The West Wing: "He Shall, From Time to Time..."

In “He Shall, From Time to Time...” the preparations for Bartlet’s second State of the Union address are thrown into disarray when the President collapses in the Oval Office. Meanwhile, Leo faces the press over his past abuse of prescription drugs and alcohol. On top of everything else, the India-Pakistan conflict continues to develop.

‘I worried over the episode,’ said Aaron Sorkin, ‘when Bartlet collapsed and was diagnosed with MS. That wasn’t a particularly strong show.’(1) Sorkin shouldn’t have worried. Without warning, “He Shall, From Time to Time...” rushes up to its audience and rips the rug right out from under its feet. This is a game-changing episode that comes to redefine The West Wing’s central character, and forge a new direction for seasons to come.

The episode’s title, “He Shall, From Time to Time...”, comprises the opening words of the passage in the executive powers section of the Constitution which deals with the State of the Union address. The State of the Union is an annual address given by the President to a joint session of the United States Congress. It exists for the President to report on the state of the American nation, but is generally used by the President to outline his or her administration’s legislative agenda for the coming year. The address is derived from the United Kingdom’s annual Speech from the Throne (as Leo notes, it dates back to Parliament), and is required by the United States Constitution. As a part of the traditional process, the President must be officially invited by Congress to enter the House of Representatives Chamber.

At first it all seems a dramatic but not unexpected episode: the story of Leo’s past drug and alcohol addiction is about to break on the eve of the State of the Union address. He struggles with his staff as they try to protect him and ensure the partisan crusade to damage the Bartlet administration doesn’t make him a casualty of the attempt. Leo’s barely controlled anger when he discovers Sam gave the President a letter of support to read is palpable.

From start to finish this episode is a powerhouse showcase for John Spencer. He develops a complex, layered and deeply conflicted performance – sometimes holding back anger, other times tears, and when faced with his daughter in his office there’s a brave front of feigned nonchalance.

Once we think we have a handle on what is taking place, the episode fires the mother of all broadsides. The President, whom the staff (and the audience with them) believe to have a bad case of influenza, also turns out to have multiple sclerosis (MS): he has been hiding a serious medical condition for several years.

Bartlet’s MS, which had an overwhelming impact on the rest of the series, was never part of the character’s original outline, nor was it carefully pre-planned or developed. When interviewed, Aaron Sorkin said ‘it all started because I wanted the president to be in bed watching a soap opera - I wanted him to be experiencing daytime TV, and I didn't want it to just be the flu.’ (2)

It also spun out of Sorkin’s desire to show Abigail Bartlet was a medical doctor. ‘I searched for an interesting way to show that she was an MD,’ Sorkin explained to the New York Times, ‘rather than have her say “as you know, I am a doctor”.’(3) Sorkin asked the writing team to research for a serious medical condition that could generate interesting storylines, yet would not impact too heavily on Bartlet’s ability to be the President. It also needed to be something that would not easily be detected by the President’s regular physical exams. After some discussions with medical advisers and doctors, the writing team came back with MS.

For this and future episodes the writing team consulted with the Southern California chapter of the National MS Society. The Society themselves praised the episode for its depiction of the disease, particularly in how Sorkin emphasised that MS isn’t fatal, and that medical treatments exists to reduce or delay its effects. Briefly, for the unaware: multiple sclerosis (MS) is an inflammatory disease of the central nervous system (CNS). During periods when the disease is active, white blood cells cause an inflammatory response in the brain and spinal cord’s ‘white matter’: that is, the myelin sheathes that protect the nerve fibres linking the central nervous system together. If severe, or untreated, the inflammation can cause permanent scarring or even the complete loss of myelin in certain parts of the CNS. What symptoms occur is entirely dependent on where the damage to the CNS occurs, but they can include numbness or tingling, blurred vision and blind spots, memory loss, loss of coordination, paralysis, depression and anxiety. The symptoms vary wildly from one person to another. The severity of symptoms vary wildly from one person to another. It is a degenerative disease – again the severity and nature of the degeneration varies – and there is to date no cure.

President Bartlet’s MS is relatively typical: he experienced blurred vision and numbness in his legs, and after consulting a doctor a magnetic resonance imaging (MRI) scan revealed small lesions on his brain and spinal cord. He has been diagnosed with relapsing-remitting MS, where he will have an attack and a loss of ability, but will subsequently regain most or even all of that ability once the attack has been treated. Relapsing-remitting MS commonly transforms into secondary-progressive MS some years after diagnosis. Secondary-progressive MS is more severe, and is typified by a gradual and unrecoverable loss of function in the brain (and therefore body). Statistics indicate that the severity of one’s MS will depend on factors such as age and gender. A woman diagnosed in her teens will often have severe MS. A middle-aged man, such as Jed Bartlet, will generally be diagnosed with a milder version of the disease – at least at first.

