At first glance, Bruenn also observed that Roosevelt was having difficulty breathing. The mere act of moving from one side to the other caused considerable breathlessness. Working quickly and methodically, the young doctor put his hands on the president’s chest and listened to the sounds of his heart. “It was worse than I feared,” he recalled.
The examination revealed that the apex of the heart was much farther to the left than it should have been, suggesting a grossly enlarged heart. If the heart is under increased blood pressure, as Roosevelt’s apparently was, one of the first things it does is to increase its size. Bruenn asked his patient to take a deep breath and hold it as long as he could. Roosevelt expelled it after only thirty-five seconds. In the president’s lungs, Bruenn heard rales, an abnormal rattling or bubbling sound indicating a dangerous buildup of fluid.
In the midst of the exam, the medical records finally arrived. Bruenn covered the president and excused himself for a moment. Reading swiftly, he noted that high blood pressure had been detected as far back as 1941 (188/105mm). Why McIntire had not called in a heart man earlier was incomprehensible to Bruenn. In the interim, much damage had been done. Roosevelt, Bruenn concluded, was suffering from congestive heart failure. His damaged heart was no longer able to pump effectively. Left untreated, Roosevelt was unlikely to survive for more than a year. And in 1944, the therapy for hypertension was limited.
Bruenn never said a word to Roosevelt of the dark thoughts that were filling his mind. McIntire had instructed him not to volunteer any information to the president. Nor did Roosevelt ask a single question about what Bruenn was finding. On the contrary, throughout the entire exam, Roosevelt chatted genially about a range of topics totally unrelated to his health, and when the exam was finished, he smiled his famous smile and extended his hand. “Thanks, Doc,” he said, and then he was gone.
Yet, at some level, Roosevelt must have felt relief in knowing that someone other than he was worrying about what was going on. Though he could not bring himself to ask the questions aloud, he must have harbored terrible fears and frustrations as he found himself unable to sleep at night and too tired to work during the day. At least now something would be done.
At his regular press conference later that afternoon, Roosevelt was asked about his health. Smiling broadly, he said that he had been suffering from bronchitis for the last three weeks but otherwise was fine. He then coughed and patted his chest to demonstrate how it affected him. Asked if he was alarmed by his condition, the president said he’d been told only one of 48,500 cases of bronchitis might develop into pneumonia, so he thought he had a rather slim chance. So effective was Roosevelt’s upbeat performance that reporters concluded that his bronchitis had been whipped and that he was feeling fine. “Not only were the President’s color and voice better,” The New York Times observed, “but his spirits were good, too.”
When Roosevelt returned to his study after the press conference, Eleanor and Anna were there. Eleanor was in high spirits. Her Caribbean trip had been an unqualified success; her meetings with the soldiers had gone well, and her press coverage had been triumphant. There was much to tell her husband, but first she had a present for him, a souvenir to add to his collection of ships. It was a little model of a jangada, a raftlike native boat used by the fishermen at Recife, Brazil. Pleased with his gift but too tired to talk, now that he no longer needed to perform, Roosevelt retired to his bedroom at seven-thirty.
Dr. Bruenn reported his alarming findings to Dr. McIntire the following day, along with a memorandum of recommendations, including complete bedrest for seven weeks with nursing care, avoidance of tension, digitalis, a change in diet to restrict salt and to lower calories, and the use of an elevated Gatch bed to relieve breathlessness at night. “McIntire was appalled at my suggestions,” Bruenn recalled. “The president can’t take time off to go to bed,” McIntire insisted. “You can’t simply say to him, Do this or do that. This is the president of the United States!”
To shore up his position, McIntire called in a team of consultants, including Dr. John Harper, Bruenn’s commanding officer at Bethesda, Dr. James Paullin of Atlanta, and Dr. Frank Lahey of Boston. They were shown the X-rays, electrocardiogram, and other laboratory data, and Bruenn was asked to present his recommendations. The seniors disagreed emphatically with Bruenn’s diagnosis; after all, someone said, McIntire had been examining the president for years; it was simply impossible to imagine that Roosevelt had become this gravely ill overnight. As for Bruenn’s drastic recommendations, the only one that they supported was the installation of a Gatch bed, which allowed the head to be elevated.
