The untold neurological disease ofFranklin Delano Roosevelt (1882–1945)
Conventional wisdom suggests that Franklin Delano Roosevelt died on 12 April1945 aged 63 from a massive cerebral haemorrhage attributable to uncontrolled hypertensionand atherosclerosis. Evidence from numerous reliable sources is presented, based largely on aconstellation of previously unrecognized neurological symptoms including seizures,encephalopathy and hemianopia, supporting a scenario that, while indeed he suffered fromsevere cardiovascular disease, Roosevelt died from melanoma with the terminal eventattributable to a metastatic lesion in the brain.
The final event
In the last two years of his life, Franklin DelanoRoosevelt manifested a constellation of neurologicalsymptoms that had a major influence on his ability tofunction as President which are, in large part, the keyto diagnosing a previously unappreciated malignantprocess that was responsible for his death on 12 April1945. The evidence is scattered in thousands of first-hand accounts, letters, newsreels, photographs anddocuments. As early as 1923, a macular lesion aboveRoosevelt’s left eye
can be seen that darkened andexpanded over the next decade and, in the mid-to-late30s, exhibited morphology compatible with melanoma,
a highly malignant and vascular tumour notorious forits propensity to metastasise and bleed in the brain.At 13:10 on 12 April 1945 at Warm Springs, Georgia,the 63-year-old President Roosevelt was stricken by acatastrophic intracerebral haemorrhage that originatedin the right posterior cerebral hemisphere and rapidlyprogressed in a classic transtentorial herniation fashion.Eyewitnesses at the scene have described these eventsin detail, namely the cardiologist and primary physi-cian Howard G Bruenn
and Roosevelt’s cousin,Margaret ‘Daisy’ Suckley.
In 1946 the presidential physician Admiral Ross TMcIntire wrote that Roosevelt’s fatal haemorrhage wasunsuspected
and vigorously defended this contentionuntil his death in 1959. The present accepted view of this event was laid out in detail by Bruenn, thePresident’s primary physician from April 1944, in his1970 paper
published with the consent and partici-pation of the family, alleging that Franklin DelanoRoosevelt (FDR) showed little concern for his healthand that his death was solely a consequence of severeand longstanding hypertension and atherosclerosis.
Bruenn’s account of events
Only recently has the veracity of Bruenn’s assertions been challenged.
Each of the dozens of major biogra-phical works published since 1970, beginning with thatof James MacGregor Burns
who collaborated directlywith Bruenn and the family, is based on Bruenn’saccount. Why should anyone doubt the first-handaccount of the man who essentially lived with thePresident and treated him daily for the last year of his life?The principal reason is the diary of ‘Daisy’ Suckleywho, unbeknown to the President and his physicians,preserved her correspondence with Roosevelt and kepta detailed diary of her relationship with him. First pub-lished in Geoffrey Ward’s 1995 book,
,no other document is more revealing of the true stateof Roosevelt’s health and psyche. The diary reveals astory of progressive loss of vitality and the deep con-cerns Roosevelt had about his health, directly and cred-ibly controverting the scenario described by Bruenn.More doubt is cast upon Bruenn’s account by under-standing how Roosevelt dealt with his previous healthproblems. After the fateful summer of 1921, Rooseveltwas never again able to stand without the use of braces. While the nature of the illness that struck him isstill a matter of debate,
his intense rehabilitative effortsand contributions toward the understanding and cureof polio, his unchallenged diagnosis during his life-time, are well appreciated.
FDR took an active role in his rehabilitation, devisingtreatments and novel ways of objectively measuringimprovement.
He sought out the most learned auth-orities in the field and gave advice to other victims,gaining him the title of ‘Doctor Roosevelt’ aroundWarm Springs. He personally financed and developedthe medical centre there and founded a charity to raiseawareness of the disease. The ‘March of Dimes’ wasdirectly responsible for funding the scientific researchthat eventually produced a successful vaccine for
MD, is a neurologist practising in New Jersey. He isa 1976 graduate of the University of Health Sciences
ChicagoMedical School and did his neurological training at the University of Minnesota. He was the president of the Neurological Association of New Jersey and currently is a member of the New Jersey State Boardof Medical Examiners. Correspondence: Steven Lomazow, 8 McGuirkLane, West Orange, NJ 07052, USA (email: Lomazow@comcast.net)
Journal of Medical Biography
: 235–240. DOI: 10.1258