Winston Churchill: acute ataxic stroke in June 1955 with excellent recovery

This article is in our series on Winston Churchill's illnesses

Introduction

At noon on 5 April 1955, Churchill held the last Cabinet meeting of his career, almost 15 years after the first Cabinet of his wartime administration and almost 50 years since he had first sat in Cabinet.¹ Churchill told the Cabinet that he intended to submit his resignation to Her Majesty at an audience that afternoon.¹ Anthony Eden, who was soon to succeed Churchill, spoke the valedictory words at the Cabinet¹:

The Foreign Secretary said that his Cabinet colleagues had asked him to speak on this occasion on behalf of them all. It therefore fell to him to express their sense of abiding affection and esteem for the Prime Minister and their pride in the privilege of having served as his colleagues… If in a succeeding Government they met with success, this would be largely due to the example which he had shown them: if they did less well, it will be because they had failed to learn from his experience and skill as a statesman. They would remember him always – for his magnanimity, for his courage at all times and for his unfailing humour, founded in his unrivalled mastery of the English language. They would always be grateful for his leadership, and for his friendship, over the years that had passed; and they would hope to enjoy in future his continued interest and support in their endeavours.¹

On the morning of 6 April 1955, Churchill received his last document at 10 Downing Street, a note written by Anthony Montague Browne (Private Secretary). That afternoon Churchill gave a tea party for about 100 staff at number 10, including the private secretaries, the telephonists, the messengers, the drivers – so that he and Lady Churchill could thank them before taking their leave.² Churchill was cheered away by his staff, who lined the long corridor leading from the Cabinet Room to the front door.² Churchill drove from Downing Street to Chartwell accompanied by Miss Elizabeth Gilliatt, his secretary since 1945.¹ ‘I was very sad. I had wished he could die in office,’ she later recalled.¹ Lady Churchill remained behind as she had many things to arrange.²

Methods

Information regarding Churchill's illnesses in 1955 was available from various sources. Foremost were those of Churchill's personal physician, Lord Moran,^3–5 and Sir Russell Brain, the eminent neurologist whom Moran consulted on multiple occasions regarding Churchill. By courtesy of the present Lord Moran and the Library at the Wellcome Collection, we have had access to his grandfather's original papers. However, permission to include information not previously in the public domain was not granted. The present Lord Brain (Michael Brain DM FRCP) has kindly allowed us to access and cite his father's clinical records held by the Royal College of Physicians. Mary Soames,² Churchill's daughter, added further details, as did Martin Gilbert (Churchill's main biographer),^1,6 Anthony Montague Browne (Private Secretary),⁷ John Colville (Joint Principal Private Secretary),⁸ Harold Macmillan (Foreign Secretary and future Prime Minister),⁹ Dr AL Rowse (historian and Sub-Warden of All Soul's College, Oxford)¹⁰ and Sgt. Edmund Murray (Churchill's bodyguard).¹¹

6 April 1955–11 April 1955: Chartwell

When Churchill arrived at Chartwell, there was a small crowd at the gates to welcome him back.² Mary Soames² wrote:

Christopher and I both dined with him; he was in quite good form, and messages were flowing in. So all had been accomplished with fitness – and, as Winston had said to a press reporter on the steps of Chartwell, ‘It's always nice to come home’.

On 7 April, Churchill began to work again on the 1939 proof sets of A History of the English-Speaking Peoples. Thus, within 48 hours of his retirement, he had found a new focus of activity.¹ Throughout 1955 Churchill's morale was much dependent on the History as Churchill told Moran on several occasions:

‘I’m interested in my book, that's all I care for now’ (17 June);³

‘Any fun I get now is from my book’ (17 June)³

‘Only my book commands my ability and my interest. All the rest is drudgery. I find the fifteenth century more interesting than the twentieth’ (21 November).⁴

The revision of the History depended principally on Alan Hodge (Editor of History Today) with Dennis Kelly (barrister and editorial assistant) chiefly responsible for retrieving and collating the various sets of proofs. Hodge recruited a series of outstanding historians, including Dr AL Rowse (see below), to work on the task.¹² The Preface of Volume 1, The Birth of Britain, was dated 15 January 1956.¹³

