Iranwire – The Supreme Leader of the Islamic Republic of Iran has had heart disease for the best part of 25 years. The fact that Ayatollah Ali Khamenei was diagnosed with this condition as far back as 1998 was only recently revealed in the latest instalment of former Iranian president Akbar Hashemi Rafsanjani’s memoirs.
In his diary entry for May 30, 1998, which was published as part of the new 840-page tome In Search of Expediency, Rafsanjani wrote that he had just learned the news from Ali Akbar Nategh Nouri, then-speaker of the Iranian parliament.
“We had a night-time meeting with the leaders of the branches of power in Mr. Khatami [Mohammad Khatami, then-President of Iran]’s office,” he wrote. “The current situation, the disputes, insults, quarrels and grudges, were condemned, and it was decided that we must come to a solution.
“The orders of the Leadership had been conveyed to Mr. Mohajerani [Ataollah Mohajerani, then-Minister of Culture and Islamic Guidance). Mr. Nategh [Nouri] reported the Leadership’s condition and said the doctors had told him to rest, and that they had scheduled a meeting today to prevent rumors.”
Efforts to Conceal Ali Khamenei’s Illness
The very next day, Rafsanjani wrote that Ayatollah Khomeini’s grandson Hassan had informed him that Khamenei would not be speaking at the annual Demise of Imam Khomeini national holiday on June 4, because of his heart condition. Instead, Rafsanjani was asked to lead the proceedings. “I accepted in principle,” he wrote, “but I emphasized that it would be better if the Leader gave a short speech followed by Mr. Khatami.”
Before 1998, Khamenei had spoken at Khomeini’s tomb ever since the first anniversary of his death on June 3, 1989: the day before Khamenei himself took up the mantle of Supreme Leader. In recent years, Khamenei’s supporters have also used the speech-giving to verbally attack Khomeini’s surviving relatives, especially his grandson.
Rafsanjani then wrote on June 1, 1998, two days after the initial meeting: “I was worried about the news of the Leadership’s illness. I went to his residence without prior notice and found that they had gone to Qom.
“We talked to Mr. Golpayegani [Gholamhossein Mohammadi Golpanyagi, head of the Office of the Supreme Leader] and [office deputy Ali Asghar] Hejazi. They said the doctor had ordered complete rest, and asked me to cancel the noon and evening congregational prayers. There is nothing to worry about at the moment.”
The next day, Rafsanjani met with Hassan Rouhani, as then-secretary of the Supreme National Security Council: “He expressed concern about the Leadership’s situation and the decline in his popularity and health.”
But Rafsanjani then mentions a phone call he received from Ali Asghar Hejazi, who informed him that Khamenei had accepted his suggestion that he give a short speech at Khomeini’s commemoration event.
When June 4 came, Rafsanjani wrote: “We went to the Imam’s shrine for the ceremony. Ayatollah Khamenei was ready to speak briefly after taking pills, but the weakness was evident on his face. I insisted that he try to keep it short… His body language and voice confirmed his illness.”
At the end of his speech, Ayatollah Khamenei in fact made a very brief, documented reference to his illness: “I will limit myself to this today, because friends and doctors will not permit me to speak further.”
The line was picked up by international media at the time. Rafsanjani wrote on June 5 that the state of Khamenei’s health had been seized on by foreign media, stating: “Global reports have paid special attention to Ayatollah Khamenei’s illness. They have called it an ‘unknown disease’, because we had not explicitly stated it is heart disease.”
In the week that followed, Rafsanjani wrote, Khamenei’s office insisted to him on the phone that the Supreme Leader was “fine” and resting in Tehran. On June 11, Khamenei visited the city of Amol in Mazandaran on schedule and criticized factional differences in the country, as well as “foreign enemies”. He spoke in louder tones than he had at the tomb of Ayatollah Khomenei, but also alluded to his illness again: “I did not expect to talk to you this much. I thank God that when I saw you people, I was able to speak. I will cut it short and give a little prayer.”
The Supreme Leader’s Health: A Closely-Guarded Secret
The next private meeting between the ex-President of Iran and the Supreme Leader did not take place until June 14. It was during this talk at Ali Khamenei’s home that Rafsanjani learned he was suffering from aortic stenosis, a common but serious disease that causes one of the heart valves to narrow, restricting blood flow.
“He is better, but is still recovering,” he wrote. “We talked a little. He was tired. I grew sad. The disease is the narrowing of a heart valve, and the doctors emphasize that he should rest. We did not go into a serious discussion.”
Khamenei had given seven public speeches in April to May 1988, a month before his heart disease was diagnosed. In June, the number of public engagements dropped to three, and down to just two in July in August. In October Khamenei then gave eight speeches, suggesting his condition might have improved. But in the winter these appearances tailed off again.
The Supreme Leader of the Islamic Republic’s state of health has always been a carefully-guarded secret by himself and the regime. For the past three decades, Khamenei has sought to stop the tide of rumors about what medical treatment he might or might not be receiving. In 2014, when he underwent prostate surgery, the release of photos from his hospital bed was framed by the Leader’s Office as an “initiative” to prevent “further rumors”.
Khamenei has also had a personal physician by his side throughout during all the years of his rule over Iran. Dr. Mohammad Marandi was most recently pictured with Khamenei earlier this month when he received his second dose of Covid-19 vaccine. After the surgery in 2014, Dr. Marandi had mentioned in passing that Khamenei also had a “pre-existing condition”.
In his 1998 memoirs, which are the 18th volume of his diaries to be published, Rafsanjani also wrote on July 21 that “influential people” in government were lining up to provide medical care and support for Khamenei, but were not permitted to do so.
One of them, he said, was the Islamic Republic’s former foreign minister of 15 years: “Dr. Ali Akbar Velayati, advisor to the Leader on international affairs, came and asked me if he might be able to help the Leader accomplish important tasks. He wants to participate in taking care of the Leader.”