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B I O G R A P H I C A L E X P L O R A T I O N

Franklin Delano Roosevelt: A Famous Patient

Curtis W. Hart

Published online: 24 May 2014 � Springer Science+Business Media New York 2014

Abstract Franklin Delano Roosevelt is arguably one of the greatest of American Pres- idents. His encounter with the polio that crippled him at an early age and its transformative

impact upon him are here discussed with particular reference to his relationship with his

physician, Dr. George Draper. This transformation liberated energy in Roosevelt to lead

and to show empathy for others in ways that both challenged the political and social status

quo in the USA as well as helped save the world from the threat of Fascism in World War

II. This essay seeks to demonstrate how an investigation of the life and struggles of this

famous patient is one avenue for relating the study of the humanities to medical education.

An earlier version of this paper was presented as the Heberden Lecture in the History of

Medicine at the New York Academy of Medicine in 2012.

Keywords Franklin D. Roosevelt � Polio � New Deal � Patienthood � Disability � American presidency � George Draper, M.D. � Humanities in medical education

Introduction: History, the Humanities, and Medical Education

There is a steady but growing interest regarding the place of the humanities in medical

education. It arises out of an increasing awareness that medicine needs to become more

patient centered and the education of future physicians should include exposure to the sorts

of issues and concerns often best approached through a holistic approach in the profes-

sional formation of physicians. This more interdisciplinary approach represents a coming

of age, a transformation, in medical education going well beyond the concerns and vision

This essay is dedicated to the memory of George Upson Warren teacher and friend.

C. W. Hart (&) Division of Medical Ethics, Weil Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA e-mail: [email protected]

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J Relig Health (2014) 53:1102–1111 DOI 10.1007/s10943-014-9886-3

of Abraham Flexner’s revolutionary report of the first two decades of the last century.

Flexner made a successful case for grounding medical education in the sciences for the first

2 years and clinical applications of science in the treatment of patients under the close

supervision of senior physicians in the last 2 years of the traditional 4-year course. The

universal acceptance of these ideas in the USA represented a sea change, a virtual revo-

lution in medical education. Increasingly, with the advent and development of biomedical

research and its application in what is known as ‘‘results based medicine’’ life expectancy

has increased even as the costs of medicine have grown exponentially.

Something, however, was discovered to be missing in students’ learning about the

maintenance and development of the doctor–patient relationship. With skilled assistance,

young doctors and medical students can be encouraged to develop empathy and a deeper

understanding of the nature of suffering. These dimensions of medicine need to be

explored in conjunction with the concepts and applications of the sciences of the traditional

medical curriculum. The disciplines traditionally seen as part of the humanities (literature,

history, art, music) have much to add to the scientific and clinical education required for a

career in medicine. Rather than labor over some extended, abstract philosophical discus-

sion of why the humanities matter in medical education this essay focuses on an illus-

tration, a case history, showing how and why a cultivation of empathy and an engagement

with the meaning of suffering can and does make a difference in patient care. To that end

what follows is a discussion of the relationship of a very famous patient, Franklin Delano

Roosevelt, with his doctor and how his experience with his physician and with his own

illness affected his inner life as well as his public persona and political achievements. This

relationship embodied compassion as therapeutic empathy between doctor and patient. It

helped Roosevelt face his suffering and enabled his political imagination to find expression

in his presidency.

Who Was Franklin D. Roosevelt?

Let us begin by offering this quotation from our patient, one that many, or most, persons

know.

Let me assert my firm belief that the only thing we have to fear is fear itself. … nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert

retreat into advance. (Hitzik, 2011)

Those words are the cornerstone of Franklin D. Roosevelt’s first inaugural address given

on March 4, 1933. We remember them for they set the tone for the longest presidency in

our history that began at a moment of grave crisis that can only be compared to the

presidencies that began in 1861 and 2009. The Great Depression starting in 1929 had left

America beset with twenty-five to thirty percent unemployment, an economy in shambles,

and confidence in government and democratic institutions at its lowest ebb. Most know this

history, or at least some of it, but his significance can be summarized with these words of

one recent Roosevelt biographer.

