The most dangerous job in the world

With the would-be presidents of the United States currently on the campaign
trail, the battle is on to be the top man in the White House. But the winner
will follow in the footsteps of men dogged by poor health and bad luck. And
there are many parallels to be drawn with the lives of our leaders of industry

Whoever wins the race to be the next president of the US should be aware of
one uncomfortable statistic: his chances of spending two terms and eight years
in the White House are slightly lower than his chances of dying in office or
within five years of leaving office.

Cary Cooper, professor of organisational psychology at the University of
Manchester Institute of Technology, is convinced even this bad news would not
stop George W Bush and Al Gore. "They are the architects of their own
demise, they get addicted to their own biochemistry, the adrenaline, which is
why so many of them find it so hard afterwards when they have to stop."

The plight of presidential wannabes seems a little remote from the day-to-day
concerns of HR and personnel managers in industry but any study of the 41 men –
and they have all been men – to occupy the White House since 1789 suggests
there are real parallels with the lives, careers and performance of leaders in
industry. For all the rhetoric about work-life balance, the reality – driven
especially by the Internet – is that, increasingly, top executives are moving
towards the kind of 24 hours a day, seven days a week workstyle which has
endangered the health of so many presidents.

The dangers posed by the lifestyle which most presidents lead are, as Prof
Cooper says, not dissimilar to those facing many chief executives and there is
a growing body of evidence that leaders, be they chairmen of companies or
presidents of the US, have similar personalities and life stories, often
involving a severe trauma in childhood.

Under scrutiny

The medical and psychological dangers inherent in the office of president of
the US have a lot to do with the fact that they are, on average, 55 years old
when they take office. In other words, at an age when ordinary mortals are
being advised by their GP to take things easy, these men begin to lead the most
powerful nation on earth.

It is a job for which there is no recognised training, where your behaviour
is, as Prof Cooper says, "under scrutiny 24 hours a day by the press, the
public and your staff" and where every day heralds a new crisis, real or
media-made, which must be dealt with. This psychological stress weakens the
body’s immune system making it 22 per cent more likely that you will pick up a
viral infection.

"To do the things you have to do to become president you have to be
very robust", says occupational physician Jennifer Lisle, "but the
lifestyle imposed by the job brings with it a plethora of possible dangers.

Often, leaders are people who can cope without 12 hours of sleep every night
but that, in itself, can be very damaging and you build up a kind of sleep debt
where your body can never regenerate itself. And the adrenaline which keeps you
going releases a battery of hormones into the system – it is almost like an
athlete running a race but not having the time to wind down after they have
won. Often, this kind of stress leads people to rely on other props like
alcohol or cigarettes, which will lead to further damage."

Astonishingly, only four presidents have credibly been accused of suffering
from alcohol abuse, of which Richard Nixon is the most recent. Franklin Pierce,
a one-term president elected in 1852, was catapulted to the White House even
though he had already been forced to quit the Senate because of his drinking.
He resumed his old habits as president and nobody was greatly surprised when,
in 1863, he died of cirrhosis of the liver.

A more popular presidential prop has been extra-marital sex. There is
credible evidence that as many as one in three have committed adultery – and
the "sinners" include the father of the republic George Washington –
and five have fathered illegitimate children.

"Many of these people actually suffer from low self-esteem. I think
that’s true of Clinton, not because of anything he’s done but of what he had to
put up with as a child, and they have a continuous demand for love and
approbation," says Cooper. "You see the same tendency with some hard-working
chief executives who, although they spend so many hours in the office, still
need closeness and may find it with someone other than their wife."

Accelerated ageing

Whatever strategies have been used, there is evidence aplenty that most
presidents suffer from what Lisle calls "an accelerated ageing
process". Even Dwight Eisenhower, who never read a memo longer than a
single page of A4 paper, had a heart attack in office while Woodrow Wilson
spent the last years of his presidency immobilised by stroke.

Warren Harding, who has the dubious honour of being America’s most corrupt
president, died of a coronary thrombosis less than 1,000 days into his
administration. He did not have an iron constitution, like his predecessor
Woodrow Wilson, and suffered at least one nervous breakdown before reaching the
presidency.

Harding is one of eight presidents to have died in office. Four of them were
assassinated – Abraham Lincoln in 1861, James Garfield in 1881, William
McKinley in 1901 and John F Kennedy in 1963 – while William Harrison has the
double distinction of giving the longest inaugural speech (8,441 words) and of
running the shortest lived presidential administration (he died of a chill a
month later).

