Joseph Lelyveld, His Final Battle:
The Last Months of Franklin Roosevelt
During the last year and a half of his life, from mid-October 1943 to his death in Warm Springs, Georgia on April 12, 1945, Franklin D. Roosevelt’s presidential plate was full, even overflowing. He was grappling with winning history’s most devastating war and structuring a lasting peace for the post-war global order, all the while tending to multiple domestic political demands. But Roosevelt spent much of this time out of public view in semi-convalescence, often in locations outside Washington, with limited contact with the outside world. Those who met the president, however, noticed a striking weight loss and described him with words like “listless,” “weary,” and “easily distracted.” We now know that Roosevelt had life-threatening high blood pressure, termed malignant hypertension, making him susceptible to a stroke or coronary attack at any moment. Roosevelt’s declining health was carefully shielded from the public and only rarely discussed directly, even within his inner circle. At the time, probably not more than a handful of doctors were aware of the full gravity of Roosevelt’s physical condition, and it is an open question whether Roosevelt himself was aware.
In His Final Battle: The Last Months of Franklin Roosevelt, Joseph Lelyveld, former executive editor of the New York Times, seeks to shed light upon, if not answer, this open question. Lelyveld suggests that the president likely was more aware than he let on of the implications of his declining physical condition. In a resourceful portrait of America’s longest serving president during his final year and a half, Lelyveld considers Roosevelt’s political activities against the backdrop of his health. The story is bookended by Roosevelt’s meetings to negotiate the post-war order with fellow wartime leaders Winston Churchill and Joseph Stalin, in Teheran in December 1943 and at Yalta in the Crimea in February 1945. Between the two meetings came Roosevelt’s 1944 decision to run for an unprecedented fourth term, a decision he reached just weeks prior to the Democratic National Convention that summer, and the ensuing campaign.
Lelyveld’s portrait of a president living on borrowed time emerges from an excruciatingly thin written record of Roosevelt’s medical condition. Roosevelt’s medical file disappeared without explanation from a safe at Bethesda Naval Hospital shortly after his death. Unable to consider Roosevelt’s actual medical records, Lelyveld draws clues concerning his physical condition from the diary of Margaret “Daisy” Suckley, discovered after Suckley’s death in 1991 at age 100, and made public in 1995. The slim written record on Roosevelt’s medical condition limits Lelyveld’s ability to tease out conclusions on the extent to which that condition may have undermined his job performance in his final months.
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Daisy Suckley, a distant cousin of Roosevelt, was a constant presence in the president’s life in his final years and a keen observer of his physical condition. During Roosevelt’s last months, the “worshipful” (p.3) and “singularly undemanding” Suckley had become what Lelyveld terms the “Boswell of [Roosevelt’s] rambling ruminations,” secretly recording in an “uncritical, disjointed way the hopes and daydreams” that occupied the frequently inscrutable president (p.75). By 1944, Lelyfeld notes, there was “scarcely a page in Daisy’s diary without some allusion to how the president looks or feels” (p.77). Lelyveld relies heavily upon the Suckley diary out of necessity, given the disappearance of Roosevelt’s actual medical records after his death.
Lelyveld attributes the disappearance to Admiral Ross McIntire, an ears-nose-and-throat specialist who served both as Roosevelt’s personal physician and Surgeon General of the Navy. In the latter capacity, McIntire oversaw a wartime staff of 175,000 doctors, nurses and orderlies at 330 hospitals and medical stations around the world. Earlier in his career, Roosevelt’s press secretary had upbraided McIntire for allowing the president to be photographed in his wheel chair. From that point forward, McIntire understood that a major component of his job was to conceal Roosevelt’s physical infirmities and protect and promote a vigorously healthy public image of the president. The “resolutely upbeat” (p.212) McIntire, a master of “soothing, well-practiced bromides” (p.226), thus assumes a role in Lelyveld’s account which seems as much “spin doctor” as actual doctor. His most frequent message for the public was that the president was in “robust health” (p.22), in the process of “getting over” a wide range of lesser ailments such as a heavy cold, flu, or bronchitis.
A key turning point in Lelyveld’s story occurred in mid-March 1944, 13 months prior to Roosevelt’s death, when the president’s daughter Anna Roosevelt Boettiger confronted McIntire and demanded to know more about what was wrong with her father. McIntire doled out his “standard bromides, but this time they didn’t go down” (p.23). Anna later said that she “didn’t think McIntire was an internist who really knew what he was talking about” (p.93). In response, however, McIntire brought in Dr. Howard Bruenn, the Navy’s top cardiologist. Evidently, Lelyveld writes, McIntire had “known all along where the problem was to be found” (p.23). Breunn was apparently the first cardiologist to have examined Roosevelt.
