Political Disorders

Title In Sickness and in Power: Illnesses in Heads of Government During the Last 100 Years

Author By David Owen

Publisher Praeger

Year 2008

Pages 448 pp.

ISBN 2147483647

Price $44.95

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David Owen has been in the thick of British politics almost since he qualified as a physician in 1962. After just four years of practicing medicine and conducting research on brain chemistry, he was elected as the Labour member of Parliament for his home constituency, Plymouth Sutton, in the southwestern corner of England. For a time, Lord Owen attempted to attend to both parliamentary business and his own research, but in 1968 he left medicine, never to return. He has since served as minister of health, foreign secretary, and leader of the Social Democratic Party. He is currently chancellor of the University of Liverpool and a member of the House of Lords.

In the six years that he practiced medicine, Owen came into close contact with doctors treating prominent politicians and observed firsthand the toll that political life takes on public figures. Thus began his interest in health and power, which culminated in The Hubris Syndrome. This book, published in 2007, argues that being in power brings about changes in one's mental state and leads to hubristic behavior, and that hubris is not merely a personality characteristic but a pathological state. Mental illness, Owen notes, "may need to be redefined to include a hubris syndrome." His latest book, In Sickness and in Power, examines how both specific diseases and intoxication with power have shaped major decisions by world leaders in the twentieth century.

A HISTORY OF SILENCE

In Sickness and in Power delves into the cases of four politicians whose judgment was impaired by disease in times of crisis: British Prime Minister Anthony Eden, who suffered from biliary tract disease during the 1956 Suez crisis; U.S. President John F. Kennedy, who was plagued by adrenal insufficiency during the 1961 Bay of Pigs invasion; the last shah of Iran, Mohammad Reza Shah Pahlavi, who had leukemia during the final years of his rule; and French President François Mitterand, who was battling prostate cancer from 1981 to 1995, during the Falklands War, the breakup of Yugoslavia, and the Rwandan genocide. Of all these cases, Eden's illness during the Suez crisis remains the single most striking historical example of a severe illness' impacting the conduct of a state.

As the United Kingdom, France, and Israel went to war against Egypt, Eden's behavior was volatile. The prime minister had temper tantrums, insomnia, and suffered from anxiety. According to Owen, Eden's inability to confront an increasingly complex situation -- involving the clashing interests of four warring nations, two superpowers, and the United Nations -- is traceable to the vicissitudes of the disease, which causes liver disturbances and high fevers. The medications Eden was taking played a role as well; the drug Drinamyl, for example, is known to produce restlessness, irritability, and overconfidence. Owen argues that Eden's judgment was "seriously impaired" when he made the crucial decisions "to collude with Israel, to mislead the American President and to lie to the House of Commons, even after the invasion." French and Israeli officials managed to convince the usually cautious Eden to join their plot -- a strategic misjudgment on Eden's part that was entirely the result of his disease and treatment, according to Owen.

American readers will be most intrigued by Owen's detailed examination of Kennedy, who assumed the presidency with a long history of Addison's disease -- a chronic adrenal insufficiency that can cause muscle weakness, fatigue, and apathy -- and was beset with severe, disabling back pain during his three years in the White House. No single physician was in charge of Kennedy's care; it was "deliberately compartmentalized," leaving different doctors to treat different problems -- often incorrectly. The two doctors closest to Kennedy -- Janet Travell and Max Jacobson (also known as "Dr. Feelgood" due to his habit of treating everything with amphetamines) -- had neither the training nor the experience to see the entire clinical picture. Most of their treatments were inappropriate.

Owen argues convincingly that the Bay of Pigs fiasco was the direct result of Kennedy's poor judgment, which in turn was the result of his ill health and inadequate treatment. Kennedy was suffering not only from severe back pain but also from stomach and colon problems, high fevers, sleeplessness, and occasional abscesses. By the time of the Cuban missile crisis, with his medical matters under much better control, a healthier Kennedy was able to make better decisions. This was largely because Travell and Jacobson were out of the picture and the president's Addison's disease was being treated by the highly respected endocrinologist Eugene Cohen.

Compounding the problem of Kennedy's clouded judgment was the White House's insistence that the president was in good health -- even while he was being injected with steroids and taking hundreds of pills per week. Otherwise honorable men, such as Cardinal Richard Cushing, a close friend of the Kennedys, lied to keep the Kennedy family's secret, as did several doctors.

Allowing Eden to govern while ravaged by disease and destabilized by drugs placed the United Kingdom in grave danger during the Suez crisis. Similarly, compartmentalizing Kennedy's care and withholding information about his health endangered the United States during the Bay of Pigs crisis.

DIAGNOSIS: HUBRIS