12 April 1955–20 April 1955: Holiday in Sicily

Then, on 12 April 1955, his sixth day of retirement, Churchill left Chartwell for a two-week holiday in Sicily with his wife. Churchill had declined Lord Moran's offer to accompany him to Sicily. Instead Churchill took two friends: Lord Cherwell (Professor Frederick Lindemann; ‘The Prof’), whom he had known for 35 years, and John Colville, who had been a member of his private office for more than eight years, latterly as Joint Principal Private Secretary.¹ While the main party travelled by air, Churchill's bodyguard, Sgt Edmund Murray,¹¹ and his valet, Jock Kirkwood, had to travel with the baggage by train via Paris and Rome, which took two and a half days.

Mary Soames² has written that her parents were away for a fortnight,

but for Clementine the holiday was a failure. She had little respite from pain [from neuritis], and in addition the weather was cold and grey. Although Chartwell and Hyde Park Gate were both at this moment uninhabitable because of alterations and decorations, she was only too glad to get back to England earlier than planned, and they both stayed for a short time at the Hyde Park Hotel.

Colville⁸ also described in his diary that it rained almost solidly for a fortnight. Churchill painted one of the caves and entertained Harry (Publisher of Time, Life, Fortune) and Clare Luce (US Ambassador to Italy), who arrived from Rome.⁸ Churchill and Murray¹¹ instructed Clare Luce how to paint. Colville⁸ wrote:

The Prof. [Lord Cherwell] talked much of the crying need for higher technological education and I volunteered to try to raise the money for a new institute or college, to be inspired and prompted by Winston. It was thus that Churchill College [Cambridge] had its origins. Our visit, intended for three weeks, was cut short because of the cold and wet and we came home about 20 April.

21 April 1955–2 June 1955: Fighting and winning the election at Woodford

While the Churchills had been away, the date (26th May) of the next General Election had been announced. Churchill threw himself into fighting for his seat and he also addressed a few meetings outside his constituency; one of them was in Bedford where he spoke for his son-in-law, Christopher Soames.² Churchill was once again elected (Figure 1) at Woodford by a large majority (15,808), and in the Country the Conservatives were returned with an increased majority (59 over all other parties) in the new parliament.

Figure 1.

Sir Winston Churchill salutes the cheering crowd which greeted his General Election victory at Woodford, Essex, where he retained his seat. Source: ©PA Images.

On 31 May, Churchill told Moran that he had spent three hours that morning working on A History of the English-Speaking Peoples. ‘Oh, it was simple, just rearrangement, and picking out an unnecessary passage here and there. It's thinking and composing I find difficult.’⁵ On 2 June, Churchill sent Alan Hodge and Dennis Kelly his thoughts and instructions about the first volume.

2–6 June 1955: Assessments by Lord Moran

Churchill telephoned Moran⁵ on the morning of 2 June and asked to see him. Churchill told Moran that after dinner with Christopher and Mary Soames the previous night, he had felt light-headed as if he had drunk too much, though this was not the case as his son-in-law, Christopher Soames, confirmed. Churchill explained that his head had ‘felt queer’ when they were at dinner. However, when he woke in the night, the light-headedness had gone, but in the morning his right hand was ‘clumsy’.⁵ ‘Twice I have knocked over my cup and upset the coffee.’ Churchill reached for his pen and wrote his name several times. ‘My writing is not good. I know that something has happened.’⁵ As he was speaking, his cigar slipped from his mouth. ‘Yesterday when I lunched with Max [Lord Beaverbrook] I kept dropping my cigar and Max kept picking it up.’⁵

Moran examined Churchill. When Churchill tried to touch Moran's⁵ finger with his right hand, he made a circle round it. Churchill had a good strong grip. When Churchill attempted to walk Moran was afraid that he might fall, his ‘right leg shot out unsteadily in the air, as if goose-stepping’. Moran⁵ told Churchill that there had been another spasm of an artery.