Three presidents dominate American history: George Washington who founded the

country; Abraham Lincoln who preserved it; and Franklin Delano Roosevelt, who

rescued it from economic collapse and then led it to victory in the greatest war of all

time. (Smith, 2008)

There are some who will protest about the virtues of Roosevelt and his legacy.

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We need to remain aware of his shortcomings in both his public and private life. He

unsuccessfully attempted to enlarge the number of justices on the Supreme Court in 1937

so that the ‘‘nine old men’’ in that body would be neutralized in declaring his prized social

legislation unconstitutional. For a person graced with extraordinary political skills, this

ploy was ill advised at best and later proved to be unnecessary given his subsequent

opportunities for the appointment of liberals to the Court. He tried unsuccessfully to use his

political influence to unseat eight incumbent Southern and conservative Democratic

Senators in 1938 thus alienating a vital part of his constituency. Some feel he derailed

economic recovery in his second term by attempting a balanced budget and reducing

government spending. He backed the relocation of Japanese Americans on the West Coast

to what amounted to concentration camps in the wake of the attack on Pearl Harbor, surely

one of the greatest abridgements of constitutional rights in our history. He failed to support

anti lynching laws to outlaw a practice that was carried on with relative, if not complete,

impunity in the Jim Crow South. He and Winston Churchill were not able to launch a

second front in the war against Germany until June of 1944 thus leaving the burden of the

fighting and dying to the Soviet Union.

On a personal level his supreme self-confidence allowed Franklin Roosevelt to

manipulate others with impunity. He could be immensely charming. Winston Churchill

once said that ‘‘meeting him was like opening a bottle of champagne.’’ And yet he was cold

and calculating in dealing with staff and colleagues. No one knew quite what he was

thinking. He managed his staff by never letting one person know what the other was doing.

Roosevelt was a ‘‘compatmentalizer’’ par excellence in the way he kept secrets as a key to

managing his presidency. For example, his new Vice President Harry Truman did not know

about the Manhattan Project to build the atomic bomb until 10 days after Roosevelt died in

April of 1945 and just 3 months before the bomb was to be tested. Consider also the

following comment found in former Secretary of State Madeline Albright’s recent memoir

Prague Winter

Roosevelt’s policies were notoriously hard to pin down. Around the time of Munich,

FDR had privately compared British and French actions to those of Judas Iscariot;

officially, he cabled his congratulations to [British Prime Minister Neville] Cham-

berlain. After the invasion of Prague, he warned Hitler against further aggression but

without specifying any penalty. (Albright, 2012)

This list could go on and on depending upon whom you read.

Roosevelt and Dr. Draper

Much of this essay depends upon material found in contemporary biographical studies

about Franklin Roosevelt. Most of it was not present in earlier studies such as Arthur M.

Schlesinger’s three volume study The Age of Roosevelt. The more contemporary studies

include significant portions devoted to what Roosevelt gained from his relationship with

his doctor, George Draper. Therein hangs a tale that all who would become healers should

know and take to heart. It illuminates and underlines what history and the humanities in

general can teach us about doctoring. What follows is an exploration of the relationship of

Franklin D. Roosevelt to Dr. Draper, medicine, and disease and what they contributed to

his inner transformation and to an articulation of his vision of the relationship between

government and its citizens that resulted in a restructuring of the notion of the social

contract in the USA.

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In 1921, while vacationing with his family at Campobello Island in Maine Franklin

Roosevelt, then thirty-nine, displayed symptoms of and was later diagnosed with

poliomyelitis, otherwise known as infantile paralysis, then a scourge until the develop-

ment of vaccines in the 1950s and 1960s. There have been those who subsequently have

hypothesized that Roosevelt may have suffered from Guillain–Barre syndrome though

this is apparently hotly debated. But no matter, the results were the same. Roosevelt was

paralyzed from the waist down. After the initial fever and paralysis subsided, he worked

assiduously with the assistance of family and aides to regain mobility. These efforts

continued for years at the treatment facility he helped to found at Warm Springs Georgia

to regain use of his lower limbs. It never happened though for the rest of his life

Roosevelt endeavored to return to full functioning. His first doctor misdiagnosed him and

advocated vigorous massage of the limbs which was absolutely the wrong thing to do in

the wake of the onset of paralysis. His second, a renowned physician, Dr. Robert Lovett

of Harvard Medical School was summoned to Campobello Island where he identified

polio. The third, George Draper, then a rising star at Columbia who had published on

polio, was asked by Roosevelt’s family and his former teacher Dr. Lovett to take on the

case. Drugs, such as they were, seemed to be of no value, and Roosevelt, then at the peak

of adult life and embarked on a political career destined for stellar achievement, was

filled with anxiety. At that point, as often happened later through his Fireside Chats to

the American public during the Depression and World War II, he helped everyone else in

his entourage to keep their spirits up no matter the bleakness of the situation. He con-

tinually provided the same sort of uplift to other polio victims later on at Warm Springs,

Georgia.

So what did George Draper do in the case of our famous patient? First, he built a finely

tuned therapeutic alliance with Roosevelt whom he had known since their boarding school

and college days at Groton School and Harvard. Second, he did not think recovery was

possible but never said so openly in all the years he treated Franklin Roosevelt. He was

able, through careful listening and reflection, ‘‘to calibrate just the right approach to

Roosevelt’s care.’’ (Feldman, 2010) Draper noted the following early on in Roosevelt’s

treatment in a note to Dr. Lovett

The psychological factor in his [Roosevelt’s] management is paramount… he has such courage, such ambition, and yet at the same time such an extraordinarily sen-

sitive emotional mechanism, that it will take all the skill we can muster to lead him

successfully to a recognition of what he faces without utterly crushing him. (Feld-

man, 2010, Brands, 2008, Simon, 2012)

At the outset, Draper displayed confidence such as is reflected in this remark to The New

York Times of September 16, 1921 at which time Roosevelt had been transferred to

Presbyterian Hospital (now Columbia Presbyterian Medical Center) in New York for

treatment

[H]e definitely will not be crippled … No one need have any fear of any permanent injury from this attack. (Simon. 2012)

Draper’s initial statement apparently was spoken to increase Roosevelt’s confidence as

much as it was for addressing the press. After 6 weeks at Presbyterian, he would add a note

in Roosevelt’s record indicating that he was not improving. And later in 1924, after having

followed Roosevelt for this extended period of time, he would write the following again to

Dr. Lovett

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I am very much disheartened about his ultimate recovery. … I cannot help feeling that he has reached the limit of his possibilities. (Simon, 2012)

It was clear that George Draper would have to turn elsewhere to find a strategy for

treating his famous patient.

Draper was at the time in the process of developing a medical philosophy he called

‘‘constitutional medicine’’ that we would probably now call ‘‘holistic medicine.’’ In that

framework, the whole person—the whole constitution—was to be treated more than a

patient with a disease. Draper was an excellent clinician, a leader in his field, who was also

interested in human psychology, what makes us ‘‘tick.’’ From that perspective, he could

understand what he was dealing with in regard to his famous patient. He treated Roose-

velt’s emotional state during the years of his recovery (the 1920s) in such a way that one

historian believes that Roosevelt ‘‘was the first American president to have received a

species of psychiatric care and to have been treated extensively for his mental state.’’

(Feldman, 2010) Roosevelt was to emerge again on the political scene at the Democratic

National Convention of 1924 and was then elected Governor of New York before his

ascent to the presidency.

George Draper deserves additional comment to sketch out both his philosophy more

fully and to provide additional historical context. As suggested above, Draper was inter-

ested in the patient as a whole person. He can be included within those who can be

considered among a group of physicians and other professionals as practitioners of psy-

chosomatic medicine in the form that arose to prominence in America in the first half of the

twentieth century. His approach is described by medical historian Robert Powell with these

words

Draper … would invite students to observe and correlate the patients ‘‘four panels of personality’’ – that is, the patient’s anatomic, physiologic, psychic, and immunologic

characteristics – and then ask ‘‘What disease or disorder is this patient as a person’’

most likely to have?’’ (Powell, 1974).