“I was only a lieutenant commander,” Bruenn said. “McIntire was an admiral. Harper was my boss. But I knew I was right, so I held my ground.” Finally, McIntire agreed to let Paullin and Lahey examine the president later that afternoon; discussions would resume the following day.
After seeing the president, Dr. Paullin announced that he now agreed with Bruenn’s diagnosis and would approve a cautious program of digitalization to tone up the heart muscle and strengthen it. “Digitalis was a miracle drug,” Bruenn observed later. In 1944, however, it was difficult to calibrate the amount of the digitalis leaf that would produce a therapeutic versus a toxic effect. “The risk,” Bruenn admitted, “was that overdosage could lead to nausea, loss of appetite, and further damage to the heart.”
Dr. Lahey apparently came away from the exam with a different set of concerns, centered on the president’s gastrointestinal tract. It is not clear exactly what worried Lahey, but Dr. Harry Goldsmith of Massachusetts, who has plumbed the question of Roosevelt’s health for more than a decade, believes that Lahey may have found an inoperable malignant tumor in Roosevelt’s stomach. The cancer may have started, Goldsmith suggests, in a mole over the president’s left eye, or in a wen that had been removed from the back of his head earlier in the year and then metastasized to his stomach.
However valid Lahey’s line of inquiry may have been, the discussion quickly returned to the president’s heart. The doctors finally agreed on a scaled-down version of Bruenn’s original recommendations: digitalis would be administered in low doses; a low-fat diet would be instituted; callers would be held to a minimum at lunch and dinner; and the president would be asked to cut his consumption of cigarettes from twenty to ten per day and to limit himself to one and a half cocktails a day. The secret conference was adjourned.
It is not clear how much the president was told of his underlying condition. Though Bruenn was brought in to see the president on a regular basis, he remained under strict orders from McIntire to reveal nothing to Roosevelt. Bruenn assumed that McIntire was talking to the president, but McIntire declared later that he deliberately did not tell Roosevelt what the diagnosis was. It was an extraordinary act of presumption on McIntire’s part, depriving Roosevelt of the right to know what was happening to his life.
Shortly after Bruenn’s diagnosis, Roosevelt confessed to Eleanor that he was worried. “He suspects the doctors don’t know what is the matter,” Eleanor admitted to Joe Lash. At one point, suffering pain in his rectal area, he feared there might be a growth. But then the pain subsided and he relaxed. Curiously, during all this time he never once asked his doctors what they knew; day after day, he took his green digitalis pills without asking what they were or why he was taking them; day after day, he had his blood pressure read without asking what it was.
The conspiracy of silence extended to the public. On April 4, 1944, one week after the disconcerting checkup, McIntire blithely assured the press that nothing was wrong, that the president was simply suffering from a case of bronchitis. The results of the checkup were excellent, he claimed. “When we got through we decided that for a man of 62 we had very little to argue about, with the exception that we have had to combat flu plus respiratory complications.” McIntire went on to say that all the president needed now was “some sunshine and more exercise.”
The digitalis worked. X-rays of Roosevelt’s ch
est taken two weeks after the treatment revealed a significant decrease in the size of the heart and a notable clearing of the lungs. His coughing had stopped, his color was good, his blood chemistries were normal, and he was sleeping soundly at night.
• • •
Although the president was improving, the doctors decided that he needed a period of rest away from the White House, where work inevitably pushed its way into his living quarters, into his upstairs study, even into his bedroom. When Bernard Baruch heard that the president was looking for a place to rest, he offered Hobcaw, his roomy brick mansion situated on a knoll overlooking the Waccamaw River in South Carolina.
Roosevelt, accompanied by Drs. Bruenn and McIntire, Pa Watson, and Admiral Leahy, arrived at the Baruch plantation on Easter Sunday, April 9. In the days before his arrival, the Secret Service had been hard at work building wooden ramps for the front and back staircases, a railing in the fishing pier, and a canvas chute that could, in case of fire, allow the president to slide from his bedroom to the ground.
