Crooked Hillary or Unhealthy Hillary?

Donald Trump, shortly after securing the GOP nomination, attached a name to Hillary Clinton, just as he did to his opponents throughout the primary process.  She was Crooked Hillary, based on a lifetime of playing fast and loose with finances, ethics, and honesty.  After photos surfaced this past weekend showing Mrs. Clinton struggling to ascend a set of steps, as well as reports of possible seizure activity, Trump may want to rename Mrs. Clinton "Unhealthy Hillary."

These health concerns are not new and were raised by me as well as others several years ago after Mrs. Clinton fainted, fell, and banged her head, suffering a traumatic brain injury (TBI) and subdural hematoma.  Could her recent behavioral and physical maladies be a consequence of this head injury?  Or could other conditions be at play?  As Trump said, did she take "a short-circuit in the brain"?

A website devoted to traumatic brain injury lists falls as one of the top three causes.  Fall down, whack your head – not hard enough to fracture your skull, but enough to cause swelling and/or bleeding in or around your brain.

These injuries can be mild or severe.  In the case of Mrs. Clinton, the injury can reasonably be considered severe based on the words of former President Bill Clinton.  Mrs. Clinton's husband revealed that his wife's injury "required six months of very serious work to get over."  He called it a "terrible concussion."

The TBI website describes a number of deficits that may occur after a severe brain injury.  These include "impairment of higher level cognitive functions" – in other words, rational thought.  Other problems include "abnormal speech or language, loss of thinking ability or emotional problems."

Cognitive deficits associated with TBI include memory.  One of Mrs. Clinton's favorite answers when queried about past issues is "I don't recall."  Other memory issues include her false recollections about sniper fire in Bosnia and being named after Sir Edmund Hillary.  More worrisome are deficits in "executive functions," something atop the job description for president of the United States.

Difficulties with movement are another consequence of TBI – as in the recent photos of Mrs. Clinton needing to be steadied walking up a flight of stairs.  Other deficits include vision problems such as double vision.  When testifying before the Senate in 2013, Mrs. Clinton wore glasses with Fresnel prisms, used to correct double vision.  Light sensitivity is another problem linked with TBI.  Anyone remember the famous photo of Mrs. Clinton wearing sunglasses while inside a cargo plane?  No one else in the photo needed sunglasses.

Seizures are common after head injury.  This might explain recent photos of one of Mrs. Clinton's aides carrying and holding at the ready what appears to be a Diazepam pen, used for emergency short-term control of seizures. Diazepam is the generic name for Valium, a medication "[u]sed to treat anxiety disorders, alcohol withdrawal symptoms, or muscle spasms. Diazepam is sometimes used with other medications to treat seizures."  Presumably the Diazepam pen was for treating seizures as opposed to the other listed medical conditions.

Control of bowel or bladder may break down after TBI.  Remember Mrs. Clinton's excessively long bathroom break during the Democrat primary debate?  Loss of stamina is another symptom.  A Clinton campaign aide acknowledged Mrs. Clinton's low energy: "she doesn't have the strength.  She doesn't have the stamina."

Also described as symptoms are irritability and aggression.  Such as Mrs. Clinton exploding at her aides.  Or her "[s]creaming, child-like tantrums that have left staff members in tears and unable to work."

Finally, there is denial and lack of awareness after TBI.  Plenty of examples of this, from her lies and obfuscation over the Benghazi attack to her contorted excuses for her email recklessness and Clinton Foundation finances.

Some of these symptoms could be attributed to advancing age or an aberrant personality, but taken as a whole, they make a compelling argument for TBI due to her fall.  But any good doctor comes up with a differential diagnosis, other possibilities that could account for the patient's signs and symptoms.

What about neurosyphilis?  One variety, called general paresis, can cause paranoia, mood swings, emotional troubles, personality changes, weakened muscles, and eventual dementia.  Another variety, tabes dorsalis, leads to trouble balancing, loss of coordination, incontinence, altered gait, and vision problems.  Most of these symptoms have been described above.

Oropharyngeal cancer is another possibility, based on the hole in Mrs. Clinton's tongue and her well documented coughing fits.  There is also Parkinson's Disease, with slowed movements, difficulty walking, impaired balance, and speech changes, also noted and written about.

This is not medical grand rounds, where a final diagnosis much be reached.  Instead, it's about whether Hillary Clinton is mentally and physically well enough to serve as president of the United States.  These are legitimate questions, and an honest and diligent media would be investigating her health as they did for similarly older candidates John McCain and Bob Dole when they ran for president.  Instead, and not surprisingly, CNN circles the wagons around its favored candidate, ignoring these health concerns.

Rather than piling on every Donald Trump utterance, the health of Hillary Clinton deserves scrutiny.  Otherwise, a President Clinton might be too sick to function, similar to the fossilized general secretaries of the old Soviet Union, who rarely appeared in public and allowed their underlings to run the country. 

Brian C Joondeph, M.D., MPS is a Denver-based retina surgeon, radio personality, and writer.  Follow him on Facebook and Twitter

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