The epilepsy of Franklin Delano Roosevelt
Steven Lomazow, MD
Address correspondence and reprint requests to Dr. Steven Lomazow, Mount Sinai School of Medicine, 8 McGuirk Lane, West Orange, NJ 07052 Lomazow@comcast.net
In the 4 years since beginning research for a book on the health1 of our 32nd president, the diagnosis of Franklin Delano Roosevelt’s seizures evolved from a suspicion to a virtual certainty. Even more importantly, it is clear that they had a major impact upon his mental acuity and decision-making during one of the most critical periods in American history. There are dozens of independent reports of behavior consistent with complex partial seizures that occurred with considerable frequency for over a year prior to his death from a cerebral hemorrhage at Warm Springs, GA, on April 12, 1945, none of which were recognized as such by the observers. The true nature of Roosevelt’s neurologic illness has been one of the most closely held secrets of the 20th century, abetted by the active participation in a cover-up by his 2 most well-recognized physicians, ENT specialist Ross T. McIntire and cardiologist Howard G. Bruenn. It is ludicrous to assume that symptomatology so gross and so frequent went unrecognized by those entrusted with the health of the most important and powerful man in the world. The pieces of the puzzle are scattered in dozens of books, articles, oral histories, and a limited amount of surviving medical records. In the last year of Roosevelt’s life, the long list of observers who were aghast at his appearance, demeanor, and loss of mental acuity include Winston Churchill, Churchill’s physician, Lord Moran, and Generals Douglas MacArthur and Albert C. Wedemeyer, yet a number of others are particularly graphic and convincing. In July 1944, prior to his nomination for an unprecedented fourth term, Turner Catledge, then a reporter and soon to be editor of The New York Times, met with FDR:
When I entered the president’s office … he was sitting there with a vague glassy-eyed expression on his face and his mouth hanging open. He would start talking about something, then in midsentence he would stop and his mouth would drop open and he’d sit staring at me in silence … Repeatedly he would lose his train of thought, stop, and stare blankly at me. It was an agonizing experience for me. Finally a waiter brought his lunch, and (Chief of Staff, General Edwin “Pa”) Watson said his luncheon guest was waiting, and I was able to make my escape.2
Watson was Roosevelt’s chief of staff and close confidante since the earliest days of the New Deal, having been brought into Roosevelt’s inner circle (as was Presidential physician McIntire) by Dr. Cary T. Grayson, the orchestrator of the medical cover-up of Woodrow Wilson’s devastating 1919 stroke. In January 1945, Senator Frank Maloney of Connecticut, a long-time acquaintance of the President, met with him over lunch.
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Roosevelt looked up but said nothing, his eyes fixed in a strange stare. After a few moments of silence, Maloney realized that Roosevelt had absolutely no idea who his visitor was. A pious Catholic, Maloney crossed himself and ran to get Pa Watson, fearing the president had suffered a stroke. “Don’t worry.” Watson said. “He’ll come out of it. He always does.” By the time Maloney returned to the oval office, Roosevelt had pulled himself together. Smiling broadly, he greeted Maloney warmly and launched into a spirited conversation.3
Watson’s dismissive response to the event is strong testimony to both the frequency and the familiarity with which FDR’s intimate associates dealt with the problem. Frances Perkins, America’s first female cabinet member, gave the best description:
The change in appearance had to do with the oncoming of a kind of glassy eye, and an extremely drawn look around the eyes and cheeks, and even a sort of dropping of the muscles of the jaw and mouth, as though they weren’t working exactly. I think they were, but there was a great weakness in those muscles. Also, if you saw him close to, you would see that his hands were weak … When he fainted, as he did occasionally—not for many years, but for several years—that was all accentuated. It would be momentary. It would be very brief, and he’d be back again.4
A January 5, 1948, memo from a Chicago Tribune reporter, Orville “Doc” Dwyer, to his colleague, Walter Trohan, best illustrates the historical importance and also reliably reports that Roosevelt’s daughter, Anna, who served as his hostess and aide for the last year of his life, was well aware of the problem, though she
From the Mount Sinai School of Medicine, West Orange, NJ. Disclosure: Author disclosures are provided at the end of the article. 668 Copyright © 2011 by AAN Enterprises, Inc.
The source document, quoted misinterpreted the seizures as TIAs. The source was a below, is available physician “for years,” a close friend of Anna Roosas a data evelt Boettinger. supplement on the The doctor told me that from what Anna has outNeurology® Web lined to him Franklin D. Roosevelt was for a long time before he died—and particularly when he went site at to Yalta and Tehran (sic)—suffering from hemorwww.neurology.org. rhages of the brain. The doctor said he died “from a
big hemorrhage” but for several years before his death had a lot of “little hemorrhages,” small blood vessels bursting in his brain. When these burstings occurred—and they were frequent during his last years— he would be unconscious (completely out) although sitting up and apparently functioning for periods of from a few seconds to several minutes. Dr. Schmidt said he has no doubt from his conversations with Anna that these were occurring regularly at the time he was meeting with Churchill and Stalin and holding other momentous conferences of the utmost importance to the United States. He said the effect would be that he would be cognizant of what was going on, then suddenly lose the thread completely for anywhere from a few seconds to 2 or 3 minutes—and that he could not possibly have known what was going on in between.5
in Bruenn’s allegedly definitive 1970 paper on Roosevelt’s health.6 Bruenn was assigned exclusively to Roosevelt and saw him daily beginning on March 29, 1944. Present-day neurologists spend a good portion of their time diagnosing seizures and public education in epilepsy continues to be a major focus of the specialty. It is not surprising that Roosevelt’s seizures went unrecognized by those outside his most inner circle of physicians and confidantes. With the intense media and greater disease awareness in the 21st century, it is unlikely that these dramatic events would today escape notice in such a high-profile persona.
Dr. Lomazow receives royalties from the publication of FDR’s Deadly Secret (Public Affairs 2010) and serves on speakers’ bureaus for GlaxoSmithKline and Pfizer Inc.
Received August 6, 2010. Accepted in final form October 4, 2010. REFERENCES 1. Lomazow S, Fettmann E. FDR’s Deadly Secret. New York, NY: Public Affairs; 2010. 2. Catledge T. My Life and Times. New York: Harper and Row; 1971: 146. 3. Goodwin DK. No Ordinary Time: Franklin & Eleanor Roosevelt: The Home Front in World War II. New York, NY: Touchstone; 1995: 571. Goodwin identifies her source as Eliot Janeway, the noted columnist. 4. Perkins F. Columbia Oral History Project, Part 8, Session 12. 1955: 283–284. 5. Walter Trohan Papers, Herbert Hoover Presidential Library, West Branch, IA. January 5, 1948. 6. Bruenn HG. Clinical notes on the illness and death of President Franklin D. Roosevelt. Ann Intern Med 1970; 72:579 –591.
Considering the frequency, duration, stereotypic nature, and rapidity of change of this behavior, alternative diagnoses other than complex partial seizures are hard to surmise. Their etiology is most attributable to cerebrovascular disease, no surprise considering Roosevelt’s severe uncontrolled hypertension and 2-pack-a-day cigarette habit. Roosevelt was prescribed phenobarbital, between 60 and 90 mg/d, at least from the beginning of April 1944, allegedly for his soaring blood pressure. Amazingly, no reference to lapses of consciousness or, indeed, any neurologic symptomatology whatsoever (other than those associated with the fatal brain hemorrhage) is mentioned
February 15, 2011