William McKinley was the first President to insist that his wife sit beside him at state dinners.
In McKinley’s time, having an illness or disability was seen as a liability. People felt they had to hide their illnesses, as society viewed some of the illnesses as indicative of character flaws or weaknesses. Sadly, these individuals were often shoved to the outside of society, as their difficulties were little understood. Often they lived in asylums or sanitariums that were far removed from society.
Enter Ida Saxton McKinley, wife of William McKinley into elite social and political circles. The McKinleys attended many public functions together, including formal dinners. The tradition was to have the husband and wife sit on opposite sides of the table in order to facilitate conversation among themselves as well as with the other dinner guests. However, this tradition fell by the wayside when William McKinley took office. Ida Saxton McKinley had seizures, which could have proved to have been a challenge to William McKinley’s political career. Of course, the seizures were highly unpredictable. So, whenever possible, William McKinley asked that his wife be seated next to him at formal dinners. According to the White House Historical Association, “Contrary to protocol, she was seated beside the president at state dinners as he kept close watch for signs of an impending seizure. If necessary, he would cover her face with a handkerchief for a moment. The first lady and her devoted husband seemed oblivious to any social inadequacy. Guests were discreet and newspapers silent on the subject of her “fainting spells.” Only in recent years have the facts of her health been revealed.” Historian Carl Anthony states, “Further, the White House staff would ensure that a clear path was kept from her seat to the elevator in case she had to abruptly be escorted from the table up to the family quarters.” Anthony further states that a letter written by future President William Howard Taft, along with two other first-hand accounts, corroborated the fact that McKinley did this. However, these events took place at private dinners at the McKinleys’ home, not formal dinners.
Since that time, the President has been given the option of sitting next to his wife or across from her at formal dinners. Either protocol is now considered correct.
 The White House Historical Association, “Ida McKinley.” Retrieved 6.28.2016 from https://www.whitehousehistory.org/bios/ida-mckinley
 Carl Anthony, “The Disabled First Lady with the Napkin-Covered Face Myth.” carlanthonyonline.com on November 4, 2013 • ( 4 ) Retrieved 11.17.2015 from http://carlanthonyonline.com/2013/11/04/disability-in-the-white-house-the-napkin-covered-face-myth/