When you are the president's doctor

Unlike commoners who are attended to by any doctor on duty, presidents have personal physicians, and for many reasons. 

For starters, the presidency is so stressful. Most presidents are sworn in sporting black hair only to exit with greying heads. Stress is therefore a force multiplier of other underlying health conditions. Besides constant jet lag and attendant fatigue, there is the constant dread of assassination attempts and political pressure.

All Kenyan Presidents have thus had personal physicians: Founding President Mzee Jomo Kenyatta had Dr Njoroge Mungai and Dr Eric Mgolla. The late Daniel arap Moi had Dr David Silverstein, the late Mwai Kibaki had Dr Dan Gikonyo and Dr Francis Kiragu.

President Uhuru Kenyatta has Dr Robert Mathenge, a cardiologist at Nairobi Hospital-where all Kenyan presidents seek treatment when not jetting out to foreign hospitals.

“Being the President’s doctor is more than a job. It is a patriotic duty,” Dr Gikonyo said in a past interview. “One wrong move could throw the country into panic. The health of the President is the health of the nation.”

Kibaki’s first trip to Washington in 2003, for instance, was indicative of the extent the accident he had along Mombasa Road during campaigns for the 2002 General Election, had on him.

While introducing his entourage to President George W Bush, Kibaki “introduced everyone as Francis Muthaura” then the Head of the Civil Service, notes British historian Daniel Branch in his book, Kenya: Between Hope and Despair 1963-2011.

A personal physician thus becomes a crucial cog in the wheel of presidential duties at home and abroad; checking out opportunistic diseases, diet, and signs of depression.

Dr Silverstein recalled how "among my duties was to ensure we were not eating exotic animals such as cats, snakes, dogs or drinking buffalo milk while in China,” he joked during Moi’s funeral on February 12, 2020.  

Indeed, any untoward health conditions cause panic. In 1995, President Moi missed from news bulletins, the usual Sunday Service. Panicky Kenyans left workplaces in a huff, others packed, ready to flee upcountry. Schools and shops began closing.

Apparently, Dr Silverstein had advised bed rest owing to the president’s limp from Achilles Tendonitis as British biographer, Andrew Morton notes in Moi: The Making of an African Statesman. 

Rumours about President's health saw increased bank withdrawals, ticket bookings, and stocking on foodstuff. To reassure Kenyans he was hale and hearty, Moi walked from his Harambee House office to Parliament: “Do I look like I am dying,” he joked while exchanging pleasantries.

Within a country’s shores, the health of a president can impact on elections, enactment of laws, policies, financial markets, and geopolitics. Internationally, it can affect trade, treaties, agreements, peace accords, and the economy hence the need for a personal physician. Most are friends, trusted loyalists of the president.

Dr Joseph Aluoch, a chest specialist at Nairobi Hospital says globally, most personal doctors of a president are cardiologists as, on average, presidents suffer heart attacks and other cardiovascular diseases.

"Heart attack and other cardiovascular diseases are commonly referred to as the diseases of the executive. Dr Gikonyo is a cardiologist and so is Dr Mathenge,” says Dr Aluoch.

Most politicians are also aged when they become presidents: Jomo Kenyatta and Kibaki were in their 70s.

Jomo Kenyatta’s funeral, for instance, was planned 10 years earlier after his heart troubles began in 1968 as British historian, Charles Hornby informs us in, Kenya: A History Since Independence. 

So politically dicey was Mzee Kenyatta’s health that the Attorney General, the late Charles Njonjo, secretly invited South African heart surgeon, Dr Christiaan Barnard, to check him up in 1976.

Kenya had severed diplomatic ties with South Africa owing to its then Apartheid policy. Njonjo didn’t give a hoot. He housed Dr Barnard in his Muthaiga home, brewing bitter bile with Foreign Affairs Minister, the late Dr Munyua Waiyaki.

Mzee Jomo Kenyatta also suffered memory loss and incoherence. At State House Nakuru, Jomo once introduced Minister of State Mbiyu Koinange and Foreign Affairs Assistant Minister, Kassim Mwamzandi as “my father and mother.” Never mind Mbiyu was his brother-in-law.

Former Central Bank Governor, Duncan Ndegwa, recalls in his 2009 memoirs, Walking in Kenyatta Struggles: My Story, how Jomo’s poor eyesight meant his written speeches had to be in very large fonts. He had to be shown his signature to remember it.  

But it was Jomo’s refusal to be fitted with plastic heart pacers that sent Dr Barnard sobbing during a farewell speech at Nairobi Club, according to Hornsby.

The diagnosis of the President who often lost his way to servant quarters at State House Mombasa was not good. Jomo died in his sleep on August 22, 1978.

While in Kenya the personal doctors of all Presidents have been civilians, the same is not the case in the USA where all are from the military- who have all the time.

Dr Lawrence Mohr, personal doctor to President Ronald Reagan and George H.W. Bush told CNN that canvassing or applying for the job is the best way not to get it.

Presidents have private doctors due to their accessibility, efficiency, conducive environment, privacy, security, stability, honesty, safety and better services.

