by David Martin
In his testimony, the only special sort of depression that Forrestal might have had, according to Dr. Raines, was “reactive depression,” or, conveniently for the official story, one that might lie dormant until touched off by some external factor like, say, reading a depressing poem.
Reading over the various doctors’ use of the term “depressed” to describe Forrestal, one is struck by how fast and loose they are with the term. Virtually nowhere is it explained how the “depression” showed up or how it could be detected or measured, though it is often spoken of as something as discrete and measurable as heart rate or blood pressure. The only manifestation that might possibly be separated out from simply the effects of heavy sedation are verbally expressed suicidal tendencies. Dr. Raines, though, is the only one who says that, and the testimony of the other doctors and the peculiarity of some of Dr. Raines’ assertions seem to call his reliability on this matter into question.
Dr. Raines Weighs In
Dr. Raines was the third person to testify, after the two photographers, and he was the only person to testify twice. He was the only witness to appear before the board on the last two days of witness testimony. Here are some key early passages:
Q. Would you tell the board the results of your observations and treatment of Mister Forrestal, especially in reference to his mental status?
A. Mister Forrestal was obviously quite severely depressed. I called the hospital from Hobe Sound on the morning of the second and asked that they have two rooms available, one on the officers’ psychiatric section and the other in the tower. At that time I had not examined Mister Forrestal, was not at all sure of how much security he needed. On the flight up I had opportunity to talk to Doctor Menninger at great length and to see the patient briefly. As a result, I felt he could be handled in the tower satisfactorily, provided certain security measures were taken. Consequently, he was admitted to the tower with a continuous watch when he arrived here. The history indicated that Mister Forrestal had had a brief period of depression last summer but that this had cleared very rapidly when he went on vacation. His present difficulties seemed to have started about the first day of the year, perhaps a little earlier, with very mild depressive symptoms beginning at that time and a good many physical symptoms, noticably (sic) weight loss and constipation. The depression had been rather marked from about the fifteenth of February nineteen forty-nine but had not become actually overwhelming until the week-end preceding admission which would have been approximately March twenty-fifth and twenty-sixth. At that time he became very depressed and I believe as a result of that relinquished his office some three days earlier than had been previously planned. He was seen by Mister Eberstadt on the Monday before admission and on his advice immediately relinquished his office and went to Florida for rest. The physical examination was done by Doctor Lang immediately after admission which showed nothing remarkable except some elevation in blood pressure. The neurological examination was negative except for small, fixed pupils which, so far as I know, had no significance. Mister Forrestal was obviously exhausted physically and we postponed any complete studies until such time as his physical condition could be alleviated. He was started immediately on a week of prolonged narcosis with sodium amytal. His physical condition was so bad we had difficulty adjusting the dose of amytal because of his over-response to it. About the third night his blood pressure dropped to fifty-five systolic under six grains of amytal. To prevent any confusion in the orders on the case I selected two of the residents, Doctor Hightower and Doctor Deen, and put them on port and starboard watch to begin at five o’clock each evening. The doctor on watch slept in the room next to Mister Forrestal. On Monday after admission on Saturday security screens were provided for the room that Mister Forrestal occupied and for the head connected with it by moving them from tower five. At the same time a lock was placed on the outer door of the bathroom and strict suicidal precautions were observed. I saw Mister Forrestal for interviews daily during the morning of that first week when he was allowed to come out of the narcosis for short periods of time. These interviews were devoted primarily to history-taking. His response to that early treatment was good and he gained about two pounds during the course of the weeks’ narcosis. The following week, beginning the eleventh of April we started Mister Forrestal on a regime of sub-shock insulin therapy combined with psycho-therapeutic interviews. This was continued about four weeks but his response to it was not as good as I had hoped it to be. He was so depleted physically he over-reacted to the insulin much as he had to the amytal and this occasionally would throw him into a confused state with a great deal of agitation and confusion so that at the end of the second week I had to give him a three day rest period instead of the usual one day rest period. I am not sure that that was the end of the second or third week. At the end of the fourth week again he was over-reacting to the insulin and I decided to discontinue it except in stimulating doses. From that time on he was carried with ten units of insulin before breakfast and another ten units before lunch with extra feedings in the afternoon and evening. In spite of this he gained only a total of five pounds in the entire time he was in the hospital. His course was rather an odd one, although in general it followed the usual pattern of such things. The odd part came in the weekly variation of the depression. I can demonstrate it and explain. Instead of the depression lightening, instead of straight up in a line he would come up until about Thursday and then dip, hitting a low point on Saturday and Sunday and up again until the middle of the week and down again Saturday and Sunday. Each week they were a little higher. He was moving upward steadily but it was in a wave-like form. In addition, he had the usual diurnal variation, the low point of his depression occurred between three and five a.m. so that the course towards recovery was a double wave-like motion, the daily variation being ingrafted on his weekly variation. The daily variation is very common, the weekly variation is not so common and that was the portion of the course that I referred to as “odd”.
