A political campaign is in complete disarray, fingers pointing in all directions, and now the physician to the president’s credibility and impartiality has been called into question. An unholy alliance of the White House, the Democrat Party, the media, and the medical establishment has foisted a conspiracy of silence and misinformation on the American public. To paraphrase the famous words of the late Sen. Howard Baker, R-Tenn., during the Watergate hearings some 50 years ago: What did the president’s doctor know, and when did he know it?
It is no secret that President Biden has been in a steady physical and mental decline, particularly in the past two years. A national poll from January 2022 found that 49 percent of voters “disagreed with the statement that Biden is mentally fit,” and 54 House Republicans requested that he take a cognitive test. In 2022, I publicly recommended that he undergo a fitness-for-duty exam with cognitive testing, based on his memory lapses, inattentiveness, and frequent misstatements.
Yet the media focused (until Biden’s poor debate performance) on questioning Trump’s mental fitness while giving Biden a free pass and castigating anyone who noted his decline — even after Robert Hur released a report citing the president’s poor memory. Despite my recommendation and those of others, Biden’s next two annual physical exams specifically omitted cognitive testing. Until recently, only a few medical professionals have gone on the record with their concerns about the president’s ability to serve. But now even Dr. Sanjay Gupta, a neurosurgeon and CNN chief medical correspondent, has called for the president “to undergo detailed cognitive and neurological testing and share his results.”
It defies belief that while the American people questioned President Biden’s cognitive and physical abilities, the physician to the president and other medical professionals told us there was nothing to worry about.
While president, Biden has had three official annual physicals, supervised and signed off by the physician to the president, Dr. Kevin O’Connor, a board-certified family medicine physician who has served as Biden’s personal physician since 2009. These exams took place on Nov. 19, 2021, Feb. 16, 2023, and Feb. 28, 2024.
When comparing these exams side by side, the common themes of omission, deflection, and misdiagnosis emerge, while issues of concern are painted in the best light possible. Biden’s “stiffness,” for example, is explained away due to spinal arthritis, yet there is no mention of the substantial chronic pain that would accompany such a diagnosis or the need for any specific therapy.
The following passage was repeated verbatim in each of the three examinations: “An extremely detailed neurologic exam was again reassuring in that there were no findings which would be consistent with any cerebellar or other central neurological disorder, such as stroke, multiple sclerosis, Parkinson’s or ascending lateral sclerosis.” There are several problems with this statement.
First, the condition “ascending lateral sclerosis” does not exist, and it is not recognized as a legitimate diagnosis by the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). Was that a typo, a malapropism, or perhaps he meant to say “amyotrophic lateral sclerosis”? The fact that this same nonexistent term appears in three successive presidential physicals indicates either a lack of knowledge on the part of O’Connor, indifferent editing, or both.
Next, there is no mention of the results of a simple “Mini-Mental State Exam” (MMSE) or any other type of cognitive testing having been performed. Cognitive tests evaluate attention, executive functioning, language, memory, orientation, thought content, thought processes, and visuospatial proficiency, among other things. The American Academy of Family Physicians states: “Early detection of cognitive impairment can allow for identification and treatment of reversible causes. … Clinicians should remain alert to early signs or symptoms of cognitive impairment (e.g., problems with memory or language) and evaluate the individual as appropriate.”
If the neurologic exams were truly “reassuring,” as O’Connor reported, why was it necessary for a noted Parkinson’s disease expert, Dr. Kevin Cannard of the Walter Reed National Military Medical Center, to meet with O’Connor and two others at the White House residence clinic on Jan. 17, 2024? In addition to this, Dr. Cannard’s name appears in the visitor logs 10 times since Nov. 15, 2022. If cognitive testing had identified Biden’s deficits two years ago, and the Democrat Party had acted appropriately in selecting a different candidate, we would not be in the mess we are in right now.
O’Connor has given the president a “pass” three times over since 2021. The physician to the president is personally selected and appointed by the president, and considering O’Connor’s civilian status, he answers to no one but the president. That reporting relationship would put any physician in a tough spot and may limit the physician’s objectivity. Certainly, some doctors are enamored by the prestige and status that accompany the position (and fearful of losing it). One would hope this would not sway their professional opinions, causing them to overlook medical problems that need to be diagnosed and treated.
Things have become even murkier as Rep. James Comer, R-Ky., has called O’Connor to testify before the House Committee on Oversight and Accountability. O’Connor allegedly had business dealings with the president’s brother James Biden, as well as Hunter Biden and the president of a hospital being acquired by Americore, a now-bankrupt hospital chain accused of massive Medicare fraud. The acceptance of gifts or cash from patients, or their proxies, to secure or influence care or to secure preferential treatment is considered unethical by the American Medical Association, and as an employee of the executive branch, O’Connor may also have run afoul of 18 U.S. Code § 208 (“Acts affecting a personal financial interest”) if he had monetary gains from these business dealings.
The way forward is clear. Like any other private citizen, Biden is protected by the HIPAA Privacy Rule. That said, he can waive these rights and allow O’Connor, Cannard, and other specialists who have evaluated and treated him to testify before Congress. It would be helpful to know why clinical practice guidelines were not followed and a fictitious diagnosis was mentioned, and at whose behest.
Without a full accounting to Congress and the American people, followed by a fitness-for-duty evaluation with cognitive testing, President Biden can say goodbye to his campaign for president, as his former supporters and donors look elsewhere for a viable candidate.
