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Dr. Spurling, who would basically preside medically over Patton from that point on, examined his new and important patient. He found what the others had. Patton’s condition was “precarious,” mainly because of the “restriction on breathing.” The part of his diaphragm that was working was doing double duty, the strain of which was worrisome. An operation was “out of the question” simply because there was no operation to “restore” a damaged spinal cord. And even if there was, it “would have been almost an impossible task because the patient was barely able to breathe under normal conditions, much less under anesthesia.” Whether or not he pulled through, he would never ride horses again, Spurling told Patton in response to the general’s private questioning when they were alone. Of Patton’s reaction, Spurling said, “he thought a moment and he said ‘Thank you, Colonel, for being honest.’ Then in a flash he returned to his old jovial mood.”

The following day, wrote Spurling, “there seemed to be a distinct improvement in the General’s condition. He regained a little more power in one arm and a very minute amount of power in one leg.
Also the muscles of respiration began to function feebly. This gave us high hopes that the cord was not as seriously damaged as we had every reason to believe in the beginning. In addition to these favorable neurological signs, his general condition remained remarkably good. He was cheerful and took a well balanced diet freely. His temperature and pulse remained normal....”
³⁰
Improvement, wrote Spurling, continued for several more days until it “ceased and he showed no further return of his spinal cord function. Yet, in spite of this grim outlook, his general condition held up remarkably well.”

On December 17, with the hooks in his cheekbones “each day” becoming “more unbearable,” it was decided to try removing them and substituting a “light plaster cast” to support his neck. Tests showed that the tongs had done their work. “The flow of spinal fluid was free and there was not the slightest indication of pressure” at the injury. The bone alignment was “perfect.” The hooks were removed and the cast was molded to his shoulders and neck in his room “without disturbing him in the least.” Patton “was much happier.”
³¹

By December 18, he was doing so well that it was decided, at the urgings of Mrs. Patton, that he would best be served at a major hospital near his Massachusetts home. His nurse wrote on his chart that day that he was “cheerful, very alert.”
³²
Farago says he told her, “I am feeling really well, Ann. For the first time.”
³³
Usually not hungry, she noted he ate, “soup, mashed potatoes and gravy.” A comprehensive physical spurred by the turnaround showed that despite the problems caused by his paralysis, he was otherwise generally in “excellent” health. He might never ride horses again, but his blood pressure was normal. His heart tones were good. There were even some new movements detected in his thigh and biceps.
³⁴
Dr. Spurling, the most optimistic of his doctors, cabled the surgeon general’s office in Washington: “Arrangements
being made air evacuation General Patton, 30 December,” he wrote.
³⁵
It was set. Patton would be home a week after Christmas. Sergeant Meeks, his black orderly and friend who had attended him throughout the war, began a crash course on how to function as Patton’s nurse during the return. Farago likened Patton’s improvement to the time almost exactly a year before when, during the Battle of the Bulge, he had ordered his chaplain to write a prayer for clear weather so Allied planes could fly in support and the prayer had been answered. It was “mysterious,” an “enchanting miracle,” he ventured.
³⁶
Patton had done it again.

Then he had a sudden downturn.

Since she arrived, wrote Spurling, Mrs. Patton “had been concerned about the possibility of an embolism”—the obstruction of blood flow in an artery, usually by a piece of clotted blood that breaks free in one place in the circulatory system and travels to another. It is a problem particularly for older patients who are bedridden. Air, fat globules, pieces of errant tissue, or even hardened pus can cause obstruction. In 1937, while riding with his wife, Patton had been kicked by her horse when it suddenly bolted. The kick had broken bones in his right leg. Bedridden with a cast for nearly four months, he had developed “thrombophlebitis,” a blood clot condition which had sent two emboli to his pelvic region .
³⁷
But he had recovered and been formally certified by army doctors as free of “any illness of a chronic nature,” a requirement for him to be put back on active duty.
³⁸
The medical examination then specifically noted that all his vitals, including heart, blood, and respiratory systems, were “normal.” Nevertheless, wrote Spurling, Mrs. Patton “kept saying to me every night, ‘If he just doesn’t get an embolism I think he may pull through.’”

But according to Spurling and at least some of Patton’s other doctors, an embolism—or multiple emboli—suddenly attacked
him late in the night of December 19. Copies of Patton’s medical records from those hours, sent by the Army Reserve Personnel Center in St. Louis, are so faint that they can not be deciphered. But Farago writes—and a hospital summary
³⁹
appears to agree—that shortly after 10:00 p.m. Patton “was jolted awake by a violent coughing spell.” Farago’s is the only account that describes the attack. He portrays it this way: “No crisis was expected and the tension had eased in [Patton’s room. His nurse], whose shift was ending, was standing at the door, talking with another nurse. When she heard the patient’s sudden discomfort, she rushed to his bed....”
⁴⁰

In other words, Patton was alone in the room when the attack began.

Dr. Hill, in a letter, called the attack a “shower emboli,” which presumably meant more than one embolism. With his paralysis impairing his ability to cough and breathe, Patton had trouble raising fluid from his lungs. “For minutes afterward,” continued Farago, “he remained in desperate straits” until doctors arrived and he was given codeine and other medications that eventually steadied him. His diminished breathing during and after the attack combined with blood traces in his sputum made doctors suspect embolism (or emboli) had hit his one working lung and caused the crisis. The problem causes tissue around the obstruction to die and thus deprives the lungs of more oxygen-supplying cells. By morning, Dr. Spurling wrote in his memoir, “he was feeling fine again.” But Farago cautions, “the improvement was superficial and deceptive.”
⁴¹

The dying process was beginning its final stages.

