SHE HAD OUTLASTED TYRANTS. NOW the end was in sight. The fevers of July returned harshly in August, night sweats, chills, but she had no fear of them.
David had given his word that she would not die in the hospital. The prospect of ailing and growing increasingly weak at home, in private, did not trouble her. There, after all, she could hear the happy sound of a small child—David and Edna’s now thirteen-month-old daughter, Maria. She went out and bought a crib for Maria to use at Val-Kill.
Her own crib-mate from the birth of Val-Kill, Nancy Cook, had died just days before, survived by Marion Dickerman, life partners to the end. Edith Benham Helm, from ER’s White House secretariat and the Wilson years, also slipped away that month, joining Edith Wilson, gone the previous December at the age of eighty-nine; and in this same season of a generation’s passing, Molly Dewson, first female political boss, the “Little General.”
Then the first of September brought word that Eleanor’s old schoolgirl crush Nelly Post had died as Mrs. Montague Charles Eliot, 8th Earl of St. Germans, buried by her sons on Gibraltar.1 By strange coincidence one of her life’s other most-important unsung figures was soon to join that season’s departed: Lillian Cross, who in Miami, the winter of ’33, three weeks before FDR’s first inauguration, had grabbed the shooting arm of Giuseppe Zangara, averting the assassination of the president-elect and much else in the twentieth century. She would be buried on the eleventh of November.
ON SEPTEMBER 5, THE WEDNESDAY after Labor Day, Eleanor had a visitor from St. Paul’s Tivoli,2 the rustic parish behind which she had buried every Hall in the crumbling family sepulcher,3 most recently her brother. She now wanted to have the vault torn down4 and the bodies buried properly. The local undertaker had found out it was Mrs. Roosevelt and the price had gone up by several thousand.5
But that was not why she had urged the rector of St. Paul’s, the Reverend James Elliott Lindsley, and his wife, to come for lunch at Val-Kill. Aunt Maude’s husband, her beloved uncle David Gray, and Maureen Corr were also at the table, Maureen ladling out the house chile con carne, a family recipe. Unobtrusively, Eleanor was served a hamburger for the iron.
She was not interested in the meat or its nutrients. She seemed, recalled Lindsley, eager to talk about death. She thought out loud to her seventy-ninth birthday, coming up quickly in October. “What more do I have to live for?” she said.
“You might be ready to die,” said the rector, and many years later he sighed deeply as he recalled, “Others were not ready to let her die.”6
Archbishop McIntyre of Los Angeles had attacked her for certain remarks she had made on Edward R. Murrow’s CBS radio program, This I Believe, telling listeners that she had no rigid views of the nature of immortality or after-death states. She said, “I don’t know whether I believe in a future life,” and suggested that in these matters, especially, it did no harm to think for ourselves. “I think I am pretty much of a fatalist. You have to accept whatever comes, and the only important thing is that you meet it with courage and with the best that you have to give.”
To this, the archbishop responded by accusing Mrs. Roosevelt of “assuming the role of an agnostic and a fatalist,” as if she were guilty of a double crime against the doctrine of the immortality of the soul. The archbishop then made an astonishing leap, declaring her unfit to chair the UN’s Commission on Human Rights. How could Mrs. Roosevelt fashion a bill of human rights: “Does this mean an agnostic or an atheistic world?”7
Later, looking back on it, the Reverend Lindsley “was sorry he did not let her talk and say why she felt she wanted to die.”8
At their lunch at Val-Kill, Eleanor told the Lindsleys about her most recent hospitalization. She launched a prolonged discussion about death, and said several times, “I am not afraid to die.” She said she believed that nature conditioned people her age, schooling their bodies for whatever was to come; and she said that her work was done.9
WEAKER AND WEAKER, SHE MADE an appearance on a truck in Greenwich Village, just one block away from her old place on Washington Square, campaigning for Ed Koch for assemblyman. Seventy-eight years old and terminally ill, Mrs. Roosevelt climbed up the ladder and began to speak. As soon as people noticed her, a great crowd gathered. A yellow cab came along, and the driver impatiently honked his horn. Several people hushed him. “Don’t you tell me to shut up,” the cabbie shouted. “I have a fare here in my cab and he’s in a hurry.” Someone told him that the person speaking was Mrs. Roosevelt. “Eleanor Roosevelt?” He got out of his cab and, letting his fare sit there, listened attentively until she finished her speech.10
Every day she struggled out from East Seventy-Fourth Street to run her errands, but her breathing shortened, and shaking chills would stop her in her tracks. She tried attending a reception for the U.S. delegation to the Seventeenth General Assembly, but her fever spiked, driving her home and into bed.
