by James Tobin
According to Howe, FDR did not hesitate. He flashed his giant grin and said, “Well, when do we begin?”
There is every reason to think FDR had made that decision already. He did not need Louis Howe to arouse his ambition.
* * *
For Eleanor Roosevelt, her husband’s decision meant she must abandon the work she wanted to do, or so it certainly seemed.
Soon after FDR’s failed campaign for vice president in 1920, she had begun to work in politics herself. Women had just gained the right to vote, and Eleanor saw that many women needed encouragement to take a larger part in public affairs—to vote, to campaign for candidates, to organize supporters in favor of good laws and policies, even to run for office. She began to join committees and work for Democratic Party candidates in New York.
But now her husband’s illness seemed to dominate everything. FDR wanted Louis Howe to move in with the family so he could help with FDR’s recovery, his business affairs, and his political plans. So Eleanor would have to reorganize the whole household to make room for Howe. She would have to arrange all the details of hiring a live-in nurse and making appointments with doctors. Getting Franklin ready for a return to politics was going to be a full-time job. She would have less time than ever for her own projects.
That would be difficult enough, but the idea of retiring to Hyde Park seemed to Eleanor to be even worse. In Hyde Park, her mother-in-law ruled the roost. The estate there belonged to Sara, not her son. Eleanor loved her mother-in-law, but she resented Sara’s efforts to dominate the family’s life. Retirement to Hyde Park before Eleanor was even forty years old would mean consigning herself to a comfortable cage.
She went to Dr. Draper: What did he think of her husband’s wish to return to politics?
Dr. Draper said he was all for it. Even if FDR didn’t succeed in the long run, he told her, the effort would lift his spirits and improve his chance to make a strong physical recovery.
Eleanor agreed. Frances Perkins, now Eleanor’s friend as well as Franklin’s, said, “She thought he would die spiritually, die intellectually, and die in his personality, if he didn’t have political hope.”
As for her own hopes, Eleanor said much later, “I do not think I ever stopped to analyze my feelings. There was so much to do to manage the household and the children and to try to keep things running smoothly that I never had any time to think of my own reactions. I simply lived from day to day and got through the best I could.”
She fit a new job into her crowded routine. In league with Louis Howe, she set about keeping FDR in touch with politics and government even as he lay in his bed. She clipped newspaper reports and editorials for him to read. She invited friends in politics to come to the house and fill him in on the latest news and gossip. She and Louis sat and talked with him by the hour.
* * *
Sara Roosevelt could hardly believe what she was hearing.
It was absolutely crazy—a crippled man running for office? Like most people, she took it for granted that a man with a disability should remove himself from public view. If being crippled was not quite shameful, she thought, it was certainly something to be kept as private as possible. Her son, exhibiting himself with crippled legs before common people? Unable to go up a staircase unless two men carried him?
She insisted that he stop the nonsense. She became “quite vociferous in her demands,” Anna remembered.
Sara went to Louis Howe. She disapproved of the little man, with his sour manners and his sloppy habits, but she respected his judgment. Surely, she said, Howe, with all his experience, must realize that FDR had no future in politics.
In fact, Louis told her, he still believed that one day her son would be president of the United States.
Finally FDR told his mother he had heard quite enough. She was not to speak of the matter again.
“Franklin had no intention of conforming to my quiet ideas for his future existence,” Sara wrote later. “He was determined to ignore his disability and carry on from where he had left off.”
He simply refused to voice any doubt of his ability to make a complete recovery. “He has never said he could not walk,” Eleanor remarked later, and he wanted no one else in the family to say it, either. If he allowed himself to think for an instant that he might not reach his goal, then he might lose his courage and fall into despair.
Psychologists call this way of thinking denial. It means refusing to accept a fact that you just can’t bear. It can get you in deep trouble. Usually it’s best to face up to harsh truths, just as Uncle Fred had advised FDR.
