Monday, November 9, 2009

Health

A change of heart

FDR's death shows how much we've learned about the heart

By Daniel Levy and Susan Brink
Posted 2/6/05
Page 2 of 5

Roosevelt took the helm of the nation at a time that would have taxed the hardiest of souls. America was then home to between 13 million and 15 million unemployed workers. A couple of million of them created a whole class of homeless migrants. They left behind dust-ravaged farms and boarded-up factories to wander the country in search of work. The plight of a stricken populace surely took its toll on their leader during his first term. "I see millions whose daily lives in city and on farm continue under conditions labeled indecent by a so-called polite society half a century ago. . . . I see one third of a nation ill-housed, ill-clad, ill-nourished," he said in his second inaugural address.

As the strain registered in medically measurable form, McIntire hardly made note of the rise in the president's blood pressure. It was 169/98 in 1937 as Roosevelt began his second term. From then on, it would fluctuate but remain abnormally high. His vital numbers rose to 188/105 in 1941, when the Japanese bombed Pearl Harbor. Still, as is typical, he had no outward symptoms of hypertension. Roosevelt launched a nationwide war effort, committing more than 16 million U.S. troops to the Allied cause in World War II. By the time American soldiers landed in Normandy in June 1944, his blood pressure was 226/118--a life-threatening level. The limited medical technology of the day, electrocardiograms and chest X-rays, showed a damaged, enlarged heart. Still, no one told FDR the bad news, nor did he ask.

Roosevelt was absent from the White House for nine weeks during the first five months of 1944. In those days, he would go to Warm Springs, an impoverished farm community 80 miles southwest of Atlanta, for an "off the record" absence from duties. In an era when the media grant no mercy in exposing the secrets of public officials, it is difficult to fathom that back then journalists would comply with and help promote such a public deception. McIntire insisted that the president's health was good, that Roosevelt's blood pressure was normal for a man his age. In his treatment notes of April 1944, when the president's blood pressure was 210/120, McIntire wrote, "A moderate degree of arteriosclerosis, although no more than normal for a man of his age."

There is hardly an American today who doesn't know enough to shudder at the president's vital numbers. Careful listeners to his radio fireside chats might have noticed, certainly by 1944, an audible short-windedness that probably reflected some degree of congestive heart failure. And his family was becoming increasingly alarmed. Indeed by early 1944, Eleanor Roosevelt was ready to reject McIntire's diagnosis and ask for a second opinion, and in March the president went to Bethesda Naval Hospital for a thorough examination.

There, a young cardiologist, Howard Bruenn, pronounced the president desperately ill. But McIntire carefully controlled the disclosure of all medical information and believed Bruenn's view of FDR's health would disturb the president and his family.

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