President Trump renewed a drumbeat of claims that rival Joe Biden is too feeble to serve as commander in chief, while casting a shadow on his own opaque health history by embellishing, then rebutting, speculation that he may have had a stroke last year.
Trump largely fueled the kerfuffle about presidential fitness himself by denying that he had a "series of mini-strokes," then tried to flip the narrative by suggesting, with no evidence, that maybe it was his opponent, former Vice President Biden, who had suffered a stroke.
Trump, who has boasted about acing a cognitive test usually given to detect early signs of decline, also reiterated unsubstantiated claims that Biden suffers from dementia.
With his flurry of tweets and asides, the president again thrust age, and its impact on mental and physical functioning, to the front of the campaign. Experts say it’s a subject that holds no obvious benefit — while planting dangerous land mines — for both the 74-year-old president and the 77-year-old challenger, either of whom would be the oldest person ever elected to the presidency.
Video of Trump’s apparent misstep mounting a stage in New Hampshire last week provoked endless scrutiny, like an NFL touchdown replay (Did he almost fall or was he joking, as the campaign said?) along with the hashtag #TrumpIsNotWell. Biden’s halting description of the death toll from the COVID-19 pandemic reappeared, more than once, on Trump's Twitter stream.
Presidential health has always been a topic of fascination, as has the tendency of pundits and the public to extrapolate, based on minimal evidence. That can lead to misinterpretation, rather than the more sound judgments that come from assessing leaders based on their performance, said scholars who have studied the subject.
Claims of strokes and low mental functioning — with such limited evidence — is both “ageist” and "ridiculous," said Stuart Jay Olshansky, a public health professor at the University of Illinois, who has studied presidential longevity.
“When you describe someone as feeble or cite one thing they did that was wrong, you are describing attributes of almost everyone over the age of 60 or 65,” said Olshansky. “If the candidates are insulting each other, they are also insulting the entire U.S. [senior] population, many of whom they need to vote for them to get elected.”
But missteps and misstatements live on forever on video. A five-second GIF can make a deeper impression than a lifetime of labor. That’s a truth that even one of America’s foreign adversaries may be attempting to exploit, according to news reports.
In early July, the Department of Homeland Security had evidence of a Russian scheme to promote “allegations about the poor mental health” of Biden, ABC News and the New York Times reported last week. An intelligence bulletin warning state and local law enforcement about the scheme was withheld by senior Homeland Security officials, the network reported.
The health issue emerged in a roundabout fashion. In a new book, New York Times reporter Michael S. Schmidt wrote of a November incident when aides whisked Trump to Walter Reed National Military Medical Center. Schmidt reported that Vice President Mike Pence was put on standby "to take over the powers of the presidency temporarily if Trump had to undergo a procedure that would have required him to be anesthetized."
Seizing on that revelation, CNN pundit and former Clinton administration Press Secretary Joe Lockhart wondered on Twitter whether Trump might have suffered a stroke that he was "hiding from the American public." The Trump administration has maintained that the unscheduled November hospital visit was for the president's annual physical.
On Tuesday, Trump tweeted: "It never ends! Now they are trying to say that your favorite President, me, went to Walter Reed Medical Center, having suffered a series of mini-strokes. Never happened to THIS candidate — FAKE NEWS. Perhaps they are referring to another candidate from another Party!"
That created confusion, since no significant news outlet or commentator had reported on a claim about "mini-strokes," until Trump raised the subject. The rumor gained more fuel via a banner headline Tuesday on the Drudge Report, a conservative news site whose editor opposes Trump: "Trump denies mini-stroke sent him to hospital."
Trump countered, via Twitter, suggesting Matt Drudge or Biden had suffered strokes: "His Fake News report on Mini-Strokes is incorrect. Possibly thinking about himself, or the other party’s ‘candidate.’”
White House physician Sean P. Conley followed with a statement, saying Trump "has not experienced nor been evaluated for a cerebrovascular accident (stroke), transient ischemic attack (mini stroke), or any acute cardiovascular emergencies, as have been incorrectly reported in the media."
Trump continued tweeting, saying the Walter Reed visit was “to complete my yearly physical."
But that didn't line up with the administration's explanation at the time that Trump's visit was to begin, not complete, his physical. And Pence, in a Fox News interview, did not explicitly deny Schmidt's reporting, saying he didn’t recall being put on emergency standby. The net result: Many journalists and voters were again focused on Trump's health.
Trump long has marveled at his own health and vigor. In late July, he boasted about his “perfect score” on a cognitive test. He told an interviewer how he was successfully able to recall a series of words —"person, woman, man, camera, TV” — from the beginning of the exam to the end.