But sometimes denial is a powerful tool that helps people do things no one else thinks they can do.
FDR knew very well that people privately made fun of him as a man spoiled and bossed around by his mother. His hard-charging Roosevelt cousins—Theodore Roosevelt’s children—used to say his initials stood for Feather Duster. People said all the good things in life had been handed to him on a silver platter.
Now he’d been cut down by a disease that normally struck children. In every phase of his life, it seemed, somebody had whispered that he was a weakling.
So he just said no—no to the insults, no to his mother, no to polio.
He intended to show everybody who and what he really was.
PART 2
STANDING UP
NOVEMBER 1921– JULY 1924
Chapter 5
TRIAL AND ERROR
“When do we begin?” he had asked Louis Howe.
FDR wanted to start today, tomorrow—whenever the doctors gave the signal, if not sooner.
“The patient is doing very well,” Dr. Draper wrote Dr. Lovett in November 1921. “[He] navigates about successfully in a wheel chair. He is exceedingly ambitious and anxious to get to the point where he can try the crutches.”
For the time being, Dr. Draper insisted, more rest was essential.
But FDR wanted no more rest.
“I absolutely concur in your belief that a fellow ‘can put anything across if he is game to tackle it,’” he wrote one friend. “I am trying out the theory myself, having determined to get well in the shortest possible time.”
“I am still just as much of an optimist as ever,” he declared.
He got an encouraging message from Joseph Tumulty, a powerful politician who had been chief of President Woodrow Wilson’s staff in the White House. FDR replied: “The doctors all predict a speedy and complete recovery for me. I hope not only to be back on the fighting line but to have a lot of highly spirited ammunition in the way of convincing arguments as to why one should be a Democrat.”
When he talked like that, he was stretching the doctors’ predictions well beyond what they had really said. True, Dr. Lovett had told FDR to expect some improvement in the first few weeks. But that was very different from saying he would make “a speedy and complete recovery.” Dr. Lovett had said only that a complete recovery wasn’t out of the question. FDR didn’t hear it that way. He wanted progress by leaps and bounds.
Dr. Lovett’s whole approach was the opposite of leaps and bounds.
The doctor was thinking about the microscopic landscape of FDR’s muscles. Deep in the muscle tissue, some of FDR’s nerve cells had been killed and would never come back to life. Others had survived the attack with no damage at all. They might be ready to take over the work of cells that had died. And still other cells had been sitting still for so long they’d gone to sleep—but they might wake up again.
Which cells were which? Right now, no one could tell. The only way to find out was to get FDR’s legs moving.
It would be best if he could make the muscles move on his own. If he couldn’t, a nurse could grasp his legs, one at a time, and move them.
But there was danger in overdoing it. A patient who rushed recovery from polio might wind up very sorry. Trying too much too soon could kill injured nerves that might have been saved. A patient who became exhausted might have to quit for a while. That would waste time and energy, and
it might deflate the person’s hopes.
So … go slow—that’s what Dr. Lovett had learned in his years of treating polio patients in the gloomy months that trickled by after the virus had finally left the body.
Go slow … but watch closely. It was also possible to go too slowly. Paralyzed limbs, if left alone, could bend and twist out of shape and stay that way.
The poliovirus attacks a bundle of muscles the way a tornado attacks a town. A tornado can leave one block of houses untouched, while it plows up a row of houses just one street over. It’s the same with the virus. It leaves the nerves in one bunch of muscle fibers alone while it ruins the nerves in the fibers next door. Then, day after day and little by little, the healthy muscles pull against the dead muscles. After weeks or months, the victim notices—though it seems unbelievable—that the paralyzed limb is actually changing from its normal shape or getting stuck in an extended position. Doctors call this a contracture.
It can happen in the toes, ankles, knees, hips. Even the spine can curve under the pressure of a contracture. A contracture can be prevented, but only by encasing the body part in casts and braces. It’s also possible to reverse a contraction after it develops, but that takes a hard operation—more pain, more time, more suffering.
