Hugo Chavez Image Credit: AP

I have been reading Venezuelan President Hugo Chavez's comments about his cancer. It is, apparently, an assassination attempt by America. I wonder if that's what happened to me recently. I had the norovirus and spent Christmas in bed. I had put it down to bad luck. But maybe there was something more sinister at work.

While you wouldn't call me a dictator as such, maybe there are people out there who want to stop me writing When you're a totalitarian, nothing is ever as straightforward as falling ill. This week, Cristina Fernandez de Kirchner, the president of Argentina, was diagnosed with thyroid cancer. Dilma Rousseff, the president of Brazil, has had cancer, as has her predecessor Luiz Inacio Lula Da Silva. And Paraguay's Fernando Lugo.

These South American leaders are all democrats, however. And not one has attributed their cancer to anything other than the fact that people do, unfortunately, get cancer. Dictators, though, think differently. Dictators live in a bubble of paranoia. So when Chavez was diagnosed with cancer last June, he considered it not an act of God or poor luck, but imperialist aggression.

An assassination attempt, in fact, by the US. "It's very difficult to explain, even with the law of probabilities, what has been happening to some of us in Latin America," he said in a speech last week. "Would it be so strange that they've invented technology to spread cancer and we won't know about it for 50 years? I'm just sharing my thoughts, but it's very, very, very strange." Chavez also revealed that Fidel Castro, his close ally, had warned him: "Chavez, be careful, they've developed technology, be careful with what you eat, they could stick you with a small needle."

Castro is living proof of the maxim that just because you're paranoid, it doesn't mean they're not out to get you. One of the former Cuban dictator's bodyguards published a book a few years ago, claiming that there had been 638 attempts made on Castro's life, including the exploding cigar that was meant to blow up in his face.

Plenty of other assassination plans did not even make it to fruition. My favourite was the CIA's crackpot scheme, under then president Bill Clinton, to fill deep-sea molluscs with explosive and paint them in lurid colours to attract Castro and dispense with him while he was diving. Dictator's Paranoia covers a multitude of sins. Kim Jong-il, for instance, would have had us believe that his passion for train travel was to help him feel closer to his people. The truth was that he was paranoid about flying, fearing assassination. And when he had to visit Moscow, that meant a 24-day round trip from Pyongyang.

Lunatic ideas

Fear of assassination is, one has to concede, a pretty reasonable form of Dictator's Paranoia, under the circumstances. But other plainly lunatic ideas can take on a wholly magnified importance when, as a dictator, you can simply act on your personal fancy. The former Myanmarese leader Ne Win harboured an irrational fear of the number 100.

So he simply abolished Myanmar's 100-kyat note and had it replaced with a 90-kyat note. Than Shwe, also a former leader of Myanmar, went even further, in 2006, when he shifted the capital city from Yangon to a place called Naypyidaw, smack bang in the middle of the jungle, without running water or electricity. His personal astrologer had told him that he would lose power if he didn't.

It's easy to laugh at the crackpot leanings of the totalitarian. But darker forms of paranoia seem to emerge once dictators have been in control for many years. For obvious reasons, they see more enemies in more places. And there's rarely been a dictator looking for a group to attack for disloyalty who hasn't, at some point, turned on the Jews.

The worst episode under Stalin was the "Doctors' Plot" in 1952, the year before his death. A group of prominent Jewish Moscow doctors were "unmasked" as conspirators behind the would-be assassination of Soviet leaders. The whole thing, Kruschev later revealed, had been invented. But it's not just dictators who suffer. Few leaders have ever been more paranoid than Richard Nixon. "Never forget," he told Henry Kissinger and Alexander Haig in a taped conversation in 1972, "the press is the enemy, the press is the enemy. The establishment is the enemy, the professors are the enemy, the professors are the enemy. Write that on a blackboard 100 times." Maybe it was Nixon who did me in.

— The Telegraph Group Limited, London 2011