The Beeswax Chronicles

Remember five minutes ago when Biden's health really mattered?

President Joe Biden delivers a prime-time address to the nation in the Oval Office of the White House on July 14, 2024.

I suppose the impulse has passed. A week ago, many Democrats and their donors were demanding that Joe Bader Biden withdraw from the presidential race, on the grounds that he has turned into a Roomba. The fear is that his continued lapses will make independents and swing-state voters forget that, of the two candidates, he’s the one who isn’t the career criminal, serial fraudster, rapist, liar, sociopath, fascist demagogue.

But then, because he thinks his last bad day will be his last bad day (which is like thinking the Mets are just about to turn things around), Biden declined to quit the race. In an impassioned message to the American people, he declared [unintelligible due to voice trailing off and his office TV turned up too loud]. He then went mall walking.

But then the briefly energized movement vanished, utterly displaced in the public's consciousness by two stunning developments. The lesser of those was the Pennsylvania assassination attempt against Donald Trump, who emerged from the despicable act of political violence as a career criminal, serial fraudster, rapist, liar, sociopath, fascist demagogue with a mangled right ear and a hero’s aura. This disruption in the news cycle was second only to the emergence of the Hawk Tuah Girl.

As recently as a week ago, George Clooney and several whole-grained oligarchs were begging for Biden to try something new in his twilight years, such as golf-course starter or leathercraft, because the fate of democracy depended on it. Now they’re obsessively refreshing their news apps to see if please, please, please Thomas Matthew Crooks was a Travis Bickle Republican trying to trigger a civil war.

None of those developments has somehow magically reversed whatever neurological issues bedevil the president’s vocal strength, word and name retrieval, gait and other relatively superficial age-related deficits — let alone whatever else may lurk beneath. Yes, he has had an almost shockingly successful presidency, considering the naked obstructionism of and unprecedented vilification by Trump and the GOP. But the MAGA zealots who believe he is a treasonous, corrupt, fascist, Marxist pedophile are not the electoral concern. The concern is suburban Michigan, Pennsylvania, Wisconsin and Florida women who like his positions on abortion, taxes and climate but worry about him trying to access Netflix and accidentally launching ICBMs at North Korea or South Dakota.

Look, I’m voting for him even if he starts singing “Molly Malone” and sharts his pants at the Democratic convention. Alas, having contacted all my Soros-backed district attorney pals, I realize now I can’t go on a swing-state road trip and rig the election with phony ballots and space lasers the way MAGA fears. So I take little comfort in the pinky swear from Presidential Press Secretary Karine Jean-Pierre (“Has the president been treated for Parkinson’s? No. Is he being treated for Parkinson’s? No, he’s not. Is he taking medication for Parkinson’s? No.”) That’s an odd way of phrasing the denial, almost as if it hinged on the word “Parkinson’s,” when there are other related disorders — notably progressive supranuclear palsy (PSP) — that are not, strictly speaking, Parkinson, but nonetheless progressive and incurable.

Which is why I got in touch with Reed Pyeritz. That’s Reed Pyeritz, MD, PhD, retired William Smilow Professor of Medicine, Emeritus, at the Perelman School of Medicine at the University of Pennsylvania. He had sent a message to a mutual friend expressing wonderment that a movement-disorder specialist had visited the White House several times in the past six months if something weren’t going haywire. He also homed in on Biden’s stiff gait and facial movements to call bullshit on Jean-Pierre’s seemingly categorical denial.

“Between you and me,” he told me, “I am casting doubt on the official reports coming out of the White House. I think it’s just unlikely that there are that many people at the White House who are being treated for movement disorder or Parkinson.”

Now, he makes a point of distinguishing his observations from a diagnosis, because it’s unethical for a physician to diagnose without examining the patient. But he sees what he sees, and he’s been seeing it for quite a while.

“Really months ago, just seeing him walk across the lawn, in terms of his stiff gait and the absence of him swinging his arms.” Two classic movement-disorder symptoms.

“People say, ‘but his hands don’t tremble.’ Parkinson has numerous, variable symptoms, with tremor being one that, while common, is not required for the diagnosis. His other obvious physical signs — slow unsteady gait, instability, mask-like facial expression, difficulty coming up with the right words when speaking off the cuff — clinch the suspicions.”

Hmm. I ran his observations by a doctor relative, who winced at the ethical question, but also suggested other explanations for the strangely frozen presidential countenance. “Like 200 facelifts,” she said. And she observed that, esteemed as Dr. Pyeritz was in his career, he was a geneticist, not a neurologist, specializing in connective tissue disorders, not neurology.

This is where the plot thickens. When I confronted him with my relative’s misgivings, he pointed out that he was also an internist, experienced in a host of disorders comprising all specialties. Secondly, and this seems relevant, he has Parkinson Disease. As did his brother. As did his father.

“I do have personal experience and have been able to translate what is going on with me over the past two years, and the past 30 years of my brother’s life and the last few years of my father’s.”

It’s a disease, he says, with a frightening trajectory.

“Deterioration of the brain only worsens over time and without a major intervention, such as deep brain stimulation, the symptoms become more debilitating. To many, including me, decreased mental acuity, often progressing to dementia, is the most feared complication.”

And he is all too up to date on the neurological consensus.

“I’m able to read the literature more intelligibly than most, and have access to my own neurologist who agrees with me.”

But here’s the kicker. On the question of minding his own beeswax when the subject is not his patient, Dr. Pyeritz has history. In his actual specialty, on more than one occasion, he has intervened with strangers on the basis of casual observation — because he suspected they were afflicted with a congenital disorder for which he is one of the world’s foremost experts. It’s called Marfan Syndrome. Marfan patients have faulty fiber in their connective tissues that can lead to tragic consequences, including sudden death. Because the syndrome is seen often in very tall people with exceptionally elongated hands and feet, in his practice he saw it frequently in basketball and volleyball players. The most well known Marfan case was probably Flo Hyman, whose team won an Olympic silver medal in 1984. A few years later, playing professionally in Japan, she dropped dead on the court with “a sudden dissection of the aorta,” commonly known as an aortic aneurysm.

Even in the face of such tragedy, ethical proscriptions lead doctors, when their own patients are not involved, to sit on the sidelines. Dr. Pyeritz had a different philosophy, even when he was literally on the sidelines. In several cases, as a spectator seeing players on the court with classic characteristics of Marfan, Dr. Pyeritz got proactive.

“There was one instance where I noticed a chap on the basketball court, and so I went up to a coach and asked if he’s had a physical exam. In another instance, I just approached an athlete directly.”

After Hyman’s death, he made it his business to examine her family members. Her sister, an athlete, refused to accept her genetic bad luck. Her brother had an aortic aneurysm that hadn’t been torn, and underwent corrective surgery with a dacron graft. Her mother required a mitral valve replacement.

He declined to be specific, but says butting into the private health matters of total strangers has “a number of times” changed outcomes. Presumably, he doesn’t say “saved lives” because that’s frowned on, as well. The canons of medicine insist, “First do no harm.” But sometimes doing nothing is tantamount to doing harm, even if you have to get out of the medical profession’s comfort zone. Furthermore, the ethicists perhaps should factor in mitigating factors. Such as:

Biden’s beeswax is our beeswax, too.