It is fortunate that many of Draper’s ideas abut the interplay of psyche and soma arose

during the period in which he was treating Franklin Roosevelt and at a time when, as noted,

there was an increased interest in psychosomatic medicine in the USA. And, in addition, it

was Draper who also came to treat Associate Justice of the Supreme Court William O.

Douglas for a series of crippling conditions rooted in Douglas’ personal history of fears

relating to peritonitis from which he nearly died as a child.

There are a number of issues that surface here in regard to Roosevelt that deserve

elaboration and debate. This situation might be discussed and reflected upon through the

following lens having to do with ethics and patient care. What are the concerns to be raised

here? First, there is economic reality. Because Roosevelt was among the social and

moneyed elite he could afford the best and got it including superior physiotherapy. It is not

for nothing that given his later economic reforms in the New Deal that he was referred to as

‘‘a traitor to his class.’’ Then, as now, access and affordability along with quality were

crucial for optimal health care. Second, Roosevelt had a family who were invested in

helpful ways with his care, a factor that is always important in any assessment for recovery.

Third, Roosevelt was motivated to get better. He never gave up even in the face of what

appeared to be a grim future. Fourth, he had a life, a future, a vocation through his calling

to public service. If nothing else everyone, including his enemies of whom he had a great

number, could see that Roosevelt was grandly ambitious. He wanted power. He intuitively

understood this about himself from very early on in life long before the onset of his polio.

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He was not to be denied. Fifth, there is, for lack of a better term, a ‘‘spiritual’’ component

to healing (that is, making whole and thus different from curing) that enlists the patient’s

will, determination, and hope. Here, George Draper was instrumental in both preserving

and enhancing those qualities of his mind and spirit. Sixth, Roosevelt became dependent on

others and could accept help in sustaining his political contacts and in the everyday

maintenance of his personal needs. He did not become isolated. Last, and this is the most

obviously problematic, with the help of Dr. Draper and others he was able to remain in

denial of his prognosis. Was this a good thing? Aren’t doctors and other care givers

supposed to be honest and not withholding of significant information from their patients,

no matter how sensitively it might be communicated, such as ‘‘you have polio, you’re

crippled and will never walk again.’’ Or was Roosevelt’s autonomy, the term in medical

ethics for self determination, best served through the compassion and encouragement

embodied in Draper’s studied ‘‘constitutional’’ approach to his famous patient? And if they

did collude was this an act of mutual dissembling or one based on shared values? There is

material here for a protracted conversation involving historiography, psychology, and

ethics.

A First Rate Temperament and ‘‘Old Doc Roosevelt’’

As I have come to understand it, Roosevelt’s experience of patienthood and the way it was

handled by Dr, Draper affected two important aspects of his life going forward. The first

has to do with how Dr. Draper and others’ therapeutic alliance with Franklin Roosevelt

preserved and enhanced what has been identified by Jonathan Alter and others as his ‘‘first

rate temperament.’’ The second has to do with how Roosevelt’s coming to grips with his

paralysis and his experience of the medicine of his day contributed to his self concept of

leadership and his political and medical persona as ‘‘Old Doc Roosevelt.’’

Shortly after assuming the presidency, Franklin Roosevelt went to pay a courtesy call on

the retired Justice of the Supreme Court Oliver Wendell Homes, then 92, at his home in

Washington, D.C. Mr. Justice Holmes was a larger than life figure who had been on the

Court for decades and figured in its most far reaching decisions. He was an ardent sup-

porter of individual constitutional rights and though not formally a philosopher he is

acknowledged as a founder of the school of thought known as pragmatism. Given his

Boston Brahmin background, he was deserving of the title given to him by his early

biographer Catherine Drinker Bowen as ‘‘Yankee From Olympus.’’ At the end of the visit,

Holmes was heard to say (and we are not altogether certain whether he meant this for

