Following the publication of Michael Wolff’s book “Fire & Fury” — reviewed for Quadrant Online by Geoffrey Luck — there has been a cacophony of comment on the president’s mental state and whether Amendment 25 in the US Constitution can be applied to remove him from office. The amendment was instituted during the Eisenhower administration, the intention being to provide a mechanism for being rid of a president rendered incapable of governing. The example in mind was the severe incapacity of Woodrow Wilson from a stroke during his last years, his wife and doctor colluding to hide this from the government.
There are many examples of presidential mental states that led to concerns about psychiatric disorder; Richard Nixon and Ronald Reagan’s Alzheimer’s-afflicted final years in office being just two. In those cases, nothing was done and the fact remains that there has never been an attempt to remove a president on these grounds.
For those contemplating such action with the current incumbent, a look back in history at a baroque example will serve as a warning. The case concerns the monarchical defenestration of King Ludwig 11 of Bavaria and the Palatinate, known to this day as “Mad King Ludwig” (above). This is a startling tale of royal eccentricity and grandeur, venal relatives, penny-pinching bureaucrats and miscarriage of justice, to say nothing of broken medical ethics. Those studying the current White House will recall Marx’s dictum that history repeats itself first with tragedy, then with farce.
Ludwig was the splendid king of Bavaria. Influenced by Richard Wagner, he built a number of fairy-tale castles – Neuschwanstein, Herrenchiemsee, Linderhof, Nymphenburg and Hohenschwangau – for no purpose other than to meet his fantasies. His castle-mania drained the state coffers, causing much concern to the treasury and unpaid creditors escalated. His family, a Macbeth-like bunch, seethed with jealousy, resentment, intrigue and envy. To add to the problem, Ludwig queered the pitch with his rampant sexual exploits, rogering the stable men and guards in the royal barracks. His nocturnal sleigh-rides and opulent orgies with soldiers in artificial grottoes did not go down well in staunchly Catholic 19th century Bavaria.
By 1886, the anti-Ludwig forces had enough. Ludwig had to go. As assassination was no longer considered an acceptable way of solving problems of regal succession (there was too much of it occurring for unrelated reasons), a psychiatric solution was sought. The constitution provided for the king to be removed from the throne if it was determined he was not mentally fit to hold the position. After that, the details were suitably vague; neither were there precedents to consult.
As a posse of psychiatrists, two-thirds of them Democratic donors and ardent supporters of Hillary Clinton, pushes for Trump to be ejected from the Oval Office on grounds of mental infirmity, their campaign can be noted as an echo of that long-ago scheming in Bavaria. As far as his enemies were concerned, Ludwig had provided enough evidence that he was mad. He was flamboyant, erratic, failing to meet his obligations as a monarch and, of course, pillaging the treasury. His incessant fondling of strapping young men did not even have to be brought into it. A stage villain, Count von Holnstein, obtained a long list of complaints, anecdotes and gossip from royal servants. On a sliding scale of royal misbehaviour this was minor league stuff, compared to, say, most of the Romanovs and some of the Habsburgs.
Psychiatrists (or “alienists” as they were known in those days) – Professor Bernard Von Gudden, Drs Hubrich, Hagen and Grashey (Gudden’s son-in-law) – given the evidence of Ludwig’s unfitness to rule by the officials, signed a document approving his monarchical defenestration. Von Gudden was regarded as a leading psychiatrist – and German psychiatry at that time ruled the field. In their report of 8 June 1886, Ludwig II, king of Bavaria and the Palatinate, was declared incurably insane and permanently incapable of handling the affairs of state.
There is widespread agreement that the psychiatrists’ document was, by any standards, grossly unethical. The information they had been given about Ludwig was contradictory, inconsistent and could inspire multiple interpretations, and that is to say nothing of the likely bias of its sources and compilers. The king was never placed under observation and never subjected to examination by any member of the medical commission. The sole basis for the diagnosis was the reports from government circles and the sometimes grotesque statements made by the courtiers.
It was, in short, a right royal miscarriage of justice in which the psychiatrists were heavily implicated. A critic later referred to them as “medical hirelings”. Again, one should note this with interest considering those psychiatrists now publicly calling for Trump’s removal — an example of medical science prostituting itself in the name of partisanship so blatant that the American Psychiatric Association last week demanded that they keep their opinions to themselves.
The initial plan, carried out on the night of 9 June, was to seize Ludwig, intended to have him certified insane and placed under constant psychiatric supervision in an asylum. The plan miscarried because the king had the medical commission arrested and committed to jail. On the night of June 11 another attempt was made, this time successful. Ludwig was transported to Berg Castle on the shores of Lake Starnberg.
The next day it was decided to do what should have been done from the start: to have Ludwig examined by Von Gudden. At 6.30pm Von Gudden and the deposed king went for a walk around the lake, presumably to provide a calming, lacustrine background for a discussion that was likely to be anything but easy. The king’s attendants were told to follow at some distance to maintain their privacy. That was the last time they were seen alive.
The frantic search that night found Von Gudden’s body alongside the lake shore while Ludwig’s body was floating in the water. A very hurried post mortem, probably intended to hide rather than discover evidence, decided that Von Gudden had been first strangled and then drowned, followed by the drowning of Ludwig.
This may well be the truth but there were enough loose ends to leave persisting doubts as to how both of them had met their fate. Was Ludwig already mad, or driven to such despair at the unjust situation in which he found himself? We shall never know. One of the psychiatrists who signed the document expressed doubts about the diagnosis and another was not convinced of the king’s mental instability.
In the intellectual parlour game that psychiatrists so love, Ludwig racked up an impressive number of diagnoses including paranoia, schizotypal personality, meningitic brain damage, orbitofrontal lobe syndrome, schizophrenia, manic depression, and social phobia. It was an impressive tribute to the psychiatric imagination, to say the least. Regardless of his unethical behaviour (as well as that of his colleagues), Von Gudden did not deserve his fate. It remains therefore the only case in history where a king killed his psychiatrist.
And, after all that rather Roman excitement, Ludwig’s legacy is substantial. His romantic castles provide the state of Bavaria with a huge source of revenue from tourists, to say nothing of their reincarnation in Disney movies. Showing how history turns everything into kitsch, he is now commemorated with prominent portraits in Bavarian hotels and inns.
What do we learn from this tragic story? The removal of a leader from government on psychiatric grounds, unless virtually comatose, is riddled with problems and unlikely to succeed.
Let those who rush to psychiatric judgement on Mr Trump consider the story of King Ludwig and hold their fire. No good will come of it. Of doctors who perjure their Hippocratic oath in the service of the state there are sadly all too many, with more likely to follow in future. One only need to look at the Nazi ‘euthanasia’ practices to see how this can turn out. Let there be no more.
Robert M Kaplan is a forensic psychiatrist. His book The King who strangled his psychiatrist and other dark tales is in press.