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The sicknesses of leaders have always been troublesome variables in world affairs, giving rise to some of the more tantalizing hypothetical questions of history. What if Alexander the Great had not gone on a three-day binge of eating and drinking in Persia in 323 B.C.? That overindulgence may have hastened his death at the age of 33. Would he have completed his conquest of Asia Minor and founded a more durable empire? There are historians who theorize that if Napoleon had not been suffering from hemorrhoids and insomnia at Waterloo, he would have had the presence of mind to prevent Field Marshal Blücher's retreating Prussians from joining forces with the Duke of Wellington's English army. Napoleon might then have won the battle and changed the course of the 19th century.
As longevity has increased, the leadership of nations has fallen more and more to old men, whose experience tends to be inversely proportional to their physical vigor and sometimes their mental acuity as well. Decrepitude is particularly an occupational hazard of autocrats and leaders of authoritarian regimes. For many, their first choice is immortality. Failing that, they aspire to dying with their jackboots on and being interred in marble mausoleums.
There certainly is nothing new about the almost pathetic spectacle of an infirm Soviet leader clinging to power rather than wielding it. In Vladimir Lenin's last years a series of strokes partially paralyzed both his body and his ability to act decisively. Lenin's incapacity contributed to the rise of his successor Joseph Stalin. At the end of his life Lenin, who had been so ruthlessly effective in his prime, was reduced to whining about Stalin's "rudeness" and "suggesting" that his comrades on the Politburo remove Stalin from the post of Party General Secretary.
Stalin's own dotage and death in 1953 were marked by a macabre irony. His last purge was to have been a mammoth pogrom. The pretext was the spurious charge that the Kremlin doctors, most of them Jews, were poisoning political luminaries in their care. In his terminal paranoia, Stalin came to believe in the plot and suspected that his personal physician was a British agent. As blood vessels began to burst inside his own brain, plunging him into a prolonged agony, the dictator would not let any doctor near him on his deathbed.