Q. Captain Raines, I show you a clinical record, can you identify it?
A. This is the nursing record of Mister Forrestal. The only portion I don’t recognize is this poem copied on brown paper. Is that the one he copied? It looks like his handwriting. This is the record of Mister Forrestal, the clinical record.
In the following excerpts from the testimony of Dr. Raines, the “Q” and “A” format will not be strictly adhered to. Rather, the portions relating to Forrestal’s supposed suicidal tendencies are selected from Raines’ answers to various questions:
As late as the twenty-ninth of April the patient was still quite suicidal and personnel were reminded of this by an order in the chart. A week later the insulin therapy was discontinued and beginning on the eighth of May the patient was placed on the stimulating doses of insulin which I previously mentioned. He continued to improve in the irregular fashion which I have described and by the ninth of May I felt it safe for Mrs. Forrestal to make her plans to go abroad but didn’t think he should go with her. My reason for objecting to his going was, ironically enough, that I knew in the recovery period which seemed at hand the danger of suicide was rather great. The son returned to his work in Paris on May thirteenth. The family was at all times kept fully advised as to the patient’s progress but I didn’t warn them continuously of the suicidal threat nor did I mention it to any one except my immediate colleague, Doctor Smith.
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I first eased the regulations as a test on the twenty-sixth of April but found that the patient was not ready for it and that resulted in an order on the twenty-ninth of April that the watch was to remain in the room at all times, that the patient was still quite suicidal. The relaxation of the afternoon watch was only a few days later, on May first, which indicates how abruptly his condition would change at times in these undulating moments in the illness.
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He was very close to well actually. When I saw him on the eighteenth I felt we could, didn’t tell him, but felt hospitalizatio
n for another thirty days would probably do the trick. He was that close to the end of it. That, of course, is the most dangerous time in any depression.
Q. Did Mister Forrestal make any attempts at suicide while he was under your care?
A. None whatsoever. The matter of suicide in Hobe Sound, he told Doctor Menninger that he had attempted to hang himself with a belt. Menninger and I were very skeptical of that and both he and I were of the opinion that it was sort of a nightmare. The man had no marks on him and there was no broken belt. Very frequently a depressed person has a fantasy of dying and reports it as real. So far as I know he never made a single real attempt at suicide except that one that was successful. He was the type of individual, fast as lightening (sic), of extremely high intelligence and one reason I doubt previous attempts I knew if he decided to do it he would do it and nobody would stop him. He was a boxer in college and his movements, even when depressed, were so quick you could hardly follow them with your eye. In the course of psychotherapy he talked a great deal about his suicide; he would tell me when he was feeling hopeless and had to do away with himself. At those times we would tighten restrictions. He would tell me in symbolic language. One morning he sent me a razor blade which he had concealed. When I interviewed him I said “What does this mean?” He said “It means I am not going to kill myself with a razor blade.” Of course, he had the blade and could have done it. A man of that intelligence can kill himself at any time he desired and you can’t very well stop him. He is my first personal suicide since nineteen thirty-six, thirteen years ago. The last one was on a locked ward at St. Elizabeth’s Hospital under immediate supervision of an attendant. He discussed, whenever he felt badly enough, he would talk about the possibilities of killing himself and I am sure that when I left here on the eighteenth he had no intention of harming himself.
Q. Had he, in the course of your interviews, either symbolically or otherwise, suggested his method if he committed suicide?
A. Yes, I am sure he didn’t jump out of the window. My interviews with him were for one to three hours a day over a period of eight weeks (sic); can’t go into all the material that makes me think that but by the time he had been here four weeks I was certain there were only two methods he would use because he had told me, one was sleeping pills. He said that was the one way he could do it and the other was by hanging which made us feel somewhat more comfortable about the period of risk, knowing that he wasn’t going out one of the windows. I haven’t gone into all the details of what happened, but personally feel he tried to hang himself. I don’t think he jumped; he may have; don’t think it was out the window; think he meant to hang. For some time he had had complete access to the open windows in the residents’ room and for a short period of time he even slept in there for two or three nights. There were two beds in the residents room and he would sleep in one of those until about three o’clock and then go back to his own bed. That was the one thing that puzzled me, when he called me (sic), as to what had happened; I couldn’t believe it because of the window, until I got back and found out about the bathrobe cord.
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Actually, he dealt quite well with almost everything. It is my own feeling from what I know that the period of despondency which caused him to end his life was very sudden of onset and probably the whole matter was on an impulsive basis. That was the one thing I had feared, knowing of his impulsivity. Again, I say, he moved like lightening (sic), some of those on pure impulse. That is supported by several things. I talked to Doctor Hightower last night and was glad to hear him say spontaneously and not just in agreement with me that he felt that this was an impulsive thing of sudden origin, but one of the main evidences is the complete absence of any suicidal note or expression of suicidal intent in any way. He left no message at all except this poem which I am sure was meant for me and was not a portion of the suicide. That is to say, I think he was simply writing that out to demonstrate how badly he felt.
