by svanderwerff | 23 February 2015 By Andr? B. Sobocinski, BUMED Historian [caption id="attachment_8067" align="aligncenter" width="747"] The photographs taken of FDR at Yalta show him looking worn down and wan. Heavy smoker with high blood pressure?a devotee of fried foods?under chronic stress?occasional chest pains. ?? These factors would raise red flags for any physician, especially the one overseeing the health of the President of the United States. [caption id="attachment_8068" align="alignleft" width="255"] The president?s primary physician Vice Adm. Ross McIntire recruited Lt. Cmdr. Howard Bruenn (1905-1995), a talented Navy cardiologist at Naval Hospital Bethesda, Maryland, to conduct a complete heart and lung examination on the president. In a country where the president?s health is often seen as a reflection of the country?s well-being?it can impact most everything from national morale to world economies;and ?it?s no wonder that Franklin Delano Roosevelt?s medical condition was such a guarded secret his final years. Scholarship presents a picture of a man whose deterioration was steady and may have even been worsened by other terminal conditions such as melanoma. One thing is certain, in 1944, with the country ?still at war, FDR was a sick man. Early in March 1944, the president?s primary physician Vice Adm. Ross McIntire recruited Lt. Cmdr. Howard Bruenn (1905-1995), a talented Navy cardiologist at Naval Hospital Bethesda, Maryland, to conduct a complete heart and lung examination on the president(1) Dr. John Bumgarner would write in The Health of Presidents, that Bruenn?s initial examination of Roosevelt revealed, ?a drawn, gray, and exhausted individual, who became short of breath on the very slightest exertion. The examination of his eyes revealed some changes due to arteriosclerosis and hypertension.? Bruenn concluded that the president was in heart failure.? McIntire summoned honorary Navy medical consultants Dr. James Paullin, President of the American Medical Association, and Dr. Frank Lahey, of Lahey Clinic Fame, to discuss the president?s health.?? Bruenn presented Roosevelt?s cardiogram, blood pressure readings and the result of the physical exam. ?I said that we had to digitalizehim,? Bruenn later remembered.(2)? ?They thought that was all too drastic and extensive.? Bruenn had the president reduce his calorie intake and recommended improved sleeping habits. When the new diet made the president face increasingly gaunt his medical team advised that they reverse course and increase his calorie intake in order to present the picture of a healthier man. [caption id="attachment_8069" align="alignright" width="219"] Bruenn?s initial examination of Roosevelt revealed a drawn, gray, and exhausted individual, who became short of breath on the very slightest exertion. Roosevelt?s condition was such that in February 1945, Bruenn would travel with him to the Yalta Conference (February 4-11).? The photographs taken of him at Yalta show him looking worn down and wan. Bruenn would recall that after a particular day of tough negotiations, ? he had something we call pulsus alternans which means that every alternate beat was less strong than the previous one.? That's a very bad sign.? But that too subsided after 12 hours.?? Bruenn had the president cut down on his activities for the next 24 hours and on the return trip home was fine. In March 1945, Roosevelt traveled to the ?Little White House? in Warm Springs, Georgia, with his cardiologist again in tow.? His blood pressure went through drastic changes from 170/88 up to 240/130. Bruenn later remembered, ?A combination of arterial change and the blood pressure ?was a constant strain on the arteries.? For some reason, one popped.? [caption id="attachment_8070" align="alignleft" width="287"] While sitting for a portrait Roosevelt complained of a terrible headache. Fifteen minutes later, the president was dead of a massive cerebral hemorrhage. On the afternoon of April 12, 1945, while sitting for a portrait being painted by the artist Elizabeth Shoumatoff, Roosevelt complained of a terrible headache. Fifteen minutes later, the president was dead of a massive cerebral hemorrhage. After the president?s death, Bruenn went back to Naval Hospital Bethesda before leaving service in 1946. ?The very same year Vice Adm. McIntire would publish the memoir The White House Physician which has been called by some a ?fine piece of subterfuge? and a means of keeping the president?s actual medical condition shrouded in mystery. Mystery or not, interest in FDR?s health record has waned little over the last seventy years and continues to be the subject of books and academic articles.? ?And today the question remains: is there anything that could have been done to prolong the beloved president?s life? Footnotes: (1)?? An otolaryngologist (and first presidential physician with a specialty certification), Vice Adm. McIntire was first introduced to the president by Woodrow Wilson?s physician Cary Grayson in 1933. Mcintire was appointed as the president primary physician in 1938 and would serve in this role concurrently while serving as the Navy?s Surgeon General. (2)?? Digitalis, or foxglove, is a powerful cardiac stimulant used to increase heart function and efficiency. Sources: Bumgarner, John. The Health of the Presidents: The 41 United States Presidents Through 1993 from a Physician?s Point of View. Jefferson, NC: McFarland & Company, Inc. 1994. Deppisch, Lud. The White House Physician: A History from Washington to George W. Bush. Jefferson, NC: McFarland & Company, 2007. Evans, Hugh. The Hidden Campaign: FDR?s Health and the 1944 Election. Armonk, NY: M.E. Sharpe. 2002. Herman, Jan. Oral History with Dr. Howard Bruenn, January 31, 1990.? BUMED Oral History Collection.