the president's nurse

Behind the Blue Curtain: Professor Joan Huber is Also Captain Huber, Former Senior White House Nurse

Under her bed, Assistant Professor of Nursing Joan Huber keeps a plastic box filled with memories from a life lived all over the country and the world. If her house ever catches fire, she says, she will grab the box and run.

One of the treasures in that box is a pristine copy of the March 1989 American Journal of Nursing. Marking page 334 is what looks like an ordinary ivory-colored piece of card stock, until you open the magazine and see the Seal of the President of the United States printed on the card above the words Welcome Aboard Air Force One. Typed on the card are the words Cdr. Huber. It marks a three-page photo essay titled “The White House Nurses,” and there, linking arms with a Ronald Reagan who had just left office, is Huber, who served from 1986-1990 as senior White House nurse.

Speaking about her tour of duty at 1600 Pennsylvania Avenue, Huber, who retired from the U.S. Navy as a captain in 2001 after 30 years' service, likes to get a few oft-asked questions out of the way: Yes, Mrs. Barbara Bush is as nice as she seems. No, Mrs. Reagan did not really like astrology. Huber was not present when President Reagan was shot, nor did she see any signs of his Alzheimer's disease. Yes, she has been to the Reagans' ranch and the Bush home in Kennebunkport, Maine, and she has been in the personal quarters of the First Family in the White House. Yes, she has met the younger President Bush, as well as other world leaders, and traveled – everywhere – on Air Force One. And no, she was not sorry to leave the White House bubble for her next assignment.

Thanks, Dad

Born in Boston, Huber moved around New England frequently before finishing high school in Connecticut. She spent the summer after graduation at home, unsure of how best to pursue her desire to become a nurse, debating between a hospital school and college. Huber chuckles when sharing how the choices her 18-year old self made ended up bringing her to the iconic center of democratic power.

“I fought with my mom a lot that summer, and at some point I went to my father and said, 'Okay, that's it, one of us has got to go,' somehow thinking that he would get rid of my mom. Instead he said, 'That's fine, I'll drive you tomorrow morning to the recruiter.' In our small town, all the armed forces had representatives in one recruiting center. I went from desk to desk to see what they could offer and was intrigued by the educational opportunities. I was interested in the different roles in the military, but the reason I chose the Navy, to be honest, was because I thought the uniforms were the cutest.”

It's a good thing Huber liked the outfits, as unbeknownst to her, her father changed her contract from two years active duty to four. She didn't find out until she thought her time was almost up. A corpsman at the time who was working with personnel returning from Vietnam, she was willing to do whatever would get her off her ward the fastest. Her senior chief said he could have her in nursing school in a month, and that sounded just right - she enrolled at Villanova University and earned her bachelor's degree.

“They sent me to college so I owed them four more years, and toward the end of that I was leaning toward getting out, but I didn't know exactly what I wanted to do,” says Huber. “I decided to stay for another tour, and by then I was sort of in the lifestyle.”

An Opportunity Nearly Missed

Growing into the decisions made by her younger self, Huber flourished in the Navy and accumulated the experience that culminated in her receiving The Call to come to the White House to interview for senior White House nurse. That position oversees a staff of 12: the physician, nurse, physician's assistant and independent duty technician that the Army, Navy and Air Force each contribute.

Military people don't do interviews, Huber explains. They get orders. That's why, when on temporary duty in Maine, she thought her staff was having a laugh by conveying the message that the White House wanted her in Washington, D.C., the next day. Finally convinced, after increasingly emphatic messages, Huber headed south for a seven-hour interview. She was single and a critical care clinical specialist, as the Navy required; she had been in for more than the minimum two tours, including one abroad, and, the ultimate deciding factor, the Reagans and the George H.W. Bushes liked her. That is important because, for every waking moment, the president, vice president and their spouses – the principals, as they're referred to – are accompanied by a medical staff member.

A Witness to History

The ultimate goal of the medical personnel's presence is continuity of government. The 25th amendment of the Constitution says that if at any time the president or vice president is unable to do their job, then the responsibility of their position has to pass to the next person in Constitutional succession. In order to make that determination, someone has to be with the four principals all the time.

