Ruben Oropeza, George T. Pack and Franklin Roosevelt

George T. Pack was one of the top cancer surgeons of the first half of the twentieth century. Among other important accomplishments, he founded the Gastric and Mixed Tumor Service where he was "Mr. Melanoma" at Memorial Sloane Kettering Cancer Center and treated countless international dignitaries, most famously Eva Peron and, surreptiously, Franklin Roosevelt.

Ruben Oropeza from 1963 to Pack's death was Pack's closest protegee and confidante. After Pack's stroke and heart attack, Oropeza performed all of his surgery with Pack scrubbed in at his side. He was totally devoted to Pack and managed all his medical affairs. Pack confided in him as he did with only one other individual, Dr. Irving Ariel. Ariel was sworn to secrecy about many of the details of what Pack told him. Oropeza is alive and well at age 81 and living in Texas and Mexico.

Dr. Oropeza has related information to me that is reliable and authoritarian. His recollections about Pack are quite analagous and equally as reliable as those of Margaret "Daisy" Suckley were to FDR.

As with Daisy, the vast balance of the material is an incredibly valuable and unique archive. I will be posting excerpts of his notes and hope to incorporate the material into a journal article.

The photographs above were among the archive I have so far received. With respect to FDR, there were two operations he personally performed on the melanoma, one local and the other (with Frank Lahey in Boston) an abdominal "open and close" procedure. The dates are still unclear.

Ruben Oropeza is the last living link to unlocking the truth of FDR. I will be posting excerpts from the material and hope to incorporate it into a more comprehensive scientific paper. I am incredibly fortunate to have been able to contact him.

Happy New Year to all!

SL

A Correction of the New York Times on Alzheimer's Disease

The vaunted NYT did not see fit to publish my response to Lawrence K. Altman's subltle yet effective hatchet job of our book. Today they feature an article bluntly stating the Alzheimer's disease is "untreatable".

Perhaps hey will publish this letter, timely submitted.

http://www.nytimes.com/2010/12/18/health/18moral.html?_r=1&hp


Dear Editor,

First of all, Alzheimers is not untreatable as the author bluntly states. There are two classes of drugs that have proven efficacy, albeit modest, that reduce progression and slow disability. Patients with early diagnosis might opt to begin these medications "off label" since they are only indicated for moderate to severe disease. I know I would.

A good analogy analogy here is that, just like drugs for baldness, early use may not regrow brain cells, but can reduce the frequency of dropout. Early diagnosis and provision of patients with all therapeutic options is essential, not only for dementia, but for all disease. With current understanding, genetic counseling is an important adjunct to medical treatment.

The days when patients not being informed of disease such as maligancies are thankfully coming to an end (though not as fast as some might think, especially in Japan!) The prevalence of AD (50% at age 85) mandates aggressive, state-of-the-art, measures at prevention of progression.

Steven Lomazow, M.D.
Assistant Professor of Neurology
Mount Sinai School of Medicine
President, Neurological Association of New Jersey

When Was the First Operation on FDR's Eye? 1935!

Two photographs I recently purchased on eBay spurred my renewed interest in finding the date that FDR's melanoma was first operated upon.

According to Dr. Ruben Oropeza, Dr. George Packs's closest protegee and an exceedingly valuable source of information, Pack was following FDR for a "Hutchinson's Melanotic Freckle" for ten years prior to his death and personally performed two operations on FDR, the first being a local excision, and the second, a much later "open and close" laparotomy with Frank Lahey and Isodore Ravdin.

The photos below are entirely consistent with that scenario. The first was taken on January 30th 1935 and shows only the scar that had been seen on photos for at least twenty years and probably comes from the childhood incident described by Geoffrey Ward that occurred in early childhood.

The second photo, taken 14 months later is dramatically different, with an entirely new scar in the eyebrow directly below the lesion. Remember, any notion of a malignancy by the public and FDR's political career is over. This dates back prior to the second term! Quite clearly the lesion was cosmetically removed beginning in mid to late 1940 (see the cover of the book that has a photo from mid-August 1940). By Pearl Harbor it was gone, with absolutely no other explanation other than staged surgical removal.

Pretty impressive, huh?

I'll be shortly off to the FDRL yet again to comb through all of the 1935 photographs and FDR's daily schedule to try to determine with greater accuracy when the first operation took place. Obviously, more to follow.

FDR's battle with his health was sooooooooooo different than has been portrayed and had a tangible and previously unappreciated effect on many of his political decisions.

The paperback edition of our book is to released in two weeks. My paper in NEUROLOGY on FDR's epilepsy will appear on February 15th (I'll post a link to it on the blog after it is released).

Season's Greetings to all.

SL

Could It Happen Again? George W. Bush

I am often asked whether a cover-up of presidential health on the scale of FDR could occur again.

Judge for yourself.

Here is a link to a webpage that makes a strong argument that George W. Bush was wearing a portiable defibrillator during his presidency.

http://houston.indymedia.org/news/2004/12/35839.php

Here's yet another, far more convincing photo.

A similar bump was seen under his jacket at his recent appearance at the world series.

Upcoming Events

1) Release of the paperback of our book in January 2011

2) January 5, 2011. Medical Grand Rounds at Robert Wood Johnson University Hospital, New Brunswick, NJ
"A Cancer on the Presidency, The Medical History of Franklin Delano Roosevelt"

3) Publication (approved but exact date pending) of my paper entitled "The Epilepsy of Franklin Delano Roosevelt" in the prestigious journal Neurology.

4) April 9, 2011. My co-author and I will share the podium at the Lahey Clinic in Boston with Dr. Harry Goldsmith for a comprehensive discussion of the health of FDR.

Changing long-standing historical misperceptions is an agonizingly slow process, especially since they go direct against the very powerful desire of the most important historical figure of the twentieth century!

More on the Truth of the Lucy Mercer Affair

Here is a definitive document obtained from the Trohan papers at the Hoover Library in Iowa.

It pretty much tells it the way it really was. The famous incident of Eleanor finding the letters in the suitcase upon FDR's return from France was not the first time she was confronted with the affair. The great Geoffrey Ward agrees with this version.

Howard Bruenn and the Lahey Memorandum

On January 30, 1990 Jan Herman the medical historian of the Navy, interviewed Howard Bruenn at his summer home in Maine. Jan has kindly supplied me with the complete transcript of that most interesting encounter. It was, in retrospect, an interesting work of manipulative fiction on the part of Bruenn.

An excerpt:

Q: (Dr. Harry) Goldsmith reiterates your 1970 findings, but then steps off from there and talks about the President having cancer. He also brings up the subject of Dr. Lahey.

A: Lahey, at the only meeting we had following my initial examination [in March 1944], said, "This is nothing in my field." and signed himself off.

Q: Lahey really didn't have anything to do with the President's care after that?

Oh, no, not a bit. To my knowledge, he never saw him again. Dr. Paullin, some time after the President died, wanted me to give him my notes, but I didn't give them to him. I was afraid that he might do what Lord Moran [Churchill: Taken From the Diaries of Lord Moran, Houghton Mifflin Co., Boston, 1966] did to Churchill. He went into some pretty personal things and did himself and Mr. Churchill no good. I can tell you Churchill was very fond of his scotch and so on, but that had nothing to do with history.

Q: Back to the cancer, Goldsmith went into this thing about the mysterious pigmentation above the President's left eyebrow. He says there's a photograph that was taken much later in which the pigmentation is missing.

