Eleanor Roosevelt's cause of death and end of life issues examined during clinicopathological conference

Today, the Medical Alumni Association of the University of Maryland School of Medicine (SOM) along with notable national experts review the cause and end of life issues surrounding the death of one of the most prominent figures of the 20th Century: former First Lady and leading women's and civil rights advocate Eleanor Roosevelt as part of the 21st Annual Historical Clinicopathological Conference.

Eleanor Roosevelt

The Historical Clinicopathalogical Conference, established in 1995, has evaluated more than 20 historical figures including Joan of Arc, Alexander the Great and Vladimir Lenin among others. The 2007 conference focused on treatment outcomes for President Abraham Lincoln, had he suffered the same injury today, to determine if the historical diagnosis, treatment and outcomes would have been different with the use of modern knowledge and technology.

The Historical Clinicopathological Conference is sponsored by the SOM and the Medical Alumni Association. Additional notable participants in this year's conference include Daniel Sulmasy, M.D., Ph.D., the Kilbride-Clinton Professor of Medicine and Ethics at the University of Chicago, and Christopher Brick, M.A., editor of The Eleanor Roosevelt Papers documentary history series.

Known as an avid supporter of civil liberties and the assertion of the rights of women, Roosevelt, the subject of this year's conference developed a reputation as a tireless worker who was rarely ill. Her attending physician at the time of her death, Dr. A. David Gurewitsch, gave a diagnosis of aplastic anemia and conducted test upon test, driving the First Lady to beg for a hastened end to her life. Experts from UM SOM are now re-evaluating her diagnosis due to the wide range of symptoms she exhibited and her generally excellent health, while also reviewing and considering the end of life and right to die issues that surrounded the final period of her life.

Along with her husband, Eleanor Roosevelt remains one of the twentieth century's most iconic figures. In 1999 the Gallup organization drew on more than six decades worth of public opinion data to rate FDR the sixth most admired person of the previous hundred years, and ER—as she often signed letters to close friends and associates—the ninth.

"Unfortunately, Eleanor Roosevelt's role in history remains poorly understood, in good part because period scholarship has tended to downplay or overlook entirely the remarkable years of public service and achievement that followed her husband's presidency," said Christopher Brick, M.A., an editor of The Eleanor Roosevelt Papers documentary history series. "With concerted effort, however, the records that document this final phase of Eleanor Roosevelt's life and career are coming to light, and as this year's Clinicopathological Conference demonstrates, they bear great relevance not just to her time, but our own as well."

Leading the evaluation of the former First Lady is Philip A. Mackowiak, M.D., M.B.A., Clinical Professor of Medicine and the Carolyn Frenkil and Selvin Passen Scholar-in-Residence at the University of Maryland School of Medicine who is also a 1970 graduate of the medical school. Dr. Mackowiak is well known for his evaluation of other historical figures and the clinical pathology of their deaths, including a recent evaluation of William Henry Harrison. He is also the author of "Diagnosing Giants: Solving the Medical Mysteries of Thirteen Patients Who Changed the World."

"Identifying the ailments and deaths of key historical figures helps us to understand the narration of socio-political events and environments," said Dr. Mackowiak. "Sometimes the truth is more fantastic than the myth. Gaining this understanding helps us unlock the past by discovering ways the future, and the technology we possess today, can help more accurately tell the story of significant historical figures."

"Eleanor Roosevelt is a remarkable subject for this conference in terms of the striking differences between how medicine was practiced at the time of her death compared with today. In particular, there were significant bioethical and end-of-life issues in this case that were not considered or discussed at the time, and of course, there was no such thing as 'hospice care' or ethics committees and the like," said Dr. Daniel Sulmasy, M.D., Ph.D. "As we conducted this analysis, it was fascinating to see how the doctor-patient relationship has evolved over time. Indeed, studying Eleanor Roosevelt and the circumstances of her death is perhaps better understood from the vantage point of the present day than it would have been to do so in the period following her death."

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