McIntire promised to have Roosevelt’s medical records delivered to Bruenn prior to his initial examination of the president, but failed to do so, an “extraordinary lapse” (p.98) which Lelyveld regards as additional evidence that McIntire was responsible for the disappearance of those records after Roosevelt’s death the following year. Breunn found that Roosevelt was suffering from “acute congestive heart failure” (p.98). He recommended that the wartime president avoid “irritation,” severely cut back his work hours, rest more, and reduce his smoking habit, then a daily pack and a half of Camel’s cigarettes. In the midst of the country’s struggle to defeat Nazi Germany and imperial Japan, its leader was told that he “needed to sleep half his time and reduce his workload to that of a bank teller” (p.99), Lelyveld wryly notes. Dr. Bruenn saw the president regularly from that point onward, traveling with him to Yalta in February 1945 and to Warm Springs in April of that year.
Ten days after Dr. Bruenn’s diagnosis, Roosevelt told a newspaper columnist, “I don’t work so hard any more. I’ve got this thing simplified . . . I imagine I don’t work as many hours a week as you do” (p.103). The president, Lelyveld concludes, “seems to have processed the admonition of the physicians – however it was delivered, bluntly or softly – and to be well on the way to convincing himself that if he could survive in his office by limiting his daily expenditure of energy, it was his duty to do so” (p.103).
At that time, Roosevelt had not indicated publicly whether he wished to seek a 4th precedential term and had not discussed this question with any of his advisors. Moreover, with the “most destructive military struggle in history approaching its climax, there was no one in the White House, or his party, or the whole of political Washington, who dared stand before him in the early months of 1944 and ask face-to-face for a clear answer to the question of whether he could contemplate stepping down” (p.3). The hard if unspoken political truth was that Roosevelt was the Democratic party’s only hope to retain the White House. There was no viable successor in the party’s ranks. But his re-election was far from assured, and public airing of concerns about his health would be unhelpful to say the least in his re-election bid. Roosevelt did not make his actual decision to run until just weeks before the 1944 Democratic National Convention in Chicago.
At the convention, Roosevelt’s then vice-president, Henry Wallace, and his counselors Harry Hopkins, and Jimmy Byrnes jockeyed for the vice-presidential nomination, along with William Douglas, already a Supreme Court justice at age 45. There’s no indication that Senator Harry S. Truman actively sought to be Roosevelt’s running mate. Lelyveld writes that it is tribute to FDR’s “wiliness” that the notion has persisted over the years that he was “only fleetingly engaged in the selection” of his 1944 vice-president and that he was “simply oblivious when it came to the larger question of succession” (p.172). To the contrary, although he may not have used the used the word “succession” in connection with his vice-presidential choice, Roosevelt “cared enough about qualifications for the presidency to eliminate Wallace as a possibility and keep Byrnes’s hopes alive to the last moment, when, for the sake of party unity, he returned to Harry Truman as the safe choice” (p.172-73).
Having settled upon Truman as his running mate, Roosevelt indicated that he did not want to campaign as usual because the war was too important. But campaign he did, and Lelyveld shows how hard he campaigned – and how hard it was for him given his deteriorating health, which aggravated his mobility problems. The outcome was in doubt up until Election Day, but Roosevelt was resoundingly reelected to a fourth presidential term. The president could then turn his full attention to the war effort, focusing both upon how the war would be won and how the peace would be structured. Roosevelt’s foremost priority was structuring the peace; the details on winning the war were largely left to his staff and to the military commanders in the field.
Roosevelt badly wanted to avoid the mistakes that Woodrow Wilson had made after World War I. He was putting together the pieces of an organization already referred to as the United Nations and fervently sought the participation and support of his war ally, the Soviet Union. He also wanted Soviet support for the war against Japan in the Pacific after the Nazi surrender, and for an independent and democratic Poland. In pursuit of these objectives, Roosevelt agreed to travel over 10,000 arduous miles to Yalta, to meet in February 1945 with Stalin and Churchill.
In Roosevelt’s mind, Stalin was by then both the key to victory on the battlefield and for a lasting peace afterwards — and he was, in Roosevelt’s phrase, “get-at-able” (p.28) with the right doses of the legendary Roosevelt charm. Roosevelt had begun his serious courtship of the Soviet leader at their first meeting in Teheran in December 1943. His fixation on Stalin, “crossing over now and then into realms of fantasy” (p.28), continued at Yalta. Lelyveld’s treatment of Roosevelt at Yalta covers similar ground to that in Michael Dobbs’ Six Months That Shook the World, reviewed here in April 2015. In Lelyveld’s account, as in that of Dobbs, a mentally and physical exhausted Roosevelt at Yalta ignored the briefing books his staff prepared for him and relied instead upon improvisation and his political instincts, fully confident that he could win over Stalin by force of personality.