At the request of Lady Churchill and Christopher Soames, Moran⁵ accompanied Churchill to Chartwell and stayed the night. On arrival at Chartwell, Churchill rejected all attempts to help him up the steps. Churchill ‘made his way to the office in a succession of darts, bumping against the wall, first to the right then to the left, so that it seemed he must fall. In the office he flopped into a chair’.⁵

The following morning, Churchill was much better and again wrote his name out several times. While Moran was examining Churchill's signatures, his right arm ‘made a sudden purposeless and uncontrolled movement, upsetting the cup, so that his fingers ended in the coffee’. That night Churchill went to bed after taking a ‘red’ (quinalbarbital 100 mg) capsule and a ‘green’ one (identity not known), washed down with a little whisky.⁵

On the morning of 4 June, Churchill told Moran,⁵ ‘I think I am definitely better.’ Once again Churchill wrote out his name several times. ‘Yes, the first signature is almost normal. I am better, definitely better.’ Later in the day, while watching a film, Christopher Soames reported to Moran that Churchill had retired to his room because his heart was ‘pounding’. When Moran examined him, he found that his pulse was rapid and irregular. However, when Churchill woke up the following morning, ‘I felt master. I was on top. I was in good health again.’⁵

On 6 June, Churchill gave Moran⁵ one of his pictures and told him ‘it is wonderful that you have kept me going for so long’. Churchill was now sufficiently recovered that he made plans to see as much of Alan Hodge and Dennis Kelly as possible to move forward with A History of the English-Speaking Peoples. Churchill now reread chapter 7, which had lain unaltered for nearly 20 years, and he was not completely satisfied with what he read.

8–9 June 1955: Opening of Parliament

On 8 June, Churchill was well enough to be driven to London for the Opening of Parliament. On the following day, Churchill received rapturous applause both from Members of Parliament and the public gallery. Moran³ recorded:

Mr Attlee rose from his seat and, quickly crossing the floor, took Winston by the arm pushing him forward in front of him towards the table. Sir Winston must take the oath before him; while the whole House, seeing what was being done, rose to applaud…Then he [Churchill] signed the role of Members, writing his name for the thirteenth time in the roll of the Parliaments of Great Britain, very carefully, very deliberately – no doubt he had in mind what had happened at Chartwell.

Churchill took the place he had habitually occupied in the 1930s – the first seat below the gangway on the Government side.²

Churchill attended the Trinity House (a charity dedicated to safeguarding shipping and seafarers since 1514) Dinner that evening and the Other Club (founded by Churchill and FE Smith, subsequently Lord Birkenhead in 1911) Dinner on 9 June. On being asked by Moran³ how the dinner went, Churchill replied, ‘I don't think anyone noticed anything unusual…I’m not so well as I was before this happened. I wonder if I shall get back where I was.’ Moran³ recorded against an entry dated 12 June that Churchill had been dreading another stroke ‘almost from hour to hour’ and had wanted to see Moran every day. On this day Churchill proclaimed, ‘I’m writing better, much better. I think I’m over this turn.’³

15 June 1955: Assistance from Anthony Montague Browne

On 15 June, Churchill learned from Harold Macmillan (Foreign Secretary) that he could use the services of one of his former private secretaries, Anthony Montague Browne, who had returned to the Foreign Office. Macmillan wrote to Churchill¹⁴:

I have had a talk with Montague Browne and I am glad to hear he is being of service to you. Please make all use of him you can for as long as you wish…I leave tonight on the first lap of the great journey on which you started us [Meeting in New York to discuss the proposed Summit]. It is sad to think that you will not be at the ‘top level’ meetings yourself, but you have the satisfaction of being the pioneer. I have asked Montague Browne to show you one or two telegrams.

This was generous of Macmillan as Churchill had already summoned Montague Browne¹⁵ to help him at Lord Beaverbrook's villa, La Capponcina, at Cap d'Ail, before formal arrangements were made.

16–21 June 1955: Assessments by Lord Moran

On 16 June 1955, Moran found Churchill in the rose garden at Chartwell. ‘What is my pulse like? It was very quick yesterday afternoon.’³ Moran has not recorded an assessment in his published account. On 17 June, Churchill discussed his forthcoming speech at the Guildhall with Moran. Moran³ reassured Churchill that, ‘We'll get you through Guildhall without any trouble.’

Churchill had been invited to spend the weekend of 18–19 June at Hatfield House, the home of Lord Salisbury (Leader of the House of Lords). Moran recorded that Churchill had rather dreaded his visit to Hatfield, but it had been arranged that he should not get there till 7 o’clock on Saturday and return on Monday morning. That only left the midday hours on Sunday and with a ‘minor’ (amfetamine sulfate 2.5 mg, aspirin 160 mg, phenacetin 160 mg) Churchill expected to get through lunch. Churchill informed Moran³ on his return that he thought the weekend had ‘gone all right though he was walking badly’.

