Tragedy seemed to plague Ida Saxton McKinley. A month after her beloved mother died, Ida endured a difficult labor with the birth of her second child, only to see her die before she was six months old. Two years later, her remaining child, three-year-old Katie, contracted typhoid fever and passed away. Grief nearly leveled Ida McKinley, and the once attractive, independent, and lively woman aged prematurely, became completely reliant on her husband, and suffered the ravages of a severe illness.

Ida McKinley had experienced severe headaches for years, but the onset of convulsions and seizures mystified doctors. It is quite possible she suffered from epilepsy, but since doctors at the time did not understand the illness, they diagnosed her with phlebitis -- an inflammation of the veins. Since no one figured out the cause of Ida's troubles, both she and her doctors treated the symptoms. She cut her hair short to remove the need for wearing heavy braids, in the hope that her headaches would abate. She took medicine, prescribed by doctors in order to control the seizures, that often made her dull and listless. And finally, she shifted her attention from herself to her husband, believing her cherished "Major," like her children, would be taken from her.

Ida McKinley's behavior affected the way William McKinley approached his personal, professional, and political interests. Although Ida had always been somewhat jealous and overprotective, both traits were exaggerated with the death of her mother and children. She insisted that her husband devote extraordinary amounts of time and attention to her, and McKinley acceded to these demands: he cut back on work, performed certain daily rituals to prove his love and affection, and pursued his political interests from home. Ida McKinley became a campaign issue during her husband's run for the 1896 presidential election. Observers praised the candidate's patient and loving treatment of his wife, and his devotion to her became a major political asset. Yet rumors about Ida's character pervaded the campaign, so much so that the Republican Party published a short biography of her to counter accusations that she was an English spy, a mulatto, and a lunatic. Regardless of whether the account of Ida's life made any measurable difference to voters, William McKinley was elected, and the couple prepared to move into the White House.

The way Ida McKinley would handle her tasks and responsibilities as First Lady was evident even as her husband prepared to assume his own presidential duties. At one point, she declined a dinner invitation from the White House, so the president-elect dined alone with the departing Clevelands. Ida attended both William McKinley's inauguration and the ball that followed, but she fainted and had to be escorted home -- the new President at her side. It was a pattern that would repeat throughout the McKinley administration as the President adjusted White House protocol, his schedule, and his life to monitor and manage his wife's condition.

Ida McKinley's illness not only affected her husband's handling of his presidency but also her own conduct as First Lady. Although she occasionally appeared at state dinners and in receiving lines, her attendance at these functions was sporadic due to the unpredictability of her seizures. In an attempt to present a more stable demeanor, Ida's doctors sedated her with narcotics; at such times, she received guests holding a bouquet and sitting in a large blue velvet chair. At state dinners, the First Lady sat next to the President instead of across the table-a change in protocol necessitated by the President's need to respond to his wife's possible seizures. William McKinley also enlisted the aid of Jennie Hobart, the vice president's wife, to ease Ida's social responsibilities. Jennie became a friend to Ida, calling on the First Lady daily, guiding guests through receiving lines and past the seated and often drugged Ida McKinley, and being available to spend time with the First Lady whenever the President called.

Despite her illness, Ida McKinley often insisted in playing the part of hostess, and at times she did so successfully. Particularly during 1898, she gave a number of elegant receptions and invited friends from Ohio to attend a series of musicals she organized. Yet while she could be witty and charming one minute, she could be shrewish and irrational the next, depending on the medication she was taking. Even when sick, she refused to relinquish the role of presidential hostess to her younger nieces, canceling the entire 1900 social season rather than abide someone standing in her place. Although an invalid, Ida McKinley was hardly incapacitated. She took short outings alone to New York and Baltimore and longer trips throughout the country with her husband. Although she did not direct the refurbishment of the White House, she did choose the colors of fabrics and paints. She even occasionally granted interviews to the press. While she crocheted hundreds of bedroom slippers as fund-raising items for charities, she adopted no special cause, concentrating her focus on the husband she adored. Her adulation, however did not prevent her from offering the President her political opinions. William McKinley took her advice seriously, and Ida's influence seems to be apparent in his adoption of temperance, in some of his government appointments, and in his interest in sending missionaries to the Philippines. It is possible that it was Ida who encouraged the President to make the Philippines and Luzon American territories during the Spanish-American War, but there is little evidence to bolster such a claim. At the very least, given Ida's devotion to her husband and his policies, she was sure to have supported the idea. With the First Lady being utterly dependent on the President, many believed Ida McKinley would be unable to cope with the assassination of her husband. Yet she surprised almost everyone by her reaction. For the eight days that McKinley lingered following the attack, Ida remained at his side, comforting and nursing him. After his death, she accompanied his coffin from Buffalo, the site of the shooting, to Washington, D.C., and attended the funeral without being medicated. Ida McKinley's tenure as First Lady was one of great paradox. Concerned about the demands incumbent on a political wife, Ida was apprehensive about her husband's political ambitions, even as she devoted herself to his career. An invalid, she was well enough to travel, both with and without her husband. As First Lady, it was the President who adjusted his schedule to hers, instead of the presidential spouse sublimating her life to the President's. An occasional hostess who adopted no special project and was publicly mute on political issues, Ida McKinley was First Lady in name only.