In March 1944, a new cardiologist brought in to check up on Franklin D. Roosevelt made a disturbing diagnosis: the president was suffering from congestive heart failure. Roosevelt, up for election that year, was unlikely to survive another term of office, and even with treatment might not even make it another 12 months. (He did, but just barely, dying in April 1945.)
But neither FDR's doctors nor the White House chose to make that medical information public; they simply assumed this was something the public had no right to know. And why should they think otherwise, considering that almost a quarter-century after Roosevelt had contracted polio, the American people were still not fully aware just how extensive was the damage it had done to him. They didn't know because FDR's political associates, and the journalists who covered the presidency, willingly went along with his handlers' efforts to obscure the fact that he was virtually a cripple.
Those days are long gone in the US of course, and obviously here in Israel as well. Prime Minister Ehud Olmert's announcement Monday that that he has been diagnosed with prostate cancer and will soon undergo surgery, set new local standards for candor about the medical condition of a high public official, especially a prime minister.
What political impact this will have on Olmert and his government is open to interpretation, as was his motives in being so forthcoming.
However, most of the initial reactions to the PM's frankness in disclosing his medical condition is that this openness represents a healthy development, that whatever the outcome, his admission is all for the best.
In these circumstances, that's certainly the case. But just how much should the public know about the medical condition of elected officials? Are there times when they might be given too much information, especially when a diagnosis is open to interpretation, or misinterpretation? Can the impact of such medical knowledge sometimes weigh too heavily on the political condition of an elected official, in ways that are unhealthy for the democratic process?
There's no question that in the Israeli political sphere this is a relatively new development. There are many well-known instances where the public was never made fully aware of the severity of the medical problems suffered by our prime ministers. The list includes: Levi Eshkol, whose deteriorating health in the years just prior his death in 1969 definitely hindered his job performance; Menachem Begin, whose sudden retreat from office in 1983 might have been less of a shock if the public knew just how much he had been affected by his chronic heart problems; and of course Ariel Sharon, collapsing into a coma less than three months before a general election.
It was of course the criticism over the failure to fully disclose the extent of Sharon's condition and treatment, that led Olmert to make such a dramatic announcement yesterday. It was unlikely in any case that he had much choice. After Sharon's collapse, the media was stung by criticism, some of it internal, that they had been negligent in not more aggressively pursuing the story of his condition, as well as raising questions about the course of his treatment.
The press clearly will no longer observe the discretion it once did regarding health issues. Indeed, even the request of the Prime Minister's Office yesterday morning that no advance notice be given that Olmert's health was the subject of the press conference was almost immediately breached.
With a more vigilant and uncooperative press, there is almost no way the PM could have long kept quiet his need for a medical procedure, without sparking off a flood of rumors and speculations as to the cause.
Having now admitted it is prostate cancer, and even with the very positive diagnosis given by his doctors, Olmert will undoubtedly face intrusive and sometimes unpleasant scrutiny of (as the old song goes) the condition of the condition he's in. One can be sure the next time the cameras catch him in a public appearance where he appears wan, drowsy, and his eyelids begin to shut, it won't simply be ascribed to sleepless nights over the Winograd Report or the various police investigations against him.
Olmert is at least fortunate in that he is not expected to face the voters anytime soon (although his medical condition might be one of his lesser problems in this regard). It is during election season that health concerns come into biggest play; as the media in Western democratic societies become ever more frank about the health of politicians, it is perhaps not surprising that this is accompanied by what appears to be an increase in the number of younger candidates attaining the highest offices.
Would the relatively young, vigorous energy of French president Nicholas Sarkozy, for example, have been so remarked on had he not followed into office Jacques Chirac, who was criticized during his last year in office for concealing his own health issues?
On the down side, disclosure of medical problems that in the past were kept confidential, can easily be blown out of proportional by media sensationalism and a public sometimes quick to draw panicked conclusions. Despite advances in a general understanding of mental health issues, it is doubtful that almost anywhere in the world today - and certainly not here - a candidate or holder of high office could openly admit any kind of psychiatric or psychological counseling, without suffering real political damage.
And even where there should be genuine concern over the medical condition of a public official, with hindsight one might argue that it might not always have been so beneficial for this information to be public knowledge.
If it was revealed that FDR was completely wheelchair-bound during a time when handicapped individuals were less socially accepted, would the American people have elected him four times to the White House, to lead the US out of the Depression and through WWII?
Would America have been better off if during the election of 1960, it became known that John F. Kennedy was suffering from the potentially terminal Addison's Disease?
And if Yitzhak Rabin's brief mental and physical collapse on May 23rd 1967, had been instantly reported at the time by the media, would the public have permitted him to resume his role as IDF chief of staff and lead the IDF to victory just two weeks later in the Six Day War?
Perhaps, to paraphrase an old saying, sometimes what we didn't know then about the health of our leaders couldn't hurt our political judgment.
But as Olmert's announcement makes clear, these days not knowing what ails our prime ministers is not an option - so it's up to us to make sure we can make the proper diagnosis, when deciding if our leaders' medical conditions are a genuine factor in their ability to ensure our own well-being.