When Edith Galt met President Woodrow Wilson in 1915, she had no real interest in politics. But when the recently widowed president began courting her, she soon found herself discussing state matters at length. 

The couple married after just a few months. But as first lady, Edith eschewed the traditional ceremonial duties of a president’s wife. She delegated those matters to her secretary in favor of examining politics with her husband. She rarely left his side and even worked on decoding secret transmissions during World War I. 

However, her role as a confidant and advisor became much more substantial when in October 1919 President Wilson suffered a massive stroke. The president’s health had never been in peak condition; he’d had several strokes even before becoming president, leaving his right side weak and causing him to go blind in one eye. His health often worsened when he was under great stress and his physician had warned him to keep a very light schedule — not exactly an easy task for a wartime president. 

This last stroke left him incapacitated. Wilson spent the remainder of his presidency in seclusion. Every attempt was made to conceal the president’s true condition. Dr. Cary Grayson examined the president and informed the cabinet of Wilson’s condition. But refused to sign any document that would confirm Wilson’s disability and strongly advised against notifying the public of Wilson’s health.

Only Edith was permitted inside the president’s sick room. She took over his routine duties, and all communication with the president went through her. Edith called this period her “stewardship.” She chose which matters required her husband’s attention and left cabinet members to run their departments independently. Messages leaving the president's quarters were all written in her handwriting. Because Edith was so secretive and Wilson had not been seen in such a long time, many speculated that he had actually died. 

Although Edith claimed that the president was entirely lucid during his recovery, it is impossible to know the extent of her role as his advisor. Outside the president’s quarters, Edith Wilson effectively ran the executive branch. 

Today, Wilson would certainly have resigned, but, at the time, no rules spelled out what should happen if the president becomes incapacitated. The 25th Amendment, which authorizes the vice president to become acting president in case of a presidential disability, was not ratified until 1967 — nearly half a century after Wilson left office.