rehabilitation center for polio patients.: 33–34 governor and president roosevelt was twice elected governor of new york, on november 6, 1928, and november 4, 1930. he moved into the governor's mansion in albany in january 1929. before he moved in, the mansion was made wheelchair-friendly with ramps and an elevator.: 68–87 roosevelt won the 1932 presidential election in a landslide and became the first (and, as of 2023, only) physically disabled person to be president of the united states. before he moved into the white house, ramps were added to make it wheelchair-friendly. any photos of the president were taken at certain angles and at a distance.: 88–105 public awareness roosevelt exiting a car during a campaign trip to hollywood, california (1932)roosevelt walking with assistance toward the dedication ceremony for the home of woodrow wilson (1941) roosevelt took great care to convince even close confidants that he was getting better, which he believed was essential if he was to run for public office again. to richard e. byrd, he wrote "by next autumn i will be ready to chase the nimble moose with you." to general leonard wood: his leg muscles "were all coming back." his public appearances were carefully choreographed to avoid the press covering his arrival and departure, which would have shown him getting into or out of a vehicle or train. in private he used a wheelchair, but was careful not to be seen using it in public, although he sometimes appeared on crutches. he usually appeared in public standing upright, supported on one side by an aide or one of his sons. for major speaking occasions, an especially solid lectern was placed on the stage so that he could support himself on it; as a result, in films of his speeches, roosevelt can be observed using his head to make gestures because his hands were gripping the lectern.: 88–105 journalist john gunther reported that in the 1930s, he often met people in europe, including world leaders, who were unaware of roosevelt's paralysis.: 239 david brinkley, who was a young white house reporter in world war ii, stated that the secret service actively interfered with photographers who tried to take photos of roosevelt in a wheelchair or being moved about by others. the secret service commonly destroyed photographs they caught being taken in this manner; however, there were occasional exceptions. disability advocate hugh gallagher posited that roosevelt was desperate to appear able-bodied. "fdr did not want the public to be aware that he was forced to use a wheelchair.": 92 when discussing roosevelt's limited use of a wheelchair in public, gallagher stated, "this was not by accident. it was a strategy that served to minimize the extent of his handicap: to make it unnoticed when possible and palatable when it was noticed.": xiv in contrast, historian james tobin argued that roosevelt used his disability to his advantage. tobin stated, "but he could, instead, show himself to be something he had never been seen as before: a fighter and, and better yet, an underdog. not a man to pity; not a man to envy; but a man to cheer.": 273 when roosevelt addressed the congress in person on march 1, 1945, about a month before his death, he made public reference to his disability for almost the first time in 20 years.: 36 "i hope that you will pardon me for this unusual posture of sitting down," roosevelt began, "but i know you will realize that it makes it a lot easier for me not to have to carry about ten pounds of steel around on the bottom of my legs." legacy roosevelt accepts a $1 million check, the proceeds of the first national president's birthday ball (1934) march of dimes on january 3, 1938, roosevelt founded the national foundation for infantile paralysis, now known as the march of dimes. basil o'connor, an attorney and close associate of roosevelt, helped establish the foundation and was its president for more than three decades. the organization's annual fundraising campaign coincided with roosevelt's birthday on january 30. the organization initially focused on the rehabilitation of victims of paralytic polio and supported the work of jonas salk and others that led to the development of polio vaccines. today, the march of dimes focuses on preventing premature births, congenital disabilities, and infant mortality. because he founded the march of dimes, a dime was chosen to honor roosevelt after his death. the roosevelt dime was issued on january 30, 1946. warm springs institute roosevelt's center at warm springs operates today as the roosevelt warm springs institute for rehabilitation, a comprehensive rehabilitation facility operated by the state of georgia. a center for post-polio treatment, it provides vocational rehabilitation, long-term acute care, and inpatient rehabilitation for amputees and people recovering from spinal cord injuries, brain damage, and stroke. franklin delano roosevelt memorial wheelchair statue the roosevelt memorial in washington, d.c., includes a statue of roosevelt in a wheelchair. the wheelchair statue was not originally included in the memorial. the statue was added in january 2001 because of the concerns of disability-rights advocates and fundraising by the national organization on disability. retrospective diagnosis statistical analysis a 2003 peer-reviewed study by armond goldman and others reconsidered the diagnosis of roosevelt's illness, using three diagnostic methods – pattern recognition, reconstructing the pathogenesis, and bayesian analysis – and found guillain–barré syndrome (gbs) more probable than poliomyelitis. for the bayesian analysis, the best estimate of the annual incidence of gbs was 1.3 per 100,000. for paralytic polio in roosevelt's age group, an annual incidence of 1.0 per 100,000 was used. the paralytic polio rate was derived from the exceptionally severe polio epidemic that struck new york city in 1916, to tilt the odds in favor of polio. the prior probability of paralytic polio in roosevelt's age group in the united states in 1921 was likely much lower because paralytic polio was at one of its lowest ebbs in the northeastern region of the country at that time.: 123 : 26 in july 1921, three cases were reported in new jersey. by late august some 100 cases were reported in the state of new york. based on the incidence rates for gbs and paralytic polio, and symptom probabilities from the medical literature, roosevelt's symptoms were analyzed by bayesian analysis to obtain posterior probabilities, as listed below. goldman and his co-authors found that six of eight symptoms favored gbs, with the posterior probability of gbs shown for each: 98%: roosevelt's paralysis was symmetric and ascending, and progressed more than four days, whereas the paralysis in poliomyelitis is typically asymmetric, variable in its ascent or descent, and usually progresses for only two to four days. a review of the medical research literature revealed only one report of paralytic polio with a symmetric, ascending paralysis. 