According to cardiologist Bruenn’s memoir, published a quarter of a century later, early in the conference Roosevelt showed worrying signs of oxygen deficiency in his blood. His habitually high blood pressure readings revealed a dangerous condition, pulsus alternans, in which every second heartbeat was weaker than the preceding one, a “warning signal from an overworked heart” (p.270). Dr. Bruenn ordered Roosevelt to curtail his activities in the midst of the conference. Churchill’s physician, Lord Moran, wrote that Roosevelt had “all the symptoms of hardening of arteries in the brain” during the conference and gave the president “only a few months to live” (p.270-71). Churchill himself commented that his wartime ally “really was a pale reflection almost throughout” (p.270) the Yalta conference.
Yet, Roosevelt recovered sufficiently to return home from the conference and address Congress and the public on its results, plausibly claiming victory. The Soviet Union had agreed to participate in the United Nations and in the war in Asia, and to hold what could be construed as free elections in Poland. Had he lived longer, Roosevelt would have seen that Stalin delivered as promised on the Asian war. The Soviet Union also became a member of the United Nations and maintained its membership in the organization until its dissolution in 1991, but was rarely if ever the partner Roosevelt envisioned in keeping world peace. The possibility of a democratic Poland, “by far the knottiest and most time-consuming issue Roosevelt confronted at Yalta” (p.285), was by contrast slipping away even before Roosevelt’s death.
At one point in his remaining weeks, Roosevelt exclaimed, “We can’t do business with Stalin. He has broken every one of the promises he made at Yalta” on Poland (p.304; Dobbs includes the same quotation, adding that Roosevelt thumped on his wheelchair at the time of this outburst). But, like Dobbs, Lelyveld argues that even a more physically fit, fully focused and coldly realistic Roosevelt would likely have been unable to save Poland from Soviet clutches. When the allies met at Yalta, Stalin’s Red Army was in the process of consolidating military control over almost all of Polish territory. If Roosevelt had been at the peak of vigor, Lelyveld concludes, the results on Poland “would have been much the same” (p.287).
Roosevelt was still trying to mend fences with Stalin on April 11, 1945, the day before his death in Warm Springs. Throughout the following morning, Roosevelt worked on matters of state: he received an update on the US military advances within Germany and even signed a bill, sustaining the Commodity Credit Corporation. Then, just before lunch Roosevelt collapsed. Dr. Bruenn arrived about 15 minutes later and diagnosed a hemorrhage in the brain, a stroke likely caused by the bursting of a blood vessel in the brain or the rupture of an aneurysm. “Roosevelt was doomed from the instant he was stricken” (p.323). Around midnight, Daisy Suckley recorded in her diary that the president had died at 3:35 pm that afternoon. “Franklin D. Roosevelt, the hope of the world, is dead,” (p.324), she wrote.
Daisy was one of several women present at Warm Springs to provide company to the president during his final visit. Another was Eleanor Roosevelt’s former Secretary, Lucy Mercer Rutherford, by this time the primary Other Woman in the president’s life. Rutherford had driven down from South Carolina to be with the president, part of a recurring pattern in which Rutherford appeared in instances when wife Eleanor was absent, as if coordinated by a social secretary with the knowing consent of all concerned. But this orchestration broke down in Warm Springs in April 1945. After the president died, Rutherford had to flee in haste to make room for Eleanor. Still another woman in the president’s entourage, loquacious cousin Laura Delano, compounded Eleanor’s grief by letting her know that Rutherford had been in Warm Springs for the previous three days, adding gratuitously that Rutherford had also served as hostess at occasions at the White House when Eleanor was away. “Grief and bitter fury were folded tightly in a large knot” (p.325) for the former First Lady at Warm Springs.
Subsequently, Admiral McIntire asserted that Roosevelt had a “stout heart” and that his blood pressure was “not alarming at any time” (p.324-25), implying that the president’s death from a stroke had proven that McIntire had “always been right to downplay any suggestion that the president might have heart disease.” If not a flat-out falsehood, Lelyveld argues, McIntire’s assertion “at least raises the question of what it would have taken to alarm him” (p.325). Roosevelt’s medical file by this time had gone missing from the safe at Bethesda Naval Hospital, most likely removed by the Admiral because it would have revealed the “emptiness of the reassurances he’d fed the press and the public over the years, whenever questions arose about the president’s health” (p.325).
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Lelyveld declines to engage in what he terms an “argument without end” (p.92) on the degree to which Roosevelt’s deteriorating health impaired his job performance during his last months and final days. Rather, he skillfully pieces together the limited historical record of Roosevelt’s medical condition to add new insights into the ailing but ever enigmatic president as he led his country nearly to the end of history’s most devastating war.
Thomas H. Peebles
La Châtaigneraie, France
March 28, 2017