hyperthyroidism do not make decisions as well as they would normally." "An important question,"
wrote Altman, "is when Mr. Bush's case of Graves' disease began." One way to shed light on thisquestion would be to test stored blood samples that Bush's doctors would routinely keep. But the
Secret Service has a policy of destroying all such specimens for security reasons! According to Dr.
Andre Van Herle of UCLA, among patients suffering from hyperthyroidism, "some are not
disturbed at all; others are basket cases." Altman elaborates that
people with hyperthyroid conditions can exhibit uncharacteristic behavior like showing shortened
attention spans, making snap decisions, behaving frenetically, and tiring more easily than usual.
People have been known to inexplicably get married or divorced when such important decisions are
out of character. Students with overactive thyroids may be so jittery that they cannot sit through
class or they do poorly on examinations.
The worst form of hyperthyroidism, known as thyroid storm, can be charctarized by fever, marked
weakness, muscle-wasting and psychosis. Mr. Bush's doctors have described his case as mild, and
never near thyroid storm.
According to Dr. Peter C. Whybrow, head of the department of psychiatry at the University of
Pennsylvania, mild depression can be an initial symptom of hyperthyroid disorder. People with
overactive thyroid glands "don't perform quite so well," in his view. "They feel, for reasons they
cannot explain, a little agitated, a little preoccupied with themselves, jumpy. Their concentration is
a little off." According to Altman, "some experts have raised the possibility that Mr. Bush couldhave had a mildly overactive thyroid in the 1988 Presidential campaign, or even earlier." Any
normal medical checkup administered by a private doctor would have detected Bush's thyroid
ailment through a $20 blood test that is done automatically unless it is specifically ruled out by the
physician in advance. [fn 39]
These views were supplemented by a piece in the Washington Post by Abigail Trafford, the editor
of that newspaper's weekly health supplement, who was herself a victim of Graves' disease. Ms.
Trafford warned her readers of "the bad news: It is difficult to live with and adjust to Graves's
disease. What's missing in all the upbeat press releases from the White House is the powerful
emotional impact the disease has on many patients and the effects of hypebehavior, and judgment. And while Graves' is, indeed, curable, it can take months, sometimes years,rthyroidism on mood, (^)
for people to get their thyroid function back to normal." Joshua L. Cohen, assistant professor of
medicine at George Washington University, told Ms. Trafford that "Graves' disease strikes on a
psychological basis and it strikes a population that is not used to the concept of being sick."
According to Washington endocrinologist James N. Ramey, "There's no question that the emotionsare severely out of whack." Terry Taylor, acting chief of endocrinology at Georgetown University
Medical Center described Graves' patients: "Emotionally, they can be feeling very good and then
very bad. There are a lot of ups and downs....They cry at TV ads.""It takes several half-lives to get
the thyroid level in the blood down." Therefore some patients take three months to feel like "their
old selves," and some take a year. Ms. Trafford recalls that on August 10, 1990, duriweek, of the Gulf crisis, when Bush left for his summer vacation in Maine, he was heard to say: ng the first
Life goes on. Gotta keep moving. Can't stay in one place all the time. [fn 40]
According to the Textbook of MSuddarth, hyperthyroidism "may appear after an emotional shock, nervous strain, or an infection --edical-Surgical Nursing by Lillian Sholtis Brunner and Doris Smith
but the exact significance of these relationships is not understood." According to these authors,
"patients with well-developed hyperthyroidism exhibit a characterstic group of symptoms and signs.
Their presenting symptom is often nervousness. They are emotionally hyperexcitable; their state of
mind is apt to be irritable and apprehensive; they cannot sit quietly; they suffer from palpitation;