August 29, 2008

By John H. Mather MD CIP FACPE

Lord Moran (Dr. Charles McMoran Wilson, pronounced to rhyme with “sporran”) was Winston Churchill’s primary physician from 1940 until his patients death in 1965.[1] The following year he simultaneously published his memoirs in the UK and USA.[2] The response was immediate and highly critical. Churchill’s family and his immediate political entourage were outraged.

Moran’s medical colleagues considered the revealing of any information on his illustrious patient a breach of medical ethics.[3] Several of Churchill’s confidants during World War II and his second premiership were incensed by Moran’s book and considered it “an inexcusable breach of confidence.”[4] Six authors challenged Moran on several counts, including his assessments of Churchill’s performance, political acumen and personal relationships, especially his disparaging remarks about the indefatigable General Hastings “Pug” Ismay. This “inner circle” felt their riposte was necessary because Moran did not confine himself to “technical medical details” and that the doctor “has also given his assessment of Churchill’s qualities as a statesman and leader of his country in war and peace. We cannot accept this assessment as it stands: we believe that in some respects it is incorrect and in others incomplete and on both accounts misleading.”[5]

The present Lord Moran, in an apparent attempt to rebut the criticisms that have been leveled at his father over the past four decades, has republished the work in two editions. The first (2002) covers May 1940 to July 1945, with thirty-one additions to the original text, and includes an introduction as an explanation for his father’s “diary. “[6] In it he refers to the publishing controversy and speculates whether it can be “allowed to rest,” as he goes on to explain what sort of record his father kept.[7] His proposition is that his father’s book should be judged as to the reliability of the various notes and notebooks his father maintained, which he used to write his two books.[8]  Lord Moran’s coverage of the remaining years in his original book, 1945-60, was republished as a companion volume in 2006. This volume contains thirty-three additions and one new medical event. All but one page of the last two chapters are omitted, which now appears as an epilogue.[9]

The introduction, not by Moran’s son, provides insight into the resource files for his father’s work: “All these three strands—the absolutely contemporary,the near contemporary and the essay material—were mingled in the same notebooks.”[10] Nonetheless, the conclusion is that the diary is “an invaluable source for anyone interested in understanding the doctor, as well as his patient.”[11]
It must now be concluded that Lord Moran did not produce a diary in the generally accepted use and meaning of the word, as there are many breaks and gaps in the chronology. It is not a day-by-day record, unlike other diaries kept by other Churchill associates.

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What can be said now about the accuracy, veracity and comprehensiveness of Moran’s “diary”? Does it provide useful and clear insights into historical events? Is it a full record of the medical care received by his patient? What inferences might be drawn about Moran as a historian, physician and person? Lord Moran often refers to keeping a diary and he appears in places to consult earlier diary references.[13] The text is full of quotations of events and conversations, none of which he appears to have checked with the participants for accuracy, which resulted in many ruffled feathers.[14] Yet he wrote, “When I put down my pen I wished to be sure that I had reported faithfully those who have talked to me about [WSC]. I trust that in checking those conversations I have forgotten no one.”[15]

His text appears to involve a considerable amount of retrospective editing, for obvious errors have crept in, such as confusion about dates and who was the more ill at Yalta, Churchill or Roosevelt. His son attributes these errors to his father’s age and exhaustion.[16]

Lord Brain, Churchill’s neurologist, was particularly disturbed by Moran quoting him without his knowledge and approval. Brain was concerned that his clinical practice might be adversely affected. The dispute was settled, but his son, Dr. Michael Brain, later commented that Moran’s use of his father’s remarks “showed a gratuitous insensitivity to the feelings of a loyal and very supportive colleague.”[17]
Sir Thomas Dunhill, Churchill’s surgeon, was also damned with faint praise: “Dunhill rather funks an operation on a man of [WSC’s] age and eminence. He is a simple soul, though a fine craftsman.”[18] These recorded remarks seem consistent with Moran’s personality: even when he admired someone, he had a knack of saying something negative before giving praise.”[19] Sir John Colville said, “Though Moran is vain, egotistical and exceedingly indiscreet, his judgment of people is often shrewd, though by no means always right.”[20]