21 June 1955: Speech at the Guildhall at the unveiling of Churchill's statue by the Lord Mayor

On 21 June, Churchill gave a speech at the Guildhall when his statue was unveiled.¹⁶

I regard it as a very high honour that the City of London should decide to set up a statue of me in this famous Guildhall, which I have so often visited and spoken in during the last half century. I must admit that I think that the House of Commons has made a good rule in not erecting monuments to people in their lifetime. But I entirely agree that every rule should have an exception. The fact that you have done so in my case will both prove the rule, and emphasize the compliment. I greatly admire the art of Mr Oscar Nemon whose prowess in the ancient realm of sculpture has won such remarkable modern appreciation. I also admire this particular example, which you, my Lord Mayor, have just unveiled, because it seems to be such a very good likeness. But on this point, as indeed in any other part of this ceremony, I cannot claim to be either impersonal or impartial. I am indeed an interested and biased party… It is to the future that we must turn our gaze. I confess that, like Disraeli, I am on the side of the optimists… Whatever is the outcome, we must persevere in the maintenance of peace through strength… Let us go boldly forward and play our part in all this.

That evening, Churchill told Moran that his performance at the Guildhall had restored his confidence. ‘It was a formidable ordeal. Did you like my speech? It would be easy on such an occasion to say foolish, conceited things. I carefully avoided that.’³ After Churchill had explained to Moran³ that he had slept for more than an hour after his return from Guildhall, Moran commented for the published record that sleep did him almost as much good as a ‘minor’ (amfetamine sulfate 2.5 mg, aspirin 160 mg, phenacetin 160 mg).

22 June 1955: Assessment by Sir Russell Brain Bt

Brain assessed Churchill at the invitation of Moran at 9.15 am on 22 June. He learned from Churchill and Moran that two weeks ago (in fact it was three weeks previously on 1 June), while dining at Chartwell, on getting up Churchill felt as if drunk–swimmy. After this, Brain recorded, Churchill had difficulty in controlling his right hand, misjudged distances, and knocked things over. His writing got very bad and he became a bit unsteady on his feet. Moran stayed with him for five days and he had steadily improved. Moran said that his speech became worse at the time. He is still somewhat dysarthric, his speech not always intelligible. Otherwise, there was no change in his physical signs except that now both plantars were extensor. There was no ataxia, nystagmus, or new sensory loss. His gait was fairly good with an effort. He was said to be good in the mornings and unresponsive at lunchtime unless he took a ‘minor’ (amfetamine sulfate 2.5 mg, aspirin 160 mg, phenacetin 160 mg).

Moran³ also recorded this assessment by Brain. Churchill explained that three weeks ago ‘I bumped up against the wall. I thought I was drunk, but in the morning my writing was bad. I put my signatures in an envelope, but I have left it at Chartwell.’ Churchill reached for his pen and wrote his name several times and handed them to Brain.

This is like my normal writing, whereas that morning my hand lingered so that I upset things – I cannot sprinkle sugar as well even now. I wondered if it would get worse as in 1953, when I did things the day after my stroke, and I was not paralysed until the following day. But this time the other channels opened up. I'm getting rather good at that. And Charles watched me like a cat, day and night, for five days. I can walk all right if I set my mind to it. He flung off the bed-clothes and stalked across the room. Then he stood and lifted first one leg and then the other. I'm still not very steady.³

Moran³ recorded that Brain made a careful examination, then sat back in his chair and said nothing. ‘Charles is right,’ Brain said at last. ‘It was a spasm, and now the artery has opened up again. I see no reason why you should not in a short time be as good as before.’³

‘You mean before I resigned?' asked Churchill.³

Of course, putting down responsibility is a very relaxing affair. My whole psychological position had to be changed. After my return from Sicily I had to begin my election address. The quality of thought, such as it is was, was not diminished, but I had become very slow. I got it out all right in the end, but I dislike original composition. I am not ambitious any more. I really want not to make an ass of myself. I began my Guildhall address on Monday. I did 300 words in the car coming up from Chartwell, another 300 between 10 o'clock and midnight. In the morning I finished it off only just in time. My bad time is from noon until 4:30. I am embarrassed by the midday blur.³