A: That's a photograph error or something. He never had anything wrong with that. He had something on top of his head, something benign. A doctor named Winchell, a surgeon from Mayo, took it off at Bethesda, no problem. (What Bruenn was referring to here was actually neurosurgeon Winchell Craig, who assisted George Webster to remove a benign epidermoid cyst from the back of FDR's head in February 1944. Webster or Craig never removed anything from FDR's face. By this time the lesion above the left eye was long gone, having been cosmetically removed between mid 1940 and late 1941. sl)

In his 1970 paper for Annals of Internal Medicine (aka"The Gospel According to Bruenn), The eminent cardiologist describes Dr. Lahey's impression after examining FDR for the first and only time. Here are Bruenn's handwritten notes, allegedly written at the time , that appear verbatim in his paper:

(click on image to enlarge)

The Lahey memorandum quite clearly states that in July 1944, Lahey informed Admiral McIntire that after again examining the president, he determined that he would not survive a fourth term. McIntire then informed Roosevelt of the prognosis.

The greatest abdominal surgeon of his day quite cryptically opined that a cardiac problem would inevitably return and bring about FDR's demise.

The memorandum was only to be released if Dr. Lahey's reputation subsequently came under criticism for "allowing" FDR to run when terminally ill.

Why then did Bruenn include Lahey's concerns about the abdomen in his 1970 paper, especially when the entire thrust of the article was to promote the notion of a purely cardiovascular death?

The answer is quite clear: Bruenn was quite aware of the memorandum in 1970 and inserted this language to protect Lahey and specifically reduce the probability that the memorandum would be released.

In fact, the intentional deception can be carried even further: The 1970 paper was written in such a manner that if the Lahey Memorandum ever became public, it would consistent with Bruenn's treatise and not expose him as a participant in the cover-up. Clever indeed, and to this day, quite successful in its purpose.

Oh! What a tangled web we weave!

On the face of it, this all might seem quite conspiratorial, yet four years of watching this unfold tells me that it is indeed the case.

Last Wednesday I attended a well prepared and well received lecture at the Lahey Clinic by Dr. David Steinberg, whereupon the eminent director of the ethics returned a facsimile of the memorandum to the clinic. Among others, James Roosevelt Jr., the oldest son of FDR's oldest son, and a major executive in the administration of the Lahey Clinic was in attendance. While it was not the appropriate forum to address the above controversies about the memorandum, it did raise some very valid and interesting questions that will hopefully be dealt with in the near future.

My sincere thanks to Doctors Steinberg and Phil Kousoubris for their hospitality and courtesy.

And Nobody Read It....

I just bought this newspaper, the April 13, 1945 Chicago Tribune, on Ebay for $25. I was the only bidder. It is one of countless newspapers reporting the death of President Franklin Delano Roosevelt but this one contains a little different information than all the others.

Just below the picture of the new President Truman on the front page appears an article by Walter Trohan (no byline but most definitely Trohan) entitled "President's Health Failed Steadily Since Late '43".

(double click on the article to enlarge it)

The article reports that Howard Gerald Bruenn, a cardiologist, was commissioned into the Navy in late 1942 and was almost constantly with FDR since he was commissioned. It also discusses a "parade of doctors" that had been seeing FDR and that he was told in the Summer of 1944 that he had six months to live (as confirmed in the Lahey memorandum). It also mentions that an operation for cancer was anticipated by Dr. Lahey but he later determined it was "too late." The doctor mentioned who "refused to operate" was William Calhoun Stirling.

This is not at all the picture painted by Bruenn in 1970 of the gallant leader struck "out of the blue" by an unexpected brain hemorrhage. In his paper Bruenn clearly asserts that he saw the FDR for the first time in March 1944.

The widely circulated Tribune laid out a story that was largely accurate the day after FDR died. For the most part- either nobody read it or nobody cared!

In 2010 we have finally brought the true story of FDR's Deadly Secret back to the front pages of America. Perhaps this time it will be believed!

A Page From FDR's Calendar

At the FDR library there is a database that can be easily accessed that records FDR's activities each day of his presidency. It is taken from a number of sources, primarily the White House Usher's diary.

If one searches under the key word "doctor", a remarkable record comes out. Virtually every day FDR is in Washington from late 1938 to 1945, ther is a record to document a protracted visit to the doctors office. The cover story is that he had been seeing presidential physician Ross McIntire for "sinus" treatment. The reality is likely quite a bit different and related to his panoply of other unadmitted medical problems.

Visits to the hospital clearly documented on laboratory slips are not reflected in the diary. Just another of the many layers of cover-up of the extensive amount of medical treatment FDR received. Treatment that occupied a large and previously unappreciated portion of his life.

Just one page of dozens for your perusal.

A Photo on Ebay

This photo is presently for sale on Ebay. See for yourself. How long will it take before the world accepts the fact that FDR had melanoma?

A Curious Gruping of Signatures. 4 Roosevelts in Two!

I bought this for a pittance on eBay recently. It was advertised as an authentic signature of older FDR's half brother James Rossevelt "Rosy" Roosevelt (1854-1927), which indeed it is. Rosy was also the father of FDR's slightly older and somewhat strange and embarrasing half-nephew and short-lived Harvard Classmate Taddy, who may have been the nidus for the bitter disappointment of FDR not being named to the premier Harvard society, The Porcellanian.

The document in question is a fragment of a 1925 legal document, perhaps his will. The most interesting aspect of the document. wholly missed by the seller, was the witness, E.R. Roosevelt, none other than FDR's wife Eleanor Roosevelt Roosevelt. This is surely a more valuable signature than the one featured in the sale. It also completes the rather curious grouping of signatures with two Roosevelts in it!

I have been kindly invited to attend a lecture on October 18th at the Lahey Clinic concerning the Lahey Memorandum.The post-lecture Q and A should be most interesting! As I have said, FDR probably had a secret middle-of-the-night operation there for his metastatic cancer (open and close by all reports).

AStunning New Photograph Portrait ca.1920

I just purchased this magnificent close-up portrait of FDR on eBay.

I initially thought it was earlier but this Chicago Tribune file photo is clearly dated to the 1920 campaign and he is apparantly wearing the same suit and tie, leading to the conclusion that this portrait was airbrushed, considering the lack of the mole on the right cheek and lack of the scar on the lateral left eyebrow seen in earlier photos that probably came from the incident as a child described in Geoff Ward's Before the Trumpet. The pre-malignant melanoma still dates back to 1920.

Here is a pot-pourri of earlier pictures from various dates. As previosly noted, on the basis of these photographs, it would appear that FDR had some minor cosmetic work done about the time of the 1920 campaign.

Wikileaks. Old News! See Amerasia Magazine

In early 1945, Amerasia Magazine published the title article above. It was a top secret document that had been purloined and leaked, most probably by John Stuart Service.

see:http://en.wikipedia.org/wiki/Amerasia

The FBI then raided the Amerasia offices and found a huge cache of top secret material. Unfortunately, the case against Service was botched and he never came to appropriate justice. In fact, he was reinstated and later wrote extensively in his own defense.

The notorious Joseph McCarthy used the Amerasia leak in his red-baiting rantings in the early 1950's.

A lot different than the current environment. The Amerasia leaks were quite similar in importance to those recently found on Wikileaks. Perhaps we've learned our lesson. Perhaps not!

The Grace Tully Papers

FDR has once again made the news with the "discovery" of the sequestered Grace Tully papers, the former archive of the disgraced FDR biographer Conrad Black, currently imprisoned. Black's excellent, exceedingly long volume was published by Public Affairs, the same house that published our book.

Hightlights of the "new" material include a letter to FDR from Mussolini, a nice letter from Joseph Kennedy and a letter expressing great concern for FDR's health by Lucy Rutherford, in which she arranges her last visit to Warm Springs.