Franklin Roosevelt or his cousin, Theodore) that he was a man with ‘‘a second rate intellect

but a first rate temperament.’’ This description has stuck with Franklin Roosevelt ever

since. That is because he was seen earlier on in his life as something of a snob or what was

then called a ‘‘swell’’, a lightweight when it came to ideas and the capacity to theorize

regarding just about anything. But then there was his ‘‘temperament’’, a major constituent

part of leadership. Temperament is more like what psychologist Daniel Goleman and other

have called ‘‘emotional intelligence.’’ How do you gather ideas, see into and through

conflicts, grasp opportunities, use others’ skills and gifts effectively, be ruthless when

necessary all the while maintaining a vision of the future? These are qualities necessary for

leadership. Roosevelt consistently amazed both his friends and foes at how tough and

charming he could be at the same time, how he could see weakness as well as opportunities

in both policies and persons, and how he could flatter others. He could display this intuitive

gift to see around corners and into a future for those whom he was elected to govern in

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domestic crisis and whom he would later lead to victory in war. Roosevelt biographers and

commentators consistently record data to support his having this ‘‘first rate temperament’’

for leadership. Former Secretary of State and National Security Advisor Henry Kissinger

states it this way

All great leaders walk alone. Their singularity springs from their ability to discern

challenges that are not yet apparent to their contemporaries. Roosevelt took an

isolationist people into a war between countries whose conflicts had only a few years

earlier been widely considered inconsistent with American values and irrelevant to

American security…. Roosevelt was able to persuade a society which had for two centuries treasured its invulnerability of the dire perils of an Axis victory. And he

saw to it that, this time, America’s involvement would mark a first step toward

permanent international engagement. During the war, his leadership held the alliance

together and shaped the multilateral institutions which continue to serve the inter-

national community to this day. (Kissinger, 1994)

Whether a ‘‘first rate temperament’’ is the product of nature or nurture is not known. It

does not seem to be able to be reduced into some formulaic mold. Jonathan Alter states

Beneath the loud motor of his energy lay a sensitive gauge, handcrafted by his own

suffering. Like many disabled people, he developed a strange sense of how others

reacted to him. (Alter, 2006)

This ‘‘sensitive gauge’’ was what Dr. Draper had identified early on in his treatment as

his ‘‘extraordinarily sensitive mental mechanism.’’ Others might underestimate him but he

was capable, as the columnist Joseph Alsop noted, that in relation to rivals Roosevelt ‘‘was

deftly using them while they thought to use him.’’ (Alter, 2006) If Dr. Draper and others

had confronted Roosevelt with the severity and hopelessness of his prognosis could this

evolution of his ‘‘first rate temperament’’ have ever taken place? His political genius may

never have been given an opportunity to find expression and fulfillment.

Moreover, this preternatural sensitivity to others, born in part out of his experience of

illness, was a major component in Roosevelt’s quest for and use of power. He could ‘‘read’’

people, allies and adversaries alike, with uncanny skill. Robert Caro in his Master of the

Senate, the third volume in his magisterial study The Years of Lyndon Johnson, notes that

Power, Lord Acton said, corrupts. Not always. What power always does is reveal.

(Caro, 2002)

Here, Caro is making reference to the famous dictum of Lord Edward Acton in 1887

that ‘‘Power tends to corrupt and absolute power tends to corrupt absolutely, Great men are

almost always bad men.’’ This is no idle comparison in that Franklin Roosevelt became

one of a number of Lyndon Johnson’s early mentors. And Johnson’s Great Society pro-

grams (Medicare, Medicaid, fair housing, aid to education, etc.) represent a continuation

and a fulfillment of the New Deal agenda. What, then, did Franklin Roosevelt, trapped in a

paralyzed lower body, reveal in his demonstration of power? He possessed a masterful

capacity to see into and shape events through appeals to an idealistic vision and accom-

plished oftentimes through an adept combination of persuasiveness, guile, and force of

will.