Churchill went on to complain of his poor memory, particularly for names. He looked at the glass of whisky by his bed. ‘I keep it by me all day. Oh, it is only weak, and I only sip it. It is more a companion than a stimulant.’³ Brain listened attentively to Churchill's story but offered no comment, according to Moran.³ ‘Winston waited impatiently for suggestions, but they did not come. He told Brain the whole story that he might get his help. He wanted to be told that his mind was not giving way. He wanted to do something.’³ Brain said, ‘There is nothing I can add to the treatment.’³

Moran³ summarised Brain's assessment as follows:

Brain is an honest man, he has no patter. He told me, when I saw him to the door, that he noticed Winston a good deal changed. But of course he had not seen him for a year. There was really nothing to be said. He did not try to say comforting things. He would be more popular with Winston if he did.

Brain¹⁷ was offended by the two comments made about his seeming failure to communicate adequately with Churchill. These observations were disturbing to Brain¹⁷ as he thought that if Moran's book was widely read, the comments might be detrimental to his clinical practice. Legal advice was sought, but wisely the issue was not pursued.¹⁷ Although Brain's¹⁷ son concluded that the remarks about the lack of patter rang true, he considered their publication showed a gratuitous insensitivity to the feelings of a loyal and very supportive colleague.

30 June 1955–15 August 1955: Visit of Dr AL Rowse and further assessments by Lord Moran

On 30 June, Churchill wrote to Macmillan, ‘AMB [Montague Browne] is a great help to me in my official and semi-official aftermath.’

Moran³ assessed Churchill again on 6 July. ‘My mind works as well as ever, but I dislike the effort when I have to use it’ Churchill told his doctor who thought this statement was ‘generous’.³ Churchill told Moran³ that he was spending four or five hours a day on corrections and alterations to the History. Moran³ noted in his records that he must ask Hodge whether this involved ‘mental effort’. As Moran³ was leaving, Churchill told him that two of his fingers had gone numb before he went to bed. ‘It doesn't mean anything, Charles? I’m not going to have another stroke… Tomorrow Henry Luce's people will be here about business in connection with the book. I want to be in good form.’³

Rowse¹⁰ has written of an encounter with Churchill on 11 July at Chartwell.

Before lunch I was summoned up to his bedroom, and there, and last, was the so familiar face, much aged: that of an old man who gone back to his baby looks. The eyes a cloudy blue, a little bloodshot, spectacles on snub nose, a large cigar rolled round in his mouth. He had been at work. ‘I like work’. Beside the bed a small aluminium pale for cigar-ash; before him, stretching right across the bed, a tray-desk on which were the long galleys of his History of the English-Speaking Peoples.

Churchill welcomed Rowse with a touch of old-fashioned exaggerated courtesy as if the honour were his that the professional historian had come to see him. Rowse¹⁰ returned the compliment by stating that Churchill had beaten the professionals at their own game, that his Marlborough was an historical masterpiece along with Trevelyan's Age of Queen Anne. Churchill said that now that he had some time, he was rereading the History he had written before the War, but he wasn't satisfied with it.¹⁰ Rowse then read the revised chapters on Henry VII and Henry VIII while Churchill got dressed. ‘The figure all the world knew then entered: striped blue zip suit, blue velvet slippers with WSC worked in gold braid, outwards, in case anybody did know who was approaching.’ Over lunch, Churchill told Rowse¹⁰ of the severe stroke he had suffered, so that he couldn't feed himself – and yet managed to hold onto office.