It is no secret that Tully knew about Lucy. In fact she mentioned her neing in Warm Springs in 1948 and no one picked up on its significance. The Chicago Tribune knew about Lucy's presence in 1948 and sat on the story until Jonathan Daniels' 1966 article in LIFE.

I don't expect anything significant in the remainder of the archive with respect to FDR's health though it will be fun to go over some fresh material. We are quite correct in our book about the reality of the situation and it will take a while until it sinks in so that mainstream historians come on board. It will happen- just a matter of time. No credible medical professional has yet to puch a hole on our thesis.

FDR most probably died of a brain hemorrhage into a metaststic melanoma- period.

This blogger would be most receptive to presenting a personal lecture at any academic venue.

Yours in history,

SL

The Top Ten Disgraced American Military Leaders. Stanley McChrystal

The world loves lists. This one seems appropriate in view of the recent fracas over General Stanley McChrystal. I'd love to hear comments and suggestions for additions. Thanks!


In view of the recent highly-publicized firing of General Stanley McChrystal, I offer my retrospective list of the top ten American disgraced military leaders (in descending order).

1) Benedict Arnold
Arnold is the epitome of the word “traitor, the first in American history and by virtue of the fact that he actually led battles against his former country must head the list as the number one all-time disgraced military leader.

2) Douglas MacArthur
MacArthur’s greatness as a World War II general, career military officer and rehabilitator of Japan is unquestioned. His highly publicized recall by President Harry Truman for insubordinate behavior in Korea, nearly bringing about World War III with China, ranks as the greatest act of outright defiance of an American president.

3) George B. McClellan
The legendary firing of George McClellan by President Abraham Lincoln for failure to press the Confederacy is one of the defining moments of the Civil War. He was replaced by the bumbling and incompetent Ambrose Burnside, himself soon removed in favor of Joseph Hooker. Unsuccessfully ran for President against Lincoln in 1864.

4) Curtis Lemay
Another brilliant career officer. The orchestrator of B-29 incendiary bombing of Japan during World War II and subsequently fortified the Strategic Air Command. During the Cuban Missile Crisis in 1962, after the Soviets turned back he urged President Kennedy to bomb Cuba. Fortunately, he was overruled and a nuclear holocaust was averted. It was later revealed that the Russians had and were authorized to use tactical nuclear weapons in the event of invasion. After retiring from the military in 1968 he further reduced his credibility as the vice-presidential candidate of segregationist George Wallace.

5) William Hull
After fighting in American Revolutionary campaigns in Connecticut, New York, and New Jersey, in 1805 he was appointed governor of Michigan Territory. At the outbreak of the War of 1812, he was appointed brigadier general and charged with defending Michigan and attacking Canada. His poorly planned invasion of Canada forced him to retreat to Detroit, where he surrendered without a fight. He was court-martialed and convicted of cowardice and neglect of duty. His death sentence was remitted by President James Madison because of his earlier service.

6) Joseph Stilwell
A brilliant field commander and beloved leader during WW II, he nearly lost China to the Japanese while vainly campaigning in Burma and his “Vinegar” personality later so incensed Chiang Kai-shek that he threatened to make peace with the Japanese that would have mobilized over a million troops against our forces in the Pacific. He was recalled by President Franklin Roosevelt and replaced by the more diplomatic Albert C. Wedemeyer.

7) George Patton
The swashbuckling and brilliant field commander who nearly lost his command and was soundly and publicly disciplined by Dwight Eisenhower after slapping a shell-shocking soldier on August 3, 1943.

8) George McChrystal

9) George Casey/John Abizaid
Both men were fired in early 2007 by President George W. Bush in a “clean sweep” of the military leadership of the Iraqi war. They publicly opposed the buildup of troops on the grounds that it could delay "the development of Iraqi security forces and increase anger at the United States in the Arab world." Replaced by Admiral William J. Fallon.

10) Thomas Algeo Rowley
While commander of a division at the Battle of Gettysburg on July 1, 1863, the brigade suffered heavy casualties confronting Confederates and he was thrown from his horse during the retreat. Following a confrontation with Brigadier General Lysander Cutler, he was removed for drunkenness and disobeying orders. Convicted by a court martial, he was reinstated by order of Secretary of War Stanton only to resign on December 29, 1964 after not being re-assigned to a field command.

Dishonorable mention: General Ricardo Sanchez (Abu Gharaib). Lieutenant William Calley (My Lai)

Does anybody know Oliver Stone?

Just back from a "grand" time at the FDR Reading Festival at Hyde Park (as usual we were skipped over by book TV). Gave two lectures which were well received and signed about thirty books. The next event is the paperback edition in January.

Anyhow, I've been thinking that Oliver Stone would make a great movie of our book. A la "JFK" but this one really happened! Eventually the truth will be accepted. There's just too much evidence to ignore and an ever increasing body of legitimate historians are believers. It would nice, though, to get a bump from Hollywood. So if anyone knows Mr. Stone, please give him a heads up. For that matter, the same goes for the History Channel or HBO (they did a three part series in 1980 based on Jim Bishop's book, starring Jason Robards as FDR)

More new an interesting information to follow.

SL

Rewriting History: Henry Wadsworth Longfellow and Howard Gerald Bruenn.

Over and over, we find instances of how the written word changed or redefined a historical event. Perhaps the most quoted example, the epitome of Yellow Journalism, the “I’ll furnish the war” telegrams between William Randolph Hearst and Frederick Remington, are themselves open to dispute by W. Joseph Campbell. In his Summer 2000 article in Journalism and Mass Communication Quarterly, Campbell presents a well-documented and convincing argument that the communications, as reported by the sole source of the anecdote, James Creelman, were never sent.

It is undisputable is that the pen has had a remarkable and long-standing influence on the way history is perceived. No better example is the legacy of Paul Revere as defined by Henry Wadsworth Longfellow, in his epic poem, “Paul Revere’s Ride” in the January 1861 issue of the venerable Atlantic Monthly. Prior to the poem, Revere was best remembered as a silversmith and engraver. After 1861, he rose to the iconic status he enjoys today as one of the major heroes of the American Revolution. Longfellow had the specific intention of creating a legend and, as the most “revered” poet of the age, his words were exceedingly successful to that end.

Over the years, historians have recognized that Longfellow’s account was, in great part, historical fiction and Revere’s role in the events of 1775 role have been taken in a more realistic perspective.

Intentional deceptions often take time to be realized and accepted and this is the case that I have been persistently making about the 1970 paper in Annals of Internal Medicine by Doctor Howard Gerald Bruenn entitled “Clinical Notes on the Illness and Death of President Franklin D. Roosevelt. “ Bruenn wrote that paper with very much the same intent as Longfellow- to redefine how the world thought about his mentor and patient. He had a great teacher. “The Juggler” Roosevelt practiced deception as religion. His masterful manipulation of the press projected a lasting and powerful impression on the vast majority of the American people of an image that often did not exist. Yet, if it was not reported, it virtually never happened.

The intentions of Bruenn’s 1970 paper are laid out in the accompanying editorial . “We are given, by Dr. Bruenn, the picture of a great and gallant man, fatigued by the burdens of his office and by his hypertension and reduced cardiac reserve, yet quite able to exercise his judgment and to use the fruits of his unique knowledge and experience in guiding the war effort.”

Twenty-five years after Roosevelt’s death, Bruenn’s paper set the standard for every subsequent historical account of Roosevelt’s life. The myths he perpetrated, the twentieth century equivalent of Longfellow’s “one if by land and two if by sea” remain, for the most part, unscathed.

