The impact of bereavement in heads of government has been little studied. Two US presidents lost their teenaged sons in a traumatic manner, leaving them profoundly affected as they struggled to serve in office. We describe the bereavements of Presidents Franklin Pierce and Calvin Coolidge, using biographical and source material. Pierce and Coolidge were adversely affected by their bereavements, which almost certainly rendered them less effective in the discharge of their duties. The loss of their sons had a devastating effect on both men and deprived their presidential service of significant personal meaning. Lincoln's resilience in similar circumstances offers a contrasting perspective, however. We conclude that the psychiatric consequences of losing a child can adversely affect heads of government, may cause clinically significant distress, altered behavior, and reduced ability to provide effective leadership.