Not all health issues are created equal. As a matter of medical and political ethics, maybe the only salient issues are those that could endanger a person’s life while in office—you want the person you vote for to finish their term, right?—or things that prevent that person from executing their duties. That’s why people worried that Ronald Reagan was showing signs during his second term of the Alzheimer’s disease that killed him. And it’s the reason you’d assume people might be worried, in good faith, about Trump’s cognitive function.
The age of candidates and presidents seems to be going up—Joe Biden is three years older than Trump. With age, chronic issues can become more debilitating. Possibly, neurodegenerative disorders might compromise someone’s ability to lead gradually by eroding executive function.
But again, the general case here might differ from the specific. A test like the Mini-Mental State Exam, which assesses cognitive status, might not say much more about Trump than what he has already revealed on social media? “There’s so much power the executive can wield that I think the public should know something about their mental health. That said, we have to walk a fine line because we don’t want to be ableist. We don’t want to assume that someone with depression, let’s say, couldn’t do the job,” Brown says. “But even our previous president didn’t give us the same kind of direct access to his thoughts that this president does … We’ve got his everyday ramblings—his stream of consciousness—in his Twitter feed. We’ve never had that with a president.”
It does seem like the West Point ramp kerfuffle got past Trump’s ego-shields, for some reason. The president Streisand-effected the issue by, of course, tweeting about it: “The ramp that I descended after my West Point Commencement speech was very long & steep, had no handrail and, most importantly, was very slippery.”
In an interview with Michael Bender of The Wall Street Journal, the president—unbidden and unasked—went even further: “The general said, ‘Sir, Are you ready?’ I said, ‘I’m ready.’ And he led me to a ramp that was long and steep and slippery. And I said, ‘I got a problem because I wear, you know, the leather bottom shoes.’ I can show them to you if you like. Same pair. And you know what I mean, they’re slippery. I like them better than the rubber because they don’t catch. So they’re better for this. But they’re not good for ramps. I said, ‘General, I got a problem here. That ramp is slippery … so I’m going to go real easy.’ So I did. And then the last 10 feet I ran down.”
Which, you know, sure.
Sometimes it’s not even the substance of the medical information that matters as much as the fact a president or candidate is willing to release it at all. Voters might want to know that a person in power values transparency, both personal and professional. “The issues that have come up with Trump in the last few days don’t really get at the heart of, are these incidents indicative of some serious disease? They might or might not be,” says Lawrence Altman, a physician and, for decades, The New York Times’ lead correspondent on the health of presidents. “The point is, he has not been transparent in the way he has released his medical information … and therefore questions always arose about his medical records or the information in the records.”
Is that suspicious? Frankly, yes. Presidents have obfuscated and outright lied about disabilities before—and not just the ones that didn’t matter to their leadership. Yes, Franklin Roosevelt and his aides famously covered up the fact that he was paralyzed due to polio. But then you’ve got, like, Grover Cleveland, who in 1893 underwent secret surgery to remove a tumor on a yacht in New York Harbor. Woodrow Wilson had a series of strokes in office that left him incompletely in control during the conference around the Treaty of Versailles. In 1919 he was totally incapacitated for four months while his wife covered for him and nobody knew who was actually in charge. John F. Kennedy, who campaigned in part on being young, energetic, and hearty, actually had Addison’s disease, various infections, and chronic back pain, and got by on shots of cortisone and pain-killers—and even briefly took an antipsychotic drug.