There’s an old joke that goes, “The brain is the most important organ—according to the brain.” It’s a clever little tautology, but also a perfect introduction to one of the most underdiscussed, overmassaged, and completely gaslit topics in American politics: the mental health of U.S. presidents—past, present, and definitely future.
But let’s make something clear right off the top: This isn’t about age. It’s about brains. Gray matter. Cognition. Reality testing. And, of course, the bizarre, marble-columned theater that surrounds presidential medicine—a luxurious land where your golf handicap gets more scrutiny than your MRI.
Let’s talk about VIP Syndrome, the fascinating phenomenon where rich, powerful, or “important” people get worse healthcare than the rest of us because doctors are too intimidated to treat them like normal humans. Yes, it's real. And yes, it’s how we end up with a 79-year-old Commander-in-Chief who confidently tells a reporter, “I spoke to President Mitterrand of France last week”—even though François Mitterrand died in 1996.
But let’s not get ahead of ourselves. Grab your cognitive screening test (you know, the one where you have to remember the words person, woman, man, camera, TV), and let’s dig into Presidential Health, Brains, and VIP Delusion Syndrome.
Chapter One: History of Presidents and the Spectacular Lies Surrounding Their Health
Presidents lie. Their press secretaries lie. Their doctors lie. Hell, even their dogs lie (looking at you, Commander, the Biden family’s “biting enthusiast”).
Let’s go down memory lane.
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Woodrow Wilson had a massive stroke in 1919, leaving him bedridden and likely cognitively impaired. His wife, Edith, essentially became acting president for the last year and a half of his term. She said she was just “filtering decisions” for her husband. Cute! It’s always good when the First Lady becomes the gatekeeper of the nuclear codes.
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Franklin D. Roosevelt was in way worse shape than most Americans knew. By the time of the Yalta Conference in 1945, his blood pressure was a cool 260/150, and he looked like a wax figure left too close to a radiator. But sure, let’s keep the cameras flattering and the press neutered. What could go wrong?
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John F. Kennedy, the dashing young Camelot hero, had Addison’s disease, debilitating back pain, and was taking a cornucopia of pills ranging from cortisone to methamphetamines. Dr. Feelgood was practically his Chief of Staff.
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And who can forget Ronald Reagan? That charming Gipper reportedly began showing signs of Alzheimer’s while still in office. But it wasn’t until five years after he left that the diagnosis became public. By then, he'd long since gifted America his shining city on a hill and wandered off into the fog.
So, no, today’s questionable presidential health is not a new phenomenon. What is new is that every single moment is now recorded, shared, memed, dissected, and shouted across Twitter timelines.
And still, we pretend not to notice the verbal salad, the vacant stares, and the sudden inability to recognize a NATO ally versus a kitchen appliance.
Chapter Two: The Brain as a National Security Risk
When the president of the United States can't remember where he is, the world notices.
Imagine you’re Xi Jinping watching an American president mix up Egypt and Mexico. Do you worry America is strong? Or do you call your military advisors and say, “Now might be a good time to test the South China Sea waters, boys”?
Cognition isn’t just a private health issue when you're the person whose finger hovers over the nuclear button—or more realistically, tries to remember where the nuclear button is and ends up pressing a garage door opener.
Now let’s be fair: brains age. Everyone forgets a name now and then. But when the forgetting becomes habitual, and the syntax gets weirder than a late-stage David Lynch film, it’s time to stop hiding behind euphemisms like “gaffes,” “slips,” or the endlessly forgiving “just being folksy.”
No, Brenda, it’s not “folksy” to forget which war your own son fought in or to say, “God save the Queen, man,” in the middle of a domestic policy speech in Delaware.
That’s not charm. That’s neurological spaghetti.
Chapter Three: VIP Syndrome—Or, Why Presidents Get Garbage Healthcare
Enter VIP Syndrome, a term coined in medical circles to describe the paradoxical situation where high-status patients receive substandard care because physicians become overly deferential, break protocols, or skip diagnostics entirely just to keep the powerful person happy.
It's the medical version of “Yes, sir, your jokes are hilarious!”
When a regular person comes into the ER slurring words, the staff orders a CT scan. When a president does it? They call it “charisma.”
Doctors assigned to presidents aren’t necessarily lying—they’re just not exactly telling the whole truth. They want to stay in the inner circle. They want to keep their job. And they really don’t want to be the guy who accidentally tweets, “Yeah, POTUS is showing signs of moderate-to-severe dementia.”
So they wrap it in medical metaphors, talk about “vigor,” “mental sharpness,” and the always-vague “he’s fit to serve.” Which could mean anything from “he jogged a mile this morning” to “he can still spell his own name without help.”
