Bill Bradley has acknowledged suffering four episodes of unusually fast heartbeat, lasting as long as 12 hours, since he disclosed in mid-December that he suffers from atrial fibrillation, a common ailment. Although he insists that campaign stress is not the cause, three of the four episodes immediately preceded or followed debates with Al Gore.
As voters prepare to elect a new president, candidates' health problems should give them pause. The presidency has been a debilitating, even deadly, job. Its stresses are unrelenting. Even excluding the four assassinated chief executives, presidents have tended to die prematurely, despite being wealthier and better cared for than most Americans.
Mr. Bradley's revelations remind us that President Bush was hospitalized in May 1991 for the same condition. Before Mr. Bush developed a rapid heartbeat, he had appeared fatigued and showed the effects of the intense pressures associated with the Gulf War. Had medication failed to improve the president's condition, he would have been anesthetized and physicians would have used electrical shocks to stop his heart for a moment so that its normal rhythm would be restored. The 25th Amendment would have been invoked, making Dan Quayle acting president until Mr. Bush was fit.
Luckily, Mr. Bush's heart responded well to medication and soon resumed its normal beat. But Mr. Bush was also diagnosed with thyroid dysfunction, which too can be stress-related, and which some commentators blamed for his lethargic re-election effort.
Stress can bring on a variety of ailments. In recent years, a rapidly expanding field of medical research--psychoneuroimmunology--has thrown new light on the relationship between stress and illness. Stress is now strongly linked to abnormal immune response; those who cope poorly with stress seem prone to a breakdown in bodily immunity against diseases of all kinds. This is borne out in the case of American presidents. The least effective ones, overwhelmed by the strains of office, have died even more prematurely than their more successful counterparts.
The image of strength is essential to leadership, so presidents have often concealed their illnesses. When Grover Cleveland underwent two operations for cancer of the jaw in 1889, the White House announced that he had had a tooth removed. Woodrow Wilson's massive stroke in 1919, which caused complete paralysis on his left side, was initially described by the White House as indigestion and then as nervous exhaustion. As Warren Harding was about to die in 1923 due to severe cardiovascular illness, his official physician said he was suffering from food poisoning.
Franklin Roosevelt's death in 1945 may have stunned the world, but it didn't surprise his doctors. Throughout John F. Kennedy's presidency the White House stoutly denied that he had Addison's disease, a condition requiring intense medication. In 1981 the nation was told that Ronald Reagan swapped jokes with his doctors after being shot in an assassination attempt, but not that Mr. Reagan had lost half his blood and had come within minutes of dying. And although Bill Clinton seems robust and active, his former associate Dick Morris has described him as being ill and seriously depleted during much of his presidency. The stresses of the presidency may be related to Mr. Clinton's very visible aging in office.
Candidates too have hidden their ailments. In 1992 former Sen. Paul Tsongas, running for the Democratic presidential nomination, did not disclose that the cancer that had led him to retire from the Senate in 1984 had recurred in 1987, necessitating new radiation treatments. Tsongas's TV commercials showed him swimming laps in a pool, apparently in excellent health. A week after the November election, doctors diagnosed still another recurrence of cancer, a more aggressive type that killed him on Jan. 18, 1997--two days before the end of the presidential term for which he had run.
Political leaders are mortal like the rest of us. Bill Bradley suffers from a condition that afflicts millions of Americans. We shouldn't be surprised at his reluctance to disclose it. But we can hardly take comfort in what Mr. Bradley said when he explained his belated disclosure: "You don't want me to go around disclosing every time I flip out for an hour or two." Americans should be concerned about a president whose health problems may be aggravated by the stresses of office--or one who "flips out" for an hour or two.
Robert E. Gilbert is a professor of political science at Northeastern University and author of "The Mortal Presidency: Illness and Anguish in the White House" (Fordham University Press, 1998).
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