8-04-08
Vice Admiral Ross T. McIntire: A Reassessment of an American Hero
By Steven Lomazow, M.D.
Dr. Lomazow, Assistant Professor of Neurology at Mount Sinai School of Medicine, is working on a book about FDR's health problems. Click here for his blog. This article first appeared in Navy Medicine (July 2008).
Ross T. McIntire was personal physician to Franklin Delano Roosevelt, from 1932 to 1945. During that time, he rose to the rank of Vice Admiral and Surgeon General of the Navy. The widespread presently-held view of Mcintire's performance in that capacity is as an excellent and competent wartime administrator but as an abject failure as Presidential physician. While the former is undoubtedly correct, the latter could not be farther from the truth.
As a result of intense research which has led to remarkable new insights about the health of Franklin Roosevelt, McIntire emerges not as the incompetent Eye, Ear Nose and Throat Specialist as historians have pictured him, but rather as a masterful head of a dedicated and highly skilled group of physicians, mostly naval officers, who delivered to the President, as well as his close associates, the highest quality of medical care available at the time. Moreover, Admiral McIntire was more than a physician to his most important patient; he was an indispensable close confidante and a member of the most inner circle of trusted presidential advisors.
A native of Oregon, Admiral McIntire graduated from Willamette School of Medicine in 1912 and joined the navy as an assistant surgeon in 1917. In 1932, when FDR was looking for a personal physician, he turned to his old friend Admiral Cary T. Grayson, who is best remembered as the mastermind of the cover-up of Woodrow Wilson's massive disability following a stroke while in office in October 1919. Roosevelt befriended Grayson during his tenure as Assistant Secretary of the Navy in the Wilson administration. Grayson, like McIntire, was more than just physician to the President, he was his dear friend, introducing Wilson to his second wife, Edith, and was best man at their White House wedding. Grayson recommended McIntire not only for his competence as a HEENT physician, since FDR was subject to frequent "sinus infections":, but also because of his ability to "keep a close mouth".
FDR enjoyed generally good health in his first and the early part of his second term. During this time, McIntire accompanied Roosevelt on most of his frequent global escapades, almost always aboard a U.S. Naval vessel. In 1938, the frequency of McIntire's medical treatment markedly accelerated, continuing until FDR's death in 1945. While there is no official explanation for this increased attention, at about this time a pigmented lesion above FDR's left eye first seen in 1923 began noticeably expanding and taking on the characteristics of a highly malignant tumor then known as melanotic sarcoma, one which was, at the time, a virtual death sentence. In January 1940, in response to an inquiry by a leading Gynecological Oncologist, Doctor Reuben Peterson (3), McIntire responded, in confidence, with the only known public acknowledgement of the lesion's existence stating:
"the pigmented lesion above the President's eye is very superficial and has never shown any sign of an inflammatory nature. You can rest assured it is under observation at all times."
The existence, treatment and ultimate consequences the pigmented lesion, known to present day physicians as melanoma, is only now being defined. This remarkable new information also casts additional light on the specific role of Admiral McIntire as Presidential physician and the high quality of naval medicine in general.
Roosevelt's behavior with respect to his life-defining malady, polio, is a clue to McIntire's role as presidential physician as well. The President applied great energy to conquering polio, devoting the years between the time he was stricken in 1921 until his re-entry into public life in 1928 to undertaking a vigorous program of rehabilitation, seeking out the finest doctors, the most expert information available and performing intensive personal research into devising specific treatments, earning him the nickname around Warm Springs of "Doctor Roosevelt". He also personally financed the rehabilitation center and even founded a charity, later known as "The March of Dimes", to support polio research and awareness. While many biographers continue to believe the later public pronouncements of one of FDR's physicians, Howard Bruenn, (2) that FDR showed little interest in his health, his past behavior is ample evidence to the contrary.
In sharp contrast, extraordinary measures were taken to minimize the extent of FDR's own disability from the public. Roosevelt's personal battle with polio, as well as was any aspect of his health, were matters of the most intense privacy. The press was complicit in this highly orchestrated program of disinformation. Of the tens of thousands of images in existence of Franklin Delano Roosevelt, less than a handful portray him in any physically compromised way, and none of those were ever publicly released. Any article or news story about presidential health was personally reviewed by the president. The control of the presidential image was so strict that there was even a ban on photographing or filming FDR while he was frowning!