More urgently than ever, David pursued a diagnosis. “A doctor’s role is to preserve life and not to prolong dying,” he had often said. With Eleanor, however, the need to explain the cause of her illness, foremost to himself clinically, so that all paths to cure could be found and tried, overrode other considerations as he now consulted with specialists at Memorial Sloan Kettering Cancer Center, an infectious disease specialist, and with several internists at Columbia-Presbyterian, including Alfred Gellhorn, Martha’s youngest brother, who got Eleanor to submit to a battery of tests up on Morningside Heights, none revealing for clinical diagnosis.
On September 23, she made cause with young John Lindsay on the subject of radiation. As members of a television-show panel Eleanor and the handsome New York congressman called on President Kennedy to let the American people know about the dangers of radioactivity in the field of medicine and fallout from nuclear tests. “The President has got to make a speech to the people and ask them to listen,” implored Eleanor.11
Three days later, she could not keep it up. Her fever was taking over earlier each morning, more powerfully than before, and she was passing blood in her stool. Clearly, this was more than aplastic anemia and David made arrangements for admission to Columbia-Presbyterian. Eleanor filed “My Day” to Harry Gilburt at United Feature Syndicate, meeting her deadline as always, and Jimmy, per David’s instructions, came to help prepare his mother for the hospital.
But she would not go, she did not want to. She staged a strike, sending Jimmy up to the Gurewitsches with her terms: absolute refusal. If treated, she must be treated at home. David broke off his urgent telephoning, his erect posture stiffening, the German in his accent breaching its Anglicized cosmopolitan coverings.
Ordering Jimmy and Edna to wait outside on the stairway, David faced down his patient. The exchange was terse: David vehement, Eleanor embittered.12 Silence followed. Finally David told her that if she did not go to the hospital, he would have to come down to her bedside nineteen times during the night ahead.
She announced that her housekeeper could pack her bag.
That was that. Her surrender was for David’s sake alone. Her anger remained, implacable, pointing the finger. Her embarrassment, however, at having drawn the house to a sword’s-point standstill was so great that on her first night back three weeks later, she would urgently ask David to tell Edna that she intended to “behave better.”
SHE WENT QUIETLY TO COLUMBIA-PRESBYTERIAN—HER fourth hospitalization. But now she put her foot down: no visitors, no unnecessary tests, no more teams of experts arguing how to save their famous patient, no more pitying looks. Just as when she first became an orphan, later lost her second child in infancy, still later became her husband’s partner in poliomyelitis, and more recently as the President’s widow, she could not bear to be pitied. She responded by sympathizing with the person offering sympathy.
Letting herself be hospitalized “for David’s sake” appeared possibly to be paying off this time. Aplastic anemia was heard of no more, and a new chest X-ray showed atypical results, which meant the doctors had no choice but to consider the possibility that David was right: tuberculosis would explain a lot of things.
Eleanor tried to dial back their anxieties by letting them treat her like a sick old woman. (“I tried to be good and do what I was told, hoping to get out as quickly as possible.”13) She was, in fact, paler than ever, covered with bruises, an oxygen tank giving her some relief from shortness of breath.
From yet another huddle of the Columbia team came the theory that the cause of the fever was tuberculosis—according to David a reactivation of Eleanor’s old infection, misdiagnosed by a British doctor as pleurisy after her visit to the Front in 1919, and now reacquired, possibly during one of her hospitalizations, although the doctors considered prednisone the more likely source, since prolonged treatment with corticosteroids runs the risk of reactivating healed tuberculosis, which it did in Eleanor’s case, but with a further twist.14 On prednisone, she had become reinfected with an untreatable form of tuberculosis.15
The Columbia team now began a protocol to rule out “miliary” tuberculosis, a rare form that might explain the severity and persistence of ER’s fevers. Because the latest X-ray showed no sign of TB spreading to the lungs, the team had no way to rule out tuberculosis in the bone marrow itself except by attempting a relatively dangerous biopsy. For this, David approached a prominent New York surgeon, Edmund Goodman, who agreed to perform the procedure as well as to obey David’s one additional request: the surgeon was not to follow the usual protocol and visit the patient before the operation. Goodman found this unfathomable but took the biopsy as directed; and when he followed his own ritual of tiptoeing into the recovery room the next morning to check for bleeding around the incision, Eleanor stirred, offered an apology, and told Goodman that she disapproved of his being barred from seeing her before the procedure. She was sorry, he later recalled Eleanor saying, “to meet me at this stage in her life, as she had no desire to live in failing health.”16
For the time being, the bone-marrow biopsy only started the clock on another long waiting period for answers—four to six weeks for a culture—and raised difficult questions about Eleanor’s treatment. For if a bone-marrow biopsy had been performed as early as the Rip Van Winkle warning in April 1960—or even in August 1962—Eleanor would have had to undergo a painful procedure, but with those results, she and David—or an oncologist, if David had been wiser about recusal—could have been far more sure of what was causing the trouble and how to treat it.