Not every viewer was satisfied with the President’s MS, including Dr Thomas Leist, who treated MS patients at the Thomas Jefferson University Hospital in Philadelphia. ‘If this is a reflection of MS,’ he noted, ‘it’s the most optimistic reflection.’ (4) One of the most common major symptoms of multiple sclerosis is chronic fatigue. No matter the infrequency of attacks, or the amount of interferons Bartlet is injected with, fatigue should easily get the better of his stressful and non-stop lifestyle. Either Bartlet has about the mildest MS imaginable, or we must as viewers take a leap of faith and ignore the facts in favour of the best story. The drug that Bartlet is taking by injection to treat his MS, Betaseron, is a genuine drug used in the treatment of the disease. It is a form of beta interferon, which helps reduce the frequency and severity of attacks. If Bartlet is a typical MS patient, he will be receiving an injection once every two days.

The MS allows us to see a completely new side to President Bartlet. We see it 25 minutes in, when Leo – who has just learned about the President’s condition – goes to speak with him about it. He’s mad as hell. He scolds him. Quite significantly he calls him ‘Jed’. ‘You haven’t called me Jed since the campaign,’ replies a surprised Bartlet. ‘It rips on a lot of levels,’ said John Spencer, ‘the disappointment and the hurt that my best friend on earth didn’t share something so great with me... fear, because there’s a duality now, a kind of devotion and love for [Bartlet] as the man, and a desire to protect the presidency and the administration.’(5) Finally we meet Jed Bartlet the man: not the Nobel laureate, or the politician, or the vengeful Commander-in-Chief, or the President of the United States. This is just a man: he has lied to his friend, he has kept secrets, and he is ashamed. It’s a beautifully played scene – both men look as if they’re on the verge of bursting into tears – and absolutely cements the closest of friendships in the entire series.

The MS also sets The West Wing on course for Seasons 2 and 3, with Bartlet’s public admission of the disease and the resulting fallout forming the central story arc for the next two years. Shortly after the episode aired, Aaron Sorkin admitted that ‘basically, all I was thinking during that entire thing, was, “was the MS a terrible mistake? My God, what have I done? I've absolutely torpedoed my series. What did I do?”’(6)

The gravity of the episode seems to extend to the other characters. Abbey is a far more sharper, edgy character here than in “The State Dinner”. Part of that is her concern for her husband but it seems Aaron Sorkin went a step further than that. It’s this edgier version of the character that stays for the rest of the series. It is also established here for the first time that Abbey is a doctor: it positions her as a capable, independent, highly intelligent woman – an equal to her Nobel laureate husband. ‘I never have a lot of medical terminology,’ Stockard Channing later noted. ‘They learned that about the first or second year of West Wing. I’m hopeless at it. They just let me go with other stuff. On take 10, they said, “This is the end of this. This is clearly not her forte.” I don't see how they do it on ER.’(7)

 Likewise Lord Marbury (Roger Rees) has been toned down. The eccentricity remains, but here it seems to complement the rest of the episode rather than combat it.

In between Bartlet’s health scare and Leo’s press conference, Toby forces a rewrite of the State of the Union address with a day and a half to spare. It’s a wonderful episode for Toby, displaying his now trademark gruff idealism in its purest form. For all the build-up we never actually hear Bartlet’s speech. This becomes quite a common occurrence in The West Wing, and it is a genius manoeuvre on Sorkin’s part: it’s incredibly difficult to write a first-class political address, so why not skip it entirely and just assure your audience it was brilliant? Much as it sounds like a cliché, the speech in our imaginations will always be better than the speech we could have seen. More than that: in The West Wing, the speech itself is rarely the point of any given episode.

There’s a mild romantic through-line in the episode. This week Sam is continuing his Mallory O’Brian subplot, rather than the Laurie one. When Mallory has passionately kissed him, Sam admits ‘well now I’m even more confused’. I think perhaps half his audience is with him. C.J. and Danny finally kiss, in a wonderfully played comedy scene. It – and the President’s conversation with Secretary of Agriculture Roger Tribby – help end the episode on a much warmer and more positive note than it’s sustained for the rest of the running time.

