Introduction
Lumley et al.1 reported on psychotherapy for
centralized pain and presented the case of Mr. A who had chronic low
back pain (LBP), a typical case of centralized pain. Mr. A. was a
middle-aged man who had developed LBP 7 years earlier while exercising,
without any apparent injury. Although neurological examination revealed
no impairment, he had a L4–L5 fusion and later developed a sacroiliac
joint fusion; however, he continued to have significant pain. Mr. A.’s
parents had high expectations of him. He described himself as a
sensitive child who worried that he was not good enough. He was often
anxious and had stomach aches before school presentations or due to fear
of disappointing his parents, particularly his father. John Fitzgerald
Kennedy (JFK, 1917–1963), the 35th President of the United States of
America, has a surprisingly similar history to Mr. A. JFK also had
chronic LBP, considered centralized pain,2 and various
other medical issues. He bore unusually high expectations from his
parents, especially his father, and was not good at expressing his
feelings.3
Since childhood, JFK continuously suffered from several diseases, such
as irritable bowel syndrome (IBS), malabsorption, adrenal insufficiency,
hypothyroidism, chronic prostatitis, allergies, and
insomnia.3 The most disquieting condition was LBP,
which also contributed to his death.3 JFK’s LBP
started in 1937, which developed during football, although a specific
cause for his pain was never identified. It aggravated with stress, and
it did not respond to several analgesics, including codeine. Despite
undergoing four lumbar spine surgeries, including L4/L5 laminectomy,
lumbosacral and sacroiliac fusion, JFK’s LBP exacerbated rather than
improved. At the time of JFK’s assassination in Dallas in 1963, when the
first bullet struck him in the back of the neck, his back brace held him
erect, allowing the second and fatal bullet to strike the back of his
head.3
However, according to the final report of the House Select Committee on
Assassinations, there were other anthropogenic factors that contributed
to Kennedy’s assassination.4 Despite being aware of
the danger of assassination and warnings from people around him, JFK
chose not to attach a protective bubble-top to the convertible, making
it easier for the sniper to take aim. This kind of impulsive tendency
was often observed during his early childhood and contributed to his
promiscuous behavior even within the White House.3,5,6
Attention deficit hyperactive disorder (ADHD) is a development disorder
associated with central nervous system (CNS) dysfunction and is
classified into predominantly inattentive, predominantly
hyperactive-impulsive, and combined types. JFK’s biographies are filled
with tales of the President’s inattention and hyperactivity. In recent
years, ADHD has been found to be associated with centralized pain and
chronic LBP.7-9 Moreover, it is believed that JFK had
ADHD characteristics.10 This article, based on his
biographies, provides a literature review of JFK’s potential diagnosis
of ADHD, and it discusses JFK’s medical problems, including centralized
pain and ADHD.