With the nation fighting for its very survival against the British in the War of 1812, President James Madison is in serious trouble, both professionally and personally.  The war is going badly - and in the first year of his second term, Madison is sick.  Suffering from a high fever, delirium and epileptic-like seizures thought to be brought on by malaria, Madison is thought to be temporarily deranged by illness, and incapable of carrying out his responsibilities in office.

But in part due to the war, in part due to Madison's Vice President (Elbridge Gerry) being near death himself, no serious discussion of Gerry acting as President was initiated - and while Madison would recover, Gerry would die at the age of 70 on November 23, 1814.  In a bit of irony, Vice President Gerry would be elected along with Madison a quarter century after he voted against the establishment of the office while serving as a member of the Constitutional Convention of 1787.  Gerry ultimately refused to sign the document.

Madison's successor, James Madison, would also fall victim to malaria, five years later.  Like Madison, Monroe would fully recover and serve two full terms (1817-25), and a transfer of executive authority to the Vice President was never seriously considered.  In Monroe's case, his Vice President (Daniel Tompkins) was widely regarded as an alcoholic, unfit to serve as the nation's chief magistrate even on a temporary basis.  This belief regarding Tompkins would prove more than speculative when, just 99 days after leaving office, the now-former Vice President would meet an alcohol-related demise.