SEVERE MIALNUTRITION IN A PUBLIC SERVANT OF

THE WORLD WAR II ERA: THE MIEDICAL

HISTORY OF HARRY HOPI?KNS*
JAMES A. HALSTED, M.D.

Harry Hopkins occupied a unique place in the nation's history as a

devoted friend and advisor of President Roosevelt. During World War II
he wielded power and influence which, according to testimony by Secretary
of War Stimson and General George C. 1\Iarshall amoong many others, was
of great benefit to the war effort.
Since 1948 I have been interested in his serious illnesses occurring simul-
taneously with his historic activities. Hopkins had had a gastrectomy for
cancer of the stomach in 1937. About a year later he began to have recurrent
bouts of devastating malnutrition and finally, he developed liver disease
from which he died on January 29, 1946. How could he accomplish the
prodigious feats w-hich he did, living wNith three such near lethal diseases?
His activities were those for a man of unusually good health plus an in-
domitable will. He had the latter but rarely the former, except during partial
remissions in the malnutrition problem which was never adequately diag-
nosed.
To investigate his illnesses I was able to obtain copies of the Mayo Clinic
and i\Iemorial Hospital Records, plus the autopsy report from Memorial
xhere he died.
Hopkins was born in Iowa in 1890, with a background which was deeply
religious. At 22 he graduated from Grinnell College, and later became a
social welfare worker in New York. During his years in New York he be-
came Executive Director of the New York Tuberculosis Association, the
president of which was James Alexander Miller. (Dr. M\1iller was a member
of the Climatological from 1905 to 1948 and its president in 1916). He had
demonstrated marked leadership ability and administrative qualities which
were unusual but effective. The Association under Hopkins' executive
directorship grew enormously in membership with a large increase in both
income and expenditure.
He believed in positive action when he had the power to take action and
worried about finding the money later, a characteristic which shaped his
later career as Administrator of Federal Relief and de facto Administrator
of Lend-Lease during World War II. He felt that when money was available
* From the Clinical Nutrition Program, Division of Gastroenterology, Depart-
ment of Medicine, Albany Medical College, Albany, New York.
Address for reprints: R.D. #2, Hillsdale, New York, N.Y., 12529.
23
24 JAMES A. HALSTED

it should be spent wrhen there was compelling need. This philosophy applied
not only to his public but to his personal life. He loved a good time and
rarely saved.
When Roosevelt was Governor of New York from 1928-1932, Hopkins
was appointed Director of the Temporary Emergeney Relief Administra-
tion. He was very effective in this job and w-hen F.D.R. became I'resident
he was made Director of Federal Relief CWA, and later, WPA-in May
1933.
President Roosevelt trusted Hopkins and turned to him more and more
for advice, ideas and action. Nine billion dollars was spent on Relief and
sixty-nine billion on Lend-Lease supplies to the Allies. This great sum was
largely under Hopkins' direction. He had become de facto Administrator
of Lend-Lease in 1941. Despite outcries to the contrary he was told by
F. D.R. to have no truck with politicians and Harry refused to look out for
"deserving Democrats". These enormous funds offered juicy patronage
plums and Hopkins' refusal to play ball was undoubtedly the source of many
of the personal attacks on him such as a lead story in the Chicago Tribune
before the 1936 election headlined, "Throw the Rascals Out !" His integrity
and honesty, doubtless eoupled with his ill health, probably contributed to
the hostility.
Hopkins' advisory activities were primarily related to tacties rather than
strategy. He was not a man likely to suggest broad topics with philosophical
overtones but rather he was extremely effective in summing up a problem
or a policy matter which had been proposed and discussed by others. He
had a keen analytical mind and was extremely adept at defining the prob-
lem at hand and the solution decided upon, then to get things done by
succinct action. Churchill facetiously declared that he was going to propose
him for the House of Lords with the title of "Lord Root of the M\Iatter".
In October 1937 Hopkins' second wife died of cancer. He had had a
duodenal ulcer in 1934, confirmed by x-ray, but because his father had died
of cancer of the stomach he suspected that he, too, had the same. On De-
cember 17, 1937 he entered the Mayo Clinic because of a recurrence of ulcer
symptoms plus vomiting. Two months previously x-ray had demonstrated
a pre-pyloric ulcer with crater. Upon admission pyloric obstruction was
suspected, confirmed by gastric aspiration, and after three days he was
operated upon. There was a mass 4 X 2 X 1 cm. in size, with firm omental
nodes. The liver was normal. A high, partial gastrectomy of anterior Polya
type wN-as carried out with an entero-enterostomy performed ten inches
below the anastomosis. The pathologic report was that of a large adeno-
carcinoma of the greater curvature with involvement of adjacent lymph
nodes. The cancer never recurred, surprisingly, because statistically the
cure rate of such a large adenocareinoma is in the neighborhood of two or
three per cent.
 MIEDICAL HISTORY OF HARRY HOPKINS 25

