Physicians and the media
24 November 2023, updated 23 July 2024
This is the first in a series of essays about physicians and the media. The purpose is to help physicians anticipate problems and think about how to avoid them.
As physicians, we have expertise in understanding, diagnosing and treating disease. We do not have expertise in dealing with powerful and manipulative people. They may push us to do and say things outside of our normal practice.
President Donald Trump is a powerful and manipulative person, in the opinion of many. This essay discusses the experiences of his physicians so that we can learn from them. I have bolded text that is outside the norm for physicians.
Harold Bornstein, M.D. (see also here), was Trump’s physician for 35 years when in 2015, during the Presidential campaign, he released this signed letter to the public that he supposedly wrote himself:
To Whom My Concern:
I have been the personal physician of Mr Donald J. Trump since 1980. His previous physician was my father, Dr Jacob Bornstein. Over the past 39 years, I am pleased to report that Mr Trump has had no significant medical problems. Mr Trump has had a recent complete medical examination that showed only positive results. Actually, his blood pressure, 110/65, and laboratory test results were astonishingly excellent.
Mr Trump has suffered no form of cancer, has never had a hip, knee or shoulder replacement or any other orthopaedic surgery. His only surgery was an appendectomy at age ten. His cardiovascular status is excellent. He has no history of ever using alcohol or tobacco products.
If elected, Mr Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency.
Harold N Bornstein, MD, FACG
Department of Medicine, Section of Gastroenterology
Lenox Hill Hospital, New York, NY
Source: Independent.
This letter, particularly the bolded text, exhibits the hyperbole associated with Trump. Thus, it was not too surprising that in May 2018, Dr. Bornstein disclosed that Trump dictated the letter, not himself. As a result, Dr. Bornstein is now remembered, not for his lifelong achievements as a physician, but for being manipulated by Trump and made to look ridiculous. We should learn from Dr. Bornstein’s experience and not allow our patients to dictate our letters or make other medical decisions for us, regardless of who they are.
Ronny Jackson, M.D. served as Physician to the President from 2013 to 2018 under Presidents Bush, Obama and Trump.
In January 2018, at a White House press briefing, Dr. Jackson credited the president’s genes for his “excellent” health despite his fast food habits and lack of exercise.
“It’s called genetics. I don’t know, some people have just great genes,” Navy Rear Adm. Dr. Ronny Jackson said at the White House press briefing after delivering the results of Trump’s physical.
“You know, I told the president that if he had a healthier diet over the last 20 years, he might live to be 200 years old,” Jackson continued.
In addition to these somewhat unprofessional remarks, Dr. Jackson was also accused of falsely reporting Trump’s height and weight so that he would not be considered obese.
It appears that Dr. Jackson was trying to please his patient - yet another example of how a physician was unable to maintain his professional standards in the face of a powerful person, and was made to look ridiculous.
Dr. Jackson was suggested as a nominee for Secretary of Veterans Affairs, but this was withdrawn.
Dr. Jackson was subsequently elected to the House of Representatives for the 13th Congressional District.
On 7 March 2024, the Washington Post reported that in July 2022, the Navy demoted Jackson from First Admiral to Captain due to a Pentagon inspector general’s report that substantiated allegations of his inappropriate behavior as a White House physician.
Sean Conley, D.O. was Trump’s physician from 2018 to 2021, including during his hospitalization for COVID-19.
On May 18, 2020, President Donald Trump surprised listeners when he revealed he was taking hydroxychloroquine as a preventive measure against COVID-19. He confirmed that he was taking it under the guidance of Conley, who later issued a confirmation. Even at that time, several medical warnings had been issued against the drug’s use for treating COVID-19.