Roosevelt’s patienthood itself evolved from his time of his treatment at the center at

Warm Springs, Georgia for which he was primarily responsible. He both discovered it and

provided for its initial funding. His natural joy and exuberance became released and his

comfort with other fellow sufferers from polio allowed him to reach ‘‘a certain mental

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stage in a patient’s ‘polio progress’ where a patient did not walk again but when he begins

to concern himself with others—a priceless ingredient for recovery.’’ (Alter, 2006) Here

recovery must be re-contextualized and re-framed to be seen more like an inner spiritual

transformation, something that Roosevelt’s Secretary of Labor, Frances Perkins, noted in

him. Perkins had some authority on this subject having known him earlier on in their lives.

It should be added that Roosevelt was possessed of a keen practical and pragmatic

intelligence having to do with the maintenance of power and a grip on the grand strategies

of his presidency. He had a virtually photographic memory that allowed him to digest the

relevant content of four newspapers a day, recall the details and interlocking histories of

political figures and issues in every region of the USA, remain aware of salient aspects of

diplomatic and economic conflicts around the world, and retain the content of past con-

versations with confidants and those he sought to convince or woo.

This transformation did not mean that Roosevelt somehow became magically emptied

of guile and manipulation. Conversion, epiphany, and spiritual transformation never mean

a complete change in a person’s character. Rather, in this case recovery meant service,

meant action. Recovery meant what Roosevelt called in the New Deal ‘‘bold and

continuing experimentation.’’ His approach served those who had lost hope in the

Depression as had many of the patients who had come to Warm Springs. And Roosevelt,

like them, had to overcome the stigma and anxiety in others created by his paralysis that

led, for example, to remarks such as those of Supreme Court Justice James McReynolds

who called him ‘‘that crippled S.O.B.’’ There were also rumors circulated in the campaign

of 1932 that his paralysis was the result of his having contracted venereal disease. These

comments regarding Roosevelt recall Harry Truman’s remark ‘‘If you want a friend in

Washington, get a dog.’’

As noted earlier, Roosevelt’s efforts at developing the center for treatment of polio at

Warm Springs, Georgia that took place in the 1920s was a turning point in his inner

development. It was an old, rundown resort owned by a family friend in Bullochville,

Georgia nearby to Macon. Roosevelt bought it and proceeded to engaged in advertising its

warm, mineral springs as a curative for paralysis. He characterized himself as ‘‘Old Doc

Roosevelt’’ as he attempted just about every therapy then known to be of value in helping

him and others. As was the case earlier in his treatment nothing worked but he went on

trying less out of a sense of futility and more as a sign or chance for hope. The process was

in its way strikingly similar in political terms to the variety of responses and programs

arising out of the New Deal which were called by its opponents the ‘‘alphabet mon-

strosities’’—the NRA (National Recovery Act), the CCC (Civilian Conservation Corps),

the WPA (Works Projects Administration), the REA (Rural Electrification Administra-

tion), the AAA (Agricultural Adjustment Act), etc.

Some of the arrogance that had been a hallmark of the young Roosevelt departed. Now,

he unselfconsciously became ‘‘Old Doc Roosevelt’’ who would try virtually anything.

Because he had seen so many errors and missteps in his own treatment, he had grown

suspicious of the medical profession who apparently possessed few answers to his and

others condition. Again, there is here a parallel process to the suspicion he felt toward the

Congress, the Courts, and those in the business community whom he later called in 1936

‘‘the economic royalists’’ who had failed to respond to the Depression because of their own

conventional thinking. From Roosevelt’s perspective, they did not see clearly the issues of

social ill health posed by the Depression and its aftermath. What took place in the response

of Roosevelt and his Brain Trust was to find ways to legislate around and through the

banking and other critical situations they inherited upon taking office in 1933. These

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critical situations can be viewed as the legacy of what Arthur Schlesinger later called ‘‘the

crisis of the old order.’’

