Now to the Questions About Trump’s Age and Health
Now to the Questions About Trump’s Age and Health
We need more reporting, perhaps including about his published test results
Welcome to Second Rough Draft, a newsletter about journalism in our time, how it (often its business) is evolving, and the challenges it faces. This edition is being published early in light of yesterday’s news.
Now that the President of the United States, as I had long feared, has been driven into retirement by questions about his age and health, I hope the press will turn some of the attention it belatedly mustered on this question to analogous concerns about the other elderly candidate for president, Donald Trump.
The Boys of 1946
First, let’s be clear: As presidents go, Trump too is old. He is just 43 months younger than Joe Biden, which means that in the last year of the term he is now seeking, he will be older than Biden is today. But here are two other reference points: Trump is a couple of months older than Bill Clinton, who came into office 31 years ago and retired from the presidency more than 23 years ago, and he’s a few weeks older than George W. Bush, who retired more than 15 years ago.
Finally, Trump is, right now, about the same age Ronald Reagan was when he left the presidency— perhaps already impaired by the Alzheimer’s which eventually took his life. There is no question Reagan was impaired at an age Trump would attain about half way through the next presidential term. Trump’s father died of Alzheimer’s, having been first diagnosed with dementia at age 86 after “obvious memory decline in recent years.” The former president has already outlived his two brothers, one older, one younger.
Questions about a scanty record
We weren’t told all that much about Biden’s health before a few weeks ago. We’ve been told far less about Trump’s. The last detailed medical report on Trump was issued six and a half years ago by Dr. Ronny Jackson, then the White House physician and since demoted by the Navy in which he was then serving from rear admiral to captain for conduct “not in keeping with the standards the Navy requires of its leaders.” (These days, Jackson serves in Congress from Texas.) Jackson praised Trump’s “great genetics” without mentioning his father’s Alzheimer’s.
Jackson in 2018 reported a range of specific data about Trump, but the credibility of at least some of that information is in serious doubt. For instance, Jackson said Trump is 6’3’’, which was convenient, because if he was 6’2” or shorter, his reported weight of 239 pounds would have qualified him as obese. Barack Obama was reported in 2016 to be 6’1 ½’’; numerous photos of the two men standing together on inauguration day 2017 make quite clear that Obama and Trump were then roughly the same height.
Given the track records of both Trump and Jackson, I don’t think the rest of the specific data in the 2018 White House report should be accepted on its face by reporters. (Let’s not forget that both Trump and the company he formerly ran have been separately convicted of criminal falsification of records.)
After the 2018 Jackson report, little more has emerged. Trump’s 2019 physical report was far less detailed, made no reference to a repeat of the cognitive test Jackson claimed to have performed, and reported Trump had gained four pounds, tilting him into obesity. The report did say the dosage of his cholesterol medication had increased. Trump’s 2020 report said he had gained another pound, and was taking a drug that is variously prescribed to treat an enlarged prostate and male pattern baldness. Curiously, the report indicated that it was based on data across a range of six months, ending two months before its release; it seems likely that much of the data was actually gathered in November 2019 when Trump made a visit to Walter Reed Army Medical Center.
Trump famously suffered a briefly-life-threatening case of COVID in October 2020. No detailed physical reports on his health have been issued in the intervening nearly four years. Even after the recent shooting, attending doctors in Pennsylvania have said nothing publicly, and the only “medical” report came seven days later from the same Ronny Jackson (no longer a licensed physician), who did not even see Trump until both traveled to New Jersey, more than 10 hours after the injury.
A private doctor put out a vague letter 10 months ago indicating that Trump has lost weight (he didn’t say since when, how much, or whether drugs were involved), and that he was fine and dandy, including positing “exceptional” but entirely unspecified cognitive results.
The average score on the Montreal Cognitive Assessment for someone of Trump’s age and education level who is not deemed impaired is 27. The highest possible score is a 30. The test from six years ago, even if accurately reported then, would be meaningless by now in a man of 78.
The task just ahead
The Trump we all saw after the shooting was certainly resilient and determined, which is relevant to an assessment of his health, but hardly dispositive. It no more entitles him to a pass on health and age questions than did Reagan’s shooting and recovery when he sought another term— one he barely got through.
Trump’s mendacity is legendary, but is it also clinical? His cruelty is performative, but is it also pathological? He seems to occasionally repeat himself, to nod off in public, to confuse people, dates and events and to ramble as he did even in his acceptance speech last week. What do doctors make of all this? These seem like questions which could bear more reporting.
But more prosaically, and perhaps importantly, are subjects it might prove easier to report out. How much time does Trump spend each day working? (In the White House, when he was four to seven years younger, the answer was not much.)
Beyond that, the questions I posed for reporting on Biden last October seem to apply here as well:
How much debate about contentious issues does [he] personally entertain, and what do witnesses take away from his participation? How much, if any, reading does he do… on an average night? How extensive are his comments, in writing or in meetings? How many of the words in speeches are his own? If he is sometimes too fatigued to work, what difference does it make? Have there been useful trips foregone? Important meetings not held or foreshortened? Do congressional or foreign leaders find him responsive or confused on phone calls?
As with Joe Biden before the debate, what is missing—and needed—is not just stories noting the facts above, but actual journalism, fresh reporting about Trump’s aging and health. The press waited too long, until it was almost too late, to suss out answers to such questions about Biden—and acted only when events forced the issue. I know the shooting was just nine days ago, but we are running out of time. Please, let’s not make the same mistake twice in one year.
Second Rough Draft will likely be off the next couple of weeks.
This is itself a model of fresh reporting. Who knew that Trump had lied about his height? And a rare example of a Substack picture that actually tells a story.
When my father declined and ultimately died six years ago, I was primary caregiver and hospital interface because my mother's dementia became openly apparent. Like many loved ones do as cognitive decline accelerates, my father had covered for her very well. But when she awoke me in their living room one night with a .38 pistol, confused and not recognizing me, I knew that taking her car keys was ignoring the depth of the issue. My personal wish in the aftermath of President Biden’s decision and our reflection on former President Trump’s behavior is that all of us develop a better set of skills and safety nets that help family members guiding loved ones through states of decline with dignity and grace. It’s not just for them.