When Illness Strikes the Leader: The Dilemma of the Captive King

by Robert S. Robins, Jerrold Post

The illness or disability of a world leader can change the course of history. When Lenin became too infirm to remove Stalin from a position of power, when the shah of Iran's terminal cancer was kept secret from his fellow Iranians and his foreign supporters until Ayatollah Khomeini's Islamic revolution had succeeded, the political consequences were monumental. In this book, two experts in political psychology reveal how the infirmities of leaders have affected their own societies and the broader course of world events. Drawing on a wide range of examples, including Mad King Ludwig of Bavaria, Woodrow Wilson, Adolf Hitler, Idi Amin, Deng Xiao-peng, Ferdinand Marcos, Franklin Delano Roosevelt and Menachem Begin, Dr. Jerrold M. Post and Robert S. Robins explore the impact of physical and mental illness on political leadership. Post and Robins investigate the effects of illness on the leader, his inner circle, his followers, and the political system itself. They discuss such topics how the nature of the illness affects decision-making; how mortal illness can make a leader more determined to make his mark on history; how a leader's disability can be hidden from the public in every political system; the effects of prescribed drugs and substance abuse on leadership behaviour; the conflicted role and ethical dilemmas of physicians who care for the powerful; and how the demands and privileges of high office compromise the quality of medical care. In closed societies where there is no clear mechanism of succession, say the authors, the ailing or ageing leader and his close advisers can become locked in a fatal embrace, each dependent upon the other for survival; a captive king and his captive court. In the absence of clear rules for determining when a leader is disabled and should be replaced and how a successor will be chosen, illness in high office can be highly destabilizing.

Genres: Politics, Science

280 pages, Hardcover

First published March 31, 1993

Reviews

[Bruce · Rating 5 out of 5]

I was reading this book before I saw the headline in today's (Nov. 28, 2013) post--Karzai faces backlash at home-- and read the article. Part of the issue with this leader might be undiagnosed (or unrevealed) mental degradation. The authors of this book have analyzed the problems of when a leader becomes ill. In their introduction they note they use the word king to include democratically elected leaders. The book provides several examples of leader's incapacitated by disease, some incipient others acute,and the reactions of the inner circle. Treatments for maladies (and diseases) also affect the leader's ability to function. A very interesting book every historian, and I would add, everyone interested in good government should read.

[Colleen · Rating 5 out of 5]

This book is truly fascinating, and since I read it I've found it has a huuuuge range of applicability, from reading the modern day news, to watching TV shows (most recently on AMC's Turn and FX's The Americans, with King George and George Washington both being applicable in the first and President Reagan (from the Soviet POV) in the second), to thinking about politics, when you consider how unvetted/unchecked the medical capacity of American presidents sometimes was just in the last century.

[Allyson Dyar · Rating 5 out of 5]

Who’s Really in Charge?

You can consider this a companion piece to the previously reviewed book, When Illness Goes Public: Celebrity Patients and How We Look at Medicine by Barron F Lerner. While that book viewed the public and private battles of well-known people, When Illness Strikes the Leader: The Dilemma of the Captive King takes a historical look at the how being a world leader doesn’t necessarily bring the best medical care. In fact, it can be a hazard to your health.

Why? Simple. Your health is not your own. Your health doesn’t just affect your friends and family but of your country and the course of history. While other books have concentrated on either the historical perspective or the health/medical perspective, this book has the unique combination of both a historian and medical doctor who give a complete analysis of both the political and medical aspects of how a leader’s illness and its consequences.

I had the fortune of reading this book when one of the major plot points of the TV show The West Wing pivoted upon keeping the public unaware of the United States’ President’s multiple sclerosis diagnosis. The politicians kept the secret while the doctor (his wife) wanted the best care for her husband. It’s an interesting dilemma where the treatment rests not on whether or not the patient can afford it but whether or not the nation in question can “afford” it. In most all instances, what the patient needed was secondary to what the nation needed.

Of course, there are instances where the leader’s impairment was obvious but because of how he held the power, nothing could be done about it. A very scary situation when you think about how many countries have weapons of mass destruction and the leader in question isn’t working on all cylinders.

I remember really enjoying this book the first time I read and it the second time was no different. This isn’t necessarily an “easy” book to read but this is a book that both world historians and medical historians will find utterly fascinating.

I initially gave this book 5 stars and my opinion hasn’t changed. Well recommended.