paralytic illness of franklin d. roosevelt paralytic illness of franklin d. roosevelt franklin d. roosevelt, later the 32nd president of the united states from 1933 to 1945, began experiencing symptoms of a paralytic illness in 1921 when he was 39 years old. his main symptoms were fevers; symmetric, ascending paralysis; facial paralysis; bowel and bladder dysfunction; numbness and hyperesthesia; and a descending pattern of recovery. he was diagnosed with poliomyelitis and underwent years of therapy, including hydrotherapy at warm springs, georgia. roosevelt remained paralyzed from the waist down and relied on a wheelchair and leg braces for mobility, which he took efforts to conceal in public. in 1938, he founded the national foundation for infantile paralysis, leading to the development of polio vaccines. although historical accounts continue to refer to roosevelt's case as polio, the diagnosis has been questioned in the context of current medical science, with a competing diagnosis of guillain–barré syndrome proposed by some authors. rare photograph of roosevelt in a wheelchair, with ruthie bie and fala (1941) illness and aftermath the roosevelt family at campobello (1920)roosevelt supporting himself on crutches at springwood in hyde park, new york, with visitors including al smith (1924)franklin (showing leg brace) and eleanor at hyde park (1927)roosevelt in his wheelchair at springwood in hyde park (1937) on august 9, 1921, 39-year-old franklin d. roosevelt, at the time a practicing lawyer in new york city, joined his family at their vacation home at campobello, a canadian island off the coast of maine. among those at campobello when roosevelt arrived were his wife, eleanor, their children, his political aide louis howe, howe's wife, and their young son.: 40–42 on august 10, after a day of strenuous activity, roosevelt came down with an illness characterized by fevers, ascending paralysis, facial paralysis, prolonged bowel and bladder dysfunction, and numbness and hypersensitivity of the skin.: 47 roosevelt came close to death from the illness. he faced many life-threatening medical problems including the possibility of respiratory failure, urinary tract infection, injury to the urethra or bladder, decubitus ulcers, clots in the leg veins, and malnutrition. eleanor's nursing care was responsible for roosevelt's survival.: 148–151 most of the symptoms resolved themselves, but he was left permanently paralyzed from the waist down. timeline of illness mid july: roosevelt gave testimony to a senate committee investigating a navy scandal.: 7–9 july 28: roosevelt visited the boy scout jamboree at bear mountain state park. august 5–8: roosevelt traveled to campobello with his friend and new employer, van lear black, on black's ocean-going yacht.: 19 august 9 (tuesday): roosevelt fell into the cold waters of the bay of fundy. later, he arrived at campobello.: 1 august 10: roosevelt spent the day physically active. afterward, he complained of chills, nausea, and pain in his lower back. he skipped dinner and went to bed. chills lasted through the night.: 10 : 235 august 11: in the morning, one of his legs felt weak. roosevelt had a fever. dr. eben h. bennet, a general practitioner in the nearby village of lubec who had known the roosevelts for years, visited roosevelt and diagnosed a bad summer cold. by the evening, one leg was paralyzed, and the other had become weak.: 10–11 august 12: both legs were paralyzed. his temperature was 102 °f (39 °c). pain shot through his legs, feet and back.: 51, 54 bennet suggested a consultation with dr. william w. keen, an eminent retired neurosurgeon vacationing nearby. roosevelt's legs were numb. they then became painfully sensitive to touch, "so painful that he could not stand the pressure of the bedclothes, and even the movement of the breezes across his skin caused acute distress.": 11 he could not pass urine. august 13: roosevelt was paralyzed from the chest down. on that day and the following, his hands, arms, and shoulders were weak. he had difficulty moving his bowels and required enemas.: 234 keen made what eleanor described as "a most careful, thorough examination".: 57–58 august 14: roosevelt continued to be unable to pass urine for two weeks, and required catheterization. his fever continued for a total of six to seven days.: 234 keen repeated his examination, a bending and prodding that elliott later termed "excruciating" for his father.: 58 keen diagnosed a clot of blood to the lower spinal cord, and prescribed massage of the leg muscles. eleanor and howe began massaging roosevelt's legs as instructed by keen, bringing on agonizing pain.: 13 august 15: prostrate and mildly sedated, roosevelt was occasionally delirious.: 14–15 august 19: frederic delano, roosevelt's uncle, had received a letter from louis howe requesting to find a doctor to come see roosevelt. delano called his son-in-law, a physician, who recommended he speak to another physician, a dr. parker. parker told delano that the case sounded like infantile paralysis, and that the leading authorities on the disease were at the harvard infantile paralysis commission in boston. delano caught a train and arrived the next morning.: 64 august 20: dr. samuel a. levine was at his office when delano telephoned brigham hospital on saturday morning. levine said the senior members of the harvard infantile paralysis commission, dr. lovett and dr. peabody, were out of town, but he would try to answer delano's questions. after reviewing the messages delano had received from campobello, levine thought roosevelt had acute poliomyelitis. he urged that a lumbar puncture be done, with the goal of making a diagnosis, but mainly because levine believed there could be acute benefit from the procedure.: 64–65, 327 : 192 delano phoned and wrote eleanor the same day,: 239 advising her to stop massaging roosevelt's legs, and to disregard keen's advice: "i think it would be very unwise to trust his diagnosis where the inf. paralysis can be determined by test of the spinal fluid.": 66 eleanor communicated with keen, who "very strenuously" resisted the idea of poliomyelitis. keen asked lovett to visit campobello.: 66 august 22: lovett met levine for dinner. lovett asked how to distinguish whether paralysis was caused by poliomyelitis or by a clot or lesion of the