His recovery Nas uneventful with no digestive problems nor other signs
of the post-gastrectomy syndrome. About a year after the operation Hop-
kins was appointed Secretary of Commerce. At that time, early January
1939, he had developed ambitions of being the Democratic nominee for
President in 1940. Indeed, it appears that he was first on F.D.R.'s list of
possible choices to succeed him in the White House.
This career pathway was soon obliterated because in M\Iarch 1939 he had
the first of numerous long episodes of great weakness with collapse, diarrhea,
edema of the extremities, poor vision and signs attributable to several
vitamin deficiencies. He had vomiting on and off for three weeks and lost
18 pounds. With bedrest he improved somewhat but could only work half-
time. He spent the summer of 1939, which was tense with the build-up to
war, in a country house near Washington. One of his sons had written
about his condition as follows: "We were amazed at how sick he was. His
letters never indicated this. He went fishing in the morning and took a nap
in the afternoon. Then he began having trouble with his legs and soon was
too N-eak to step into a boat". Hospitalization became imperative and on
August 23rd he re-entered the M\ayo Clinic where he stayed for three weeks,
being discharged on September 14, 1939.
Hopkins' medical records are of special interest in the multiplicity of de-
tailed and frequent progress notes by many physicians well known to most
of us. These notes constituted the best of medical observation and logic ex-
pressed in a quality of English rarely seen today. Of course in those days
clinical laboratory tests were less sophisticated than at present.
The significant features of the second Mayo Clinic admission were as
follows: he had lost weight but, importantly, had a good appetite. He had
edema of the legs, shiny scaly skin, sore shin bones, and burning of feet and
ankles with redness of the toes. There was glossitis, ataxia and weakness of
legs. He had poor vision and diarrhea.
Examination revealed no abdominal mass, hepatomegaly nor palpable
lymph nodes. X-ray studies showed that the anastamoses functioned well.
Barium enema did not reveal a gastro-colic fistula.
The laboratory findings showed moderate anemia (Hemoglobin 10 gm.
per 100 ml.) and macrocytosis on blood smear. (This was reported several
times both at this admission and later ones, being emphasized by the labora-
tory physician). Blood chemistry findings were: Calcium 7.7, cholesterol
105, total protein 2.04 and 3.47. The prothrombin time was 20 seconds.
Stool fat was 10.4 gm. in 24 hours.
These findings may be interpreted in light of present knowledge of in-
testinal absorption as showing malabsorption of fat (steatorrhea and low
cholesterol), protein, calcium, vitamin K, vitamin A (poor vision), water
soluble B vitamins (the neurologic findings and glossitis), and probably
folic acid (moderate anemia with macrocytosis).
26 JAMES A. HALSTED