A Historical Record

Moran does not record such events as the 1941 “Atlantic Charter” conference, the 1940 “Battle of Britain” speech and the 1946 “Iron Curtain” speech; at other times he was not in attendance. Later on, Moran was asked to or sought to accompany Churchill on many of the latter’s trips. He became aggravated when his request to go along to see President Eisenhower in 1959 was denied.[21]

When Moran did accompany Churchill, unless it was when he provided medical attention or when Churchill was relaxing at various places in to the South of France (as commonly happened after 1955), he was not usually in attendance at meetings involving strategy or statecraft. He makes a number of comments in his “diary” on what had transpired, which has more recently resulted in historians questioning the accuracy of his record. There are conflicting accounts of the timing and nature of events and historians have recently begun to unravel these discrepancies.[22]

John Colville acerbically commented that “Moran was seldom, if ever, present when history was made; but he was quite often invited to dinner afterwards.”[23] Moran may have given more credence to what he heard from Churchill than was warranted. One historian wrote: “Churchill’s style of tossing ideas around with his companions, often to test their effect, mistakenly inclined Moran to give these half-formed thoughts and suggestions the status of hard fact.”[24]

Relying on Moran’s work for accurate dates is risky. The “Moran Papers” at the Wellcome Institute Library, University College, London, are almost unavailable to historians and researchers. When Sir Martin Gilbert sought to have a particular date confirmed he was informed the entry did not exist, although the date appears in the “diary.” Even existing entries, he wrote, “were not a diary in the accepted sense of the word….The mind boggles at how much misinformation may have crept into history books, mine included, by such routes.”[25]

Medical Events

Anyone familiar with the medical events in Churchill’s life during this period of twenty-five years will note the omissions. The archivist for the “Moran Papers” acknowledges that there is data not in the “diary”: “This material includes some sensitive medical information and is therefore closed for a period.”[26] The incident in June 1962, when Churchill broke the head of his right femur, is not recorded, as are the medical events of Churchill’s last five years. At this point Moran comments that “the short entries in my diary add little to the record. I have thought it proper to omit the painful details.. .because they are no longer of historical significance…”[27]

Sir John Parkinson, who saw Churchill in consultation about an apparent heart ailment on 24 August 1953, said he was “shocked” by the way WSC had aged since he saw him four years before. There is no “diary” entry for Dr. Parkinson in 1949, or when he had indicated he had seen WSC after the supposed heart attack in December 1941.[28]

Another instance of an inaccurate date concerns Lord Brain, who kept scrupulous notes on his patients. Moran claimed that Lord Brain had first seen Churchill on 25 May 1950, while Lord Brain records that date as 5 October 1949. Brain also records eight subsequent visits that Moran does not record. Churchill’s engagement cards at the Churchill Archives Centre show all of the visits made by Brain. The first is as he recorded, 5 October 1949.[29]

Lord Moran as Physician

When Moran became Churchill’s primary physician, he had a modest private practice; Lord Beaverbrook and Brendan Bracken were amongst his patients. Soon Churchill was his only patient, while Moran involved himself more in medical politics. Elected President of the Royal College of Physicians, he represented hospital consultants’ interests in the initiation of the National Health Service. This positioned Moran to know the best physicians and surgeons he could summon to treat Churchill. The record demonstrates this as one of his strengths, although his choice of Sir Thomas Dunhill, a thyroid specialist, for Churchill’s hernia repair in 1947 may have been a marginal decision.[30]

Moran’s biographer, Richard Lovell, had to spend a lot of time organizing the various materials in order to write a cogent and balanced picture. Other medical information about Churchill will eventually be forthcoming.

