Three days after entering Walter Reed National Military Medical Center for surgery first lady Melania Trump tweeted out a thank-you to the medical staff there and said she is “feeling great,” but she has otherwise been out of public view. (Susan Walsh/AP)

Melania Trump’s request for privacy while undergoing a procedure to treat a “benign” kidney condition this week has largely been respected by the American public.

In the days following the White House’s announcement of the surgery, there has been little word on Trump’s condition. Three days after entering Walter Reed National Military Medical Center, she tweeted out a thank-you to the medical staff there and said she is “feeling great,” but she has otherwise been out of public view. On Saturday morning, Trump was released from the hospital, and returned to the White House.

Such privacy is a rare commodity when it comes to life at 1600 Pennsylvania Ave.

The way the first lady and the White House have handled her health issues this week highlights the competing interests at work in such moments — transparency to the public, a desire to keep intimate matters under wraps, and sometimes, the opportunity to turn a personal health issue into a public campaign.

While the public is privy to details about presidents’ health, their spouses are not under the same microscope and have more leeway in determining what details to share about their health conditions. Almost nothing has been said about Trump’s time at the hospital — the procedure she underwent was described as a complication-free “embolization.”

The lack of public disclosure is in line with Melania Trump’s well-known desire for privacy but also reflects the way some of her predecessors handled their own health care.

“Almost across the board, first ladies’ health issues have been treated as private matters,” said Myra Gutin, a professor at Rider University in New Jersey who studies first ladies. “The public typically isn’t informed until the problem was resolved or procedure had been completed.”

Even Betty Ford, who smashed taboos about public discussion of breast cancer, did not share that she had undergone a mastectomy in 1974 until after the surgery was deemed a success. But by openly documenting her own recovery and chemotherapy for a tumor in her right breast — discovered just weeks after her husband took office — Ford was credited with boosting mammograms and screenings among American women.

Ford allowed a photographer to take photos of her after her surgery at the Bethesda Naval Hospital. Wearing a bedjacket, her hair in a perfect halo, she is seen in one image, with her arm around her husband, and in another tossing the football he had brought her as a get-well gift — it was the game ball from the Washington Redskins’ win over the Denver Broncos, sent to her by Redskins Coach George Allen.


Former President Gerald Ford and former first lady Betty Ford read a petition, signed by all 100 members of the United States Senate, in the President's Suite at Bethesda Naval Hospital following the first lady’s breast cancer surgery in October 1974. (Courtesy Gerald R. Ford Library/White House Photograph via Reuters)

In a 1975 “60 Minutes” interview, Ford said she sought to normalize the illness to remove its stigma. “I thought there are women all over the country like me,” she said. “And if I don’t make this public, then their lives will be gone or in jeopardy.”

And when Nancy Reagan had a mastectomy in 1987 after a breast-cancer diagnosis, the White House revealed many details of her condition and the surgery (she requested vegetable soup and gelatin for dinner after the procedure). Afterward, Reagan often gave interviews on the subject.

She had undergone surgery previously in 1982 in the White House physician’s office to remove skin cancer from her upper lip. Her spokeswoman disclosed the diagnosis and the treatment simultaneously, noting that Mrs. Reagan had quipped she was keeping “a stiff upper lip’’ and did not plan to change her schedule, which included a staff party at the White House that evening.

Other first ladies have dealt with health issues in a more under-the-radar fashion.

In late 2006, after White House reporters asked why Laura Bush was wearing a bandage on her leg, a press aide revealed that she had a small patch of skin cancer removed from her shin — five weeks earlier. “The fact is, she is entitled to her medical privacy,” said Tony Snow, who was then a White House spokesman.

A first lady’s health, of course, isn’t a matter of public record the way her husband’s is. The White House physician routinely reveals the results of the president’s annual physical, which is how we know that President Trump weighs 239 and that former president Barack Obama struggled to keep his cholesterol count down. But it’s easier to justify interest by the body politic in presidents’ health than in first ladies’.

Gutin said there’s always been a “murkiness” about the first lady’s status: She’s a private citizen and yet is often a public figure and the face of her husband’s administration.

“The president is the elected official, and yet most of us look at her as a de facto member of the administration,” Gutin said. “There is an obligation to disclose what’s going on with the president’s health, and that hasn’t been the same for the first lady. She has this rather odd status — she’s seen as noncombatant, and yet when she’s, say, campaigning for her husband, she’s an advocate.”

And although both Nancy and Ronald Reagan, who had a cancerous polyp removed from his colon in 1985, used the scrutiny of their health to educate the public, Nancy found the public attention to their health the most intrusive of all the attention that came with the presidency.

“Mrs. Reagan was particularly upset by the sight of a detailed diagram of the president’s intestines on national television . . . and was appalled when CBS ran an actual medical school video of a proctoscopic instrument probing the inside of a colon,” Larry Speakes wrote in his book about his years as President Reagan’s spokesman.


President Ronald Reagan and Nancy Reagan wave from the Bethesda Naval hospital after his surgery for colon cancer. (Ray Lustig/The Washington Post)

For modern first ladies, the level of disclosure is a personal decision. In Melania Trump’s case, the relative lack of detail that’s been released about her condition tracks with her ­long-documented preference for keeping the media at arm’s length.

Other factors come into their decisions, too. Betty Cuniberti, a former Los Angeles Times reporter who covered Nancy Reagan, said the first lady reached out to her after learning that the journalist too had been diagnosed with breast cancer and offered advice and encouragement. But Reagan worried at all times about overshadowing her husband and did not want to bring too much media coverage to her own health.

“She was always really reticent about attention to her,” Cuniberti said.