President Biden’s Physical Offers Only Partial Window Into the Health of Commander-in-Chief
For decades, the public release of the president’s annual physical has provided a window into the White House inhabitant’s wellbeing, listing their medications, weight and at times signalling a benign condition.
But it typically offers a fairly narrow health update that hasn’t revealed bombshells about any president’s health, and it is often framed by the administration to portray the president in robust health.
President Biden’s physical, conducted Wednesday at Walter Reed National Military Medical Center, is the latest in this trend. Even before the results were released, Biden said there was “nothing different” in his physical this year from last year. He joked at a White House event, “they think I look too young.” Later, the White House physician, Dr. Kevin O’Connor, declared the 81-year-old Biden to be “fit for duty,” as the president’s age appears to be among his biggest impediments to re-election. The report did disclose that Biden uses a positive airway pressure machine at night to treat sleep apnoea and reiterated that he underwent a dental root canal in June.
Biden didn’t undergo a cognitive screening because O’Connor and the president’s neurologist didn’t believe it was necessary, White House press secretary Karine Jean-Pierre said. “He passes a cognitive test everyday,” she told reporters.
There is nothing to indicate that the White House or the doctor shielded any inconvenient part of Biden’s physical from the public, but the medical information of past presidents has rarely been illuminating. Biden is the oldest U.S. president and he has sought to beat back questions about his age, so his health condition is under unique scrutiny.
Former President Donald Trump, who is 3 and a half years younger at age 77, is Biden’s likely Republican challenger, putting a spotlight on the health of both candidates in their expected rematch.
But those factors don’t mean their health is an open book.
“Only what the patient, the president, wants released is released. So we have no idea whether it’s a comprehensive portrait or not. And we’ve learned many times that what is shared is not the entire picture,” said Jacob Appel, a physician and professor at the Icahn School of Medicine at Mount Sinai in New York who is writing a book on presidential health.
Appel said a White House physician doesn’t face a “dual loyalty” between the president and the American public because of the need for patient privacy and confidentiality. “The White House physician’s only obligation, legally and ethically, is to the president,” he said.
There is no federal law requiring U.S. presidents to release their health records or the details of their annual examinations. But it has been commonplace since President Richard Nixon, the first president to mainstream the practice of publicising the White House physical.
Nixon frequently underwent his annual examination around the year-end holidays, and his White House physician, Dr. Walter Tkach, often urged the president to spend more time at vacation homes in San Clemente, Calif., and Key Biscayne, Fla.
In late December 1970, Tkach described Nixon, then age 57, as being in “really excellent health” and said the president had “a young man’s blood pressure,” a reading of 118 over 82. The report also mentioned that the president occasionally smoked cigars and drank alcohol, according to news accounts at the time.
That kind of rosy description of the president’s health has become standard practice – and in the past the reports from the White House doctor have revealed few dramatic details.
President Ronald Reagan, who was the oldest person to serve in the White House before Biden, received a clean bill of health in 1988, with his doctor saying he was in “remarkable physical condition.”
After appearing to have increasing memory problems, he disclosed in 1994 that he was suffering from Alzheimer’s disease. He died in 2004 at age 93.
Douglas Brinkley, a presidential historian who edited Reagan’s diaries before their release in 2007, said there was “no proof” that anyone had knowledge of Reagan having early stages of Alzheimer’s while in office.
But he said the diaries show Reagan, who was nearly assassinated in 1981, writing that he was “a little upset” when he struggled in 1986 to remember the name of California’s Topanga Canyon during a helicopter ride. “In his last year of office, there seemed to be a slowness,” Brinkley said.
Some past presidents concealed serious health issues. Woodrow Wilson, for example, had a stroke in October 1919, leaving him incapacitated, an event that was kept from the public and members of Congress. The role of his wife, Edith Wilson, was elevated in importance, as she relayed messages to the president after the incident.
Richard Menger, a University of South Alabama neurosurgeon who co-wrote a 2015 paper on Wilson’s stroke in the Journal of Neurosurgery, wrote that it was believed to be Wilson’s fourth stroke and the president was treated and diagnosed by his physician, Admiral Cary Grayson, a personal friend.
“The linchpin in this is that Dr. Grayson refused to acknowledge or sign the paper of disability,” Menger said. “So there’s the president’s personal physician who sort of stopped that conversation, or stopped the talk of presidential succession from happening.”
Other annual White House physicals have highlighted health issues commonly faced by many Americans.
Bill Clinton’s tests showed his fluctuating weight during his presidency and campaigns. Barack Obama’s physical in 2016 disclosed that he had quit smoking – a habit that he worked to eliminate during his two terms – but that he occasionally used nicotine gum.
In 2018, Trump’s doctor said that he had encouraged the president to lose weight through diet and exercise. It wasn’t clear the advice stuck, as Trump was revealed to have gained several pounds the following year.
Last November, on the day of Biden’s 81st birthday, Trump released a letter from his personal doctor proclaiming him to be in excellent health. “His physical exams were well within the normal range, and his cognitive exams were exceptional,” wrote doctor Bruce Aronwald. It said the former president achieved weight loss through “improved diet and continued daily physical exercise, while maintaining a rigorous schedule.”
But other Trump physicians have drawn notice for their fawning descriptions of his vigour. One doctor, Harold Bornstein, later acknowledged that Trump dictated him a 2015 letter deeming him to be in “astonishingly excellent” health and that he would be “the healthiest individual ever elected to the presidency.” In 2018 Bornstein told CNN: “I just made it up as I went along. It’s like the movie ‘Fargo’: It takes the truth and moves it in a different direction.” – Alex Leary contributed to this article.
Dow Jones
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