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You don't have to be mad to work here... There can be no better guide through the medical records of our leaders than David Owen, whose life has revolved around medicine and politics. Peter Elson reports.

Byline: Peter Elson

THERE is a popular belief that anyone barmy enough to want to be prime minister or president should be automatically excluded from the job. As if to prove this piece of folk wisdom, David Owen in a new book offers evidence that, in some cases, past heads of state ruled with ailments that would disqualify them from serving in the Army catering corps.

As a result, In Sickness and In Power, which has taken Lord Owen, Chancellor of Liverpool University, six years to research and write, is an absolutely gripping read.

Although it appeals to humankind's desire for gossip, the book goes far beyond mere speculation as it sticks to the facts and is therefore as near to source as most of us will ever get.

"Every single fact is properly referenced," confirms Lord Owen, who deservedly glows with pride at what is a very impressive accomplishment.

The book presents case studies of around 30 heads of state from the earliest 20th century to the present, plus analysis and the author's own particular offering of what happens when things go wrong, a condition he calls "hubris syndrome".

Never has a book lying on the corner of my desk created so much interest, as colleagues drifting by would irresistibly start dipping into it.

I'd look up they'd still be silently standing by me 15 minutes later, totally absorbed.

Or as one colleague put it, glancing down the list - which includes Churchill, Roosevelt, Hitler, Stalin, Pol Pot, Mao Zedong, Mugabe, Thatcher, Bush and Blair - "Oh my God! They're all here."

Among many astonishing cases, the most jaw-dropping is that of President John Kennedy, whose medical history and lifestyle make you wonder how he ever functioned in the most basic way, never mind as leader of a superpower.

But as Lord Owen says: "It's the nature of the beast". These are abnormal people with incredible ambition, whose driven personalities power them through incredible medical setbacks.

It probably explains why so many were depressive personalities.

Lord Owen says it was while working as a junior doctor at St Thomas Hospital, London, across the Thames from the Houses of Parliament, that his interest grew in the relationship between politicians and doctors.

"It has fascinated me for all of my adult life. In particular, I've been interested in the effect on the course of history of illness in heads of government.

"It raises many issues, including the impact on decision making, the dangers inherent in keeping illness secret, the difficulties of getting rid of ill leaders, not only in democracies but also in dictatorships.

"There is also the effect on the behaviour of doctors. Should they be loyal just to their patients, as in any normal doctor-patient relationship, or do they have an obligation to do what's best for their country?"

With many generations of his family involved in both medicine and politics (mainly at a local level), he finds it perfectly normal to consider both professions in tandem.

Perhaps this is particularly fitting as he specialised in neurology and some psychiatry, practising medicine for six years.

Had politics not enveloped him, Lord Owen reckons he would have tried to become a professor of neuropsychiatry.

Liverpool University's vice chancellor, Prof Sir Drummond Bone, says that "David Owen has a contacts' book to die for" and he has certainly used it to devastating effect in this book.

He has had access to hitherto previously unquoted or deeply guarded medical records, including those of the Shah of Persia and still-closed documents about Anthony Eden's health during the Suez Crisis, in 1956.

"The consultants for whom I worked at St Thomas' Hospital treated a number of well-known politicians and I saw the stresses of political life within the confidential doctor - patient context," he says.

"I helped treat one senior politician who was an alcoholic and another who was severely depressed. I saw the pressures under which they lived and wondered ever since how much of a part that stress played in their illnesses.

"I've always been interested in the politics of decision making and was spellbound watching the Cuban Missile Crisis develop in 1962 and the Vietnam War three years later.

"I was always puzzled why Kennedy made such crass mistakes over the Bay of Pigs invasion fiasco and yet a year later handled the Cuban Missile Crisis in such a statesman like way.

"The issue has never really been answered. People blame the Bay of Pigs on Kennedy's inexperience as a new president, but that's never rung true for me. Juxtaposing the two events to me indicated that it was as clear as daylight that, in the earlier episode, Kennedy was out of control medically.

'ABOUT the Cuban crisis, the Soviet secretary general, Khruschhev, said it was a 'time when the smell of burning hung in the air'. We now know how close the world came to being blown up and Kennedy was crucial in stopping that."

The episode also indicates how events stack up on one another. Had Kennedy not mishandled the Bay of Pigs and appeared so weak to Khrushchev at their Vienna conference, the Soviet leader might not have risked placing missiles in Cuba.