He was treated with a low residue diet high in vitamins, parenteral vita-
mins plus crude liver extract intramuscularly three times a week, three
blood transfusions and intravenous amigen in 10 % dextrose.
He progressed well, the glossitis and edema disappearing with rise in
total protein to 5.4 gm/100 ml. He had written his brother Lewis Hopkins,
a physician, while in the hospital that his problem was inability to absorb
proteins and fat, that he was losing his vision, had lost 30 pounds, that there
was no evidence of recurrence of the cancer. He said that weakness and
other signs of malnutrition had begun "about a year ago" after a throat
infection, with periods of improvement and relapse until July 4, 1939 when
he had to take to his bed most of the time. He wrote that he had "a general
sense of well-being, excellent appetite, no nausea and no diarrhea. The best
I can tell you is that I have a very severe malnutrition".
The entire picture was indicative of intestinal malabsorption. Interest-
ingly up to now his physicians had not mentioned sprue, nor the post-
gastrectomy syndrome including "the dumping syndrome", nor attempted
to analyze or clearly define, other than to use the general term of malnutri-
tion. Since the physicians involved included leading authorities on malnu-
trition secondary to disease it is an indication of the paucity of knovWledge
35 years ago of intestinal function in relation to nutrient absorption and
the nutritional effects of gastrectomy.
After leaving the Mayo Clinic he continued to improve very slowly but
was unable to leave his home for uninterrupted work for another eight
months. Eventually, however, he became well enough to have six more
years of memorable accomplishment, even though interspersed with remis-
sions and relapses.
On May 10, 1940, the day of the German attack on the Low Countries, he
went to dinner at the White House. He was feeling miserable and F.D.R.
prevailed upon him to spend the night. He remained there for three and a
half years, where he was easily available.
On August 22, 1940 he resigned as Secretary of Commerce to become a
Special Assistant to the President.
Although the ups and downs in the effects of his nutrition problem con-
tinued, when an emissary was needed to talk to Churchill, Hopkins asked
F.D.R. to send him to London. He set off on January 5,1941. This was at a
time of partial remission but Churchill wrote later: "There he sat, slim,
frail, ill, but absolutely glowing with refined comprehension of the Cause
(the defeat of Hitler)-to the exelusion of all other purposes, loyalties, or
aims. "
The British recognized his ability and relied increasingly on his counsel
and intuitive good sense.
In July 1941 Hopkins was sent to 1\Ioscow from London where he was on
 MEDICAL HISTORY OF HARRY HOPKINS 27
a second mission. Described as "gaunt and ailing" he made a long dangerous
journey by, flying boat north of Norway to Archangel where he had to
attend a four hour banquet, have two hours sleep, then fly to M\1oscow for
talks with Stalin and others. Returning home he was heavily occupied with
lend-lease matters and being instrumental in soluitioIn of many monumental
problems. In April 1942 he was in London for a third mission and in August
for a fourth. In July 1942 he was remarried. He and his wife, Louise, stayed
on at the White House for a year with Diana Hopkins, the daughter of
Barbara who had died of breast cancer in 1937, but in August 1943 they
moved to their owIn home.
In about October 1943 Dr. Rivers of the i\Mayo Clinic saw Hopkins in
Washington. This was four years after he had been so desperately ill when
malnutrition first manifested itself in 1939. Despite relapse and remission
he had carried on the strenuous work involving Lend-Lease matters, with
five trips to London and MIoscow for conferences with Churchill and Stalin,
and with participation in the Casablanca, Quebec, Cairo and Tehrai. con-
ferences.
Dr. Rivers noted that he had edema and ascites, a serum protein of 5.0
gm/100 ml. and red blood count of 3.5 million/cu.mm. He was started on
plasma infusions to be given every three weeks. None of the measures was
of much benefit because all through the winter of 1943-1944 he was criti-
cally ill, unable to work and re-entered the 1\1ayo Clinic on 1\larch 9, 1944
where he stayed until May 7, 1944.
The history at this time uncovered the very important fact that he had
begun to have attacks of mild diarrhea, often brought on by a large ingestion
of fat, in 1931-6 years before his gastrectomy.
Other significant findings were as follows: Weight was stationary with a
good appetite and fair strength. He had poor vision and impaired dark
adaptation. There was absence of body hair. The laboiatory examinations
revealed macrocytic anemia (R.B.C. 3.30 million, Hgb. 13.6 and macrocytes
on blood smear). The serum protein was 5.4 gm/100 ml. Stool fat showed
14.4 gm. and nitrogen 4.5 gm. per day. Serum carotene was "low". A new
observation was that he had noted brief jaundice before admission which
subsided. Serum bilirubin on two occasions was 2.5 and 3.75 gm/100 ml.
An exploratory operation was done to rule out cancer recurrence and to
revise the anastamoses, hoping to obtain better mixing and a larger jejunal
absorptive surface. The operation revealed no evidence of recurrence and
the liver was reported as being normal. A biopsy was taken but no record of
this was available. The pancreas and small bowel appeared normal.
Some opinions expressed were as follows:
1. Malnutrition leading to hypopituitarism with adrenal cortical insuffi-
ciency.
2(S JAMES A. HALSTED

