[This review was first published in the national political blog Race42012.com]

While gossip mavens love to write about or read about the sexual and
other private peccadillos of presidents of the United States, there is
another aspect of presidential private lives that is much more pertinent
in consideration of executive performance in our political history. That is
the question of the medical (including the psychological) condition of the
chief executive/commander-in-chief of the national armed forces, and
the historical occurrence of secrecy and cover-up when a president is
seriously or grievously ill.

Most of the time, the secrets come to light only after the term, or after
the death, of a president.

The first presidential medical crisis was not a secret, nor a cover-up, but a
case of colossal misjudgment. On inauguration day, March 4, 1841,
newly-elected President William Henry Harrison (nicknamed “Tippecanoe”
after the famous battle he had won as a general) decided to deliver his very
long inaugural address on a bitterly cold Washington, DC day without an
overcoat. He subsequently caught pneumonia, and a month later, died. (One
might say it was the antithesis of a cover-up.) In any event, the Harrison
campaign slogan “Tippecanoe and Tyler, Too!” was unexpectedly fulfilled
when John Tyler became the first vice president in U.S. history to succeed
prematurely, albeit constitutionally, to the presidency.

Numerous secret medical crises have confronted U.S. presidents since,
including a possible undiagnosed case of Marfan’s Disease for Abraham
Lincoln, the severe alcoholism of Andrew Johnson, the cover-up of
Grover Cleveland’s secret surgery for cancer of the jaw on a naval
battleship, Woodrow Wilson’s incapacitating stroke which made his wife
the de facto president for almost two years, cover-ups of medical
conditions/surgeries of Dwight Eisenhower and Lyndon Johnson, and the
complete suppression of the facts by John F. Kennedy when he took office
with then-fatal Addison’s Disease that had also made him, in effect, a drug
addict. (There is no evidence yet that Ronald Reagan’s physicians knew he
had onset Alzheimer’s Disease when he ran for re-election in 1984.)

But the latest revelation of presidential medical cover-ups may be the
most serious of all of in historical risks and consequences for the nation.

“FDR’s Deadly Secret” by Steven Lomazow, M.D. and Eric Fettman (Public
Affairs, 2010) is an extraordinary medical detective story that will force
some re-evaluation of the nation’s longest-serving president. Roosevelt was
sworn in for this fourth term on January 20, 1945. Less than three months
later, the generally beloved “war president” (age only 63) died of a
cerebral hemorrhage in his retreat at Warm Springs, Georgia, and Vice
President Harry Truman took his place. Roosevelt’s physicians, including
his primary caregiver, Rear Admiral Ross McIntyre, cited hypertension as
the cause of death. Although Roosevelt’s physical condition had dramatically
deteriorated since 1943, McIntyre and Roosevelt himself had repeatedly
reassured the public that his health was good.

In fact, as authors Lomazow and Fettman conclusively demonstrate in their
book, the president was grievously ill from 1940 on, and almost certainly
knew most of the extent of his condition, as did the physicians taking care
of him. Roosevelt’s immediate cause of death was the cerebral hemorrhage,
and he did have severe (“uncontrolled” his cardiologist admitted in 1970)
hypertension, but Roosevelt’s underlying conditions of metastatic cancer
(melanoma) and congestive heart failure were kept from public view for at
least five years.

(Technically, although Lomazow is a distinguished neurologist and Fettman a
very credible historical journalist, their contentions are theoretical, and they
say so, because no autopsy was performed, and all pertinent medical records
were destroyed or suppressed. Nevertheless, the first-hand testimony of so
many involved, and the brilliant medical detective work of the authors makes
their scenario accurate, in my opinion, beyond a reasonable doubt.)

In fact, on the day before in 1944 when he informed the Democratic National
Committee that he would run for the unprecedented fourth term, the book’s
authors disclose that Roosevelt had been told unambiguously and forcefully by
his doctors that he could not survive a new term. Records of this do exist.

The precedent for the cover-up of his desperate medical condition, of course,
had been set at the outset of his presidency when Roosevelt, his entourage,
and the entire national media participated in the total cover-up of his paralysis
following a bout with poliomyelitis in 1923. Hard as it may seem to believe
today, most of the nation was unaware that the president of the United States
was crippled. My father, a general practitioner and lifelong admirer of Roosevelt,
first noticed this in October, 1932 when (New York) Governor Roosevelt passed
through his home city of Erie, Pennsylvania on a presidential campaign stop.
Having succeeded in the most amazing (and for the media, willingly) medical
cover up in presidential history to that point, Roosevelt no doubt felt that he could
succeed in a much more serious cover-up a decade later. (The book’s authors do
mention the somewhat disturbing fact that, in later years, if FDR saw a
photographer taking a picture of him with his braces, he would signal the Secret
Service in the room who, in turn, would confiscate the photographer’s camera and
remove the film before returning it.)