Of those who died soon after leaving office, James Polk (1845-1849) survived
his presidency by only three months and Chester Arthur (1881-1885) succumbed to
the kidney disease in 1886 which had been diagnosed while he was in office.

Lisle says, "Most doctors advise people who retire to do so gradually,
to scale down their workload and find other interests, but there is no gradual
way of going from president to non-president."

Jimmy Carter has publicly admitted his own post-presidency trauma while
Ronald Reagan, who spent many afternoons of his second term in pyjamas playing
with his dogs, may be held to have followed Lisle’s advice.

The good news for this year’s candidates is that presidents are living
longer once they have left office. The bad news is that this may be because
they are not spending as long in office. Only three out of 10 presidents have
been re-elected to serve a second full-year term since 1945.

The transition from centre stage to offstage is particularly painful because
there is a mass of evidence to suggest that most presidents, like other chief
executives, belong to a particular personality type, often referred to as Type
A, which studies show are at much higher risk of heart disease than Type B
people.

Psychologist Oliver James, author of Britain On The Couch (Arrow), says,
"It’s often just a matter of upbringing which decides whether a person of
this type ends up in jail or running a company or in the White House. These
people score high for narcissism, their willingness to take risks and their
ability to put different parts of their life into different boxes so that, for
instance, they would be untroubled by a lie or an affair with someone who may
only be as old as their own children. They are often social loners who have
great faith in their own ability to charm or manipulate other people to get out
of any situation."

Prof Cooper does not go this far, saying that although many leaders in
politics and business cannot publicly admit they have a conscience they are
troubled in private although, and this is what marks them out as leaders, they
deal with this and move on.

Certainly Richard Nixon, described by Harry Truman as a "no good liar
who could lie out of both sides of his mouth at the same time and even if he
found himself telling the truth, he’d tell another lie just to keep his hand
in", fits this profile.

Naturally awkward, his need to ingratiate himself with an audience often
went to extraordinary lengths. After his father died in September 1952, he
returned from a week’s mourning to campaign in Buffalo, New York, where he won
the crowd’s hearts by declaring, in a tear-filled finale, that Buffalo was his
father’s favourite city in the world. This was odd in itself – his father had,
after all, spent most of his life in smalltown California – but became even
odder when, at stops at Rochester and Itaca that same day, he repeated the same
closing paragraph simply changing the name of the town.

Nixon’s family was, in some ways, typical for that of a future president.
His father would use the strap on him and his mother, as he saw it, rejected
him in her concern for his two ill brothers, both of whom would die of
tuberculosis.

Both Clinton and Reagan had to cope with an alcoholic parent, in Clinton’s
case the stepfather from whom he took his surname.

One in four presidents had lost at least one parent before becoming an
adult. Prof Cooper says, "This means they get introduced to reality a lot
sooner than many of us and that they are driven to try and recreate the past
only this time with them in control providing their own ending."

Even among presidents who had not suffered parental loss, there was no
shortage of life-changing trauma. Teddy Roosevelt (1901-1909) was 20 when his
mother and his wife died on the same day. Like one of his successors John F
Kennedy, Roosevelt had suffered a near-fatal childhood illness – in Teddy’s
case asthma – and his distant relative Franklin Roosevelt (1933-1945) had to
fight polio in his quest for the presidency.

But few presidential wannabes can match the ill-luck of Martin van Buren
(1837-1841) who, between the ages of 32 and 37, lost his mother, father, wife,
one son and his job.

Anyone who studies all the presidents’ kin is struck by the toll of death
and disaster. Nine lost a wife either before or during their period of office,
more than half saw one of their children die in their own lifetime and in 17
cases that child died before they reached the age of 10.

Prof Cooper says you will find the same high incidence of parental loss or
life-changing trauma in the childhood of many business leaders, adding weight
to the contention that leaders are born not made. His studies show another
recurring motif in the collective biographies – they are often born in a
socially ambiguous background. As Reagan once said of his upbringing, "We
weren’t on the wrong side of the tracks but you could hear the train whistle
where we were." This even applies to Kennedy who, although the son of a
multi-millionaire, was too shrewd not to realise how socially isolated his
family were in upper-class Boston.

The road to the White House is a solitary one, with the successful
candidates usually exhibiting powerful personal charm, the constitution of an
ox and a willingness to take risks which other people – career managers in
Oliver James’s terms – would never take. Risk-taking can veer into
brinkmanship, as when Andrew Johnson (1865-1869) addressed a hostile crowd with
a pistol in his hand and invited critics not to waste words but just to take
the gun off him and shoot.