Roosevelt didn’t care about his health and was never informed of his diagnosis? He remained mentally clear until the moment he died? The presidential physicians were incompetent and made false statements to cover their own shortcomings? All unadulterated poppycock!

If Longfellow had wrote it might have read this way:

Read on my children and you shall see
Of the health and the greatness of Franklin D.
His heart was sick, but his mind was clear
Free to inspire a freedom from fear

He led the nation through depression and war
With a pressure of blood that continued to soar.
His docs kept him going the best they could
Though they would not tell him that all was not good.

He lost forty pounds, his doctors aghast
“I like my flat tummy” he said when they asked
There were no strokes. There was no cancer
A bad circulation was the only answer.
He led us with vigor till the day he died
Out of the blue in April forty-five.

The Sick Man at Yalta

My article on the historical implications of FDR's health at Yalta and afterwards is presently on History News Network.

http://www.hnn.us/articles/126978.html

Another Graphic and Important Report of Roosevelt's Seizures

I've been going through my files from my trip to the Herbert Hoover Library in Iowa where I went to peruse the Walter Trohan papers. I have already shared a number of the documents with you but this one, for some reason escaped. When I saw it again today, its importance became quite evident.

The players:

1) The Colonel- Robert McCormick, publisher of the Chicago Tribune , a notably anti-Roosevelt yet quite credible newspaper.

2) pmaloney- J. Loy. "Pat" Maloney, managing editor of the Tribune who was later responsible for the infamous 1948 "Dewey Defeats Truman" Headline

3) Walter- Walter Trohan, long-standing White House reporter for the Tribune and the source of many unique and credible accounts of Roosevelt's behavior and health. Highly suggested reading- his 1975 memoir "Political Animals".

4) Anna Boettinger- Roosevelt's oldest child and only daughter.

click on document for greater resolution

What you have just read is a reliable account of FDR's daughter describing her father's seizures. There is one glaring error, they began months before he ran the fourth time, not the third, nonetheless dramatic. As previously written, these events were interpreted as "little strokes" or "burstings" by those outside Roosevelt's very inner circle (Ross McIntire, Howard Bruenn, "Pa" Watson, Harry Hopkins and most probably a number of other physicians who treated him). They were quite clearly what neurologists (as I am) would diagnose as complex partial seizures.

The implications are obvious (see the Dwyer memorandum on this blog for yet another graphic report)

More on Lucy Mercer Rutherfurd, Cary Grayson

The above note was obtained on my recent trip to the Cary Grayson papers at the Woodrow Wilson Birthplace in Staunton. When I came across a file of letters of condolence to Gertude Grayson upon the death of her husband from lymphoma, I looked for and found this one from Lucy (Mercer) Rutherfurd.

Since FDR and Grayson were both very tight-lipped we will never know the the true extent of their relationship but there is much room for educated speculation.

It is highly probable that the two men were extremely close and that Grayson called most of the shots medically for FDR until his own death in 1938. It is no coincidence that Ross McIntire was not promoted until shortly after Grayson's death.

There is absolute evidence in the Grayson papers that not only McIntire was chosen by Grayson, but also fellow Virginian Edmund "Pa" Watson. The other important individual in FDR's life for whom CTG was responsible was George Adam Fox, the medical aide who functioned in the same capacity for Woodrow Wilson.

Grayson was undoubtedly aware of FDR's affair with Lucy and likely facilitated her presence at the two inaugurals he chaired. Interestingly, when Grayson needed to rest up for his 1934 surgery at the Mayo Clinic (where both Hopkins and FDR son James were operated as well) (Mayo was the FDR and company clinic of choice until Frank Lahey came on the scene), he chose to go to stay at Hobcaw Barony, the estate of his old friend Bernard Baruch. It is likely no coincidence that in April 1944 when FDR need a similar rest and being too sick to fly to Guantanamo (the plans were active until at least April 30th), he chose Hobcaw as an alternative.

The Probable Truth of the Lucy Mercer Affair

Here's a letter found in the Westbrook Pegler file at the Herbert Hoover Library. It lays out what is probably the true story of how Eleanor learned about Lucy Mercer and how she reacted ab when she she did.

Even a very prominent FDR historian who has written about the affair has told me privately that he believes this version to be the truth. For your reading pleasure:

The Yalta conference was supposed to be in November 1944!

I have just finished reading "My Dear Mr. Stalin. The Complete Correspondence of Franklin D. Roosevelt and Joseph V. Stalin, edited by Susan Butler, Yale University Press, 2005.

Aside from some very good source material on Poland, there is one revelation that can only be surmised with an advanced (post FDR's Deadly Secret) understanding of FDR's health.

p. 264 Stalin to Roosevelt, October 17, 1944

"Ambassador Gromyko has informed me about his recent conversations with Mr. Hopkins, in which Mr. Hopkins expressed an idea that you could arrive in the Black Sea at the end of November and meet with me on the Soviet Black Sea Coast. I would extremely welcome the realization of this intention. From the conversation with the Prime Minister (Churchill had just met with Stalin in Moscow), I was convinced that he also shares the idea. Thus the meeting of the three of us could take place at the end of November in order to consider the questions which have accumulated since Teheran. I would be glad to receive a message from you on this matter."

p. 265 Roosevelt to Stalin, October 23, 1944

I am delighted to learn from your message dated October 19 and from reports by Ambassador Harriman of the success attained by you and Mr. Churchill in approaching an agreement on a number of questions that are of high interest to all of us in our common desire to secure and maintain a satisfactory and durable peace. I am sure that the progress made during your conversations in Moscow will facilitate and expedite our work in the next meeting when the three of us should come to a full agreement on our fiture activities and mutual interests.

We all must investigate the practicability of various places where our meeting in November can be held (emphasis added) such as accessibility, living accomodations, security, etc., and I would appreciate suggestions from you. I have been thinking about the practicabilty of Malta, Athens, or Cyprus if my getting into the Black Sea on a ship should be inpracticable or too difficult, I prefer traveling and living on a ship.

p. 267 Roosevelt to Stalin November 18, 1944

All three of us are of one mind- that we should meet very soon, but problems chiefly geographical do not make this easy at this moment. I can, under difficulties arrange to to go somewhere now in order to get back here by Christmas, but, quite frankly, it will be far more convenient of I could postpone it until after the Inauguration which is on January twentieth.

FDR then goes on to make excuses for the dealy based on "constitutional obligations".

Just as the April 1944 Bermuda summit had to be cancelled due to FDR's health (this is not speculative, see details in the book) so, most probably, did the Yalta conference have to be delayed.

The more likely reality:

Fdr's health worsened necessitating a postponement and trip to Warm Springs to recuperate (his first visit there since April 1943). I initially thought that the operation describd below was the reason but a re-reading of the Suckley diary makes that possibility very weak- There was not enough time to allow for recovery. When the operation took place is still unknown- so many layers of smokescreen!

There is ever increasing evidence of a top secret operation (still!) at Lahey, largely based on information gathered by Dr. Harry Goldsmith and personal conversations with Dr. Ruben Oropeza, a close confidante and protege of Dr. George T. Pack. Most probably, the primary surgeon was Pack (the greatest melanoma surgeon of the twentieth century) assisted by Frank Lahey (a world-reknowned abdominal surgeon) Richard Cattell (Lahey's number 2 and head of the clinic after Lahey's death in 1953) and Isador Ravdin (renowned surgeon from the University of Pennsylvania who later operated on Dwight Eisenhower's ileitis. Ravdin had been stationed in Burma (where he treated Mountbatten), but did return to the US once in 1944).

