Bernie Sanders: Health Overview (2020)
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Using his standard technique, Dr. Zebra has examined the medical reports of Senator Bernie Sanders -- especially regarding his heart attack -- and concluded:
- The reports fail to disclose critically important prognostic information about Senator Sanders' health.
- Abundant evidence indicates that medical information is being deliberately covered-up.
- The reports disclose significant deviations from the standard of care in Senator Sanders' heart attack treatment, without explaining why those deviations occurred.
- Senator Sanders' medical reports portray him as an average 78-year-old man, physiologically [§2.7]. Given the above conclusions, however, his physical health is likely not as robust as his medical reports say, with the reports underplaying the fragility and/or uncertainty of his cardiovascular status. Thus, entering the presidency at age 79, Senator Sanders would carry considerable medical risk, attempting to serve to age 83.
It is often said that the rigors of the campaign trail serve as a medical stress test for presidential candidates. If so, Senator Sanders failed his stress test. He had a heart attack.
The heart attack's effects on Senator Sanders' work capacity are already evident. He has adjusted his campaign so as to conserve his strength. As president, his duties may not be so adjustable.
The Cuba Precedent
For example, the 13 days of the Cuban Missile Crisis were all-consuming for President John Kennedy. Getting only a few hours of sleep for days on end was enormously taxing for the 45-year-old President -- who was not a well man -- and even for his 36-year-old Attorney General (and brother), who was a well man.
Couldn't the president conserve strength by delegating? No, for two reasons. First, an inability to delegate, for whatever reason, defines a crisis. Second, responsible leaders understand that delegation risks abdicating leadership, as in the Cuban Missile Crisis, which ended happily only because Kennedy was personally present in meetings and able to quell the war fever that had gripped many of his advisors.
The Sanders Concealment
And so, with history unequivocally showing that enduring a two-week existential world crisis is a reasonable minimum standard for the medical fitness of a President, we must ask: What would happen if a similar crisis heaped two weeks of stress, sleeplessness, and the weight of humanity's future on the shoulders of a President Sanders, entering the office at age 79?
The answer is: We don't know, and Senator Sanders does not want us to know.
The Sanders Concerns
To clarify the risks of Sen. Sanders' medical condition, it may help to list some of the specific concerns his physicians would have for him, as a heart attack survivor, during an intense multi-day or multi-week trial like the Cuban Missile Crisis.
Aside from the obvious challenge of sleeplessness upon cognitive function, their concern would arise from the damage known to exist in Sen. Sanders' arteries and heart muscle. (Arteries are important because heart attacks are, in actuality, typically a manifestation of "coronary artery disease" -- atherosclerosis that has built up in a coronary artery.)
Damaged arteries and heart-muscle make survivors uniquely susceptible to the stress hormones our bodies secrete when responding to some challenge. In fact, the effect of stress hormones on heart patients is so inimical, even in everyday life, that cardiologists prescribe a "beta blocker" medication for all heart attack survivors, specifically to block the action of stress hormones. (A major question is why Sen. Sanders is not taking a beta-blocker [§1.28].)
Thus, physicians attending a President Sanders would focus on four key physiological factors during a crisis, trying to spot failure signs early so they do not become life-threatening -- as any of them might:
- The coronary arteries feeding the heart
- Potential for: unstable angina or another heart attack, requiring, at a minimum, hospitalization, an invasive catheter procedure or possibly a bypass operation.
- The cerebral arteries feeding the brain
- Potential for: stroke or other neurological emergencies, requiring urgent evaluation and treatment, possibly with clot-dissolving medication or an invasive catheter procedure.
- The pump function of the heart and its interplay with blood pressure
- Potential for: fatigue, light-headedness, frequent blood pressure monitoring, frequent medication changes (with resultant potential to cause adverse effects), and unrefreshing sleep
- Pump function appears adequate for Sen. Sanders on the campaign trail today, but it could worsen if his salt intake changes, if his blood pressure climbs for any reason, or if new atherosclerosis deposits or clots degrade blood flow to the heart.
- The electrical function of the heart
- Potential for: cardiac arrhythmias, ranging from trivial to fatal.
Of course, no human being is immune to any of these considerations. However, by virtue of his heart attack, even what little we know of it, Sen. Sanders is at far higher risk of these complications than any healthy person, even those of a similar age. The major concern for voters in 2020 is that the concealed information about his medical condition would elevate his risk for one or more of these scenarios higher than voters have been led to believe.
Popular Misconceptions
Dr. Zebra has seen many comments having this sentiment: "Sen. Sanders has had a heart attack. There's no need to know more. If he dies in office, the Vice President takes over. That's routine."
This is terribly wrong, for both medical reasons and for common-sense governmental reasons.
It is wrong for medical reasons because all heart attacks are not alike. This is a big reason why it takes 7 years of training after medical school to become a cardiologist: learning the many varieties and complications of heart attacks and the different ways to treat them. Predicting well the future, which is what interests us here, is hopeless without knowing the large data-set of information that modern cardiological care obtains from each heart attack patient.
It is wrong for common-sense governmental reasons because death is not the likeliest near-term complication of Sen. Sanders' cardiovascular condition. A dead president is indeed no big deal, constitutionally. A sick president, however, is a major deal, constitutionally.
What Could Go Wrong?
A president suffering a non-fatal heart attack, or stroke, or coronary bypass operation in the midst of a crisis would be a nightmare scenario, because it would layer a Constitutional crisis atop the world crisis. Unless he surrendered power voluntarily, the sick president would retain all presidential authority until the Vice President and Cabinet stripped it from him by applying the 25th Amendment.
Imagine a president sick to a degree where he:
- Could only work three hours a day, or
- Had to take a handful of pills several times a day that left him dizzy or nauseated or with a pounding headache, or
- Got chest pain during tense meetings with advisors, or
- Was simply not 100% focussed on his job because he was worried about dying.
With these sickness scenarios, one can only imagine the uncertainty, the disputes, the distraction involving questions of the 25th Amendment: a crisis unto itself. One can also imagine, easily, the exploitation of it all by an adversary. The government may not be able to handle two -- or three -- crises at once.
Summary
Concealing medical information short-changes voters, who are, after all, making a bet on the country's future when they cast their ballot. No one forces candidates to run for president, so appeals to blanket medical privacy rights are not germane.
Senator Sanders is concealing basic medical information that would give voters a better idea of his fitness for office. Claims that he has released medical records are false -- he has released physician letters, the content of which he controlled. Claims that he has released the "normal" amount of medical information are fatuous -- there is no norm for presidential candidates with a fresh anterior wall myocardial infarction.
Based on the scant information Senator Sanders has released, a precarious prognosis for him cannot be ruled out, nor can the possibility that he would be unable to physically withstand a two-week world crisis -- just as he could not physically withstand the much less stressful task of speaking at campaign events, which almost killed him.
| Between the plan and the fulfillment stands always the frail barrier of a human life. |
| -- George R. Stewart |
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