Based on the Lord Henry Cohen History Of Medicine Lecture, University Of Liverpool, 22 February 2005

On 26 July 1956, the anniversary of King Farouk's abdication in Manshiya Square in Alexandria, the Egyptian President Abdel Nasser announced in a passionate speech the nationalization of the Suez Canal Company. Under the terms of the Suez Canal Base agreement, the last British troops had left Port Said on 13 June 1956, and it was the man who had negotiated that controversial agreement as Foreign Secretary, Sir Anthony Eden, who was now Prime Minister and feeling under political pressure from within his Conservative Party. At the time that Nasser was telling the crowd with nationalistic fervour that ‘In the past we were kept waiting in the offices of the British High Commissioner and the British Ambassador’, Eden was hosting a dinner in 10 Downing Street for King Faisal of Iraq and his Prime Minister.

Nasser was a popular nationalistic leader who cleverly tried to demonstrate, in the way he nationalized the Company, that he was not acting illegally. Free passage along the Suez Canal was, however, regarded as Britain's lifeline, and Eden, who had developed a personal animosity to Nasser, believed he should not be allowed ‘to have his thumb on our windpipe’. Egypt, however, was intent on showing that it had no intention of interfering with any nation's shipping and few nations feared this other than Israel. The threat to world shipping was an issue on which Britain never really managed to mobilize international opinion. Nor was international opinion much concerned about Egypt's growing links with the Soviet Union. Even more importantly, President Eisenhower was not prepared to link the seizure of the Canal with the danger from the Soviet Union, and he would be the single most important person in determining the outcome of the Suez Crisis.

The decisions taken over the next three months ended with Eden being humiliatingly forced by his Cabinet to accept a ceasefire within 24 h of launching a military operation with the French to secure the Suez Canal. The subsequent troop withdrawal came as a result of the financial pressure from the US Secretary to the Treasury, who refused to agree any financial support for the falling pound without such a commitment. The debacle had the most profound effect on British and French foreign policy. The French moved towards challenging US hegemony, the UK to rebuilding and relying on the special relationship. In the words of The Times obituary in 1977, Eden ‘was the last Prime Minister to believe Britain was a great power and the first to confront a crisis which proved she was not’.

One of the many fascinating questions of the Suez crisis is to what extent Eden's handling of the situation was influenced both by his past surgery and by the sedatives and stimulants that he was taking. In 2003, three notable additions were made to the literature on the subject of Eden's medical history, which throw new light on his condition.

It was a misfortune not just for the Foreign Secretary, Sir Anthony Eden, but for international diplomacy, that on 12 April 1953, what should have been a routine cholecystectomy in the London Clinic, went badly wrong. The operation was undertaken on the advice of his physician, Sir Horace Evans, because of previous episodes of jaundice, abdominal pain, and the presence of gallstones. An Australian Professor, Gabriel Kune, a specialist in hepatic biliary surgery, wrote in January 2003 that Sir Horace Evans had recommended three different surgeons to Eden, all with expertise in biliary tract surgery. However, Eden chose to be operated on by the 60-year-old Mr John Basil Hume, a general surgeon at St Bartholomew's Hospital, who in Eden's words had ‘removed my appendix when I was younger, and I’ll go to him’.1

In November 2003, an excellent review article was published by an American surgeon, Dr John Braasch, on ‘Anthony Eden's (Lord Avon) Biliary Tract Saga’. He had operated on Eden in 1970, and had had personal communication with Richard Cattell, who had undertaken the third and fourth operations on Eden in America in June 1953 and again in April 1957. Both men were associated with the Lahey Clinic in Massachusetts, and this surgical retrospection is the closest we will probably ever get to what exactly happened.2 Braasch very fairly quotes a minority opinion written by a retired London surgeon-knight to another US surgeon, claiming to be one of the few people who knew the facts, that while the ligature on the cystic duct had blown following the first operation (which was then evacuated in the second re-exploration operation on 29 April), Eden's ‘common duct was not injured at all. When he left for America his biliary fistula had dried up, he was not jaundiced and he was perfectly well’. The letter must have been passed on to Dr Cattell. Dick Cattell was not only arguably one of the great abdominal surgeons of the 20th century, but also a gentleman, and he did not respond to the several insulting remarks contained in the letter. Another source, Sir Christopher Booth, formerly Professor of Medicine at the Royal Post Graduate Medical School, London describes Eden's first operation as a ‘schoolboy howler’ of surgery in which ‘inadvertently [they] tied the bile duct as it comes out of the liver’, resulting in the obstructive problems in the biliary tract.3

According to Richard Thorpe's biography on Eden published in 2003, telling a tale that had not before been told, the surgeon, Hume, was so agitated that the operation had to be put on hold for nearly an hour to allow him to compose his nerves. After what happened in the first operation, Hume felt he could not lead the second operation, which was led by Mr Guy Blackburn, an assistant at the first. This operation has been described as ‘even more tense than the first, and Eden was within a whisker of death at several stages of the lengthy and traumatic process’.4 The generally accepted view, supported by his official biographer, Robert Rhodes James, writing in 1986, was that Eden's biliary duct was accidentally cut and Eden was told that ‘the knife slipped’.5

Professor Kune further believes that there was at some stage in the London operations an injury of the right branch of the hepatic artery. This he supposes because there was found to be a high injury of the common hepatic duct in very close proximity to the right hepatic artery, and more importantly, at two re-operations in Boston, there was also a localized stricture of the right hepatic duct well away from the original duct injury site. Also, at the 1970 re-operation, the right lobe of the liver was found to be abnormally small, which suggests to Kune that at the time of the bile duct injury the right hepatic artery was also inadvertently ligated: this relative ischaemia, since the liver has a second blood supply from the portal vein, led to the development of both the stricture and the liver lobe atrophy. There is no evidence, however, that Eden's liver metabolism was affected.

There was an amazing background to the London and first US operations. Winston Churchill, as Prime Minister, involved himself in Eden's treatment from the start, constantly letting Hume know how eminent was his patient and how nothing should go wrong. Churchill also intervened again after the operations. Horace Evans asked Cattell, a world renowned expert in this field of surgery, who was by chance in London lecturing, to see Eden. Cattell insisted that Eden should travel to Boston for a third operation, and Evans agreed. Lord Moran, who had earlier been Eden's doctor, diagnosing a duodenal ulcer, thought Eden's operation could be done just as well in London. Churchill felt to go abroad would reflect badly on Britain and no doubt egged on by Moran, persisted to the extent that Evans and Cattell had to go and visit him in 10 Downing Street. In the Cabinet Room, Churchill talked about having been operated on a kitchen table for an appendicectomy. Both doctors had to explain patiently that an appendix operation was a relatively simple procedure whereas a bile duct repair operation was of a different order in its complexity and skill.6

On the same day, 23 June, that Eden was operated on in Boston, Churchill, still the Prime Minister, suffered a severe stroke. Lord Moran told Churchill's Private Secretary, John Colville, that Churchill would probably die over the weekend.7 Churchill had given Colville strict instructions not to let it be known that he was incapacitated. A medical bulletin was drawn up by Lord Moran and the neurologist Sir Russell Brain, which had a reference to ‘a disturbance of the cerebral circulation’, but this was cut out after discussions with Rab Butler and Lord Salisbury. John Colville consulted Churchill's three friends, the press lords Camrose, Beaverbrook and Bracken, who joined the conspiracy of silence and persuaded their colleagues in Fleet Street not to print a word about how severe Churchill's illness was.8

Meanwhile, Cattell in Boston had performed an end-to-side hepaticojejunostomy using a 16-F rubber Y-tube as a stent. Eden was according to Braasch, ‘then well until 1954 when he experienced fevers and chills on one occasion and in 1955 on three occasions. None was severe or prolonged.’ It was perfectly reasonable for Eden to believe that his health now allowed him to succeed Churchill as Prime Minister, which he did on 6 April 1955. Always determined to call an early election, Eden won in May, with a majority in the House of Commons up from 17 to 58, with 49.7% of the overall vote, the highest percentage total by any party in the post war age, helped by what opinion polls had always shown: that Eden was one of the most popular politicians of his era. That Election was followed by the Four-Power Summit in Geneva in July, where Eden was able to make his own assessment of the Russian delegation led by Bulganin and Khrushchev. Eden waited perhaps too long before reshuffling his Cabinet on 20 December, when Harold Macmillan was reluctantly moved from being Foreign Secretary to Chancellor of the Exchequer and Selwyn Lloyd became Foreign Secretary, ensuring Eden got back control of the Foreign Office.

The fateful year of Eden's Prime Ministership, 1956, started with a lot of press criticism and a particularly hurtful article that appeared in the Daily Telegraph on 3 January, which perhaps as the Suez Crisis developed, made him determined to act forcefully. ‘There is a favourite gesture with the Prime Minister. To emphasise a point he will clash one fist to smash the open palm of the other hand but the smash is seldom heard’, said the article, and went on to say that people were waiting in vain for the ‘smack of firm government’. Also a few days later Rab Butler, then Leader of the House, said in an interview, ‘My determination is to support the Prime Minister in all his difficulties’ and then unwisely assented, without any qualification to the Press Association reporter's loaded question, as to whether Eden was ‘the best Prime Minister we have’. It was a rather typical Butler equivocation but one which Eden never forgot.

On 6 February 1956, Eden wrote to his wife from Government House, Ottawa, ‘I am well but was very tired yesterday, so stayed in bed all day’. That was not the behaviour of a fit man. Lack of sleep and tiredness are too often underplayed when trying to assess the effect of people's health on their decision-making. Lord Moran in his diary entry for 21 July wrote: ‘The political world is full of Eden's moods at No 10’. There has been much written and said about Eden's behaviour and health over the next three months. Some of it is gossip, some mere speculation, some true. It is necessary to sift through all the evidence and try to form a judgement based on medical and political probabilities.

Eden's immediate decisions after Nasser's speech on 26 July, to prepare for but to postpone immediate military action, were understandable, given the attitudes of the Chiefs of Staff, and if anything at this time Eden's decisions were too cautious. They contrast dramatically with the more reckless decisions he took from 14 October.

Eden cautiously involved the Americans from the start, calling in the US Charge d’Affaires as well as the French Ambassador to talk the issues over with four Cabinet Ministers (Selwyn Lloyd, Salisbury, Kilmuir and Home) and two Chiefs of Staff (Templer and Mountbatten) until 4.00 am on 27 July. Eden did not immediately embrace the Lord Chancellor Kilmuir's view that Britain could base its case solely on grounds of illegality. Nor did he take the view of one of his old and close friends, J.P.L. Thomas, then the First Sea Lord, ‘who always believed that if force was to be used, it should have been in July, and not later in the autumn, by which time Nasser had covered many of his tracks‘,9 and also thought that Eden, who had never worked in America, did not understand how the American mind worked, particularly approaching a Presidential election.

It is not clear when Eden ruled out involving British troops in Libya, fearing an Arab backlash. Using these forces in Libya was something which he still contemplated when Churchill went to see him very privately on 6 August. Churchill left behind a memo which he had dictated in the car and had had typed in a lay-by en route to Chequers. In it he warned Eden with great perceptiveness about just taking over the Canal, and believed that the armoured division in Libya would be used.

‘The more one thinks of taking over the Canal, the less one likes it. The long causeway could be easily obstructed by a succession of mines. We should get much of the blame for stopping work, if it is to be up to the moment of our attack a smooth-running show. Cairo is Nasser's centre of power. I was very glad to hear that there would be no weakening about Libya on account of the local Prime Minister etc., but that the armoured division, properly supported by air, with any additional forces that may be needed, would be used. On the other side, a volte face should certainly free our hands about Israel. We should want them to menace and hold the Egyptians and not be drawn off against Jordan.’10

Churchill saw that toppling Nasser would involve Cairo. A central weakness of the eventual operation was that the British bombing was designed for purely military purposes along the Canal, not for the political purpose of toppling Nasser. The Chiefs of Staff (who did not emerge well from the whole crisis) and the Cabinet believed that with three divisions on the Canal, it would not be long before Nasser fell from loss of face—a strange underestimate of the forces of nationalism that Nasser had unleashed.

Figure 1.

Anthony Eden, Prime Minister of Great Britain, speaking to the nation from the BBC studio at Lime Grove, London at the time of the Suez canal crisis.

Figure 2.

President Nasser of Egypt waves to the crowds after nationalizing the Suez Canal Company, July 1956.

Figure 3.

John Foster Dulles, US secretary of state, shaking hands with Anthony Eden on the steps of 10 Downing Street, 24 August 1956.

On 17 August, Eden wrote to Churchill, ‘I am sorry to have been away on Monday, but I needed a few hours off. I am very fit now.’ He also said, ‘Most important of all, the Americans seem very firmly lined up with us on internationalisation.’ But Eisenhower never hid from Eden his opposition to the use of force. Writing on 3 September: ‘I must tell you frankly that American public opinion flatly rejects the use of force. I really do not see how a successful result could be achieved by forceable means …’ There was a clear divergence of interest between Britain and the US throughout the crisis. Britain was not solely concerned with the safety of vessels going through the Suez Canal. Considerations of UK prestige were also of major importance, and the Government was not able to draw a clear distinction between the question of the Canal and that of Nasser's regime. This is the retrospective conclusion of Guy Millard, who wrote in 195711 a most detailed private history of this period. He felt that it was a mistake for Britain to try to solve the two problems simultaneously, and this was a criticism of British policy made by the Americans during the crisis.

Eden's own diary entries are virtually non existent during the Suez crisis. One, on 21 August reads: ‘Felt rather wretched after a poor night. Awoke 3 30 am onwards with pain. Had to take pethidine in the end. Appropriately the doctors came. Kling was more optimistic than Horace. We are to try a slightly different regime. Agreed no final decision until a holiday has given me a chance to decide in good health’. The ‘final decision’ related to the possibility of another operation, the ‘different regime’ to a change of drug treatment. Yet despite having had pethidine, Eden chaired a Cabinet meeting at noon and had other meetings in the afternoon before seeing his doctors again later that day.

On 7 September he comments: ‘After fair night. Sleep at least uninterrupted, but not long, 5 hours’. On 12 September, ‘there were two difficult days in the House. I was quite exhausted by the end of the debate.’

Eden's engagement diary shows that, apart from his weekend in hospital on 5–8 October, he ‘consulted Dr Evans or Dr Kling on at least ten occasions between the canal nationalisation and the end of October’.12

The Countess of Avon kindly allowed me access to the still closed Medical Records of her husband in Birmingham University Special Collections Archives, and there I found a letter Horace Evans wrote on 15 January 1957 to any doctor who might have to treat Eden while he visited New Zealand about his drug regime during the Suez crisis:

‘His general health during the past year has been maintained with extensive vitamin therapy—sodium amytal gr 3 and seconal enseal gr 1.5 every night and often a tablet of Drinamyl every morning. These treatments have only become really essential during the past six months. Before his rest in Jamaica the general condition was one of extreme over-strain with general physical nerve exhaustion, and at this time he seemed to be helped by rest, some increase in the sedation and Vitamin B.12 therapy’.13

Sir Horace Evans, unlike Lord Moran, was discreet and in the great tradition of eminent doctors, like Lord Cohen of Birkenhead, who believed that a patient's secrets went to the grave with them. Rab Butler, whose own doctor was Evans, and who on 23 November was to become the acting head of the government, writes that he saw Evans, probably on 19 November in the drawing room of No. 10, who said to him, ‘that Anthony could not live on stimulants any more and that since he was unlikely to relax at a clinic a few weeks in Jamaica had been recommended for recuperation.‘14

There is no doubt, therefore, that Eden was taking dextro-amphetamine, a stimulant which, combined with amylobarbitone, is contained in Drinamyl. This combination, also called Dexamyl in some countries, used to be referred to in Britain as ‘purple hearts’. We do not know how many a day Eden was taking, particularly after 5 October and until his doctors became deeply concerned about his health on 19 November. Amphetamines are stimulants that produce a feeling of energy and confidence. First synthesized in 1887 they were introduced into clinical practice in 1935, and then became very widely used in the 1950s and 1960s. In 1964, following a press outcry about their misuse, the unlawful possession of amphetamines was made an offence and doctors began to use them much less. Amphetamines act not only on the brain but also on the lungs, heart and other parts of the body, after releasing noradrenaline from binding sites. The effect depends upon the amounts used, but even moderate doses often produce insomnia, restlessness, anxiety, irritability, over-stimulation and overconfidence. Amphetamines do not create energy, they simply use it up. Prolonged use, even of a moderate dose, is invariably followed by fatigue, and the ‘come down’ effect is also often accompanied by difficulty with sleeping. Another sequel described after amphetamine use is called the ‘crash’.15

Some of the minor side-effects of one Drinamyl each morning may have begun to develop in Eden by July 1956. It seems that they were increased after the episode on 21 August and possibly again in October, and contributed to his collapse in November. I found no evidence, however, of any reference by his doctors to excessive usage of amphetamine, no record of any clandestine use, nor of any dependence. Indeed there was one letter to a doctor in the Lahey Clinic in March 1971, where Eden shows a proper caution about drugs and their interactions on one another.

‘One other question about sleeping pills. As you know, I take Sparine. Is there any harm if I take the equivalent of four little yellow pills or two red ones occasionally at night? Sometimes I find that it is best to take a little yellow one an hour or more before I go to sleep, and another little yellow one as I turn out the light, followed by a red one, should I wake up, say about 2 00 am. Alternatively, I may take a red one on going to sleep and one yellow one about 3 00 am, should I be lying awake then, and another at 5 00 am if I have not gone to sleep. Both these methods are unusual, one red and one yellow is usually enough for a night, but I do use them occasionally. My local doctor felt that there was no harm at all in such a practice, but I thought that I should check up with you …‘16

Against this cautious approach by Eden, one has to set the fact that doctors well know that even the most careful of patients during times of stress feel some initial comfort in upping their dosage of amphetamines to give them a temporary boost of energy, and they may not tell anyone, relatives or doctors that they are doing this. Eden has been accused of ‘his own self medication involving injections by his personal detective‘.17 Yet Eden made no attempt to hide his dependence on stimulants during the Suez crisis in the notes which he had prepared to read out to his colleagues in the Cabinet on 9 January, 1957, informing them of his resignation. He openly refers there to having considerably increased his amphetamines, which he calls stimulants, since July. The full text of this is in his official biography. The relevant passage reads:

When I collapsed in November, I was told by my doctors that if I wanted to carry on as PM I must get right away at once. This I did as I was anxious not to have to resign. When I returned from Jamaica I was depressed to find that my health though improved, had not done so as much as had been hoped. It was decided that we would wait another two weeks to see if it had improved. It has not. As you know, it is now nearly four years since I had a series of bad abdominal operations which left me with a largely artificial inside. It was not thought that I would lead an active life again. However, with the aid of (mild) drugs and stimulants, I have been able to do so. During these last five months, since Nasser seized the Canal in July, I have been obliged to increase the drugs considerably and also increase the stimulants necessary to counteract the drugs. This has finally had an adverse effect on my precarious inside. Naturally the first thing I asked the doctors was whether I could last out till the summer or Easter at the earliest. They told me they doubted it, and think it would not last (more than) six weeks. I know that many of you are genuinely tired and worn out by your work, but I can assure you that my past medical history puts me in a different class. I do not think I should be serving the best interests of my colleagues or of the country if I were to continue in my present condition.’18 (this author's underlining, not Eden's)

Some people say Eden's decisions during the Suez Crisis—and this is the view of his wife, friends and some of his biographers—were unaffected by his illness. I do not think that this is sustainable in the light of his rigor and fever of 106°F on 5 October, eight days before one of the key decision-making moments in the Suez Crisis.

Robert Carr was as a young man a close friend and admirer of Anthony Eden, and someone whose judgement I respected when we were MPs together. Robert Carr served as Eden's Parliamentary Private Secretary and I have been much influenced by his comments:

‘I find it difficult to accept the judgement that Anthony's health did not have a decisive influence at least on the conduct of his policy. I agree that he might well have pursued the same basic policy had he been well, but I find it very hard to believe that he would have made such obvious miscalculations in its execution both in the political and the military spheres.19

The judgement of the surgeon Braasch is that ‘This sequence of events strongly suggests an important factor of illness in the decision making during the crucial months of October, November and December of 1956’, and in making that judgement he was helped by a review of all the Avon papers by Professor R.C. Simmons of Birmingham University. Also the surgeon, Kune, concludes ‘the Suez Canal debacle … was significantly contributed to by the disastrous and tragic consequences of his bile duct injury’.

His physician, Sir Horace Evans, writing after the Suez crisis, in his letter of 15 January 1957, explains the feverish attacks, certainly those with rigors, of which the most serious was that of 5 October 1956, as indicating a transient ascending infection of the liver ducts, which he treated with mild sulphur drugs.20 The fever on 5 October took place on a Friday afternoon while Eden was visiting his wife who was an in-patient at University College Hospital. He suddenly felt freezing cold and began to shake uncontrollably with a fever. On medical advice, he went to bed in a room close to his wife's and his temperature rose to 106°F, a very high reading for an adult. He was allowed to leave, it has been reported, much refreshed on Monday, 8 October. Most people were quite unaware of what had happened, including his colleagues. Eden carried on work, but as his official biographer noted, ‘a sinister bell had been sounded’. What is harder to unravel, apart from the cholangitis, is the contribution thereafter made by the sedatives and amphetamines that he was taking. Some have claimed that this high temperature could have been stimulated by taking amphetamines. A survey of the literature provides no convincing evidence for this.

To place the fever of 5 October in the context of the time, one needs to acknowledge that the Suez crisis was now coming to a head. On 3 October in Cabinet, Eden said there was ‘a risk that the Soviet Union might conclude a pact of mutual assistance with Egypt; if that happened it would become much more hazardous to attempt a settlement of this dispute by force’. He knew too that as the British troop build up continued in Cyprus and elsewhere there would come a moment when he could not hold them in a state of military readiness, and on 5 October in the Security Council, Egypt complained about both British and French troop movements. On 8 October, Butler chaired the Egypt Committee, which normally would have been chaired by Eden, who came out of hospital that day.

Later that week Eden, however, was well enough to speak in the traditional leader's slot on the last day of the Conservative Party Conference on Saturday 13 October at Llandudno. The party faithful loved the passage when he said, ‘We have always said that with us force is the last resort, but cannot be excluded. We have refused to say that in no circumstances would we ever use force. No responsible government could ever give such a pledge’.

On the same day as his speech, he was informed in Wales by Anthony Nutting that the French Prime Minister Mollet had requested that Eden urgently see emissaries whom he wanted to send over from Paris. The French had been in close contact with Israel ever since Egypt's 1954 agreement with Britain. Israel felt the British troop withdrawal from Egypt had made them more vulnerable, while France feared Egyptian interference in their massive military and political challenge in Algeria. French arms sales to Israel were already stretching the balance of arms provision in the Tripartite Agreement which France had signed with the US and the UK. On the evening of 13 October after the Prime Minister had returned to Chequers from the Conference, Nutting told him on the telephone about the visit to London by Sir Gladwyn Jebb, our Ambassador in Paris. Jebb had revealed that the French had delivered 75 of the latest Mystere fighter aircraft to Israel without it being cleared with the UK and the Americans as part of the procedures of the Tripartite Agreement. Eden was suspicious, and asked Nutting whether the French were putting up the Israelis to attack Jordan, which was a major British anxiety at the time. Eden appeared not to have had any inkling that the French were already deep in collusion with the Israelis over Egypt.

On Sunday 14 October, Eden held a crucial meeting in the afternoon with General Maurice Challe, a Deputy Chief of Staff of the French Air Force and the French acting Foreign Minister, Albert Gazier. Anthony Nutting had lunch with Eden first when they discussed with some hope the direct negotiations Selwyn Lloyd was having in New York with the Egyptian Foreign Minister. The Challe Plan contained the first indication of a ‘conspiracy’ with Israel which was later to haunt Eden's conduct of the Suez crisis. It is cited by some as a sign of a slightly paranoid mental state that when his private secretary, Guy Millard, prepared to take a record, Eden said, ‘There's no need to take notes, Guy’. But in fairness to Eden, once a note had been taken, it would have been hard for the Private Secretary not to circulate it at the very least to the Permanent Secretary to the Foreign Office. He would have then circulated it to other senior diplomats and by telegram to the Foreign Secretary in New York. The circle of people in the know would have inexorably widened. It was wholly legitimate for Eden at this early stage to decide for himself who should be in the know.

The Challe Plan was that Israel would invade the Suez Canal Zone area, British and French forces having previously agreed with Israel to intervene to separate Israeli and Egyptian forces, posing to the world as peacekeepers between the combatants. The Royal Air Force would take out Egyptian planes which might otherwise threaten Israeli territory. To any Prime Minister, let alone Eden with his vast experience as Foreign Secretary, this was a highly contentious plan, and one that was bound to be fraught with political dangers at home and abroad. Eden did not formally commit himself to the plan, but that was in itself a decision. The nature of his questions left the French in little doubt that he was on board for the concept. Challe sensed that Eden was thrilled, Millard felt he was merely ‘intrigued’. The normally cautious pro-Arab Eden might have been expected, on his past record, to have ruled out the plan from the moment he heard of it. Nutting, previously very close to Eden, asked in his book, ‘How and why was this mortal decision arrived at? And how and why did the man, whose whole political career had been founded on his genius for negotiation, act so wildly out of character?’21 It was over these few days that Eden also decided that he would have to proceed on the basis of not informing the Americans of his intentions. This was the truly fateful consequence of colluding with Israel and France, and I judge that if Eden had been fit and well, he would have realized that such a course contained the seeds of its own destruction.

Eden decided personally to tell Selwyn Lloyd what Challe had proposed and asked for Lloyd to be summoned to fly back to London, where he arrived on the morning of Tuesday 16 October. Eden authorized Nutting to talk only to two senior Foreign Office diplomats, and specifically excluded the Legal Adviser. Eden knew that the Attorney-General and the Foreign Office Legal Adviser would say that what he proposed to do could not be justified in international law. Instead he relied on advice from the Lord Chancellor, who was not constitutionally the Legal Adviser to the Cabinet or the Prime Minister, but who maintained that intervention could be legally justified.22 After Cabinet, Eden and Lloyd had lunch together before they both flew from Heathrow at 4.00 pm to Paris for a meeting with the French Prime Minister, Guy Mollet and his Foreign Minister, Pineau.

Nutting had had a quick conversation with Selwyn Lloyd before the Cabinet telling him what Eden was up to, and claims that Lloyd replied spontaneously: ‘You are right, we must have nothing to do with the French plan’. Nutting spoke to Lloyd again by telephone after his lunch with Eden, but found Lloyd was now in no mood to listen to his pleadings. The relatively inexperienced Foreign Secretary was not only acquiescing in the Challe Plan but saying that his agreement on six principles in New York with the Egyptian Foreign Minister would not be honoured by Nasser.

It was a sign of how desperate Eden had become that he saw the Challe Plan as an opportunity to defeat Nasser, and was ready even to contemplate what the French were advocating. He swept his Foreign Secretary off to Paris within hours of landing from New York, without either man having had, as far as one can determine, any formal professional input from the Foreign Office, though Eden could rely on the Permanent Secretary, Kirkpatrick. This failure to consult was an action quite out of character. This was but one of many examples of how personalized and unstructured Eden's decision-making had become in 10 Downing Street. Even during the Second World War under Churchill, the machinery of the War Cabinet functioned and different Departments of State had their input.

Eden was depending on his political instinct from 14 October onwards, but how sound were those instincts at that time when he had only a week earlier an exceptionally high fever, was daily taking a mixture of sedatives to sleep and stimulants to counter the effect of the drugs, and had been under prolonged stress since the end of July?

Alec Douglas Home, one of nature's gentlemen and someone who would always lean over backwards to be fair, was a supporter of Eden's policy, serving on the Egypt Committee. He described Eden's conduct of such meetings in a retrospective BBC radio programme in 1987.23 ‘They were fairly restless’, he said, and the Prime Minister ‘was not undoubtedly well. I don't think it probably clouded his judgement, that will be for historians to tell us later on’. He went on to say that the ‘meetings were probably not as methodically conducted as at times of lesser stress’. On the same programme the Permanent Secretary at the Ministry of Defence, Sir Robert Powell, whom Eden constantly rang up, described him as ‘very jumpy, very nervy, very wrought’. In another interview Sir Richard describes Eden as having ‘developed what one might call a pathological feeling about Nasser’ and as being ‘in a state of what you might call exaltation … He wasn't really 100% in control of himself. Extraordinary, strange things happened.’24 Air Chief Marshall, Sir William Dickson, Chairman of the Chiefs of Staff Committee, speaking in April 1957 to Churchill's former Private Secretary, John Colville, used the same word ‘exaltation‘, saying Eden ‘during the final days was like a prophet inspired, and he swept the Cabinet and the Chiefs of Staff along with him, brushing aside any counter arguments and carrying all by his exaltation’. Webster's International Dictionary defines exaltation as ‘a marked or excessive intensification of a mental state … a delusive euphoria.’ Dickson also said he ‘had never been spoken to in his life in the way the PM several times spoke to him during those tempestuous days.‘25

Against these descriptions one has to weigh the account of Eden's coolness under the strain and stress of 30 October, when Eden telegraphed Eisenhower after the launch of the invasion that he felt that ‘decisive action should be taken at once to stop the hostilities‘, by his Press Secretary, William Clark, who opposed the invasion. He described Eden's and Lloyd's mood, saying: ‘The big decisions are over and they seem calm and detached’. Also Elizabeth Home, on 31 October, when British bombers attacked military bases in Egypt, wrote: ‘Much impressed by how well the PM and everyone in Government look’.26 There are, however, many other observations from people involved at the time confirming that the volatile personality of Eden was at various times in the Suez Crisis reacting atypically to the strain.

Eden's personality as it developed over the years is openly explored by Robert Rhodes James, and with some candour, helped by the author having been a Clerk to the House of Commons and then a Conservative MP, and writing from actual experience of how politics is ‘a high stress profession’. He makes no attempt to hide that Eden was highly strung, but he writes that he seldom became angry when really important matters were involved, but instead did so over irritating trivialities, usually in his own home, and very seldom did he lose his temper in public. An exception to this that he cites was when Eden lost his temper on the floor of the House of Commons. General Glubb, the British Commander in Chief of the Jordanian Army, had been peremptorily dismissed by King Hussein, and Eden, who thought Nasser had been trying to destabilize Jordan for some time, overreacted. The Labour Opposition forced a debate in the House of Commons on 7 March 1956, and when Eden came to make the wind-up speech, the House was in a noisy mood. After his speech, which in his memoirs Eden describes as one of the worst in his career, there were derisive cries of ‘Resign!’. Clarissa Eden wrote in her diary on 7 March, ‘The events in Jordan have shattered A. He is fighting very bad fatigue which is sapping his power of thought. Tonight's winding up of the debate was a shambles.‘27

Anthony Nutting describes Eden shouting down the phone at him, ‘What's all this nonsense about isolating Nasser or ‘neutralising’ him as you call it? I want him destroyed, can't you understand? I want him removed and if you and the Foreign Office don't agree, then you’d better come to the Cabinet and explain why.’28 Whether this account is true or not, it was true that Eden wanted regime change, not just to control the Canal. Another example of Eden's irritability is described in an incident involving the Foreign Office lawyer who reported back to Eden on the research he had ordered into the legality of Nasser's action, saying that Nasser's action was indeed perfectly legal so long as he did not close the canal to shipping. Eden allegedly tore up the report in front of the lawyer and flung it in the lawyer's face.‘29 Since there was almost certainly a civil servant present on this occasion, it is stretching one's imagination that Eden behaved quite like this report, and one has to be very careful about assuming that stories such as these are true. To illustrate this, The Times on 29 November 2003 carried an interview with John le Carré by James Naughtie. Le Carré, who was a master at Eton during Suez, said that during the crisis Eden found time on several evenings to climb into the prime ministerial car to drive to Eton and consult his old housemaster about what to do. Two people who knew Eden's movements challenged whether he could have made such visits, and his biographer, Richard Thorpe, pointed out that his housemaster had died in February 1956. All received apologies from le Carré and a promise of retraction, but even this story may at some stage reappear as fact. Another example is an incident described in Leonard Mosley's book on Dulles,30 in which the widely respected military expert and historian, Captain R.H. Liddell Hart is reputed to have had a meeting with Eden in 10 Downing Street, during which Eden threw an inkwell at Liddell Hart. Yet this story is pure fiction, as Liddell Hart's wife and son confirm, since the men never actually met during the Suez Crisis.

Lord William Deedes, the distinguished journalist, who was also a Minister in Eden's government, accurately said on television in 2004 that during the Suez crisis, Eden ‘under prescription had, as many did, and still do, barbiturates, I think, to assist rest and sleep etc. and amphetamines sometimes for a little bit of a pick up’, and agreed that this was what was called ‘uppers and downers’.31 That combination is contained in Drinamyl, identified by Eden's own doctor as the drug he was on. Drinamyl is now very rarely used, as the medical profession have become more aware of their effect on judgement, energy and mood. Deedes’ account, however, contrasts with Eden's wife's view that he was not taking ‘uppers and downers’ and was only taking anything like it (Benzedrine) in the last fortnight before he resigned.32

There have been a number of stories about Eden being on very large doses of amphetamines such as Benzedrine. Hugh Thomas, the historian, alleges that Eden told an adviser that he was practically living on Benzedrine.33 Thomas also wrote that a leading doctor who knew Eden well—probably Dr T. Hunt—thought he would not have acted very differently in the Suez Crisis if he had been in robust health. Hugh Thomas, nevertheless, went on to write, despite that viewpoint, that he felt it was also possible that from his fever in October onwards, Eden was really ill and that his doctors should have recommended his resignation.34

If Eden had decided to resign on grounds of ill health, or more likely to go to Jamaica to recuperate, in the week of the Party Conference beginning on 9 October, not as he did later in November, the history of the Suez Crisis would have been very different. Selwyn Lloyd's negotiations in New York with the Egyptian Foreign Minister, which Eden and Nutting considered with a measure of optimism before meeting Challe at Chequers, would have been given a few more weeks. Neither a caretaker Prime Minister, like Rab Butler, nor any new Prime Minister would have been in any position even to consider a totally new policy like that proposed by Israel until after the US Presidential elections on 6 November.

Guy Millard, Eden's junior Private Secretary in the Foreign Office during the Second World War who then served the Prime Minister within 10 Downing Street, was not only present at all his most important meetings on international affairs, but would see him late at night, early in the morning, read his notations on documents and listen in on many of his telephone conversations. A contemporaneous diary entry of 1 November 1956 on Eden's state of mind in October by a Foreign Office diplomat quotes Millard: ‘Guy Millard says he is not mad, but merely exhausted.35

Eden was certainly not mad, nor drugged in a way that he could not conduct himself as Prime Minister, and his stamina was in many ways remarkable after his fever. What is at issue was whether his decision-making, his judgement, were functioning at the same levels of consistency, caution, courage and calculation in October 1956, as during his conduct of Foreign Policy over the previous two decades. For example, Eden deliberated carefully and consulted widely during his period of disillusionment with Chamberlain, which led up to his resignation in 1938. During the Second World War, on numerous occasions it is well documented how he provided stability to Churchill's decision-making. After 1951, when he returned to government as Foreign Secretary, Eden's foreign policy decisions were taken dispassionately and like the 1954 Suez Canal Agreement, explicable in the context of the time. Yet analysing the crucial month of October 1956, one sees an honourable and courageous man, borne down by illness and fatigue, weighing very difficult questions but then making too many decisions which were not in keeping with his past record. An historical analysis by Professor David Dutton, who wrote a book on Anthony Eden: A Life and Reputation, also concludes that ‘it is difficult to understand why Eden believed that he would get away with the Franco/Israeli plan and conceal it from the United States, unless you believe that his judgement was not what it was at its peak.’ He also goes on to say that ‘all the evidence is that he [Eden] was seriously ill by that stage … In the beginning of October he was weak and tired and desperately in need of a rest and probably on the verge of a nervous breakdown‘36

In Eden's defence, why did the Cabinet of healthy men on 23 October and on 4 November go along with the policy and then by 6 November be ready to disown the policy? The short answer to both questions is realpolitik, and for a few of them, particularly Macmillan, party politics. Any Prime Minister on international affairs supported by the Foreign Secretary has great influence on a Cabinet—similar to, but rather greater than, the effect on domestic affairs when supported by the Chancellor of the Exchequer. Harold Macmillan had advised Eden on scant evidence after visiting Washington in September that the Americans would ‘lie doggo’. Macmillan, however, apparently had a slight ‘wobble’ at the Egypt Committee on 4 November, but had no wish to jeopardize his position within the Conservative Party when that same day each member of the Cabinet was asked for their view on military action. It was only when his judgement of Eisenhower's reaction was proved wrong that on the night of 5–6 November he changed,37 and this was powerful because he was able to speak with the authority of being Chancellor about the danger to the pound. Eden's authority, never more brittle than on 6 November, could have been challenged by Macmillan, the one man who could have swayed a Cabinet that had already lost its nerve to disown Eden. Eden summoned the Cabinet to meet in his room in the House of Commons at 9.45 am, and said that with the Americans likely to support economic sanctions in the Security Council later that day, there was no alternative but to announce a ceasefire. It was not the threatening letter from the Soviet leader Bulganin, or even the pressure on the pound: the crucial reality was France and Britain had run out of friends. It was a diplomatic debacle. It would have been wiser from Eden's point of view to have delayed calling the Cabinet together until 7 November, taking the whole Canal in the meantime and then veto with the French any UN resolution on sanctions.

Robert Rhodes James admits that over Suez it is difficult for him ‘to be precise about the factors that pushed Eden from an absolutely legitimate position to what was perilously close to being an illegitimate one’.38 Along that path, we will probably never know what was the exact dosage of amphetamines Eden was taking, but on the assumption that he was by October taking more than one Drinamyl tablet a day, a review of the literature indicates that it could have affected his judgement and decisions, making him more changeable and unpredictable from one day to another, depending on whether he was under greater influence of their stimulant or their sedative actions.

Figure 4.

Soldiers boarding the troopship Dilwara at Southampton, November 1956.

Figure 5.

French commandos going ashore in an amphibious tank at Port Fuad, Egypt, 10 November 1956.

Undoubtedly Eden saw Russia and their short- to long-term intentions in the Middle East as an immense threat. His views are clearly expressed in a letter he wrote to a fellow Conservative MP, Irene Ward, on 28 December 1956:

I find it strange that so few, if any, have compared these events to 1938 —yet it is so like. Of course Egypt is no Germany, but Russia is, and Egypt just her pawn. If we had let events drift until the spring I have little doubt that by then, or about then, Russia and Egypt would have been ready to pounce, with Israel as the apparent target and western interests as the real one. Russians don't give away all that equipment for fun.’

‘Yet so many seem to fail to see this and give Nasser almost as much trust as others gave Hitler years ago.’39

Yet an assessment of the way Eden was using intelligence at the time has been provided by Percy Cradock, a very experienced diplomat and former Chairman of the Joint Intelligence Committee, and someone well aware of how a Prime Minister functions in No 10. He wrote that ‘by the Spring of 1956 JIC assessments were not having much influence on Eden. He had by now come to see Nasser as irredeemable; he regarded himself as an authority on the area; and he was already falling into the dangerous practice of selecting the pieces of intelligence that fitted his preconceptions and neglecting the Committee's more balanced overall view.‘40 A somewhat similar situation to that which existed prior to the invasion of Iraq by Tony Blair as Prime Minister.

Eden has written his own memoirs in which he refers to the Russian threat and relations with the US. The private and succinct explanation of the reasons for the initial military intervention and then its withdrawal that he gave to his former and still very trusted Private Secretary, Bob Pierson Dixon, gives a special insight. Dixon had flown up from the UN in New York to meet Eden at his request in Ottawa on 25 May 1957, and found Eden:

‘sure that it was right to have intervened. The trouble was that one could never prove that the situation would have been worse if action had not been taken. He still felt that the issue against Nasser was really the same as the issue against Mussolini – something had to be done to stop dictatorship. To take another example, had we moved against Hitler over the Rhineland there would have been much criticism but it would have been the right thing to do and many millions of lives would have been saved. His calculation was that Nasser and the Russians would have moved in the Middle East (presumably against Israel) about March or April of this year. Since the troops could not be kept hanging on indefinitely in Cyprus, he had felt bound to take the decision at the end of October to strike before the Egyptians.’

‘Sir Anthony said that he did not mind about the ceasefire. By that time we were ashore in Port Said and thus had a ‘gage’. What he did object to was the way in which the United States had pushed us into immediate withdrawal. Mr Lodge [US Ambassador at the UN] was the real nigger in the woodpile and could not easily be forgiven for his failure to support the Belgian amendment. He had good reason to believe that President Eisenhower did not want to push us into immediate withdrawal which, of course, spoilt the whole operation. On the morning of the ceasefire the President had telephoned to him and said he was glad about the ceasefire and had added that now that we were ashore he supposed that we had all we needed. Sir Anthony had not been able to pursue the conversation since he was off to the House of Commons to announce the ceasefire and had told the President that he would call him back. After lunch he had spoken to the President and suggested that they ought to ‘get together’. The President had agreed, and asked when. Sir Anthony had said, the sooner the better. The President then suggested that M. Mollet ought to come too, and Sir Anthony had agreed to bring him along. The President had said something about resolutions that were being prepared in the United Nations, to which Sir Anthony had said that he did not want to talk about the United Nations. With some difficulty he had then persuaded M. Mollet to fly to Washington that evening. Later in the afternoon the President had again telephoned and said that, on thinking the matter over, he believed that the moment was not ripe for a visit from the British and French Prime Ministers. Sir Anthony believed that he had consulted Mr Dulles in hospital and that Mr Dulles had advised against the visit.’