Let’s not forget Dr. Ronny Jackson, who famously declared Donald Trump “might live to 200” and “has incredible genes.” This was the same press conference where we learned Trump’s diet consisted largely of Diet Coke and Filet-O-Fish sandwiches. Incredible genes indeed.
Chapter Four: The Bipartisan Brain Fog
It would be easy to dunk on just one president’s cognitive lapses, but let’s not kid ourselves—this is a bipartisan dumpster fire.
One side insists that Joe Biden is mentally sharp because he occasionally squints convincingly into the camera and says, “C’mon, man.” The other side thinks Donald Trump is a genius because he remembered five nouns in a row during a televised cognitive test—after being prompted—and said, “I was so proud of that.”
We’re in a weird Cold War of Cognitive Decline, where each side desperately wants you to ignore the evidence of your own eyes and ears.
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One guy claims windmills cause cancer and suggests injecting disinfectant into the lungs.
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The other guy forgets the names of his Cabinet members and has been known to wander away from live events like a confused uncle at a wedding.
This isn’t a political critique. It’s a neurological plea.
Chapter Five: The Neuroscience We’re Avoiding
Here’s a fun fact: the human brain starts to shrink in your 30s. By the time you’re in your 70s or 80s, certain cognitive functions like working memory, processing speed, and decision-making capacity are very likely diminished—even without any diagnosable disease.
Now imagine being in your 80s, waking up at 4:30 a.m., getting briefed on a potential war in the Middle East, negotiating a trade deal with Japan, doing a press conference, signing executive orders, and then hosting a diplomatic dinner with a man who believes vaccines are made from soybeans and Satan.
Your average 40-year-old would break under that schedule. Your average octogenarian might have trouble remembering it even happened.
But sure, let’s keep pretending these guys are just “wise elders.”
In reality, we’re watching two grandpas square off in a battle of episodic memory, and the American people are stuck in a national version of “Who Forgot It Better?”
Chapter Six: What Cognitive Testing Looks Like—And Why Nobody Will Do It
There are plenty of standardized cognitive assessments that could give us some insight into a president’s mental acuity:
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The MoCA (Montreal Cognitive Assessment), which tests things like orientation, short-term memory, attention, and abstract thinking.
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The MMSE (Mini-Mental State Exam), which is great for screening dementia.
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Or even a full neuropsychological battery, which would be ideal if we weren’t collectively too chickenshit to demand it.
You’d think such testing would be mandatory for the most powerful job in the world. But no. We get vague physician statements like, “The President is healthy and fit for duty,” as though that tells us anything.
Fit for what duty, exactly? Signing birthday cards?
Let’s make this simple: Every presidential candidate over the age of 65 should have to take a transparent, independent cognitive test—live. On camera. No flashcards, no notes, no teleprompters.
Make it a game show. Hell, Ryan Seacrest can host.
Chapter Seven: The Consequences of Pretending
Why does this matter? Because pretending everything is fine when it’s not is how you end up in constitutional crises.
Imagine a scenario where a president is rapidly declining, but nobody wants to invoke the 25th Amendment because it would create political chaos, destabilize the markets, and embarrass the party in power.
So instead, everyone lies. The doctors hedge. The staffers create “bubble schedules.” The media uses the word “gaffe” like it’s a magic spell to ward off the obvious.
And then something bad happens. A missile launch. A hostage situation. A peace negotiation that ends in disaster because someone forgot which country they were talking to.
When the brain goes, everything goes—credibility, strategy, deterrence, you name it.
Chapter Eight: We Deserve Better Brains
Here’s a radical thought: maybe the president of the United States should be in peak cognitive shape. Not just not-demented. Not just “still better than the other guy.” Not just lucid most of the time.
And maybe—just maybe—we should stop mistaking long résumés for mental readiness.
If your airline pilot was 82, forgot where the cockpit was, and called the stewardess “mom,” you’d get off the plane. Why should we expect less from our head of state?
Presidents are not immortal. They are not gods. They are very old men, clinging to power, surrounded by enablers, and desperately hoping no one notices the lights are dimming upstairs.
Final Thoughts: Time to Drop the Delusion
In an ideal world, the mental health of our leaders wouldn’t be a taboo topic. It would be part of the vetting process—transparent, scientific, and mandatory. No spin. No euphemisms. Just data.
But we don’t live in an ideal world. We live in America. A country where your choice for president in 2024 is likely between two men whose combined age equals one whole brontosaurus.
So until we demand cognitive transparency, here’s a tip:
Next time a president mixes up Poland and Portugal, or thinks he’s shaking hands with Abraham Lincoln, don’t roll your eyes and say, “That’s just Joe/Don being Joe/Don.”
Say what the rest of the world is thinking: “Is anybody home up there?”
Because if we don’t care about the presidential brain, we might wake up one day and find out that nobody's really running the country at all.