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The epilepsy of Franklin Delano Roosevelt

Steven Lomazow, MD In the 4 years since beginning research for a book on the health1 of our 32nd president, the diagnosis of
Franklin Delano Roosevelt’s seizures evolved from a suspicion to a virtual certainty. Even more importantly, it
is clear that they had a major impact upon his mental acuity and decision-making during one of the most
Address correspondence and critical periods in American history.
reprint requests to Dr. Steven
Lomazow, Mount Sinai School of
There are dozens of independent reports of behavior consistent with complex partial seizures that occurred
Medicine, 8 McGuirk Lane, West with considerable frequency for over a year prior to his death from a cerebral hemorrhage at Warm Springs,
Orange, NJ 07052 GA, on April 12, 1945, none of which were recognized as such by the observers. The true nature of Roos-
evelt’s neurologic illness has been one of the most closely held secrets of the 20th century, abetted by the active
participation in a cover-up by his 2 most well-recognized physicians, ENT specialist Ross T. McIntire and
cardiologist Howard G. Bruenn. It is ludicrous to assume that symptomatology so gross and so frequent went
unrecognized by those entrusted with the health of the most important and powerful man in the world. The
pieces of the puzzle are scattered in dozens of books, articles, oral histories, and a limited amount of surviving
medical records.
In the last year of Roosevelt’s life, the long list of observers who were aghast at his appearance, demeanor, and
loss of mental acuity include Winston Churchill, Churchill’s physician, Lord Moran, and Generals Douglas
MacArthur and Albert C. Wedemeyer, yet a number of others are particularly graphic and convincing.
In July 1944, prior to his nomination for an unprecedented fourth term, Turner Catledge, then a reporter
and soon to be editor of The New York Times, met with FDR:
When I entered the president’s office … he was sitting there with a vague glassy-eyed expression on his face and his
mouth hanging open. He would start talking about something, then in midsentence he would stop and his mouth
would drop open and he’d sit staring at me in silence … Repeatedly he would lose his train of thought, stop, and
stare blankly at me. It was an agonizing experience for me. Finally a waiter brought his lunch, and (Chief of Staff,
General Edwin “Pa”) Watson said his luncheon guest was waiting, and I was able to make my escape.2
Watson was Roosevelt’s chief of staff and close confidante since the earliest days of the New Deal, having
been brought into Roosevelt’s inner circle (as was Presidential physician McIntire) by Dr. Cary T. Grayson,
the orchestrator of the medical cover-up of Woodrow Wilson’s devastating 1919 stroke.
In January 1945, Senator Frank Maloney of Connecticut, a long-time acquaintance of the President, met
with him over lunch.
Supplemental data Roosevelt looked up but said nothing, his eyes fixed in a strange stare. After a few moments of silence, Maloney
realized that Roosevelt had absolutely no idea who his visitor was. A pious Catholic, Maloney crossed himself and
at ran to get Pa Watson, fearing the president had suffered a stroke. “Don’t worry.” Watson said. “He’ll come out of it. He always does.” By the time Maloney returned to the oval office, Roosevelt had pulled himself together. Smiling
broadly, he greeted Maloney warmly and launched into a spirited conversation.3
Watson’s dismissive response to the event is strong testimony to both the frequency and the familiarity
with which FDR’s intimate associates dealt with the problem.
Frances Perkins, America’s first female cabinet member, gave the best description:
The change in appearance had to do with the oncoming of a kind of glassy eye, and an extremely drawn look around
the eyes and cheeks, and even a sort of dropping of the muscles of the jaw and mouth, as though they weren’t
working exactly. I think they were, but there was a great weakness in those muscles. Also, if you saw him close to, you
would see that his hands were weak … When he fainted, as he did occasionally—not for many years, but for several
years—that was all accentuated. It would be momentary. It would be very brief, and he’d be back again.4
A January 5, 1948, memo from a Chicago Tribune reporter, Orville “Doc” Dwyer, to his colleague,
Walter Trohan, best illustrates the historical importance and also reliably reports that Roosevelt’s daughter,
Anna, who served as his hostess and aide for the last year of his life, was well aware of the problem, though she

From the Mount Sinai School of Medicine, West Orange, NJ.