2. A fatty liver from malnutrition "with low-grade cirrhosis".

3. "The fundamental difficulty stems from non-tropical sprue".
The post-operative course was uneventful and he recovered to his previ-
ous degree of ill health. The therapy, as it had been throughout, was heavily
weighted to parenteral vitamins, diet and transfusions both of blood and
plasma. After leaving the AMayo Clinic he spent a long convalescence at
White Sulphur Springs. Back in Washington July 4, 1944 he was incapable
of much work but continued in an advisory capacity to the President,
participated very little in the 1944 presidential election but continued as a
conduit between London and Washington at highest levels respecting N-ar
problems. His astute intellect and negotiating ability, despite the fact that
he, was too ill to work more than 2 to 3 hours a day, made him a key person
in planning the Yalta Conference which he attended in February 1945.
At Yalta he was so sick that he had to spend much of the time in bed
but attenided all conferences. On the returni he became wN-orse and left the
ship at Algiers whence he flew home to go directly to the M\ayo Clinic for
the fourth admission,Februar 27 April 13, 1945..
There were no new findings at this admission, laboratory tests being
about as they were a year before. One physician with long experience in
nutritional problems, especially steatorrhea, noted in the chart "As far as
I am concerned this is non-tropical sprue".
Hopkins left the Clinic considerably improved the day after F.D.R.
died. He determined to retire from government but negotiations in San
Francisco at the Conference to establish the United Nations ran into diffi-
culties essentially over misunderstandings with the Russians. President
Truman decided to send Hopkins to M\oscow for talks directly with Stalin.
Hopkins was so highly regarded in Russia that the 4 days of meetings prob-
ably saved the San Francisco Conference, according to Sherwood.1 He re-
turned exhausted and retired after declining President Truman's request to
attend the Potsdam Conference in July 1945.
He gave up his Washington house and moved to New York, the city he
loved most. He was given an honorary degree from Oxford and planned to
go there on October 25, but by that time another episode of collapse with
diarrhea and great weakness required hospitalization. He went to 1\Iemorial
Hospital on November 1, 1945 where he remained until his death on
January 29, 1946.
The MI\emorial Hospital admission revealed little new respecting the basic
nutritional problem. It Nas emphasized, however, that his attacks of great
weakness, with collapse, muscle cramps, parathesias, diarrhea and dis-
turbed vision seemed to be recurrent and intermittent about every three
months. Examination revealed cheilosis, papillary atrophy of tongue, blood
pressure of 102/70, liver and spleen not palpable. Laboratory findings of
 MEDICAL HISTORY OF HARRY HOPKINS 29
significance were an elevated serum bilirubin which gradually rose to 9.6
shortly before death, serum vitamin A low at 20 units/100 ml., stool fat
35 gm. and stool nitrogen 10 gm. per day.
After some initial improvement, increasing jaundice, edema and ascites
appeared. Gastro-intestinal bleeding occurred toward the end, then coma
and death, three months after admission. The autopsy revealed much blood
in stomach and bowel, esophageal varices with rupture, ascites, but no
e vidence of recurrent carcinoma. The liver was small, weighed 1350 grams,
and had nodules which were irregular in size, some of which were large, with
streaks of broN- pigments. The pancreas was diminished in size and yel-
lowish-brown. The autopsy diagnosis was hemochromatosis, pigment cir-
rhosis, ruptured varices, atrophy, fibrosis and pigmentation of the pancreas.
In analyzing Hopkins' medical history three basic problems are involved.
The first, a large adenocarcinomna of the stomach, was undoubted and con-
firmed. This never recurred. One might speculate (perhaps wildly) that his
severe malnutrition might have played an inhibitory role in neoplastic
yrosvth.
The second problem was the etiology of his mlalnutrition. Two physicians
at the M\Jayo Clinic were convinced that the basic cause was non-tropical
sprue. The others both at the Mlayo Clinic and M\emorial used the term
"malnutrition" without specifying an underlying cause or relating it to the
gastrectomy. In view of the onset of diarrheal attacks six years before the
gastrectomy, with important signs of piimary malabsorption characterized
by recurrences and relapses over a seven year period preceding his death,
it seems reasonable to conclude that non-tropical sprue was indeed the best
explanation for his malnutrition. There was no evidence for rarer causes
of malabsorption such as Whipple's disease, regional enteritis, etc.
The third problem was the pathogenesis of the cirrhosis from which he
died. Although hemochromatosis was diagnosed it is unlikely that this was
in fact correct. Recent examination of the slides show that the iron found
was primarily in Kupffer cells, not in the hepatocytes as is characteristic
of hemochromatosis, nor was there an excessive amount of iron in other tis-
sues especially the pancreas and spleen. Alcoholic cirrhosis must always be
considered but there was nothing to suggest that Hopkins was ever more
than a social drinker and during his periods of ill health he often took no
alcohol for long periods of time.
Because he had had about 35 blood transfusions and innumerable in-
fusions of pooled plasma he was exposed very heavily to hepatitis B virus.
Thus it seems more plausible that he had post-necrotic cirrhosis secondary
to serum hepatitis. The post-mortem findings were not inconsistent with
such a diagnosis.
Considering the course of events in Hopkins' health history, beginning
30 JAMES A. HALSTED

