“The Presidential Physical Test” – US News

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We know what President Trump thinks about kneeling during the national anthem. His umpteenth derisive tweet about the NFL came Thursday as he declared, “The only way out for them is to set a rule that you can’t kneel during our National Anthem!”

Inadvertently it raises an unrelated kidding-on-the-square question: Is Trump himself actually able to kneel, whatever his intent, be it proposing marriage, thanking Hillary Clinton for an awful campaign or discussing political strategy with pro bono cheerleader Sean Hannity?

Seriously, what’s the deal with his physical and medical health? He is, after all, a 71-year-old man who’s overweight, doesn’t get much sleep (witness the tweets during the cable news morning shows), doesn’t exercise and has a pretty stressful job.

We don’t know, because his departure from multiple presidential traditions includes that of the annual check-up. If you’ve covered Washington, you know the rite of the presidential motorcade of black limos and SUVs and sharpshooters screwing up traffic as it heads to the doctor, usually to the National Naval Medical Center in Bethesda, Maryland.

There’s the check-up, return to the West Wing and the subsequent White House release of results, even if they’re far from detailed. With Trump, there has been nothing.

No check-up, no results, only the odd Republican primary campaign disclosure last year of a one-page letter from an odd New York gastroenterologist and Trump’s own appearance on “The Dr. Oz Show” that confirmed only the use of a cholesterol-lowering drug.

“I think every president, and every vice president, should have an annual physical,” says New York University bioethicist Arthur Caplan. “We do need to know that the individuals holding those jobs are capable of carrying out the functions.”

Caplan discerns lots of perhaps misplaced media interest in Trump’s mental health. The literature so far includes a piece in STAT, a superior new daily site on the life sciences, which inspected substantial changes in his speech over the years and raised (largely speculative) doubts about his mental health.

“Everybody is focusing on his mental health,” says Caplan, “and, no doubt, a psychiatric component should be part of an annual physical for candidates. But that’s not driving my interest.”

What does intrigue Caplan is the reality of an older man who is obese, “who doesn’t exercise and has had dubious primary care in the past.” (Trump reportedly thinks exercise wastefully drains the body of a finite store of energy.)

Such a call for greater care about his physical well-being, Caplan says, is not about politics, namely some negative fallout if real ills were to be discerned. Those who back Trump, he says, are not likely to change if it turns out that he’s got, say, diabetes.

It’s really about being mindful about his ability to do the job, not some ideologically driven vehicle to potentially get rid of him. There’s a public policy interest in making sure the guy running the government is managing personal physical and even mental conditions he should manage and not flouting medical science in the way he flouts climate sciences (or journalism fact-checking). Call it personal health denial.

Of course, there is a rich tradition of covering-up the realities of a president’s health, as succinctly detailed by The Washington Post last year in “The hidden history of presidential disease, sickness and secrecy.” It includes the public not knowing for months about Woodrow Wilson’s 1919 stroke and, famously, about Franklin Roosevelt being relegated to a wheelchair.

Historian Matthew Algeo, who wrote about Grover Cleveland’s secret cancer surgery aboard a friend’s yacht in 1893 in his book, “The President Is a Sick Man,” says, “The first thing that comes to mind is that it is not unusual for presidents to conceal problems they have. There’s a long tradition. What is unusual is not to even pretend,” thus not going in for the very public check-up.

Trump’s “disregard for the custom of the annual check-up is interesting,” says Algeo. “It’s a charade we all go through. It’s like pardoning the Thanksgiving turkey. But at least it reassures people that the president is being cared for. Trump is not giving us that reassurance.”

A different perspective – and, ultimately, harsher when it comes to Trump – is offered by Ben Michaelis, a psychologist in New York City whose resume includes hundreds of fitness-for-trial assessments at the request of judges in the court system. Most have been criminal defendants at Rikers Island, the city’s primary jail complex.

Michaelis suggested (diplomatically) that the premise of our initial discussion was wayward, namely in my asking questions that reflected a journalist’s frequent introspective, verbal and self-reflective view of the world. He’s encountered same with other journalists.

In particular (“In all due respect…”), he didn’t buy my theory that perhaps Trump is simply fearful of the outcome of a real check-up. His ego might be shattered by disclosure of infirmity and weakness, or so I figure.

While underscoring that he obviously has not personally evaluated Trump in a clinical setting, “This is not someone with the introspection you or I would recognize,” says Michaelis. By that he meant that one can easily try to assess Trump from rational precepts, but it’s a mistake since Trump exhibits “this level of pathology. All bets are off.”

When Michaelis evaluated individuals for their competence to stand trial, even the many coming from Rikers were easily understood. “But there was this very small percentage – maybe less than five percent” who were far more difficult “since they don’t work on the same principles that I do.”

“Most people are rational actors, even if they don’t have the benefit of education or certain life circumstances,” he says. But there was that percentage that is not, and he views Trump from that vantage point.

Yes, there is the history of presidents and other politicians not disclosing information that would reflect negatively on their health. But he sees the Trump disinclination in conjunction with his history of providing sketchy information of all sorts about himself or his businesses.

Ultimately, it is a disdain for others and reflects the make-up of somebody who feels “that no one else is entitled to understand him because he believes himself to be so far above other human beings.”

So don’t take a knee and hope Trump will come to a sensible change of heart.

This article was originally published on US News

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