One issue has already surfaced: the full extent of Moran’s prescription of various drugs. Some were to help Churchill sleep, while the more controversial were the stimulants which allowed him to be in top form. Churchill appears to have been given a supply of these several drugs, and was able to self-medicate.[31]

Throughout his “diary,” Moran selectively records medical information about his patient. He frequently records Churchill’s pulse, but there is no record of blood pressure. Lord Brain recorded one of 160/90 in his initial examination.[32] Churchill often took his own temperature, and called for Moran when it was elevated, which sometimes proved to be the harbinger of pneumonia. Churchill once called for Moran when he thought he had a temperature of 66 degrees! Moran commented that if so he would be dead. Churchill looked again and reported 96 degrees, but Moran went to see his patient anyway.[33] He seems to accept that his patient would not curb his consumption of alcoholic beverages and cigars, however limited in later years, and his prodigious appetite for fine food. The overall impression Moran left with Colville is that “His skill in diagnosis and the unhesitating speed with which he found the right men at the right time were the greatest services he rendered.”[34]

Some Additional Observations

Moran’s book was not the first “memoir” to cast Churchill in a less than noble light. Field Marshal Viscount Alanbrooke had published his own day-by-day diary nine years earlier.[35] Moran ironically commented that Alanbrooke’s work “was taken by Winston’s friends.as an affront to his fame, and came to Alanbrooke’s colleagues “as a complete surprise.”[36]
Moran’s “diary” was different. Besides medical information on Churchill’s physical ailments, such as eye problems, pneumonias and strokes, Moran’s diary included detailed information on his patient’s moods and mental status.

There is a reference to Churchill’s depressive tendency, the “Black Dog,” which was promptly dismissed, although now well established.[37] Moran provides excruciating detail about Churchill’s mood swings, decay and decrepitude, and his dismissive attitude: words Churchill’s family could identify as truthful but nonetheless very upsetting. Moran also intimates that he can help Churchill to “open his heart, and feel better for his candour.” Churchill did have a genuine reliance on and affection for Moran, and is quoted as saying, “It is wonderful that you have kept me going for so long.”[38] Perhaps the revealing of this intimacy upset the family, while others may have sensed that Moran had inappropriately traded on his special relationship with his patient. It all exposed Churchill to the possibility that he was human after all, and the possibility that he was not so worthy of admiration and honor. Happily his reputation remained undiminished.

Summary

Notwithstanding the discrepancies in the diary, and with the benefit of forty years of hindsight, we may conclude that Moran was the first physician significantly to reveal important information about a world figure that no one else would have been able to record. When under attack, and in his own defense, he commented to The Times: “It is not possible to follow the last twenty-five years of Sir Winston’s life without a knowledge of his medical background…. It was exhaustion of mind and body that accounted for much that is otherwise inexplicable. Only a doctor can give the facts accurately.”[39]
Moran’s revelations of Churchill’s physical and mental health was a first, but subsequent biographers have not been squeamish about covering similar ground.[40] This is a big plus for medical historians. Commenting on Moran as a diarist, an academician observed in 1969: “The topical question of whether a patient’s confidence has been outraged by his physician’s account of him both in his strength and in his weakness will no longer agitate the reader.”[41]

Today, the issue of ethical propriety in revealing intimate medical details about notable personages seems to be of much less concern. As Sir Winston’s primary physician, Moran mobilized his medical colleagues and provided a level of medical care consistent with contemporary medical practice. His reliance on certain drugs to bolster Churchill’s spirits in later years might be questionable, but his patient evinced a strong, rarely ambivalent, and high regard for his services.