Roosevelt’s taking on of this medical persona can be seen in this exchange by letter with

George Draper in 1934 when he (Draper) like others felt the New Deal was going too far,

too fast. Draper wrote

There is a giant lying supine across the continent. He is paralyzed in arms and legs –

a victim of infantile paralysis. He is in the hands of a most earnest and conscientious

doctor. But the doctor is overtreating him. Would not the giant react more quickly

and completely if the current prescription of massage and specialized exercises were

interrupted for a period. Nature works in mysterious ways to heal wounds. The ideas

of man may interfere with the natural processes. (Alter, 2006)

Roosevelt responded to this evocation of the principle of melioration and faith in the

innate powers of the market to revive the giant in the following way

I like your supine giant and I should like to stop treatment were it not for the fact that

sixteen million little cells in his body would lose their circulation, starve and die, if

we were stop the gentle massage which keeps the blood running through these

sixteen million little cells. That is the only treatment being given at the present time.

Also, in cases like this medical history proves that if treatment is suddenly stopped

the giant is apt to leap from his bed and either commit suicide or die of an epileptic

fit. (Alter, 2006)

The persona Roosevelt adopted and the medical metaphor he employs suggest the

degree to which his experience of patienthood had affected his conception of leadership.

His ‘‘caring physician’’ knew the cost of inaction for a ‘‘supine patient’’ when left unat-

tended to. The entire body politic including its self, its soul, would be affected. It might

well be compelled to give up and die as democratic institutions and the economy failed

again and again to offer relief or resuscitation. Or it could become suicidal or die ‘‘of an

epileptic fit’’ by turning compulsively in the direction of temptations to either communism

or fascism. Roosevelt’s description, moreover, may unconsciously reflect something of his

own condition of despair and the temptation to give up experienced during the early phases

of his coming to grips with his paralysis.

Finally, there was a subsequent transformation as his biographers note, from Roosevelt

moving from being ‘‘Dr. New Deal’’ to ‘‘Dr. Win the War’’ after 1941. In getting to that

point he had once more utilized a medical term when in the face of the hostile moves by

Japan, Germany, and Italy. In a highly publicized speech in 1937, he called for a ‘‘quar-

antine’’ on the aggressors. By that time, Japan had invaded China, Italy had conquered

Ethiopia, and Germany had reoccupied the Rhineland and was clearly preparing for war. In

that address he said

… the epidemic of world lawlessness is spreading. … And mark this well! When an epidemic of disease starts to spread, the community approves and joins the quar-

antine of the patients in order to protect the health of the patients against the spread

of the disease. (Smith, 2008)

Beyond the obvious political context, there may be here a more intimate and inner

reference, perhaps altogether unconscious, to quarantines for the flu epidemic of 1918 and

for polio both of which Roosevelt lived through and knew. This prophetic utterance took

place long before others would confirm his viewpoint, his diagnosis of the world’s

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precarious position. This was not a speech that gained him much, if any, favor from those

who wished to retain a traditional American isolationist posture.

Conclusion

A Patient of Exceeding Import

The psychoanalyst Erik Erikson says the following in his psychobiography of young

Martin Luther

Soren Kierkegaard wrote in his diary ‘‘Luther … is a patient of exceeding import for Christendom’’ [after which Erikson continues] … In quoting this statement out of context I do not mean to imply that Kierkegaard intended to call Luther a patient in

the sense of a clinical ‘‘case’’; rather, he saw in him a religious attitude (patienthood)

exemplified in an archetypal and immensely influential way … (Erikson, 1958)

The above description may indeed hold true for our famous patient who, like Luther,

was also a reformer. Both were larger than life historical figures. Roosevelt embodied,

quite literally, the archetypal condition of the country he came to lead and for whom he

became, in Erikson’s words ‘‘immensely influential.’’ He and his country had become

paralyzed and there had to be a way for both of them to stand erect once more and walk.

His struggle with illness was crucial for his leading government to care for society and its

people in new and revolutionary ways. And his dramatic utterances, his speeches, became

ways of addressing both audibly and through their eventual metamorphosis into public

policy the deepest needs in the human condition as he found it. He made his suffering

count for something. That is why Franklin Delano Roosevelt deserves to be known as a

famous patient.

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