Together with 51,269,999 others, I watched the Trump-Biden debate on Thursday, June 27, 2024. I also paid attention to the obligatory spin from both sides. In addition to the usual talking head commentary, the Biden side released information about Joe’s health during his encounter with Trump. Based upon that narrow, self-serving information, one medical publication embarked upon an entire essay of uniformed Biden apologetics.

The Hill: “President Biden has a cold, a White House official told The Hill amid the first presidential debate.”

The Wall Street Journal: “A Biden campaign source familiar with the president’s health said that Biden is suffering from a cold. Biden’s voice is hoarse and he coughed a bit as he began the debate. He has been in Camp David for the past week preparing for the debate.”

Image by AI.

Predictably, the moment health is mentioned, some within the medical profession pipe up and opine. This is not dissimilar to (although it’s different from) the irresponsible (IMHO) armchair psychiatric speculations from some alleged health professionals regarding Trump.

MedPage Today published an opinion piece on June 29, 2024, titled “Did Cold Medications Affect Biden’s Debate Performance? – How the American people assess the debate hinges on the answer.” The first author is “a professor of leadership practice,” and the second is “a cardiologist and a professor of medicine.”

There is a clear bias to the article. It begins:

Early last week, Donald Trump suggested that Joe Biden would be on performance-enhancing drugs for the presidential debate and demanded a drug test. The claim was widely laughed off as Trumpaganda, creating another fact-free conspiratorial haze. Still, perhaps Trump was onto something. The country is struggling to reconcile Biden’s cognitive impairment during the debate with his obvious recovery well into the night and the next day.

(Trumpaganda? Hmmm.)

The essay then immediately segues into a conclusory statement:

The most probable explanation for this transient period of cognitive impairment in an older person with a cold is a side effect of cold medications. If this is so, the hand-wringing should cease, and we should use the debate as a reminder of how common such reactions are rather than an indication that the president is chronically debilitated.

Competent, caring, thorough medical practitioners generally take the time to obtain a patient’s history before attempting diagnosis. It is noteworthy that these authors, the leadership practice prof and the cardiologist/medicine prof, characterize Biden’s behavior as a “transient period of cognitive impairment.” The implication is that his debate behavior was a unique moment.

I do not for an instant give these authors any benefit of the doubt. Their squishy comment, “this transient period of cognitive impairment,” can be interpreted to relate only to the debate. However, this is misleading. Biden does not live in a world of a solitary episode of cognitive impairment. He has taken up permanent residence in the Land of Cognitive Impairment. So many episodes in so little time. The history of his struggles with cognition is out there for all to see.

Given the multiple cognitive impairment events, if one applies the authors’ analysis, Biden suffers from a cold medicine-secreting tumor of lasting duration.

Further adding to what I believe is intentional deception is the following:

Biden’s symptoms appeared consistent with someone suffering from temporary drug-induced cognitive impairment. We now know he had a bad cold during the debate.

The authors could not be more in error. Neither they nor we “know” that Biden had any cold whatsoever. Let alone “a bad cold.” We are told he had one. We do not “know.” They do not “know.”

But we sure do know about things that appear consistent, and those are Biden’s lies:

More than 50 former senior intelligence officials have signed on to a letter outlining their belief that the recent disclosure of emails allegedly belonging to Joe Biden’s son “has all the classic earmarks of a Russian information operation.”

[snip]

“Such an operation would be consistent with Russian objectives, as outlined publicly and recently by the Intelligence Community, to create political chaos in the United States and to deepen political divisions here but also to undermine the candidacy of former Vice President Biden and thereby help the candidacy of President Trump,” the letter reads.

Doubling down on the cold story, though, the MedPage today authors seek support from…a professor:

Upon hearing our perspective, Yale professor of psychiatry Marshal Mandelkern, MD, PhD, concurred: “As a clinician, when someone presents with ‘altered mental status’ I would always think of the possibility of drug ingestion as a cause. This is not only common, it is usually the most benign explanation for a change in mental state.”

We are not privy to how the “perspective” was presented, i.e., whether this prof was misled into making his statement as applied to Joe’s performance or if he was quoted out of context or any other information about his statement. I hope that his support is limited to the presentation of a single or very, very, very few episodes of “altered mental status” and not a parade of them.

To further endear themselves to the TDSers, the authors continue: “Trump misleads the American public in many areas…”

The article has more foolishness, e.g., using media reporting that does not mention his impairment as proof of its non-existence. That is, proving absence using the absence of evidence. Read it. Lose more trust in sick care.

I make no apologies for one of my professions, i.e., the medical one. It is neither my fault nor responsibility that this low-quality, tendentious dross gets published.

An explanation as to how it got published is that the MD author is “a member of the MedPage Today editorial board.” This might be an instance of “ineptotism,” i.e., where an inept person with power uses that power to promote himself.

Whether I will support Trump or his opponent is immaterial.

I would prefer that medicine and medical journals kept their collective noses out of politics, especially because they turn to ad hominem attacks on individuals. Sure, go ahead, advocate for policy. But tell half the story and plainly mislead? That’s bridge too far.

My preference is meaningless, of course. I am but one voice. Still, medicine is reeling from all sorts of missteps engendering mistrust with the public. Whether it is Covid, BLM, UCLA Medical School, or more, the fact remains that a more neutral posture will better serve the patient-physician relationship and the providing of sick care – in virtually all respects – than partisan publications masquerading as clinical science. Especially, to create excuses promoting a politician.

MedPage Today should be ashamed.

Michael Applebaum is a physician and lawyer in Chicago.