It is an intriguing thought.
Many political analysts have wondered for years why Botha suddenly dug in his heels around the mid-1980s after he had started major reforms to apartheid, including the scrapping of many apartheid laws and sanctioning his justice minister's visit to Nelson Mandela in prison in 1985.
The ruptured vessel may be a part of that explanation.
The National Party (NP) was poised to make a giant leap towards the scrapping of apartheid and the acceptance of full citizenship by all South Africans in August 1985, to be announced by Botha at a party congress. Instead, he was his belligerent old self, threatening and wagging his finger during what became known as the Rubicon speech, a disaster that put the apartheid state under immense pressure.
Roelf Meyer, a leading NP reformist at the time and later chief government negotiator at Codesa, told me in an interview about two years ago: "My only regret [regarding the negotiated settlement with the ANC] is that we didn't start the process in 1985, when we should have. It would have saved so many lives and the negotiations would have been a different ball game."
The majority of the cases of gross human rights violations before the 1996 Truth and Reconciliation Commission were perpetrated between 1985 and 1990. It was a period of heightened resistance by the United Democratic Front, Cosatu and the ANC – also the time of states of emergency, mass detentions without trial, the lawlessness of death squads such as the South African police unit at Vlakplaas and the South African Defence Force's (SADF's) Civil Co-operation Bureau and directorate of covert collection.
Niel Barnard, Botha's closest confidante and at the time head of the National Intelligence Service, told me in 2007 that "around the time of the Nkomati Accord" (March 1984), Botha was "starting to think along the lines of a negotiated settlement in South Africa".
On August 2 1985, Chris Heunis, the minister of constitutional development and leader of a special Cabinet committee appointed by Botha to consider constitutional alternatives, put his committee's proposals to a Cabinet meeting at the Old Observatory in Pretoria. He proposed, among other things, that black members be appointed to the Cabinet and the President's Council as a prelude to negotiations with the black majority on how they would gain full citizenship in a unitary state. It was radical stuff at the time.
New way forward
Botha "did not blow a gasket and we all thought this was going to be our new way forward", a Cabinet minister told me.
If Botha had implemented those proposals, it would have meant "the end of apartheid and the old South Africa", former foreign minister Pik Botha told his biographer, Theresa Papenfus. "And if we released Mandela, started dismantling apartheid and negotiating with black leaders – well, there'd be no going back either. We'd have to go ahead, for better or worse."
FW de Klerk wrote later that the Old Observatory decisions "meant that several of the pillars on which grand apartheid had rested would be destroyed. … Together these new guidelines meant nothing less than that the ideology of grand apartheid was something of the past. We believed these new announcements, provided they were properly presented and marketed, would draw the world's attention and convince the international community that things were really changing in South Africa."
So this was the message Botha was supposed to deliver to South Africa and the world on August 15 1985. Senior members of the departments of constitutional development and foreign affairs prepared the speech and the foreign affairs ministry spread the word far and wide that "something big" was coming.
Pik Botha himself apparently added the words at the end of the speech: "We have crossed the Rubicon." He and other reformists in the NP were convinced they were on the brink of a negotiation phase that would bring about peace and democracy. Pik Botha told whoever would listen that the speech was going to be "the biggest thing in South Africa since the arrival of Jan van Riebeeck".
But a ruptured blood vessel in Botha's brain seems to have played a major role in determining that Van Riebeeck's arrival remained the more important event.
Historian Hermann Giliomee's statement in his latest book, The Last Afrikaner Leaders, that Botha had suffered a first stroke in March 1985, is supported by other evidence, despite denials by his children.
A senior Afrikaner Broederbond leader told me off the record during an interview three years ago that he met Botha regularly on a one-on-one basis during the 1980s. When he met him again in mid-1985, he knew "something had happened – I could see it clearly". Botha also mentioned to him then that he was planning to retire soon. The Broederbond leader said he had mentioned it to someone in the Cabinet who said he had no knowledge of anything that had happened in regard to Botha's health.
"Then I met with FW [de Klerk] and told him he should check the military records [meaning the military hospital records] to find out if PW had had a stroke. And so it was confirmed that it did happen.
"I had no doubt that PW was different after that stroke. It wasn't the old PW I had met so many times. Perhaps it was just a small dot (kolletjie) that died, but something was dead in his brain."
"En toe slaan daai ou man remme aan. Ons het 'n paar jaar verloor – drie jaar, meer," he told me. (And then the old guy hit the brakes. We lost three years, more.)
Botha's stroke was possibly the best-kept secret in the country at the time – it seems only the medical staff who treated him and possibly his closest confidante, Niel Barnard of the National Intelligence Agency, knew about it.
A close relative of a neurosurgeon recalled this week that the surgeon was asked to examine Botha after the 1985 stroke, but was suddenly taken off the case when it became clear it had been a stroke.
This and another source confirmed that "Dr Death", the controversial cardiologist Wouter Basson, the head of the SADF's chemical and biological warfare programme, was appointed to care for Botha after his initial treatment to make sure the news of the stroke did not leak.
There is even a suggestion that Botha's wife, Elise, and their children were not informed about what exactly had happened to him. His son Piet said after the controversy stirred up by Giliomee: "My father certainly did not suffer a stroke during 1985 … My father had a crystal-clear intellect until the day he died."
Botha suffered another, more serious, stroke in January 1989 and could not hide it that time. But he was in denial about that too. When his Cabinet eventually forced him to a meeting where it asked him to resign, he shouted that there was nothing wrong with him and said, according to one Cabinet minister: "Show me all the pills in your pockets!"
Senior Nats I talked to this week say they did not know about the first stroke, but two of them did say they recalled that he was much more difficult to work with during the last three years of his term.
Former finance minister Barend du Plessis told me in an interview some years ago that Botha "sometimes behaved like an absolute maniac". He recalled a sensitive meeting Botha had with a group of agriculture leaders when one farmer asked to be excused because he wanted to go to the toilet. Du Plessis said Botha screamed at him: "You will sit in that chair. I don't care if you wet your pants – you will sit there and you will listen until I have said everything I wanted to say." But, Du Plessis said: "I have also seen PW Botha cry."
It was during this time that Botha got the nickname "Groot Krokodil". Giliomee writes that Botha's erratic performance in the second half of his term may well have been the result of his medical condition.
Of course, a simple democracy in a unitary state as agreed to in 1994 was far from what Botha and his party had imagined when they thought about "power-sharing" and "negotiations with the black majority" in the mid-1980s – and it is inconceivable that the United Democratic Front and ANC would have accepted much less than that.
But, remember, FW de Klerk still rejected majority rule in one South Africa well after he unbanned the ANC in 1990 and went to Codesa with plans for a white veto and minority rights. He was simply overcome by events and was left with little choice once he had set the negotiation ball rolling.
One can only ponder how different history would have been had the blood vessels in the Groot Krokodil's brain remained intact and had he actually delivered the original Rubicon speech.