So go slow and watch closely were Dr. Lovett’s strict instructions—not just to FDR but to Kathleen Lake, the no-nonsense nurse who first knocked on the Roosevelts’ door in early December 1921.
Mrs. Lake had worked for Dr. Lovett and his patients many times before. She knew all about polio, and she practiced the new medical specialty called physiotherapy. This was a method for teaching people with injured limbs to move as well as they possibly could. It was hard, slow, exacting work for the patient and the nurse alike.
Mrs. Lake knew just how to do it. Day after day, dressed in a starched white uniform, she got down to business with her famous new patient.
* * *
First, Mrs. Lake and a young woman named Edna Rockey, FDR’s live-in nurse, would lift and haul the patient onto a long wooden board set up in his bedroom. With dark humor, FDR began to call that room “the Morgue.”
During the long weeks when he had been lying and sitting still, some of his unused muscles had started to stick to each other. These points of stickiness are called adhesions. Another man who had polio remembered what it was like to tear adhesions apart, even by so simple a movement as being helped to sit up in his bed. “The least deflection of my limbs from the horizontal produced intense, exquisite pain,” he wrote. “I had not been aware, until I was moved, just how painful and sensitive my body still was, nor did I expect the extreme fatigue that overcame me.”
Now, every day, FDR began to go through that kind of pain.
Once he was in position on the long board, Mrs. Lake would give orders.
Move your left big toe, she would say.
He would try. Nothing would happen.
Try again, she would say. Again, he would strain just to twitch a muscle in the toe. Still nothing.
“Try it again.”
“Try again.”
“Again.”
She wasn’t being cruel. She knew it might take a hundred tries before a sleeping muscle moved, and if it moved once, it might move a second time. Then blood would start to flow through the muscle, and the whole toe might start to revive. If he could move one toe, he might be able to move one foot, and so on, but only with mind-numbing repetition. And there was no guarantee that one bit of progress would lead to more progress.
FDR was hoping for massage. It just seemed natural that rubbing and kneading the muscles would wake them up. But Dr. Lovett had forbidden any massage until the patient was free of pain. Later, massage could do some good. But at this stage, it could overwork and damage muscles just starting to recover.
Day by day, Mrs. Lake studied each of FDR’s limbs as he struggled to do the exercises. She thought his left leg—the weaker of the two since the attack—was getting a bit stronger. But she also thought contractures might be forming in the hamstrings, the big muscles in the back of the thighs. So she and Nurse Rockey bent FDR’s legs at the knees over and over, stretching the hamstrings to keep the legs from curling out of their normal shape.
So it went, testing and watching and working every muscle, not just below the waist but in the arms and hands, too, and in the abdomen and lower back.
Above the waist, Mrs. Lake saw real progress. FDR was doing many pull-ups with his overhead straps every day. While his lower body shriveled, his chest, shoulders, and upper arms were gaining new bulk and new strength. By the first week of January 1922, Mrs. Lake wrote to Dr. Lovett: “A friend of his told me he wouldn’t have believed he was the same man he saw in November.”
“He is a wonderful patient,” Mrs. Lake wrote, “very cheerful & works awfully hard & tries every suggestion one makes to help him.”
But then she became suspicious.
As January turned to February, she noticed that FDR would seem to make progress for a day or two. Then she would arrive the next morning to find the patient tired and cranky, with his ankles strangely swollen.
She called in Dr. Draper and told him what was happening.
Have you been overworking the patient? Draper asked.
Absolutely not, Mrs. Lake replied.
They were puzzled.
So Mrs. Lake did “a little private detective work” with Nurse Rockey, who attended FDR at night, when Mrs. Lake was gone.
Mrs. Lake asked the nurse if Mr. Roosevelt had been exercising at night.
Yes, he had, Miss Rockey replied.
