Matters of the mind

When former Vice President Joe Biden released a three-page summary of his medical history in December, his ­doctor had declared him a “healthy, vigorous 77-year-old male, who is fit to execute the duties of the Presidency.”

Stuart Jay Olshansky, a professor at the University of Illinois, studies presidential longevity. After reading the report, he told The Washington Post he thought Biden’s workout regimen was a good indicator of his physical stamina. He also noticed, “The only test that hasn’t been done is the cognitive functioning test.”

Olshansky didn’t seem alarmed. He said doctors usually don’t order such tests unless they detect a problem, and “the fact that he’s on the campaign trail and meeting a rigorous travel and meeting schedule probably would suffice as a replacement for the formal test for cognitive functioning.”

The replacement test ended quickly.

Less than three months later, the COVID-19 shutdown began, and Biden retreated to his Delaware home. He recorded videos and interviews from his basement and later resumed making some public appearances, but he’s escaped the intense rigors of the campaign trail and the impromptu exchanges with the media and public that have marked every modern-day presidential campaign.

The retreat seemed timely.

Biden had shown noticeable shakiness during his bid for the Democratic nomination: He told a crowd he was running for the U.S. Senate. He almost referred to Super Tuesday as “Super Thursday.” He struggled to quote the Declaration of Independence: “We hold these truths to be self-evident. All men and women are created equal by the—you know—the thing.”

Meanwhile, Trump struggled to manage his own public message as the pandemic worsened. He dominated daily COVID-19 briefings and wondered aloud if there might be a way to inject disinfectants to battle the virus, since cleaning agents kill COVID-19 on surfaces. He later clarified he didn’t mean injections, but “almost a cleaning and sterilization of an area. Maybe it works, maybe it doesn’t.”

Pundits pointed out that Trump has long indulged off-the-cuff remarks and that Biden has grappled with a stuttering problem that may cause some verbal gaffes.

Both observations are true, but some voters still seemed concerned: In July, a Monmouth University poll reported 52 percent of surveyed voters said they thought Biden had the mental and physical stamina required to carry out the job of president. For Trump, 45 percent said yes.

Mental acuity is a serious issue, and it’s a legitimate question to examine when it comes to presidential candidates running for one of the most demanding and stressful jobs in the world.

Questions about presidential fitness seem unlikely to disappear. In June, a Zogby Poll reported some 55 percent of surveyed voters said they thought it was more likely than not that Biden was in the early stages of dementia.

During the same month, Biden was leading presidential polls against Trump by nearly 10 points.

Biden speaks during a Feb. 28 campaign event in Spartanburg, S.C. Matt Rourke/AP

DIAGNOSING MENTAL FITNESS is a job for physicians, but it also inevitably becomes a judgment call for voters. Whatever the polls show, the Trump campaign isn’t holding back: It has directly questioned Biden’s mental acuity in television and online ads and seems likely to continue the strategy.

How the campaign pursues that strategy may prove crucial to how well it works or whether a tactic of taunting backfires on Trump.

Some Democrats already have cried foul, accusing the Trump campaign of smearing Biden. But less than a year ago, Democratic contenders and major media outlets were raising some of the same questions about Biden’s mental fitness that they now decry.

Meanwhile, some are floating a new idea: Given Trump’s volatility, perhaps Biden shouldn’t debate the president at all—an extraordinary proposition that would push Biden to attempt to cross the finish line without major exposure to public scrutiny during the final stretches of the campaign.

Biden has said he’ll debate Trump. Indeed, backing out could give the president enormous fodder to use in a contest where he’s struggled to gain solid footing.

Trump has long indulged off-the-cuff remarks, and Biden has grappled with a stuttering problem that may cause some verbal gaffes.

Trump, 74, has sometimes treated the issue of mental acuity with contempt instead of sobriety. In an interview with Fox News, the president raised the question of Biden’s mental competence and told Chris Wallace: “Let Biden sit through an interview like this—he’ll be on the ground crying for mommy. He’ll say, ‘Mommy, mommy, please take me home.’”

Taunting opponents isn’t a new tactic for Trump, but it could be a risky one in this case: Older voters are the most active voting group by age, and Biden has appeared to gain ground among the demographic in recent polls.

Still, a series of online ads by the Trump campaign treated Biden’s age and questions about his mental state with levity. One spot began with an image altered to appear like Biden being spoon-fed in a nursing home. It came at an unseemly time: Nursing home residents were dying by the thousands, as COVID-19 spread through facilities nationwide. Another ad declared, “Geriatric mental health is no laughing matter,” while playing a jovial tune and showing Biden falter in campaign appearances.