On 13 July, Churchill sent a specially designed silver V-sign to 113 former members of his staff and the establishment at 10 Downing Street, including the cleaners, electricians, telephonists, messengers and carpenters. The recipients also included Colville, who wrote on 17 July,

I treasure the silver V-sign, commemorating your Second Administration, and am placing it on my watch chain as an object to be very especially prized. I hope that during the last week of July or at any time in August you will let me know if you feel the need of either companionship or Bezique, and I will be at your disposal.⁶

Churchill attended The Other Club dinner on 14 July from 8:45 to 11:45. Although most of the diners had left by then, Churchill stayed to the end. ‘There was some good fun. I got home [Chartwell] at a quarter to one, tired but not unduly tired.’³

President Eisenhower wrote to Churchill on 15 July:¹⁸

Dear Winston

Soon Anthony [Eden] and I will be meeting with the French and the Russians at Geneva… Personally I do not expect, and I hope the people of this country and of the world do not expect, a miracle. But if we can inch a little closer to the dream that has been yours for these many years, if together at the meeting table we can create a new spirit of tolerance and perhaps, in concert, come to the realization that force and the threat of force are no longer acceptable in dealings among nations, we shall gain much that will help us in the long and complicated process that must come after the Summit meeting. As I leave Washington, my thoughts are with you…

Churchill replied by return on 18 July:¹⁹

My dear friend

I am deeply grateful to you for your letter and the thought that prompted you. I was touched by what you said when I resigned, and I had two of your letters with me at the time which I had not answered… It is a strange and formidable experience laying down responsibility and letting the trappings of power fall in a heap to the ground. A sense not only a psychological but of physical relaxation steals over one to leave a feeling both of relief and denudation. I did not know how tired I was until I stopped working. I cannot help, however, feeling satisfied with the way things have turned out…

August 1955: Macmillan visits Chartwell and arranges for Montague Browne to be seconded full-time

Macmillan⁹ wrote in his diary on 5 August:

I made a pilgrimage to Chartwell where I found Churchill alone. He was very grateful for the smaller attentions which I been able to show him. Montague Browne goes to see him two or three days a week. He helps him with his immense correspondence and also brings a selection of foreign telegrams for him to see.

Macmillan reported to Moran at lunch on 10 August on his conversation with Churchill. ‘Of course Winston is older but when I took the conversation back to Lloyd George his memory was surprisingly good.’³ Macmillan asked Moran³ how long Churchill would go on like this. Moran replied that was guesswork.

On 12 August, Moran visited Churchill at 6 o'clock in the evening. Although Churchill had just gone to bed, he had spent the day painting a portrait of Lady Churchill from a photograph taken 20 years previously.³

Moran³ visited his patient again on 14 August and found Lady Violet Bonham Carter (longstanding friend and daughter of the Prime Minister, Herbert Henry Asquith, at the time of Churchill's close association with him) was staying at Chartwell. She told Moran that she was shocked by the deterioration in him. She had made a point of speaking about the past, but all Churchill said was, ‘I can't remember.’³

Macmillan wrote to Montague Browne¹⁵ in early August 1955:

Many thanks for your note of August 2. I dined with Winston on Friday night [5 August 1955]. I thought him in good form – better than I expected. He is extremely grateful for all the work you gave him, and I hope you will be able to go on doing so… I do not know what you are doing for leave, but if you are in the Foreign Office on Monday, August 15, you might look in for a moment and see me.

The Foreign Secretary told Montague Browne:¹⁵

Winston needs you. He's going to travel extensively and as you know he is already deep in correspondence with Ike, with Adenauer, de Gaulle and I don't know who else. Moreover, the Middle East Department is not one that one can flit in and out of like a weekend cottage – I know it's not your fault. So I'm going to second you to Winston. You will continue to be a full member of the Service, and will pay you as before. Winston will reimburse the Treasury. In the nature of things it will be two years at the most.

In fact, for nearly another 10 years Montague Browne was to be Churchill's constant and devoted private secretary to the very end.

7–27 September 1955: Presentation of the portrait of Sir Winston Churchill as Warden of the Cinque Ports and his holiday in the South of France

On 7 September, Churchill spoke at the presentation of his portrait by Bernard Hailstone as Lord Warden of the Cinque Ports in Hastings.²⁰

I take great pride in holding the office of Lord Warden of the Cinque Ports. When you approach the end of a long life there is a comfort in looking back on the past, and belonging to an institution of such age and dignity… I am most grateful, Mr Speaker, for your many compliments. It is quite true that I was called upon to play a part in the War, and, oddly enough, that this entailed many visits to the Cinque Ports… We now have to look forward, and not back we now have to think of the perils of the future, and not those of bygone years…

