The hospital room was quiet, but the man inside was anything but peaceful. Roy Cohn, the legendary "whispering" legal assassin of the 20th century, was fading. By August 1986, the guy who had built a career on being the toughest, meanest, and most connected lawyer in America was essentially a ghost. He looked gaunt. His skin was tight over his bones. Yet, even as the end neared, he was still spinning the story.
If you asked Roy Cohn at the time what was killing him, he’d look you dead in the eye—or as close as he could get to it—and tell you it was liver cancer. He said it with the same conviction he used to send the Rosenbergs to the electric chair. But the world knew. Or at least, they suspected the truth that he fought to bury until his very last breath.
What Did Roy Cohn Die Of? The Official Cause
On August 2, 1986, Roy Cohn died at the National Institutes of Health (NIH) in Bethesda, Maryland. He was 59 years old. Officially, the cause of death was listed as cardio-respiratory arrest caused by complications from AIDS.
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It’s a clinical way to describe a brutal reality. Despite his public denials, Cohn had been battling the virus for at least two years. He was diagnosed with HIV in 1984, right when the epidemic was hitting its terrifying peak. For a man who built his identity on "power" and "strength," a disease that was, at the time, associated with social pariahs was a diagnosis he simply could not accept.
So, he lied. Honestly, he lied to everyone. He told the press he had liver cancer. He told his friends he had liver cancer. He even reportedly threatened his doctors, telling them he'd ruin their careers if they ever breathed the word "AIDS."
The Irony of the AZT Stash
One of the most surreal parts of this story is how he treated the illness. While thousands of people were dying in the streets because they couldn't get medical attention, Cohn was using his massive political weight. He managed to get into an experimental AZT trial at the NIH.
AZT (azidothymidine) was the "holy grail" of the mid-80s, the first real hope for treating the virus. Most patients had to jump through impossible hoops to get it. Cohn? He just made a few phone calls. Some reports even suggest he had a private stash of the drug hidden in a refrigerator in his hospital room. It’s the ultimate Roy Cohn move: even when the Grim Reaper is at the door, you still try to cut a deal for better terms.
The Public Denial and the Private Reality
Roy Cohn wasn't just a lawyer; he was a fixer. He was the mentor to a young Donald Trump, a right-hand man to Joseph McCarthy during the Red Scare, and a friend to presidents. To him, being gay—or having "the gay plague," as it was cruelly called then—was a sign of weakness.
He once famously said, "I have my own definition of what a homosexual is... someone who is not part of the establishment." Since he was the establishment, he figured he couldn't be gay. It’s a wild bit of mental gymnastics, right?
But the physical evidence was hard to ignore.
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- The Weight Loss: In his final months, he lost a massive amount of weight, looking skeletal in his last TV appearances.
- The Lesions: Many observers noted the tell-tale signs of Kaposi's sarcoma, a skin cancer common in AIDS patients.
- The Gaunt Face: His face, once sharp and predatory, became hollowed out.
Even when he was disbarred by the New York Supreme Court just weeks before his death—for ethical violations including "dishonesty, fraud, deceit and misrepresentation"—he still wouldn't admit the truth about his health. He went out the way he lived: fighting the facts.
Why the Cover-Up Mattered
You might wonder why it matters so much that he lied. In the 80s, the stigma was a death sentence for a reputation. Cohn’s entire brand was built on being a "tough guy" for the conservative elite. Admitting he had AIDS meant admitting he was part of the very community he had often worked against or distanced himself from.
It’s also worth noting the political climate. His friend, Ronald Reagan, was famously slow to even mention the word AIDS in public. Cohn was a man of the Reagan era, a time when the "Moral Majority" was on the rise. For Cohn, the truth wasn't just a personal secret; it was a political liability.
The Final Weeks in Bethesda
Cohn spent his final weeks at the NIH Clinical Center. It’s a bit of a paradox that a man who spent his life railing against "big government" ended up relying on a massive federal research facility to try and save his life.
According to various biographies, like Citizen Cohn by Nicholas von Hoffman, his room was a revolving door of high-powered visitors, even as he drifted in and out of consciousness. He was still trying to manage his affairs, still trying to stay relevant. But the virus was relentless. AIDS doesn't care who your friends are.
By the time the end came, his body was simply done. His immune system had been scorched. The official report of "cardio-respiratory arrest" basically means his heart and lungs stopped because the rest of him had already given up.
The Legacy of a Secret Death
Roy Cohn’s death became a symbol of a very specific, very dark era in American history. He is immortalized in Tony Kushner’s play Angels in America, where his character dies a lonely, hallucinatory death while being haunted by the ghost of Ethel Rosenberg.
In real life, his name was eventually added to the National AIDS Memorial Quilt. The panel for him reads: "Roy Cohn: Bully, Coward, Victim." It’s a harsh epitaph, but one that captures the complexity of a man who died of a disease he refused to name.
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What You Should Take Away
The story of Roy Cohn’s death is more than just a medical mystery—it’s a study in how far someone will go to protect a curated image. If you’re looking into this for historical or health reasons, here are the cold, hard facts to keep straight:
- Primary Cause: AIDS-related complications.
- Date of Death: August 2, 1986.
- The "Liver Cancer" Claim: This was a deliberate fabrication used to maintain his social and professional standing.
- Treatment: He was one of the first people to receive AZT, thanks to his political connections.
If you are researching the history of the HIV/AIDS epidemic, Cohn serves as a reminder of the inequality of healthcare in the 1980s. While he had access to experimental drugs at top-tier facilities, thousands of others had nothing.
To get a fuller picture of the time, I’d suggest looking into the medical records of the NIH during the mid-80s or reading the disbarment proceedings from June 1986. They offer a startling look at a man who was losing his grip on his career and his life simultaneously.