In the spring of 2001, then-60-year-old Vice President Dick Cheney was lying in a hospital bed recovering from surgery to prevent a repeat heart attack, watching the television news.
Television host Tim Russert suggested Cheney step down and spend her remaining time with her family, recalled Jonathan Reiner, Cheney’s doctor, who was in the room with her.
“I looked at the vice president and said, perhaps innocently, ‘I want you to understand that if I don’t think you’re capable of doing your job, you don’t have to ask me, I’ll just tell you,'” Reiner, who remains one of Cheney’s physicians and is a professor of medicine and surgery at George Washington University, told USA Today.
“I think what’s important for people who care for these unusual patients is to have the ability to be open with them,” he continued. “To provide ordinary care for unusual patients.”
Reiner said that’s the current challenge for President Joe Biden’s physician, Kevin O’Connor.
Biden’s health has come under increased scrutiny since he stumbled during a televised debate two weeks ago. A lifelong stutterer, he has regularly made verbal gaffes, but his stunned expressions and stuttering on the debate floor made those gaffes take on greater significance.
In a statement released on Monday, O’Connor responded to rumors about a neurologist who had visited the White House multiple times, saying that while the doctor treated many patients at the White House, he had never met the president outside of annual checkups.
Biden’s final neurological exam in February showed no signs of stroke or Parkinson’s disease, but he has not undergone cognitive testing, and has not made the results public.
Reiner said that if he were O’Connor, he would have Biden, 81, tested again for symptoms he exhibited at the debate and other recent public appearances, and that he would also test former President Donald Trump, 78, who is the presumptive Republican presidential nominee. Trump’s recent public comments have also been alarming.
“I think both candidates have demonstrated behavior worthy of a cognitive test. That’s all,” he said.
Tension between patient privacy and public needs
O’Connor’s decision not to administer the cognitive test to Biden may be because she didn’t want to know the results, Reiner said, adding that he knows O’Connor personally and has “great respect” for her professionally.
“Whatever the test result is, you need to be prepared to deal with it,” Reiner said. “If the test comes back clean, you don’t have to disclose anything.”
Reiner said that’s the danger of having the president’s physician on the White House staff: Their loyalties will be split between what’s best for the patient and what’s best for the presidential team.
“Anything they say, not just this time but always, is vetted by the White House management hierarchy before it’s released,” Reiner said.
The president has the same legal right to medical privacy as any other patient, and his medical team can only release information with the president’s permission.
During his eight years treating Cheney, who is now 83, he had numerous health problems including multiple surgeries, but “the White House never falsified anything I said,” Reiner said.
Reiner said that was a benefit of having him as a physician outside the White House chain of command, combined with a patient more concerned about his health than his political future and more willing to be public about his health, No. 2 to the president rather than the president himself.
Most of the president’s physicians are active-duty members of the US military, giving them some distance from White House politics, but that doesn’t mean the situation is foolproof, he said.
Dr. Sean Conley, who served as President Trump’s physician from 2018 to 2021, including at the start of the COVID-19 pandemic, holds the rank of Navy commander. Reiner noted that’s a relatively low rank for someone in a position to tell a commander in chief that he has a health problem that could prevent him from carrying out his duties.
“Is he going to say to the president, ‘I think you’re not doing a very good job, so I think you need to hand over power for a while?'” Reiner said. “What are the chances of that happening? Zero.”
The president’s long history of hiding his health problems
Presidents and their doctors have a long history of remaining silent about their health problems.
In 1893, President Grover Cleveland underwent two secret operations on board his yacht to remove cancerous tumors from his mouth. Implants were made to replace missing parts of the roof of his mouth, allowing the president to speak somewhat normally.
In 1919, President Woodrow Wilson suffered a severe stroke that disabled him for the final two years of his term, and he had apparently suffered from vascular disease for 16 years before he was elected president, but he never made it public.
When Franklin Delano Roosevelt, then 63, ran for a fourth presidential term in the fall of 1944, his health was becoming an issue.
Roosevelt allayed doubts by campaigning in a convertible through the five boroughs of New York City. Despite pouring rain, three million New Yorkers came to see the president, who delivered his State of the State address that evening. He made similar tours and speeches in other major cities, including Chicago, Philadelphia, and Boston.
However, a few months later, at the Yalta Conference in February 1945, both British Prime Minister Winston Churchill and Soviet Premier Joseph Stalin expressed concern about Roosevelt’s health, and some historians even suggest that Roosevelt had suffered a minor brain hemorrhage, which impaired his memory of the treaty negotiations and decisions.
Roosevelt died on April 12, 1945 from a massive cerebral hemorrhage.
Recent leaders have also had health problems.
President John F. Kennedy had Addison’s disease, a rare condition in which the body doesn’t produce enough of certain important hormones. He was diagnosed at age 30 but never made his diagnosis public, even though the disease can still be fatal.
President Ronald Reagan’s Alzheimer’s disease may have begun before he left office in 1989. He announced his diagnosis in a letter he wrote in 1994, but the disease can sometimes start years before an official diagnosis.
When former Massachusetts senator Paul Tsongas ran for president in 1992, he said he had fully recovered from non-Hodgkin’s lymphoma, a type of blood cancer, and was in good health. But after he dropped out of the Democratic nomination race, it was revealed he had cancer again. Tsongas died three years later.
Biden’s medical records
Biden has undergone annual medical exams and made the results public during his presidency, a tradition for presidents but not required by law, Reiner noted.
According to his annual medical report dated February 28, the president underwent a “very thorough neurological examination” which found “no findings consistent with stroke, multiple sclerosis, Parkinson’s disease, ascending lateral sclerosis or any other brain or neurological disorder, and no signs of cervical myelopathy.”
According to the report, he is taking the following medications:
- The statin Crestor is used to prevent heart disease and is taken by about a third of adults (cardiologists say far fewer people are taking it than they should).
- Eliquis is a blood thinner that also reduces the risk of heart attack and stroke.
- Two types of acid reflux medication: Pepcid and Nexium
- Seasonal allergy medications Allegra and Dymista nasal spray.
He’s also been “incredibly committed” to using CPAP machines to treat sleep apnea, a condition that causes people to wake up frequently during the night and that, if left untreated, can increase the risk of heart disease and early death.
The medical team also examined his awkward gait and determined it had “not worsened since last year,” and X-rays confirmed the previously diagnosed arthritis.
By contrast, Trump has not released any medical information for years. “We don’t even know what he weighs or what medications he takes,” Reiner said.
“I don’t even know what happened when he was rushed to Walter Reed Hospital on a Saturday afternoon in November 2019,” he said.
The former president is known to be visibly overweight, have unhealthy eating habits and avoid exercise.
Neither man smokes or drinks much alcohol.
Digging deeper:Report finds Trump-era White House medical unit improperly dispensed drugs, misused funds
Reiner said it would be reasonable for anyone in charge of the U.S. government and military to undergo a full medical examination every year and make the results public.
After all, pilots, truck drivers and school bus drivers must meet certain physical standards, as do Secret Service agents who protect the president, he noted.
“Why do we give an indulgence to the man who commands the most powerful military in the history of the Earth?”
Karen Weintraub can be reached at kweintraub@usatoday.com.