With respect to the White House Staff, including the presidential physician, any and all information released pertaining to the health of the President was under the direct and strict control of Roosevelt himself. All of Admiral McIntire's public statements about the health of the President, even those after Roosevelt's death in 1945, were made as a result of the expressed wishes of his Commander-in-Chief. (author's emphasis)
McIntire was a highly skilled and competent physician within his specialty. He personally treated Franklin Roosevelt on thousands of occasions. None of these records are known to exist, but a 1946 summary by McIntire of his treatment of his assistant Commander George A. Fox, reflects the highest professional competence employing "state of the art" medications and techniques (3). McIntire also did not hesitate to call in the finest consultants, such as Doctor Frank Lahey, whom he considered to be America's greatest surgeon. His wartime commissions and advisory boards were manned by a roster of world class medical specialists and scientists.
Roosevelt was treated at Bethesda at least 29 times at between 1941 and 1944 (4). The exact nature of these treatments cannot, at present, be determined, but they were directed under the ultimate authority of Dr. McIntire under an extremely tight veil of secrecy.
According to Howard Bruenn's 1970 paper (5), Franklin Roosevelt was first diagnosed with severe congestive heart failure on March 28th 1944. From this time on Bruenn, chief of cardiology at Bethesda, had only one patient and one assignment- to keep the President of the United States alive. Bruenn convinced a panel of physicians convened by McIntire to employ the use of digitalis, over the initial objection of at least one member, James A. Paullin. When Paullin finally acceded to Bruenn's recommendation, the unpublished notes of Bruenn reveal a fatherly wink of success from the Surgeon General (6). In fact, all of the existing communications between Bruenn and McIntire reflect the highest degree of personal respect and professional cooperation.
On February 5, 1944, less than two months prior to Bruenn's alleged "de novo" diagnosis of congestive heart failure, a benign epidermoid cyst or "wen" was removed from the back of the President's head at Bethesda. The primary surgeon was the Navy's chief of plastic surgery, George Webster, assisted by the head naval neurosurgeon, Winchell M. Craig. A recently revealed, reliable letter written by Webster describing the incident indicates that five other physicians, including McIntire, were present in the operating room as well (7). Webster noted that the President was being treated at the time for a "cigarette cough" and that his first professional contact with FDR was in the operating room on that day, clearly indicating that he was not privy to any other detailed information about Roosevelt's history, likely being chosen for the task by McIntire solely because of his technical expertise. There is little doubt that the President was in cardiac failure at the time. It is unconscionable that this group of distinguished, senior naval physicians was present at the performance of a surgical procedure upon the President of the United States and that none knew of his cardiac status. This would not only reflect poorly upon McIntire as Presidential physician, but would also constitute a wholly unrealistic indictment of the quality of naval medicine itself.
Roosevelt's heart failure was likely symptomatic and known to his physicians long before Doctor Bruenn allegedly first entered the picture. As early as January 1943, Admiral McIntire ordered that the President's plane fly no higher than eight-thousand feet on his flight to Casablanca. In early 1944, he was sleeping propped up in bed, a cardinal sign of cardiac compromise. Even Bruenn refers to a "history of orthopnea" (8) When the President's cardiac status had deteriorated to such an extent that his life was in imminent danger and it was deemed that more aggressive treatment as well as a cardiologist's personal, daily, undivided attention was necessitated to keep him alive, Bruenn could no longer be hidden and some acknowledgement of the condition he was treating became necessary for family and those who were with FDR on a daily basis. Letters between Bruenn and McIntire in 1946 and Mcintire's own book (9) confirm that Bruenn had been treating the President for considerably longer. White House reporter Walter Trohan goes so far as to say that Bruenn was recruited into the Navy specifically to care for the President (10).
Throughout this time, Mcintire's attributed the president's haggard appearance, frequent, prolonged absence from public view and cancelled press conferences to "influenza" or "a cold" and his weight loss to pride in his "flat tummy". Even after Roosevelt's death in April 1945, McIntire continued to publicly deny the severity and, indeed, the very existence of the President's severe medical problems. His 1946 book, White House Physician, written with historian George Creel, who balked at the speed and quality of McIntire's input, is testimony to his continuing program of disinformation. As late as 1951, when James A. Farley, formerly a close associate of Roosevelt, made some public statements about the severity of FDR's illness, McIntire gave an interview to U.S News and World Report(11) rebutting Farley'?s claims in typical fashion, even in the face of widespread recognition that Farley's assertions were correct. McIntire was, and continues to be vilified for his lack of candor, interpreted as a combination of incompetence and hubris. Thomas Fleming's excellent 2001 book, The War Within World War II, refers to him as a "medical ignoramus" (12). Nothing could be further from the truth.
