Medicine is an equalizer, and the president may find that he cannot outrun his own condition.
President Donald Trump’s temperament has always been a big part of his political brand. Depending on who you ask, he is either refreshingly frank or shockingly unpresidential. But increasingly, critics of the president have gone from criticizing his rhetoric to worrying about his mental fitness for office. His critics now include mental health professionals after several news stories, as well as the president’s own tweets, revealed Trump continues to believe in several thoroughly debunked conspiracy theories.
At no other time in U.S. history has a group of mental health professionals been so collectively concerned about a sitting president. This is not because he is an unusual person — his presentation is almost typical for a forensic psychiatrist like myself whose patients are mostly violence offenders — but it is highly unusual to find such a person in the office of presidency. For the U.S., it may be unprecedented; for many parts of the world where this has happened before, the outcome has been uniformly devastating.
A group of us put our concerns into a book, “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President.” That book became an instant New York Times bestseller. Within days, it was out of stock at the big outlets and sold out in bookstores around the country. One of the nation’s largest publishers could not keep up with the demand for weeks. Clearly, our concerns were resonating with the public.
One way or another, the consequences of Trump’s presidency are affecting pretty much all of us. Much of this has to do with his effects on our own mental health.
For one, Americans are exhausted. The 24/7 news cycle may be part of the reason why, but there’s potentially another explanation. Pathology is confusing to the healthy. There is a reason why staying in close quarters with a person suffering from mental illness usually induces what is called a “shared psychosis.” Vulnerable or weakened individuals are more likely to succumb, and when their own mental health is compromised, they may develop an irresistible attraction to pathology, destruction, and even death (of self or others). The resulting harm is how we tell illness from health.
Politics has nothing to do with medicine, which is why a liberal health professional would not ignore a kidney stone in a patient just because he is Republican. Similarly, health professionals would not call liver cancer something else because it is afflicting the president. When signs of illness become apparent, it is natural for the physician to recommend an exam. But when the ailment goes so far as to affect an individuals ability to perform his duty, and in some cases risks harm to the public as a result, then the health professional has a duty to sound the alarm.
Human beings are an enviably adaptable species. However, when mechanisms go awry and reach a state of disorder, the capacity for variety and diversity diminishes and behavior becomes very predictable. This diminishing of flexibility is as consistent in the failing heart as it is in the cancer cell or the disordered human mind.