This engaging collection edited by Jeffrey Engel and Thomas Knock brings a fresh aspect to the historiography of the American presidency. Twelve leading scholars offer a series of thought-provoking chapters on the human dimension of being the nation's chief executive. Stories of presidential illness and personal challenges are well documented in print and film. What Engel and Knock achieve is to marry together actions and circumstance in order to offer explanation and observation on how personal difficulty faced by individual Presidents may actually have directly impacted their presidency and decision making. Written in an era when our understanding of mental health has vastly improved, and the stigmas relating to it are reduced, this book feels timely and insightful. It reminds us that like everyone else, Presidents have shouldered their share of psychological, emotional, medical, marital and familial difficulty.

The collection offers three typologies of personal presidential challenges, in the form of bereavement, scandal and illness. At times during these twelve chronological stories, the themes overlap or are extended. Aaron Scott Crawford's chapter on John Tyler deals with the difficulty of filling a deceased predecessor's shoes, whilst Daniel Feller's opening chapter offers a riveting account of Andrew Jackson's break with John C. Calhoun.

Subsequent chapters deal with the more straightforward, if devastating, challenge of personal loss. Michael F. Holt and Michael Burlingame analyse respectively the consequences of family bereavement for Franklin Pierce and Abraham Lincoln. Holt's tale of the Pierce family loss is an especially traumatic one as Franklin and his wife had to deal with the death of each of their three sons, the final one in a train crash where he died violently in front of them. Whilst historians agree that there were never outward signs of Pierce's bereavement, despite his acknowledged shortcomings as President, there is perhaps a wider observation to be drawn from the inevitable fact that when Presidents and their families face profound personal challenges, the impact may manifest in ways that are difficult to measure.

Michael Burlingame considers the impact on Abraham Lincoln of the death of his eleven-year-old son Willie. In 1862, two of Lincoln's boys fell ill, and Willie's death caused his father to remain “in a stupor of grief” (89). Mary Lincoln had apparently demonstrated signs of psychological imbalance long before her son's death, but this loss took her to such extreme mental ill health that she was later confined to a psychiatric hospital. Burlingame does not attempt to overtly link Lincoln's loss to any specific development in his presidency in the way that Holt does, but there is a strong sense that this experience acted as a microcosm for the epic loss of young men that the nation at large faced, in the form of 700,000 soldiers’ lives. The story of Calvin Coolidge reacting to the death of his sixteen-year-old son has a positive message, as Amity Shales concludes that in the long term, the bereavement made for a better President.

Later chapters deal with the consequences of physical illness, as experienced by Woodrow Wilson in the form of a stroke, Franklin D. Roosevelt's paralysis and the Kennedy family's range of health issues. Any book that touches on the mental health of Presidents must have sections on Lyndon Johnson and Richard Nixon, with their depressive personalities and paranoid leadership style. Here Randall B. Woods and Jeremi Suri consider examples of the impact that these imperial Presidents and their complex psychological challenges had on key moments in their presidencies. William Chafe's reflections on the Clinton marriage and the impact of their relationship on key moments of the “disastrous first term” (3) chime with Feller's chapter on Andrew Jackson and the Eaton affair.

Probably the most powerful content, in terms of consequence, is the suggestion by Kiron Skinner that Ronald Reagan's recalibrated approach to dealing with the Soviet Union was a result of the assassination attempt he faced in the early days of his presidency. Skinner credits Reagan's motivation towards improved superpower relations and a safer world in no small part to his own dramatic brush with death.

Engel and Knock's book goes further than what is perhaps the nearest scholarly offering, Robert Gilbert's The Mortal Presidency, written in 2005, as they explore issues relating to emotional intelligence. This raises a range of stimulating questions around the type of individual who may be best equipped to manage the hazardous job of being POTUS.