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My first reading of When Illness Strikes the Leader was a wide-ranging exploration of the historical vicissitudes of a number of differently structured political systems—the democratic, the totalitarian (Fascist and Communist), and the Royalist—initiated by the illness of particular nation states' political leaders. The illnesses of the leaders were sometimes actual and sometimes confabulated physiological or psychological disorders of different degrees of severity and were responded to by the succession or replacement of the ill leader by opponents or supporters of the ill leader's political party or by the often opportunistic adherents of the leader's prevailing political thinking. There were no significant examples of a nation-state led by a female chief executive.
Clearly in most, if not every, situation, the leader's constituency was not openly informed of the actual state of the leader's health and of his consequent incapacity to continue to exercise power as the country's leader—and this secrecy existed both where the populace bowed silently to the leader's authoritarian directives and where the population exercised a long-standing and robust participation in the affairs of state. Neither the fact that the nature and severity of the leaders' illnesses differed; nor the type of economic or political system that existed; nor the length of time the leader was in power; nor the particular historical period during which the leader held power; nor the de jure or de facto nature of