Disclosure: Author disclosures are provided at the end of the article.

668 Copyright © 2011 by AAN Enterprises, Inc.

The source
document, quoted misinterpreted the seizures as TIAs. The source was a in Bruenn’s allegedly definitive 1970 paper on Roos-
below, is available physician “for years,” a close friend of Anna Roos- evelt’s health.6 Bruenn was assigned exclusively to
as a data evelt Boettinger. Roosevelt and saw him daily beginning on March 29,
supplement on the The doctor told me that from what Anna has out- 1944.
Neurology® Web lined to him Franklin D. Roosevelt was for a long Present-day neurologists spend a good portion of
time before he died—and particularly when he went their time diagnosing seizures and public education
site at to Yalta and Tehran (sic)—suffering from hemor- in epilepsy continues to be a major focus of the spe- rhages of the brain. The doctor said he died “from a
big hemorrhage” but for several years before his death cialty. It is not surprising that Roosevelt’s seizures
had a lot of “little hemorrhages,” small blood vessels went unrecognized by those outside his most inner
bursting in his brain. When these burstings oc- circle of physicians and confidantes. With the intense
curred—and they were frequent during his last
years— he would be unconscious (completely out) al- media and greater disease awareness in the 21st cen-
though sitting up and apparently functioning for pe- tury, it is unlikely that these dramatic events would
riods of from a few seconds to several minutes. Dr. today escape notice in such a high-profile persona.
Schmidt said he has no doubt from his conversations
with Anna that these were occurring regularly at the
time he was meeting with Churchill and Stalin and DISCLOSURE
holding other momentous conferences of the utmost Dr. Lomazow receives royalties from the publication of FDR’s Deadly
importance to the United States. He said the effect Secret (Public Affairs 2010) and serves on speakers’ bureaus for Glaxo-
would be that he would be cognizant of what was going SmithKline and Pfizer Inc.
on, then suddenly lose the thread completely for any-
where from a few seconds to 2 or 3 minutes—and that Received August 6, 2010. Accepted in final form October 4, 2010.
he could not possibly have known what was going on in
Considering the frequency, duration, stereotypic 1. Lomazow S, Fettmann E. FDR’s Deadly Secret. New
nature, and rapidity of change of this behavior, alter- York, NY: Public Affairs; 2010.
2. Catledge T. My Life and Times. New York: Harper and
native diagnoses other than complex partial seizures
Row; 1971: 146.
are hard to surmise. Their etiology is most attribut- 3. Goodwin DK. No Ordinary Time: Franklin & Eleanor
able to cerebrovascular disease, no surprise consider- Roosevelt: The Home Front in World War II. New York,
ing Roosevelt’s severe uncontrolled hypertension and NY: Touchstone; 1995: 571. Goodwin identifies her
2-pack-a-day cigarette habit. Roosevelt was pre- source as Eliot Janeway, the noted columnist.
scribed phenobarbital, between 60 and 90 mg/d, at 4. Perkins F. Columbia Oral History Project, Part 8, Session
12. 1955: 283–284.
least from the beginning of April 1944, allegedly for
5. Walter Trohan Papers, Herbert Hoover Presidential Li-
his soaring blood pressure. Amazingly, no reference
brary, West Branch, IA. January 5, 1948.
to lapses of consciousness or, indeed, any neurologic 6. Bruenn HG. Clinical notes on the illness and death of
symptomatology whatsoever (other than those asso- President Franklin D. Roosevelt. Ann Intern Med 1970;
ciated with the fatal brain hemorrhage) is mentioned 72:579 –591.

Neurology 76 February 15, 2011 669

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