The 1958 Middle East crisis led to a change in the relations between the United States and Israel. The Eisenhower administration looked at Israel as a strategic ally in a region that fell under the sway of the Soviet Union. Hesitantly, the seeds for strategic cooperation between the two nations were being sown. The deepening strategic ties between the two nations led the American recognition that the Arab–Israeli conflict was conflated with the Cold War. Consequently, the United States recognized that Israel needed arms in order to maintain its strength whilst facing an Arab military challenge due to the Soviet military support for the Arab states. In a gradual process that began with President Eisenhower and culminated with President Lyndon Johnson, the United States became Israel’s main arm supplier. The 1967 June War further deepened the attachment between the two nations. Evangelicals cherished what they saw as the fulfilment of the prophecies about the restoration of the Jewish state, and the American people and politicians viewed the Israeli victory as additional proof of the Israelis’ high spirit and capabilities, especially when compared to the failing war in Vietnam. For Israel, which came to control more territories, the war provided an additional opportunity to deliver its messages to the United States through tourism diplomacy. The war also forced Israel to contemplate its place in the Middle East, with peace becoming a more plausible option.

In the 1960s and 1970s, consensus was growing about the need for professionalism and ethical standards in medicine and psychiatry. Using the APA’s archives, I show that the Fact episode of 1964 concerned the APA greatly. Not only did the APA write to Ginzburg and object to his special Fact issue on Goldwater, but it followed Ginburg’s subsequent career closely. The group adopted the Goldwater Rule in 1973 in order to prevent episodes like the Fact debacle. After the Rule’s adoption, disagreements over it emerged within the APA. Members wrote in apparent confusion to the APA Ethics Committee, seeking guidance on how the Rule applied to their work. The APA never contemplated applying the Rule to forensic psychiatry, to the work of psychiatrists in insurance companies, or to the practice of psychological profiling for the FBI and CIA. It was comment in the media, and the risk of damage to psychiatry’s public image, that concerned the APA. The result was the appearance of a double standard: individual psychiatrists are banned from commenting on public figures, while psychiatrists working for organizations and government agencies may comment without interview or consent.

In many respects, as he confessed later in life, McNamara’s mistakes were mistakes of omission not commission. They were mistakes nonetheless. His mistakes raise important counterfactual questions. What if McNamara had inherited another model for civil-military relations? What if the State Department had been stronger? Could a counterinsurgency strategy have worked in South Vietnam? Could different funding arrangements in Washington have produced different outcomes? What if Johnson had been less of a New Dealer? What if McNamara had defined “loyalty” differently? What would President Kennedy have done?

The book provides a reassessment of Robert S. McNamara’s decisions during the Vietnam War. It situates him at the end of a historical process for the Office of the Secretary of Defense (OSD), a young agency that was still in flux and trying to define the proper balance between civilian and military advisors. McNamara’s concern for economic issues meant he resisted international commitments, in Vietnam and elsewhere. His idiosyncratic views on loyalty led him to self-censor and adopt public positions that were at odds with his private views. He ultimately became the spokesperson for a war that he had resisted. The book has benefited from a host of new sources, including McNamara’s papers at the Library of Congress, recently declassified Defense Department materials and the private diaries of his assistant for International Security Affairs, John T. McNaughton.

The year 1966 was one of interlocking crises. The consequences of escalation in Vietnam ricocheted onto the domestic and global economy. The SFRC and SASC blamed McNamara for the administration’s economic and political obfuscations. Stung by congressional criticism and the label of “McNamara’s war,” McNamara set out to restore his reputation and protect his legacy at the Defense Department. His friendship with “Bobby” exacerbated his disenchantment with the war and strained his loyalty to Johnson to the breaking point. Like many Kennedy holdovers, he drew unfavorable comparisons between the two Presidents that he had served. In Vietnam, despite a burst of diplomatic activity, the prospect of a negotiated settlement in Vietnam all but ended. Instead, escalation continued with no clear objective in sight. With nothing left to lose, McNamara stepped out of his self-imposed restrictions and began to question the administration’s strategy. He returned to the ideas that he had defended in the Kennedy administration and, in 1967, bypassed the State Department and stepped in to run a peace overture himself.

President Lyndon B. Johnson was inclined to favor “tougher” military responses that promised victory. He understood the intricacies of the policy that he had inherited but changed it. He promoted Rusk to the detriment of other advisors who had supported a counterinsurgency program and who left, including Hilsman, Michael Forrestal and Ted Sorensen. McNamara initially resisted expanding the commitment in Vietnam. In a presidential election year, he was sent on two trips to South Vietnam, in March and May, that were designed to placate possible critics of Johnson’s policies, including the JCS, Ambassador Lodge, the Senate Armed Services Committee (SASC) and the SFRC. Johnson pressed his Secretary to give the Chiefs “something” militarily. In response, McNamara looked for “disavowable actions” and eventually moved to support a bombing program as a substitute for deploying ground troops.

At the start of 1965, the Johnson administration was primed to act militarily in Vietnam. On the economic front, Secretary of the Treasury Dillon left and Johnson chose his Great Society over fiscal discipline. McNamara began to manipulate the budget to hide the true costs of military escalation. Initially, he staked his hopes on a bombing program: it would ensure civilian control, be cost-effective and quick. When political overtures failed to materialize, however, he became frustrated. In July, McNamara recommended a wholescale escalation with a tax increase and reserve call-up. Johnson chose escalation without aligning the resources to his new commitments. As a result, a rift emerged between the President and his Secretary of Defense. As the year went on, the rift widened and McNamara considered leaving. He grew impatient with the White House and State Department’s inflexibility over negotiations with North Vietnam and threw his weight behind a bombing pause.