The Dying President: Franklin D. Roosevelt, 1944-1945 (review)

The Dying President: Franklin D. Roosevelt, 1944-1945. By Robert H. Ferrell. Columbia: Univ. of Missouri Press, 1998. Pp. 200. $24.95.

Dr. Howard G. Bruenn, a rather heroic figure in this book, was an attending physician of mine at Columbia-Presbyterian Medical Center when I was a medical student in the early to mid-1960s. I therefore was very much interested in the publication of Robert H. Ferrell's book, in which Dr. Bruenn figures so prominently. Robert H. Ferrell is a Distinguished Professor of History Emeritus at Indiana University.

Ferrell's thesis is that FDR orchestrated medical cover-ups to allow his reelection in 1944, and these cover-ups ultimately had an extremely negative impact on his political performance. The book begins with the statement that FDR "knew he was suffering from cardiovascular disease, knew he was seriously ill, and chose to keep that fact a secret." Mysterious things seem to happen to the medical records of presidents, and FDR's medical record has disappeared. This book is based on the diary of Margaret Suckley, a cousin of the President, on notes kept by Dr. Bruenn, and on interviews with Dr. Bruenn and others who were involved in the care of FDR.

Cardiology was a relatively new field in the 1930s and 1940s. James B. Herrick first diagnosed a myocardial infarction due to occlusion of a coronary artery in 1910, and he was not believed by most of the medical community. The electrocardiograph was being developed at about the same time. The field itself was created by Dr. Paul Dudley White in the 1920s, but there was little expertise in cardiology in the 1920s and 1930s. Both diagnosis and therapy were primitive.

Dr. Bruenn represented the new generation of well-trained specialists. He had received his M.D. from Johns Hopkins in 1929, and both his house-staff and cardiologic training at the Columbia-Presbyterian Medical Center in New York. He received his military commission on 29 October 1942, and was assigned to the Bethesda Naval Hospital, where he became head of the Electrocardiograph Department.

The President's primary physician was Vice Admiral Ross McIntire, Surgeon General of the U.S. Navy. Dr. McIntire was the protégé of Rear Admiral Cary Grayson, the personal physician of President Woodrow Wilson who was directly involved in keeping the knowledge of Wilson's stroke from the American public. Grayson, referring to FDR, said to McIntire, "The President is as strong as a horse with the exception of a chronic sinus condition that makes him susceptible to colds. That is where you come in." McIntyre, after all, was an otolaryngologist.

On FDR's return from the Teheran Conference in December 1943, he was ill. He fatigued easily, was tired, experienced breathlessness, and began to have headaches. Anna Roosevelt, the President's daughter, was uncertain about the care FDR was receiving and arranged to have Dr. Bruenn examine the President. On 28 March 1944, FDR was examined by Dr. Bruenn, who found him to have uncontrolled hypertension and severe hypertensive heart disease with congestive heart failure. On 30 March, despite Dr. Bruenn's conclusions, Admiral McIntyre said that the President had a respiratory infection together with a sinus disturbance: "When we got through, we decided that for a man of 62-plus we had very little to argue about, with the exception that we have had to combat the influenza plus the respiratory complications that came along after."

Dr. Bruenn told McIntire that FDR should be given digitalis, receive bed rest, and be given a careful diet. According to Bruenn's diary, McIntire was furious, "S.G. [Surgeon General] somewhat unprintable when notified." Bruenn, however, insisted on his diagnosis and treatment. Admiral McIntire assembled a board to consider these recommendations. The board consisted of Admiral McIntire; Dr. Bruenn; two administrators, Captains John Harper (Commandant) and Robert Duncan (Executive Officer); Charles Behrens (head of Radiology at Bethesda...