Trump subsequently was hospitalized for a severe COVID-19 infection:
In an October 4 press conference, Trump's medical team said that he was "doing really well" after his oxygen level dipped the day before and after he was given the steroid dexamethasone, which works by reducing inflammation in the lungs. Asked if CT scans showed pneumonia or lung damage, Conley said, "There's some expected findings, but nothing of any major clinical concern." He declined to say what was found, citing HIPAA guidelines that ensure patient privacy. When asked why he was reluctant to disclose that Trump had been given oxygen during the October 3 briefing, Conley stated that he did not want to "give any information that might steer the course of illness in another direction" and "it came off that we're trying to hide something, which wasn't necessarily true.” White House director of strategic communications Alyssa Farah later stated that it was "a common medical practice that you want to convey confidence, and you want to raise the spirits of the person you're treating," while also asserting that Meadows' anonymous statement to reporters was intended to "give you guys more information just to try to be as transparent as we can".
Outside physicians stated that the depiction of Trump's illness as relatively mild was inconsistent with the aggressive treatment he was receiving. Trump's medical team made cryptic remarks about his status and declined to say whether Trump's CT scans contained indications of pneumonia or lung damage.
According to the Associated Press, "then-White House chief of staff Mark Meadows said at the time that Trump's condition was worse than Conley had let on".
Dr. Conley’s failures, according to this narrative, included:
Prescribing hydroxychloroquine as a preventative measure, most likely to please his patient. The medical consensus has largely been that this drug has no proven value for prevention or treatment of COVID-19, that it has harmful side effects and that its use for COVID-19 threatens its availability for people with malaria and auto-immune diseases, for which it is effective. However, this drug was promoted by President Trump, based on his “gut instinct”:
However, the politicization of the treatment was a more important factor in promoting interest in use of this drug. On April 4, the US president, “speaking on gut instinct,” promoted the drug as a potential treatment and authorized the US government to purchase and stockpile 29 million pills of hydroxychloroquine for use by patients with COVID-19. Of note, no health official in the US government endorsed use of hydroxychloroquine owing to the absence of robust data and concern about adverse effects. Nonetheless, use of hydroxychloroquine increased substantially, and the US Food and Drug Administration had issued an Early Use Authorization for the use of hydroxychloroquine as treatment for COVID-19 on March 28, 2020, which was later revoked on June 15, 2020, following further examination of preliminary data. JAMA
He was dishonest about the status of his patient, particularly by stating that he was “doing really well” when all indications were that he was seriously ill and receiving aggressive treatment. As a professional, he could decline to answer, but he should not lie.
Dr. Conley, like his predecessors, appeared to be trying to please his powerful and manipulative patient, who thinks he knows more about COVID-19 than doctors. Instead, Dr. Conley was made to look ridiculous and damaged the public perception of physicians.
Bruce Aronwald, D.O., based in Morristown, N.J. has been Trump’s physician since 2021 and conducted a comprehensive exam on September 13, 2023.
“I am pleased to report that President Trump’s overall health is excellent,” Aronwald wrote. “His physical exams were well within the normal range, and his cognitive exams were exceptional.”
“It is my opinion that President Trump is currently in excellent health, and with his continued interest in preventative health monitoring and maintenance, he will continue to enjoy a healthy active lifestyle for years to come,” Aronwald concluded. The Hill
It is hard to believe that Trump’s cognitive exams were exceptional, given his frequent mental lapses. Even Megyn Kelly, former Fox News host, indicates that there is ‘No denying’ Donald Trump is suffering from cognitive decline (see transcript of this video). In addition, there is no evidence that Trump has a “continued interest in preventative health monitoring and maintenance”. His diet is high fat, high red meat, minimal fruits and vegetables, which he has apparently maintained most of his life. This is not healthy but is strongly associated with cancer, heart disease, diabetes and stroke.
In November 2023, Dr. Aronwald wrote that Trump was in excellent physical and mental health and later made the bizarre statement that “there is no need for President Trump to release another medical report in addition to the one he recently made public.”
It appears that Dr. Aronwald has continued the tradition of being Trump’s puppet when speaking to the public and not necessarily providing accurate information.
Of course, few of us are likely to have patients as powerful or manipulative as Donald Trump. But we should, from time to time, think about our professional integrity and try to focus on making honest statements and providing evidence-based medical care, despite what our patients may want us to do.
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