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On October 2, 1919, Wilson suffered an even more serious stroke, one that left him paralyzed on his left side, and with only partial vision in the right eye. He was confined to bed for weeks and sequestered from everyone except his wife and physician, Dr. Cary Grayson. For some months Wilson used a wheelchair and later he was able to walk with the aid of a cane. His wife and his aide Joseph Tumulty embarked on a cover-up of the President's condition, hidden even from Vice-President Thomas Marshall. They convinced journalist, Louis Seibold, to write a false account of an interview with the President, reporting his health to be much better than it actually was.
First Lady Edith Wilson acted as gatekeeper, deciding which matters merited his attention and which could be delegated to his cabinet members. For a time Wilson resumed attendance at cabinet meetings, but was unable to participate in any meaningful way.
By February 1920, the president's true condition was publicly known. Many expressed qualms about Wilson's fitness for the presidency, both in and out of his party. A number of issues were clamoring for attention, including labor unrest, unemployment, inflation and the threat of Communism. No one close to Wilson, including his wife, his physician, or personal assistant, was willing to take responsibility to certify, his "inability to discharge the powers and duties of the said office", the Constitutional requirement for his removal. (Congress later passed the 25th Amendment to control succession to the presidency in case of illness).
At the Democratic Convention, held in San Francisco beginning on June 28, 1920, it took the Democrats 44 ballots to settle on Ohio Governor James Cox as their candidate (and a young Assistant Secretary of the Navy from New York named Franklin Delano Roosevelt as his running mate.) Democrats selected Cox in part because the Republicans had earlier nominated another Ohioan, Senator Warren Harding, and Ohio was seen as a pivotal election state.
Wilson had hoped that the election would be a referendum on the League of Nations, but this did not happen. Harding and Cox were both lukewarm to the idea and waffled on the question in order to keep the support of those on both sides of the issue in their parties. When Cox went to the White House to seek Wilson's endorsement, he learned of how unpopular the League was even among Democrats.
Governor Cox campaigned on the road, often speaking from the back of his campaign train, while Harding ran a "front porch campaign" similar to that run by William McKinley in 1896. Thousands of voters came to the Harding home in Marion, Ohio, where Harding spoke from his home.
On election night, November 2, 1920, Harding won in a landslide, receiving 16,144,093 votes (60.32%) and 404 electoral votes, compared to 9,139,661 votes (34.15%) and 127 electoral votes for Cox. Socialist Eugene V. Debs of Indiana finished third with 913,693 votes (3.41%, but no electoral votes) even though he was an inmate in an Atlanta Penitentiary at the time, jailed because he had encouraged young men to resist the draft in World War I.
After the election, the Wilsons moved from the White House to an elegant 1915 town house in the Embassy Row (Kalorama) section of Washington, D.C. His health precluded him from leaving the house much, though he did like to go on regular car rides.
After the election, Harding had announced he was going on vacation, and that no decisions about appointments would be made until he returned to Marion in December. He went to Texas, where he fished and played golf with his friend Frank Scobey, the man that he would appoint as Director of the Mint. He then traveled by ship to the Panama Canal Zone. When he returned home to Washington, he was given a warm welcome when Congress opened in early December as the first sitting senator to be elected President. He then returned home to Marion where he said that he planned to consult with the "best minds" of the country on appointments.
Many were surprised when Harding chose League of Nations supporter and the 1916 Republican Candidate Charles Evans Hughes to be his Secretary of State.When Charles G. Dawes declined to serve as Secretary of the Treasury, Harding asked Pittsburgh banker Andrew W. Mellon, one of the richest men in the country to take the job and Mellon agreed to do so. Harding appointed Herbert Hoover as United States Secretary of Commerce. The two Harding cabinet appointees would come back to haunt him. Harding's Senate friend, Albert B. Fall of New Mexico was named Interior Secretary, and Harry Daugherty, Harding's campaign manger, became Attorney General. Fall was opposed by conservationists such as Gifford Pinchot, who wrote, "it would have been possible to pick a worse man for Secretary of the Interior, but not altogether easy". The New York Times criticized the Daugherty appointment, stating that rather than select one of the best minds, Harding had been content "to choose merely a best friend". Both men would later be involved in scandals that would tarnish Harding's administration and his legacy.
Warren Harding was inaugurated as President on March 4, 1921. Woodrow Wilson attended the ceremony and rode in the open carriage to the ceremony with his successor. Ironically, Harding would predecease his sickly predecessor. Harding would die in office, while on a western tour, on August 2, 1923. Wilson would die the following year on February 3, 1924.