spinal cord.: 183–184 august 23: lovett left for campobello.: 68 august 24: lovett saw roosevelt and performed a "more or less superficial" examination since roosevelt was highly sensitive to touch. the arms were weak; the bladder was paralyzed; the left thumb indicated atrophy. roosevelt could not stand or walk, and lovett documented "scattered weakness, most marked in the hips".: 68 august 25: roosevelt's temperature was 100 °f (38 °c). both legs were paralyzed. his back muscles were weak. there was also weakness of the face and left hand. pain in the legs and inability to urinate continued.: 234 after a brief conference with keen, lovett saw roosevelt. lovett informed him that the "physical findings" presented a "perfectly clear" diagnosis of poliomyelitis.: 69–70 lovett ordered an end to massage, which had no benefit and caused pain, and recommended a trained nurse to care for roosevelt.: 75–76 september 1: roosevelt was still unable to urinate. his leg pain continued.: 3 september 14: roosevelt was transported to new york, by boat and train, a long and painful journey. september 15: roosevelt was admitted to presbyterian hospital in new york city for convalescence, under the care of dr. george draper, an expert on poliomyelitis and roosevelt's personal physician. lovett continued to consult from boston.: 76 there was pain in the legs, paralysis of the legs, muscle wasting in the lower lumbar area and the buttocks, weakness of the right triceps, and gross muscle twitching in both forearms.: 234 october 28: roosevelt was transferred from presbyterian hospital to his house on east 65th street. his chart still read "not improving".: 110 later: roosevelt exercised daily. his hamstrings tightened, and his legs were encased in plaster to straighten them by degrees.: 238 there was gradual recovery, but he remained paralyzed from the waist down. diagnosis after falling ill, roosevelt was seen by four doctors. eben homer bennet, the roosevelt family doctor, diagnosed a heavy cold. william keen, a retired neurosurgeon, thought roosevelt had a blood clot. robert lovett, an expert on the orthopedic management of children paralyzed from poliomyelitis, diagnosed "infantile paralysis", as did george draper, roosevelt's personal physician. roosevelt's physicians never mentioned guillain–barré syndrome (gbs) in their communications concerning roosevelt's case, indicating that they were not aware of it as a diagnostic possibility.: 455 all reports before 1921 of what is now called gbs were by european physicians, in european journals. the result was that very few american physicians knew that gbs was a separate disease. for example, lovett mistakenly believed that landry's ascending paralysis, now termed gbs, was one of the clinical presentations of paralytic polio.: 455 in 1921, an american physician would assume that if an individual developed a sudden, non-traumatic flaccid paralysis, it was due to paralytic polio. the concept of gbs as a separate disease was not widely accepted in the united states until after the second world war.: 232 efforts to rehabilitate roosevelt at warm springs (1929) roosevelt with polio patients in warm springs, georgia (1925) roosevelt was totally and permanently paralyzed from the waist down, and unable to stand or walk without support. for the next few months, he confined himself to indoor pursuits, including resuming his lifelong hobby of stamp collecting. in december 1921, after he had recuperated for several months, a physiotherapist began working with him to determine the extent of the damage. he was able to perform small exercises on his own, moving one muscle and then another. he was fitted with heavy steel braces that locked at the knee and provided enough stability that he could stand with crutches. in 1922, at springwood, he worked diligently to make his way across the room. he set himself the goal of getting down the long driveway, managing to do it once, but never trying again.: 241 in october 1922, roosevelt visited his law office at the equitable building, where a welcome-back luncheon had been arranged. the chauffeur assisting him failed to brace the tip of his left crutch and roosevelt fell onto the highly polished lobby floor. laughing, he asked two young men in the crowd of onlookers to help get him back on his feet. after the luncheon, he told friends it was a "grand and glorious occasion". he did not return to his office for two months.: 245 roosevelt believed that warmth and exercise would help rebuild his legs. he bought a run-down 71-foot (21.6 m) houseboat and, in february 1923, sailed to florida with friends and a small crew. eleanor found it dull and left, but roosevelt sailed for weeks, fishing and spending time with a succession of friends who came to visit. he designed a pulley system that lowered him into the water to swim. in may 1923, lovett documented no overall improvement over the preceding year, but roosevelt would not accept his doctors' determination that further progress was unlikely. he tried a range of therapies and made two more voyages on his houseboat, but his efforts had no effect.: 247–249 "between 1925 and 1928, franklin would spend more than half his time—116 of 208 weeks—away from home, struggling to find a way to regain his feet," wrote biographer geoffrey ward. "eleanor was with him just 4 of those 116 weeks, and his mother was with him for only 2. his children hardly saw him.": 248 roosevelt lost the use of his legs and two inches of height, but the subsequent development of the rest of his body gave him a robust physique, and he enjoyed many years of excellent health. jack dempsey praised his upper-body musculature, and roosevelt once landed a 237-pound (107.5 kg) shark after fighting it on his line for two hours.: 241, 266–267 roosevelt first traveled to warm springs, georgia, on october 3, 1924. for many years to come warm springs would be where he would retreat in comfort for hydrotherapy. with his physiotherapist at warm springs, roosevelt laboriously taught himself to walk short distances while wearing iron braces on his hips and legs, by swiveling his torso. for this "two-point walk", he would grip the arm of a strong person with his left hand, and brace himself with a cane in his right. on april 29, 1926, he bought warm springs with the intention of making it into a