It was the perfect hideaway. The three press-association reporters who had accompanied the president kept their distance from the mansion, standing by in the Prince Georges Hotel eight miles away just in case something happened. “The Secret Service impressed on us repeatedly to ‘stay out of the old man’s way,’” Merriman Smith recalled. Though just about every living soul in Georgetown knew “He” was there, Smith laughingly observed, all three reporters went along with the game, giving Roosevelt free rein to do as he pleased day in and day out.
“I want to sleep and sleep,” Roosevelt said when he first arrived, “twelve hours a night.” In the quiet of Baruch’s graceful mansion, surrounded by twenty-three thousand acres of fields, woods, and streams, the president got his wish. He awakened at nine-thirty in the morning and went to bed at nine-thirty at night. In the mornings, he read the papers and worked on his correspondence; on sunny afternoons, he fished from the pier or trolled in the bay; on rainy days, he drove around the estate, stopping to see the elaborate gardens, the deer, and the wild boar. Cocktails were usually served at six, with dinner at seven.
During the second week of Roosevelt’s vacation, the mail pouch carried an executive order for the president’s signature, directing the secretary of commerce to take possession of the Chicago offices of the mammoth mail-order firm Montgomery-Ward. Since April 12, a strike had been in progress, provoked by the company’s failure to comply with the WLB’s directive to hold fair elections. The case was a complex one, provoking fiery disagreement within the administration. Stimson argued that, since Montgomery-Ward was not doing war business, the army had no right to stick its nose into the labor situation and extend presidential power far wider than he was sure it ought to be extended. Attorney General Francis Biddle disagreed: since 75 percent of Montgomery-Ward’s customers were farmers, and since farmers were engaged in producing food vital to the country’s war operations, the army had a responsibility to take over the company.
It is not clear how much Roosevelt focused on the issue, but in the end he sided with Biddle and signed the order sending in the troops. The decision backfired. As steel-helmeted soldiers, bearing guns with bayonets fixed, surrounded the Chicago headquarters, Montgomery’s chairman, Sewell Avery, refused to leave his eighth-floor office. There was a moment of hesitation, following which Biddle ordered the soldiers to remove him. Two soldiers locked their hands together to form a seat beneath Mr. Avery; two others steadied him by the shoulders. He struggled slightly and then was lifted bodily into the elevator and onto the street.
The photograph of Mr. Avery being carried from the building—voted by news photographers the best photo of the year—prompted a wave of criticism against Roosevelt. “There is no warrant in the Smith-Connally Act or in the President’s wartime powers for this seizure,” the Washington Post editorialized. “It was the manner in which the troops were used,” Walter Lippmann observed, “which has made the affair so notorious.” This “great howl” was just what Stimson had feared. In his diary, he lamented the action and predicted “it would be used by [Roosevelt’s] enemies as corroborating fear of his seeking autocratic power.”
With this single exception, Dr. Bruenn recalled, “the whole period was very pleasant . . . . The president thrived on the simple routine. I had never known anyone so full of charm. At lunch and dinner alike, he animated the conversation, telling wonderful stories, reminiscing with Baruch, talking of current events, pulling everyone in. He was a master raconteur. There was no question about it.”
While Roosevelt was at Hobcaw, Anna flew to Seattle to pack up her belongings and get their house ready for occupancy. “Beloved of mine,” John wrote her from the White House. “Life is just a mess without you. In some ways I wonder if it is wise for me to confess to you that the whole world—except only you—is like warm flat beer to me and you are excitement and joy and life itself.”
“Anna has arranged to bring the children East,” Eleanor wrote Franklin from Hyde Park on April 21, “and we will have to open the big house from about the middle of June on. Couldn’t you arrange to go up and stay a month at a time and only come back for 2-3 days a month? It would be heavenly for us all.” She went on to say she wanted to buy a few things to make the servants’ rooms more livable and promised she wouldn’t spend much. “May I?” she asked. “Also, if I made a diagram of mama’s room so everything could be put back in place could I arrange it as a sitting room with a day bed in case someone had to sleep there?”