Whether Churchill would have approved of Moran setting forth the record of his life in such a manner is another matter. WSC might well echo his daughter Lady Soames’s conclusion that “Lord Moran understood Winston thoroughly, and he was indeed fortunate he had as his doctor a man who understood not only the medical considerations and risks to his patient, but who was also fully aware of the implications with regard to the office he held, of his condition at any time. “[42]

Endnotes

  1. Lord Moran’s long life (1882-1977) is detailed in Richard Lovell, Churchill’s Doctor: A Biography of Lord Moran, New York: Parthenon, 1993.
  2. Lord Moran, Winston Churchill: The Struggle for Survival, London: Constable 1966; Churchill: Taken from the Diaries of Lord Moran, Boston: Houghton Mifflin, 1966. (Page references are to the Houghton Mifflin edition.) In London, the Sunday Times serialized the work prior to publication, making for timely reaction.
  3. Much could be written abut the ensuing uproar. The reviewer for The New York Times commented that there was “something morbid about publishing so clinical a record of a great man; possibly something ‘unethical,’ as Americans put it.” See Ilza Veith, “On Privileged Communication: A Comparative Study of Several Medical Cases,” The Western Journal of Medicine 138:3, March 1983, 437-40. See also the editorial, “A Question of Confidence,” The Lancet vol. I, 23 April 1966, 920.
  4. Sir Leslie Rowan in John Wheeler-Bennett, editor, Action This Day: Working with Churchill, London: Macmillan, 1968, 249.
  5. Lord Normanbrook in Action This Day, 10, 31.
  6. Lord Moran, Churchill at War 1940-45- New York: Carroll & Graf, 2002. One unidentified addition appears in the text (25) where the former Duchess of Marlborough, Consuelo Balsan, is quoted: “Winston looks very well. This is due to Sir Charles. He is President of the Royal College of Physicians but has given up everything to do this….I think the P.M. was rather surprised at this pronouncement. It had never been put like this before.
  7. Ibid., introduction, xxii-xxiii. The present Lord Moran quotes his father’s biographer’s preface, stating that his father did not keep “a full diary with entries for each day, from which passages were extracted to go into the book.”
  8. Churchill encouraged Moran to publish his first book, The Anatomy of Courage (London: Constable, 1945), but refused to write a preface, saying that might hurt military recruitment. Lowell, op. cit., 213.
  9. Lord Moran, Churchill: The Postwar Years 1945-60. New York: Carroll & Graf, 2006. The reason for the omission of Chapters 71 and 72 from the original text is unclear, although it was there that the phrase “mounting decrepitude” originally appeared.
  10. Ibid., xvi. The conclusion is that “the manuscripts amount not to a ‘diary’…but rather the notes for the book on Churchill Moran always intended to write, in a near-constant state of flux and revision.”
  11. Ibid., xxvii.
  12. Review of these sources will make the point: John Martin, Downing Street: The War Years, London: Bloomsbury, 1991; John Colville, The Fringes of Power: Downing Street Diaries, New York: W. W. Norton, 1985.
  13. For the sake of consistency, Moran’s original work, Churchill: The Struggle for Survival I Churchill: Taken from the Diaries of Lord Moran will be referred to as a “diary.” Moran wrote: “My diary for those years (since summer of 1949), five of them during his retirement, is in part a sad record of the advancing signs of decay, a catalogue of lamentations over faculties that had gone.” (821)
  14. Many of the “Inner Circle” noted their dismay at the quotations attributed to them, and modified them or placed them in a broader context, to provide a more succinct and balanced picture.