On 15 September, Churchill travelled to the South of France to stay at Lord Beaverbrook's (Lord Privy Seal 1943–1945 and newspaper proprietor) villa, La Capponcina at Cap d'Ail, across the bay from Monte Carlo. Churchill was joined there by Lady Churchill, daughter Mary and son-in-law, Christopher Soames. He painted in the warm autumn sunshine and wrote to Moran on 26 September as follows:

My dear Charles

I have been very well, and lived an idle life except at the Book and painting. I have taken one minor so far since arriving, in two parts. Memory lags and tickles tease. I eat, drink and sleep well. I am sorry about Ike. He will be a great loss.²¹

Although President Eisenhower had suffered a myocardial infarction on 24 September 1955, he lived until 1961. Moran wrote to Churchill in response, ‘I was most delighted to hear from you and to get such an excellent report. It is most encouraging…If I were in Ike's shoes, I should count it no more than a provisional notice to quit.’⁶

On 6 October, Churchill wrote to Beaverbrook:

‘My dear Max

We have had a very pleasant three weeks here, and Clemmie is better. The chef is excellent, the garden lovely. I have painted another picture, and so far I have not spoiled it, which is something…'⁶

November–December 1955: Speeches and memory loss

Following his return from France on 15 November, Churchill had speeches to prepare for his Constituency (18 November), Harrow School (24 November), the Young Conservatives (5 December) (drafted by Colville), Drapers Hall (7 November) and the Mansion House dinner (16 December). Yet, on 13 December, Churchill told Moran, ‘I keep losing my memory. I could not remember Anthony's [Eden] name today. And now I have forgotten the name of Sir…’⁴

Churchill celebrated his 81st birthday on 30 November.

Churchill's doctors

Sir Russell Brain Bt (1895–1966)

Russell Brain (Figure 2) was a Consultant Physician at the (then) London Hospital and the Maida Vale Hospital for Nervous Diseases. Brain¹⁷ earned his living primarily from his private practice and as the author of Diseases of the Nervous System, Clinical Neurology, and other medical and non-medical books. He was President of the Royal College of Physicians from 1950 to 1956, succeeding Lord Moran.^22,23 Brain had assessed Churchill previously at Moran's request on 5 October 1949, 15 October 1949 and 8 December 1949 following Churchill's first stroke²⁴ and on multiple occasions in 1950–1952 for further episodes of cerebrovascular disease²⁵ and in June 1953 after Churchill's second stroke.²⁶

Figure 2.

Sir Russell Brain and Lord Moran. Source: © Alamy E0W4XR.

Brain was knighted in 1952, made a baronet on 29 June 1954, and on 26 January 1962 was created Baron Brain of Eynsham in the County of Oxford. In March 1964, he was elected a Fellow of the Royal Society.

Lord Moran (1882–1977)

Charles Wilson (Figure 2) was appointed Dean of St Mary's Medical School in 1920, a post he held until 1945. He became Churchill's doctor on 24 May 1940 and remained his personal physician until Churchill's death in 1965.²⁷ He treated Churchill for chest pain in December 1941 in Washington,²⁸ for pneumonia in London in February 1943,²⁹ for pneumonia and atrial fibrillation in Carthage in December 1943,³⁰ and for pneumonia in London in August 1944.²⁹ Moran also treated Churchill in 1949 when he suffered his first stroke²⁴ and was primarily responsible for managing the further episodes of cerebrovascular disease in 1950–1952,²⁵ as well as his second stroke in 1953²⁶ and Churchill's recovery from it.³¹

Wilson was knighted in 1938, created Baron Moran of Manton in the County of Wiltshire in 1943 and was appointed Treasurer (1938–1941) then President of the Royal College of Physicians of London (1941–1950).²⁷

Discussion

Churchill clearly suffered a further stroke on 1 June 1955. His symptoms of light-headedness, followed within hours the next morning by clumsiness of the right hand and poor writing, together with Moran's examination findings on 2 June of target imprecision of the right hand in the absence of weakness, ataxia of the right leg and gait ataxia suggest an acute cerebellar infarct.

