Dr. Marc Siegel: What Trump’s physical will (and won’t) tell us
Navy Rear Adm. Dr. Ronny L. Jackson gave President Trump his first physical exam as president Friday at Walter Reed National Military Center in Bethesda, Maryland. I expect that Jackson – who served as White House physician under President Obama and now holds the same position for President Trump – will determine that President Trump is fit to serve.
According to a Sept. 13, 2016 letter from his previous internist, Dr. Harold Bornstein, President Trump takes the cholesterol-lowering drug rosuvastatin and a low-dose aspirin, and has a normal blood pressure and cholesterol level. “Mr. Trump is in excellent physical health,” Bornstein wrote in that letter.
A good physician like Jackson will conduct a thorough physical on any 71-year-old the same way, whether he is a president or not.
I believe the doctor is sure to recommend more sleep, more exercise, a weight loss program, and a better diet to President Trump, who is known to enjoy fast food. All these interventions will lead to a longer and healthier life.
The fact that President Trump doesn’t smoke or drink alcohol is a very important prognostic sign. One prescription for the president – who is known to be a great golfer – would be to get rid of the golf cart and walk the course. Golf is a great form of relaxation and socialization, and creates a positive feeling.
Jackson is a highly qualified physician and is also a fellow in the American Academy of Emergency Medicine and served in the Iraq war.
In 2016 Jackson gave President Obama his fourth periodic physical examination as president. In his letter to White House Press Secretary Josh Earnest about President Obama’s physical, Jackson wrote: “The purpose of this exam was to provide the public with an update of the president’s current health status and to ensure the president continues to enjoy all the benefits of good health. This examination focused on evidenced-based health screening and disease prevention.”
President Obama’s exam results were released to the public with his permission. They included reports on his blood pressure, weight and other vital signs. Findings from an examination of President Obama’s major organ systems – including heart, lungs, gastrointestinal tract, musculoskeletal system and skin – were also released, along with plus basic laboratory tests for cholesterol and Prostate Specific Antigen, plus an electrocardiogram. Smoking and drinking history, diet and exercise, medications and immunizations were all reviewed.
One misconception that has been propagated in the media lately is that somehow a president is supposed to be in perfect health to perform the functions of the office. Granted, the presidency is a high-wire act filled with stress and demands, but perfect fitness is not a requirement, nor should it be.
Dr. Jonathan Davidson, emeritus professor of psychiatry at Duke University Medical Center, has studied presidential fitness extensively. He wrote to me in an email that severe impairment is the exception rather than the rule, citing as examples William Howard Taft’s severe sleep apnea, Woodrow Wilson’s incapacity following stroke, and the reactive depression of Franklin Pierce and Calvin Coolidge.
Regarding Pierce and Coolidge, Davidson wrote: “both men suffered from grief resulting from the untimely deaths of their young sons, Pierce just before taking office, and Coolidge while in the White House. They became indecisive, depressed, and unable to function anywhere near their peak.”
According to Davidson’s research, mental health issues are common during the presidency.
Davidson wrote to me: “Research on the biographies of US presidents and UK prime ministers has shown that between 30 and 50% likely experienced conditions of a mental disorder, and many of these were evident while the incumbent was in office. This seems to have been a constant no matter what period of history was assessed. The effects of mental disorder ranged from non-impairing to significantly impairing.”
This is not to say that any of this applies to President Trump. Despite rampant speculation in the media by several psychiatrists, there is no objective evidence whatsoever that the president has a mental disorder – and certainly not one significant enough to impair his function as president.
The American Psychiatric Association again this week released a statement reaffirming what has become known as the Goldwater Rule, which warns its members against speculating about the mental health of public figures they’ve never met or examined. The rule was created in 1973, after psychiatrists speculated that Sen. Barry Goldwater of Arizona, the unsuccessful 1964 Republican candidate for president, was mentally ill.
“Armchair psychiatry or the use of psychiatry as a political tool is the misuse of psychiatry and is unacceptable and unethical,” the statement says. “A proper psychiatric evaluation requires more than a review of television appearances, tweets and public comments.”
Constant playing of the “mental health card,” by pundits or doctors who have never even met President Trump, but want to denigrate or diminish him, is a disservice to patients with true mental health problems who are trying to overcome the associated stigma.
A physical exam like the one Jackson is performing on President Trump is a good idea, and is likely to provide reassurance that the president is healthy enough to handle the demands of his very demanding job.