The ill-fated triad: Roosevelt, Stalin and Churchill-Post-Yalta strokes and the impact on world leaders

The Yalta Conference of 1945 brought together three of the most influential leaders of the 20th century: Franklin D. Roosevelt, Joseph Stalin and Winston Churchill. Surprisingly, all three leaders would go on to suffer strokes after the conference. This manuscript examines the health status of these leaders during and after the Yalta Conference, the factors that contributed to their strokes (including the role of hypertension), and other modifiable risk factors present in each one of them, and the impact of their declining health on their countries and the world. Roosevelt's demise, prior to the conclusion of the war, triggered a leadership transition during a critical moment in history, while Churchill and Stalin's passing shaped the early Cold War era. A veil of secrecy shrouded the health conditions of these pivotal leaders. "The Big Three" made considerable efforts to hide their health conditions from both the press and the public at large.

Inter-individual variability in disease expression: the Tudor-Churchill spectrum

Henry VIII and Winston Churchill are clinically instructive when appreciating inter-individual variability in disease expression. Both were illustrious English leaders who as young men sustained multiple traumatic brain injuries, which may (or may not) have profoundly influenced their successes and failures of later years. Both men were admired and castigated; both struggled at various times with their bodies and their minds. Ultimately, one was initially a great man who descended as a flawed leader; the other was initially a flawed man who ascended as a great leader. Their similar yet contrasting case histories define the full spectrum (“Tudor-Churchill Spectrum”) of inter-individual variability in response to brain disease or injury. The Tudor-Churchill spectrum is the immense variability between individual patients and reminds us that every person is unique, deserving of individualized thought, personalized diagnosis and tailored treatment.

Sir Winston Churchill's doctors on the Riviera 1949-1965: Herbert Robert Burnett Gibson (1885-1967) and Dafydd (David) Myrddin Roberts (1906-1977)

In May 1940, Sir Charles McMoran Wilson (later Lord Moran) was on the instigation of Lord Max Beaverbrook and Brendan Bracken, (both patients, then friends of Wilson) introduced to Winston Churchill. Thereafter, he remained Churchill's personal physician until Churchill's death. In his controversial book detailing Winston Churchill's health, Lord Moran refers briefly to two doctors resident in Monaco, who were involved in the management of Churchill's declining health from 1949. One was Scottish, Herbert Robert Burnett Gibson and the other Welsh, Dafydd Myrddin Roberts. The military and civilian careers of these doctors are profiled here.

Observing carbon cycle-climate feedbacks from space

The impact of human emissions of carbon dioxide and methane on climate is an accepted central concern for current society. It is increasingly evident that atmospheric concentrations of carbon dioxide and methane are not simply a function of emissions but that there are myriad feedbacks forced by changes in climate that affect atmospheric concentrations. If these feedbacks change with changing climate, which is likely, then the effect of the human enterprise on climate will change. Quantifying, understanding, and articulating the feedbacks within the carbon-climate system at the process level are crucial if we are to employ Earth system models to inform effective mitigation regimes that would lead to a stable climate. Recent advances using space-based, more highly resolved measurements of carbon exchange and its component processes-photosynthesis, respiration, and biomass burning-suggest that remote sensing can add key spatial and process resolution to the existing in situ systems needed to provide enhanced understanding and advancements in Earth system models. Information about emissions and feedbacks from a long-term carbon-climate observing system is essential to better stewardship of the planet.

The life, times, and health care of Harry L Hopkins: Presidential advisor and perpetual patient

Harry Hopkins was the most important nontitled allied leader in World War II. He was the advisor to President Roosevelt who managed the diplomacy between Roosevelt, Churchill, and Stalin from 1941 to 1946. Throughout these times, Hopkins was ill and required transfusions, admissions to the hospital, and nutritional supplementation to keep him well enough to travel the world and manage the allied war diplomacy. There has been no unifying theory to account for all his symptoms and his reported pathologic and autopsy findings. In this paper, we will review his political and medical history and a differential diagnosis of his illness.

Winston Churchill (1874-1965), Dr Robson Roose, MD Brux, FRCPE (1848-1905) and Dr Joseph Rutter, MD Lond, MRCP (1834-1913): Treatment for pneumonia in March 1886

This paper will review Winston Churchill's severe respiratory illness in March 1886 when he developed pneumonia of the right lung as an 11-year-old boy. Winston was treated supportively with 'nourishment, stimulants [probably alcohol] and close watching' at his school by the 'celebrated' family physician, Dr Robson Roose, with the assistance of Dr Joseph Rutter. Roose was exemplary in his commitment to his young patient and assiduous in informing Lord Randolph Churchill of his son's clinical progress by letter.

Arthur Conan Doyle (1859-1930): Physician during the typhoid epidemic in the Anglo-Boer War (1899-1902)

When the Anglo-Boer War broke out in October 1899, Arthur Conan Doyle, a retired ophthalmologist, was already famous as the creator of Sherlock Holmes. Motivated by patriotism and adventure, Doyle joined the medical staff of a private field hospital endowed by philanthropist John Langman (1846-1928). Langman Hospital opened in Bloemfontein, South Africa, at the height of that city's typhoid fever epidemic which raged from April to June 1900. There were nearly 5000 cases of typhoid and 1000 deaths but official statistics do not truly reflect the magnitude of the suffering. Doyle argued that the British Army had made a major mistake by not making antityphoid inoculation compulsory. Because of the new vaccine's side effects, 95% of the soldiers refused immunization. Despite his strong opinions, Doyle failed to press the issue of compulsory inoculation when he testified before two Royal Commissions investigating the medical and military management of the war in South Africa. One can only imagine how the army might have benefited from the new idea of prophylactic vaccination in preventive medicine if Doyle had not let these opportunities slip away. As a consequence, antityphoid inoculation was still voluntary when Great Britain entered World War I in August 1914.