HaBO: Book Opens with a Surgery on Grover Cleveland

This HaBO request is from Jennifer, who is trying to track down what sounds like a dramatic family saga:

I’m looking for a book I read in the early to mid 90s. I remember most of the plot but not the title or author.

It was set a few decades post-Civil War, but a lot of events affecting the story happened then. It started with a surgeon named Charles operating on the president on a yacht; I think mouth/jaw cancer. He has a wife, Araminta (pretty awful), and a sweet teenage daughter (Elizabeth, maybe?). I remember she was artistic. His wife has a daughter named Cassie from her first marriage with an awful husband named Stanley (sub-plot – he’s having sex with his sister, yuck). His daughter has fallen in love with a young man I think named Jonathan.

Charles find out and gets upset because, turns out Jonathan’s mother is his first wife, who remarried when she thought he was dead in the war. He survived but by the time he found her and their little girl, she had remarried and had a baby son. Rather than cause a scandal for her, he went off and remade his life, changed his name from Coin to Charles and became a surgeon. Araminta knew about all this (I think her first husband was related to one of them) and sort of blackmailed him into marrying her for her silence.

So the first wife, I think her name was Maggie, has been having a happy life. Her husband is some sort of politician. Her daughter has married and lives somewhere Western-ish. (Chicago? The two young people visit her there, running away? Something about the Pullman Strikes?) Her son’s doing well. Then Jonathan and Elizabeth fall in love and everything goes crazy. Lots and lots of drama.

The internet tells me those strikes were 1894 and the president was Grover Cleveland, who had secret surgery on his mouth on a yacht in 1893. That sounds about right.

Well that’s going to be an awkward family reunion. Anyone know this one?