A First Rate Madness: Uncovering the Links Between Leadership and Mental Illness

On the whole this is a fascinating book to read, or even to contemplate: Nassir Ghaemi posits that mental illness enhances crisis leadership, using many examples from history to make his case, most notably Abraham Lincoln, Winston Churchill, and John F. Kennedy. Yet, my enthusiasm for this book waxed and waned as I read. Sometimes it felt a bit clunky: crammed with the familiar jargon of the psychiatrist who wrote it. At these times, I would set it aside and turn my attention to some other book or project. Eventually, though, I was pulled back to it because, at the end of the day, it offers a series of excellent portraits of any number of Great Men from times past. By focusing on their mental health or lack thereof (and this book is primarily concerned with the ones who were a bit deficient in that area), it spotlights history from a new angle.

As examples of the mentally ill leader, General Sherman, Winston Churchill, FDR, MLK, JFK, Teddy Roosevelt, Gandhi, Abraham Lincoln, Adolf Hitler, and even Ted Turner all go under the knife at some point in this book, so to speak. (The sane leaders, by the way, are George McClellan, Neville Chamberlain, and Richard Nixon; Tony Blair and George W. Bush also make appearances, though Ghaemi cautions against drawing too many conclusions about the still-living. The analysis is sometimes stiff (as I said in the paragraph above, the jargon can be hard to read), but generally fascinating. So many Lincolns suffered debilitating depressions that one relative referred to it as the “Lincoln horrors.” MLK and Gandhi both attempted suicide as teenagers; Lincoln was once suicidal to the extent that his neighbors kept vigil over him to prevent him from attempting the act. The book also brought to light new facts for me, some of which I have probably learned at some point or another (for example, FDR did not contract polio until he was 39) and some of which I don't believe I've ever known (that Hitler was a big time drug addict and that Kennedy's chronically poor health repeatedly sent him to death's door - he was 6'1" and in 1944 weighed only 126 pounds, for example).

Additionally, when he explains it in plain English, the psychiatry itself is interesting. In addition to full blown depression and manic-depression, he spends a great deal of time examining dysthymic (always melancholy though never depressed, dysthymics tend to go through life at a very slow pace, even walking and talking slowly) and hyperthymic temperments (always in a frenzy, hyperthymics walk and talk a mile a minute, have 100 ideas a day, and generally sleep very little).

I also particularly enjoyed the liberal use great quotes, as well as lines the Ghaemi wrote himself. He quotes Sherman saying of Grant, "He stood by me when I was crazy, and I stood by him when he was drunk." Writing of Hitler's extensive drug use he writes, "To call Hitler a time bomb would be to understate matters."  “There is not Kennedy curse. There is a Kennedy gene…that is both a curse and a blessing.” But, my very favorite lines from this book begin with an excerpt from a Thornton Wilder novel:

George Brush is my name

America's my nation

Ludington's my dwelling place

and Heaven's my destination

As Ghaemi then writes, "One couldn't have have invented the irony - only the letter 'r' in George Brush's name separates fiction from recent reality. You'll have to A First-Rate Madness yourself to learn whether he thinks the man behind the recent reality was mad.