James F. Toole, M.D.

When an American President “Loses It”

It has happened, of course—and not infrequently. Just in this century, American presidents who continued to serve in office while seriously neurologically impaired include Woodrow Wilson, Franklin D. Roosevelt, and Dwight D. Eisenhower. In the first two, there is a credible historical case that the results were catastrophic on a world scale. But the real question is: Could it happen again? Neurologist James Toole headed a Working Group on Presidential Disability, established in 1994 at the invitation of former President Jimmy Carter and Atlanta’s Carter Center, that made strong recommendations for guarding against a recurrence, but little has been done. As a result, says Dr. Toole, a time bomb (or a somewhat larger explosive) is ticking away. There are steps that would be simple—though not politically easy—to implement.