Every presidential election season, the candidates are asked to bring forth their doctors and medical records to attest to their good health for the next four years.
That's happening in the current campaign, especially recently as Hillary Clinton, the Democratic nominee, took a break to recover from what is presumably a case of community-acquired pneumonia.
So does Clinton's illness mask, or foretell, a more serious health problem?
It could. But it probably doesn't. More likely it's the consequence of a transient dip in immunity-lowered resistance from the strain of nonstop campaigning by a 68-year-old.
Nevertheless, an array of non-physicians (and at least one physician, TV doctor Drew Pinsky) has speculated that Clinton is hiding something big--seizures, Parkinson's disease, a clotting disorder, general debility. At the same time, Donald Trump's doctor has issued a statement that pictures the Republican candidate as an aging Charles Atlas, with "extraordinary" strength and stamina.
Calls are growing for an independent panel of physicians to evaluate the health of candidates, as well as the suggestion that unedited medical records be available for public review. Before either option gains more traction, it's worth asking where they might lead us.
What's enough information, but not too much? As with most things in medicine, the decision requires judgment as well as evidence.
It seems to me candidates should be expected to reveal their medical "problem list"--active and inactive diagnoses and conditions. This list is a key way physicians organize their thinking.
They should reveal what drugs they take on a regular basis--things such as Clinton's anticoagulant and Trump's cholesterol-lowering statin. As-needed meds (painkillers) could be withheld. They should report weight, blood pressure, heart rate and a few key blood tests. A case could be made for revealing recent diagnostic procedures and a summary of the results.
Clinton has come closer to this than Trump. Nevertheless, as someone who has had more demonstrable health problems (a fall, a concussion, a blood clot in the brain and now pneumonia) than her opponent, Clinton needs to tell us more than the bare minimum.
None of this information, however, comes close to what we already have attesting to a candidate's physical fitness.
It's hard to hide serious illness. If either Clinton or Trump had cancer, a brain tumor, congestive heart failure, epilepsy, an untreated mood disorder or a half-dozen other things that could get in the way of a president's performance, we'd know it by now.
They've been crisscrossing time zones, sleeping irregularly, eating things handed to them, not exercising enough and forswearing privacy for two years. They're still standing (except for Clinton) and making sense (more or less). A presidential campaign is a marathon only the fit can finish.
Editorial on 09/18/2016