Brain did not see Churchill until 22 June 1955, three weeks following the onset of the stroke. Brain had not assessed Churchill since 25 August 1953, almost two years previously, when Churchill was recovering from his acute left hemiparesis.²⁶ At their consultation on 22 June 1955, Churchill told Brain that his speech had also been affected at the onset and that his gait was still not very steady. Brain found that there was dysarthria, his gait was ‘fairly good with an effort’, and both plantar responses were extensor. No other abnormal signs were recorded, but this examination took place three weeks following the onset of the stroke, by which time the neurological deficit would be expected to have improved. Indeed, there had been steady improvement during this period, as documented by Moran. Churchill was able to return to editing his book by 6 June 1955, and he was well enough to make a speech at the Guildhall on 21 June 1955.

Brain does not suggest a localisation for this stroke and indeed, his clinical note for 22 June 1955 is fairly brief. However, the dizziness, dysarthria, limb and gait ataxia, in the absence of limb weakness or focal brain stem signs, suggest that this was a cerebellar stroke, most likely an acute infarct. There were no clinical features to indicate that this was a cerebellar haemorrhage. The persistent dysarthria and gait ataxia, when the right limb ataxia had resolved, suggest a predominantly centrally placed cerebellar lesion, but also affecting right cerebellar hemisphere function, though nystagmus was not recorded at any stage.

However, an alternative anatomical localisation of Churchill's acute ataxia was a deep lacunar infarct in the pons or internal capsule, producing a so-called ataxic hemiparesis, a syndrome originally described by Miller Fisher in 1965 and more recently reviewed with clinical and radiological correlations.³² Features of a lesion in one of these extra-cerebellar sites include dysarthria, limb ataxia (features that were present in Churchill), nystagmus (in pontine lesions), contralateral facial weakness and occasionally ipsilateral hemisensory loss involving the face, body and limbs (features that were not present in Churchill). Taking all this into consideration, but of course without the benefit of either CT or MRI at the time, we conclude it is more likely that Churchill's acute presentation was the result of an acute cerebellar infarct. The prodromal light-headedness would perhaps also be more in keeping with a cerebellar lesion.

Moran noted a rapid irregular pulse on 4 June 1955, possibly atrial fibrillation, but this appears to have been transient, and it occurred three days following the onset of the stroke. A cardiac embolic basis for the stroke seems less likely than thrombosis in situ as the pathology of the stroke.

This stroke occurred in the context of symptoms indicating gradual cognitive decline. On the day before the onset of the stroke, Churchill had noted that while he could edit his book, ‘It's thinking and composing I find difficult.’ And on 22 June 1955, he remarked that his memory was poor, particularly for names. However, his exceptional speech and language skills were objectively largely maintained, as evidenced by his successful electioneering between April and the end of May 1955, his Guildhall speech on 21 June 1955, only three weeks following the onset of this most recent stroke, and his letter to Eisenhower, following the cerebellar stroke, on 18 July 1955.

A change in Churchill's mood was noted by Brain,¹⁷ as reported to him by Lord Woolton (Chancellor of the Duchy of Lancaster 1952–1955) towards the end of 1955. Woolton referred to Churchill while he was still Prime Minister, remarking to Brain, ‘I can't think what you doctors have done to him. Before, he used to stick his chin out; now he is genial and humorous, even on serious matters.’¹⁷ This could be seen as an indication of a change in personality, reflecting the advance of cerebrovascular disease. However, we should remember that Churchill was by then 80 years old and knew that his days as Prime Minister were numbered. A little mellowing of his mood at that time should perhaps not be over-interpreted.

Nevertheless, it is very likely that Churchill was indeed becoming gradually cognitively impaired, his symptoms being the most reliable indication of this. However, all the evidence suggests that any modest impairment of Churchill's intellect still left him with greater cognitive skills at the age of 80 than most could hope for in the prime of their lives. He was certainly not stuck for words.

Declarations

Competing Interests

None declared.

Funding

None declared.

Ethics approval

Not applicable.

Guarantor

JWS and JAV.

Contributorship

JWS and JAV wrote the paper.

Acknowledgements

We are most grateful to Michael Brain DM FRCP, Lord Brain's son, for allowing us to quote from his father's clinical records held by the Royal College of Physicians and to Pamela Forde, Archive Manager at the College, for granting us access to these records. The authors are grateful to Professor David Werring for his review of this paper and his suggestions, which have been most helpful in revising and improving the paper.

Provenance

Not commissioned; peer-reviewed by David Werring.