After McIntire's death in 1959, the role of chief protector of the secrets of FDR's health was passed to Howard Bruenn. His 1970 paper in Annals of Medicine was written in conjunction with the Roosevelt family to allegedly clear the air of all the rumors about the President's health. While it did reveal new details of the severe cardiovascular problems that the President suffered in the last year of his life, it was indeed nothing more than a more sophisticated and updated document of purposeful deception, timed to divert the impact of a book written by a highly-regarded historian, Hugh L'Etang that credibly raised the possibility that Roosevelt had melanoma (13). In 1979, when surgeon Harry Goldsmith presented a similar assertion in a respected medical journal, Bruenn flatly denied the president had any form of cancer when contacted by TIME Magazine (14).
In his later years, Bruenn was frequently sought out to discuss his experiences treating President Roosevelt, including a detailed interview by Navy Medicine in 1989. To all Bruenn spoke with, he left a distinctly negative impression of his mentor, Admiral McIntire. This is highly out of character for the honorable, competent physician and loyal naval officer that Bruenn was. The logical inference is that this again was no more than another calculated technique of subterfuge, designed to protect the most intimate secret of his commander-in-chief, the most powerful and charismatic personality of the twentieth century. It would not at all be surprising if McIntire himself had given Bruenn permission to speak as he did, in order to protect Roosevelt, knowing that his own reputation as Presidential physician was already irretrievably tarnished.
A true reflection of the respect that FDR had for McIntire and naval medicine is well seen in Robert Sherwood's book Roosevelt and Hopkins: An Intimate History, in a revealing anecdote about the medical treatment in 1939 at the Mayo Clinic of Harry Hopkins, FDR's close associate, for a severe life-threatening gastrointestinal disorder. It also provides revealing insight into Roosevelt's personality and how he approached an allegedly insurmountable medical problem:
"Hopkins" son, David, was informed at this time that his father had about four weeks more to live. And Roosevelt told friends, "The doctors have given Harry up for dead."
Hopkins himself believed that he could not live more than a few weeks. However, Roosevelt proceeded to assume charge of the case himself. Ever intolerant of the defeatist attitude, he indignantly rejected the possibility that Hopkins' life could not be saved. He turned the problem over to the U.S. Navy and Dr. McIntire called in Admiral Edward R. Stitt, (former) Surgeon General of the Navy and one of the greatest authorities on tropical diseases. Hopkins was moved from Rochester to Washington to become a guinea pig for all manner of biochemical experiments; it was a tremendous ordeal, but it was ultimately successful in prolonging a few weeks' margin of life into six years of memorable accomplishment. (15) Mcintire himself refers to this incident in his 1946 book (16):
"Study developed that Harry's trouble came from an imbalance of proteins in the blood stream, and the use of blood substitutes soon helped him".
Dr. McIntire retired from the navy in 1946. Among his many distinguished subsequent appointments were as Director of the American Red Cross National Blood Bank Program and Executive Director of the International College of Surgeons. He ran unsuccessfully for congress in 1954.
The truth has now emerged. Ross T. McIntire was a physician of high competence and character and the epitome of the duty and honor of a naval officer, consistently compromising his own personal reputation in order to honor the wishes of his Commander-in-Chief. His recognition in this role is long overdue.
A January 29, 1945 letter to Albert Q. Maisel from Doctor Frank Lahey, a man not easily given to compliments, about McIntire sums it up well (17):
"I do not flatter him in the least when I say I have never known a more completely unselfish individual in such a high and influential position. He wants nothing for himself". "Everywhere I go in the Navy, I talk with commanding officers and they all feel as I do, that the Navy and the country is blessed with such a Surgeon General."
1. Mcintire, RT and Creel, G, White House Physician; C.P Putnam's Sons, 1946; p. 58
2. Bruenn, HG, Clinical Notes on the Illness and Death of President Franklin D. Roosevelt. Annals of Internal Medicine 72: 579-571, 1970
3. Ross McIntire papers, Franklin Roosevelt Library
4. Crispell, KR and Gomez, CF; Hidden Illness in the White House; Duke University Press, 1988; p. 118, FOIA file 81-DFI-1259
5. Bruenn, p. 579
6. Howard Bruenn papers, Franklin Roosevelt Library
7. Goldsmith, HG, Conspiracy of Silence; IUniverse, 2007; pp. 50-53
8. Bruenn, p. 581
9. McIntire, p. 27
10. Trohan, Walter; Political Animals; Doubleday & Company, 1975; p. 200
11. McIntire papers, FDR Library
12. Fleming, Thomas; The War Within World War II; Perseus Press, 2001; p. 398
13. L'Etang, Hugh, The Pathology of Leadership, Hawthorn Books, 1970; p. 95
14. TIME Magazine, December 17, 1979
15. Sherwood, Robert E., Roosevelt and Hopkins, An Intimate History, Harper & Brothers, New York, 1948 p.121
16. McIntire, p. 94
17. McIntire papers, FDR Library
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