"What's important is that Kennedy knew it is wise never to corner one's adversary in international diplomacy without leaving a face-saving line of retreat and he gave Khruschev this lifeline," says Lord Owen. It was fortunate for the world, that given Khrushchev's hypomanic personality, he was not made to feel embarrassed during the missile crisis and had a sense of satisfaction about its outcome.

"It took time for the whole truth about the way he and the USSR had been humiliated by Kennedy to sink in and this contributed to his final unravelling.

"Interestingly, after Khrushchev's unexpected enforced 'retirement' in 1964, he suffered a very serious and persistent depression until his death in 1971."

Kennedy's health was a mess. He took rafts of separate drugs to cope with, among other conditions, his acute back problems, Addison's disease and VD.

On top of his heavy prescriptive drugintake of cortisone, testosterone and adrenaline substitutes, Kennedy was a recreational drug user and had "shots" of steroids and amphetamines.

These were courtesy of Dr Max Jacobson, a physician nicknamed "Dr Feelgood", who was undaunted by the more usual hypocratical ethics.

"Unfortunately, Addisonian patients are unusually sensitive to the mood-elevating effects of steroids. No doubt his drug intake fuelled his tremendous sex drive," says Lord Owen.

"Kennedy was in denial about his medical conditions and compart-mentalised them. It was only when Dr Hans Kraus, a top back specialist took overall control of his health that it improved dramatically - a benefit for Kennedy and the rest of the world."

France's President Mitterand suffered from prostate cancer and Lord Owen says: "That he carried on as president is amazing as he was treated with massive amounts of drugs.

"But because of the secrecy surrounding his condition, his treatment was not how it should be. Drips for intravenous drugs were hung from picture rails in embassies when he was abroad."

HUBRIS syndrome is the name Lord Owen gives to an as yet nonmedically defined condition.

"Some psychiatrists believe it to be product of the environment in which heads of government operate," he says.

"To me, hubris builds up over time, it does not manifest iself quickly unless prompted by a specific event like 9/11. It appears to be self-generating, whereby the individual is gripped by something which is no longer driven by outside factors, but comes from within themselves.

"After German unification, Margaret Thatcher became out of control, not listening to her cabinet, not taking information and advice.

"Long after his election, President Bush was revealed to be an alcoholic and these people are always at risk and prone to other issues. They have to be monitored.

"But polio made Franklin D Roosevelt one of the talented presidents as fighting to overcome his illness seemed to give something so much extra.

"Leadership is not only about holding power, it's also about retaining a connection with life, maintaining a sense of humour and a healthy cyncism about people and events."

And what of Lord Owen (who has a surprisingly self-deprecating sense of humour)? Having served in the highest offices of state and once mooted to become prime minister, is he not prone to certain attitudes or mindsets himself ?

His book reminds readers that he was publicly accused of meglomania. He says: "That was included at the suggestion of Shirley Williams so I call it the Shirley Williams' amendment.

"It occurred when I ceased to be leader of the SDP and the natural constraints of party politics were no longer guiding me."

So, if behaviour is dictated by context, would he disguise a serious illness if prime minister?

"I do believe that I would not have covered up a medical illness. Had Kennedy lived and been far more open about his illnesses, I believe he would have been one of the greatest presidents."

IN SICKNESS and In Power, by David Owen, Methuen, pounds 25 A life in politics IN HIS previous incarnation, Dr David Owen was one of the political jungle's biggest beasts during the 1970s and 1980s.

He was the second youngestever Foreign Secretary (after Anthony Eden), serving under Labour premier James Callaghan. After leaving the Labour Party, he was a cofounder of and later led the Social Democratic Party, 1983-7.

After contesting Torrington for Labour in 1964, he became MP for Plymouth Sutton and later Devonport from 1966-81, then as an SDP MP, from 1981-92, when he was created a life peer.

From 1992-5, he was EU cochairman for the International Conference on the Former Yugoslavia, and is chairman of Global Natural Engery.

His medical career started at St Thomas' Hospital in 1962 and he was neurological and psychiatric registrar there from 1964 and then research fellow at the medical unit.

Now aged 70, he sits in the House of Lords.

Ohmy God!

They're all here

CAPTION(S):

Former Prime Minister Winston Churchill; Chancellor of Liverpool University Lord David Owen at the Walker art gallery; George W Bush; Ex-President JFK
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Title Annotation:Features
Publication:Daily Post (Liverpool, England)
Date:Jul 28, 2008
Words:1685
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