President Trump requested that his first formal medical exam include a cognitive test and “did exceedingly well,” receiving a score of 30 out of 30, the top White House doctor announced on Tuesday afternoon.
Navy Rear Adm. Ronny L. Jackson, who has been the lead White House doctor since 2013, said that he has interacted with the president several times a day for the past year and saw no need for a cognitive test. Jackson said that the president is “very sharp” in their conversations and does not repeat himself. He added that he has seen no evidence of any cognitive problems. . . . The test includes asking a patient to name several animals, draw a clock with the hands at a certain time, copy a cube and recall a short list of words, among others. Jackson said he has “no indication whatsoever that he has any cognitive issues.”
Trump did not receive a psychiatric exam, and therefore no one can rule out non-physiological mental-health issues (e.g., narcissistic personality disorder, paranoia). Trump may, of course, have no physical or mental excuse for his behavior — his inability to focus, his constant repetition, his angry outbursts, his refusal to work a full day or read much of anything, his habitual lying, his racism or any other personal, temperamental or intellectual deficit. One can have horrible judgment, be disloyal and cruel, and possess none of the characteristics necessary to function in the presidency yet find it easy to distinguish a cow from a rhinoceros or put the hands of a clock in the correct positions. One can be so ignorant as to be completely manipulated by the last person one speaks to and still be able to draw a cube.
In short, we know virtually nothing more about the genesis of Trump’s dysfunctional behavior than we did a week ago. Just in the last fortnight, however, we’ve seen ample evidence of his unfitness to govern and to comprehend the enormity of his responsibilities under the Constitution:
- He did not seem to grasp the basic immigration issues before him during a meeting with lawmakers, agreeing with diametrically opposing views in short succession.
- He labeled an entire continent a “shithole,” boasted about this language to friends and then denied he said it.
- He expressed a preference for white Norwegians over brown and black immigrants.
- He continued to lash out at the FBI, make unfounded and extreme allegations against lawmakers (e.g., accusing California Democratic Sen. Dianne Feinstein of “possibly illegal” behavior) and use first-grade taunts to strike out at his critics.
- He refused to accept that there is a basis for the Russia investigation and to definitively state that Russia tried to interfere with the election on his behalf.
We could go on, but you get the point. We now return to the central dilemma of the moment: what we do when a president is manifestly unfit and his own party controls both houses but refuses to hold him accountable for his words and actions. The answer is, as it has always been, twofold. First, voters must change the majorities in one or both houses. Second, if there is a basis for impeachment — which I believe exists now — Democrats and Republicans can take the action set forth in the Constitution. The first is easy, the second manifestly more difficult.