Why Trump's physical provides little insight

Why is Donald Trump undergoing a physical?

Because he chooses to. There is no legal requirement for Trump or any other US president to undergo a physical examination by a medical doctor while in office. Having said that, Trump, in this case, is in keeping with prior precedent, as all presidents since Ronald Reagan have scheduled physicals while in office and released the results to the public.

Still, the decision to schedule a physical for this coming Friday was ultimately up to Trump. What was interesting about the public announcement of the exam by the White House was its timing. It came one day after Trump's speech on recognizing Jerusalem as Israel's capital in early December. During his remarks Trump appeared to slur his words, prompting questions about the health status of the oldest man elected president.

The decision to schedule a physical could thus be interpreted as a move to tamp down talk about Trump's physical and mental health that surfaced during his campaign and since then has never disappeared. Trump's erratic style has of course provided ample fodder for critics who view him as mentally unsound. Trump supporters, meanwhile, consider his unorthodox style one of his greatest assets.                   

Trump's decision to schedule a physical is also noteworthy because it conflicts with his seeming reluctance to provide a detailed health report during the presidential campaign. The terse letter written by Trump's then-physician Harold Bornstein famously culminated in the declaration that Trump "will be the healthiest individual ever elected to the presidency." Other than that, the missive which Bornstein said was put together in a hurry included few details, but several typos, and overall did little to assuage concerns about candidate Trump's health.         

What will the results of the exam say about Trump's health?

In a nutshell: only information the president wants to be published.

That is not just because of the traditional physician-patient privilege that applies to the president as to every other US citizen, but also because of medical laws like the Privacy Rule which protects patients' personal health information. This means that Trump essentially has to greenlight any medical information released about him.

"My historian's impulse and knowing what I know about presidents' health is you are not got going to get definite information about the president's condition," said Robert Dallek, a presidential historian who in his Kennedy biography "An Unfinished Life" detailed the president's numerous medical problems and drug use.

"I hope I am wrong, but I expect very little," said Barbara Perry, the director of Presidential Studies at the University of Virginia's Miller Center. "It's hard for me to believe that particularly this president, who does not have a penchant for transparency either in his tax returns or in his medical history, would make a U-turn and suddenly release everything."

While it's accurate that any health information released about Trump must be approved by him, that does not mean that the bulletin written up by the president's physician, Ronny Jackson, should simply be viewed as a thinly veiled attempt to whitewash any concerns about the president's health, said Robert Darling, a former White House physician who served President Bill Clinton from 1996 to 1999.

"This is not just Dr. Jackson doing a physical," he said. "The president will be going to Walter Reed National Military Medical Center in Bethesda and will be meeting probably 12 different doctors who will be examining him, and a collective assessment is made which will be reported by Dr. Jackson at the appropriate time. So this will be a very, very thorough, in-depth examination of the president of the United States."

The presidential physical does not usually include a specific mental health assessment, said Darling, a view which was confirmed by the White House press secretary responding to question on the issue at a recent press conference.

How have previous presidents informed the public about their health?

Curiously, as far as being reluctant to freely divulge ample and useful information about his health status is concerned, Trump could almost be considered a traditional president. That's because many of his predecessors were not only hesitant to reveal information about their health, but actively hid negative aspects of their mental and physical condition.     

Among the more extraordinary efforts to cloak severe health issues was Grover Cleveland's secretive decamping to a yacht in New York's East River in 1893 for several days to undergo surgery for oral cancer.

When Woodrow Wilson suffered a stroke that would limit his ability to carry out his presidential duties in 1919, the public only found out about it much later. It also did not really know the extent to which Wilson's wife Edith helped him and took over a good deal of his role until the end of his term two years later.

There has been a lot of discussion surrounding Ronald Reagan's mental health condition towards the latter portion of his second term. Five years after the end of his presidency, he revealed he had been diagnosed with Alzheimer's disease.

"We have a long history, sadly, in this country of presidents covering up their medical situations," said Perry, who thinks that is reason enough to argue that presidents should be required to waive their medical privacy protections.   

"Our lives are in the hands of American presidents just as our lives in the hands of airline pilots, and so I want my airline to know what's happening with my pilot physically and mentally; and I think the American people have the right know the physical and mental status of the president of the United States and commander in chief, who, as this president constantly reminds us, has his finger on the nuclear button."