  15. Moran (1966), op. cit., acknowledgements. Lord Moran was not above telling Wendy Reves that Lady Churchill had “edited out” many passages on Churchill’s visits to the Reves chateau, La Pausa, when Mrs. Reves expressed regret that his happy days there were largely unrecorded. In fact, Lady Churchill had never laid eyes on the manuscript until publication. (Private information.)
  16. Moran (2002), op. cit., introduction, xxvi. Despite the “discrepancies,” his son states, “in the main his account was a truthful and accurate one,” supporting this assertion with a series of quotations from supportive commentators.
  17. W. Russell Brain, “Encounters with Winston Churchill,” Medical History, vol. 44, 2000, 3-20.
  18. Moran (1966), op. cit., 342
  19. Richard Lovell, “Choosing People: An Aspect of the Life of Lord Moran (1882-1977),” Medical History, vol. 36, 1992, 442-54. Lovell reminds the reader that Lord Moran’s nickname was “Corkscrew Charlie,” which, depending on friend or foe, meant he was either shrewd and clever or devious and manipulative.
  20. Colville, op. cit., 515. Observation in his diary for 14 September 1944.
  21. Anthony Montague Browne, Long Sunset. London: Cassell, 1995, 260. Churchill is quoted as saying, “No I don’t want that bloody old man,” although the author immediately goes on to add, “Actually he [WSC] was rather fond of Moran….”
  22. John Ramsden, Man of the Century: Winston Churchill and His Legend since 1945. London: HarperCollins, 2002. David Reynolds, In Command of History: Churchill Fighting and Writing the Second World War. New York: Random House, 2005.
  23. John Colville, Action This Day, 110.
  24. Anthony Seldon, Churchill’s Indian Summer: The Conservative Government 1951-1955. London: Hodder & Stoughton, 1981, 32.
  25. Martin Gilbert, In Search of Churchill. London: HarperCollins, 1994, 233.
  26. P.A. Baker, “Illustrations from the Wellcome Institute Library: The Moran Papers.” Medical History, vol. 36, 1992, 455-59.
  27. Moran (1966), op. cit., xii.
  28. Moran (1966), op. cit., 488.
  29. Brain, op. cit., 7-8, footnotes 17-18.
  30. Prior to performing the hernia repair, the 71-year old Dunhill practiced die operation for a week on National Health Service patients at St. Bartholomew’s Hospital. See Richard Gordon, An Alarming History of Famous and Difficult Patients. New York: St. Martin’s Press, 1997.
  31. Richard Lovell, “Letters: Lord Moran’s prescriptions for Churchill.” British Medical Journal, vol. 310, 1999, 1537-38. Moran (1966), op. cit. 508, 546, 564, 610, 619, 628, 648, 658.
  32. Brain, op. cit., 9.
  33. Montague Browne, op. cit., 142.
  34. John Colville, Winston Churchill and his Inner Circle. New York: Wyndham Books, 1981, 245.
  35. Arthur Bryant, The Turn of the Tide. New York: Doubleday, 1957; Triumph in the West 1943-1946. New York: Doubleday, 1959 A subsequent combined and more complete work is thought to be even more scathing. See Alex Danchev and Daniel Todman, Alanbrooke: War Diaries 1939-1945- Berkeley, University of California Press, 1998. See Andrew Roberts, “Not For Publication?” Finest Hour 111, Summer 2001; and Christopher Harmon, “Alanbrooke and Churchill,” Finest Hour 112, Autumn 2001.
  36. Moran (1966), op. cit., 758-59.
  37. Moran (1966), op. cit., 179, 195, 794, 804.
  38. Moran (1966), op. cit., 690, 707.
  39. Lord Moran, letter to the editor of The Times, 25 April 1966.
  40. Several books have been published since 1966 on medical biography (pathography), both general and specific. See Bert E. Park, Ailing, Aging and Addicted: Studies of Compromised Leadership, Lexington: University of Kentucky Press, 1993; Clarence G. Lasby, Eisenhower’s Heart Attack, Lawrence: University of Kansas Press, 1997; Robert H. Ferrell, The Dying President: Roosevelt, Columbia: University of Missouri Press, 1998. The author can provide a list.
  41. Douglas Hubble, “Lord Moran and James Boswell: The Two Diarists Compared and Contrasted.” Medical History, vol. 13, 1969, 1-9.
  42. Mary Soames, Clementine Churchill. Revised and updated edition, Boston: Houghton Mifflin, 2002, 470.

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