By all reports, the surgery was "open and close" after the discovery by the surgeons of widespread abdominal and liver metastases.

No, we can't prove it, though the records are probably sequestered in the Boston area. Let's just call it "educated speculation".

Reviews of Our Book

Aside from what appears to be a viscious and intentional effort to reduce our book sales on Amazon.com (you see we are conspriracy theorists after all!), the overwhelming majority of reviews have been favorable. We have yet to hear from a single expert specialty physician who has controverted our scenario in any significant way.

“An engrossing medical biography. … Given what we know now about cancerous lesions and the dangers of malignant melanomas, the authors make a plausible case. ... Their work is buttressed by an array of private notes and diary entries from those who dealt with Roosevelt in the White House and were alarmed by what they saw but did not publicize.”—David Shribman, Wall Street Journal

“The authors present their material in an engaging, though not sensationalistic manner. As a result, 'FDR’s Deadly Secret’ will find a wide following among those interested in one of American history’s most compelling medical mysteries." -- Claude R. Marx, Boston Globe

“The most provocative evidence the authors present is that Roosevelt had a left-sided hemianopia — a loss in vision — toward the end of his life. This indicated a mass in the right side of his brain. Lomazow and Fettmann arrive at this conclusion based on an ingenious bit of research.” – New York Times Week in Review

“[An] astounding argument…If Lomazow and Fettmann are right, Republican Thomas E. Dewey or a different Democrat should have been elected president in 1944. In that case, Harry S. Truman, FDR's vice president, would almost certainly not have been commander-in-chief from 1945 to 1952. The Cold War and subsequent American history might have taken a very different path. Lomazow and Fettmann's research is of great importance.” – Dr. Barron H. Lerner, Slate

“An increasingly feeble and distracted FDR died in office and was succeeded by Harry Truman, who performed well as the 33rd president. But this chilling new book by Eric Fettmann and Steven Lomazow reveals that America had a narrow escape. … The point of this well-researched book is not to score points off a deceased president, but to assert the vital importance of honesty in discussions of presidential health.” — Geoffrey Wawro, University of North Texas, History Book Club and Book of the Month Club

“This is a superior addition to the diseases-of-famous-men genre. … Journalist Fettmann and neurologist Lomazow assert that they’ve discovered the true cause of FDR’s 1945 death … We will never know the truth, but the authors make a reasonable case.” – Publishers Weekly
“Effective and thought-provoking ... easy to entertain the authors’ charges of a medical cover-up ... intriguing.” -- Kirkus Reviews

“Readable and interesting and should appeal to both specialists and the general public. Recommended.” – Library Journal

"Fascinating and grisly ... graphic and telling ... If Roosevelt was suffering from even a fraction of the diseases Lomazow and Fettmann say he was, the disclosure ... at the very least casts Roosevelt's presidency in a new light." -- Ira Stoll, Commentary

"A persuasive case ... The documentation the authors cite is thorough enough to be compelling. ... [A] meticulously pieced-together case study." — Elizabeth Lopatto, Bloomberg News
"Well-told ... The authors make a good case for their thesis ... Lomazow and Fettmann have gone as deeply into the medical evidence as is possible, and produced a convincing sidelight to history." — Palm Beach Post

"‘FDR's Deadly Secret’ documents a pattern of deceit about the president's health." -- Glenn C. Altschuler, Tulsa World

“Historians and lovers of history might smother their valentines with kisses if they receive Steven Lomazow and Eric Fettmann’s ‘FDR’s Deadly Secret’ today. … ‘FDR’s Deadly Secret’ will likely be fodder for those who believe FDR was impaired when he went to Yalta to meet with Winston Churchill and Joseph Stalin near the end of World War II.” — Howard Dukes, South Bend (IN) Tribune

“A lively and readable account of a fascinating subject and, taken for what it is—a strong possibility rather than a slam dunk—its argument is a valuable contribution to presidential history.” — Martin Rubin, Washington Times

“Lomazow and Fettmann are right that this ancient history matters. It raises anew the moral argument over whether a political leader has any right to medical privacy.” — Brian Bethune, Macleans

"An extraordinary medical detective story that will force some re-evaluation of the nation’s longest-serving president. ... 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."—Barry Casselman, Racefor2012.com

Our article in Neurology Today. What was FDR's Deadly Secret?

The currrent issue of the American Academy of Neurology publication Neurology Today contains a long and well-written article on our book.

http://journals.lww.com/neurotodayonline/Fulltext/2010/02040/What_Was_Franklin_D__Roosevelt_s_Deadly_Secret_.13.aspx

Response to a comment.

This comment was left by an anonymous reader but since it epitomizes many that have been posed, I felt compelled to address it.

The commentors remarks are in regular type and I have interjected my answers in Italics.

Anonymous has left a new comment on your post "FDR's Deadly Secret.":

i found this subject most interesting but it will prove a frustrating thesis due to lack of definitive proof....however that does not mean that we cannot know....

i was surprised to learn that fdr was a frequent visitor to bethesda naval hospital and needed 9 pints during a blood transfusion...

the nine pints (and possibly more) were administered not in one session, but over a period of two months. These are only the ones that we can prove with certainty

of interest is why there was no autopsy of roosevelt and why all of his medical records were destroyed....bethesda surely has some for which an enterprising investigator should submit a foia request to have those records released....

No autopsy was performed because it would have revealed many facts about FDR's health that were hidden then and many that are still hidden today. There have been many FOIA (freedom of information act) requests over the years, a nunber of which have reavealed considerable information, vis a vis those of Kenneth Crispell and Carlos Gomez in 1981. Virtually every Roosevelt historian interested in pursuing FDR's health has gone down this avenue. There is very little that can be accomplished with further requests.

a medical file as deep as fdr's does not just disappear without concerted help...

quite true indeed. See: Ross T. McIntire and Howard G. Bruenn

a cranky reviewer on amazon suggests that fdr's reading by hand was due to failing eyesight - astigmatism from old age and that he had used that method since 1938 rather than de novo during the congressional report as this book reports although the reviewer offers no proof about the old age causation.

the reviewer you mention is a non-physician with an obvious desire to discredit the book. his ideas about failing eyesight are laughingly inept. Our conclusions are based on four years of intensive research in consultation with hundres of top physicians. I am a board certified neurologist and stand by my findings without qualification. If the commentor can produce a single expert of equal standing, I would be more apt to listen. To this point, none of the hundreds of my colleagues have found reason to dispute my findings.

this same reviewer mentions that fdr's paralysis was due to Guillain-Barré syndrome rather than polio and that the blood transfusion could have been due to diverticulitis....again no proof was offered....

See our blog post that discusses Guillain Barre Syndrome. FDR had polio. Likewise, the diverticulitis theory has been discussed with dozens of board certified gastroenterologists and surgeons and is not the reason for the GI bleed.

this book covers an excellent subject and should not be dismissed out of hand as some know-nothing types are wont to do...

Thank you!

Our Page in the Current Issue of History Book Club Magazine

Click on the image to read.