The authors of “FDR’s Deadly Secret” are telling a medical story, and as admirers
of Roosevelt the politician, but they cannot avoid the conclusion that the
president’s fourth term bid was a fraud from its outset, and a terrible risk for a
nation still at war. They also point out that, contrary to popular opinion, Roosevelt
wanted to keep Vice President Henry Wallace on the ticket in 1944. Roosevelt only
agreed to name Truman after he was informed that the Democratic convention
would likely refuse to renominate Wallace, or at the least, it would split the
Democratic Party. His choice of Truman, the evidence suggests, was not because
Roosevelt foresaw Truman as the excellent president he became, but because
Truman would be the most acceptable to the convention and likely to hold the
party together.

The book suggests that Roosevelt was informed that he had a malignant
melanoma in late circa 1940. A large mole on his forehead had appeared in
the 1920’s, but had undergone acute changes circa 1939. Photographs in the
book show the changing mole and its disappearance (by surgery) over the
next two years. Although there was no autopsy of the president in 1945, and
no records of a melanoma diagnosis survive, the book plausibly shows that
this deadly skin cancer had probably spread to the president’s brain and
stomach prior to the 1944 election.

Furthermore, the authors conclusively reveal that Roosevelt had been
diagnosed with never-publicly disclosed congestive heart disease in this
same period, and that he had a series of undisclosed heart “events”, also
prior to 1944. This book also reveals that the president spent much of his
last year and a half in office sleeping up to 12-18 hours a day, and only
occasionally fully engaged in his duties. His physicians, staff, colleagues and
family all participated in a massive concealment of Roosevelt’s condition
although only the president himself and three or four physicians caring for
him knew the whole extent of his illnesses.

[Another publicly-unrevealed illness was a life-threatening case of FDR's
anemia in the early 1940's. The cause of this has not ever been explained,
nor does this book. But the nation came "within one pint of blood of
having Henry Wallace as president," the authors quote one of the attending
physicians.]

As is well-known, Roosevelt only met with Truman privately once after
January 20, 1945, and that the vice president was mostly in the dark about
many issues facing the nation at war after his nomination, including most
notoriously, the existence of the top-secret Manhattan Project developing
the first atomic bomb. Only months after taking office and learning about
the secret bomb project, Truman had to make the momentous decision of
whether to drop two atomic bombs on Japan.

In recent years, a number of biographies of Roosevelt and other histories
of his era, most notably Doris Kearns Goodwin’s excellent “No Ordinary
Time” (1994), have increasingly mentioned in passing Roosevelt’s medical
“secrets” and a few of them have cited reports of a possible melanoma,
noting the disappearance of the mole over FDR’s left eyebrow. Dr. Harry
Goldsmith’s “A Conspiracy of Silence” (2007) is much more detailed about
Roosevelt’s medical condition, but rejects melanoma as the source of
possible cancer. Dr. Goldsmith, a distinguished physician himself, suggests
the cause of death was metastatic cancer of the prostate. Some of
these books have also analyzed the impact of the heart disease on
Roosevelt’s executive performance, particularly at Yalta. Lomazow and
Fettman’s book, however, concentrates on the medical facts, and traces
the evidence to what might be a “beyond a reasonable doubt” conclusion of
the skin cancer metastasis as the principle cause of FDR’s dramatic
physical decline and death. That new material, plus the exhaustive
demonstration of a massive cover up that has continued to the present day,
is what makes this book so valuable.

By today’s standards, all of this cover-up is unthinkable, and with the
frequent appearances of a president live and on camera, close to
impossible. In 1945, my father who, as I previously noted, had met
Roosevelt briefly in 1932, had become commandant of the post
hospital (Arlington Hall) at General Marshall’s headquarters in Virginia.
Although he treated Marshall and his wife on occasion, my father did
not treat the president, nor did he see him up close in person. But he
did see him in newsreels, and he remarked then to my mother and
later to me that he knew Roosevelt was very ill. And so did intuitively
virtually all who met with him from 1943-44 on, especially those who
had known Roosevelt before the war. Nevertheless, Roosevelt’s own
insistence, and that of his personal physicians, convinced most to
accept that his ghastly appearance was simply the result of fatigue
and the stresses of the war and his duties as president.

Franklin Delano Roosevelt was a major president in American history.
He developed an unprecedented bond with a majority of voters while in
office as a result of his efforts during the Depression of the 1930’s. He
skillfully guided the nation into its role as the defender of democracy and
Western civilization before and after December 7, 1941. A case can be
made that he was the indispensable man to be president for a third term in
1941 when the rest of the world was at war. In late, 1944, however, with the
war clearly coming to an end, he was no longer indispensable; his inability
to function daily as president put the nation and our war effort at huge
risk. His performance at the Yalta Conference in 1944 has been universally
criticized. The failure of this Conference, many contend, prolonged the
ensuing Cold War (which ended finally in 1991). The current constitutional
limit of two terms was instituted following FDR’s terms.

As the case of President Franklin Roosevelt and this book show, someone
holding the most powerful executive position in the democratic world
too long is likely to lose his (or her) good judgment.

Copyright (c) 2009 by Barry Casselman
All rights reserved.