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.