by David Martin
Still, there are anomalies and curiosities in Raines’s testimony and treatment. He says the only person he shared Forrestal’s suicide talk with was Dr. Smith. One would think that those with the most need to know about the specifics of Forrestal’s putative “suicidal tendencies” would be the people right on the front lines guarding against it, Drs. Deen and Hightower. And much of what Dr. Raines says, especially his assertion that he took the patient at his word as to what method of suicide he might use, comes across as self-serving, and just plain strange. If he really believed Forrestal was considering hanging himself because it is on his short list of preferred methods, do those Venetian blind cords in the room make any sense, or the relaxation of rules against cords and belts?
As an example of the self-serving quality of Raines’s testimony, notice how he volunteers that the poetry transcription looked like it was in Forrestal’s handwriting. Was there any particular reason why he would know what Forrestal’s handwriting looked like, or that this sample resembled it? When had he seen Forrestal’s handwriting? Does he take special note of what people’s handwriting looks like? Did he place the paper with the transcription on it beside a known sample of Forrestal’s writing? Is the good doctor qualified at recognizing forgeries?
As much as he talked about suicide, Dr. Raines does seem to put to rest the widely circulated reports that Forrestal had made previous attempts at it. Even today, at an Arlington Cemetery web site, one can find the following passage, based upon no known reliable evidence whatsoever, the following passage:
On May 22, after several prior attempts at suicide, and after copying a passage from Sophocles’ “Chorus from Ajax,” he jumped from the 16th floor hall window.125
We know, of course, that it wasn’t a hall window that he went out of, either.
Other Doctors
Now let us look at the observations of the other four doctors with respect to Forrestal’s suicidal tendencies. Doctor Nardini, who only became actively involved in the case when he took over during the absence of Drs. Raines and Smith on May 18, can be dispensed with rather quickly:
Q. Were you aware of the possibility of suicide?
A. Yes, sir.
.....
Q. Did Mister Forrestal make any attempt at suicide while you had charge of the patient?
A. No, sir, none that I was ever informed of, became aware of, or suspected.
Q. Did Mister Forrestal indicate in any way that he might do harm to himself?
A. None whatever.
Notice that Dr. Nardini volunteers nothing about Forrestal’s lurid musings on the subject. Dr. Raines has told us that he told no one but Dr. Smith about them, and among those excluded would appear to be the doctor in absolute charge of the patient in their absence. Now we turn to the next person to testify, Dr. Hightower.
Q. Were you fully aware of the various phases of Mister Forrestal’s condition from shortly after he was admitted as a patient to the hospital?
A. Yes, sir, Doctor Raines, Doctor Smith, Doctor Deen and I had discussed at intervals various procedures and therapeutic efforts that were being made during the course of the entire case.
Q. During the period of his stay in the hospital did you feel that he was making some gradual improvement?
A. Yes, sir, my feeling from the first was that he was pretty overly depressed, as evidenced by his lack of interest in his surroundings, interest in personal contact with me on the brief occasions that I saw him, whereas as the case progressed, particularly during the insulin period he seemed to become more alert, more interested in his surroundings, and particularly interested in what was going on about the floor itself and the hospital.
Q. What was your feeling in regard to the possibility of suicide during the first few days of his stay in the hospital?
A. My feeling with regard to suicide during the first few days of his stay in the hospital was that it was potentially present, that being based on psychiatric experience with depressed patients. I had no actual factual evidence of any sort which would lead me to be able to say specifically that suicidal thoughts or ideas were present. However, I did feel and consider it a possibility on the basis of general psychiatric knowledge.
Q. What was your feeling in regard to the possibility of suicide at approximately the time that Doctor Raines left Washington?
A. At that time I felt that Mister Forrestal had made a definite improvement in the overall picture from the time of his admission and that the possibility of suicide was much more remote than earlier in the case. There were several observations made during the course of the case which led me to feel this. About two weeks before Doctor Raines left I went up to stand the watch one night and stopped by the room to speak to Mister Forrestal, asked him how he was feeling. He said “About as usual.” We chatted briefly about my medical education and where I lived and what not; then later, when I came up to go to bed about twenty-two forty-five, he was awake and I asked him how he was feeling. He said “About as usual” but he felt his room was a little stuffy and in view of the fact that two of the windows were stuck and couldn’t be opened I agreed that the room was a little stuffy. He said that he thought possibly he would be able to sleep better if he slept in the room with me, there being two beds in my bedroom and I said I thought that would be a good idea, it might be more comfortable over there. My feelings at this time were that the patient was making an effort to broaden his horizons. I felt that he was lonely and felt the need of friendly contact with other people and also felt at the time that the suicidal possibilities had lessened sufficiently to make it safe for him to remain out of his room. The danger of suicide had been discussed with Doctors Raines and Smith on several occasions prior to this and we had been encouraging the patient to broaden his activities even prior to this particular incident.
.......
