BOOK REVIEW / A dangerous virus in the body politic: 'When Illness Strikes the Leader' - Jerrold M Post & Robert S Robins: Yale, 19.95 pounds

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The Independent Online
EARLIER this week, the Chinese Premier, Li Peng, cancelled a trip to Mongolia because he had been taken to hospital with a cold. It must have been quite a nasty one: most of us grumble a bit when the dreaded 'cold' strikes, but . . . hospital? Presumably, Li Peng was sicker than anyone was admitting, but there is something rum about our willingness to swallow sugar-coated versions of the medical truth. We can be pretty sure there is something wrong with a man who doesn't mind appearing such a sissy. Rushed into hospital for a cold? It's the geopolitical equivalent of holding the matron's thermometer against the radiator in the hope of an off-games slip.

If Jerrold Post and Robert Robins are to be believed, Li Peng was probably suffering from something like a retarded myocardial infarction, with progressive cerebral arteriosclerosis, and perhaps a multiple pulmonary occlusion or two thrown in for good measure. Their subject, a good one, is the ill health that dogs VIPs, and the damaging culture of secrecy that surrounds the slightest change in their temperature.

It is not surprising, as the authors point out, that so many presidents and prime ministers should have had health problems. Quite apart from the exceptional stress in their lives, they are almost always getting on a bit. But it is certainly true that the subject is not much discussed. Of the 35,000 photographs at the Roosevelt Presidential Library, only two show the great man in a wheelchair. The consideration of health in the existing literature is, by all accounts, 'spotty'.

It seems odd that our obsession with health should fade when it comes to political debate. Top politicians offer us a robust and energetic image, and we seem happy to go along with it. Perhaps we think they must be cuckoo to start with, and regard other maladies as small beer, or none of our business.

But maybe we shouldn't be so delicate. The list of VIPs with depressing symptoms is almost endless. It embraces all the celebrity dictators - Stalin, Hitler, Idi Amin - but also a disheartening number of democrats. When the 76-year-old Winston Churchill ran for office in 1951, for instance, he was riddled with broken parts:

'Scarcely an organ remained unaffected. He had significant illnesses affecting his heart, brain, lungs, gastrointestinal tract, skin and eyes. His medical history included several attacks of pneumonia, a heart attack, a major stroke, two episodes of cerebral ischemia, diverticulitis, inflammation affecting the eyes, eczema, and intermittent severe depression.'

No wonder he was depressed. In one sense, the idea of carrying on in the face of all those exotic diseases speaks of a heroic stamina. In another, it is plain madness. Anyway, Churchill won by 17 seats.

The ability of the political winners to shield followers or voters from the true facts depends on two things: the stealth of doctors and the easy availability of drugs. If the illness doesn't drive you round the bend, the treatment might. Hitler's personal physician, Theodore Morell, was so sharp in administering narcotic injections that he was nicknamed 'the Meister-Jabber'. His diary listed 73 medications he gave to the Fuhrer, including:

'Cardiazol, a cardiac stimulant; several variants of belladonna; barbituates, cortisone; Orchikrin, a combination of male hormones, an extract of bull testes; hormones from the female placenta; an array of powerful narcotics; laxatives and enemas.' He also received daily cocaine treatment for chronic sinusitis.

The authors' interest in all this is not merely morbid. The historical assumption behind their work is that individuals do make a difference, and that the work of one man can change the world. It comes as a refreshing corrective to the notion that our leaders are the passive agents of larger forces. When the leaders of the Soviet coup against Gorbachev were rounded up, they were deep in their cups: the whole adventure was not much more than a drunken prank - the high- level equivalent of a medical student nicking a policeman's helmet. And when Hitler launched operation Barbarossa, it wasn't the expansionist Third Reich opposing the Bolshevik menace, it was a mad, bad gesture by a man who was, by the sound of it, totally zonked on the Jab-Meister's special brew.

When Illness Strikes the Leader is composed in a polite, courtly key that borrows Machiavellian terms and an arch, pseudo-scientific tone well-suited to its theme. At times the authors sound like a couple of sly policemen addressing the court with tongue-in-cheek sobriety: 'Decisions made under the influence of stimulants, which can produce a heady overoptimism, are quite different from those made under the influence of tranquilizers, which may cloud the sensorium'.

After a few pages, even factual descriptions come to sound like crafty diagnoses. Ataturk, we learn, suffered from Collective Denial of Mortality; President Macias Nguema of Equatorial Guinea was plagued by Unconstrained Paranoia (Reign of Terror). These things are hard to shake off - almost as bad as colds. In a marvellous series of chapter headings towards the end, Marcos is held to be a victim of Terminal Control, Papandreou labours under the malign influence of Terminal Machismo, and de Gaulle bears the scars of Terminal Grandiosity. This was so complete and so dispiriting that some wag referred to France's glorious culture of Liberte, Fraternite, Senilite.

The combination of serious illness and even more serious drug abuse is, as we might expect, anything but conducive to shrewd and far-sighted statesmanship. When Illness Strikes the Leader lists the examples. At the Yalta Conference in 1945 Roosevelt's judgement was impaired by 'a combination of hypertension, diffuse atherosclerosis, and congestive heart failure'. According to Churchill's doctor, 'He intervened very little in discussions, sitting with his mouth open. . . . He has all the symptoms of hardening of the arteries of the brain.'

Well, we think, thanks for telling us. And that's the whole point. The naturally covert reflexes of government, and the historic discretion of doctors, combine to hush up anything that might be interpreted as bad news. President Georges Pompidou kept quiet about his multiple myeloma for well over a year, while the Shah of Iran concealed the truth about his lymphocytic leukaemia even longer - long enough to lose control of his country as well as his life. The year he found out about his fatal condition, he broke with Opec and sparked the world oil crisis - perhaps prompted by a desire to accelerate the transformation of Iran.

Even death can be kept quiet. The amazingly protracted demise of General Franco led to a nice joke, cited here, which describes someone asking Prince Juan Carlos of Spain, the heir-in-waiting, whether he wanted the good news or the bad news:

'Tell me the good news.'

'Franco is dead.'

'What's the bad news?'

'You will have to tell him.'

In the end, despite all the po-faced recitation of medical data, this is a book about power and secrecy. Illness, the authors show, is a serious virus in the body politic, and it does not seem likely that the new information order will include reliable data on agonising VIP ulcers and bad Tory gums. But who knows? Perhaps, from now on, top interviewers will take a different tack. Less about personalities, more about peritonitis. Wouldn't it be fun if one day somebody asked John Major whether he was planning to visit Washington any time soon, and he replied: 'What, with my hip?'