For the people who believe history is important, here is a partial list of the historical questions that an MEN2B diagnosis would answer. More importantly, the list also includes new historical questions that would be raised by an MEN2B diagnosis.

After the historical list, other ramifications of the diagnosis of MEN2B are also provided. It is safe to say that the MEN2B diagnosis would be the greatest change to our view of Lincoln in at least 60 years.

The question is not how Lincoln might have died. The question is how he might have lived.

Historical Questions

• Were the burdens of the Presidency killing Lincoln?

Lincoln's horrible physical decline in the White House is well known (see pictures). Almost universally it has been ascribed to the burdens of his office. An MEN2B diagnosis would all but prove it was cancer, not stress, that physically ruined Lincoln in the White House.

Knowing this answer has relevance today, as the demands of the Presidency tax human abilities to an increasing degree.

To get a quick sense of Lincoln's state in his last weeks, read this remarkable editorial from the Chicago Tribune, written in March 1865.

• Did Lincoln know he was dying?

Lincoln was a very smart, very observant man. If, in his last three months, he was as sick with an MEN2B cancer as the historical record suggests, he would certainly have known something was horribly wrong with him.

He would also have told no one.

Or maybe he was trying to tell us. "I feel a presentiment that I shall not outlast the Rebellion."* Establishing a diagnosis of MEN2B would cast an entirely new light on this and similar statements of Lincoln's. It would transform romantic and mystical interpretations of Lincoln's accurate prediction into a simple self-assessment of health.

• How would knowledge of looming death affect Lincoln's decisions?

Looming death influences a person's view of the world. Among the most remarkable elements of Lincoln's Presidency were his mercy and the lenient treatment he planned for the vanquished South. Could these elements have been strengthened, or perhaps even born, by his realization early in his Presidency that he was seriously ill?

This may be the most fascinating -- and contentious -- discussion arising from an MEN2B diagnosis.

• If Lincoln knew he was dying, why was he so distant from his Vice President?

Historians dispute the degree to which Lincoln was involved in selecting Andrew Johnson as his running mate in 1864. If Lincoln knew he was ill, would not a deep interest in the Vice President be rational? Perhaps even Lincoln, the great yet superstitious rationalist, could not accept the reality.

A diagnosis of MEN2B would add considerable complexity to history's view of Lincoln's role in choosing and collaborating with his Vice President(s).

• Was Lincoln's increasing religiousness influenced by a sense of looming death?

Scholars have proposed various reasons why, during his Presidency, Lincoln increasingly used religious imagery and quotations in his writings. If Lincoln had an MEN2B cancer and even a subconscious awareness of an approaching end, one might expect his thoughts to turn to religious matters.

• Was Lincoln's cavalier attitude about personal safety influenced by a sense of looming death?

I have not paid attention to any evidence that would shed light on this matter. It is a purely speculative question, but one that seems reasonable to ask.

• Was Abraham Enloe the father of Lincoln?

A diagnosis of MEN2B would kill the unsupported yet persistent theory that Abraham Enloe fathered Abraham Lincoln.

The Enloe theory is based on the physical resemblance between the two men. If Lincoln had MEN2B, his physical appearance would be dominated by MEN2B. This would mean Enloe-as-father would also have to have MEN2B. This is impossible, however, because Enloe lived to age 70, and people with untreated MEN2B never survive to 70.

• What of the assassin?

A diagnosis of MEN2B, with the implication that Lincoln was dying of cancer in his last months, would help move the assassin toward the rotting obscurity he deserves, by making his deed a futile act of little achievement.

(This statement is only half-facetious.)

• Was Lincoln depressed?

Short, yet heretical, answer: no. And MEN2B is not needed to refute the diagnosis of depression. MEN2B does, however, explain why so many people thought Lincoln was depressed.

The Physical Lincoln analyzes depression and Lincoln in detail.

• Was Lincoln really the Hercules that popular history paints?