At 10:00 a.m., Patton’s neck and chest were x-rayed. Eventually, according to hospital notes,
⁴²
the films “showed evidence of an acute pulmonary complication . . . of embolic nature.” In other
words, it confirmed that an embolus (or multiple emboli) had caused the crises in Patton’s working lung. They logically suspected it had originated at the site of his neck injury. But tests showed Patton’s “spinal condition to be stable.”
⁴³
Spurling said, “We had accomplished a perfect reduction of the fractured vertebrae . . . as far as the spinal cord injury is concerned he was making very good progress.”
⁴⁴

So what was the origin of the embolism?

Still thinking it was the neck injury, they could not be sure.

Exasperated, Spurling wrote in his memoir, “There was no predicting where the embolism might have formed. There was certainly no external evidence of phlebitis [inflammation of a vein] in any part of the body.”
⁴⁵

The situation did not change substantially the rest of the day except that around 3:30 p.m., Patton, according to his chart, had another coughing spell.
⁴⁶
While records do not indicate it was as violent as the earlier one, his condition continued to deteriorate. Each cough taxed his heart. The vital organ had to work harder pumping blood in order for him to expel mounting fluid from his lungs so he could breathe better. His lungs got wetter. His blood pressure got weaker. He was given medicines through the mouth and IV but they did not stop the deterioration. At 9:00 p.m. his nurse wrote, “No coughing. Restless & tired.” Copies of his released hospital records for the rest of the night are too faint to read but Farago says sometime during those hours he told his nurse, “Why don’t they just let me die?”
⁴⁷

At 7:00 a.m., December 21, obviously not doing well, his charts say he “refused breakfast.” The doctors continued testing and treating him. By 10:30 a.m., his nurse noted, “Patient sleeping or resting quietly.” At noon, he drank some eggnog and seemed to feel better. Nevertheless, according to hospital notes, he “told
nurse several times that he was going to die.”
⁴⁸
Around 2:00 p.m., according to Farago, he fell asleep again and his wife left the room, probably to get some sleep herself since she had been in an almost round-the-clock vigil since the coughing had started. She had a room down the hall.

Just after 3:00 p.m., according to his chart, he started coughing again. By 4:00, he was “very drowsy” and “unable to take fluid.” Soon he was sleeping and “breathing irregularly,” his pulse fading. Alarmed, the nurse summoned Dr. Duane, who, seeing the gravity, according to Farago, “ran down the corridor to summon” Mrs. Patton, “who came immediately, followed by Colonel Spurling.”

Too late.

Patton was dead when they arrived.

Patton’s War Department
death certificate lists “Pulmonary Edema & Congestive heart failure” as the cause of death,
¹
meaning his heart failed trying to clear his lungs.

It sounds like he died from complications caused by the car accident.

But we do not really know.

There was no autopsy.

Dr. Spurling, apparently not certain about the exact cause of the embolisms, requested one, but Mrs. Patton refused.
²
She did so, Spurling later wrote, “for two reasons: First, there wasn’t a fully qualified pathologist available . . . and, second, Mrs. Patton felt that under the circumstances she would prefer not to have one performed. I am sure, though, had there been adequate facilities for careful study of the remains, she would have granted permission.”
³

In such circumstances, Mrs. Patton’s wishes would have to be respected. But not having a “fully” qualified pathologist or
“adequate” facilities seems a weak excuse, as Spurling gives it, and something the authorities could have remedied easily. They certainly had spared no expense or effort in locating Dr. Spurling thousands of miles away on a train in Ohio and immediately flying him and Mrs. Patton back across the Atlantic. They found other medical specialists throughout Europe and flew them in too. Upon Patton’s death, authorities “rounded up” two registered morticians, according to Spurling, and immediately started planning a major funeral and burial procession by train to Luxemburg, a distance traversing two countries. The costs and effort for the procession alone easily would have exceeded any to find a qualified pathologist. And would not one of the hospital’s surgical rooms or labs have done for the facilities?

Farago notes that “within hours of his death,” rumors that Patton had been assassinated spread “throughout Germany.”
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And not only amongst Germans. Rank and file U.S. soldiers who had served in Patton’s Third Army, most by then home and returning to civilian life, believed he had been murdered.
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These were honored and hardened troops, not prone to exaggeration or naiveté. General James M. Gavin, leader of the 82
^nd
Airborne Division, which had jumped into Normandy, later wrote, “It seemed incredible when we learned . . . he had died . . . . We followed what we assumed was his recovery... and expected at any time that he would be out of the hospital.”
⁶
Patton’s nephew and friend, Fred Ayer, Jr., an FBI official stationed in France, wrote that upon initially hearing of the accident, his immediate response was, “Accident hell. It was murder. Those communist sons of bitches killed him.” Intelligence operatives thought the same.
⁷
In view of such speculation, wouldn’t officials have wanted to quell the rumors? Patton had been front page news since landing in France after
D-Day, and his being fired in September had been widely covered. His controversies with ranking Allied generals, the Russians, the Democratic administration and its punitive deNazification, and general anti-German policies were well known and had become one of the big stories of the immediate post-war months. Those believing the rumors pointed publicly to his detractors—respected Allies all—as possible perpetrators.

Most curiously, it appears that Mrs. Patton herself had questions. In spring 2006, FOX News
War Stories
with host Oliver North broadcast an episode entitled, “Remarkable Life and Mysterious Death of General Patton.” In the show, Patton’s grandson, James Patton Totten, an adult now and spokesman for the Patton family, is quoted on camera as saying, “My grandmother hired several private detectives to investigate [the death]. They didn’t find anything to substantiate the rumor.” He gives no details but his statement shows she, at least, wondered. Why? When? What prompted her to pursue such an investigation?