This last photo shows Lenin in a wheelchair after suffering three stokes in the previous two years. By the end he was paralyzed and completely mute. Beside him are his sister Anna Ilyinichna Yelizarova-Ulyanova and one of his doctors A. M. Kozhevnikov.

The mental strains of leading a revolution, governing, and fighting a civil war aggravated the physical debilitation consequent to the wounds from the attempted assassinations. In 1918, Lenin narrowly survived an assassination attempt, but was severely wounded. His long term health was heavily affected. In March 1922 physicians prescribed rest for his fatigue and headaches. Upon returning to Petrograd (Saint Petersburg) in May 1922, Lenin suffered the first of three strokes, which left him unable to speak for weeks, and severely hampered motion in his right side. By June, he had substantially recovered; by August he resumed limited duties, delivering three long speeches in November. In December 1922, he suffered the second stroke that partly paralyzed his right side, he then withdrew from active politics. On March 10, 1923, Lenin’s health was dealt another severe blow when he suffered the third stroke, this one taking away his ability to speak and concluding his political work. Lenin was mute and bed-ridden until his death but officially remained the leader of the Communist Party.