in 1931, and in light of all the available facts up to his death in 1946, it
seems justifiable to speculate that he had non-tropical sprue or adult (eliac
disease (gluten enteropathy), and that post-necrotic cirrhosis developed
as ail end result of hepatitis B infection, and occurring as a result of the treat-
ment he received for malnutrition. However, since histologic proof is lack-
ing for a diagnosis of sprue, the C.P.C. is incomplete! Had his life span
occurred a few years later he might have enjoyed the benefits of the "wheat-
free diet" which grew out of the observations of the Dutch pediatricians,
Dicke and Wejers, who noted that during the Nazi occupation of Holland
with starvation conditions, childhood celiac disease disappeared.
Harry Hopkins' place in history may well be judged as more important
than many people now recognize. The judgments of Secretary of War
Stimson, General George C. Marshall and several historians would bear
this out. His role in the war effort which led to the defeat of Hitler, despite
his extremely complex and debilitating illnesses, may be regarded as rank-
ing close to the top in importance. Whether, a hundred or more years from
now, that event the defeat of Hitler-will be considered one of the great
turning points in history, no one yet knows.
ACKNOWLEDGMENTS
I am indebted to Mr. Harry L. Hopkins' children, Mr. David Hopkins,
Mrs. Diana Baxter, and Mr. Robert Hopkins for making it possible to
obtain medical records from the Miayo Clinic and the Memorial Hospital,
New York, which provided the basis for the medical history. I am also in-
debted to those institutions for their cooperation. Dr. Patrick Fitzgerald,
Chairman, Department of Pathology, Sloane Kettering Memorial Cancer
Center, was enormously helpful in reviewing the pathologic material. The
staff of the Franklin D. Roosevelt Library, Hyde Park, New York was
most generous in making materials available on 1lIr. Hopkins' life, and
providing photographs and slides of the Roosevelt era.
REFERENCES
1. SHERWOOD, ROBERT E. ROOSEVELT AND HOPKINS: An intimate history. Harper
and Brothers, New York. 1948.
2. BURNS, JAMES MACGREGOR. ROOSEVELT: The soldier of freedom. Harcourt Brace
and Jovanovich, Inc., New York. 1970.
3. CHARLES, SEARLE. Minister of Relief. Harry Hopkins and the Depression. Syra-
cuse University Press, Syracuse, N.Y. 1963.
DISCUSSION
DR. GEORGE E. SCHREINER (Washington): I find this very interesting. I started
medical school at Georgetown in 1943 in the Spring and lived in a house on 34th
Street which was just two doors away from an old Georgetown house that had just
been purchased by the Hopkins and one hot afternoon there was a knock on my door,
 MEDICAL HISTORY OF HARRY HOPKINS 31
and I presume this was the second Mrs. Hopkins. She asked if she could see how we
had fixed up our room and furnished it because they were just in the process of be-
ginning to refurnish the house, and we lived there with several other medical students.
The following day she asked if she could bring Mr. Hopkins back to see what we had
done on redecorating the room, and he came in and I introduced him to my room-
mates, and we noticed the sallow skin and slight edema and after he had left specu-
ulated that he might have cirrhosis. I never really did know the outeome of the story.
DR. HALSTED: Thank you, Dr. Schreiner, for this interesting observation. I sus-
pect that the sallow skin and slight edema which you noted in 1943 and speculated
might be due to cirrhosis was more likely caused by hypoproteinemia and anemia
resulting from malabsorption at that time. But since he died three years later from
complications of cirrhosis you may have been partly right. However, the explora-
tory laparotomy a year after you saw him revealed a normal liver grossly.
DR. J. EDWIN WOOD, III (Philadelphia): Editorial opinion expressed recently
suggests that health records of public officials should become a matter of public
record. Do you hold any opinion on this issue?
DR. HALSTED: I recently discussed this question, in part, in a letter which I wrote
to the New York Times Book Review Section and shall send you a copy. However,
that was not really pertinent to this paper although the health record of public
servants is certainly a highly important matter. I would say, however, that as we
all know even the most sophisticated and educated person who is not a clinician
could not accurately interpret such public health records. To answer your question
specifically I am not in favor of the suggestion, not that health data of this sort
should be hidden-although that of course is another question of ethics-but because
they could not be fairly or accurately understood by the public.
DR. JOHN STAIGE DAVIS, IV (Charlottesville): I would like to add that one's
interpretation of the role Harry Hopkins played depends a lot on one's political
point of view. For example, one thing I gather from this is that our country was not
only being run by a President in extremely poor health but was advised by a man
who was also in extremely poor health. We might characterize the decisions made
at these conferences as not reallv so astute, but because of Mr. Hopkin's illness,
extremely hasty.
DR. HALSTED: As a physician I am merely trying to relate Hopkins' serious health
problems to the extraordinary physical and mental effort he was able to exert, per-
haps because of an extreme degree of motivation and dedication. Both Secretary of
War Stimsoni and General Marshall had the highest regard for Hopkins' ability and
positive accomplishments in the war effort, as dicl several respected historians. The
same viewpoint respecting the President's ability to function in relation to his health
might apply I think. The facts known about his health have been published by Dr.
Howard Bruenn.* The rest is conjecture and speculation. As to the results of Con-
ferences these muist be judged by historians. I was interested to read "Witness to
History" by Charles Bohlen, who was present at Yalta as the President's interpre-
ter. He believed that Roosevelt was mentally sharp and effective. The interpretation
of policy juidgments as possibly affected by health matters is very subjective.
1)R. IRVING S. WRIGHT (New York): I wouild like to ask a question that was not
touc('hed UpoIn. I believe I may have some idea of the answer. What was the alcoholic
history of Harry Hopkiiis?
*
Bruenn, Howard G. Clinical notes oni the illness and death of President Franik-
lin D. Roosevelt. Annals of Internal Medicine. 72: 579-591, 1970.
32 JAMES A. HALSTED