“She remarked with some pride,” Mrs. Lake wrote Dr. Lovett, “that she was doing some ‘quite heavy manipulation’ (her own words) on the patient at night.”
Mrs. Lake went straight back to FDR, who admitted under questioning that he had asked Nurse Rockey to administer heavy Swedish massage to his legs—“to build up the muscles!” he told her. This was exactly the sort of deep-muscle massage the doctors had forbidden.
Mrs. Lake scolded him. Didn’t he remember that massage could damage his fragile muscles at this point? He must take things slowly. Didn’t he want to learn how to walk with crutches? He would never do so if he overworked his muscles.
Of course, he said. He was sorry.
“I am getting on extremely well,” he wrote a friend just then, “though it seems slow, and I am not out of the house yet. However, as complete and permanent recovery is promised in a few months I am not worrying.”
* * *
Dr. Lovett came from Boston again. He saw something Mrs. Lake had missed. Yes, as she feared, FDR was developing contractures in the hamstring muscles. But Lovett also saw that where the legs met the upper body, muscles were hardening into contractures that could leave FDR permanently bent at the waist.
So Lovett brought in a specialist, Dr. Arthur Krida, who encased Roosevelt in rock-hard plaster casts from his waist to his ankles, one for each leg, with hinges at the joints.
Now FDR had to lie on his bed with his lower body absolutely rigid, twenty-four hours a day. Every day, Dr. Krida came back to the house. Every day, he would pound wedges into the joints of the casts. The farther he pounded the wedge, the more the contracting muscles stretched.
With no way to exercise his legs, FDR’s fears rose to the surface. He asked Mrs. Lake, With all this time lying still, won’t I lose all the strength I’ve regained?
For two weeks he lay entombed in the plaster casts. Finally Dr. Krida cut them off. The muscles had stretched. The danger of contracture was past, and the patient had not lost much strength.
Now, Dr. Lovett said, it was time to get Roosevelt up on his feet. The next goal was to learn the difficult art of walking with crutches.
* * *
Of all the mammals, only humans stand upright on two feet. It is one of the traits that define us as a species. It seems easy to most of us only because we’re used to it. We learned it as toddlers. But we forget the weeks of trial and erro
r.
The apparently simple act of standing is actually a highly complicated effort requiring the coordination of nerves, muscles, and bones. The brain of a person getting up from a chair sends millions of signals through the motor nerves to the toes, feet, ankles, calves, thighs, buttocks, lower back, and abdomen, all the muscles moving in harmony to keep one hundred or two hundred pounds safely balanced on two loosely jointed stalks. The muscles have to be loose and limber enough to allow the legs to bend at the ankles, knees, hips, and waist—then strong enough to tighten in an instant, holding the bones in a straight line, locked at the joints.
Paralysis in any of the complex muscles of the legs makes this a mess.
That’s how it was with FDR. The doctors and nurses tried once or twice to get him upright. But his knees and ankles simply collapsed under his weight.
So back came Dr. Krida to the house on East Sixty-Fifth Street. He took careful measurements of FDR’s legs, ankles, and feet. In a few days he returned with a set of metal braces that weighed about ten pounds apiece. The braces were fastened to FDR’s legs with leather straps and metal buckles. They extended from just above his waist down to his heels, with hinges at the knees. When the hinges were locked, FDR’s whole lower body was held as stiff and straight as a tree trunk.
The nurses lifted him to his feet. They inserted a crutch under each armpit. With a nurse on each side, he stood up for the first time in half a year.
It was strangely frightening to attempt this feat, once so simple. Another young man recovering from polio—a less severe case than FDR’s, with only one leg paralyzed—wrote: “It depressed me to find it so difficult … I had not known that the weakness of my hips, only slightly involved, would so completely destroy my feeling of security. Even with my back to a wall, my brace locked at the knee, I would feel brittle and vulnerable, at least ten feet tall; thinking that if I fell I would shatter on the floor like a tower of blocks.”