Other ads take a more serious tone, and the Trump campaign spent some $6.5 million on a television ad in June that declared Biden lacks “the strength, the stamina, and the mental fortitude to lead the country.”

The Biden campaign has rejected claims that the candidate isn’t mentally sharp. But the Trump campaign wasn’t the first to raise the question.

In June 2019, Andrea Mitchell of MSNBC asked about Biden: “The question is, does he still have his stuff? How sharp is he?” Morning news host Joe Scarborough called Biden’s summer debate performance “disturbing.”

While Sen. Cory Booker, D-N.J., now a Biden supporter, was campaigning for the nomination, he told reporters, “I think that we’re at a tough point right now because there are a lot of people concerned about Joe Biden’s ability to carry the ball all the way across the end line without fumbling.”

U.S. Rep. Tim Ryan, D-Ohio, told Bloomberg News during his own brief Democratic bid: “I just think Biden is declining. I don’t think he has the energy. You see it almost daily. And I love the guy.”

Most Democrats haven’t raised those concerns since Biden secured the Democratic nomination. But shortly before the COVID-19 shutdown, Biden stumbled in an appearance in Kansas City, Mo.

As he spoke about the importance of Democrats working together, he said: “We cannot get reelect, we cannot win this reelection, excuse me, we can only reelect Donald Trump … if in fact we engage in this circular firing squad.”

White House aide Dan Scavino posted a clipped version of the video showing Biden saying, “We can only reelect Donald Trump.” The Biden campaign decried the post, saying it removed the full context. That was true, but the larger context wasn’t ambiguous: Biden looked confused about what he was saying.

Obviously, Trump has faced plenty of his own criticisms.

The Biden campaign hasn’t run ads questioning the president’s mental fitness, but the Lincoln Project, a political action committee run by Republican critics of Trump, has taken aim with a series of ads, including a spot called “Trump Is Not Well.”

It shows a series of images of Trump making exaggerated faces, drinking from a water bottle with two hands, and walking slowly down a ramp at a recent West Point graduation. It’s not the most convincing collection of moments to demonstrate overall unfitness, but former GOP operative John Weaver has acknowledged one of the group’s aims is to provoke Trump to respond.

In this case, it seemed to work.

In May, Trump held his first presidential rally in months. The country was reeling from the coronavirus pandemic, racial riots, and the economic downturn, but the president spent nearly 15 minutes railing against criticism of his tentative walk down a slick ramp and demonstrating he could drink with one hand.

In other cases, the president raises hackles with no provocation: In July he openly questioned whether the United States should delay the presidential election because of his concerns over mail-in ballots and potential fraud.

Lawmakers from both parties flatly rejected the notion. Steven Malanga of the conservative Manhattan Institute called Trump’s tweet “more panicked than presidential.”

Trump speaks during a meeting in the Cabinet Room of the White House. Doug Mills/The New York Times/Bloomberg via Getty Images

WITH ALL THE TALK of presidential fitness, why not just take a cognitive test?

Trump says that he has taken such a test and that doctors were impressed with the results. He’s challenged Biden to do the same.

When a reporter asked Biden in June if he’d taken a cognitive test, he said he’s “constantly tested.” His campaign clarified he meant that running for president is a test of cognitive ability. In early August, another reporter pressed Biden on whether he’d taken a cognitive assessment. Biden replied: “No, I haven’t taken a test. Why the hell would I take a test?”

At least one major test lies ahead: The first presidential debate on Sept. 29.

In the absence of traditional campaigning during the pandemic, it’s one of the most significant opportunities for voters to hear from both candidates. The televised showdown will likely draw a substantial—if not massive—viewership.

In early July, New York Times columnist Thomas Friedman urged Biden to refuse to debate unless Trump agrees to release his tax returns and allow a real-time, fact-checking team to report any false statements uttered during the debate. It’s not clear either candidate would agree to those conditions.

In late July, former Bill Clinton press secretary Joe Lockhart argued on CNN that Biden should refuse to debate Trump because he says Trump doesn’t follow the rules or tell the truth. A few days later, The New York Times ran another opinion piece titled “Let’s Scrap the Presidential Debates.”

So far, Biden hasn’t agreed.

After he bristled about being asked whether he had taken a cognitive test, Biden said: “I’m so forward looking to have an opportunity to sit with the president or stand with the president and the debates.” He added: “I am very willing to let the American public judge my physical as well as my mental fitness and to, you know, to make a judgment about who I am.”