“Totalitarianism in power invariably replaces all first-rate talents, regardless of their sympathies, with those crackpots and fools whose lack of intelligence and creativity is still the best guarantee of their loyalty.” ― Hannah Arendt, The Origins of Totalitarianism
This gives rise to a machiavellian struggle for power. The inner circle will spend more time plotting against and impeding each other, than working as a cohesive team. Alliances are made and betrayed quickly. Outsiders plot against the insiders to replace them. A sick leader makes this worse.
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Thanks for adding to my rather long reading list ... looks interesting.