Background: Little note was taken when Franklin Delano Roosevelt was alive and since his death of the pigmented lesion above his left eyebrow that fulfilled clinical criteria for melanoma. Observations: On morphologic grounds alone, it is impossible to exclude the possibility that Roosevelt had a melanoma. Conclusions: The failure of observers of Roosevelt, especially his physicians, to comment on his riveting facial lesion and to identify it as a probable melanoma speaks volumes about how flawed were clinical criteria for diagnosis of flat and slightly raised lesions of melanoma in the 1930s and 1940s.

In the 4 years since beginning research for a book on the health 1 of our 32nd president, the diagnosis of Franklin Delano Roosevelt's seizures evolved from a suspicion to a virtual certainty. Even more importantly, it is clear that they had a major impact upon his mental acuity and decision-making during one of the most critical periods in American history.There are dozens of independent reports of behavior consistent with complex partial seizures that occurred with considerable frequency for over a year prior to his death from a cerebral hemorrhage at Warm Springs, GA, on April 12, 1945, none of which were recognized as such by the observers. The true nature of Roosevelt's neurologic illness has been one of the most closely held secrets of the 20th century, abetted by the active participation in a cover-up by his 2 most well-recognized physicians, ENT specialist Ross T. McIntire and cardiologist Howard G. Bruenn. It is ludicrous to assume that symptomatology so gross and so frequent went unrecognized by those entrusted with the health of the most important and powerful man in the world. The pieces of the puzzle are scattered in dozens of books, articles, oral histories, and a limited amount of surviving medical records.In the last year of Roosevelt's life, the long list of observers who were aghast at his appearance, demeanor, and loss of mental acuity include Winston Churchill, Churchill's physician, Lord Moran, and Generals Douglas MacArthur and Albert C. Wedemeyer, yet a number of others are particularly graphic and convincing.In July 1944, prior to his nomination for an unprecedented fourth term, Turner Catledge, then a reporter and soon to be editor of The New York Times, met with FDR: When I entered the president's office … he was sitting there with a vague glassy-eyed expression on his face and his mouth hanging open. He would start talking about something, then in midsentence he would stop and his mouth would drop open and he'd sit staring at me in silence … Repeatedly he would lose his train of thought, stop, and stare blankly at me. It was an agonizing experience for me. Finally a waiter brought his lunch, and (Chief of Staff, General Edwin "Pa") Watson said his luncheon guest was waiting, and I was able to make my escape. 2 The change in appearance had to do with the oncoming of a kind of glassy eye, and an extremely drawn look around the eyes and cheeks, and even a sort of dropping of the muscles of the jaw and mouth, as though they weren't working exactly. I think they were, but there was a great weakness in those muscles. Also, if you saw him close to, you would see that his hands were weak … When he fainted, as he did occasionally-not for many years, but for several years-that was all accentuated. It would be momentary. It would be very brief, and he'd be back again. 4 A January 5, 1948, memo from a Chicago Tribune reporter, Orville "Doc" Dwyer, to his colleague, Walter Trohan, best illustrates the historical importance and also reliably reports that Roosevelt's daughter, Anna, who served as his ...

Conventional wisdom suggests that Franklin Delano Roosevelt died on 12 April 1945 aged 63 from a massive cerebral haemorrhage attributable to uncontrolled hypertension and atherosclerosis. Evidence from numerous reliable sources is presented, based largely on a constellation of previously unrecognized neurological symptoms including seizures, encephalopathy and hemianopia, supporting a scenario that, while indeed he suffered from severe cardiovascular disease, Roosevelt died from melanoma with the terminal event attributable to a metastatic lesion in the brain.

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A large body of evidence is presented in support of a probable cover-up of Roosevelt's health problems, perpetrated by his doctors and close confidantes. The necessity of challenging conventional thinking about the health of our leaders and the fundamental importance of understanding their health issues is also emphasized.