worries were not unreasonable. In 1974 Betty Ford was one of more than ninety thousand women diagnosed with breast cancer; thirty-three thousand women died.
Along with the breast and some supporting muscle, the doctors removed lymph nodes from Betty’s armpit. Traces of cancer had been found in three. At the time, women who had no cancer cells in their lymph nodes had a 75 percent chance of surviving five years after breast cancer surgery and a 65 percent chance of surviving ten years. However, women with cancer cells in one or more lymph nodes had only a 50 percent chance of surviving five years, and three out of four women were dead within ten years.
The family discussed it, and the consensus was to be completely open about Betty’s surgery and the prognosis. Within hours of the operation, the three physicians involved—Dr. Lukash, Dr. Fouty, and Dr. Richard Thistlethwaite—appeared at a press conference at the White House. They revealed the details of how the lump had been detected in a routine exam, just seven months since her previous checkup, and that primarily because the cancer had been detected early, the first lady’s prognosis was excellent.
What happened next was remarkable. Across the country, the phone lines at doctors’ offices and organizations such as the American Cancer Society were inundated with calls from women—thousands upon thousands of women—looking to make appointments for breast exams.
“Even before I was able to get up,” Betty recalled, “I lay in bed and watched television and saw on the news shows lines of women queued up to go in for breast examinations because of what had happened to me.”
A spokesperson from the American Cancer Crusade said that its phones were “ringing off the hook. It’s a tragedy for Mrs. Ford, but she may have saved an awful lot of women’s lives.”
The White House, too, was overwhelmed with phone calls and correspondence. Twenty-six-year-old Nancy Chirdon was a secretary in the Military Office of the vice president, and since a new vice president had not been confirmed yet, she was brought in to assist Mrs. Ford’s staff to respond to the flood of mail.
“One Sunday, I was sitting at home,” she remembered, “and I got a call from a man whose wife had just been diagnosed with breast cancer. He was so distraught and didn’t know what to do, so he had called the White House asking to speak to Mrs. Ford.” The White House operator, not knowing what else to do, had forwarded the call to Nancy, at home.
“People saw in Mrs. Ford a woman who was so relatable that they felt like they could just pick up the phone and talk to her,” Nancy said.
Literally overnight, Betty Ford removed the stigma from breast cancer. No longer was it a source of shame, but a disease like any other that needed to be addressed and treated. Newspaper articles described how women could perform their own self-exams, complete with drawings of women’s breasts, and explained how mammograms—a relatively new imaging technology available only in a small number of places—could detect potential tumors.
In the first week after Betty’s surgery alone, more than thirty-five thousand men, women, and children sent cards and letters to the first lady.
“This was a revelation,” said breast cancer survivor and advocate Nancy Brinker, who founded the Susan G. Komen Breast Cancer Foundation in 1982. “It really had never happened before. And with it, she began a movement of patient empowerment, advocacy, information, and a real desire to create a prevention and a cure of the disease.”
A fourteen-year-old wrote that her mother had the same kind of operation three years ago, and that she could truly sympathize with her. “I will even go so far as to say I don’t think there’s anyone in this country, except of course those who know you personally, who feels as bad about this as I do,” the teen wrote. “This has nothing at all to do with my political beliefs, since I would never in my entire life dream of voting for a Republican, but I will pray for you every night and please get better!”
Women offered advice and encouragement from their own experiences: “This operation makes us stronger women than we were before.” Others wrote of their admiration: “One thing you have demonstrated to the American people is that you are not superhuman. You’re just a super lady.”
Thousands wrote that her bravery in going through surgery prompted them to get checked; people sent $1 and $5 bills with handwritten notes designating the money go to research organizations such as the American Cancer Society; and men wrote to President Ford thanking him for helping them understand better how to be supportive of their own wives going through not only the physical trauma but also the emotional impact of breast cancer.
Betty realized that the loss of a breast was not going to diminish, in any way, her husband’s love and affection for her. Still, she knew the first time he saw the wound, it would be a shock.
“She had Dad walk into her hospital room when they were changing her dressings so that he saw it with the nurse there for the first time,” Susan remembered. “With all the drains and the ugliness of surgery, it was not pretty.”
The one thing Betty worried about was whether she’d be able to wear the kinds of evening gowns she adored, many of which were cut to accentuate a woman’s breasts.
“Don’t be silly,” Jerry said. “If you can’t wear ’em cut low in front, wear ’em cut low in back.”
There were some difficult moments, like the evening Dr. Lukash brought Betty a little brown bottle of pills and told her it was chemotherapy, to ensure the disease wouldn’t spread. She would have to take the pills for five days in a row, every five weeks, for two years. At first, it was upsetting.
Every time I look at these pills, she thought, it’s going to remind me of the fact that I’ve had cancer. But then, in typical fashion, she put the negative thoughts in the back of her mind and focused on what she needed to do to move forward. Betty kept a positive attitude, working hard at the exercises prescribed to get back her strength and celebrating every step of progress. The first day she could pick up a cup of tea with her right hand was a triumph. Just one week after the surgery, she had made tremendous strides, and on that day, she decided to surprise her husband when he arrived for his daily visit. She always knew when his motorcade rolled up to the hospital because through the window, she could hear the noisy army of press that always preceded him.
Betty got up out of bed, and, under the supervision of a nurse, she walked out of her room to stand by the elevator.
