A presidential candidate’s fitness to serve in office is a central metric in any election. But it’s become a very literal one in the past weeks of the 2016 campaign.
Conservative commentators like Fox News’ Sean Hannity, right-wing news outlets like the Drudge Report and Breitbart, and a host of fringe sites have recently been revisiting dark conspiracy theories suggesting that Hillary Clinton is seriously ill, either with Parkinson’s disease or some deadly brain blood clot, and that the Democratic presidential nominee requires constant supervision to prevent from collapsing or forgetting information. With Donald Trump publicly questioning Clinton’s “stamina,” the Clinton campaign even felt the need to issue a strong denial in a statement emailed to reporters Tuesday night.
At the same time, Trump’s mental health has been questioned, with psychiatrists and psychologists who have never met him speculating that he might have narcissistic personality disorder or be a sociopath. Trump’s campaign released a letter from his physician last year which proclaimed the candidate is in stellar health.
So what’s the truth?
If elected, Clinton, who turns 69 in October, would be the second-oldest president to take office, just behind Ronald Reagan. (Reagan was just weeks away from turning 70 when he took office in 1980; his second term, he was just under 74.) But Trump, who turned 70 in June, would actually be the oldest first-term president in history (he would be 70 on Inauguration Day to Hillary’s 69). Given their ages, it isn’t unreasonable to wonder whether either have any health issues. But there’s also no evidence that Clinton — or Trump — suffer from a debilitating, diagnosed physical or mental disorder.
Here are the claims that have been made about the contenders’ health, and what we actually know.
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The conservative commentators’ allegations about Clinton point to videos and ostensibly “leaked” medical evidence circulated on social media to support their case. A lot of this centers on a well-known December 2012 incident when Clinton, still running the State Department, fainted and suffered a concussion that kept her from testifying in front of a House committee that week.
State Department officials explained at the time that Clinton was fighting a stomach virus and had become dehydrated, causing her to faint, and that she required no hospitalization despite the concussion — an assertion that was confirmed by her physician, Dr. Lisa Bardack, in a letter released by the Clinton campaign last July.
Bardack, an internal medicine physician, also noted that followup evaluations revealed Clinton had a blood clot in a vein between her brain and skull, but the clot dissolved completely after treatment with anticoagulants by 2013. She stressed that Clinton is in “excellent physical condition.”
But the people questioning Clinton’s medical fitness argue that the concussion may have been far more serious than her spokespeople and doctor have said. Their proof? A widely-circulated (and heavily edited) video of a June 10 Clinton campaign event in which Clinton appears to be exaggeratedly shaking her head. (Other versions of the video include snippets in which Clinton pauses lengthily while making comments, or appears to have people helping her walk up a flight of stairs).
Conservative commentators, like Sean Hannity, fed speculation that Clinton might have had a seizure, saying that AP reporter Lisa Lerer, who is standing by Clinton, looked “scared” by Clinton’s “violent” movements. Lerer flatly debunked the seizure claims over the weekend. “Video of the moment shows me holding out my recorder in front of her, laughing and stepping back in surprise,” she wrote, adding that Clinton was exaggeratedly reacting to a flock of journalists shouting questions at her. “Where I saw evasiveness, they see seizures. For the record, I wasn’t scared for a moment.”
The Clinton camp initially refrained from adding any comments beyond Bardack’s same two-page statement from last July, which listed the Democratic nominee’s blood pressure at 100/65 and healthy cholesterol levels in a March 2015 physical exam. That letter also spelled out Clinton’s medical conditions and the drugs she’s currently taking for them: vitamin B12; antihistamines for allergies; a treatment for hypothyroidism; and the anti-clotting drug Coumadine as a precautionary measure after her 2012 fall (Bardack notes Clinton hadn’t tested positive for any clotting disorders).
But the campaign decided to release a new statement from Bardack Tuesday night after faked Clinton medical documents began circulating on the Internet. The image, posted by a Twitter account that has since been deleted, showed a sheet of paper made to look like an official 2014 document from Bardack’s office describing Clinton as having random blackouts on top of “uncontrollable twitching” and “fatigue,” even stating she’d been previously diagnosed with “Partial Complex Seizures” and a form of dementia.
