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JANUARY/FEBRUARY 2016

BOOK REVIEW
The Physical Lincoln: Finding the Genetic Cause of Abraham Lincoln’s Height, Homeliness, Pseudo-Depression, and Imminent Cancer Death

By Joan Baum, Ph.D.

 

The Physical Lincoln:
Finding the Genetic Cause of Abraham Lincoln’s Height, Homeliness, Pseudo-Depression, and Imminent Cancer Death

By John G. Sotos, MD
Mt. Vernon Book Systems, 2008, 310 pp.

Get a five-dollar bill and take a long look at the bump on Abraham Lincoln’s lower lip. Then read Dr. John G. Sotos’ amazing book, published a few years ago: The Physical Lincoln: Finding the Genetic Cause of Abraham Lincoln’s Height, Homeliness, Pseudo-Depression, and Imminent Cancer Death. You’ll be fascinated, even if you don’t read every single word — he doesn’t even expect that, which is one of the amazing features of this massively researched tome. Another impressive feature is Dr. Sotos’ style, one of the most accessible and lively in recent memory on a highly technical subject. Not only is he conversational, as if you were in the room and he sat you down in a comfy armchair to hear him out, he’s reasonable and self-effacing. His logic is impeccable – those studying forensics would be wise to watch how he aggregates data, excludes evidence that isn’t overwhelmingly convincing and arrives at a persuasive hypothesis, all the while allowing for challenge – though he’s confident he’s right. And what is he right about? Not that our 16th president may have had a genetic disorder (no news) that would account for his unusual height, unusually long limbs, asymmetrical skull, cleft in the soft palate at the back of the mouth, distended irregular bumpy lower lip and other telltale facial signs, including as Lincoln said of himself, “ugliness,” but that genetic disorder, which had been asserted decades earlier, is not what medical researchers thought it was: Marfan syndrome, which seemed to have been confirmed when the Marfan gene was discovered in the 1990s. For skeptical and sharp-eyed John G. Sotos, MD, however, an esteemed cardiologist and medical researcher whose hobby is studying rare diseases, evidence led elsewhere.

From 2004-2012, Dr. John Sotos was consultant to the highly popular, award-winning medical drama, “House, MD” that ran on Fox. Trained at Johns Hopkins and holding degrees in chemistry, mathematics and computer science, as well as in medicine, Dr. Sotos has said in interviews that his discovery of the cause of Lincoln’s physical condition (and the mental condition accompanying it) came to him in the summer of 2006 when he was reading yet another book on The Civil War and picked up on a reference to a cleft palate in the case of Lincoln’s fourth son, Tad. Dr. Sotos had also been reading a wholly different kind of article which made him think of a carcinoma associated with overgrowth of bones. To cut to the chase: Dr. Sotos found what he says is an even rarer (“one-in-a-million”) genetic disorder: multiple endocrine neoplasia, type 2b, or MEN2B syndrome, which causes cancer. Had Lincoln not been assassinated in 1865, Dr. Sotos contends, the president would have died from pheochromocytoma, associated with MEN2B) in six-to-12 months. (Dr. Sotos quotes from visitors to The White House and reproduces photographs taken toward the end of Lincoln’s life – all testifying to Lincoln’s “startling, emaciated appearance.” Dr. Sotos believes that Lincoln, who was 56 when he was shot, had medullary thyroid carcinoma for some years. As Dr., Sotos writes, “ . . . misinterpretations of the physical Lincoln have led to misinterpretations of the mental Lincoln.”

Dr, Sotos’ research is exhaustive and impressive, including analysis of 200 illustrations, mostly photographs. He argues both for his hypothesis and against other theories, with a meticulous regard for inductive and deductive reasoning. And humility. “Medicine,” he writes, “is a very humbling field; human knowledge is limited . . . the unexpected occurs often, and the only absolute is that there are no absolutes.” He even acknowledges that he may be wrong about some findings. Of course, DNA would be confirming evidence, but no way is Lincoln’s casket going to be disturbed (as it once was in 1876), nor does it seem likely that blood and tissue samples from the assassination will be released by the federal government. Dr. Sotos is also sensitive to charges of meddling with an icon, and in a final chapter, he reasserts his “enormous fondness and admiration” for Lincoln, one of his great heroes. “I do not want anyone to leave this book thinking otherwise.” He wrote the book, he says, because it was impossible for him to condense all the argument and evidence into a peer- reviewed article.. His only intent was “:medical detachment, not disrespect.” He also hopes that people who are unaware they may have MEN2B will benefit from knowing that there is now interest in this rare disease and will “gain strength” from knowing that no matter what the diagnosis, “a life of purpose and accomplishment can still be led, as Lincoln proves. He also hopes that his own example as a researcher may inspire young people to go into medicine and into medical research. And into medical writing, it also might also be said. At one point in the text, Dr. Sotos writes that “In technical terms Lincoln had an intermittent vertical hypertropia of the left eye, which is a type of strabismus. His head tilt is known as Bielschowsky tilt.” And then he adds, with a delicious sense of common sense and humor: “These terms need not be remembered.”#

* The book comes with a Sourcebook, providing complete documentation for a total of 818 pp.

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