Harry Groener plays Roger Tribby. Sharp-eyed viewers might notice that back in “Enemies” there is a different actor playing the Secretary of Agriculture during the cabinet meeting. Secretary Tribby briefly returns in Season 4’s final episode, “Twenty Five”. Born in Germany in 1951, Groener is a three-time Tony Award nominee, for Oklahoma, Cats and Crazy for You. Fans of cult television will probably best recognise Groener from his 14-episode stint as Mayor Richard Wilkins in Buffy the Vampire Slayer. Other television roles include playing Ralph Drang in Dear John, Brockwell in four episodes of Mad About You, Gunther the Chef in Las Vegas, and one-off appearances in CSI: Crime Scene Investigation, Bones, Enterprise, Malcolm in the Middle, Boston Public and Star Trek: The Next Generation.

Bartlet’s conversation with Tribby is beautifully written and lightly played. Watching Bartlet describe Tribby’s perfect chief of staff – your best friend, smarter than you are, and you’d trust him with your life – while Leo overhears from the next room is a genuinely touching moment. Both men have had an emotional fall in this episode, but their friendship is as strong as ever.

David Spielberg plays the clueless congressman who doesn’t know the difference between Arthur Murray and Arthur Miller. Spielberg had previously played Dr Neil Bernstein in ER and Herb Ketcher in Wiseguy. Also sitting in on Toby’s NEA meeting are Austin Tichenor as Raymond Burns and Ronne Troup as Pratt. Tichenor is best known for his recurring role as A.D.A. Tisbury in David E. Kelley’s The Practice. Troup is best known for playing Polly Williams Douglas on My Three Sons from 1970 to 1972. Madison Mason plays Admiral Hackett, the President’s on-duty physician. Mason has guest starred in Knot’s Landing, Designing Women, Dynasty, L.A. Law, Matlock, The Wonder Years, MacGyver and The X Files.

The episode was directed by Arlene Sanford. The first woman to direct for the series, Sanford had been a director for television since the mid-1980s. She has directed episodes of Designing Women, The Wonder Years, Newhart, Ferris Bueller, Dream On, Friends, All-American Girl, Caroline in the City, Dawson’s Creek, Ally McBeal, Desperate Housewives and Boston Legal. Sanford, like all female television directors, is a rare commodity. In the 2013-14 US television season, for example, only seven per cent of the episodes broadcast on American television were directed by women. Interviewed by the DGA Quarterly, Sanford noted ‘I think there are a lot of myths about women directors that producers need to be educated about. We still hear that we can’t control a set. But if we’re too powerful then we’re bitches.’(8)

Sanford is the first of seven women to direct for The West Wing: the others are Laura Innes, Jessica Yu, Lesli Linka Glatter, Mimi Leder, Matia Karrell and Julie Hebert. Together they directed 21 out of 155 episodes, or 13.5%. In this regard the series is somewhat ahead of the curve in comparison to other American TV dramas.

The television show that President Bartlet and Charlie are watching while the President is in bed with the flu is Passions, an NBC soap opera. The woman on-screen (with the severe bun hairstyle) is Pilar Lopez-Fitzgerald, portrayed by Eva Tamargo. The woman she is talking to (who at first we can only see the back of) is Ivy (Winthrop) Crane, portrayed by Kim Johnston Ulrich.

Aaron Sorkin may have felt “He Shall, From Time to Time...” was one of his weaker episodes, but he is truly doing himself a disservice. While it does have some slightly shaky moments (the President’s collapse in the teaser feels like an extraordinary cliché), it is comprised of well-crafted scenes and beautifully human performances. In many respects it is a perfect West Wing episode: uplifting, dramatic, funny, heartfelt and enticingly idealistic.

If you want to read more, all West Wing posts have been indexed here.

1. Dusty Saunders, “Wing cliffhanger a sellout? Hang in there”, Rocky Mountain News, 18 July 2000.

2. Tom Feran, “President’s collapse surprised fans, The West Wing”, Cleveland Plain Dealer, 19 January 2000.

3. Lawrence K. Altman, "The Politics of Illness", The New York Times, 15 October 2001.

4. Randy Dotinga, “MS goes West”, Health Scout News, 26 November 2001.

5. Ellen Gray, “A doctored plot”, Philadelphia Daily News, 19 January 2000.

6. Lisa Lipman, “The West Wing creator talks about MS storyline”, The Post and Courier, 30 January 2000.

7. Kate O’Hare, “Channing Returns for More ‘Practice’”, zap2it.com, 22 March 2006.

8. Amy Dawes, “DGA Roundtables: Female Directors”, DGA Quarterly, Fall 2006.