Yet Another Stunning Report of Roosevelt's Seizures and Disability

This report comes from an oral history taken for the Herbert Hoover Presidential Library on December 1, 1969 of Walter S. Robertson, a senior offiical in the state department. The document is 28 pages in length. The following begins of page 24:

"I had been out in Australia for two years and I was coming home to go over to the State Department, and I went by to tell him (General Douglas MacArthur) goodby. I haven't seen this in print anywhere. The man who collected General MacArthur's papers probably doesn't know it ever existed. I'm telling you of a personal conversation I had with him on August 1, 1944. As I went in he greeted me and said. "You can't guess where I've been." He said, "I've just come back from a meeting with the President in Honolulu." It was a secret meeting, it later came out. He said: "He asked me to come to meet him there, and I hadn't seen Franklin Roosevelt for X-number of years" -- I forget how many -- he had been out in the Phillippines and then down to Australia. And he sais, "I was so shocked when I saw him. He's a doomed man." He said: "Before, he was this dominant personality that dominated every conference he was in." He said: He sat there, and his head bobbed up and down, and his mouth sort of hung open. Admiral Leahy was his aide, and we talked." However, I don't think I'll put on the record what he said. And he said "You can't guess what he wanted of me," and then he told me. But then he went on to say: "If he lives until November, he will be elected President of the United Sttaes, but whoever is elected the Vice President of the United States will serve his term. He's an ill man and don't you be surprised to hear of his death at any moment," But Roosevelt did go back, he went to his doctors and they said he was all right, and he ran. Then when they inaugurated him in January they propped him up -- the doctors saying he was all right. He was inaugurated in January and was dead in April. But Douglas MacArthur told me in his office in August '44 not to be surprised at his death at any moment. I'll tell you off the record -- I won't put in on tape -- what it was the President . . . (machine turned off)

This is but one of dozens of similar accounts, though perhaps one of the most graphic and one of the earliest, of the degree of medical problems FDR was experiencing. This is the first account I've seen of MacArthur's comments from his meeting with FDR in Honolulu.

To recount, other graphic reports of his seizures come from: Anna Roosevelt Halsted, Frances Perkins, Senator Frank Maloney, future NYT editor Turner Catledge, to mention only a few.

As stated in the book, these seizures most probably came from a stroke as a consequence of vascular disease. The visual deficit seen after January 1945 was more probably related to a brain metastasis from melanoma as was the fatal brain hemorrhage on April 12th 1945.

I will leave it to you to judge the impact of these astounding findings on the course of history.

When did they know? Connecting more dots.

I have previously posted a photograph from LIFE magazine, published in 1937, with a caption that stated FDR had been avoiding photographers for four days for a "sty" that in his eye that I subquently found to be his left eye, raising the question as to when they really knew of the malignant potential of the lesion. There is now some further evidence to report.

In my recent conversations with Dr. Pack's close confidante, Dr. Oropeza, he told me that Pack told him that they were following the lesion for "about ten years" and that it was a "Hutchinson's Freckle" that eventually turned malignant. As you can read in my paper with Dr. Ackerman, that was exactly the thinking in the 1930's.

Re-reading Dr. Harry Goldsmith's book, which is full of stories collected in the early 1980's akin to the ones I am getting now, he recounts on page 70-71 his conversation with Dr. Harry Ungerleider, a retired physician who had examined FDR in 1935 and found a "medical problem" during an insurance exam, after which, because he refused to release the information to government agents, he was hounded by the FBI and IRS to the point that he personally burned the file.

Are Doctors Oropeza and Goldsmith making this up? I think not.

Connecting Dr. Oropeza's story with that of Dr. Ungerleider, there is a suggestion that what the latter physician noted was the pigmented lesion above FDR's left eye.

This is all admittedly incredibly speculative and circumstantial but, if true, dates the problem prior to the second term, during the time when Cary Grayson was still alive (and probably calling the medical shots).

I could never assert with any reasonable probability that the lesion was diagnosed this early, but, knowing the case as I do, my gut feeling tells me that it was.

Knowing more about FDR’s Health. Why does it matter?

Since publication of our book, perhaps the most frequent question I am asked is “Even if we now know FDR died of cancer, what’s the difference? This sentiment even rose to the level of a bad joke in the opening monologue on a recent Jay Leno show.

If one is to believe the conventional wisdom as espoused by the editors of the Annals of Medicine in the accompanying editorial to Howard Bruenn’s 1970 paper “We are given, by Dr. Bruenn, the picture of a great and gallant man, fatigued by the burdens of his office and by his hypertension and reduced cardiac reserve, yet quite able to exercise his judgment and to use the fruits of his unique knowledge and experience in guiding the war effort”, then the findings in each and every historical treatise about Roosevelt and his policies since this time should be considered valid. In fact, the reality of FDR’s health and the consequences of it upon his behavior and decision making are a far different story.

It is quite evident, despite the protestations of Howard Bruenn to the contrary, that FDR was well aware of his diagnosis and prognosis prior to accepting the 1944 Democratic nomination for president (we believe he knew it prior to the third term). The Lahey memorandum makes it clear that the president was informed, in no uncertain terms, on July 7th 1944, that he would not survive a fourth term. This had to have had a tangible effect upon Roosevelt’s thought process going forward, especially in light of the fact that he had personally witnessed the decline of Woodrow Wilson and the consequential failure to establish a successful world peace organization due to his marked infirmity. Roosevelt had a close personal relationship with Wilson’s physician, Cary Grayson, and the very same person who administered daily physical therapy to the hemiplegic Wilson, George Fox, later became Roosevelt’s daily personal medical assistant as well.
The establishment of the United Nations dominated Roosevelt’s thinking in the last year of his life. It is easy to see how different his approach might have been with an unlimited amount of time as opposed to the reality of his knowing of his race against death. How much did he then appease Stalin, whom he considered essential to any success?

By 1945, Roosevelt was barely functioning. Was he unable to comprehend the legitimacy of a Japanese peace offer brought to him in January 1945 by MacArthur? If he pursued it more vigorously would we have been spared the loss of hundreds of thousands of lives at Iwo Jima and Okinawa? Would it have been necessary to use atomic weapons in Hiroshima and Nagasaki?
If Roosevelt was able to focus on the information brought to him in March 1945 by General Albert C. Wedemeyer (who wrote he was in “never-never land”) about the future of China, or if he heeded the warnings of Governor George H. Earle about Stalin (instead of exiling him to Samoa) would there have been a Korean war? Would there have been a war in Vietnam? Would there have been a cold war?

All of these questions must now be revisited, based on the enhanced knowledge we now have about the thinking process and mental capabilities of the man responsible for making the most important decisions.

The cadaverous images of the cachectic Roosevelt at Yalta and the dozens of reliable reports of his diminished ability to function in the last year of his life are largely attributable to diseases not at all addressed until now.

So does it matter? Yes Mr. Leno, it surely does.

Our Letter to the Editor of the New York Times

In the extensive article devoted to our book “FDR’s Deadly Secret” (Science Times, January 5th), Lawrence K. Altman implies that we may not have adequately “fact-checked”. The case we have laid out is a result of four years of painstaking research. It is the consummation of the prevailing opinions of hundreds of highly trained physicians, across many disciplines, to whom we have presented our findings at many of America’s finest institutions of medicine including Harvard, Columbia, Mount Sinai, SUNY Albany and in the inaugural lecture of The Surgeon General’s Lecture Series at the Bethesda National Naval Medical Center.

As to melanoma, we consulted with the “legendary” Dr. A. Bernard Ackerman (as the Journal of The American Academy of Dermatology called him on the occasion of his 70th birthday) with whom I co-authored a paper in Archives of Dermatology after we examined many hundreds of photographs at the Franklin Delano Roosevelt Library at Hyde Park. In their abstract, the editors of this esteemed publication wrote “the lesion, when fully developed most closely resembled a melanoma with central regression”. This is reflective of the degree of care and high level of expertise utilized in all of the material presented.

Nor are all of our findings speculative. That Roosevelt suffered a near-fatal gastrointestinal bleed in 1941 requiring at least nine previously unreported transfusions over two months is an absolute certainty. That he suffered frequent and clinically evident seizures for over a year before his death goes well beyond any reasonable doubt and the evidence presented that presidential cardiologist Howard Bruenn’s 1970 paper is less than an unimpeachable or unbiased source is overwhelming.

