The last time they got together, they were physically battered, one recovering from heart bypass surgery and the other relegated to a wheelchair by a knee injury.
As they meet again today, nearly 18 months later, it is their political health that is in need of intensive care, with each facing a domestic crisis that threatens to end his career prematurely, albeit for drastically different reasons.
The first summit between President Clinton and Russian President Boris Yeltsin since their March 1997 meeting in Helsinki features a reunion of two world leaders who since then have been deeply wounded at home, their political authority so sapped that they can barely advance their own agendas, let alone help each other. While Mr Clinton braces for possible impeachment proceedings following his confession that he lied to the country about his affair with Monica Lewinsky, Mr Yeltsin tries to deflate speculation that he will step down in the face of political and economic disarray.
"These two guys are going to be like two corpses getting together, and I don't see how either of them can do anything for the other," said Ms Priscilla Johnson McMillan, a historian affiliated with the Davis Centre for Russian Studies at Harvard University, Massachusetts.
"Kosovo? Iran? NATO? . . . Nothing that these two presidents could talk about means anything to the Russian people," said a former administration official who specialised in Russia. "Neither has any political capital that can benefit the other."
Never have US and Russian leaders convened in such a mutually weakened state. With a new Russian government under construction, agendas were being rewritten and even the place settings at the negotiating table remained uncertain for what promises to be the most unpredictable summit since the Cold War.
The personal dramas involving two besieged politicians obscure the stakes involved. With its economy on the verge of collapse, Russia faces a critical moment in its passage to democracy and, despite the Third World quality of its dilemma, remains the only country besides the United States with the capacity to destroy the world in a nuclear hailstorm.
Summits with Russian leaders have measured the strength of an American president in times of trouble before. With his domestic agenda buried in Congress, Mr Clinton has found comfort as he travelled abroad extensively this year. His historic journey through Africa in March and his tough-talking visit to China in June were declared triumphs and provided respites from talk of subpoenas and sexual escapades.
The world stage might not provide such relief this time, given the gravity of Russia's turmoil. "He may think this is going to be a nice way of distracting attention from his own problems, but I think the risks are much greater than the opportunities here," said Mr Peter Reddaway, a Russia scholar and political science professor at George Washington University in Washington DC.
Moreover, Mr Reddaway said, "His weight in international diplomacy is undoubtedly reduced by his troubles at home and this is very unfortunate. It will be a hardship in Russia. There's no way of avoiding that."
While hardly asked about Lewinsky in Africa or China, Mr Clinton almost certainly will face questioning on the subject in Russia during tomorrow's news conference with Mr Yeltsin, the first opportunity for reporters to interrogate him since he told the nation he "misled people, including even my wife" about his affair with the former intern.
Advisers considered cancelling the news conference but decided there was no practical way to do so, and the president has resisted recommendations that he speak out on Lewinsky again before leaving to offer a more contrite apology and defuse some of the political tension. Eventually, White House officials concluded he would be confronted with the situation in Russia one way or the other and are hoping a sex-and-lies scandal will pale next to the economic collapse of a major power.
"There's such a world of difference between Yeltsin's situation and Clinton's situation," said a senior White House official. The president's political troubles "seem small in comparison to the very real problems Yeltsin is dealing with."
But just being seen with Mr Yeltsin poses dangers. In Washington, critics say Mr Clinton has invested too much in Mr Yeltsin and his "often unpredictable and apparently irrational style of governance," as House International Relations Committee Chairman, Mr Benjamin Gilman, put it. Similarly, experts warn that associating himself with Mr Yeltsin will exacerbate anti-American sentiment in Russia, where many people blame their economic problems on the United States and its embrace of a corrupt and ineffective government.
When the rouble fell off a cliff, Mr Yeltsin's political standing went with it. Even before the devaluation, Mr Yeltsin was held in low esteem by the Russian people. His poll ratings were regularly in single digits. His frequent absences, health problems, the war in Chechnya, economic deprivation and tolerance of corruption and chaos had eroded his grassroots support.
But Mr Yeltsin had, until this year, kept Russia's influential elites in check. Often, he was the final arbiter of disputes among the various power centres of the new Russia, such as the financial-industrial clans. Since none of the rival groups enjoyed a dominating position, Mr Yeltsin's presence served to keep them all off guard.
Also, Mr Yeltsin had no clear successor, so for a long time, the elites were loath to undercut him because they did not want to see early elections. What has changed is that Mr Yeltsin seems to have lost much support among these groups in the upper strata. The Russian economy has been on a downward slide since last October, and the money problems have squeezed many of the elites Mr Yeltsin once looked to for support.
Mr Yeltsin is regularly and roundly criticised in much of the press, which is largely owned and controlled by industrial and financial magnates. His reported infirmities and television appearances are viewed with a jaundiced eye, like those of the ageing Soviet leaders.
Mr Mikhail Gorshkov, a sociologist, told reporters recently his public opinion surveys show confidence in Russia's leadership has tumbled to where it was after the violent confrontation with parliament in October 1993. "After the October 1993 crisis, 91 per cent . . . described the situation in the country as a crisis or disaster," he said. "And today, nine out of 10 Russians assess the situation similarly."
Mr Sergel Rogov, director of the Institute for the study of the USA and Canada in Moscow, said the meeting will be the "summit of the tow lame ducks". But "if the American duck is lame on one leg," he added, "the Russian duck is a total non-flyer."