The forthcoming midterm elections are a referendum on President Donald Trump’s policies, not his health. But when those policies include renaming the Atlantic “Trump Ocean,” or affecting indifference about whether Iran might “take out” Los Angeles or San Diego, or prohibiting nominees for executive branch positions from saying out loud, “Joe Biden won the 2020 election,” that changes the equation. With directives like these emanating from the White House, it’s everybody’s civic duty to consider whether its occupant is a well man.
Navy Captain Sean Barbabella, who is physician to President Trump, pronounced five months ago that Trump is “fully fit to carry out all duties of the Commander-in-Chief and Head of State.” Barbabella said much the same after Trump’s chest and belly underwent a CT scan the previous October. But no presidential physician has ever dared state otherwise. Rear Admiral Cary Grayson said Woodrow Wilson’s stroke in 1919 was merely a bout of “nervous exhaustion.” Dr. Janet Travell lied her head off to cover up John F. Kennedy’s Addison’s disease. Even the autopsy report sent to the Warren Commission omitted that Kennedy’s adrenal glands were only barely still present, presumably because these pathologists didn’t want to acknowledge the undisclosed cause.
Compared to Trump, though, Wilson and JFK were compulsive truth-tellers. So what are the odds we’re getting the straight story about the president’s physical and mental fitness now? Any serious inquiry into Trump’s health must weigh the official line against medical doctors’ analyses of what they see on television; observations from Trump’s staff; and various reports from books, newspapers, magazines, and so on. We scrounge for evidence where we can.
Diagnosing any patient from afar is a tricky business, especially when the diagnostician (me) never attended medical school. It is also perhaps unkind. But to any who would criticize the following inventory as cruel, let me remind you that, 22 months into his presidency, Trump still habitually blames “Sleepy Joe Biden” or “Slow Joe” for everything that goes wrong. Other countries, Trump said last October, “looked at him falling down stairs every day, every day the guy’s falling down stairs.” In January, Trump told The New York Times: “I think Joe Biden is the worst thing that ever happened to old people.” When Biden disclosed that he had Stage 4 prostate cancer, Trump said: “If you feel sorry for him, don’t feel so sorry, because he’s vicious.”
In saying such manifestly cruel things, Trump forfeits any right to deference about his own physical frailties. Plus, he’s the president! In that spirit, let’s plunge our tweezers into President Cavity Sam, and try not to set off too many buzzers.
Hair
It’s dyed. Natural hair doesn’t change color except to turn gray or white, and nobody would wear a toupee this bad. Trump’s hair is sometimes blonde, sometimes orange, and sometimes a little pink, though that may just be Trump’s angry-red scalp peeking through an ever less convincing comb-over. Male-pattern baldness has reportedly stalked Trump for decades. According to Harry Hurt III’s book Lost Tycoon, Trump had scalp reduction surgery in the 1980s and it didn’t go well. Jeffrey Epstein confirmed Trump had the procedure, but Trump has denied it.
Why such weird colors? Ivanka Trump has reportedly said her father uses a product called Just for Men that you’re supposed to apply slowly, but Trump lacks the patience to do that, so he ends up with weird coloration. Michael Wolff reported this in Fire and Fury (2018), so take it with a grain of salt; the book’s reliability is a matter of debate, and besides, nearly a decade has passed. Wolff said recently on his podcast that Trump has an emergency hair kit, carried by Natalie Harp or perhaps someone else, containing “small tufts of hair that match whatever color his hair might be at the time. And those are applied if needed and necessary.” Interesting, if true.
Face
Clearly Trump sprays or slathers something on it. The consensus is that it’s some self-tanning product like Man Tan. That would also explain the white circles frequently seen around his eyes. Wearing goggles under a tanning bed would do that too, but Trump’s former press secretary Stephanie Grisham wrote in her 2021 book, I’ll Take Your Questions Now, that, at least during Trump’s first term, the White House was tanning bed–free. Grisham writes, “The president’s look was created with makeup that he put on his face every morning,” and that before one public appearance, Trump borrowed her face powder. Grisham refers in the book to an “arsenal of products” that an aide traveling with Trump would carry, but she doesn’t enumerate what they were.
Brain
This is of course the principal area of concern. I reviewed serious reasons for worry in some detail last month (“Why Trump May Not Serve Out His Presidency”). To summarize: STAT News reported nine years ago that neurolinguistics and cognition experts comparing old videos of Trump with more recent ones observed deterioration in the complexity of Trump’s unscripted public utterances. Former Maryland Governor Martin O’Malley compared Trump’s 2016 rhetorical style to “a monkey with a machinegun.” (That’s not a medical opinion, but it’s very good.) Groups of mental health experts again declared in 2024 that Trump displayed signs of cognitive decline, and 18 months later that he’d “deteriorated even further.” Trump falls asleep a lot during White House meetings. He says crazy stuff all the time. The latest expert to note this is Trump himself. At a MAGA rally in Clarksville, Tennessee, earlier this month, Trump said, “I could say the stupidest things, and you’d clap me.”
Right ear
This is the most famous presidential body part; it’s Trump’s battle scar from the attempt on his life in Meridian, Pennsylvania, in July 2024. The bullet created a two-centimeter wound, according to the former White House presidential physician Ronny Jackson, who by then was a Republican House member from Texas. There’s apparently a scar on Trump’s ear now, but in September 2024 Trump showed it to New York magazine’s Olivia Nuzzi and she said she couldn’t see it. Nuzzi, however, has come to be regarded as a potentially problematic source.
Neck
Asked last March about some really alarming redness on the right side of Trump’s neck, Barbabella said, “President Trump is using a very common cream on the right side of his neck, which is a preventative skin treatment. The president is using the treatment for one week, and the redness is expected to last for a few weeks.”
