Is Blair suffering from PMS?

Traditional history portrays Henry VIII as the ideal Renaissance Prince, who led successful military adventures abroad and smashed dissent at home. Ray Winstone’s turn as Henry on ITV1 in mid-October, however, presented the King as being steeped in the values of the culture of emotionalism, where the hero’s strong sense of agency is a sign of mental pathology. At least it wasn’t suggested that Henry’s death was stress-related….

After Henry VIII concluded, a news bulletin announced that our current leader, Tony Blair, was facing a ‘heart scare’ of his own. The facts of the matter have been well-aired: Blair felt unwell and experienced chest pains during the morning; initially he attended Stoke-Mandeville Hospital, from where he was transferred to Hammersmith Hospital; there he was diagnosed as suffering from an irregular heartbeat, for which he was successfully treated and discharged six hours later. More recently, former US President Bill Clinton has claimed that Blair confided in him about his ‘heart problems’ five years ago.

The whole matter seems trivial, both medically and politically – but the reaction from the media, MPs and from Downing Street itself deserves further scrutiny. From the moment the incident was announced, there was a flurry of speculation about whether it had been caused by the excessive demands of the job and whether Blair would be able to continue his Premiership.

Many reasons were given for why Blair might have been feeling stressed: an unpopular war on Iraq; the ‘sexed-up’ dossier on Iraq’s weapons of mass destruction; the subsequent failure to find any; the David Kelly affair and subsequent inquiry; and the loss of close political allies like Alastair Campbell. Others felt that even in a better year the pressures of leadership were difficult to bear. Veteran Labour MP Tam Dalyell said nobody should be allowed to be party leader for more than 10 years, because ‘the strain is too much’.

Downing Street was quick to quash suggestions that the PM’s health scare had anything to do with workload or the pressures of the job. Doctors were wheeled out to confirm the trivial nature of the complaint and the fact that it was not stress-related. The following day Blair returned to his duties with only minor changes to his diary.

The government was angered by the speculative furore in the media and Houses of Parliament – but perhaps it should consider the extent to which it has itself contributed to the heightened sense of physical vulnerability that currently pervades society. Dozens of health scares, from the dangers of mobile phones through to skin cancer from sunbathing, have given the impression that the human body is essentially frail. Not only are many of these health scares not refuted by government, they are actively amplified through health promotion campaigns.

At the current time, the government’s Health and Safety Executive (HSE) is developing a series of standards aimed at encouraging employers to tackle stress in the workplace. Other HSE documents have emphasised the relationship between work stress and heart disease. In the current climate, where stress is commonly perceived to be a cause of heart disease, it is hardly surprising that pundits should speculate as to whether this was the case with Blair.

What the pundits fail to recognise, however, is the subjective element in the transition from heavy workload, busy timetable, heavy responsibilities, to the experience of stress. The point was brought home in a Guardian article, which asked five celebrities to describe how they had changed their lives after a health scare (1). First up was veteran explorer Sir Ranulph Fiennes, who underwent a double heart bypass operation following a major heart attack. Fiennes described how his wife had spent three days watching surgeons attempt to revive him, and how the cardiologist had said that if he did come through he would probably have brain damage.

Yet just four months later, Fiennes was about to start the Land Rover 7x7x7 Challenge, which entails running seven marathons on seven continents in seven days. It’s tempting to conclude that Fiennes’ cardiologist must have been right about the brain damage – but Fiennes’ remarkable tenacity does reveal the highly subjective nature of stress appraisals.

The point was underlined by a second case: Liberal-Democrat MP Nigel Jones, who experienced two minor heart attacks in November 2002. ‘I had one tiny one where I was very ill for about an hour and I had another one when they gave me an angiogram…. My doctor told me if you have a heart attack you need six months to recover. I had two, so I’m looking at a year.’ The heart attacks caused Jones to reassess his working life and capacity for dealing with stress: ‘If I find myself getting in a stressful state or a little bit more agitated than normal, I think: “Should I be doing this? Or should I sit down for a bit?”’

The subjective aspect of stress appraisals depends not just on the personality of the individual, but on the social context. Long hours and a heavy workload may well feel wearisome if they are spent flipping burgers or answering the phone in a call centre, but if they are spent in shuttle diplomacy over the Iraq war or in trying to resolve the Irish conflict then they take on a wholly different meaning. Rather than indicators of alienation, they become the means by which the individual achieves fulfilment of his potential.

Even in these apolitical times, prime ministerial office represents the pinnacle of political power, enabling the incumbent to become actively engaged in the historical process. Blair is no more likely to experience something like the Hutton Inquiry as a stressor than Henry VIII was to be phased by the dissolution of the monasteries. PMS (Prime Ministerial Stress) is, therefore, a myth.

The exercise of state power may be more cumbersome under bourgeois democracy than it was under absolute monarchy, but it remains a life-affirming, self-realising act. Blair is more than capable of withstanding its demands and pressures. It is our own disengagement from practical political activity that explains much of the modern malaise.

David Wainwright is the co-author with Michael Calnan of Work Stress: The Making of a Modern Epidemic, published by the Open University Press, 2002. Buy this book from Amazon (UK) or Amazon (USA)

(1) Guardian, 21 October 2003