- The Washington Times - Monday, January 11, 2010

ANALYSIS/OPINION:

FDR’S DEADLY SECRET

By Steven Lomazow, M.D. and Eric Fettman

Public Affairs, $25.95, 259 pages, illus.

Reviewed by Martin Rubin

The story of just how ill Franklin Delano Roosevelt was during his presidency - and especially in its final year - is not a new one. Not only was the full extent of his disability from polio not known to most people, but it was revealed two decades after his death in 1945 that he had in fact already been desperately, terminally ill with heart failure when he ran for that unprecedented fourth term in 1944. Now along comes this book claiming that even the story of coronary disease was a cover of sorts: that FDR was actually dying of cancer, specifically a malignant melanoma which had metastasized to his abdomen and brain, in addition to heart disease.

Why should this matter in any case? There is always a certain amount of prurient interest in ghastly medical stories and tragedies waiting to happen - such is human nature. But the question of the health of a national leader and its effect on public policy is an infinitely complex and important subject. “FDR’s Deadly Secret” focuses chiefly on the narrowly medical aspects of the president’s case, but its authors are careful to frame their discussion within the wider contexts. They explore the question of just whom the presidential physicians are serving: the office holder or the individual? To whom do they owe their duty of loyalty: a person entitled to his privacy like any other patient or the government or indeed the nation he leads?

These questions open up truly fascinating lines of inquiry and the book ranges back to previous presidential medical cover-ups: Grover Cleveland’s cancer operation and Woodrow Wilson’s disabling stroke, both instances where doctors protected the patient’s privacy pretty much to the exclusion of any other considerations. So there were certainly precedents for what went on with FDR. The authors explore the increasing revelations concerning presidential health scares seen in particular with presidents Eisenhower and Reagan, but also show that even in these more open administrations, there were omissions, to say nothing of the total cover-up involving John F. Kennedy’s Addison’s Disease.

But certainly the question remains: Could FDR conceivably have been re-elected in 1944 if voters had understood the gravity of his medical situation, cardiac or otherwise? And, of course, the even bigger question of whether his health - including the fatigue associated with its breakdown - affected his conduct of state affairs?

On the subject of the agreements reached at Yalta, the authors quote the president’s comments to Adolph A. Berle that it was not a good result, but simply the best that he could achieve. This shows some insight and certainly realpolitik, but also leaves open the possibility that it was the presidential exhaustion rather than the geopolitical situation at that moment in history which produced a result that even he knew was unsatisfactory.

“FDR’S Deadly Secret” does provide a wonderful portrait of the man at the center of this story. Inevitably, though, as is always the case with such larger than life characters, readers will take from it differing conclusions depending on their point of view. Admirers of the president will see a beleaguered courageous man struggling to do a superhuman job with gallantry, despite progressive disabilities and sufferings worthy of Job. Critics will see a power-hungry megalomaniac determined to keep his hands on the tiller whether or not he was capable of guiding the ship of state the way he had once been able to do. Where some will see his blitheness as magnificent, others will simply see overweening and fatal hubris.

It’s fascinating also to discover through a book like this just how quickly medical regimes can change. Whatever else might be said about FDR’s medical care, it was in accordance with the highest standards of the time, directed in particular from the cutting edge Mayo Clinic. But only a scant decade before President Eisenhower’s heart attack and the postwar obsession with low-fat diets, what are we to make of what was considered appropriate for a patient with advanced coronary disease? The most important point apparently was to avoid spicy food, lest it put too much strain on the heart. So FDR was fed a “light diet” featuring such dishes as “Cream Toast,” i.e. white bread toasted and soaked in heavy cream.

Consider the meal he ate a week before he died, as reported in this book: “An excellent dinner: a very rich mushroom soup, scrambled eggs and bacon, peas, stewed peaches and cream.” Not many years later, feeding such a meal to a patient with advanced cardiac disease would have been considered tantamount to murder.

The authors of this book are clearly convinced of their hypothesis and they construct a plausible case that the longstanding dark lesion removed from FDR’s eyebrow had become a metastatic melanoma. But there really is no smoking gun here: What they say might well be true - their speculation is informed by a great deal of medical expertise, one of them being a distinguished physician and professor of neurology - but their argument is not in the end conclusive. There are too many other medical explanations for incidents they cite, and in particular, they do not take sufficient account of the deleterious effect of FDR’s polio on his constitution. They are so intent on building their case that they have tunnel vision.

But their book is nonetheless 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 is a writer and critic in Pasadena, Calif.

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