Q. Before he came to Bethesda while he was down south, did he make any attempt to slash his wrist?
A. No, he had a small scratch on his wrist which he told me was not a suicidal attempt but he was considering it and he was wondering what he could do to himself and he took a knife or blade and scratched his wrist, so superficial it was not even dressed, and wouldn’t come under the heading of “attempt” so far as I am concerned.
Now let’s examine Dr. Raines’s remarks. He says that he ordered two rooms to be prepared, one in the officers’ psychiatric suite and the other in “the tower.” After some deliberation he concluded that Forrestal “could be handled in the tower satisfactorily, provided certain security measures were taken.” It’s really not a matter of whether he could be housed on the 16th floor but, rather, should he be put up there. No one on the panel asks Dr. Raines or anyone else why they should ever consider putting Forrestal on the 16th floor when they claimed to have believed that he was a danger to himself. Why take the chance? We also learn that initially there were not even any security screens, such as they were, on the windows, though there was a full-time guard to keep an eye on this “fast as lightning,” “impulsive” patient.
The revelation in Chapter One that the orders came from “downtown,” that is, the White House, to put Forrestal up on the 16th floor, to the general consternation of the psychiatric staff, looks better in light of these revelations. The board might have known better than to ask why Forrestal was placed in “the tower,” because they knew there was no good medically defensible reason that could have been given.
Dr. Raines is wrong about the reason for the advancement of the date of Forrestal’s departure from office. It was not Forrestal’s decision, brought on by his “depression,” but President Truman’s decision. Forrestal’s alarming, almost zombie-like behavior, was first noticed by his assistant, Marx Leva, and called to the attention of Ferdinand Eberstadt, some hours after Forrestal had been replaced by Louis Johnson.
We also learn from Raines’s testimony that constipation was among Forrestal’s physical symptoms upon entry into the hospital as well as constricted pupils of the eyes, but he makes nothing of it. According to the web site on narcotics we find that these are both symptoms of someone on heroin.123 That is not to argue that Forrestal was necessarily on heroin, but it does raise the question of whether some of Forrestal’s sudden lethargic and apathetic behavior—a radical personality change for him—in the wake of his stepping down from the Defense Secretary’s job might have resulted from his having been secretly drugged. Drowsiness and apathy are also heroin symptoms. At least one of the doctors on the panel should have picked up on the constricted pupils and inquired as to whether Forrestal had been tested for drugs, but the possibility is never considered by any of these medical men.
If Forrestal already had an opiate like heroin in his system, sedating him with a strong barbiturate like sodium amytal could have been dangerous, and might explain Forrestal’s poor reaction to it. One might question the wisdom of putting Forrestal on sodium amytal in any case, and it is doubtful that it would have been done given the current level of medical knowledge. This comes from McDermott’s Guide to the Depressant Drugs:
Like opiates, barbiturates are addictive, only more so. Taken to help you sleep, after a few days, it becomes impossible to sleep without them. Like the opiates, barbiturates produce tolerance so that you need to keep upping the dose to get the same effect, but the real humdinger is the withdrawal syndrome. If withdrawal from opiates is cold turkey, then withdrawal from barbiturates could be cold raven. Besides the craving, discomfort and inability to sleep, barbiturate withdrawal also causes major epileptic seizures. Nobody dies from opiate withdrawal, but it is a strong possibility with barbiturates and you should only think about it under the supervision of a doctor, preferably as a hospital in-patient. The possibility of overdose is amplified greatly if barbs are injected into a vein rather than taken orally. By and large, it is usually only those people who have had their switches set to automatic self-destruct
mode who use barbiturates because the drug isn't at all pleasant or enjoyable. Barbs lack the euphoric content of opiates and the social lubricant properties associated with alcohol. They simply produce a dark, blank oblivion and as such will always remain popular with those people who hate themselves or their lives so much that their behaviour is governed by a compulsion to obliterate all possibility of thought and self-examination. Do yourself a favour. Just say no.124
As we noted, it is sometimes difficult to sort out what in Forrestal’s behavior was a result of his presumed condition and what was caused by his medication. For example, if the description of Corpsman Prise of Forrestal walking the floor restlessly on the night he died is accurate, he might well have been simply exhibiting a case of barbiturate withdrawal. In his resistance to taking sodium amytal as a sleep aid, the patient seemed to exhibit a keener sense of what was good for him than did his doctors
Suicidal Tendencies?
Now let us look at Forrestal’s “suicidal tendencies,” as related by Dr. Raines. “In the course of psychotherapy he talked a great deal about his suicide; he would tell me when he was feeling hopeless and had to do away with himself.”
That statement, along with his two written orders in the medical chart, first on April 7, “Still suicidal - keep close watch” (underlining in original) and again on April 29, “Watch in room @ all times. Suicidal. Don’t get careless,” represent the strongest evidence that Forrestal was, indeed, inclined toward ending his own life and eventually succeeded.