‘IN THE WHITE HOUSE, THE PRESSURES ARE BEYOND ANYTHING THAT human beings are designed to handle,’ a presidential adviser once said. Presidents are made of the same stuff as you and me and, occasionally, they break.
A recent study by one of our leading medical faculties concluded that nearly half the presidents between 1789 and 1974 met the Diagnostic and Statistical Manual of Mental Disorders’ criteria for mental illness.
By most definitions, Robert S. Thompson was in rude mental health when he took office, if you ignored the madness that would make one want to be president in the first place.
But four months into his administration, he had a dream – the kind that sticks to you for days, like smoke. He told no one – to begin with, not even Jennifer, his wife.
Then he had another.
And another and another.
They took on many different forms, but always ended the same way: with his assassination.
Soon, he was losing sleep – to the point where he was getting maybe a couple of hours a night – and people began to notice that he had lost his campaigning sparkle. That was the point at which he opened up to Jennifer.
Reuben was the second person in whom he confided. Relieved that the changes he’d seen in his boss had an explanation, he urged Thompson to see the White House Doctor.
Thompson refused: The doctor was an appointee of the previous administration. He might even be in on it.
Reuben knew then that he had a problem: what had manifested in the President’s dream-state had now been pulled into his waking reality. So he picked up the phone and rang me.
Reuben and I have known each other a long time. We’ve served together and fought together.
Two years after returning from Iraqi Freedom, George W. Bush’s war against Iraq, he landed a job in Washington as a security adviser to Senator Tod Abnarth, an old friend of his parents, and the first politician to back Thompson for the White House.
For as long as I’ve known Reuben he’s been ambitious, but I don’t hold that against him. He’s motivated by a deal more than fame and power. Like me, his sensibilities have been forged by war, but Reuben’s strengths lie in administration – mine in hands-on medicine. After Iraq, we each chose a new path.
For reasons that are still hard for me to examine, let alone discuss, I chose to retrain. I returned to the Uniformed Services University of the Health Sciences in D.C., known as USU, where I undertook a four-year residency, which included a year at Georgetown University. I graduated as a fully qualified physician and psychiatrist.
By then, Reuben’s political career had started to take off, so we got together less often.
With a specialism in the treatment of the mental and physical impacts of trauma under my belt, primarily in the military sphere, I returned to active duty. I ended up as the head of the medical facility for US Central Command and US Special Operations Command at MacDill Air Force Base, on Florida’s Gulf Coast.
Embedded within the hospital was what I like to think is now one of the premier trauma units in the country, so when I first got the call from Reuben, I wasn’t wild about the idea of coming back to Washington. I wasn’t wild, either, about working for the President.
Thompson is young, moneyed Texas, clever and unblemished by scandal. He speaks eloquently, and has a picture-perfect family.
His wife, Jennifer, is a strikingly beautiful and successful attorney and a former human rights lawyer. She is intensely proud of her African American roots. Their three kids – five, eight and ten years old – are so stereotypically cute and well mannered they could have won Thompson the election on their own.
It wasn’t hard to see what those who’d voted for him had bought into: the promise of a better world, a world without division.
But for my money, and evidently a fraction under half the country’s voters, there was something a little too slick about Bob Thompson.
So, to begin with, I said no.
Reuben flew down to see me, drove me out to a secluded beach somewhere south of the base, and in the course of a long walk, told me about the breadth of Thompson’s ambition and what he wanted to achieve. The dreams, he said, threatened to derail it all, and there was no one else – no one – he could trust to see Thompson, to examine him, and not have it leak.
‘See him, Josh, see him once, and offer him the benefit of your advice. Of all people, I understand what you had in D.C. – what you had and lost. But it’ll only be for a day. Two at the outside. Then you’ll be back on a plane and back with your patients.’
So, I flew up, only for a day – two at the outside – to see Thompson; to give him – to give them both – the benefit of my advice.
‘One man’s paranoia is another man’s due caution’ remains a particularly helpful adage for anyone in Washington with political ambition, but I felt the President’s increasing wariness was most probably adaptive: a means of coping. It wasn’t, in my opinion, evidence of anything pathological, like an underlying illness.
For a while, my diagnosis made the President feel better. I saw him breathe a sigh of relief when I told him this, and his health, according to Reuben, improved steadily from that moment.
Inside of two days, I was back with my patients in Florida and Thompson was soon pretty much back to his old self.
But while the nightmares diminished in frequency, they did not go away. And when they came for him, they were brutal.
Reuben flew to Florida to see me again and, after some back and forth, offered me a new deal. The incumbent White House Doctor, an Army brigadier-general who was coming up for retirement anyway, would be let go. If I’d agree to it, I’d replace him. There would be no fanfare; no approvals had to be sought; the appointment was entirely at the discretion of the President.
When I said no this time, he threw Iraq at me.
‘You and I do what we do because of what happened over there,’ he said. ‘Thompson is the real deal, Josh. I swear.’
Whilst campaigning, Thompson had vowed to do away with the machinery of what the previous president called the ‘deep state’ – that dark, unknowable part of government that exists below the waterline of accountability.
In Thompson’s eyes, especially since the war on terror, it had gotten out of control. He wasn’t against increasing military expenditure – but wanted to target the causes of conflict, rather than expanding the armory.
In the shadow of the dreams, however, Reuben noticed that Thompson had become increasingly wary of the people he needed to win over for his reforms to take effect.
The dreams seemed to come from a place of genuine fear.
Of our forty-something presidents, four have been assassinated. Almost a one-in-ten hit rate. Not good, statistically or personally.
I’d asked Reuben what exactly he wanted of me.
‘To be the President’s doctor, Josh – but also to be his eyes and ears.’
When I’d asked him if anyone else thought that Thompson was at risk of assassination, his answer came as a shock: his head of security, a long-time Secret Service veteran, White House Special Agent in Charge Jim Lefortz.
Reuben had worked with Lefortz on the campaign trail. Both ex-military men, they’d quickly forged a strong relationship. Thompson immediately bonded with him too.
After his wife and Reuben, Lefortz was the third person in whom Thompson confided about the dreams.
Christy Byford, his trusted National Security Adviser, was the fourth.
When I accepted the job, I became the fifth.
Reuben, Lefortz and I agreed we would pay special attention to any unusual threats so that if Thompson ever did ask, we could tell him we had them covered.
We’d labeled it No Stone Unturned.
Is Thompson the real deal? Is he, as Guido asked me, ‘a good man’?
I don’t know.
But his tapping into our code for the President’s illness demanded my strong attention.