“These documents are false, were not written by me and are not based on any medical facts,” Bardack said in a statement. “Secretary Clinton is in excellent health and fit to serve as President of the United States.”
Trump’s ‘astonishingly excellent’ health
Donald Trump’s physician, Dr. Harold Bornstein, said that he’d been treating the GOP nominee since 1980 in a letter released by the campaign last December. And he lavished praise on his patient’s health in unusually colorful — some might even say, Trumpian — terms.
“His physical strength and stamina are extraordinary,” wrote Bornstein, adding that if he wins, “Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency.” (The latter claim is, at the very least, debatable.)
Bornstein’s statement is brief and lacks the details contained in Bardick’s statement on Clinton. He lists Trump’s blood pressure (110/65) and assures “astonishingly excellent” lab test results. Bornstein also says Trump takes daily aspirin and a statin in low doses. The Trump campaign did not respond to Fortune‘s request for comment about whether it planned on releasing more detailed information about his health.
But critics have made Trump’s “mental fitness” and temperament an issue in the campaign, and they’ve received plenty of assistance from psychologists and psychiatrists who have openly speculated about Trump’s mental health. To cite just one of many examples, Dan McAdams, a professor of psychology at Northwestern University, wrote an extensive piece for the June 2016 issue of The Atlantic attempting to map Trump’s psychological makeup by analyzing his various public statements and information from his biographies (it was not a flattering picture — the words “narcissist” or “narcissism” appeared in the piece 26 times).
So many mental health professionals, who don’t know Trump personally, have speculated on Trump’s mental health that the American Psychiatric Association (APA) felt compelled to issue a rebuke earlier this month.”The unique atmosphere of this year’s election cycle may lead some to want to psychoanalyze the candidates, but to do so would not only be unethical, it would be irresponsible,” wrote the organization.
Back in 1973, the APA adopted the “Goldwater rule,” named after 1964 Republican presidential candidate Barry Goldwater, which prohibits psychiatrists from offering opinions on people they have not personally evaluated, as the New York Times explains. (Nearly 1,200 psychiatrists had said that Goldwater was mentally unfit to become president in a survey published by Fact magazine during that contentious election cycle.)
How the campaigns stoke the fires
When it comes to the dubious rumors about Clinton’s health, Trump has used loaded words that may play into the innuendos about his opponent while trying to avoid commenting on them overtly.
Last Friday, Trump claimed he wouldn’t comment on Clinton’s health.
Trump took a different approach this week. Clinton “lacks the mental and physical stamina to take on ISIS and and all of the many adversaries we face, not only in terrorism but in trade and every other challenge we must confront to turn our great country around,” he said during a speech in Ohio on Monday as the meme continued to spread.
Meanwhile, Clinton supporters and even some conservative-leaning journalists have also openly questioned Trump’s psychiatric fitness. After a series of gaffes following the Democratic National Convention, Republicans and conservatives were “asking about [Trump’s] mental health,” MSNBC host Joe Scarborough, a Republican, claimed on a “Morning Joe” segment earlier this month.
“[E]verybody was calling me saying, ‘What’s happening to him?’, ‘What is wrong with him?'” said Scarborough, prompting former Obama administration official Steven Rattner to add, “Somebody’s gotta do a psychological profile of the guy and find out why he acts the way he acts, and is he really healthy?”
Clinton herself has called Trump a “loose cannon.”
“He’s not just unprepared — he’s temperamentally unfit to hold an office that requires knowledge, stability and immense responsibility,” she said during a speech addressing foreign policy in June.
How much is enough evidence of a candidate’s health?
Presidential contenders are expected to divulge massive chunks of their lives to the public in exchange for its trust, and polling suggests that voters feel they have a right to know about presidential candidates’ health and tax records. (Trump has been under fire for not releasing his tax returns.)
Some experts and bioethicists have suggested independent physicians should evaluate candidates’ physical and mental health, but that could prove challenging to implement.
For now, it’s the candidates’ prerogative to choose what information to divulge from their doctors. In 2008, John McCain released thousands of pages of medical records covering eight years of worth of his health history, deeming it a necessary move since he was 71 and had previously fought multiple battles with melanoma. His eventual opponent, Barack Obama, 46 at the time, offered a far more succinct release in May 2008 — a 300 word letter from his Chicago physician.