By Gerard J. Gianoli, M.D., a member of the Association of American Physicians and Surgeons, AAPS
I've encountered some interesting responses to my several articles on Hillary Clinton's health. While I am a physician, I've never proclaimed a diagnosis in her case. I have simply asked if two of her known diagnoses – her concussion of 2012 and the left transverse sinus thrombosis (blood clot in the brain) – have been assessed for long-term consequences. What I have asked for, and I am still waiting for, is some medical records reporting on whether she has any of the well-known, long-term sequelae of these two potentially life-threatening disorders with their well-known, often permanent cognitive impairments.
Most of the responses to my editorials have been favorable. However, the negative responses are actually more helpful, and they reveal a lot about those who write them. There are basically five different themes.
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First: "It's nothing. She's completely normal and healthy. This is just a right-wing conspiracy."
This remark can't even be made with a straight face by the Clinton campaign since her collapse after spending 90 minutes hanging out at the 9/11 memorial ceremony. It is an even harder sell since last week's speech at Temple University where Mrs. Clinton had to be helped up a few steps to the dais and then, during her speech, displayed "crazy eye movements" that are most consistent with a lateral rectus palsy – weakness of one of the eye muscles. Even if we ignore the recurring "medical episodes" she has had "frequently" (according to her husband), the concussion, the transverse sinus thrombosis, the deep vein thromboses, or the fact that a "healthy" patient does not have to take Coumadin the rest of her life, the eye movements are potentially ominous on their own. I'm still waiting for a serious physician (not paid by the Clintons and not ideologically blind) to put his reputation on the line by saying, "She's completely normal and healthy."
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Second: "Privacy laws are such that it is unethical for a physician to say anything about Hillary's health."
Mrs. Clinton is not my patient, and therefore I am not obligated to Mrs. Clinton in any way regarding discussion of her health. However, Dr. Lisa Bardack is Mrs. Clinton's private physician. Consequently, Dr. Bardack cannot make any comments about Mrs. Clinton's health without Mrs. Clinton's consent. If Mrs. Clinton wants Dr. Bardack to make a statement about pneumonia but not about any neurocognitive testing she may have undergone, then Dr. Bardack has an ethical and legal requirement not to discuss any of the neurocognitive testing. If Mrs. Clinton were to tell untruths about her medical problems, Dr. Bardack cannot legally speak out to correct the record. Dr. Bardack's letters are approved directly by Mrs. Clinton.
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Third: "A doctor should never speculate about a diagnosis of someone he's never seen or examined personally."
This is utter nonsense. I've never speculated about her diagnoses. They've been given to us by Mrs. Clinton and her doctor. I've only asked what are the consequences of these diagnoses. Both concussion and transverse sinus thrombosis have known long-term negative consequences for cognitive function. It is not out of place to ask whether Mrs. Clinton has any residual cognitive dysfunction from these problems.
I contend, however, that it is more than acceptable to speculate about Mrs. Clinton's medical diagnosis. I think it is important for physicians to speak out about this. Mrs. Clinton has been less than forthcoming about her medical problems, and her reticence to a full release of her medical records suggests to the public that she is hiding something. For a private individual, this would be fine. But she is applying for the job of commander in chief. If she will not disclose the problem, we need physicians to let the public know what are the possibilities of her disability.
Fourth: "This is a non-issue. The public doesn't care about it."
The media have reported on polls that claim the majority of the voting public think Mrs. Clinton is healthy enough to do the job of president. Of course, those polls ignore the fact that the majority of the voting public does not even know Mrs. Clinton has medical problems. In a recent poll, when registered voters were asked if they knew Mrs. Clinton had any medical problems, roughly half did not. However, if they did know, most would be less likely to vote for her – and that concern crossed party lines.
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Fifth: "You're exactly right and I agree with you, but I don't want to speak out and get harassed by the Trump-haters."
That one says it all, doesn't it? Physicians have been bullied into silence.
My final diagnosis of Mrs. Clinton's health problems can be summed up in her own quote: "What difference, at this point, does it make?" We know that she has "medical episodes" that are "frequent" (Bill Clinton), "not frequent, rare" (Bill Clinton), or "a couple of times, I can't remember how many" (Hillary Clinton) that leave her completely incapacitated for a period of time. They are frequent enough that she travels with a nurse, and the Secret Service does not rush her to the hospital when they occur – as after the 9/11 event.
Should we elect a candidate that we know will not be responsive to the needs of the presidency on a regular basis? I think not.
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Gerard Gianoli, M.D., F.A.C.S. specializes in Neuro-otology and Skull Base Surgery. He is in private practice at The Ear and Balance Institute, located in Covington, Louisiana, but is also a Clinical Associate Professor in the Departments of Otolaryngology and Pediatrics at Tulane University School of Medicine.