DR. HALSTED: I was skipping a bit to finish on time but did have a note to mention
alcohol since this is the commonest cause of cirrhosis. Hopkins drank socially but
not excessively according to testimony of people who knew him and with whom I
have talked. It is known that he went for long periods of time without any alcohol.
I don't think he could have functioned as he did if he drank a great deal.
DR. DANIEL N. MOHLER (Charlottesville): What did the autopsy show in the small
bowel, in the histology of the small bowel?
DR. HALSTED: They took a biopsy of the jejunum at the second operation and I
tried to get it but it was lost. The bowel at autopsy was not compatible with sprue
but the material was fixed thirty years ago and autopsy material is not likely to give
an accurate picture of intestinal epithelium. All one can say is that sprue canniot be
ruled in or out.
DR. JOHN H. KNOWLES (New York): I have two questions. The first is related
to ethics. Even though Hopkins' children gave you permission to inspect his medical
records do you think it is ethical to publish them? The second questioni relates to
your reaction to another man's view of Roosevelt and to another question asked
this morning. These would imply to me that science isn't completely pure and de-
pends on the ideological bias of the observer. One man's illness, in someone he likes,
is interpreted by the friendly observer as leading to creativity. In another whom
the observer doesn't like, he could conclude that illness is what led him to make so
many mistakes! To me the ethics of your work, and the substantial question about
the objectivity of observers when it comes to famous people and their medical his-
tories would lead me to wonder how you personally feel about this.
DR. HALSTED: Regarding the ethics.-As I stated, this was discussed with Hop-
kins' heirs-his three children-with their approval. Here is a man, occutpying an
uindeniably important place in history, with a disabling health problem who has been
dead for 30 years. This to my ethical sense demands as objective studv as possible and
with ptublication-for the sake of historical perspective and the work of future his-
torians. A book about Churchill's health and its effect on his judgment, written by his
personal physician, Lord Moran, has been widely criticized as an invasion of privacy,
unfairly or not, depending on one's viewpoint. The book was published one year
after Churchill's lifetime. Would you clarify your other question, John?
DR. KNOWLES: The other question is that in this day and age illness doesn't nec-
essarily do anything to a man's judgment and it might even make it more creative.
But in Hopkins' case the situation might lead you in certain paths of interpretation.
DR. HALSTED: Meaning your political bias?
DR. KNOWLES: Yes.
DR. HALSTED: Well, it certainly might! I can only say that I leaned over back-
ward in my own mind in trying to be as objective as possible.
DR. KNOWLES: Great! Jim, thank you very much. It is of some comfort to me that
they lose biopsy reports at the Mayo Clinic as well as other places.
DR. HALSTE-D: Not the M.G.H., John?