Occasional paper QJM Diseased, demented, depressed: serious illness in Heads of State

As both a physician and a politician, I was first touched by the question of how illness can affect the decision-making of Heads of State or Govern-ment when I met the Shah of Iran in Tehran in May 1977.1 He appeared to be at the height of his power: self-confident, and enjoying his global role in helping to determine world oil prices. It would have been a great help to have known then, and particularly a year later, that he had been suffering from chronic lymphocytic leukaemia. He had been diagnosed in April 1974 by the French haema