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December 7, 1994

Who Is Minding the World?

Author Affiliations

From the University of Rochester (NY) Medical Center. Dr Joynt is editor of the Archives of Neurology.

JAMA. 1994;272(21):1699-1700. doi:10.1001/jama.1994.03520210083038

The power of the president of the United States is unparalleled, so concerns about the physical and mental health of the incumbent are and should be of major concern. There are several reasons for these concerns with any leader, but some are specific to the president. First, the schedule of business, entertaining, and travel is exhausting and stressful. The travel may be over several time zones with the attendant problem of jet lag and disrupted sleep patterns. Second, the president is a frequent target of assassins. Third, the position and authority of the staff are dependent on the continuing and active presence of the president. They would be loathe to point out personal frailties to the incumbent and to make these frailties known to the public. There are several instances of this, the most prominent being that of President Wilson. Post and Robins,1 writing about the effect of illness

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