The Pathology of Leadership: A History of the Effects of Disease on 20th-Century Leaders
George III and the Mad Business
The vulgarities of election campaigns, the bogus bonhomie of international tours, the airport genialities, the carefully planned informality of press conferences, all the stage management and flummery create such an implausible façade for political leaders that the educated may be tempted to give them no more importance than other figures of the entertainment world and to assume that the real business of politics is handled with computerlike impersonality in anonymous offices. Against this view there is only too much evidence from historical studies and political memoirs that national and international events really are affected, especially at crises, by men of flesh and blood—and not only flesh and blood but excessive cholesterol, failing pancreas, gallstones, spirochetes, enlarged prostates, “slight” strokes…in addition to the uncertain side effects of surgical procedures and pharmaceutical supports abundantly available to keep top people functioning long after lesser men would have been retired on grounds of health.
Dr. L’Etang, combing memoirs, newspaper reports, bulletins, and occasional frank statements by physicians, has assembled a dismal array of medical facts (together with a good many suppositions) about political and military leaders from Sir Edward Grey and others involved in the 1914-18 war up to Nasser, whose disabilities when the book was written were still a matter of rumor and surmise.
If body and mind could be neatly separated the upshot of a study like this could only be admiration for the fortitude of these men, most of them elderly, who stuck to their public duties in face of pain, discomfort, and extreme fatigue: Eden with a temperature of 106 as the Suez crisis approached its climax, Woodrow Wilson struggling on after several strokes to get his international policies endorsed by the Senate, Roosevelt at Yalta. But who can believe that their judgment was unaffected by their physical condition? Baldwin in July, 1936, the year that Hitler invaded the Rhineland, was saying, “I am too tired for any fresh effort…. How long do you want me to go on?” And in October a friend was noting hopefully in his diary:
The P.M. is back at No. 10 very much rested…. There is nothing organically wrong with him. He lost his nerve and every burden became a nightmare. He will last till the Coronation we all hope, but if the foreign situation becomes very difficult he may break under it.
Inevitably the effect of ill health and exhaustion on the decisions these men made can be no more than speculation—and Dr. L’Etang speculates freely—but no one can be complacent about it. No one would realize without dismay that his accountant or lawyer or doctor was in such a state. In 1935 when the Italian attack on Abyssinia began, Samuel Hoare
…had been in poor shape since the summer. In August he was crippled by an attack of arthritis in one foot. Worse still he had a number of blackouts; at a cinema, at Glyndebourne, and in the Commons. Early in December his doctor ordered …
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