Winston Churchill's Illnesses, 1886-1965
Courage, Resilience, Determination
Allister Vale and John Scadding
Foreword by Randolph Churchill
Barnsley (Yorkshire) and Havertown (Pennsylvania): Frontline, 2020
Hardcover. xx + 522 pages. ISBN 978-1526789495. £30/$52.95
Reviewed by Antoine Capet
Université de Rouen
The general public interested in Churchill is no doubt familiar with Lord Moran’s 1966 controversial volume on his patient’s health, Churchill : The Struggle for Survival, 1940/65, widely quoted in the profusion of Churchill biographies which has appeared since then. More specialised readers, either confirmed Churchillians or members of the medical profession, are probably aware that Professors Vale and Scadding have been publishing a series of learned articles on Churchill’s health in medical journals for a few years, and following this previous research they now offer us a substantial book which not only extends the period covered by Lord Moran, but nuances or even contradicts him on many points.
Even though it is often pointed out that medicine is an art, not a science (as Churchill himself does twice in his speech on the unveiling of the portrait of Lord Moran in 1951 ), it does use the highly technical vocabulary – incomprehensible to the layman – which one associates with contemporary scientific research. So, in order to dispel any fear that the book could be inaccessible to the non-medical reader, it must be said straightaway that the authors always strive to give the explanation of technical words in plain English. One example will suffice, when they discuss the well-known ‘Acute Stroke in June 1953 in London’ [Chapter 19]:
The stroke consisted of a left hemiparesis (weakness of the left side of the body). The dysarthria (slurring of speech) was probably in proportion to the observed facial weakness, rather than indicating a cerebellar deficit (a motor coordination centre of the brain). 
In any case these technical passages are mostly limited to the final clinical discussion which concludes each chapter. The chapters themselves are arranged in chronological order, and they follow the same pattern: a state-of-the-art presentation and analysis of the large body of existing evidence (Churchill’s reminiscences in My Early Life, the Official Biography and accompanying Churchill Documents, memoirs by his contemporaries, press reports, recollections and correspondence by his family and entourage, including his male and female nurses – and of course the medical records left by Lord Moran and the consultants who examined Churchill at some stage in his long life), followed by a post hoc assessment – as far as a retrospective diagnosis is possible so long after the event, and without seeing the patient – of the nature (correct or incorrect) of the conclusions and treatment offered by Churchill’s physicians at the time, naturally taking into account the evolution of medical knowledge, of the aids to diagnostic procedures and of the pharmaceutical prescriptions and other treatments available since Churchill’s time.
To take only two examples of this evolution, the authors tell the lay reader that Churchill’s blood pressure ‘regarded as borderline normal for a man of 74 […] would now be considered too high’ , thus judging his doctors during his 1949 stroke episode according to their lights (as Churchill would have said approvingly) and not according to the criteria of 2020. And in their Introduction, they underline the ‘huge medical advances since the time of Churchill’s death in 1965’ like the introduction of the ‘computerised X-ray (CT) head scan’ or the ‘magnetic resonance (MRI) scan’ [xx].
The chronological narrative starts with Chapter 1 in 1886, when Churchill contracted pneumonia at school in Brighton. Then follow 27 other chapters, 2-17, 19-28 and 32, specifically devoted to accidents, diseases, fevers, operations, strokes, phases of convalescence and the terminal illness: all magnificently documented and discussed from a medical point of view – which of course conventional biographies do not and cannot do. Chapter 20, ‘Churchill’s Triumph at the Conservative Party Conference in October 1953 in Margate’, seems to deviate from this list of themes, but in fact it follows the usual pattern, ending as usual on a ‘Medical Aspects’ final section. The last chronological chapter is, not unexpectedly, devoted to ‘Churchill’s terminal Illness in January 1965 in London’ [Chapter 32]. As always, it ends on a discussion of its ‘Medical Aspects’ – which itself does not end on clinical, but human reflections as Churchill would have liked them: ‘Churchill died with the greatest dignity. One might be forgiven for feeling that Jock, the cat, understood how much Churchill meant to the nation and to the world’ .
In order to break what could have been the monotony of the general structure, the book offers a short chapter of a different (and entertaining) type entitled ‘Churchill unveils a Portrait of Lord Moran in July 1951’ [Chapter 18]. But four other ‘different’ chapters take us back to serious matters. The first three are devoted to thematic aspects stretching all through Churchill’s life. Chapter 29, written with Dr Ian White, a Consultant Dermatologist, examines ‘Churchill’s Skin Diseases’ – an unsual topic, not often broached in the great conventional biographies – and it tells us that ‘Churchill was 72 when the first record of a dermatological complaint is available’ . The next two chapters, on the other hand, deal with questions which have been extensively examined – seldom with the academic rigour which they require and which the authors provide here: ‘Did Churchill suffer from the “Black Dog”?’ [Chapter 30, co-authored with Dr Anthony Daniels, Consultant Psychiatrist] and ‘Was Churchill an Alcoholic?’ [Chapter 31]. For the authors, the answer to the latter question is an easy one, in spite of all the common misapprehensions, if one follows the list of eleven possible criteria for Alcohol Use Disorder (the current technical word for alcoholism) defined by the medical literature: ‘We conclude, to use the familiar lay term, he was not an alcoholic’ .
It is perhaps in the discussion of Churchill’s supposed ‘Black Dog’ that the general scepticism which pervades the volume about the value of Lord Moran’s published testimony appears most clearly, with no less than eleven pages [382-393] methodically demolishing – there is no other word – his spurious psychologising and non sequiturs, often based on invented evidence: of course the most damning of indictments in the scholarly community. These pages alone vindicate the authors’ claim in their Introduction: ‘We believe that our account of a supremely accomplished and gifted world leader not only amplifies what has been published previously but also sets the record straight’ [xix].
That they have achieved this objective is in no doubt. The book also features a very useful 25-page comprehensive repertory of ‘Churchill’s Doctors’ [Chapter 33], with many names that even seasoned Churchillians will discover besides the well-known ones, from Dr Roose, the family doctor when he was a child, to Lord Moran after 1940. Needless to say, all this is abundantly and impeccably footnoted – curiously, though, the many medical journal articles (most previously unknown to this reviewer) quoted in the notes are not taken up in the Select Bibliography, which is just that, not ‘Works Cited’, as it only lists the books mentioned. And as a further reservation about the Bibliography, one may wince at the entry ‘Churchill, W. The Gathering Storm… Penguin Classics, 2005’ , with no mention of the original date of publication: one never knows these days, some undergraduate somewhere might infer from this that Churchill was well and alive in 2005, still writing his memoirs. In contrast, the copious Index is exemplary, giving the names of diseases and drugs as well as people and places. Finally, one must not forget the 16-page central section of Plates on glossy paper, which offers excellent uncommon photographs of many of the nurses and physicians mentioned in the text besides more familiar pictures of Churchill in various surroundings.
Unreservedly recommended. No serious Churchill author will now be able to routinely quote Lord Moran as a source on Churchill’s health without taking account of the decisive caveats introduced by this fine monograph.
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