Q. Did Mister Forrestal, in the times you would be with him, express anything about international affairs?
A. No, sir.
Q. Do you think he was trying to get away from such things?
A. I didn’t have much feeling about whether he was or not. He never made any effort to talk along those lines when I was with him, no, sir. In fact, the basis of most of our conversations were relatively superficial, having to do with things of the moment; should he take his sleeping pills or not; was I going to sleep in the room next to him or not; how was the rose thorn in his finger getting along; or whether his constipation was being taken care of or not. Another one of my duties in the case was to write orders for his bowels and I had done that earlier in the course of the case.
So, although “The danger of suicide had been discussed with Doctor Raines and Doctor Smith” by Doctor Hightower on several occasions, he was still able to say that “[he] had no actual factual evidence of any sort which would lead [him] to be able to say specifically that suicidal thoughts or ideas were present,” but that, [he] did feel and consider it a possibility on the basis of general psychiatric knowledge,” at least during the early stages of the hospitalization. Once again, it is evident that the specific intimations of suicide that Dr. Raines said Forrestal communicated to him were not passed along to a doctor on the front line of Forrestal’s care. Not only that, but it would appear that Dr. Raines’s specific orders in the medical chart were not getting through, either. The episode in which Forrestal was permitted to sleep in a room with completely unprotected windows, at about two weeks before Dr. Raines left, would have taken place about five days after, “Watch in room @ all times. Suicidal. Don’t get careless,” with the Raines signature beside it can be found in the chart.
Next, we have Dr. Deen, the other doctor on periodic watch on the 16th floor.
Q. Did the matter of suicide ever occur to you?
A. It certainly occurred to me ever since the man has been there.
Q. How did you regard him from that standpoint for the first few days of his stay in the hospital?
A. Well, of course, on the first few days, it was much longer than the fi
rst few days, on admission to the hospital he was under almost continuous sedation and constant watch. After a few days they were able to get screened windows on the room and corpsmen were instructed to stay with Mister Forrestal at all times and if they needed anything from the nurse or corpsman on the outside or from Doctor Hightower or me they went through another corpsman, didn’t leave the room at any time. Following that he was on sub-shock insulin therapy for a period of something like three weeks, I believe, and the man was obviously depressed and any time a man is depressed there is always a consideration of suicide to be kept in mind.
Q. How did you regard the progress of his condition from the time of admission to the hospital until the time that Doctor Raines left town?
A. Well, I think it is best to put it this way. From discussions with Doc-tor Raines, Doctor Smith and Doctor Hightower and from the changes in the orders which permitted Mister Forrestal to have more freedom of movement in that he could go into our bedroom and he could be in the room alone without the corpsman I presumed, I felt that improvement was going along or those measures would not have been put into effect. So far as my personal dealing with Mister Forrestal on his original entry and at the time he was on insulin therapy it was always quite difficult to talk with Mister Forrestal, quite difficult because we had been instructed to try to stay away from things that were on therapy and for a man like Forrestal you couldn’t very well talk to him about the flowers and bees because he was not interested in them. I felt he was showing continually more interest in outside activities but, as I said, in the beginning the way I looked at it I felt sure things were going on in discussion with Doctor Raines probably I didn’t know about but which were indications that the man was improving considerably.
Dr. Deen’s impressions, as we see, are almost the same as Dr. High-tower’s. Each perceived, without being very specific about it, that Forrestal was depressed, but that he was getting better. They knew from experience and training that depressed people sometimes commit suicide, but it is clear that Dr. Raines, as he said, did not share with either of them anything of substance about any actual suicidal tendencies in this patient. Both say that they conferred with Dr. Raines, but virtually nothing of what he told the board seems to have made it to these two primary-care physicians. One must wonder why not.
One thing in all the doctors’ testimony to this point suggests that Forrestal might, indeed, have some psychological problem, drug-induced or not. There could not have been a man alive more interested in the world around him and, specifically of the welfare of his country than James V. Forrestal. His correspondence from 1948 alone requires five boxes for storage at the Seeley G. Mudd Libraryat Princeton University, and the 932 names of the list of his correspondents read like a who’s who of power, money, and influence on public opinion. Winston Churchill, Bernard Baruch, Omar Bradley, Dwight D. Eisenhower, Thomas E. Dewey, W. Averell Harriman, Henry J. Heinz, Vincent Astor, Lammot DuPont, William J. Donovan, Edward R. Murrow, Estes Kefauver, Eugene Meyer, Nelson Rockefeller, John D. Rockefeller, Jr., Drew Pearson, Henry R. Luce, Walter P. Reuther, Francis Cardinal Spellman, Robert A. Taft, William S. Paley, and Frank Wisner, are just a few of the names that appear. No one had a more imposing Rolodex. Yet he comes across from the testimony of these doctors as someone who was difficult to talk to and had little interest in his surroundings. We know that he was deeply troubled about many things that were going on in the government of which he was a part. His candor and forthrightness about his concerns were what got him on the bad side of so many powerful and unscrupulous people in the first place. Forrestal would have sounded more like himself if one of these politically unsophisticated medical men had said that he sounded paranoid, rather than that he was a difficult person to carry on a conversation with.
