By getting ill when he did, and how he did, the President not only exposed the entire nation to the trauma of a Head of State being unwell, but also exposed both the government and the PPP public relations apparatuses as incapable of handling any emergency. President Asif Zardari also raised old spectres, of sick Heads of State and of the crises surrounding them. That the illness remains indeterminate shows that there is still a tendency towards secrecy prevailing in Islamabad, which bodes ill for the future, and which has resulted in current problems. This refusal to face facts is distressing, and is rooted in a culture where illness is not discussed. This may well date back to the days when a fever might kill a person, but this is not the age of malaria, but dengue. The initial speculations were that the President was not ill, but had left the country on grounds of ill health, and his resignation would soon follow. That did not happen, and the presence of son Bilawal in Islamabad did not allay the rumours, though it should have. It is not enough to dismiss the rumours as the result of wishful thinking. No one wants the Head of State out of the way, unless he has failed to become the head of the entire State and the government is thought to have failed in its primary duty of looking after the affairs of the people. Zardari has failed on both counts. The rumours were the most harmful, for they belittled an illness that were more likely than not to strike at presidents. After all, presidents are men of advanced middle age, sometimes old age. Zardari is 58, which makes him about par for a President of Pakistan. Military rulers tend to be a little younger, but as the last two examples have shown, by the time one has climbed the military ladder to the post of Army Chief, one is usually in ones 50s, and becoming military ruler only comes after that. Though military promotions are supposed to depend on fitness, the tragic example of General Asif Nawaz, who died of a heart attack in mid-term shows that the system can be beaten. Of the two military rulers since this monitoring for heart disease was made universal, neither suffered heart disease in office, an indication that the system worked. However, when selecting the President, health is so low a priority as to be non-existent. This might be because healthcare is now so advanced that health problems afflicting the aged can be put off, detected and treated, but it was well known that the President had cardiac problems requiring stents to be placed. Health did not become an issue even though stenting had taken place well before he ran for President, and it could hardly be claimed that he hid his cardiac problem. Yet, he was selected mainly because he had put himself forward while PPPs Co-Chairman, thus virtually ensuring that no one else would run from his party. His health did not even come under discussion at the time. It also was not examined at the time of his becoming party Co-Chairman, though it probably should have. Asif Zardari is reported as suffering a stroke, which is a sort of brain attack that makes the mind go immediately to his father, Hakim Ali Zardari, who suffered a brain haemorrhage and died only this year. As there is a hereditary factor involved, this would make the President prone to them, as it should be remembered that the attack could affect the brain and heart as both are part of the same cardiovascular system and thus a weakness in one means that the other is at risk. Another prospect that has been mentioned is that the President suffered an attack as a result of bipolar disorder. Though he presented a medical certificate from a psychiatrist in a British court and thus avoided trial, his mental health was not an issue in his presidency, because it was assumed widely that the medical certificate was a fake meant only for the court. However, apart from that, the reminder given by a stroke took one back to Governor-General Ghulam Mohammad. He had already suffered a stroke as Pakistans first Finance Minister, but the decline he suffered in the four years he was in office ultimately meant his death in 1956 - a year after he had resigned because of another stroke. Ghulam Muhammad had all the popular symptoms of a stroke, including an incomprehensibility of speech that could only be fully understood by his Secretary. Another President whose illness proved a precursor for his departure was Field Marshal Ayub Khan. Beset by protests, and after meeting the combined opposition, Ayub had a heart attack. After he survived it, he resigned, but before that the country was told he was recovering from flu. This resignation should have meant that the Speaker of the National Assembly, an East Pakistani, would have become President, but instead Ayub called in the army, which imposed martial law. Ayubs replacement, Yahya Khan, presided over the first general election the country ever had, as well as over the secession of East Pakistan and the creation of Bangladesh after the defeat there, and overall in the 1971 war. After that he resigned, and died in 1980 of heart disease. It is worth noting that Pakistans first two military rulers suffered from heart disease. But it deserves noting that heart disease is not necessarily caused by strain. If that was the case, Yahya should have, but did not. The defeat hardly gave him heart disease, for it had been developing over years since his youth, and had to do with his lifestyle and diet. As cardiologists say: Too often, the first symptom of heart disease is a fatal heart attack. However, the strain question is relevant. The President must have found himself under strain because of the Memogate scandal, as well as the Salalah checkpost shooting. Both involved the military, and the Americans. Normally neither would bother the President, but this President, being Co-Chairman of the party in office, was not just a Head of State, but a quasi-head of government as well. The Memogate scandal, in particular, showed that the President allegedly was so much in charge of the policy towards the USA that the Ambassador to Washington was his man more than the governments. However, apart from Memogate, the Salalah checkpost killings prevented him from keeping up with the policy that he has followed ever since becoming head of the party, that of doing whatever the Americans want. It is to be assumed that the President has a number of lessons driven home to him by this episode. But apart from whatever reminders of his own mortality that he has had to face, there are the public lessons. The first is of the need for a proper mechanism, both official and party, to deal with the publics right to know about any life-threatening illnesses that might threaten the holders of high office. It is not just the President or the PPP Co-Chairman, who is in question here, but also the Prime Minister and the candidates for that office. Here we have Mian Nawaz Sharif, whose father not only died of heart disease, but who himself recently had a serious heart ailment while Imran Khan not only had a father who lived to a ripe old age, but a mother who died of cancer, a heritable disease, apart from providing him the motivation to build a cancer hospital. The incumbent, Yousuf Raza Gilani, is actually older than the President, at 59. Both history and age dictates that there should be a mechanism. The country deserves as much. The writer is a veteran journalist and founding member as well as Executive Editor of TheNation. Email: