Is Vladimir Putin’s health declining? This question – which has come up regularly in public debate for a few years – has taken on particular urgency in recent days after the publication of several videos in which he seems weakened. One of them, put online on April 21, particularly attracted the attention of Internet users. We see the Russian president, prostrate and pale-faced, during a briefing on Ukraine with his Defense Minister Sergei Shoigu.
For twelve long minutes, Vladimir Putin seems to wince in pain, his head frozen and buried in his collar. Striking detail, his right hand remains firmly gripped to a corner of the table throughout the interview. A way to camouflage tremors? On social networks, the hypothesis of a Parkinson’s disease affecting the head of the Kremlin was quickly raised. A theory that has come to reinforce the publication of another video three days later, in which he is seen welcoming Belarusian President Alexander Lukashenko. One of his legs seems stiff, and his right hand trembles.
But can we really make a medical diagnosis based on a few minutes of video? L’Express asked the question to specialists in Parkinson’s disease. They are formal: even if certain signs can raise questions, it is impossible to conclude with so few images. “A consultation is necessary, in particular to assess the patient’s muscular rigidity. This is linked to the lack of dopamine in the brain, and leads to a reduction in movements, characteristic of the disease”, notes Professor Stéphane Palfi, neurosurgeon at the Henri-Mondor hospital (AP-HP) in Créteil (94).
“It remains very speculative”
Doctors also point out that treatments for Parkinson’s disease today are very effective, at least in the early years: “With a well-treated patient, and I imagine Vladimir Putin would be, you don’t see any sign of pathology”, underlines Professor Philippe Damier, neurologist at the Nantes University Hospital and former president of the scientific council of the France Parkinson association. As the disease progresses and over time, however, the drugs become more difficult to balance. When the patients are a little overdosed, they can then present abnormal gestures: “This could prove to be compatible with the strange hand movement in the video where he meets Alexander Lukashenko, but that remains very speculative”, continues the doctor.
The hesitant gait of the Russian dictator, in this same sequence, is on the other hand not characteristic of Parkinson’s disease: “The patients advance slowly, with the weight of the body which seems to fall forward”, notes the Prof. Palfi. And his way of clinging compulsively to the table during his meeting with his Minister of Defense, in which some believed to guess a desire to conceal tremors? “In fact, we don’t see anything, so we can’t say anything about it. Not to mention that this symptom only appears in 60% of patients, and that many other pathologies can also cause it”, replies Stéphane Palfi. As for the puffy, almost lunar facies of the Russian president, he would plead squarely against this disease: “Patients rather have a face that is hollow”, indicates the neurosurgeon.
In the same way, the swelling of his face would rather tend to rule out thyroid cancer. This hypothesis comes up regularly, however, fueled by the presence with Mr. Putin of specialists in this pathology. The independent Russian media Proekt had indeed revealed in an investigation published at the beginning of April that the oncologist surgeon Evgeny Selivanov would have visited him no less than 35 times and spent a total of 166 days by his side in four years, while two otolino -laryngologists, Igor Esakov and Alexey Shcheglov, would have stayed no less than 282 days at his bedside. “Except that thyroid cancer never causes facial edema, says Dr. Maria Lesnik, ENT and surgeon at the Institut Curie. It manifests as a lump in this gland and is treated with surgery, and possibly radioactive iodine, but nothing that causes swelling or weight gain.”
Steroids or… botox?
Hypothyroidism, that is to say insufficient production of thyroid hormone, could on the other hand cause swelling of the face. But as this condition is easy to treat, the signs should not last, underlines this specialist. There remains the hypothesis of high-dose or long-term treatment with corticosteroids. If they can make you gain weight and swell the face, these drugs are not specific to a precise pathology. Lymphoma, autoimmune or inflammatory disease, kidney disease…: they are very widely used. It is therefore impossible to conclude anything. Especially since, conversely, corticosteroids are not the only ones to give this physical aspect: an excess of botox, used to erase wrinkles, can lead to the same result.
Whether he is sick or not, the dissemination of these images is not without question. More accustomed to performing bare-chested during hunting parties in Siberia, or on the tatami wearing a judogi – Putin is an 8th dan black belt in judo, one of the highest ranks – the head of the Kremlin has built his entire political career on his image as a strong man.
Russian President Vladimir Putin hunting in the Republic of Tuva, Siberia August 15, 2007
DMITRY ASTAKHOV / RIA NOVOSTI / AFP
“The fact of broadcasting these videos where he seems weakened could be a sign that behind the scenes, some are trying to prepare his succession”, advances the historian specializing in Russia Françoise Thom. In Stalin’s time, rumors that he had suffered a cerebral hemorrhage or a heart attack had begun to circulate in diplomatic circles as early as 1945, and then reflected a struggle for influence between his potential successors.
After more than 20 years of reign, very little official information has filtered to date about the state of health of Vladimir Putin, whose Kremlin has never confirmed the slightest serious illness. From his first term, the Russian president had not hesitated “to conceal” a bad fall on horseback he had made, causing him severe back pain, traces the independent Russian media Proekt. This had finally been confirmed – and minimized – years later by the main interested party, when he had mentioned in 2021 having made “a somersault” before landing “quite comfortably”, according to the official speech, on many sawdust.
“Historically, there has always been a cult of secrecy around the health of Russian leaders, and Soviet leaders before them, summarizes Françoise Thom. And when we finally noticed these health problems, it was generally because that they were becoming too obvious to be hidden.” It is still too early to know if this is the case for Putin today.