As my colleagues in the top echelon of the various specialties that deal with the panoply of pathology that FDR manifested publicly weigh in, it will provide even more reinforcement that our findings are consistent with the highest levels of present-day medical reasoning.

Our book unequivocally states that we cannot prove our hypothesis with absolute certainty absent the presence of tissue or medical records. This does not, though, require that we continually qualify every observation and statement as we present it. We hope that those who offer future critique will do so only after thoroughly reading the entirety of what we have presented, in both the book and our blog www.fdrsdeadlysecret.blogspot.com, the latter containing a wealth of corroborative and supplementary photos, videos and documents that we were unable to include in our original thesis.

“FDR’s Deadly Secret” is, by any measure, the most comprehensive discussion of the health of our thirty-second president. The enhanced knowledge of the facts of FDR’s health that we provide will permit historians to more accurately assess this highly-important and often controversial American persona.

Steven Lomazow, M.D.
Eric Fettman

What Caused the 1941 GI Bleed?

In some measure, I am publishing this post to illustrate the degree of thought that went into "FDR's Deadly Secret" and to show that our conclusions are not made flippantly are as part of a loosely constructed "conspiracy theory". I also wanted to emphatically answer Dr. Altman's inference in Science Times that we may not have "fact checked".

Our conclusions are based on sound medical reasoning backed by years of intensive research. As David Shribman so eloquently concluded in his review of our book in The Wall Street Journal, more information is better than less!
http://online.wsj.com/article/SB10001424052748703580904574638352930354872.html

So what follows is probably more than you ever wanted to know about the secret medical life of FDR.

While our book devoted considerable space to FDR's May-July 1941 lower GI bleed (and reveals for the first time that there is unequivocal objective evidence for at least nine transfusions), a detailed discussion of the differential diagnosis was felt to be far too technical and speculative to discuss there. This blog is a better forum.

Ever since the analysis of the laboratory reports in the Anna Halsted file at the FDRL revealed the details of this nearly catastrophic event, I have been trying to arrive at a reasonable answer as to its cause. This has led to study in the areas of gastroenterology, urology, radiation oncology and medical history that have been both instructive and fascinating to this neurologist. I have consulted with dozens of highly trained physicians in various disciplines and spent many hours of independent research in an effort to reach the most plausible conclusion.

This post may be too technical for the non-physician, but I think my colleagues in the medical profession will find it fascinating. We have a remarkably large amount of objective laboratory evidence from this incident to work with. Just why Ross McIntire chose to preserve this material and send it to Mrs Roosevelt in 1957 is not entirely clear, but one can hazard a guess.

1) Eleanor Roosevelt was already aware of the specific details (down to the actual lab numbers) of this episode. Whether it was FDR himself or Ross Mcintire that told her is unclear, but her letter to her daughter, as seen in Bernard Asbell's book (the original letter personally examined at the FDRL) is absolute and specific.

2) Perhaps McIntire kept them as a reminder that he almost lost his star patient at the time. As we say in the book, this is the only incident where poor medical follow-up can be documented. All the rest (missing obvious heart failure, the cardiac consult motivated only after the family insisted) are a part of Howard Bruenn's 1970 fairy tale.

3) There is no link apparent link to the deadly secret that one can connect with these lab results. though, as you will see, there may be one indeed.

You will also see that volume and type of medical testing done suggests that the etiology of the problem was probably a mystery even to FDR's physicians at the time.

Now the facts:

FDR's hemoglobin was 13.5 in March 1940, shortly after returning from his second two-week "mystery cruise" aboard the USS Tuscaloosa. At the time, he was out of the public eye for at least two additional weeks, cancelling 3 or 4 press conferences, with a cover story as told by Steve Early to the press that he had "Swamp Fever".

The following 4 photos are from Steve Early's scrapbook at the FDRL. See for yourself!

While there are urinalyses seen from this time and the succeeding months, the next hemoglobin we have is 4.5 on March 5 1941, the day after he returned from Staunton Virginia. (I was just in Staunton to do research at the Wilson Library and the director told me that FDR was reported to look pretty bad on that day, understandable considering that he only about a third of his normal blood volume.

The indicies from the May 5th lab report show a chronic process. Since this number apparantly caught them by surprise, it is fair to surmise that the bleeding was slow and not noticed by FDR or his daily attendants- George Adam Fox, his "physical therapist" who was McIntire's right hand man and Arthur Prettyman, his valet, to whom most probably fell the task of helping FDR on and off the john and cleaning up after it.

Existing lab reports reveal the following-

1) normal upper and lower GI contrast studies. Dr. Behrens remarks that there may have been a silght abnormality in the area of the cecum (possibly due to FDR's 1915 appendectomy), but the study was interpreted as normal.

2) Entamoeba Coli, a benign one-celled parasite, reported in stool for ova and parasites.
3) Normal blood chemistries, other than a low chloride.
4)Persistent low-grade proteinuria.
5)Negative studies for hemolysis.
6)A grossly bloody stool (bright red in color) on two occasions in July.

7) At least nine well-document sudden rises in hemoglobin between May and July 1941 for which there is no other reasonable explanation than transfusion.

Here is a compendium of all the lab work from this time.

http://www.scribd.com/doc/20430562/FDR-s-Weight-Chart-and-1941-Bloodwork

All this comes together as a chronic lower GI bleed with a documented loss of 9 grams of hemoglobin in 14 months with ongoing blood loss for two months requiring at least nine transfusions until the patient was apparantly stabilized.

This is beginning to look very much like a classic New England Journal of Medicine CPC, I'll bet you didn't know that there was actually one done in that esteemed journal for the case of Eleanor Roosevelt, after her unexplained death (from undetected miliary tuberculosis). Unlike FDR, medical reports of ER's final illness and autopsy (FDR never had one, its easy to understand why) are completely transparent, authorized to be released by the family and contained, in graphic detail, at the FDRL.

Differential diagnosis:

The most common cause of lower GI bleeding fitting these criteria would be colon cancer. The negative contrast study and the four year survival speaks loudly against this probability, as it does for bowel metastases from melanoma (see 1943 for this one!). Probably next in order of common causes would be diverticuli. This would not be completely excluded with a negative lower GI study, but I am told that the bleeding in this instance is generally paroxysmal and would most probably have been noticed. Remember, the hemoglobin of 4.5, unlike FDR's fatal brain hemorrhage, really did come as a "bolt out of the blue", completely unnoticed until FDR basically collapsed.

One thing this wasn't was hemorrhoids, the cover story. I've yet to find a single physician who doesn't chuckle when presented with the facts and the wholly untenable diagnosis. Even small amounts of bleeding from hemorrhoids (or other rectal pathology such as fissures) is eminently noticable and easily correctable. To lose nine gram of hemoglobin (8 pints of blood) by this route in a little over a year, not to mention in the POTUS, is a virtual impossibility. How this never got challenged until this time is mind-boggling but, of course, how a cosmetically significant "brown blob" over FDR's left eye could disappear without mention in two years is equally remarkable.

There aren't really too many other common causes, so this takes us into the "zebras".