Can you indulge me one pet peeve? The word is preventive. More substantively, Barbabella left unanswered the following questions: 1) What was it that the offending cream was intended to prevent? 2) If the cream was causing that angry rash, why was it still being applied?
The rash does seem to have gone away.
Heart
Yes, he has one. So far as we know it’s in decent shape; we don’t know why Trump’s doctors last year felt it necessary to do a CT scan of it. Trump takes two drugs, rosuvastatin and ezetimibe, to manage his cholesterol, which as a result is within normal range. Trump takes Bayer aspirin daily to reduce the risk of a heart attack. But for some bizarre reason his favored dose is 325 milligrams, which his doctors have repeatedly told him is about four times too much. A dose that high increases Trump’s risk of gastrointestinal bleeding. Trump’s doctors want him to drop down to 81 milligrams, but he refuses to do that. Is our teetotaling commander in chief an aspirin junkie, like the murderer Perry Smith in In Cold Blood? We can’t rule it out. Aspirin-use disorder is, according to one 2019 study, “an underreported condition.”
Belly
Trump’s May physical measured his weight at 238 pounds. At a reported six feet, three inches, Trump’s body mass index was 29.7. That would put him a whisker shy of “obese.” But Trump isn’t six foot three; he’s six foot two. That’s what Trump’s driver’s license said in 2012, Politico’s Darren Samuelsohn reported in 2016, and it’s what his draft card said in 1968, The Washington Post’s Craig Whitlock reported in 2015. As people age, they don’t get taller, they get shorter, so probably Trump is now closer to six foot one. But let’s be generous and say he’s still six foot two. That would put his BMI at 30.6 and make him officially “obese.” Indeed, 30.6 is higher than the BMI of any previous president excepting William Howard Taft (reigning champ at 42.3), Grover Cleveland (34.6), and Trump’s hero, William McKinley (31.1). However, Trump has a lower BMI than our other two obese presidents, Zachary Taylor and Theodore Roosevelt (both 30.2). Trump’s doctors have told him to lose weight.
Since you were about to ask: Yes, as of February 2024, “Sleepy” Joe Biden’s BMI was 23.1, classifying him as “healthy.”
Backside
Not an important concern, but a delicate one: Does Trump wear an adult diaper? He would hardly be the first national politician to do so, nor even necessarily the first president. I’m guessing there are at least four or five diapers in our superannuated Congress. But put me down for a probable “no.”
Our main source on the Trump diaper rumor is Noel Casler, a stand-up comedian who says he worked six seasons for The Apprentice, the reality-TV show Trump starred in from 2004 to 2015. (Starting in 2008, it was called The Celebrity Apprentice.) Like everything else in Casler’s story, Casler’s work for The Apprentice is unverified. In 2020, Casler said Trump’s “incontinence stems from his decades of stimulant abuse and fast-food diet.” Casler went on to explain that the stimulant in question was Adderall: “He snorts Adderall as his maintenance high. When he gets too wired, this is tempered with benzodiazepines.” Around the time Casler added that Trump “sent his secretaries to the CVS on 57th Street to pick up his scripts for ... herpes treatment,” I concluded the man was a teller of tall tales who just doesn’t like Trump.
Why, then, only a “probable” no to a Trump diaper? Because former Republican Representative Adam Kinzinger, who made an enemy of Trump by voting for his impeachment after the January 6 insurrection, and as a consequence lost his seat in 2022, said afterward that Trump constantly smells bad. “I’m genuinely surprised how people close to Trump haven’t talked about the odor,” Kinzinger tweeted in December 2023. “It’s truly something to behold. Wear a mask if you can.”
The following year, Kinzinger said on Jimmy Kimmel Live!, “If you take, like, armpits, ketchup, makeup and a little butt, it’s probably like that, all mixed up.… A little bit of a pungent odor, I would say.” If Kinzinger was telling the truth, this might simply be an unusually bad case of flatulence. But if so, then, why is Trump’s posture sometimes peculiar, and what’s with the strange bulge sometimes seen in his pants? I can’t say.
Right hand
We’ve seen weird bruising on Trump’s right hand for well over a year now. Sometimes he covers it up with makeup, but you can still see it. The White House said it was from shaking hands, but then the condition spread to Trump’s left hand. This may indicate circulation problems. The White House said that the underlying cause was Trump’s overconsumption of aspirin, which is plausible. But if Trump refuses to cut back on his daily 325 Bayer milligrams even as it turns his hands purple, that strengthens the hypothesis that Trump is hooked on aspirin.
Legs, ankles
I mentioned already Trump’s awkward posture, and how that may (emphasize may) mean he’s a nappies guy. The official diagnosis is chronic venous insufficiency, which is not life-threatening. The unofficial speculation is that, like Woodrow Wilson, Trump may have suffered an unreported stroke. Professor Bruce Davidson of Washington State University’s medical school told Sidney Blumenthal and Sean Wilentz, on their podcast The Court of History, that he thinks Trump had a stroke perhaps six months ago and that it was “on the left side of the brain, which controls the right side of the body.” There’s also been speculation that Trump is wearing some sort of leg brace, based on footage that appears to show something under his left trouser leg.
I’ll skip Trump’s feet, which at one point had bone spurs that kept him out of the Vietnam War, because the spurs vanished the moment Richard Nixon ended the draft in January 1973. The point of this exercise has not been to engage in body-shaming, or even, really, draft-dodger-shaming. I wouldn’t do it if the Cavity Sam in question weren’t president of the United States. But he is the president, he’s entered his ninth decade, and he’s been acting and looking weirder than usual. That has implications for the health of the republic.
But let me close by conceding, once again, that I am not a doctor. I’m just a guy poking some tweezers into the body politic.