But David, a recovered tuberculosis patient, saw himself standing alone with the disease. “It was left for me to make that diagnosis 40 days ago,” he would tell Joe Lash as things continued downhill far into October. “Others should have made it. The dirty linen will come out,” he vowed, casting a shadow over the Columbia-Presbyterian Medical Center that would last for years.17
NOW HER SUFFERING BEGAN IN earnest.
Chronic illness and rehabilitation, which had so often taken the place of love’s transactions—sorrow, depression, extreme self-abnegation—brought back her time-honored response to disease. Turning to the wall, she would now live by will alone.
Waiting forty days for a lab culture was absurd. Every medical and personal account of Eleanor Roosevelt circa October 11, 1962, unmistakably describes a dying woman.
She had spent her whole life discovering the strength of her character. She could have given up so many times before. Now she had the guts to go home, to die in peace. But David wouldn’t let her.
Neither would he recuse himself. “He saw himself as a savior, which is probably why he was such a good physio-therapist,” commented a colleague at Columbia-Presbyterian. “He made her story a metaphor for his existence. He loved the story that the common-sense GP made the diagnosis when the big professor experts at the university missed it. That was his story, and when he was later telling his romantic tales about how he tried to save Mrs. Roosevelt and the doctors killed her, he was selective in the evidence and denying of the truth.”18
Accordingly, even now, a biopsy would have moved things along. But the Columbia team, at David’s pressing insistence, treated Eleanor “empirically,” starting her on an anti-tuberculosis drug therapy with two of the three antimicrobial drugs then used to fight the disease in all its known forms.19 It was another peculiar choice, and not good medicine, nor the most responsible treatment, since its efficacy depended on being taken in a consistent and prolonged manner, and Eleanor had already begun hiding pills by the dozen under her lip and further back in her mouth, then disposing of them when she was left alone.
Five days after the two medications were started, the fever returned. By October 12, Eleanor was on fire—105 degrees. “Patient very miserable with temperature rising,” recorded a nurse on October 10.20
The third drug of the newly standard anti-tuberculosis regimen, P-aminosalicylic acid, known as PASA (1949),21 could have been added to the streptomycin (1943) and isoniazid (1952),22 and should have been, according to doctors reviewing records of the case in later years.23 Certainly, that should have been enough to release Eleanor to go home.
She spent six more days in the hospital without any improvement and no answers. David brought his patient home in a small ambulance, and was appalled to find photographers and reporters waiting on East Seventy-Fourth Street. Anna had tipped them off. Eleanor still out of sight inside the vehicle, David made his appeal quietly and carefully: “Mrs. Roosevelt has been so good to you all her life,” he said to photographers around the front door of Number 55. “Won’t you let her come home without taking any pictures?” To which Anna shouted, “They’re only doing their job.”
The AP wire photo circled the globe showing Mrs. Roosevelt being carried inside on a stretcher, her face bloated and hair a fright.
But she was home, and her only regret was that she had forgotten to say a word of thanks to the stretcher-bearers. As for David, she held back until they were upstairs in the quiet of her apartment. “I told you to ask them to take only two pictures. Then they would have gone away.”
ELEANOR’S “BUG,” AS SHE CALLED it, remained a mystery to medical science for the next seven days. Then, on October 26, the bone-marrow culture began reproducing itself.
At last, David had his results. He now had a curable disease to treat: M. tuberculosis. “It shows we’re on the right track,” he told the press.24
Her children were stony. The “prolonged suffering,” they told Joe Lash, “was exactly the way our mother did not want to go.”25
But from everything David knew about Mrs. Roosevelt—as, impossibly, he still called her—he was certain that she would turn every ounce of her legendary will to fighting the disease as soon as he told her what it was. After all, she had helped him find the strength for a TB cure! She had walked a mile and back just to bring him soup through the fog at Shannon.