The Man, Not Just the Patient
That brings us to Captain Stephen M. Smith, the last of Forrestal’s psychiatrists to testify and the one person with whom Dr. Raines said he shared Forrestal’s suicidal ruminations. It is noticeable from examining the nurse’s log that, although Dr. Raines might have spent more total hours with Forrestal, Dr. Smith seemed to have visited him more frequently. From the excerpts of his testimony that we will give here, the reader can judge who got to know the patient better and who gave a more candid assessment of his condition. (The patience of the reader is begged at this point. Dr. Smith is articulate, but he is also verbose, given to big words and long sentences.)
Q. Captain, will you please tell the board what you know relative to the treatment of the late Mister Forrestal?
A. Perhaps I should begin by saying that the treatment was directed by Captain George Raines who is the chief of the neuropsychiatric service and my role was supportive to his therapeutic endeavors and consultive at any time when it was deemed necessary and advisable. I first met Mister Forrestal on the day of his admission to the hospital which, I believe, was April second and subsequently saw him almost daily until May eighteenth at which time I left on authorized leave and didn’t return until after his demise. Through Doctor Raines and through my daily conversation with the patient I acquired some degree of familiarity with the emotional state which was responsible for his hospitalization. I found him to be a very cooperative patient and at all times quite willing to accept opinions concerning his illness and an expressed willingness on his part to avail himself of all the benefits which might be derived from his hospitalization here and the psychotherapeutic therapy which might be instituted. In the nature of our handling of his psychotherapeutic therapy it was an arrangement between Doctor Raines and myself that he would control all the therapeutic measures although I can sincerely state that we compared opinions almost daily, particularly in regard to the reactions of the patient and their import. Inasmuch as it is considered good psychiatric practice to avoid confliction and confusion in treatment, especially as it pertains to the interpretation of psychodynamics, that this rests entirely in the hands of one individual. As a result of this arrangement my discussions with Mister Forrestal were on a less personal level than would accrue from therapeutic endeavors. However, these conversations had a degree of intimacy and resulted in the establishment of a rapport with Mister Forrestal that I always interpreted as being friendly and comfortable. We talked of many diverse matters that had only a casual relationship to his illness as he was a man who not only was mentally alert but continued to maintain an active interest in all current matters on a level compatible with his broad public service and wide experience. These conversations ran a gamut from a discussion of matters of purely local interest to various philosophies and ruminations that touched on the behavior patterns of all people under various circumstances of stress and his astuteness and acumen were such that his comments and discourses were pregnant with comprehensive significance. As indicated previously, the matter of discussion of the more intimate aspects of his personal problems was left for his interviews with Doctor Raines. This Mister Forrestal and I both understood; that this was the arrangement and for that reason our tendency was to stay on less disturbing subjects. My interviews with him usually would last from fifteen or twenty minutes to perhaps an hour. In evaluating the course of his illness as I observed it he apparently was showing a continuous improvement with moderate fluctuations which were not incompatible with the type of emotional disturbance which he showed. He was acutely aware of his depressed state of mind and at times (illegible) interpretation of his own reaction to his predicament and (illegible) which might have led up to it although he not infrequently mentioned impending disaster. They were always of vague and non-specific character and had to do with matters which had been of paramount interest to him, namely, the safety of the country. Many times he expressed uneasiness about the future possibilities and windered (sic) whether or not people were as alert to these potentialities as they should be. Each time he would reassure himself by such assertions as, “I really have no uneasiness about the future of the country, I am certain that that is assured. But the travail might be easier i
f people were perhaps more concerned about some of these things.” We talked frequently of his recovery and the possible change in his pattern of living which would be possible with more leisure and greater opportunity for diversification of interest and a release from the tremendous pressure which his duties had imposed on him over the previous eight or nine years. He himself offered the opinion that he should have sensed that his burden had become too heavy many months previously and should have done something to correct it. He regretted that he hadn’t done so. Incidentally, he, on several occasions in connection with this type of thinking had offered the opinion that all men highly placed in public life should be more concerned about their emotional health and even perhaps come to a better understanding of the benefits which would result from a more profound knowledge of the emotional concomitant of continuous tension and strain. Inasmuch as he was a man who suffered with a depression and an interpretation of his own predicament through depressive eyes the matter of his recovery or non-recovery was discussed, even including self-destruction. He, at all times, denied any preoccupation with such thoughts and even though his construction of the future possibilities as they affected him were nebulous he not only agreed but frequently volunteered that he was certain that he would be able to reach a level of adjustment which would bring him greater happiness, especially through more intimate contacts with his family from whom he had felt somewhat separated because of the pressure of work and also because of the opportunities for less hurried and constructive endeavors which his new freedom would permit (emphasis added). He was actively interested in sports and had participated in them to a considerable extent when he was younger, following the various sporting events, not deeply but enough to be fully informed about them. He was interested in history, especially, and enjoyed discussions that pertained to historical backgrounds of various situations from the time of Alexander the Great on up to the present and often wove a very interesting course into the fabric of his conversation pertaining to these historical and philosophical backgrounds and would draw comparisons and analogies with recent happenings.