Merkel says she’s taking care of herself. But what should we know about a leader’s health?

BERLIN, GERMANY - JULY 10: German Chancellor Angela Merkel (CDU, R) trembles, an affliction she has shown lately, as she attends a military welcome ceremony with Finnish Prime Minister Antti Rinne on July 10, 2019 in Berlin, Germany. Rinne, chairman of the Finnish Social Democrats, was elected to office the previous month.  (Photo by Adam Berry/Getty Images)
Angela Merkel seen shaking for third time in under a month
01:18 - Source: CNN
CNN  — 

German Chancellor Angela Merkel says she’s taking care of health after experiencing her third bout of shaking in public in less than a month.

But she gave no further detail, doing little to put to rest speculation about what’s been affecting her.

It’s perhaps no surprise the world’s most powerful female politician caught on camera visibly trembling has stirred up a media frenzy, but do people have the right to know about a leader’s health and medical details?

“You can be sure that, firstly, I am aware of the responsibilities that come with my office and that I behave appropriately as far as my health is concerned,” Merkel said Thursday after meeting with new Danish Prime Minister Mette Frederiksen.

“And secondly you can also know that as a person I have a keen interest in being healthy and I take care of my health.”

Merkel and her doctors might not even know yet what it is, said Dr. Sanjay Gupta, CNN’s chief medical correspondent. Merkel may have recently noticed symptoms and still be in an evaluation process that involves trying different medications.

One possibility is orthostatic tremor, a rare condition that’s primarily present when someone is standing, Gupta said. It’s more common among women, and typically diagnosed in people around Merkel’s age, 64.

Treatment can involve muscle relaxers or medications used to treat seizures. Unlike Parkinson’s and some other conditions that cause tremors, it’s not something that ultimately leads to increasing disability.

With orthostatic tremor, “if they are sitting, if they are walking, if they are moving, that tremor seems to go away,” Gupta said.

Video from Thursday showed Merkel using a chair, rather than standing, during military honors for Denmark’s leader.

German Chancellor Angela Merkel, center right, and Danish Prime Minister Mette Frederiksen, sit on chairs as they listen to the national anthems on Thursday.

Privacy valued

In Germany, which has strict privacy laws, many are willing to take Merkel’s explanations at face value.

“It’s not like the US where people think they have all kinds of rights to information about the President or presidential candidates. It’s a less personalized system of government,” said Volker Best, a researcher at the University of Bonn’s Institute of Political Science and Sociology.

“I also think people are trusting Merkel to know when it’s time; if there were real health problems she’s a politician that would admit them and take the right action. She would not cling on to power,” he added.

Merkel’s long tenure as Germany’s leader is set to come to end in the next two years. She has said she only intends to complete her current term and has ruled out running for any political office after 2021.

Unlike the United States, there’s no equivalent to a White House physician nor are details from formal medical exams released to the public, Best said.

“In Germany there are no laws that force politicians to disclose their health status,” Best said.

A chance to rest

Germany’s parliament is set to go on recess on July 19, which Best says will give Merkel a chance to rest and, unless another shaking bout occurs, the topic will likely disappear from the headlines.

Susanne Michl, a junior professor in medical humanities and ethics in medicine, at the Institute for the History of Medicine and Ethics in Medicine in Berlin, said that, in theory, political leaders should disclose the cause of any incapacity that stops them from doing their job.

However, “I think even then it’s a privacy issue. You have to more or less wait until a leader would say I’m not able to do my business,” she said.

“In the case of Angela Merkel, she is in good shape, she hasn’t canceled anything. I think the shaking isn’t an issue for her to tell people what her doctors have told (her about it.)”

Former German Chancellor: ‘I was probably found a hundred times unconscious’

Historically, politicians in Germany, like elsewhere, have not been keen to admit to health problems.

Chancellor Willy Brandt resigned in May 1974, after his close aide was unmasked as an East German spy, but he was also said to suffer from recurrent depression that he kept concealed. Best said that historians thought that was a factor in his decision to go.

Helmut Schmidt, who was Chancellor from 1974 to 1982, said he had regular fainting spells that were kept secret, according to Germany news agency DPA.

“I was probably found a hundred times unconscious. Mostly only a few seconds, sometimes minutes. We have successfully kept that secret – and it has not stopped me from doing my duty as head of government,” Schmidt said in a 2014 interview.

In the US, Presidents and presidential hopefuls have gone to great lengths to be seen as healthy and vibrant, with signs of weakness often pounced on by opponents.

At age 43, John F. Kennedy, was the youngest person elected President. But he took office struggling with hypothyroidism, back pain and Addison’s disease, and was on a daily dose of steroids as well as a host of other drugs, although few people knew at the time.

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Ronald Reagan announced in 1994, after his presidency, that he had been diagnosed with Alzheimer’s. Whether it affected his ability to function while in office is a subject of debate. Though doctors were in the dark then, today, medical science knows that Alzheimer’s begins in the brain 20 to 30 years before symptoms begin.

Former US Secretary of State Hillary Clinton’s near fainting spell during the 2016 election campaign was seized on by her opponents. And concerns over President Donald Trump’s mental and physical health have dogged his presidency, with his fast food habits, lack of exercise, age and weight all coming under scrutiny.

But admitting to health issues need not derail a politician’s career.

In the UK, outgoing Prime Minister Theresa May has been open about having to inject herself with insulin up to five times a day to treat her diabetes.

May has type 1 diabetes and urged fellow sufferers not to allow the illness to hold them back from doing what they want in life.

CNN’s John Bonifield, Nina Avramova, Barbara Wojazer and Sandee LaMotte contributed to this report.