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Saturday, 3 June, 2000, 23:36 GMT 00:36 UK
Celebrity health warning
Eva and Juan Peron
Eva Peron was not told she had cancer
The rich and famous are used to good things in life - but for the true international superstar top quality healthcare may be an exception.

The case of Eva Peron graphically illustrates a phenomenon which has been tagged VIP syndrome.

The theory is that a person's celebrity may lead to poor medical care.

The treatment of Eva's cervical cancer, once diagnosed, appears to have been excellent.

But for more than a year she resisted any attempt at proper medical evaluation despite the fact that she was growing more weak and anaemic.

Although she may have adopted a head in the sand approach to her own health, this was not entirely her fault - at no time was she made aware how potentially serious her condition was, and she went to her grave unaware that she had cancer.

Veil of secrecy


Franklin Roosevelt
Franklin Roosevelt's hypertension went untreated

The veil of secrecy surrounding her condition was such that when she finally underwent a hysterectomy in 1951, she was misled as to the identity of the surgeon.

She believed the operation would be carried out by the Argentine physician Ricardo Finochietto, but the procedure was actually performed by New York cancer surgeon George Pack.

Pack entered the operating room after she was sedated and left before she regained consciousness, completely breaching standard medical ethics.

Writing in The Lancet medical journal, Dr Barron Lerner, from the Center for the Study of Society and Medicine, Columbia College of Physicians and Surgeons, New York, says it was common practice in 1950s Argentina not to inform patients about their medical conditions - particularly when the diagnosis was cancer.

However, he also suggests that political considerations were an important factor in Peron's case.

"The concealment of Evita's diagnosis may in part have reflected a decision not to burden her with the ramifications of her impending death to Argentina's future," he writes.

"In addition, because the family's decision to withhold the diagnosis from Evita necessitated keeping the Argentine people uninformed, secrecy may also have had the additional benefit of hiding information that would have increased the political vulnerability of the Peron regime."

Eisenhower a victim


Shah of Iran
Doctors argued over the Shah of Iran

President Dwight Eisenhower was another victim of the VIP syndrome - one of several US presidents to suffer.

When he suffered chest pain in 1956, he was taken to the hospital in a car rather than an ambulance.

Discharged after having had a heart attack, he made a show of walking to the plane that would fly him home.

After William McKinley was shot, several doctors explored his body with their germ-laden hands, probably infecting him.

He might have survived if everyone had not wanted to intercede.

Woodrow Wilson's doctor not only concealed the president's stroke, but did not indicate to Wilson or his wife the severity of his condition.

And Franklin Roosevelt's personal physician either did not diagnose or ignored the evidence of his severe hypertension.

The Shah of Iran is though to be another victim of his own celebrity.

It is believed that in-fighting between the many physicians attending the Shah led to a confused diagnosis that compromised his treatment.

Dr Lerner told BBC News Online that doctors were now more aware of VIP syndrome - and did their best to try to avoid it.

However, he said it was still probably a common phenomenon.

"Doctors are nervous, afraid of screwing up," he said.

"They are probably less willing to confront famous patients and take charge.

"Decisions may be done by committee of doctors instead of one taking charge.

"Sometimes, obviously, it is the patient who is obstructive and difficult and thus interferes with the doctors."

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