openpolitics.com

It is best not to diagnose the president from afar, which is why the federal government needs a system to evaluate him up close.

.. Is Something Neurologically Wrong With Donald Trump?

.. Viewers of Trump’s recent speeches have begun noticing minor abnormalities in his movements. In November, he used his free hand to steady a small Fiji bottle as he brought it to his mouth. Onlookers described the movement as “awkward” and made jokes about hand size. Some called out Trump for doing the exact thing he had mocked Senator Marco Rubio for during the presidential primary—conspicuously drinking water during a speech.

.. Then in December, speaking about his national-security plan in Washington, D.C., Trump reached under his podium and grabbed a glass with both hands. This time he kept them on the glass the entire time he drank, and as he put the glass down. This drew even more attention.

.. the alarming absence of a system to evaluate elected officials’ fitness for office—to reassure concerned citizens that the “leader of the free world” is not cognitively impaired, and on a path of continuous decline.

.. For most of America’s history, it was not possible for the commander in chief to unilaterally destroy a continent, or the entire planet, with one quick decision.

.. the country’s missileers—whose job is to sit in bunkers and await a signal—are tested three times per month on their ability to execute protocols. They are required to score at least 90 percent.

.. The lack of a system to evaluate presidential fitness only stands to become more consequential as the average age of leaders increases.

.. In 2016 the top three presidential candidates turned 69, 70, and 75. By the time of the 2021 inauguration, a President Joe Biden would be 78.

.. After age 40, the brain decreases in volume by about 5 percent every decade. The most noticeable loss is in the frontal lobes.

.. Even if the country’s psychiatrists were to make a unanimous statement regarding the president’s mental health, their words may be written off as partisan in today’s political environment

.. ould there be any way of convincing Americans that these doctors weren’t simply lying, treasonous “liberals”—globalist snowflakes who got triggered?

.. Instead of a traditional wheelchair, he used an inconspicuous dining chair with wheels attached. According to the FDR Presidential Library, “The Secret Service was assigned to purposely interfere with anyone who tried to snap a photo of FDR in a ‘disabled or weak’ state.”

.. America’s most famous Upper Manhattan gastroenterologist, whose initial doctor’s note described the 71-year-old Trump as “the healthiest individual ever elected to the presidency.”

.. The phrasing was so peculiar for a medical record that some suggested that Trump had written or dictated the letter himself.

.. Trump was once a more articulate person who sometimes told stories that had beginnings, middles, and ends, whereas he now leaps from thought to thought.

.. He has come to rely on a small stable of adjectives, often involving superlatives.

An improbably high proportion of what he describes is either the greatest or the worst he’s ever seen; absolutely terrible or the best; tiny or huge.

.. Donald Trump’s fluency has regressed and his vocabulary contracted.

.. Compare that with the meandering, staccato bursts of today. From an interview with the Associated Press:

People want the border wall. My base definitely wants the border wall, my base really wants it—you’ve been to many of the rallies. Okay, the thing they want more than anything is the wall. My base, which is a big base; I think my base is 45 percent. You know, it’s funny. The Democrats, they have a big advantage in the Electoral College. Big, big, big advantage … The Electoral College is very difficult for a Republican to win, and I will tell you, the people want to see it. They want to see the wall.

.. If Trump’s limited and hyperbolic speech were simply a calculated political move—he repeated the phrase “no collusion” 16 times in the Times interview, which some pundits deemed an advertising technique—then we would also expect an occasional glimpse behind the curtain

.. these are the sorts of changes that appear in early stages of Alzheimer’s.

.. But it generally assumed that the president would be willing to undergo diagnostic testing and be forthcoming about any limitations.

This may not happen with a person who has come to be known for denying any hint of weakness or inability.

Nor would it happen if a president had a psychiatric disorder that impaired judgment—especially if it was one defined by grandiosity, obsession with status, and intense aversion to being perceived as weak.

.. John Gartner, told me last year that in his 35 years of practicing and teaching, “This is absolutely the worst case of malignant narcissism I’ve ever seen.”

.. A personality disorder is “only a disorder when it causes extreme distress, suffering, and impairment,”

.. A presidential-fitness committee—of the sort that Carter and others propose, consisting of nonpartisan medical and psychological experts—could exist in a capacity similar to the Congressional Budget Office. It could regularly assess the president’s neurologic status and give a battery of cognitive tests to assess judgment, recall, decision-making, attention

.. Acting on that information—or ignoring or disparaging it—would be up to the people and their elected officials.