David brought home his “cheering” news to East Seventy-Fourth Street and rushed up the stairs to Eleanor.
Her chances to survive, he told her, had just increased “five-thousand percent.”
She did not seem to understand: He was going to save her. David bent to speak into her ear: “We can cure you!”
“No, David,” she said, firmly. “I want to die.”26
ON NOVEMBER 6, HER BLOOD pressure plummeted. Two days earlier she had suffered what appeared to be a stroke, and had not recognized anyone since Adlai Stevenson had briefly left the Cuban Missile Crisis to come to her sickbed.27
Confined there, she was hardly recognizable to a world that had just survived its near-extinction.
Then it was Election Day again, and a story buried on page four of the Miami News indicated how serious her illness really was. It had finally come down to this: “Mrs. Roosevelt Can’t Vote, Even As Absentee.”28 No one had thought to request an absentee ballot, or guessed she would do anything but vote as usual in Hyde Park on Election Day.
“I find myself praying,” said Anna, “that whatever is the very best for her happens and happens quickly.”29
HER SUFFERING ENDED AT 6:15 p.m., Wednesday, November 7, 1962—thirty years to the day after her husband’s election to the first of his four terms as President. Anna was with her, as were Franklin Jr. and John. Elliott came on from Miami, and Jimmy flew from the West Coast. By most accounts her heart failed at the end, “beneath the burden of her illness.” In one sense, her medical condition was understood to be the burden of being Eleanor Roosevelt; in another, of being David Gurewitsch’s patient. One twenty-first-century bioethicist examining Eleanor’s end-of-life care in a case study published in the American Journal of Medicine, concluded that while most ethical standards for care of the dying were violated by ER’s physicians in their desperate attempts to save her, “Gurewitsch’s own retrospective angst over Roosevelt’s treatment, coupled with ancient precedents proscribing futile or maleficent interventions (or both), along with an already growing awareness of the importance of respect for patients’ wishes in the 1960s, suggest that even by 1962 standards, her end-of-life care was misguided. Nevertheless, one wonders whether a present-day personal physician of a patient as prominent as Roosevelt would have behaved differently.”30
In November 1962, some of the children believed that a mistake had been made in their mother’s diagnosis and final treatment. An autopsy became inevitable, which at least solved the problem of honoring the main point in Eleanor’s instructions for burial: I want Dr. David Gurewitsch or any doctor in charge to open veins to be sure I am dead.
During the night of November 7, David and three other doctors, including Alfred Gellhorn, performed the procedure, discovering that “a remarkable amount” of tuberculosis bacteria had spread throughout her body, and that, unlike most patients, Eleanor had been unable to produce the cells and proteins to fight off the infection, in part due to prednisone treatment.
The autopsy also revealed an unexpected finding. Laboratory results showed that ER’s strain of tuberculosis was resistant to the two drugs she had received—in fact to all known anti-tuberculosis therapies. She had probably come into contact with someone with an active, drug-resistant form of the disease. “On prednisone,” summed up the findings, “which made her susceptible, she had become reinfected with an untreatable form of tuberculosis.”31
By daybreak no one was more relieved by this finding than David, who told Joe Lash that “an enormous sense of relaxation” had come over him. “Nothing,” he said, “could have been done to save her.”32 Years later Gurewitsch would reflect for Joe Lash upon the suffering he and his colleagues had inflicted upon their patient with their endless tests and ineffectual treatments. After their interview, Lash observed: “[David] had not done well by Mrs. R. toward the end. She had told him that if her illness flared up again and fatally that she did not want to linger on and expected him to save her from the protracted, helpless, dragging out of suffering. But he could not do it. When the time came, his duty as a doctor prevented him.”33
For months after Eleanor’s death, David repeatedly sought out physicians with whom he could talk about the case. One of them was Dr. Helen Gavin, who had been Elizabeth Read’s physician, and lived with Esther Lape in Connecticut after Read died in 1943. Gavin had been a pioneer in tuberculosis treatment at Bellevue Hospital, and David would come to Salt Meadow, the house Gavin now shared with Lape, and sit on the floor at her feet, going over each step of Eleanor’s treatment.
