ESSAY- White Tornado: Could John McCain have ADHD?

Cindy and John McCain at a campaign stop in Chesterfield, Missouri.

Impulsive. Easily distracted. Hot tempered. Gets into fights. Despite intellectual potential, does poorly at school. Sound familiar?

If this were your child or older brother, you would wonder if he had unrecognized and untreated Attention Deficit Hyperactivity Disorder, ADHD. Yet, when the individual in question is a United States senator running for the presidency, that possibility seems not to have been considered.

Last week, in a fit of fretting about the economy, Senator McCain suspended his campaign and attempted to cancel the first debate. 

 On Wednesday, September 17, he cancelled an appearance on David Letterman's CBS show Late Night and lied to Letterman about an immediate need to catch a plane to Washington.

He then trots off to be interviewed by Katie Couric. (Letterman later launched a devastating salvo which certainly negated anything the Couric interview might have gained.)

How sudden and thought-out were the senator's decisions?

Some say ADHD is just another over-diagnosed non-malady. Others celebrate it because along with impulsiveness come passion, creativity, and an ability to "think outside the box."

Four to 12 out of every 100 school children have it, and most carry it into adulthood.

The greatest Olympic athlete of all time, Michael Phelps, has it. Scientists such as Albert Einstein and Sir Isaac Newton, along with myriad famous actors, including the beloved Jimmy Stewart and Whoppi Goldberg, turned any alleged ADHD into careers of greatness.

But there's that impulsivity. 

"Mr. McCain is known to sign off on big campaign decisions and then to march off his own reservation," according to an August 10 New York Times article. "Out of his hearing, Mr. McCain is called the White Tornado by some people who have worked for him over the years."

Hectic campaign or residual childhood malady?

"McCain frequently forgets key elements of policies, gets countries' names wrong, forgets things he's said only hours or days before, and is frequently just confused," writes Frank Rich August 17, in which he explains why the McCain campaign has stopped the press's previously unimpeded access to Senator McCain on the formerly free-wheeling "Straight Talk Express" campaign bus.

Rich also quotes Rita Hauser, who served on the Foreign Intelligence Advisory Board in the Bush administration's first term. "If John says ‘I'm going with so and so,' you can't count on that the next morning."

Such stories may be typical of the rough-and-tumble dialogue of the political year, but they also raise the question of undiagnosed and untreated disorder.

The handbook of the mental health profession, The Diagnostic and Statistical Manual of Mental Disorders, notes the main symptoms: difficulty sustaining attention and failure to listen, to follow through, and to organize tasks.

Hyperactivity symptoms include fidgeting, excessive talking, and a personality often "on the go" as if "driven by motor." And the symptoms of impulsivity include interrupting and blurting out answers before questions have been completed.

This is a difficult diagnosis to establish in an older adult, and one cannot make the diagnosis without examining the individual and if possible talking to his family.

We know that McCain showed remarkable fortitude in surviving the repeated tortures inflicted by his North Vietnamese captors. But we also know he had a low class rank (894 of 899) at the Naval Academy, and he reportedly excelled in only those classes that interested him.

In his acceptance speech at the Republican national convention, McCain said he liked to "pick a few fights for the fun of it." Michael Leahy's August 31 profile of Senator McCain's formative years in The Washington Post opens with an account of a McCain fight in a park near Georgetown.

Leahy notes that McCain's grandfather, John Sidney "Slew" McCain, had struggled during his own Naval Academy years, as had McCain's father, John Sidney "Jack" McCain, Jr.: "He had been plagued by the same poor academy standing, made worse because of his prodigious appetite for rakish rule-breaking, a risk compounded in Jack's case because he was partying and drinking during Prohibition. Few fathers and sons could have been more alike as adolescents than Jack McCain and John Sidney III. Youthful rebellion seemed encoded in their DNA." 

With a large genetic component, ADHD is found primarily in males.

Perhaps frustrated by not being able to select friend Joe Lieberman as his running mate, McCain made the seemingly impulsive decision to choose Governor Sarah Palin as his running mate. He'd met Palin once. No McCain staff checked with anyone in the Alaska State Legislature or business community. There was no FBI background check.

Now the Couric interviews of Governor Palin reveal what many suspected. This hockey mom vice presidential candidate might actually believe she has foreign policy qualifications because her state borders on two foreign countries and she can see Russia from her coastline.

What about the current economic hurricane? On September 15, Senator McCain said, "The fundamentals of the economy are strong." Yet, that day the Dow nosedived 500 points. In Cedar Rapids, Iowa on Sunday the 21st, his proposed fix was to announce that if he were president, he would axe the chairman of the Securities and Exchange Commisstion. There is a small problem. The president does not have that power.

The next day, September 22, he claimed he had laid out his plan to Treasury Secretary Henry Paulson and had been "looking at the plan that the administration has put forth." On Wednesday the 24th he conceded, "I have not had a chance to see it [the administration's three-pager] in writing." And, then he suspended his campaign.

"The more one sees of his impulsive, intensely personal reactions to people and events, the less confidence one has that he would select judges by calm reflection and clear principles, having neither patience nor aptitude for either." That came from conservative columnist George Will on September 23.

Yet no one connects the dots.

The next president must immediately confront enduring wars in Afghanistan and Iraq, covert wars in Pakistan, Georgia, Africa and elsewhere, radical Islam on innumerable fronts, Putin's belligerence, dangerous epidemics, global warming, a crippled United Nations, and on the home front a health care crisis with forty million uninsured, the deterioration of public schools, failures of energy policy, and a decaying infrastructure. That is the short list. There will be more on the next president's plate come January. 

 Some might celebrate an ADHD president. He might pursue new ideas– perhaps novel solutions to the financial crisis or creative ways of dealing with an ascendant China. On the other hand, America has already received international scorn for unilateral military action. Is impulsiveness a good trait for someone with his hands on nuclear launch codes?

In his 2002 memoir Senator McCain said, "Often my haste is a mistake, but I live with the consequences without complaint." Can we?

The author is a psychiatrist and an Obama/Biden supporter.