“What we were really doing was a fitness-for-duty exam every day,” says Huber. “Our job was to be with them and know them well enough to know when something was wrong. The game was that we were never supposed to be so close that we would be injured by the same impact, but we had to be close enough to pull them to security. Often when you see the president speak, he stands in front of a blue curtain with the White House logo - right behind that curtain is a medical person and a Secret Service agent whose job is to reach through the curtain and pull him back. I was standing behind that curtain when he said, 'Mr. Gorbachev, tear down this wall.' I was in places like that to witness history happening."

Security and health care are inseparable at the White House, and Huber worked closely with Secret Service agents. "People may not be aware, but except for some very isolated circumstances, every effort is made to make sure that the four principals are never in the same place at the same time,” Huber says. “We never want to be in the situation where we don't have the ability for our government to persist. Even in Washington at something like a State of the Union address, at least one member of the cabinet is kept outside so that if something terrible happened, there would be at least one surviving member to continue the government.”

Traveling with one of the principals every day, Huber says, she saw them at their best, but also when they didn't feel well. "We were sort of the wallpaper in the room, we were just to blend in and be there in case something happened, and be aware of what was going on," she describes her duty.

No Such Thing as an Impromptu Trip

“Wallpaper” the medical staff may have been, in some respects, but they also got around.

Each trip was made twice. Huber sets this scenario:

“Say the president is going to Germany for an economic conference. I would go ahead of time and be part of a team that included a medical person, a member of the Air Force One and helicopter crews, a person from the Secret Service, a White House communications person to set up all the phones, radios and communications capability, and a personal aid for each of the principals. We would trace the steps of where they were going to be and try different options to see what would be safest.

“One time we were doing an advance trip when President Reagan was going to speak in California. They wanted him to come on to the stage from the opposite side of the entry, so they wanted him to climb a ladder and go on the catwalk and then climb down. I said, 'Oh, no, no, no, no … we'll find another way to get him on the stage.' So that was our mission, to figure out where it was safe to take him, and to know, at every point along the way, if something were to happen, where we would take him and how we would transport him. The rule of thumb was that it had to be a medical facility that could open his head and open his chest. That meant we had to coordinate with the nearest large medical facility, and we would have to make sure the right people were available – a neurosurgeon, a cardiac surgeon – the whole time the president was going to be in the area.

“If the president were going to speak at Colby-Sawyer, we would coordinate with Dartmouth-Hitchcock and have a neurosurgeon and the cardiac surgeon and all of the OR crew and all of the people who work in x-ray and the lab and the services that would be needed, and we would do FBI background checks on all of them to make sure that no one had ever threatened the president. In the late 1980s, we also would have checked to see if anyone had been educated behind the Iron Curtain. Remember, the Cold War was on, so if there were a surgeon or nurse educated in Bulgaria, we would have asked that that person be given the day off.

“The Secret Service traces anyone who has ever sent a letter to the president, and a lot of mail he gets is threatening. Every morning, we got a threat brief for that day's location, so we'd see a guy's bio and his picture and we were supposed to remember it all day. It's okay in small places, but when you're in New York or Los Angeles or Chicago, it was a two-hour briefing on hundreds of people. They'd determine the threat likelihood of an individual and if they thought someone was likely to do anything – if they'd ever tried to climb the White House fence or something – then an agent would be assigned to spend the day with them. All of this has to be orchestrated ahead of time.

“The agent and I would negotiate spaces. We'd select an operating suite in case it was needed. My concern was having the right equipment; the Secret Service agent's concern was security. So we'd do this plan for all the stops on the trip and go back to Washington and prepare a report for everyone going on the trip. In general, we would drive up to 50 miles, after that we'd rather fly him. It's more secure and more expedient, since the limo gets eight gallons to the mile. We have to have pre-positioned secure fuel if we're going to go very far, so that becomes part of the planning process.

“Another concern when out of the White House was food and making sure all the ingredients were secure. Plus, all the medical supplies have to be guaranteed secure and untampered with. The whole logistics of transportation and travel is very complex.”

A Suspended Life

All of the travel made having a personal life complex, as well, and though Huber says the Reagans treated her like a daughter, the reality was that she spent holidays with them instead of her own family, and that often friends didn't hear from her for months at a time.

“Leaving was in some ways a great relief; you get your life back. And the nature of military service, a lot of it is the interaction with other military personnel, and while you're at the White House, you're not having any of that. When you leave you're kind of glad to get back into the military routine. You're not really wistful for the White House; you miss the people because you spent a lot of time with them, but you don't miss the demand or the impact it has on your life.”

