Trump physical unlikely to shed light on mental fitness

01:58 - Source: CNN
Trump explains tweets on his mental state

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Trump's physical is set for Friday

There is little to indicate the check-up will provide much clarity about the state of Trump's mind

Washington CNN —  

President Donald Trump’s staunch defense of his own mental acuity this weekend all but ensured the questions mounting about his fitness will increase in the coming week, which is set to culminate Friday with his first known medical exam since taking office.

Coming amid a previously-unheard-of debate over the mental capacity of the country’s oldest president at the time of his first election, the yearly presidential physical has attracted renewed attention from a capital now consumed with Trump’s mental health. But there is little to indicate the checkup will provide much clarity about the state of Trump’s mind.

In a series of tweets dispatched Saturday morning from the frigid Maryland woods, where he was huddling with congressional leaders at Camp David, Trump, 71, declared himself a “very stable genius” and “like, really smart.”

Trump was attempting to rebut the claim made in a damaging new book that some of his aides doubt his fitness for office. But he was also speaking to the growing chorus – mostly from Democrats but also including a few Republicans – questioning his mental health.

On Friday, Trump is due at the Walter Reed National Military Medical Center in Maryland for a medical exam conducted by the White House physician, Dr. Ronny Jackson, who performed President Barack Obama’s last several physicals while he was in office. The White House has said it will provide a readout of the exam once it’s complete.

What to expect

But any hopes that the publicly released information will shed light on Trump’s mental state appear largely misplaced. A review of the past five presidents’ physical exams show only brief mentions of mental health, and none provide a readout of mental health tests.

White House press secretary Sarah Sanders declined to specify details of Trump’s physical when she was asked last week whether the exam would include mental acuity tests.

“We’ll discuss, as I said when I announced that he was going to be doing the physical, we’ll have a readout of that after that is completed and we’ll let you know at that time,” Sanders said.

Currently, the US Preventive Services Task Force does not recommend older patients without signs of symptoms receive routine screenings for cognitive impairment or dementia, citing insufficient evidence. But the government does require doctors to ask patients over age 65 during the yearly Medicare Wellness Exam whether they’ve noticed any depression or memory loss. The 71-year-old Trump is not on Medicare and not bound by the requirement.

Scientists have also determined that having a parent or sibling with Alzheimer’s increases the risk of developing the disease. Trump’s father, Fred, whose photograph sits behind the Resolute Desk in the Oval Office, developed Alzheimer’s in his 80s.

What precisely will be disclosed about the President’s health isn’t yet clear. Trump himself will determine what information to make public, a person familiar with the process of presidential exams said.

The person, who has been involved in past presidential physicals, said the White House Medical Unit typically prepares a summary to give the media after the exam is completed. Because the health information is considered private under federal law, the President himself must sign off on its release.

Doctors who have performed presidential physicals in the past said the task of releasing information that is ordinarily bound by strict privacy rules can prove daunting.

“You have to remember if there is something wrong with a president that kicks him out of office, everyone who comes with him leaves. So everyone wants to keep him in, they want to silence the doctor,” Dr. Connie Mariano, who served as White House physician for George W. Bush and Bill Clinton, told CNN in 2015.

Over the past four decades, there has been no single format for releasing information about the President’s health. Typical readings have included the President’s height, weight, body mass index (which indicates whether an individual is normal weight, overweight or obese), resting heart rate and blood pressure. Past exams have also included details about the commander in chief’s vision, thyroid, cardiac rhythms, gastrointestinal system, skin and neurological indicators like cerebellar function, motor functions and sensory systems.

Almost always, the physician conducting the exam will make a general assessment of the President’s health, and declare him fit to serve in the office. Past presidents have been largely forthcoming with their medical records, including some embarrassing details like when Bill Clinton’s doctor revealed he had hemorrhoids.

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