The Dying President

Ferrell, a professor emeritus at Indiana University, was a prolific author or editor of more than 60 books on a wide range of topics, including the U.S. presidency, World War I, and U.S. foreign policy and diplomacy. One of the country's leading historians,[3] Ferrell was widely considered the preeminent authority on the administration of Harry S. Truman,[4] and also wrote books about half a dozen other 20th-century presidents.[4][5]

Ferrell's book is one of several he wrote about health and secrecy in the U.S. presidency, along with 1992's Ill-Advised: Presidential Health and Public Trust and 1996's The Strange Deaths of President Harding.[6] It looks at the circumstances surrounding Roosevelt's final illness, who died in 1945 of a cerebral hemorrhage brought on by his cardiovascular disease.[1]^: 119 Roosevelt was diagnosed with severe hypertension in March 1944, near the end of his third term in office, by White House physician Howard Bruenn.[7] By the end, Roosevelt had difficulty concentrating, was easily tired, and could only work four hours a day at most, but still kept his health secret even from his family and Truman.[7]

Ferrell argues that Roosevelt, a naturally secretive person, chose to hide the true nature of his serious condition rather than resign his office or allow others in his administration to take over his decision-making powers. "The president knew he was ill, even if he had delusions of immortality," wrote Ferrell.[1]^: 152

Roosevelt's hypertension probably appeared years earlier than Bruenn's diagnosis, although it is impossible to say for sure since his medical records are missing. But he also went to great lengths to keep his health secret, including enlisting FBI director J. Edgar Hoover to pressure doctors into staying quiet.[1]^: 87 Roosevelt's motivations may have included a desire not to be slowed down, and fear that his illness would be seen as a weakness. Ferrell writes that maintaining such secrecy may have been necessary both for national security during wartime and for political expediency during Roosevelt's fourth run for the presidency. But he also notes that secret-keeping was characteristic of Roosevelt, who also hid his use of a wheelchair due to poliomyelitis from the public for years: "He had always been very much a self-contained person who confided in no one."[1]^: 142

Ferrell puts some blame on Roosevelt's personal physician from 1933 to 1945, Admiral Ross McIntire, who Bruenn thought was "out of his depth"[1]^: 46 and made a "gross misdiagnosis"[1]^: 40 because he was not a heart specialist. The medical science behind diagnosing heart attacks was then in its infancy compared with today. No blood-pressure readings were apparently taken of Roosevelt until Bruenn took over as his cardiologist, by which point it may have been too late to make a difference.[1]^: 44 Moreover, McIntire actively helped Roosevelt keep his secret from others but also never told him exactly how sick he was.[1]^: 138 Roosevelt may have purposely refrained from asking too many questions about his own condition, so that he himself would not know the full extent of his illness.[8] Ferrell calls McIntire's repeated statements that Roosevelt was healthy "remarkably false."[1]^: 5 He also notes that the disappearance of Roosevelt's medical records was suspicious and that McIntire was one of only three people who could unlock the safe at Bethesda Naval Hospital, where they were stored.[1]^: 87

In his conclusion, Ferrell writes that Roosevelt's incapacity may have needlessly prolonged both World War II and the Holocaust, and weakened America's postwar position in Europe, China and Vietnam. He also criticizes Roosevelt for his treatment of Truman as "inconsequential," saying that his failure to "inform his successor of anything, military, diplomatic, or administrative" was "an invitation to national calamity."[1]^: 151

Reaction to the book was positive. Historian John Lukacs, writing in the Los Angeles Times, called the book "painstaking and exceptionally researched" and "one of the most important, and telling, works" about Roosevelt.[9] Edmund Kallina, in The Florida Historical Quarterly, called the book "a devastating critique of FDR and his conduct in 1944–1945 … when he clearly no longer had the ability to carry out the duties of the office."[6] James Cassedy, writing in Presidential Studies Quarterly, said the book gives "a rich, insightful, and informed context" of the events of Roosevelt's final year. He noted the difficulty of finding the truth about Roosevelt's health amid "a wide range of contemporary rumors and often misleading official reports," as well as "Roosevelt's own mask of denial about his illnesses."[10] A review in the Journal of the American Medical Association said that "Ferrell's brief, tightly constructed book … makes abundantly clear that" Roosevelt's seemingly sudden death "was anything but an unexpected cosmic occurrence," but was "readily foreseeable in well-documented but equally well-concealed medical and nonmedical observations stretching back more than a year."[11]

Judy Barrett Litoff, in the Register of the Kentucky Historical Society, was more critical, writing that she thought Ferrell's judgement of Roosevelt was too harsh and his conclusions were unconvincingly speculative.[12]