Allister Vale and John Scadding (2020). Winston Churchill’s Illnesses 1886 -1965. Frontline Books, 2020 pp 522. ISBN 978 1 52678 949 5
Book review by Adrian Crisp
A 16 year old boy shuffled past the coffin in Westminster Hall and stood in the crowds outside St Paul’s Cathedral at his funeral. Fixed in my auditory memory as a fly in aspic is the silence broken by the crump of marching boots and by the squeaks of the gun carriage bearing the body of our “greatest Englishman”. His personal physician, Lord Moran, and his neurologist, Lord Brain, predicted imminent death following a stroke but Churchill defied “the darkness for another fourteen days” with no more sustenance than sips of orange juice.
One year later in 1966 the furore erupted with publication of Moran’s recollections of Churchill’s fitness to lead Britain through the darkest days of the Second World War and during the opening salvoes of the Cold War. Moran claimed that the Cambridge historian, G M Trevelyan, and Churchill’s close friend, Brendan Bracken, had entreated him to place on record his account of Churchill’s illnesses. Many doctors considered this a crime against the sacred confidentiality of the doctor-patient relationship. Mary Soames, Churchill’s daughter, regarded the book to be “an outrageous thing in complete breech of a doctor’s ethics”. Five decades later with the attenuation of raw sensitivities and in the interest of full historical disclosure, Vale and Scadding have written the most detailed and definitive account of Churchill’s health with the forensic skills of two distinguished physicians who have mined all available sources and integrated them in the light of both contemporary medical practice and the practice of the early 21st century. The doctors and nurses who attended Churchill come alive. This is far from a medical text book. It exposes the resilience and courage of one man who defied these medical challenges and continued to serve and lead his country until the end of his premiership in 1955.
Churchill was fond of cats but defied death on more than nine occasions. It was in December 1941, when visiting the White House soon after America’s declaration of war that he opened a window with effort and developed a dull chest pain which his physician, Sir Charles Wilson (later Lord Moran) interpreted as a heart attack. He resolved not to disseminate this as it would have diminished Churchill and Britain in the eyes of the world. He later consulted John Parkinson, a cardiologist, who found no evidence of heart disease. Churchill considered his symptoms to be of musculoskeletal origin and he was probably right. Yet the myth of Churchill’s ischaemic heart disease at this critical point in the war has persisted to the present. This can now be discounted.
Recurrent pneumonic episodes during the war could easily have ended the life of Britain’s inspiring leader. Doris Miles, who had been a gold medallist in her nursing training, nursed Churchill in 1943. He expressed his gratitude by awarding her a metaphorical “bar to her gold medal”. When she gave him a red capsule at Chequers he responded: “the price of a good woman is above rubies”. The most critical pneumonia was in Tunis in December 1943 after an exhausting tour of the Mediterranean theatre. Many physicians converged – not least the coauthor’s father, John Guyett Scadding. Penicillin, full of therapeutic promise, was summoned but not used as his physicians had no experience of its use. They relied on the trusty sulfonamides, “M and B”, after the makers May and Baker, which proved effective. Churchill characteristically took a detailed interest in his white cells and wished that his “armies were doing as well as my leucocytes to combat the enemy”. He also nicknamed his two physicians “M and B”, Moran and Bedford, with typical humour.
There were further respiratory scares, not least at Yalta in early 1945, where “Staleen’s” plans for a communist eastern Europe were promoted with the acquiescence of Roosevelt, enfeebled by uncontrolled hypertension and cerebrovascular disease which would kill him within months. The American direction of the war was more impaired by its president’s health than British leadership by Churchill’s health. He anticipated the Soviet menace to post war peace long before his American counterpart and fellow British ministers, mesmerised by Russian success on the battlefield.
In 1949 Churchill suffered his first stroke and recurrent cerebrovascular events were the leitmotif of his final decades. In 1952, after his election as prime minister, he made a rapid recovery from a further stroke but in June 1953 a more severe one incapacitated him for the next two months, before bouncing back to defy his doctors. The analysis of these neurological episodes is masterly – red meat to historians. Two years later he handed over the reins to Anthony Eden, also in poor health. Few would disagree that in the interest of good government and his political reputation in this critical period of the Cold War, that Churchill should have retired in 1953.
Moran diagnosed clinical depression which has become accepted lore: his “Black Dog”. A chapter, co-authored with Anthony Daniels, demolishes this shibboleth of depression with convincing arguments. Churchill’s experiences of reversals in life’s fortunes and his appreciation of the perils to his country triggered appropriate mood reactions but “these features were presumably the fleeting accesses of despair that can overtake anyone and do not constitute a diagnosis any more than accesses of joy constitute a diagnosis”. Any short comings? First, Moran set his clinical insights in the historical context of the Second World War and aftermath. It is assumed that readers will already have a detailed understanding of these decades but a Moran-esque synthesis of medicine, war and politics would have far exceeded their brief. A time line of the main background events would be useful. Second, the account of Churchill’s musculoskeletal problems including spinal vertebral and hip fractures constitute clear evidence for the additional diagnosis of osteoporosis omitted from this comprehensive medical portrait. Mere quibbles in a book which will appeal to historians, readers with historical antennae and doctors who appreciate the interplay between diseases and their patient’s lives. And what a life.
Lord Moran. Winston Churchill: The Struggle for Survival 1940 /1965. Constable, 1966.
Adrian Crisp is Emeritus consultant in Rheumatology and Metabolic Bone Diseases, Addenbrooke’s Hospital Cambridge, and Chair of Churchill Archives Committee and Fellow, Churchill College Cambridge.