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routinely did, won him popular respect but alarmed some people. Finance Minister Daim Zainuddin helped locate an American heart specialist travelling in Asia and directed him to Kuala Lumpur.[27] Singapore Prime Minister Lee Kuan Yew, explaining the added risks with less-experienced surgeons, offered to send in, at Singapore's expense, renowned Australian heart specialist Victor Chang.[28] But Dr. Mahathir went ahead, turning his personal ordeal into a national triumph.

One of the few times Dr. Mahathir appeared vulnerable was when confronted by flowers on which pollen was visible, which caused him to have asthmatic attacks. He was also allergic to feathers and dust, once suffering severely on Laying Laying, a Malaysia-claimed outpost in the disputed Spratly Islands, after encountering migratory birds. And, for all his self-control and gruff demeanour, Dr. Mahathir could become emotional in public, periodically breaking down in tears. While some cynics offered him acting awards, Dr. Siti Hasmah had no doubt it was genuine and heart-felt. She said, "Every time this happens, he comes back and says 'I've done something shameful. I was emotional and cried'. I said that's not shameful, it's human."[29]

In the Malaysia that Dr. Mahathir inherited, nerves of steel were necessary as political crises and confrontation became common under his stewardship. While Malaysia was modeled on the British parliamentary system, it had moved away from liberal democracy. Opposition political parties seriously contended for power in regular elections, but the obstacles they faced made it almost impossible to defeat the National Front government. The real political contest took place inside the hothouse of UMNO, given its centrality in the ruling coalition after 1969, rather than in general elections. UMNO delegates chose a president — the party met in General Assembly annually, but voted for office holders every third year — who automatically became prime minister. He would then select his cabinet ministers and appoint the chief minister of each state. By tradition, the party's deputy president was regarded as the heir apparent for the top job.

For inspiration in how to ensure he remained in power, Dr. Mahathir looked no further than the man he criticized for dictatorial traits, Malaysia's first prime minister, Tunku Abdul Rahman. Out of office in 1971, Dr. Mahathir had analysed the Tunku's modus operandi in an academic article. In office, he proceeded down the same path, only more deliberately, systematically and effectively. Dr. Mahathir said the Tunku's first action, on taking over UMNO:

...was to seek amendments to the party's constitution giving the president the right to choose his own secretary-general and nominate six other members of the executive council. These amendments decisively, gave the president complete control of the party...[They] marked the beginning of the end of democratic practices within the party, and by extension within the governments that were dominated by the party...To ensure the president will not be challenged, the 11 state branches of the UMNO were broken up into numerous small divisions which dealt with the headquarters directly...the president arrogated to himself the right to choose all the candidates for elections, his position thus became completely immune to challenge. The drift back to feudalism culminated in the president naming his successor in true feudal fashion.[30]

While Dr. Mahathir appeared to assume the leadership of UMNO smoothly on Hussein Onn's retirement in 1981, his manoeuvrings sowed the seeds of virulent factionalism that surfaced later. Tengku Razaleigh was left feeling he had been double-crossed twice and deprived of his rightful place as deputy president of the party. Tengku Razaleigh concluded that Dr. Mahathir "cannot be trusted",[31] but it was the young Kelantan prince who lost out. Although he almost unseated Dr. Mahathir when he later challenged him for the leadership of UMNO, Tengku Razaleigh was forced from the government altogether, a crushing blow for a man who had been talent spotted for national leadership in his 30s.

Dr. Mahathir had outfoxed Tengku Razaleigh when Hussein Onn summoned them both to a meeting at the prime minister's official residence in Kuala Lumpur and told them he was quitting because of ill health. There was no question he would be succeeded by Dr. Mahathir, who was deputy UMNO president and deputy prime minister. Tengku Razaleigh was finance minister and a party vice president. Hussein "implored the two of us to work together, which Mahathir acknowledged during that meeting", said Tengku Razaleigh. "I thought there was an understanding that we can work together."[32]

Assuming he would be unchallenged for the deputy presidency as part of the tacit agreement, Tengku Razaleigh told "all my chaps" to support Dr. Mahathir for president. But after Dr. Mahathir was nominated unopposed, Tengku Razaleigh found himself in a clash with Musa Hitam, the education minister, for the deputy's slot. Mindful of the need to strengthen his hold on the party, Dr. Mahathir did not openly endorse either, which would have alienated one of the powerful contestants and a legion of followers. Instead, he made a democratic virtue of leaving the choice to the UMNO General Assembly. Behind his publicly neutral stance, however, Dr. Mahathir supported Musa, with whom he had closer personal ties. Dr. Mahathir was wary of the ambitious and popular Tengku Razaleigh, whose royal status was another strike against him in Dr. Mahathir's eyes.[33] By secretly backing Musa's candidacy, Dr. Mahathir hoped to check Tengku Razaleigh's rapid rise, while recognizing that Musa, behind his easy smile, also coveted the top spot.

Tengku Razaleigh said that Dr. Mahathir, once on top, should have behaved "like a father" and not taken sides. "I could easily have become the deputy prime minister" in 1976, he said, by persuading Prime Minister Hussein Onn, a close family friend, to let Tengku Razaleigh challenge Dr. Mahathir for the deputy presidency of the party. At the time, said Tengku Razaleigh, Hussein "was not sure Mahathir should be the man, because Hussein never trusted Mahathir, never liked Mahathir". Instead, Tengku Razaleigh said, he had recommended that Hussein choose Dr. Mahathir. "I could have played to win also," Tengku Razaleigh said, "but I was being too fair — because it's

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