98%: roosevelt's numbness and hyperesthesia rarely if ever occur in paralytic polio (motor neurons affected), but are common in gbs (sensory neurons also affected). 98%: a consistent descending pattern of recovery from paralysis is absent in paralytic polio, but common in gbs. 97%: facial paralysis, as roosevelt had, in the absence of other cranial nerve abnormalities, is not consistent with a polio diagnosis, but is common in gbs. 93%: roosevelt's prolonged bladder and bowel dysfunction are rare in paralytic polio, since polioviruses do not attack autonomic nerves, but are common in gbs. 93%: meningismus (neck stiffness), a characteristic feature of paralytic polio, was absent in roosevelt's case. two of eight symptoms favored polio, with the posterior probability of polio shown for each: 99%: roosevelt had fevers up to 102 °f (38.9 °c), which is rare in gbs, although the pattern of the fevers that roosevelt experienced was atypical of paralytic polio. 72%: roosevelt had permanent paralysis, which occurs in about 50% of paralytic polio survivors, and only about 15% of cases of gbs. using a bayesian analysis with all eight symptoms, goldman obtained an overall probability above 99% that roosevelt had gbs.: 242–250 exposure and susceptibility it is possible roosevelt was exposed to an infectious agent at the boy scout jamboree in late july. the two-week interval before the onset of his neurological illness was in keeping with both the incubation period of poliomyelitis,: 13–30 and with exposure to an infectious agent leading to gbs.: 455 there are no reports that any scouts or personnel at the camp developed polio around the time of roosevelt's visit. in 1912 and 1915, roosevelt had illnesses compatible with campylobacter jejuni, a major causative agent of gbs.: 455 it has been stated that roosevelt may have been predisposed to paralytic polio by genetic inheritance.: 40 however, such a genetic predisposition has never been discovered.: 195 several authors have stated that roosevelt was more vulnerable to polio since he was raised on an isolated family estate and had little contact with other children until he entered groton at age 14. however, roosevelt was not a "boy in a bubble". he had many possible exposures to polioviruses before 1921. most polio cases are asymptomatic or a mild illness. yet those asymptomatic individuals can transmit the viral infection.: 109 goldman explored the predisposition thesis by increasing the increasing the prior probability of polio in his analysis by a factor of 100, and still obtained a 99.4% overall probability of gbs (99.97% posterior probability).: 246 cerebrospinal fluid testing a 2014 biography of roosevelt by james tobin focused on his paralysis, accepting the original diagnosis of polio. tobin believed that lovett had tested the diagnosis with a lumbar puncture, based on excerpts from an "unpublished note" by dr. samuel a. levine of the harvard infantile paralysis commission. the book stated, "levine's private note indicates that dr. lovett did examine the cerebrospinal fluid and knew very well that a high level of white blood cells was consistent with poliomyelitis... if lovett had discovered a low white blood cell count, he would have doubted that poliomyelitis was the cause of roosevelt's illness. yet lovett wrote george draper that 'i thought was perfectly clear as far as the physical findings were concerned.'": 327–328 goldman and his co-authors reviewed the note to which tobin referred and other surrounding correspondence. in response to tobin's interpretation, they pointed out that the note was written well after 1921, that no one present during roosevelt's illness mentioned the invasive procedure being done, that it would have demanded resources not available at campobello, and that the note made no mention of results.: 454 they further stated that such fluid testing is most effective within the first several days of paralysis onset, and lovett did not see roosevelt until about 15 days had passed.: 454 defense of polio diagnosis john f. ditunno, of the american academy of physical medicine and rehabilitation, bruce e. becker, and gerald j. herbison challenged the retrospective diagnosis of gbs primarily on the basis that several of the symptoms that goldman highlighted as atypical in polio were quite typical in adult cases identified as polio. they noted that the form of gbs most resembling roosevelt's symptoms is not otherwise known to require permanent wheelchair use. the authors concluded that roosevelt's case provided sufficient information to differentiate his condition from gbs, and that the polio diagnosis was properly made by physicians familiar with the then-common disease. implications for prognosis biographer jonathan alter observed that "in any event, there was no cure for either disease in 1921." levine mistakenly thought that the main benefit of a spinal tap, if done, would be to improve the outcome by lowering elevated csf pressure.: 192 even today, some authors mistakenly believe that roosevelt's paralysis, assuming a polio diagnosis, could have been prevented with early intervention.: 45, 49, 62, 66 however, there is no objective evidence that a spinal tap lessens the possibility of paralysis in polio, and it is unlikely roosevelt's physicians would have tried human serum injections into the csf, or that such injections would have helped. lovett did not think the injections were useful, and there were alarming meningeal symptoms associated with them, probably secondary to the formation of antigen-antibody complexes.: 199–200 concerning gbs, virtually all of the effective measures that are currently standard practice for the medical management of gbs were not developed until many decades after roosevelt's 1921 illness, so roosevelt's prognosis would not have improved even if gbs had been diagnosed.: 238