A president may suffer certain conditions they want to be kept private: diabetes, arthritis, cancer, Covid-19, HIV. The personal doctor provides confidentiality, and secrecy.

The first US President, George Washington, had a massive, life-threatening boil on his butt, but the public was told it was on his thigh to preserve ‘presidential dignity,’ writes Monica Hesse in a 2018 article in the Washington Post.

Treating the President is the ultimate in concierge medicine, as it “combines professional responsibility with the glamour and trappings of proximity to history,” writes Dr Lawrence Altman, a medical doctor and reporter for the New York Times.

President’s doctors are thus subjected to security scrutiny and appointed with the President’s personal approval.

Dr Gikonyo became Kibaki’s doctor while treating the late politician Njenga Karume long before Kibaki became president. They formed a bond and “a president is likely to choose a doctor he has interacted with and developed trust in,”  explained Dr Gikonyo.Dr Silverstein recalled during Moi’s funeral: “Our relationship as doctor and patient warmed over 42 years with deepening trust, mutual respect, and growing friendship.” 

A personal physician understands their patient’s nature and medical history to make accurate diagnoses in emergency situations. Just why Dr Gikonyo took charge of Kibaki's treatment shortly after the road accident in 2002. All government medics passed through him before handling Kibaki.

Is there a financial windfall in treating the President?

Well, Dr Gikonyo disagreed: “People imagine treating a President can get rich overnight. That is a big lie. The president does not pay for his medical care from his pocket. It is paid by the State and you cannot overcharge him just because he is the president.”

The biggest benefit, Dr Gikonyo said is that people believe those like him "are the best doctors simply because they treat presidents.”  

Besides Presidents, other politicians too have personal physicians: Attorney General Charles Njonjo also had Dr Silverstein as his personal doctor. Njonjo was crucial in Moi’s ascent to the Presidency following the death of Jomo Kenyatta in 1978.

So when Moi formed the Njonjo Commission of Inquiry in 1984 to probe involvement in the 1982 coup attempt, both men unloaded their stress on the same doctor. Dr Silverstein slotted Njonjo for morning sessions and Moi for afternoons, notes Morton.

Dr Mohammed Kalama, chair of the National Muslims Covid-19 Response Group explains that “stability and confidentiality are why politicians prefer private doctors from big hospitals. Most hardly betray their clients because of strong links and friendships shared.” 

 Most politicians are loaded, says Dr Kalama, and can afford private doctors which is why “they rush abroad due to little faith in local doctors. They also know about corruption in public hospitals which can result in negative treatment.” 

Politicians also fear being harmed or eliminated in the hands of doctors they do not trust or know well “and later say it is the treatment that failed,” reasons Collins Oyuu the Secretary-General, Kenya National Union of Teachers (KNUT).  

“I have a personal physician who treats me and my family. The fear by politicians of being in the hands of untrusted doctors and medics unknown to them, is not ill-conceived," says Oyuu. 

Joshua Rajwayi, former chair of Ford Youth Congress, says “In an ethnically charged society like ours, bitter political rivalry among' leaders, presidents and lesser politicians cannot just trust any doctor” as most politicians step on many toes creating endless enemies who can use untrusted doctors to their benefit.

Dr Connie Mariano was President Bill Clinton’s personal physician and the first woman to take the job.

 Was he sleeping enough? Was his temperature normal? Please describe, in detail, the president's bowels, are some of the issues the White House medical unit grappled with.

Dr Mariano told CNN "the doctor is always within a few feet away, so you essentially shadow the president. This is a patient like no other. Their decisions affect millions of lives."

In her memoirs, The White House Doctor, she writes “while my Secret Service comrades look out for bullets and bombs. I look for bugs and bad environmental conditions.”

Besides the First Family, the medical unit is “like a mini urgent-care centre,” and also provided care for the Vice President and international dignitaries. 

Personal physicians have had hands in running governments when not covering up serious medical conditions.

In 1893, for instance, US President Grover Cleveland suffered a lesion that his doctor, W.W. Keen, thought was cancer. The medical team removed five teeth, parts of his jaw, and the upper left part of his palate, all while afloat the Presidential yacht. Americans were told he had a toothache!

The reason for lying was that Cleveland supported the gold standard, not the silver. News of ill health could have sent markets tumbling.

Then there was President Woodrow Wilson who collapsed from a stroke. For almost a year, his physician, Dr Cary Grayson, and First Lady, Edith Wilson ran the government. Reason? Wilson was the only person keeping Europe from descending into communism noted the Washington Post. 

The ailment of a President can also be used by opponents to derail re-election. Just why like their taxes, health records are kept under wraps. President Franklin Delano Roosevelt was elected four times. For 12 years, voters were oblivious that he could barely walk. 

Personal physicians, however, can lead to devastating consequences. President Warren Harding's doctor was a family friend and a homoeopath and a veritable quack.

He prescribed pills for their colour, not ingredients. He mistook Harding’s chest pains for indigestion. It was heart disease. Harding fell ill, he said it was food poisoning. It was a heart attack. Harding died two years into his presidency.