Over the last several months, he has also showcased his reluctance to wear a face mask amid the pandemic and his eagerness to do in-person rallies. The president has repeatedly mocked Biden, who has followed the advice of public health experts and avoided in-person campaigning, for "hiding" in his basement; Trump on Wednesday attempted to bestow a new nickname: "Joe Hiden."
But when it comes to detailed medical information, Trump has produced fewer records than other major candidates for president, including Biden.
During his campaign in 2015, he released no specific health records but issued a letter from his doctor, a Manhattan gastroenterologist. It declared: “If elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency.” Dr. Harold Bornstein later told CNN: “He dictated that whole letter. I didn’t write that letter.”
In 2018, then-White House physician Ronny Jackson declared in the briefing room that the president, at 6-foot-3 and 239 pounds, was in "excellent" health. Jackson praised Trump's "great genes" and said that "if he had a healthier diet over the last 20 years, he might live to be 200 years old."
Months later, Trump nominated Jackson to be secretary of Veterans Affairs, though the doctor withdrew from consideration and is now a Republican candidate for Congress in Texas.
Trump’s team has gone to considerable lengths to protect his personal medical information. In 2018 — not long after Bornstein acknowledged Trump’s prolonged use of an anti-baldness treatment — the doctor said his office was “raided.” The president’s bodyguard and lawyers stormed in unannounced and left with his medical files. (The White House described the action as a standard requisition of important records.)
In 2008, Biden released 49 pages of records as he pursued the vice presidency. Last December, his campaign issued a three-page summary of his medical history, including a doctor’s declaration that he was a “healthy, vigorous” 77-year-old, fully capable of taking on the role of president.
The summary showed Biden had been treated for an irregular heartbeat, occasional allergies and gastroesophageal reflux. The report also said scans taken when he was 65 revealed no permanent damage from brain aneurysms he suffered in his 40s.
The report put the 6-foot-tall Biden’s weight at 178 pounds and his blood pressure at 128/84. A June report from Trump's physician said the president weighed 244 pounds. Body mass index charts categorize 6-foot-3-inch men who weigh 240 pounds or more as obese.
But Trump has attempted to focus the fitness debate on Biden. Twice last week, he reposted video of Biden's hesitant attempts to summarize the death toll from the COVID-19 pandemic. "COVID has taken this year, just since the outbreak, has taken more than 100 year. Look, here's, the lives, it's just,” Biden haltingly says in the video Trump posted. But the clip leaves out the more cogent end of Biden's statement: "I mean, think about it: more lives this year than any other year for the past 100 years, more than 180,000 lives in just six months."
On Tuesday, Trump casually asserted that Biden "doesn't know he's alive" in a somewhat circuitous conversation with reporters.
Biden campaign spokesman Michael Gwin said that Trump's pronouncements showed him to be "an undisputed expert at projecting his own insecurities and weaknesses onto others."
Biden supporters don’t hesitate to recall Trump lapses, like when he pronounced the name of one of America’s most renowned national parks as “Yo-Semite" and Thailand as “Thigh-land." And they spread videos of the president’s tentative steps down a ramp after speaking at West Point, where he used two hands to raise a water glass to his mouth.
Katherine A.S. Sibley, director of the American studies program at St. Joseph’s University in Philadelphia, said such events should not be a liability for Trump unless “it becomes a cumulative thing,” adding: “If there are, literally, enough missteps, then it could become a problem.”
But Trump and his team appear to have no fear of leaning into the health issue. As of July, the campaign's biggest TV ad spend of 2020 went to a spot charging that Biden lacked “the strength, the stamina and the mental fortitude to lead this country.”
Democrats countered with an ad that aired during the Republican National Convention showing Biden biking, running and hurrying about his daily business. “Some people are always in a hurry. They run when they could walk, race up steps when others take it slow,” the ad said, shifting from shots of a buoyant Biden to a shuffling Trump. “When Joe Biden is president, America is just going to have to keep up.”
Historian Sibley said that Biden needs to demonstrate that kind of energy in the final two months of the presidential race.
“It’s very important for him to get out there,” said Sibley. “Being 77, he has to confirm that he can be out and about and up to doing this very big job. If you are sequestered away, no matter what the reason, it’s going to hurt you.”
Olshansky, the longevity scholar, said the aging debate won't likely produce a shining moment for either the incumbent or the challenger.
"The problem for them is, anything one of them says about the other could very well apply to them, as well."
Times staff writer Melanie Mason contributed to this report.