Some historians, who call their approach psychohistory, argue that the
recklessness many presidents have exhibited in their private lives also drives
their public policies. This view, expressed in an essay with the tabloid title
The Phallic Presidency, is not entirely shared by James but he says,
"America particularly is obsessed with the image of the predatory, macho
male. In Europe, you could say we are more comfortable with leaders who have
feminine characteristics."

Indeed, the John Wayne war hero card is still one of the most potent any
candidate can play – it worked for Andrew Jackson, Ulysses Grant, Eisenhower
and Reagan and has helped John McCain’s challenge to George W Bush.

The question of character is becoming more central to each presidential
election because, with the death of communism, the issues and political
divisions are not as clear as they used to be, cutting across the old clichés
of Left and Right.

The US has entered an age of what Phil Noble, editor of the web site
Politics Online, calls "biography politics". Gone are the days when a
president can insist, as Chester Arthur did in 1885, "I may be president
of the US but my private life is my own damned business".

Instead, the candidates are selling their biographies to the electorate in a
punishing, adrenaline-fuelled campaign designed to give them a flavour of the
massive endurance test to come if they are successful. As Lisle says, "In
two years’ time we’ll all be looking at pictures of him and saying, ‘Hasn’t he
aged?’"

By Paul Simpson

A psychological and physical health check on five presidents

Abraham Lincoln

Period in office 1861-1865

• Lincoln’s persistent melancholy – some have alleged he suffered from manic
depression – has its roots in a childhood which would have left less robust
souls with a bad case of post-traumatic stress disorder. When he was three his
only brother died, when he was nine he is said to have helped make the coffin
for his mother to be buried in, when he was 17 a close friend went mad and when
he was 19 his sister died. His first love died of cholera when he was 26, one
son, Eddie, died aged three and another, Willie, died of cholera when he was
12. As if all that were not enough, the stress of presidency and war deprived
him of sleep for weeks on end. Although he was tall and thin when he entered
office, he had lost over 20lb by the time John Wilkes Booth shot him.

Woodrow Wilson

Period in office 1913-1921

• Wilson has the rare distinction of being the only president to be
psychoanalysed by Sigmund Freud. The founder of psychoanalysis decided the key
to Wilson’s personality was his fear of his own powerful sex drive. Twice
married, and once involved in a long-term adulterous relationship, Wilson had a
nervous breakdown in 1894, one physical symptom of which was paralysis of the
right hand. Headaches, indigestion and depression plagued him intermittently throughout
his career until his presidency was wrecked by a stroke, the severity of which
was concealed from the outside world so he could serve out his second term. He
left office in 1921, his country having rejected his vision of a League of
Nations, and died three years later.

John F Kennedy

Period in office 1961-1963

• While much has been made of JFK’s womanising, the real secret of his
presidency was his health. He was a victim of Addison’s disease, and after
operations in the 1950s to cure his bad back, had twice been given the last
rites by a priest. His brother Bobby said of him, "At least one half of
the days he spent on this earth were ones of intense physical pain." He
was a genuine war hero who lost a brother and sister in the war and had to cope
with the "loss" of another sister who had a lobotomy. One of his
favourite poems was I Have A Rendezvous With Death, much on his mind before his
fatal trip to Dallas, and he was probably convinced it was his destiny to die
young.

Lyndon Johnson

Period in office 1963-1968

• LBJ once boasted, "I have had more women by accident than Kennedy had
on purpose." He liked to hold meetings with White House staff while he was
on the toilet – and with the toilet door open. His presidency soon got bogged
down in the mire of the Vietnam War, opposition to which among his own party,
the Democrats, forced him not to seek another term in 1968. Towards the end of
his administration, he was haunted by a recurring dream. "Every night when
I fell asleep I would see myself tied to the ground in a wide open space and I
could hear the voices of thousands of people shouting ‘Coward! Weakling!’"
he told a biographer, adding that if he lost Vietnam he would be condemned as a
"man without a spine".

Richard Nixon

Period in office 1968-1974

• Like JFK, Nixon lost two siblings in childhood and felt estranged from his
mother. According to his psychiatrist, Arnold Hutschnecker, whom Nixon visited
between 1952 and 1968, the president "did have a problem standing up to
pressure". After losing a 1962 election for governor of California, Nixon
told the press, "You won’t have Nixon to kick around any more." In
office, Nixon often got drunk at weekends and, so US journalist Seymour Hersh
alleges, once called up Henry Kissinger demanding that North Vietnam be nuked.
As impeachment neared, he was seen talking to the portraits of former
presidents in the White House. After his resignation, he rehabilitated himself
as an elder statesman and died in 1994.

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