The following week, Eleanor and Anna, along with Prime Minister and Mrs. John Curtin of Australia and Costa Rican President Teodoro Picado flew to Hobcaw for lunch with the president. Though there was little time for private conversation, Eleanor noticed with satisfaction that Franklin’s color was better and his spirits were high. “I came home feeling that it was the very best move Franklin could have made.” The sunshine was working wonders, she decided, predicting that he would return from Hobcaw “in better condition than when he left.”
Anna was less sanguine about her father’s condition, having talked with Dr. Bruenn after lunch about the long-term effects of coronary disease and the necessity to change her father’s White House routine radically. Bruenn also impressed upon Anna the importance of altering Roosevelt’s diet—something Eleanor apparently did not understand, for no sooner had she returned to Washington than she sent a bunch of steaks in the mail pouch, hoping the president would enjoy them.
Eleanor’s delight in her husband’s relaxing days with Baruch would more than likely have been diminished had she known that, on the morning of April 28, at the president’s invitation, Lucy Mercer Rutherfurd was heading toward Hobcaw from Aiken, 140 miles away.
A month earlier, at Ridgeley Hall in Aiken, Lucy’s ailing husband, Winthrop Rutherfurd, had died, leaving Lucy a widow at the age of fifty-two. Survived by two daughters and four sons, Winthrop was buried at his family’s estate in Allamuchy, New Jersey. For Lucy, whose life had revolved around her husband for more than twenty years, it was not an easy time. There were complicated estate problems to solve, worries over the children, and difficult decisions to make. And, for the first time, she was alone.
Lucy arrived shortly before noon, accompanied by her stepdaughter and her stepson’s wife. In spite of all she had been through the previous month, she retained her beauty and her charm. She could still reach Roosevelt in a way that no one else could. Lucy’s presence at the luncheon that day was officially recorded in a seating chart that remains among the president’s papers. This time, perhaps because Mr. Rutherfurd was no longer alive, she is openly listed as Lucy Rutherfurd rather than Mrs. Paul Johnson. The diagram of the table shows that Roosevelt was seated at one end, Baruch at the other, Lucy to the president’s right. Other guests included Admiral Leahy and Dr. McIntire, Captain Robert Duncan, and Dr. Bruenn. Years later, Baruch vividly remembered the occasion, in part because he had to give up several of his precious war-ration tickets so that Lucy could make the lon
g drive.
For Roosevelt, Lucy’s presence must have provided a delightful tonic, reminding him of his younger self, before his paralysis, before the illness that was now overwhelming him. In Lucy’s company he could re-establish continuity with his youth, bringing back in his mind the healthy body in which he had once lived. If his future was disappearing, at least he could relive the happy moments of his past.
During lunch, word came that Navy Secretary Frank Knox had died of a heart attack at the age of seventy. The self-imposed unrelenting pace that marked the life of the energetic Knox had finally taken its toll. Eleanor was in the White House, having lunch with Mrs. Kermit Roosevelt, widow of Teddy Roosevelt’s son, when the news came. Assuming that her husband would cut his vacation short and come to Washington for the funeral, she postponed by a week an impending trip to New York, including a half-dozen speaking engagements, so she could be at home when her husband returned.
As it happened, Roosevelt did not return for the funeral, electing to remain in Hobcaw an extra week. Though his health had improved markedly during his stay, he suffered a setback later that afternoon that kept him in bed for several days. Shortly after his lunch with Lucy, he experienced acute abdominal pain, slight nausea, and a throbbing sensation all through his body. Dr. Bruenn tentatively diagnosed gallstones and made arrangements for X-rays as soon as they returned to Washington.
In the meantime, a hypodermic injection of codeine allowed Roosevelt to meet the press at eight that evening to discuss Knox’s death. Though Merriman Smith noticed that the color of the president’s skin was not particularly healthy, he “seemed in such good spirits” that the reporter thought little of it. When Roosevelt talked of Knox, he revealed little emotion. “That may have been the Roosevelt breeding,” Smith observed, “because I’ve been told people of superior breeding never let their emotions come to the surface publicly.” Knox was the first of Roosevelt’s wartime Cabinet to die, though four other Cabinet members were in their seventies—Stimson at seventy-six, Hull at seventy-two, and Jones and Ickes at seventy.
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