“Shh!” she whispered to the Secret Service agents lining the hall, breaking into an impish grin as she held one finger to her lips.
The elevator doors opened, and as soon as Jerry saw her, he froze. “What are you doing out here?”
“I came out to surprise you,” she said, grinning.
He embraced her, kissed her on the lips, and then said, “I have a surprise for you too . . .
“It’s a present from George Allen,” he said as he handed her a football. Two days after her surgery, the Washington Redskins had beaten the Denver Broncos 30–3 in a home game, and all the players, along with Coach George Allen, had signed the ball.
“What a wonderful gift!” Betty exclaimed.
She held the ball and looked at the signatures as they walked together back toward her room. Jerry got a few paces ahead of her, and suddenly she had an idea.
“Here, catch!” she called out to him.
Jerry whipped around, just in time to see her raise her right arm, football in hand, and draw it back. The ball came at him and he caught it, effortlessly, at his chest. David Kennerly was in prime position to capture the spontaneous pass, and the next day, the photo appeared on nearly every front page of every newspaper in America. It was indeed a photo that was worth more than words could say: the playful smile on the first lady’s face as she demonstrated the strength she’d regained one week after losing a breast to cancer was a priceless inspiration to anyone struggling with adversity.
Many people were still angry at President Ford for pardoning Richard Nixon—it was an anger that would persist until his last days in office—but there was an empathy for him at this time, and nothing but love and admiration for the courageous woman at his side.
Meanwhile, there were several high-profile social functions at the White House on the schedule, and there were questions whether they should be canceled. From her bed at Bethesda Naval Hospital, Betty insisted that nothing should be stopped because of her.
Barely a week after learning her mother had breast cancer, and still unsure what the prognosis was for her long-term recovery, seventeen-year-old Susan Ford made her debut as White House hostess. She had gone to visit her mother in the hospital that afternoon, eager to get approval for the sleeveless red chiffon dress she had bought for the occasion.
“Oh, Susan, it’s beautiful,” Betty said. “You’ll look lovely. But I do think because it’s a formal affair, you should wear my long white gloves. That will pull it all together. Ask Nancy Howe—she knows where I keep them.”
That night, in the Blue Room, Susan got a taste of her mother’s obligatory duties as first lady. At 9:40, after having dinner upstairs in the family residence, Susan walked down the grand staircase on the arm of her father, the president of the United States, to make an appearance at the reception for the diplomatic corps. For forty minutes, she stood, poised and smiling, shaking hands with all 315 guests as they passed through the receiving line. Some may have noticed her shifting from one foot to the other, unused to standing still for so long in high-heeled shoes meant more for show than comfort, and at one point, as she looked down the line and couldn’t see an end to the people, she whispered to her father, “When is it going to stop?”
When it finally did stop, President Ford gave her a hug and kiss. He was proud of her.
And then they took to the dance floor, with the orchestra playing Maurice Chevalier’s “Thank Heaven for Little Girls.” It was a bittersweet moment for both of them: a special moment between father and daughter, and yet both thinking about the woman in the hospital and the reason they were having this dance together.
“I knew that if she died,” Susan said, “I would have to do more events like that.”
The long white gloves were hot, the shoes uncomfortable for a girl more accustomed to blue jeans and sneakers, but for the next hour and a half, Susan danced with one ambassador after another. “At seventeen, dancing with all those much older men was not high on my list,” she recalled, “but I did it for my mother.”
Throughout the two weeks Betty was in the hospital, President Ford was under a tremendous amount of stress. Susan could see how his overwhelming concern for Betty combined with the pressures of the country were taking a toll on him. In an effort to cheer him up, she and David Kennerly decided to surprise him with a golden retriever puppy. The Fords had always had dogs, but their last golden retriever, Sugar, had died shortly before Jerry became vice president. (Keeping it a surprise proved to be somewhat difficult when the kennel owner from whom they were purchasing the dog asked relentless questions to ensure it would be placed in a suitable home. When asked if the new owner owned his own home and had a steady job, Kennerly had replied, “The people are a friendly middle-aged couple who live in a big white house with a fence around it. It’s public housing.” And the job? “He’s sure to be in town for a couple of years,” Kennerly assured the kennel owner, “but beyond that, I can’t tell you.”)
The president was thrilled with the eight-month-old golden retriever, and they decided to name her Liberty.
When Betty was finally released from the hospital, her return to the White House was like a national homecoming party. Looking out the window of the presidential helicopter as it landed on the South Lawn, Betty got a bird’s-eye view of the crowd that had gathered to welcome her home.
Hundreds of people stood outside the White House gates with signs that said “We Love You, Betty” and “Welcome Home.” The press was there, of course—cameras and reporters from all over the world—and everyone who worked in the White House was lined up outside the Diplomatic Reception Room. Members of the staff had strung hundreds of the colorful “Get Well” cards on a cord and draped it like a garland across the Truman Balcony.
Janet Ford, the sister-in-law Betty considered to be her best friend, had come from Michigan to help Betty during her recovery. She and Susan were standing on the lawn, with Liberty, waiting for Betty’s arrival. As soon as Betty stepped out of the helicopter, Susan ran to her mother and wrapped her arms around her like she never wanted to let her go.
“I had no words for the joy I was feeling,” Betty recalled. “I could only look, and touch, and smile, and hold on.”