From taboo to transparency: the beginning of the end of the myth of the strong leader

His name was Max Jacobson but his patients called him Doctor Feelgood (doctor, I feel good), due to the cocktail of hormones, painkillers and amphetamines that this doctor injected into them in the United States, in the middle of the last century. One of those patients was President John Fitzgerald Kennedy, whose good looks hid a chronically ill person, prostrated by unbearable back pain, which forced him to rely on crutches that he hid in his car. During the campaign in which Richard Nixon ran for president in 1960, the office of the endocrinologist who treated Kennedy's Addison's disease was ransacked. The alleged thieves had tried in vain to steal his medical records, an event after which Nixon's hand was revealed, aware that the poor health of his rival was one of his assets. The day after he was sworn in in January 1961, the new president denied suffering from Addison and the newspaper The New York Times He described his form as “excellent.” By then, he was relying on Jacobson's injections to cope with the pain.

Like the charismatic president assassinated in 1963, many of his predecessors had previously lied about their health. “Hiding the actual medical condition from the voter is a long-standing tradition of the American presidency,” the magazine stated in 2002 Atlantic, ignoring that examples of leaders who have hidden their illnesses abound throughout the world. That opacity has been total or partial. This week, it became known that Charles III of England suffers from cancer. It has not been revealed what type or what his prognosis is.

Cases such as that of Mohamed VI of Morocco, whose ailments are almost always a mystery, or the secrecy in the Vatican regarding the Pope's health – which has given rise to jokes such as the one that claims that the Pontiff “is always healthy until a while later.” of dying”—demonstrate the persistence of the taboo that has traditionally been the illness of leaders. That trend, however, is beginning to give way in the face of a growing demand for transparency about the health of those who have political power in their hands, at least in democracies, a demand driven by “changes in society, information and the mass media,” explains Verónica Fumanal, a political communication consultant.

“Illness on a social scale carries with it an idea of ​​weakness. Although the phenomenon of leadership has evolved and cannot now be explained by the leader's personal attributes alone, it continues to be mythologized. In collective beliefs, we continue to identify it with those attributes that were assumed to be the leaders of another time, who always came from military establishments, monarchies or religious power. For this reason, leadership continues to be linked to characteristics such as strength and aggressiveness,” the expert emphasizes.

The traditional conception of masculinity and power crystallized in the so-called “theories of the great man” in the military schools of the 1920s, says Fumanal. Autocratic leaders like Vladimir Putin continue, even today, to present themselves as the embodiment of that myth. The rumors that for years have attributed cancer to the Russian president break with the staging depicted in photographs of Putin with a naked torso, with a rifle in his hands or hunting.

Kennedy was the first president of the television era. In 1981, when French President François Mitterrand hid the metastatic cancer he suffered from—he lied for 14 years—this means of communication was already widespread. The political communication consultant Luis Arroyo emphasizes that in 2023, “with people equipped with cell phones in every corner and with constant information cycles,” it is “very difficult, if not impossible” for the health of a ruler to be able to be hidden and become a state secret.

Elisa García-Mingo, doctor in Anthropology and professor at the Faculty of Political Sciences and Sociology of the Complutense University of Madrid, agrees that the leadership model linked to the myth of the strong man is beginning to change. She cites the resignation of New Zealand Prime Minister Jacinda Ardern in January 2023, which she claimed did not have the “energy” to remain in office. This evolution is not unrelated, this specialist believes, to the growing number of female leaders. The disease of the powerful is also acquiring other aspects that, through the prism of communication, can even be positive. Recognizing an illness or mere pain can “sometimes serve to humanize a leader,” emphasizes Verónica Fumanal.

Democracy

This communication consultant highlights that the growing demand for transparency regarding the health status of political leaders especially concerns “elected politicians, who are periodically held accountable for their performance.” An example is the controversy that has surrounded the US Secretary of Defense, Lloyd Austin, who in January hid, even from President Joe Biden, that he suffers from prostate cancer and had been hospitalized for three days.

The White House has tried to silence criticism by referring to the “personal nature” of the illness, but in the debate over whether the illnesses of a leader with public responsibilities are private or of public interest, the second option has a compelling argument. Austin is second in the chain of command of the US Armed Forces. His position requires him to always be available in the event of a threat to national security or, failing that, to delegate his functions according to as provided by law.

“Democracies provide mechanisms that, to a greater or lesser extent, require transparency, especially from those who have executive duties. What is allowed to Charles III would probably not be allowed to the prime minister [Rishi] Sunak,” Arroyo points out. When it comes to someone with real power, citizens “need guarantees that there will not be a power vacuum in the Government or the Administration,” emphasizes the consultant.

The controversy over Austin has recalled another aspect of the opacity around the illnesses of leaders: “ageism,” García-Mingo asserts. The image of “vulnerability” associated with poor health is catalyzed by that which accompanies advanced age. Ailments that usually occur in old age—prostate cancer, Parkinson's, or cognitive decline—suffer even greater stigma and secrecy.

In 2019, the tremors of German Chancellor Angela Merkel at public events unleashed speculation about a possible Parkinson's and an imminent resignation, just when she was about to turn 65. The definition in the prosecutor's report of the classified papers case of President Biden as an “old man with a bad memory,” his lapses and his 81 years are serving his Republican rivals to claim his incapacitation.

“Any situation read as vulnerability, illness, advanced age, motherhood in women, serves as an excuse to expel that person from public life,” analyzes García-Mingo. An expulsion that every leader resists because “the drive to retain power is natural,” says Arroyo. Hence the need to maintain an image of vigor, even when lying.

“The disease not only affects the leaders but also has repercussions on the leader's environment, on his cliques. As soon as there are suspicions that a leader may be in his last days, the discussion immediately arises about the succession process and a questioning of the stability of power,” explains Arroyo. The way of communicating ab
out the illness of the dying leader is, he assures, one of the key issues of this succession.

In November 1975, Francisco Franco's doctors tried all possible treatments on him to keep him alive. The dictator's long agony has later been related to the purpose of preparing a transition that was expected to be complicated. For Arroyo, Franco's case is an example of Jerrold R. Post and Robert S. Robins' theory on the ethical dilemmas surrounding leaders' illnesses and their cliques' management of them. They called this theory “the dilemma of the captive king.”

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