After the White House, Huber was assigned to the Navy Inspector General Team at the Navy Yard in Washington, then was stationed in Japan as a senior nurse, returned to the East Coast as director of in-patient nursing at the National Naval Medical Center in Bethesda; spent time at Walter Reed Army Medical Center on an exchange program with the Army, and had duty stations in California before retiring.

“There's an assumption by most people that the White House duty was the highlight, but that's not necessarily true,” Huber says. “People like or dislike any assignment for any number of reasons. It might be the people you work with, or if the job is really satisfying, or the location is great, etc. At the White House, I was only affecting four people, really, whereas in other assignments there were a lot more people I had an impact on. But you can't help but look back at the White House because of the history you were there for, for the insight into government and knowing why and how things happen. It's such an unusual experience that you recognize the benefit of it."

"The principals never discussed politics with us, though," Huber clarifies. "Many think that we are privy to why they decided to invade a country or execute a policy, but that discussion is with aides. In fact, we, the personal staff, made an effort to be perceived as a haven where they didn't have to talk politics."

Along with some state secrets that will never leave her lips - woe, she says, to any Russian who tries to get her to make sense of some of the things she heard in meetings - Huber carries with her the memory of bouncing along in a Jeep stocked with Ace bandages and crutches while President Bush jogged and President Reagan rode his beloved horses, and cherishes the memory of the First Couples who were all "lovely people with distinct personalities.” President Reagan, she says, loved to tell jokes and was a natural storyteller with a great sense of humor.

“They were wonderful and personable,” Huber recalls. “It was really interesting to meet people you've only seen on TV. I attended to Margaret Thatcher one afternoon, and she was so polite and lovely. I went back to the White House and was telling President Reagan how wonderful it was to meet her, and how she's so famous, and he said, 'What am I, chopped liver?' And I said, 'No, but I see you every day.' I loved him because he had a disciplined schedule. He got up at 6 a.m., went to the office at 7:45, went home at 6 p.m., and went to bed at 11. When we were assigned to a principal, we had to be with them from the time they got up to the time they went to bed. President Bush was a horror. He would get up at 4 a.m., go running, be in the office by 6 a.m., and be up until 2 a.m. And we had to change clothes four times a day, because we had to be in the same level of attire as the president. Believe me, I know the difference between white and black tie, ladies afternoon dress, business casual, and play clothes.”

From Captain to Professor

Retiring from the Navy and looking forward to more time in “play clothes,” Huber knew she wanted to return to New England. Fond of winter, and having spent time in the area visiting her college roommate, she decided she could live here comfortably. The proximity of Dartmouth-Hitchcock Medical Center was not a factor in her decision, merely a happy coincidence. As was, it turns out, the proximity of Colby-Sawyer College to her new home.

“A friend called and said they'd seen an ad in the paper for someone to teach in the Nursing Program at Colby-Sawyer, specifically pharmacology and pathophysiology classes,” Huber recalls. “When the Navy paid for me to go to graduate school, besides a nursing degree I also got degrees in pharmacology and physiology because I was interested in those topics. And, as a critical care clinical specialist, I had taught new graduates who were coming right from school and working for the first time, especially courses like EKG interpretation and critical care nursing and pathophysiology. I hadn't planned on working at all after retiring, but this was perfect.”

The students in Professor Huber's classes these days were born, for the most part, after President Reagan left office, and the events that loomed large in her life while attending Presidents Reagan and Bush are for them just entries in history books. Not many even know about her military background, and she jokes that it's getting to be so long ago it may as well have been George Washington that she tended.

There may well be a future White House nurse among her students, though, as there are some nursing students already enlisted in, and others considering, the military. The experiences of Professor Huber, and her colleagues Associate Professor of Nursing Judith Joy-Clark and Adjunct Assistant Professor of Nursing Mary Moran, retired colonels from the Army and Air Force, respectively, combine for a powerful set of resources for the nursing students.

“We teach them all to use the strengths of our military backgrounds," says Huber. "To set priorities, focus their energy, set a goal, and use those skills we learned in the military because they're useful.”

Useful, and practiced on the most powerful people in the world.

-Kate Seamans