‘Sir Anthony said that he knew that he had been criticized for not having informed the Americans in advance about the operation. But how could he have done this? It would simply have brought Mr Dulles across the Atlantic for the fifth time and it would have been very difficult to have gone ahead in the face of US objections.’

Yet given, correctly or incorrectly, that the Soviet Union's link to Nasser was as high a concern to Eden, it is even harder to understand why he did not realize how much, therefore, the UK would need American support, and how unwise it was for him to risk angering Eisenhower in the week before the Presidential election. Alec Douglas Home41 criticizes Eisenhower for demonstrating his hostility by sailing the US Sixth fleet alongside the British invasion force, but that is to underrate the toughness that underlay the friendly personality of ‘Ike’ as he was commonly called. Given that Eden had known Eisenhower for over a decade, it was a major misjudgement of his character to believe that he would not react to being misled on such a vital issue by someone he had previously trusted. The truth, as the then British Ambassador later said,42 was that Eisenhower, not Dulles, made the major choices in US foreign policy. Eisenhower, not unreasonably, felt betrayed by Eden's behaviour, though, just after being elected for a second term, he was more generous to Eden than Dulles. It was Dulles who persuaded Eisenhower not to see Eden and Mollet so soon after the ceasefire while in hospital, strongly influenced by the acting Head of State Department, Herbert Hoover. Had the invasion been launched on 7 November, Eisenhower's reaction might have been more muted and it could have been that the whole Canal would have been taken by the British and French troops.

Figure 6.

Scuttled ships blocking the entrance to the Suez canal at Port Said, 19 November 1956.

It is easy to be overly moralistic about what is done to win in times of war. Collusion is certainly not unknown in war time. Since the Cabinet papers were revealed in January 1987 under the 30 year rule, however, there can no longer be any doubt that the Cabinet were fully told about this collusion on 23 October, arising from ‘secret conversations’ in a confidential annex. There was also a structured Egypt Committee of the Cabinet, though this was suspended from 17 October to 1 November. Eden's conduct was not, however, like Tony Blair's conduct of the Cabinet over Iraq, where we learn from the Butler Enquiry in 2004 there were no detailed papers circulated by Tony Blair before Cabinet discussion, no detailed papers circulated or minutes taken in informal meetings with senior Cabinet colleagues before the invasion, and no structured decision making. Sadly neither Prime Minister gave sufficient detailed consideration as to how to handle the aftermath of their respective invasions. There was a crucial difference, however. Blair was acting in support of the US President, whereas Eden was acting against the clear-cut advice of the US President.

It can be justified that no hint of collusion was given to the House of Commons during the actual military operation, but it was Eden's attempt to send two diplomats back to Paris to gather up and to destroy all the copies of what was later called the Protocol of Sevres,43 a suburb of Paris, which was so bizarre. Selwyn Lloyd attended the initial meeting at Sevres, and the second Sevres meeting involved a senior diplomat, Patrick Dean, and Lloyd's Private secretary, Donald Logan. The French Prime Minister, Mollet, and the Israeli Prime Minister, Ben-Gurion,44 attended having agreed to total and permanent secrecy. In democracies, Eden should have known there can be no question of perpetual secrecy. The French and the Israeli leaders afterwards resented the British Cabinet's decision to halt the advancing troops down the Canal and they had no guilty consciences about the military operation even after its failure. It was also a wholly unrealistic view of Eden's that any cover-up could be kept from American intelligence for much longer than a few weeks at best. Indeed, the CIA claimed to have known at the time. More realistic than Eden, Pineau told the US about the facts of their collusion while Eden was still pretending to the Americans that no collusion had taken place, compounding US anger. Eden's continued cover-up diminished his standing, and for Eden to say in the House of Commons on 20 December45 that ‘there was not foreknowledge that Israel would attack Egypt’ was to lie, something which he had never done in over 32 years as an MP and was totally out of character.

As a patient, undergoing surgery, Braasch pays tribute to Eden, writing that he was a model of cooperation and possessed an even humour at times of stress. But it is hard to escape the conclusion that as a politician under the stress of holding the job of Prime Minister during the Suez crisis, Eden's illness and his treatment got to him in ways that did affect his judgement and decision-making. There should be no shame for Eden's family in acknowledging this. He was having to make critical judgements hour by hour, courageously struggling with a serious illness. In some of these decisions he showed the careful consideration on which his great reputation deservedly rested. Yet in relation to three crucial decisions—to collude with Israel; mislead the American President and to lie to the House of Commons, even after the invasion—I believe his judgement was impaired, and his illness and treatment contributed to that impairment. For the good of the country, his doctors should have persuaded him to step out of the decision making process for a time at least after his high fever, and when he returned to No 10 from hospital on 8 October and admitted to Lloyd he was still ‘pretty weak’.

We need to create a climate of opinion that Heads of Government are not immune to the discipline that should and usually now is applied to all other decision-makers, whether Generals or Chief Executives; namely that when ill one must cease to take major decisions. I have studied illness in Heads of Government over the last century,46 and it shows that too often the course of world history has been adversely affected by Heads of Government and by their medical advisers not living with the normal constraints that illness should put on withdrawing from continued decision making when ill. Whether they resign or not is a different question, depending to some extent on circumstances, but essentially it is a political choice.

Eden dictated a note about his last audience as Prime Minister with The Queen on 9 January 1957, before he resigned the next day.47 ‘I told Her that the doctors report which The Queen had seen left me in my judgement no choice but to ask to be relieved of the duties of Her First Minister’. Churchill, whom he had also told in advance of his decision, wrote back that same day, ‘It is important that only one reason should be given—health. Policy and spirit will look after themselves. Anyhow one cannot do more than health allows.’

Guy Millard, Eden's Private Secretary, who 30 years later, in a radio interview, spoke publicly for the first time on the crisis, made an insider's judgement about Eden, ‘It was his mistake of course and a tragic and disastrous mistake for him. I think he overestimated the importance of Nasser, Egypt, the Canal, even of the Middle East itself.’48 A fit and well Anthony Eden would not have made all of those mistakes.

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