Short answer: no. One of the six hallmarks of MEN2B is muscle involvement.

The Physical Lincoln analyzes Lincoln's muscles in detail.

• Did Lincoln's dysmorphism influence the development of his character?

This seems undeniable. Simply reading the recollections of his first "girlfriend" conveys what a hellish experience adolescence must have been for an intelligent and acutely aware boy such as Lincoln.

If Lincoln had MEN2B, his appearance will have to be considered as being more extreme than generally visualized heretofore. (In fact, some visual scholars have mentioned that camera optics in Lincoln's time would have lessened certain unusual features in his face.) All analyses of his bachelor relations with women will find it mandatory to consider the effects of his extreme appearance.

• Did Lincoln have homosexual tendencies?

The Lincoln-homosexual theory is based on (a) Lincoln's height during youth, (b) an admiring comment about Lincoln's thighs made by one of his male friends [really, I don't make this stuff up], (c) a seeming aversion to women, and (d) his documented episodes of sleeping with other men.

A diagnosis of MEN2B wholly explains (a) and (b) and (c), and provides a medical hypothesis for (d). Thus, a diagnosis of MEN2B removes all evidence that Lincoln had homosexual tendencies.

• As news of the MEN2B theory has spread, I have been honored to receive messages from persons with MEN2B in their family. It has, however, been heartbreaking and a terrible shock to learn of multiple instances in which a succession of physicians missed the diagnosis for 10 and 15 years -- with literally fatal results.

  I would have thought it impossible that so profound a disorder as MEN2B could escape diagnosis for very long in a country with modern healthcare. Yet this is the case, despite the fact that the diagnosis can be made in the blink of an eye ... if a physician knows what to look for.

  Thus, quite simply, people are dying because physicians are not aware of this rare but treatable disease. Rapid and aggressive treatment is life-saving, but it can only occur if a physician knows of the disease and recognizes the urgency.

  If Abraham Lincoln is proven to have had MEN2B, the disease will gain significant public exposure. More physicians will become aware of MEN2B and will, therefore, be in a position to diagnose it. Even more helpfully, greater public awareness will empower non-physicians to discover and raise the possibility with their overworked and harried physicians.



• Lincoln and his three youngest sons were not classic cases of MEN2B. Specifically, (a) their lips are at the smaller end of the MEN2B spectrum, (b) Lincoln's survival was atypically long, (c) the trait of lower-lip-bigger-than-upper-lip bred true in Lincoln and his three youngest sons, and (d) Lincoln's skin was prematurely aged.

  If Lincoln proves to have MEN2B, the atypical traits above would be added to the clinical spectrum of MEN2B. This would expand the range of patients in whom physicians should consider the diagnosis of MEN2B.



• For a person with untreated MEN2B, Lincoln lived a very long time. Was this chance, or was there something about Lincoln that made him resistant to the usual ravages of MEN2B?

  Lincoln (or his mother) would be the earliest case of MEN2B known to medicine. This, in itself, would be significant. Plus, examining how Lincoln's life differed from later patients may generate clues to bio-environmental factors that retard MEN2B and potentially lead to new therapies. Examples of such factors include: decades of manual labor starting early in life, near-starvation in childhood, dietary ingredients, and near-continuous exposure to sunlight in childhood.

• For generations, Lincoln's life story has inspired people across the world who are trying to overcome grinding poverty and narrow opportunities with only their own energy and intellect -- just as Lincoln did. Even among successful people, such as the current and immediately-past Presidents of the United States, Lincoln provides inspiration as someone under enormous pressure who made wise and humane decisions.

  If Lincoln had MEN2B, this would be a third enormous burden that Lincoln overcame. Lincoln would then serve as an even more inspirational figure, especially to the many people struggling against serious disease.



• Lincoln, as a person with significant dysmorphism who was taunted about it, could help lessen the stigma that the many persons with dysmorphic features continue to face in our world.