Here is my best (highly educated) guess: radiation bowel disease. This comes from studying the history of the treatment of prostate cancer as best summarized in a wonderful May 2002 article by Samuel R. Denmeade and John T. Isaacs in Nature Reviews. Cancer (also remember that FDR's radiologist, Charles F. Behrens, literally "wrote the book" on the effects of radiation on the body).

http://www.scribd.com/doc/25010145/Prostate

In 1941, Charles Huggins and Clarence Hodges published that prostatic cancer is influenced by androgenic (male hormonal) activity, using the level of an enzyme in the blood, acid phosphatase, as an objective measure. In the same year, Huggins’ classic paper described the effective use of surgical and/or chemical castration with the administration of oral estrogen. This was the first systematic approach to the treatment of Prostate cancer and earning Huggins a Nobel Prize in 1966.

Prior to Huggins’ seminal work, brachytherapy, the surgical implantation of radium into prostate through the perineum (the area between the base of the penis and rectum), bladder or rectum was the treatment of choice. It was uncomfortable and technically difficult and rapidly fell out of favor after hormonal therapy was introduced. Prostatectomy was used mostly as a palliative measure until its technique was improved by Terrence Millin in 1945.

Though obviously speculative, the timeline of the advances in medical and surgical treatment at the time of Roosevelt’s illness fits quite well. One of Roosevelt’s frequent prolonged absences from public view, such as the "mystery cruise" or the “swamp fever” that followed would have sufficed to perform and recover from the relatively minor surgical procedure of radium implantation. Likewise, the lower gastrointestinal bleed that resulted in a loss of two-thirds of FDR’s blood between March 1940 and May 1941 would be explained by the well-recognized complication of radiation bowel disease, as would the laboratory evidence consistent with a subsequent radiation nephritis.

This also explains the well-documented presence of urologist William Calhoun Stirling, who was on the scene according to Walter Trohan and Stirling’s soon-to-be estranged daughter, at least as early as 1942. Stirling would have overseen any hormonal therapy and the tentative surgical procedure referred to in Trohan’s important 1975 book “Political Animals”. The recommended procedure could easily have been an orchiectomy. (By the way, Trohan’s 1975 memoir has been been almost completely overlooked by scholars, probably since it is not indexed, to the point that even the incredibly comprehensive archive at the FDRL didn’t have a copy (they do now, courtesy of yours truly). It is an important resource and a unique and critical look into FDR like no other).

My co-author, a non-physician, cringed at the prospect of even mentioning the possiblity of removing FDR's testicles, but that's the stark reality of real medicine. If FDR thought that a cutting edge procedure would prolong his ability to remain in power, he probably would have done it. The whole prostate scenario also gives us some insight into FDR's ability to perform sexually. He was sexually active (probably exclusively with Missy until her stroke) and here is the evidence (note another of the thirty or so aliases)!

For the uninitiated, "motile organisms" are sperm.

In keeping with the highly confidential and sensitive nature of any treatment for prostatic disease, there is no laboratory evidence of acid phosphates levels but this surely would have been available to Mcintire’s board of consulting physicians. There is no reason whatsoever to believe that a competent urologist such as Stirling would not have employed the most advanced measures to treat the world’s most important patient. Even the anticipated operation allegedly described in 1945 by Eleanor to Veronica Lake correlates well with the onset of the newly described advances in surgical prostatectomy.

There's a lot to digest here, but I'm glad for the opportunity to get it into cyberspace. I remain intensely interested in communicating with any physician who might be able to offer additional insight into the etiology of this event, since, despite the educated speculation above, the actual reason for the problem has yet to be determined with reasonable medical certainty.

Thanks.

The Gospel According to Bruenn.

Here is my article that recently ran on http://www.hnn.us/.

http://hnn.us/articles/120718.html


Some people think that this is a snipe at Dr. Bruenn and that I am trying to demean his reputation. Nothing could be farther from the truth.

Howard Gerald Bruenn was a doctor's doctor and, by all reports. a superb and cutting-edge cardiologist at the the time the specialty was in its infancy. It was for this reason that he came to the attention of Ross Mcintire, who entrusted him above all others with the health of the world's most important patient. I have previously publicly and vigorously defended Ross McIntire, who has been villified as a liar, an incompetent and even a "medical ignoramus" (by the highly regarded historian, Thomas Fleming) in an article I wrote for Navy Medicine.

http://www.scribd.com/doc/20281239/Navy-Med-Article

That Howard Bruenn fell under the spell of the most charismatic person of the 20th century is not surprising. He lived with the man for over a year and professed to Daisy Suckley on March 31st 1945, a mere two weeks prior to FDR's death:

“Miss Suckley, to begin with, you realize that like all people who work with this man – I love him. If he told me to jump out of the window, I would do it, without hesitation.”

Bruenn's role as keeper of FDR's deadly secret goes to the larger question that has been and will be debated in the future: the role of a presidential physician to balance the confidentiality of his patient and the welfare of his country. When Roosevelt was alive, it came straight from the top and after he died, both Mcintire and Bruenn's loyalty remained with FDR's wishes.

If I had cardiac disease, I could only hope to find a personal physician with the competence and ethics of Howard Bruenn. To expose the truth about FDR, and he surely could have done it, was against all that Howard Bruenn was about- the loyalty, competence and ethics of the medical profession that, quite frankly, only a well trained physician can fully appreciate.

I recently had lunch with an internist who practiced with Bruenn for many years, who told me his work was always scrupulously documented and meticulously comprehensive. Not at all surprising for one of America's best clinical cardiologists.

My paper on FDR in Journal of Medical Biography. Additional comments on FDR and Guillain Barre Syndrome (GBS).

Here is a pdf file of my paper "The Untold Neurological Disease of Franklin Delano Roosevelt" in the current issue of the well-respected British Journal of Medical Biography.

http://www.scribd.com/doc/24896077/jhm


The editor is a neurologist, Christopher Gardner-Thorpe. I chose to submit this work to JHM because it had previously published Armond Goldman's article on FDR in which he opined that Roosevelt's polio was actually Guillain-Barre Syndrome. That article garnered, and continues to garner, considerable attention. I have seen it referred to in a number of comments surrounding our book.

http://www.scribd.com/doc/25009888/fdr-gbs

To address that question:

I had the opportunity to get into the Robert Lovett papers at Harvard, which I, in turn, had sent in toto to the FDRL where they are now available on microfilm. In the file, there is a note from Lovett that reveals that FDR probably had a spinal tap at the outset of his 1921 illness (in fact, there is evidence that FDR later underwent a second spinal tap to donate his serum to other victims of Polio, since it was then believed that the spinal fluid of polios was therapeutic. Such was his dedication to curing the disease).

GBS was described in 1916 and Lovett (as many of FDR's later physicians) being the world's leading expert on Polio would surely have known how to differentiate the two. Unfortunately he died unexpectedly in 1924, leaving FDR to find another guru who eventually turned out to be Dr. McDonald. As I have stated at other times, the world's leading expert on polio in the late 1920's was none other than "Doctor" Franklin Delano Roosevelt, who, had he not chosen to re-enter public life, would have surely spent the remainder of his days at Warm Springs, promoting his rehabilitation center and treating fellow polios- so much for Howard Bruenn's 1970 myth that FDR did not care about his health!

The bottom line here, is that Lovett would surely have known that a spinal tap would unequivocally differentiate between the two diseases (polio has white cells, GBS high protein) and most probably knew the results (as undoubtedly did FDR himself). It can therefore safely be inferred that FDR's 1921 neurological illness was indeed polio.

Despite Goldman's sound academic treatise, based largely on a statistical analysis, he was not privy to the fact of the spinal tap (at least, he didn't cite it in his references). This, aside from the facts that the degree of atrophy, the muscle tenderness at the outset of the disease and the perfect timing for the incubation period between FDR's well known visit to the Boy Scout camp and onset of his illness are all most compatible with polio, all lead to the inevitable conclusion that FDR's 1921 illness was poliomyelitis.