I need to say that I have never examined Joe Biden, Jr., but I have followed medical events in his life and observed his public statements and behavior as vice president and president.  Biden does not age gracefully, and his continuing verbal gaffes are alarming.  Biden has refused to take the straightforward Montreal mental status exam that Trump passed easily when he was president.  In fact, Biden gets defensive when the issue of a cognitive exam is mentioned. 

During Joe Biden's presidency, serious questions can be raised about his cognitive functioning, decision-making process, leadership, and truthfulness.  The developing information associated with revelations stemming from his son Hunter's laptop raise serious and further questions about Joe Biden's character and possible financial corruption.  Joe Biden's questionable leadership and behavior can be seen as stemming from overlapping perturbations in his brain, mind, and character. 

In the 1980s, Joe Biden had two brain surgeries for cerebral aneurisms.  The surgeries were successful, but during the second surgery, Biden suffered a post-operative pulmonary embolism, requiring a lengthy stay in the ICU.  Such brain surgeries and head injuries can result in predisposition to later dementia and cognitive issues.  Brain surgery involving the frontal lobe area can result in impulsive and sexually inappropriate touching behaviors.  Tara Reade has accused Joe Biden of such behavior.  Biden denied such in he-said, she-said interviews.  At public occasions during his vice presidency, Biden is seen on camera manifesting such inappropriate touching behaviors — even while he was swearing in a Cabinet secretary when he was vice president.

At times, President Biden struggles with working memory and clarity of focus when answering reporters' spontaneous questions, particularly when more than one question is asked or the answer has several parts.  Biden often seems rigid, angry, and confused during and after his teleprompter speeches.  He often turns his back on reporters and seems irritated at their questions.  This pattern can occur in early stages of dementia and could be dangerous for national security.

Biden, even years before his brain surgeries, had shown perturbations of character involving prevarications.  He once bragged that he had a full scholarship to Syracuse law school and came in the top in his class.  Both were lies.  Biden has said he drove an eighteen-wheeler truck, which is not true.  Biden once claimed he was arrested for demonstrating with Nelson Mandela, which was untrue.  During an earlier presidential campaign, Biden was caught plagiarizing political speech material.  Such plagiarism was one factor in decreased funding for his presidential campaign and his dropping out of that earlier presidential campaign.

Biden's decision-making can be characterized as impulsive and even politically self-aggrandizing and melodramatic.  His abrupt and impulsive decision to leave Afghanistan despite other possible options proposed by the military did fulfill a campaign promise, but it was not executed carefully and effectively from many angles of consideration.  The consequences for our Afghan friends and allies left behind and Afghan women is devastating.  The potential for future al-Qaeda and ISIS attacks is increased in the vacuum our abrupt withdrawal created.

Biden had campaigned on green energy proposals toward America's shift to solar, wind, and electric-powered vehicles.  However, his abrupt, aggressive rejection of all fossil fuels, industries and pipelines was impulsive.  It hurt America because no gradual plan for such change to a higher and effective percentage of renewable energy was implemented.  In addition, gas and petroleum products and energy sources are impossible to forever be shut down.  Electric cars require fossil fuels for electricity that supports their operation.  Medical equipment and implements require oil-based plastic products, as do fertilizers and wrappings for meats and other foods.  Cold winters require natural gas and heating oil.  In addition, America has made huge progress in clean fossil fuel energy production and utilization via internal combustion engine technology.

As time goes on, Joe Biden's behavior is difficult to try to understand.  It seems related to overlapping and interrelated issues about his dysfunctional brain, mind, and lifelong character and behaviors.

Image: Gage Skidmore via Flickr, CC BY-SA 2.0.