One medical truth stood out as Gavin listened to Gurewitsch. “Hardest luck for a doctor that his patient should have a form of TB nobody had ever heard of,” said Gavin. “He will never get over not having diagnosed TB of the bone marrow earlier.”34
Her funeral was on a grim chilly day, the 11th of November. Some years earlier, she had advised Lorena Hickok not to let anyone “hold memorial meetings for me.” She found such services “cruel to those who really love you & miss you,” and they “meant nothing to the others except an obligation fulfilled.” Certainly, they “could mean nothing to the spirit in another sphere, if it is there at all!”35
In any case, she would consent to burial rites and wanted Charlie Curnan, her groundskeeper and driver, and Les Entrup, of the Hyde Park Luncheonette, to be her only pallbearers.36 As for anyone else attending, “I’d like to be remembered happily, if that is possible,” she proposed. “If that can’t be, then I’d rather be forgotten.”37
UNDER SILVERY WHITE SKIES, THE President of the United States, and the vice president, two ex-presidents, three first ladies (present, past, and future), the chief justice of the U.S. Supreme Court and an associate justice, the senior senator from Tennessee, the governor of New York, president of the General Assembly and representatives of several nations at the United Nations, the mayor of New York, and three past cabinet members formed what looked like a state occasion as they gathered into St. James’s off the Albany Post Road. Behind the gaunt parish church a small flat gravestone marked the one loss like no other in Eleanor’s life of too many burials—that of her son: Franklin D. Roosevelt, March 18—Nov. 1, 1909.
She may have wanted to go unmemorialized, but seating in the narrow church and for the burial afterward proved, First Lady Jacqueline Kennedy observed, “as complicated as an Inauguration.”38 Twinned memorial services would follow, one in Washington at the National Cathedral, the other at the Cathedral Church of St. John the Divine on Morningside Heights.
In the tight pews, Eleanor’s four big sons rose above the other mourners to sing the first two hymns, “Abide with Me,” and “Rock of Ages.”39 Anna had organized everything. “You made us all feel as if we were private people,” the first lady later told her, “and could share your sadness—and be with your family as people and not as Presidents and Governors and Chief Justices—all the long parade of titles and black limousines that could have turned it into a state occasion—and the private feeling would have been lost.”40
Mrs. Kennedy reached back to 1945, to one of America’s most painful and magnificent transfers of power: “You gave us something,” Jackie told Anna, echoing the just-widowed Eleanor’s baton-passing to Harry Truman, “when we were the ones who should have been giving to you.”41
The final hymn, No. 172, “Now the Day is Over,” had been written for schoolchildren in the England of Queen Victoria, whose tiny childlike coffin Eleanor as a young woman had seen borne past. The hymn’s author likened death to the close of a child’s day of joyful play, cares at last put aside to release the spirit. Three years earlier, after a day in Jerusalem, Eleanor had recorded a similar exaltation.
She and David Gurewitsch had gone down into an excavation of the tombs of the Great Sanhedrin, the seventy-one rabbis appointed to sit as a tribunal in the ancient City of David. Coming back up into the sunlight of an April day in 1959, Eleanor decided that the nicest thing about the rabbis’ crypts was that the land around them was being turned into a playground for children and that trees were planted there and that the view out over the valley was beautiful. People’s desire for permanent graves buried deep under rock had seemed to her foolish:
“I would rather be out in the open,” she ventured, “with the sky above me where my earthly remains can disappear rapidly. For my spirit, I am sure, will enjoy the soft rains and the sunshine and the white snow in winter and the fact that children can play happily in the garden.”42
Yet now she would take her expected place in her federal family gravesite, just south of Franklin and the white bier whose precise dimensions he had measured, drawn, and directed to be set, east to west, alongside the graves—just as he had done with the heraldic apparatus for their wedding day.43
Shortly after 3 p.m., a gentle rain began to fall as the burial party entered the garden through an arch in the hemlock.44 The plain silver walnut casket was lowered silently, covered by evergreen branches. Now the rector of St. James’s consigned Eleanor’s remains to the earth, pronouncing the whole world “one family orphaned” upon her loss.45
A West Point bugler played taps, the clear bitter notes of remembrance accumulating, until presently a bright light shone all around, drawing the eyes of the mourners to a cloud break over the river.46 Sun rays converged upon the garden in which she had joined her husband. Qui Plantavit Curabit, after all: Sara had planted it, Franklin and Eleanor had tended it; together they had grown America. Now, on the snow-white stone, Eleanor settled the plain account of Franklin Delano Roosevelt, 1882–1945, and Anna Eleanor Roosevelt, 1884–1962.
The cloud break closed and a cold rain fell. Out beyond the hemlock hedge, below the ice pond and the fields, the river flowed back to the city of her birth.