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Rhetoric & Public Affairs 6.4 (2003) 792-794



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The Hidden Campaign: FDR's Health and the 1944 Election. By Hugh E. Evans. Armonk, N.Y.: M. E. Sharpe Inc., 2002; pp xvii + 202. $29.95.

Fans of the television show The West Wing may be familiar with the story of a president plagued by serious illness and unwilling to disclose detailed medical information to the American public. Although only fictional, the story of a chief executive silently serving under adverse medical constraints should not be inconceivable. According to Hugh E. Evans, M.D., author of The Hidden Campaign: FDR's Health and the 1944 Election, of the 17 presidents who served during the twentieth century, only five emerged from their tenure in office without serious assassination attempts or significant illnesses. Moreover, two twentieth-century presidents were fatally wounded and two actually died of illness while in office. The Hidden Campaign examines the physically hazardous occupation that is the presidency, using Franklin Delano Roosevelt as an example of the fractious medical effects the demands of the office can have and of the manner in which many presidents choose to conceal such problems from the public. Rich with the personal accounts of professional associates, family members, and friends who witnessed Roosevelt's medical deterioration and of those charged with his medical care, this book offers a unique perspective on an essentially unexplored yet important aspect of political life.

The first chapter successfully develops the framework on which much of the book is based. Evans clearly justifies the importance of his perspective through thorough analyses of the life expectancy and longevity of the men who have assumed the role of chief executive and a brief review of illnesses and medical conditions that reportedly plagued some of the modern presidents. Drawing upon his medical knowledge, Evans also posits factors he believes contribute to the high incidence of illness that is [End Page 792] found among those who inhabit the White House. He asserts that "the factors contributing to the pattern of medical problems among presidents form a structural basis that could be described in medical terms as a pathogenesis (cause of disease)" (13). Obviously, Evans's medical background contributes substantially to his ability to address and illustrate medical concepts and conditions effectively. However, throughout the book his medical expertise often recedes into the background, and his acute understanding of the historical, biographical, and political complexities surrounding FDR and his presidency emerges.

The bulk of the book is devoted to a well-developed and fairly comprehensive examination of FDR's medical history. Because much of the literature currently existing on FDR seems to skate over his bout with polio and rarely mentions the serious afflictions he developed in office, this book proves an interesting and revealing read. Evans manages to keep sight of his unique perspective throughout the book, and in doing so successfully weaves a compelling account of FDR's presidential tenure. However, the book is by no means a simple medical history or biography. One of its most intriguing components is an examination of the press's coverage of FDR's health and of the administration's success in misleading the public as to the gravity of FDR's condition. Evans asserts, "a mortally ill chief executive, the commander in chief during the most significant war of the century, was repeatedly depicted to the public as healthy for over a year, the last of his life. In reality, he suffered from severe hypertension (elevated blood pressure) for several years. This had caused congestive heart failure, and led to his fatal massive cerebral hemorrhage 83 days into his fourth term. Death was described on the front page of the New York Times as 'sudden and unexpected'" (xiii).

One of the more compelling parts of the book is Evans's discussion of the consequences of such deception and of the inherent failure of medical intervention due to the constraints of the presidential office. He devotes his last chapter to pondering the consequences of alternative outcomes to situations such as FDR's. He...

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