Subject Did Graves' disease hasten Bush's Gulf war decisions? COPYRIGHT PACIFIC NEWS SERVI

Subject: Did Graves' disease hasten Bush's Gulf war decisions?
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  DID GRAVES' DISEASE HASTEN GULF WAR DECISIONS?


  EDITOR'S NOTE: Woodrow Wilson, Franklin Roosevelt and Dwight Eisenhower are
among the presidents whose medical problems influenced public policy-making.
Despite the wide publicity given President Bush's recent diagnosis of Graves'
disease, few have asked whether this affected his Gulf War decisions.  The
question deserves expert examination, say some authorities on presidential
decision making.  Lonny Shavelson is a California physician and
photojournalist.


  BY LONNY SHAVELSON, PACIFIC NEWS SERVICE


  With the announcement that President Bush has been suffering from Graves' 
disease -- an overactive thyroid gland -- the American public has a right to 
ask whether the disability could have affected his decision-making activities
during the Persian Gulf war.

  The thyroid gland secretes a hormone that affects almost every part of the
body -- setting the basic rate of metabolism and energy use.  When it acts up,
as George Bush's did, the body simply speeds up.  Bush lost ten pounds in
three weeks without dieting.

  No one doubts that increased amounts of thyroid hormone affected the
President's heart and body.  But a respected textbook of medicine states that
common symptoms of Graves' disease also include increased nervousness and 
irritability, at times to the point of emotional instability.  Anxiety is
described as a prominent feature.  It also lists "hyperkinesis" -- excessive
motion, having a hard time staying still.

  What, if anything, was the effect of Graves' disease on the President?  Did
a level of vague anxiety, a hyperkinetic "need to move," play any role when he
quickly bypassed General Powell's recommendation favoring sanctions over war?
Were vague feelings of hyperthyroid restlessness acting when he judged the
American public to be too impatient for prolonged sanctions?

  Stanford University's Dr. Herbert Abrams is an expert on the potential
impact of medical illness on cognitive functions and decision-making processes
of U.S. presidents -- from FDR's weakness-inducing congestive heart failure
during the Yalta conference that shaped post-World War II Europe, to
Eisenhower's self-stated difficulty in making decisions in the weeks following
his heart attack.  "The potential impact of the hyperthyroid state on the
decision-making process of George Bush is certainly worth considering," Dr.
Abrams says.  "All of the evidence suggests that the decision for a military
resolution to the Gulf conflict was a hasty decision -- in spite of advice
from six of eight former secretaries of state, three chairmen of the Joint
Chiefs of Staff, and so on.  A number of different factors were involved in
this decision, and the hyperthyroidism may have been a significant one."

  Before his thyroid disease was discovered, George Bush knew only that he was
a 66-year-old busy executive with something wrong with his heart that needed
looking into.  His personal physician asked him to slow down, then told the
press, "Every time we try to give him a break, he tries to add things to his
schedule."  Was this simply the way of George Bush? Or was this the emotional
speedup of hyperthyroidism added to a previous habit of hyperactivity --
leading to unreasonable decisions?

  While doctors at Bethesda Naval Hospital reviewed the President's thyroid
tests to decide on a course of action, Bush wandered down the hall to visit
patients who had ben wounded in the Gulf War.  Patriotism?  Hyperthyroid
restlessness?  Or the interaction of the two?

  What difference does it make if the President wandered down the hall to
stretch his legs or to soothe his over-active thyroid?  Alexander George,
well-known for his studies on Woodrow Wilson's emotional collapse followed by
a stroke during his presidency, thinks that questions should be asked about
the relationship between Bush's thyroid disease and his recent policy-making
style.  "It's a plausible hypothesis," he says.  "There are indications that
(Bush) seemed to be more impulsive: he'd blurt out statements.  But reliably
relating that to his thyroid illness would be difficult."

  One way to examine this question would be to review videotapes of Bush over
the past year, looking for any acceleration in his rate of speech brought on
by increased levels of thyroid hormone.  Or some "fidget index" could be
devised, measured and compared over time -- to allow definition of Bush's
symptoms of restlessness.  Dr. Abrams suggests that "a good clinical-medical-
psychiatric study of George Bush before and after his thyroid condition is
treated" would be helpful in reaching meaningful conclusions.  "It's certainly
something worth bringing to public attention," says Dr. Abrams.  "The
cognitive impact of diseases has not been adequately addressed in terms of
presidential decision-making."

  Bush's response to his own general's recommendation to slow down and avoid 
the war was, according to Pulitzer Prize-winning journalist and author Bob
Woodward, "I don't think there's time politically for that strategy."  Did
that reply come purely from the clarity of the President's mind -- or was the
gland in his neck speaking as well?


 (05171991)
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